bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Retrospective Analysis of Cyclooxygenase-II Inhibitor Response Patterns
Authors: Castaldo Richard S , Mato Anthony , Kaul Alan F , Gorski Heather , Bosch Ronald J 
Published: September 2013

Objective: To summarize responses to cyclooxygenase-II (COX-II) medication use and describe physicians' reasons for switching or discontinuing therapy in the management of osteoarthritis. Methods: This retrospective medical record review evaluated all patients in a private clinical practice setting with a diagnosis of osteoarthritis who had been prescribed the COX-II inhibitor rofecoxib. Results: Of 144 evaluable patients, 81 had previously experienced treatment failure with celecoxib. Sixty-three patients had received rofecoxib as their first COX-II agent. A total of 101 of 144 patients remained on rofecoxib through the time of follow up. Patients starting celecoxib as their first COX-II agent discontinued therapy significantly earlier than those initiating treatment with rofecoxib (p < 0.001). Kaplan–Meier estimates of the median time to discontinuation were 17 weeks for celecoxib and 45 weeks for rofecoxib. There was no significant difference in the time to discontinuation in the first 6 months of therapy with a second COX-II agent between the groups. Conclusions: The majority of patients demonstrating therapeutic failure with 1 COX-II inhibitor may successfully be treated with another COX-II agent.
Gatifloxacin-Associated Hypoglycemia
Authors: Parilo Miguel A 
Published: September 2013

Objective: To report a case of prolonged hypoglycemia associated with glyburide and gatifloxacin use. Case Summary: An 82-year-old white woman with diabetes mellitus type 2 and chronic renal insufficiency developed postoperative pneumonia. She had previously been on long-term glyburide therapy. Protracted hypoglycemia after institution of gatifloxacin developed despite discontinuation of oral hypoglycemic therapy. After 2 days of intravenous dextrose, sustained normoglycemia was achieved. Discussion: Hypoglycemic reactions with glyburide and fluoroquinolone antibiotics have been reported, but not with gatifloxacin. Although drug administration error cannot be excluded, no documentation exists to support this. The onset of hypoglycemia soon after administration of gatifloxacin and reports of similar interactions favor the hypothesis that hypoglycemia was induced by a gatifloxacin–glyburide interaction. Conclusions: Fluoroquinolone-associated hypoglycemia has been documented, and an interaction of gatifloxacin and glyburide appears probable. Patients with diabetes should be monitored for the development of resistant hypoglycemia, especially if they are on concomitant oral hypoglycemic medications.
Olanzapine-Induced Depression
Authors: Swartz Conrad M 
Published: September 2013

Objective: To report apathetic and hypoactive depression caused by olanzapine. Case Summary: A 29-year-old white man and a 29-year-old white woman developed apathy, hypoactivity, blunted affect, depressed mood, and other depressive symptoms while taking olanzapine. Both showed a distinctly abnormal appearance. Clinicians attributed these symptoms to psychiatric illness, but the symptoms disappeared rapidly after drug discontinuation or dose decrease. Discussion: The only previous report of depression from olanzapine involved a medication interaction with fluoxetine. Another report described olanzapine-induced orbital-frontal syndrome, with childlike oversimplicity. If such symptoms are observed, the discontinuation of olanzapine is recommended. Conclusions: These observations suggest additional cautions when olanzapine is used outside of schizophrenia.
Amiodarone Interaction Time Differences with Warfarin and Digoxin
Authors: Matsumoto Kana , Ueno Kazuyuki , Nakabayashi Toshikatsu , Komamura Kazuo , Kamakura Shiro , Miyatake Kunio 
Published: September 2013

