Int J Clin Pharm Th
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Int J Clin Pharm Th · Mar 2003
Clinical TrialSteady state bupivacaine plasma concentrations and safety of a femoral "3-in-1" nerve block with bupivacaine in patients over 80 years of age.
Fracture of the upper femur is a common injury in the elderly. Several anesthetic techniques exist for surgery of traumatic hip fracture. The aim of this investigation was to study plasma concentrations and safety of 2 mg/kg bupivacaine in a femoral "3-in-1" nerve block in patients older than 80 years of age. ⋯ A femoral 3-in-1 nerve block, using 2 mg/kg bupivacaine with epinephrine, provides prolonged pain reliefwithout local anesthetic toxicity in elderly patients. It is a satisfactory supplementary analgesic technique for hip and knee surgery in the elderly.
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Int J Clin Pharm Th · Feb 2013
Case ReportsMonitoring of metformin-induced lactic acidosis in a diabetic patient with acute kidney failure and effect of hemodialysis.
Metformin associated lactic acidosis (MALA) is a serious complication occurring especially in elderly patients given high doses of the drug. We report a non-fatal case of MALA with pronounced acidosis (pH 6.76, lactate 30.81 mmol/l) and high metformin concentrations (127 mg/l) in a patient who had developed acute renal failure after undergoing an operation. ⋯ Cases previously reported with such a severe MALA were associated with a high mortality rate. We show that close monitoring in an intensive care unit together with prompt and repeated dialysis sessions can lead to a favorable outcome.
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Int J Clin Pharm Th · Feb 2008
OTC laxative use of sodium picosulfate â results of a pharmacy-based patient survey (cohort study).
Constipation is one of the most frequent gastrointestinal symptoms. Traditionally, drug therapy for constipation is not prescribed and controlled by physicians. Instead, laxatives are sold by pharmacists as over-the-counter (OTC) medication. The aim of this study was to explore the safety and usage pattern of the OTC laxative sodium picosulfate use by collecting data from patients at their pharmacies. The study describes how self-treatment of constipation is practiced. In addition, the characteristics of patients buying the contact laxative, sodium picosulfate, for self-treatment of constipation were analyzed. ⋯ Self-medication of constipation with sodium picosulfate is efficacious and considered to be safe.
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Int J Clin Pharm Th · Mar 1996
Clinical TrialEvaluation of the therapeutic range of whole blood cyclosporin concentration in the treatment of psoriasis.
Cyclosporin (CyA) trough levels in whole blood in 17 patients receiving CyA for the treatment of severe psoriasis were measured by fluorescence polarization immunoassay (FPIA) employing a specific monoclonal antibody. Clinical success was defined as a PASI score reduction greater than or equal to 75% (group A), partial success by a PASI score reduction of 60%-74% (group B), and insufficient efficacy by a PASI score reduction of less than 60% (group C). Nine of the 17 patients given CyA (53%) exhibited an improvement rate of > or = 75% in the PASI score within 8 weeks of the initiation of treatment. ⋯ In these 2 patients the relapse may have been due, in part, to the sharp decrease in whole blood concentration secondary to partial noncompliance. Measurement of whole blood CyA trough level is the only method for assessing the patient's noncompliance. Contrary to previous reports we confirmed that the measurement of CyA concentration in whole blood was useful for monitoring the effects in patients with psoriasis.
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Int J Clin Pharm Th · Mar 1997
Interobserver agreement: Cohen's kappa coefficient does not necessarily reflect the percentage of patients with congruent classifications.
A widely accepted approach to evaluate interrater reliability for categorical responses involves the rating of n subjects by at least 2 raters. Frequently, there are only 2 response categories, such as positive or negative diagnosis. The same approach is commonly used to assess the concordant classification by 2 diagnostic methods. ⋯ Therefore, it may be of limited value in the assessment of increases in the interrater reliability due to an improved diagnostic method. The percentage of patients with congruent classifications is of easier clinical interpretation, however, does not account for the percent of agreement expected by chance. We, therefore, recommend to present both, the percentage of patients with congruent classifications, and Cohen's kappa coefficient with 95% confidence limits.