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  • 1
    Online Resource
    Online Resource
    Evaluation of the Safety of Intravenous Thiamine Administration in a Large Academic Medical Center
    SAGE Publications ; 2021
    In:  Journal of Pharmacy Practice Vol. 34, No. 3 ( 2021-06), p. 397-402
    Details
    In: Journal of Pharmacy Practice, SAGE Publications, Vol. 34, No. 3 ( 2021-06), p. 397-402
    Abstract: Previous literature describes increased incidence of infusion-related reactions when administering thiamine doses greater than 100 mg as an intravenous (IV) push. The purpose of this evaluation was to assess the safety of administering higher doses of thiamine as IV push compared to infusion. Methods: A single-center, retrospective review was performed from June to October 2017. Included patients were aged 18 years or older and received 1 dose of IV thiamine 200 mg or greater. Patients were divided into 2 groups: group 1 included patients who received 200-mg IV push and, group 2 included patients who received any dose greater than 200 mg. The primary objective was to quantify and compare rate of adverse reactions between the 2 groups. Institutional thiamine prescribing practices were examined. Wilcoxon Rank Sum and Fischer exact tests were performed. Results: Sixty-six percent of patients were male, and the median age was 55 years (interquartile range [IQR]: 44-63). Fifty percent received 200-mg IV push, 20% received a combination of IV infusion and IV push, and 30% received IV infusion. Adverse reactions possibly due to thiamine administration occurred in 4 (2.0%) patients. One patient received 200 mg via IV infusion, while 3 received 200 mg via IV push. There was no significant difference in adverse reaction rate between IV push and IV infusion administrations ( P = .640). Conclusion: Our results support administering thiamine doses of 200 mg or less as an IV push. Given lack of robust safety data, it is recommended to continue to dilute doses greater than 200 mg and infuse over 30 minutes.
    Type of Medium: Online Resource
    ISSN: 0897-1900 , 1531-1937
    URL: Article
    DOI: 10.1177/0897190019872584
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2131091-9
    SSG: 15,3
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  • 2
    Online Resource
    Online Resource
    Safety and tolerability of high‐intensity statin therapy in heart transplant patients receiving immunosuppression with tacrolimus
    Wiley ; 2019
    In:  Clinical Transplantation Vol. 33, No. 1 ( 2019-01)
    Details
    In: Clinical Transplantation, Wiley, Vol. 33, No. 1 ( 2019-01)
    Abstract: Following heart transplantation (HT), HMG CoA reductase inhibitors (statins) have been shown to reduce total and low‐density lipoprotein (LDL) cholesterol, development of cardiac allograft vasculopathy (CAV), and mortality. Studies in HT patients have demonstrated the safety of low/moderate intensity statins; however, little data exist using high‐intensity (HI) statins. The study aim was to evaluate the safety and efficacy of HI statins in HT recipients receiving tacrolimus. Methods This single‐center, retrospective analysis included adult HT recipients from January 1, 2005, to December 31, 2015, who received HI statin therapy during posttransplant follow‐up. The primary outcome, tolerability, was defined as the absence of myalgias, hepatotoxicity, rhabdomyolysis, or HI statin dose reduction/discontinuation. The secondary end point was the mean reduction in total and LDL cholesterol. Results Among the 24 patients included, one experienced myalgias and therapy discontinuation (4%; P   〉  0.99). No other HI statin dose reduction/discontinuation occurred, and no instances of rhabdomyolysis or hepatotoxicity were observed. The average reduction in total and LDL cholesterol after conversion to HI statin was 35 mg/dL ( P  = 0.02) and 19 mg/dL ( P  = 0.10), respectively. Conclusions High‐intensity statin therapy appears safe and efficacious in HT recipients receiving tacrolimus and is a reasonable option for the treatment of refractory hyperlipidemia.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.2019.33.issue-1
    DOI: 10.1111/ctr.13454
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2739458-X
    detail.hit.zdb_id: 2004801-4
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  • 3
    Online Resource
    Online Resource
    Association of Medication Regimen Complexity With Clinical Endpoints in Pediatric Patients With Cystic Fibrosis
    Pediatric Pharmacy Advocacy Group ; 2021
    In:  The Journal of Pediatric Pharmacology and Therapeutics Vol. 26, No. 3 ( 2021-03-01), p. 248-252
