Clinical pharmacy
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Randomized Controlled Trial Clinical Trial
Effect of lidocaine-prilocaine cream on pain from subcutaneous injection.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of heparin and 0.9% sodium chloride injection in the maintenance of indwelling intermittent i.v. devices.
Heparin sodium 10 units/mL was compared with 0.9% sodium chloride injection as a flush solution for indwelling intermittent i.v. devices, or i.v. locks (IVLs), in a prospective, randomized, double-blind study. The heparin and 0.9% sodium chloride injections were prepared in the pharmacy using aseptic technique. Most of the IVLs were inserted by an i.v. therapy team member. ⋯ The groups were well matched, except that the sodium chloride group received more vancomycin and dextrose-containing i.v. solutions, while the heparin group received more penicillins. There was no significant difference in the incidence of phlebitis or lost patency between the groups. When locks through which vancomycin, penicillins, and dextrose-containing i.v. solutions were administered were excluded, there was still no significant difference between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Heparin sodium versus 0.9% sodium chloride injection for maintaining patency of indwelling intermittent infusion devices.
In a double-blind study, heparin sodium was compared with 0.9% sodium chloride injection for use in maintaining patency of indwelling devices for intermittent intravenous infusion. Adult patients who required intermittent intravenous devices were randomly assigned to receive 1 mL of a heparin sodium 100 units/mL flush solution or a 0.9% sodium chloride flush solution. Observations were recorded for each catheter, rather than for each patient. ⋯ The use of penicillins, cephalosporins, or clindamycin, alone or in combination, was significantly associated with the development of phlebitis for both treatment groups. No other factors were found to correlate with either the duration of catheter patency or incidence of phlebitis. The results of this study indicate that heparin offers no advantage over 0.9% sodium chloride injection in maintaining the patency of intermittent intravenous devices.
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Randomized Controlled Trial Comparative Study Clinical Trial
Twice-daily moxalactam versus gentamicin and clindamycin in patients with penetrating abdominal trauma.
The effectiveness and total costs of moxalactam administered every 12 hours versus a combination of gentamicin and clindamycin for prophylactic use in patients with penetrating abdominal trauma were compared. Fifty patients scheduled for laparotomy after penetrating abdominal wounds were randomly assigned to receive either clindamycin phosphate 600 mg every six hours with gentamicin (as the sulfate salt) 3-5 mg/kg/day in three divided doses or moxalactam disodium 2 g every 12 hours. Therapy was begun preoperatively and continued for a minimum of three days in patients without hollow-organ injury and five days in patients with hollow-organ injury; total duration of therapy could not exceed four weeks. ⋯ No direct toxic effects of moxalactam or gentamicin-clindamycin were seen; transient abnormalities in blood-coagulation tests or serum creatinine concentration occurred in several patients. Although mean drug costs per patient for moxalactam and gentamicin-clindamycin were similar, the mean cost of therapy per patient was $125.23 higher for the combination regimen than for moxalactam when laboratory, personnel-time, and supply costs were added to drug costs. Moxalactam given every 12 hours was a safe and effective alternative to the combination of gentamicin and clindamycin for preventive use in the study patients with penetrating abdominal trauma.
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Randomized Controlled Trial Comparative Study Clinical Trial
Efficacy of patient-controlled versus conventional analgesia for postoperative pain.
Patient-controlled i.v. administration and intramuscular administration of morphine sulfate were compared in a crossover study to determine their relative effectiveness in relieving postoperative pain. Twenty adult patients scheduled for abdominal surgery were randomly assigned to one of two groups; one group received i.v. morphine sulfate for 24 hours using a patient-controlled analgesia (PCA) device, after which they were given morphine sulfate i.m. for 24 hours. The treatment order was reversed for the other group. ⋯ No significant differences in amount of narcotic used, respiratory rate, nausea and vomiting, or levels of activity or sedation were noted for the two regimens. Patients' rankings of the two treatment modes did not differ significantly, but a majority of patients indicated a preference for future use of PCA. In these postoperative patients, administration of i.v. morphine sulfate by PCA was as safe as i.m. administration and possibly more effective in relieving pain.