Background: Amiodarone has pharmacokinetic and pharmacodynamic interactions with various therapeutic agents. The mechanism of interaction between warfarin and amiodarone is the inhibition of warfarin metabolism by amiodarone, and that between digoxin and amiodarone is the inhibition of digoxin transport by amiodarone. Objective: To investigate the pharmacokinetic magnitude of the time differences between amiodarone–warfarin and amiodarone–digoxin interactions. Methods: Amiodarone was administered concomitantly to 79 inpatients who had been receiving fixed-maintenance doses of warfarin or digoxin. Seventy-seven inpatients were prescribed warfarin therapy, and 54 inpatients were prescribed digoxin therapy. To determine serum concentrations of the warfarin enantiomers digoxin, amiodarone, and desethylamiodarone blood samples were obtained with coadministration of amiodarone. Serum S- and R-warfarin, amiodarone, and desethylamiodarone concentrations were measured by HPLC methods, and serum digoxin concentrations were measured by a fluorescence polarization immunoassay. Results: A remarkable decrease of S-warfarin clearance was observed within approximately the first 2 weeks after coadministration of amiodarone. Only a small decrease in R-warfarin clearance was observed. Digoxin clearance was gradually decreased with time, and a good reverse correlation was obtained between amiodarone or desethylamiodarone concentrations and digoxin clearance. Conclusions: Relatively short-term monitoring of warfarin clearance is required when amiodarone is coadministered. Long-term monitoring of digoxin serum amiodarone and desethylamiodarone concentrations is necessary to detect the amiodarone–digoxin interaction.
Effectiveness of Sliding-Scale Insulin in Inpatients with Diabetes Mellitus
Authors: Dailey Amanda D , Lutomski Dave M 
Published: September 2013

Objective: To compare the incidence of hypoglycemia and hyperglycemia among sliding-scale insulin (SSI) regimens and determine patient characteristics that influence glycemic control in inpatients with diabetes mellitus. Methods: Main outcome measures for this retrospective chart review were rates of hyperglycemic (≥200 mg/dL) and hypoglycemic (≤60 mg/dL or symptomatic) episodes. Patients were excluded if a diabetic complication led to hospitalization. SSI regimens as well as patient demographics and clinical characteristics were evaluated for influence on glycemic control. Results: Seventy-four patients with 1020 capillary glucose measurements were analyzed. Regarding overall glycemic control, 80% of patients had ≥2 hyperglycemic events and 4% had ≥2 hypoglycemic events. Factors that significantly increased the risk of hyperglycemia were insulin use prior to admission (p ≤ 0.0001), corticosteroid use (p ≤ 0.0001), antibiotic use (p = 0.009), and dextrose-containing intravenous fluids (p = 0.004). Implementation of an SSI order form (which was associated with selection of more aggressive SSI regimens) significantly decreased the incidence of hyperglycemia (p ≤ 0.0001) without increasing the incidence of hypoglycemia. When analyzed for interactions among variables, insulin use prior to admission and concurrent corticosteroid use remained as independent predictors of hyperglycemia. Conclusions: Suboptimal glycemic control is common in hospitalized patients with diabetes. Patients receiving insulin prior to admission, corticosteroid therapy, dextrose-containing intravenous fluids, or treatment for an active infection are at increased risk. An aggressive SSI regimen does not appear to increase the incidence of hypoglycemia and may lead to better glycemic control. Whether initiating treatment at blood glucose concentrations <150 mg/dL would improve control remains unknown.
Ximelagatran: A New Era in Oral Anticoagulation
Authors: McCall Kenneth L , MacLaughlin Eric J 
Published: September 2013

Objective: To review the pharmacology, pharmacokinetics, and clinical trials of the oral direct thrombin inhibitor ximelagatran. Data Sources: All primary articles involving ximelagatran or its active form, melagatran, and indexed on MEDLINE or International Pharmaceutical Abstracts databases (1966–December 2002) were evaluated. Recent ximelagatran and melagatran abstracts were also obtained online from the American Society of Hematology at www.hematology.org/meeting/abstracts.cfm (2001 and 2002). Data Synthesis: Ximelagatran is an orally bioavailable prodrug of melagatran that directly blocks unbound thrombin and fibrin-bound thrombin. Ximelagatran displays predictable pharmacodynamic and pharmacokinetic properties with a linear dose–response relationship and low interpatient variability. These parameters allow fixed dosing of ximelagatran without routine coagulation monitoring. Ximelagatran has yet to be approved by the FDA; however, several major clinical trials have been completed. These clinical trials have revealed that an easier-to-manage ximelagatran regimen is at least as effective and has a similar safety profile as conventional therapy for prevention of venous thromboembolism (VTE). The results of studies with ximelagatran for treatment of VTE and prevention of thrombosis associated with atrial fibrillation are promising, but need further investigation. Conclusions: Ximelagatran possesses several advantages over warfarin including fixed dosing and the lack of coagulation monitoring, the absence of known diet or drug interactions, and a faster onset of action. Ximelagatran appears to be at least as effective as warfarin for prevention of VTE. Further research is needed with ximelagatran in the treatment of VTE and atrial fibrillation.
Using Medicaid Claims and Dosing Guidelines to Assess the Prescribing and Outcomes of Conventional Antipsychotics
Authors: Rickles Nathaniel M , Svarstad Bonnie L 
Published: September 2013