    Details
    In: The Journal of Pediatric Pharmacology and Therapeutics, Pediatric Pharmacy Advocacy Group, Vol. 26, No. 3 ( 2021-03-01), p. 248-252
    Abstract: Cystic fibrosis (CF) patients and caregivers are impacted by the number of pharmacological agents and unique administration needs; however, no data currently assesses how medication regimen complexity impacts clinical outcomes in this population. The objective of this study is to evaluate if an association exists between increased medication regimen complexity and clinical endpoints in pediatric patients with CF. METHODS This retrospective analysis included all pediatric patients with CF (ages 5–20 years) with at least 2 pharmacist encounters and acceptable pulmonary function tests at our pediatric pulmonary clinic during 2017. Each patient's medication regimen was scored using the validated Medication Regimen Complexity Index (MRCI) tool. The primary outcome was the correlation between MRCI score and lung function. Secondary endpoints included growth, number of infections requiring antibiotics, and hospitalizations. RESULTS MRCI scores of the 113 included patients ranged from 2 to 101 points. A negative correlation was found between initial and final MRCI score and initial and final forced expiratory volume in 1 second (FEV1; r = −0.323, p = 0.0005 and r = −0.287, p = 0.0021, respectively). MRCI scores were negatively correlated with BMI percentile for both encounters (r = −0.162 and r = −0.125) but were not significant. Higher MRCI scores were associated with increased use of oral and intravenous antibiotics and hospital admissions. CONCLUSIONS Higher MRCI scores are correlated with a significant decrease in FEV1, increased need for antibiotic therapy, and more hospital admissions in pediatric patients with CF. Larger studies are needed to determine if a correlation exists between MRCI score and growth.
    Type of Medium: Online Resource
    ISSN: 1551-6776
    URL: Article
    URL: Article
    DOI: 10.5863/1551-6776-26.3.248
    DOI: 10.5863/1551-6776-26.3.248.S
    Language: English
    Publisher: Pediatric Pharmacy Advocacy Group
    Publication Date: 2021
    detail.hit.zdb_id: 3028543-4
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  • 4
    Online Resource
    Online Resource
    Efficacy and Safety of Probiotics and Synbiotics in Liver Transplantation
    Wiley ; 2018
    In:  Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy Vol. 38, No. 7 ( 2018-07), p. 758-768
    Details
    In: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, Wiley, Vol. 38, No. 7 ( 2018-07), p. 758-768
    Abstract: This article summarizes available literature regarding the utilization of probiotic and synbiotics in liver transplant ( LTX ) recipients, reviewing efficacy in both decreasing infectious complications and immunomodulation, as well as exploring safety concerns. Data suggest that the use of probiotics containing Lactobacillus spp, either alone or in combination with prebiotics (referred to as synbiotics), may be effective in reducing infectious complications after LTX , a major contributor to graft loss, hospital length of stay, and mortality. Literature evaluating the use of probiotics to induce tolerance, reduce rejection, and prevent damage associated with ischemia–reperfusion injury is limited to animal models but compelling, as it suggests the use of probiotics may augment deleterious immune‐mediated processes in this population. While the benefits of probiotics should be weighed against potential risks, these concerns are largely theoretical in the LTX recipient, with the majority of evidence extrapolated from case reports in other immunosuppressed populations. Based on available literature, it may be prudent to avoid products containing Saccharomyces sp, as these were not used in the efficacy studies, and the majority of the adverse event reporting stems from the use of products containing this organism. Further evaluation of the safety and efficacy of probiotic therapy is warranted. Studies specifically designed to elucidate the optimal product and initiation scenario and delineate safety in this population are needed to allow expanded use of this inexpensive, relatively nontoxic, and potentially beneficial therapeutic option after LTX .
    Type of Medium: Online Resource
    ISSN: 0277-0008 , 1875-9114
    URL: Issue
    URL: Article
    DOI: 10.1002/phar.2018.38.issue-7
    DOI: 10.1002/phar.2130
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2061167-5
    SSG: 15,3
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