Journal of population therapeutics and clinical pharmacology = Journal de la thérapeutique des populations et de la pharamcologie clinique
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J Popul Ther Clin Pharmacol · Jan 2014
ReviewThe effects of antidepressant medications on mothers and babies.
Depression during pregnancy may be undertreated for a variety of reasons, one of which is concern regarding the safety of antidepressant medication. Dr. ⋯ The clinical group has published systematic reviews and meta-analyses on various potential outcomes following antidepressant exposure (i.e., congenital anomalies, spontaneous abortion, delivery outcomes, immediate neonatal outcomes and persistent pulmonary hypertension) in addition to outcomes associated with maternal depression. Some of the results of this program of research are presented together with a case example to start your thinking on the issues.
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J Popul Ther Clin Pharmacol · Jan 2014
ReviewSurviving morning sickness successfully: from patient's perception to rational management.
Nausea and vomiting of pregnancy (NVP) affects up to 85% of pregnant women, with varying degrees of severity. The most severe form of NVP, known as hyperemesis gravidarum (HG), affects up to 2% of pregnancies. ⋯ The symptoms and impact of NVP and HG can vary greatly among women, therefore treatment must be tailored to the individual. Updated Motherisk guidelines are presented.
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J Popul Ther Clin Pharmacol · Jan 2013
Multiple prescribers in older frequent opioid users--does it mean abuse?
Obtaining analgesic narcotics from multiple prescribers is sometimes called 'doctor-shopping,' implying abuse. If the use of multiple prescribers can be used as an indicator for abuse, it would be a convenient way to study abuse in large populations. ⋯ This study demonstrated that the increasing quantities of strong opioids with increasing number of prescribers are largely due to treatment of cancer/palliative care patients. While the use of multiple prescribers can be a red flag for problematic medication use, it cannot be considered synonymous with 'doctor-shopping' or abuse.
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J Popul Ther Clin Pharmacol · Jan 2013
Case ReportsComa, metabolic acidosis, and methemoglobinemia in a patient with acetaminophen toxicity.
We present a case of early coma, metabolic acidosis and methemoglobinemia after substantial acetaminophen toxicity in the absence of hepatic failure. A 77-year-old female presented to the emergency department with a decreased level of consciousness. She was found unresponsive by a family member in her bed, and was reported to be acting normally when she was last seen eight hours earlier. ⋯ Aminotransferases peaked at 44 U/L and INR peaked at 1.9. A urine 5-oxoproline assay performed five days after admission was negative, suggesting no evidence of a 5-oxoprolinase deficiency. We describe the pathophysiology and discuss the literature on acetaminophen-induced coma and metabolic acidosis in the absence of hepatic injury; and propose mechanisms for associated methemoglobinemia.
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J Popul Ther Clin Pharmacol · Jan 2013
ReviewThe management of nausea and vomiting of pregnancy and hyperemesis gravidarum--a 2013 update.
Nausea and vomiting of pregnancy (NVP) affects up to 85% of all pregnancies, yet many physicians are uncertain as to how to best treat their patients in the presence of controversial data on fetal risks. This review provides an update on the management of NVP, including pharmacological and non pharmacological approaches Due to a high rate of recurrent symptoms, it is important for women to receive early treatment to reduce the severity of symptoms with the aim of preventing hospitalization and improving quality of life.