Background: While newer atypical antipsychotics are considered the treatment of choice for schizophrenia, it is important to study dosing guidelines for conventional antipsychotics as they continue to be used alone or in combination with newer agents for patients who are refractory to treatment with newer agents. Few studies have used Medicaid claims for this purpose, even though they provide a readily available and objective means of assessing dosing in relation to guidelines and outcomes of prescribing. Objective: To examine a new multi-method approach for studying dosing guidelines and outcomes of prescribing in Medicaid recipients receiving conventional antipsychotics. Methods: Data were collected from medical records, Medicaid prescription and hospital claims, and case managers in 8 county-based delivery systems in Wisconsin during a 12-month period in 1989–1990 as a part of a larger naturalistic study. Eligible patients had a primary diagnosis of schizophrenia, a prescription for oral antipsychotics, and no hospitalizations during baseline (first quarter). Results: Of 159 patients, 46.5%, 32.1%, and 21.4% had baseline antipsychotic doses below, above, and within the guidelines, respectively. Patients dosed above the guidelines were 4 times more likely to be hospitalized after baseline (p < 0.05) than those within the guidelines after controlling for adherence, baseline functioning, and past hospitalizations. Further analysis showed that the high-dose/hospitalization relationship was mediated or explained in part by adverse effects. Conclusions: The use of Medicaid claims revealed a substantial amount of prescribing outside of guidelines and an increased risk of hospitalization during the study period. Future trials are needed to compare this methodologic approach with other approaches and to determine whether current dosing patterns and outcomes have changed. This study was made possible through Rickles' National Institute of Mental Health (NIMH) Fellowship in Mental Health Services Research at the University of Wisconsin — Madison. The study obtained data from a larger project supported by NIMH grant MH-43555 to the late Dr. James Greenley and his colleagues at the University of Wisconsin — Madison. Data from this study were presented in March 2000 at the 147th Annual Meeting and Exposition of the American Pharmaceutical Association.
Review of Tech-Check-Tech
Authors: Wilson Debbie L 
Published: September 2013

Objective: To explore the legal implications of the empiric literature and relevant legal literature on tech-check-tech. Methods: Two reviews were made: one of the states' and US holdings' laws regarding technician credentialing and tech-check-tech, and another of the empiric literature on tech-check-tech. Data Sources/Selection: The International Pharmacy Abstracts database and PubMed were searched for articles using the following key words: Tech* & accuracy, Tech* & check, Tech* & error, and tech-check-tech. When searching PubMed, the term “pharmacy” was added in each search. This search was verified July 2, 2002, to ensure that no articles were missed. Full articles and meeting abstracts were included if they contained data that allowed for comparisons between pharmacists' and technicians' accuracy or error rates in checking. Primary, secondary, and tertiary sources were used. All articles included were searched on the Web of Science to find other relevant articles. The bibliographies of the included articles were also checked. Data Synthesis: Thirty-five of the 53 US states and holdings (66%) either license, register, certify, require Pharmacy Technician Certification Board certification, and/or have technician training or educational requirements. Four states (7.5%) allow tech-check-tech in some form. Ten empiric studies were found that investigated tech-check-tech. The error detection rate was available in only 2 of the studies and showed nearly the same rates (technicians 97%, pharmacists 94%). Conclusions: This work found no evidence suggesting that tech-check-tech should not be adopted for unit-dose cart fill in every state. The credentialing of technicians varies greatly from state to state. Tech-check-tech procedures are sparsely used in the US. Training may improve accuracy, and the average error detection rate was higher for technicians than for pharmacists.
Maintenance of Goal Blood Pressure following Conversion from Lisinopril to Fosinopril
Authors: Graham Maqual R , Allcock Nicole M , Lindsey Cameron C 
Published: September 2013

Objective: To determine whether blood pressure could be maintained for patients on lisinopril following conversion to a theorized, therapeutic dose of fosinopril. The tolerability of fosinopril was also assessed. Methods: Subjects receiving lisinopril were considered candidates for this prospective, observational study. Prescribing information for both lisinopril and fosinopril suggested a milligram-to-milligram equivalency. Patients taking lisinopril 10 mg/d were switched to fosinopril 10 mg/d. Blood pressures were compared at baseline and 2, 6, and 18 weeks after conversion. A goal blood pressure of <140/90 mm Hg was assigned to all patients at enrollment and used to determine goal attainment at baseline and 18 weeks. More aggressive blood pressure goals are currently recommended; thus, medical histories were reevaluated at the end of the study and new goals were assigned and assessed. Adverse effect occurrence was also compared between visits. Results: One hundred thirty-three subjects were enrolled. The mean dose of lisinopril prior to conversion was 15 ± 11 mg/d compared with the mean final fosinopril dose of 20 ± 14 mg/d. Both the mean systolic and diastolic blood pressures increased significantly at the 18-week visit when compared with baseline (p = 0.00007 and p = 0.015, respectively). Using a goal blood pressure of <140/90 mm Hg, there was no difference detected between the baseline and the final assessment visit (p = 0.851). A greater number of subjects were unable to achieve goal status at 18 weeks when compared with baseline after applying the newly defined goals (p = 0.003). Sixteen of the original 133 subjects discontinued fosinopril due to adverse events. Conclusions: When converting subjects from lisinopril to fosinopril, equivalent blood pressure may be difficult to achieve without increasing the dose of fosinopril.
Communication of Drug Affordability between Physicians and Elderly Patients
Authors: Xu K Tom , Irons Brian K 
Published: September 2013

Objective: To identify characteristics among elderly patients associated with patient–provider communications regarding affordability of medications in prescribing and dispensing. Methods: Telephone survey data from consumers ≥65 years old collected in the Texas Tech 5000 Survey were used. The sample size for the analyses was 2,360. Demographics, insurance, financial factors, nonfinancial factors, prescription drug use, and health status were used to identify which subgroup of elderly patients recalled communication with their providers regarding the affordability of prescriptions. Statistical analyses included bivariate analyses and a multivariate logistic regression. Results: Eleven percent of the respondents reported being asked by their physicians whether they could afford prescription drugs. In the multivariate analysis, gender, race, insurance coverage for prescriptions, income, number of physician visits, out-of-pocket expenditure for prescriptions, health, and physicians' participatory decision-making score were found to be associated with patient–provider communications regarding affordability of medications. Conclusions: Further research needs to be conducted to identify ways to improve patient–provider relationships to facilitate communication regarding affordability of medications among elderly patients. Improved communication or sensitivity to prescription affordability has the potential to increase patient medication adherence and improve clinical outcomes.
Chemotherapy-Induced Delayed Emesis: What is the Role of 5-HT3Antagonists?
Authors: Ng Kwong H 
Published: September 2013

Objective: To review the current literature assessing the efficacy of different antiemetics, with a focus on comparison between serotonin (5-HT3) antagonists and other antiemetics, in the treatment of delayed emesis induced by either cisplatin or non-cisplatin cytotoxic agents. Data Sources: A MEDLINE search (1966–July 2002) was performed using delayed emesis, vomiting, nausea, chemotherapy, cisplatin, moderately emetogenic, selective serotonin subtype-3 (5-HT3) receptor antagonists, metoclopramide, domperidone, corticosteroids, dexamethasone, prognostic factors, risk factors, and neurokinin-1 (NK1) receptor antagonists as key words or subject headings. Only English-language articles were identified and included. Additional references were retrieved from selected articles. Data Synthesis: Various antiemetic consensus guidelines have recommended the use of different pharmacologic treatment, including the use of 5-HT3 antagonists, for the prevention of chemotherapy-induced delayed emesis. In some instances, it has been suggested that combinations containing a 5-HT3 antagonist may be superior to others. Current data have been synthesized in an attempt to demonstrate the efficacy of 5-HT3 antagonists in the treatment of chemotherapy-induced delayed emesis. Conclusions: Dexamethasone has consistently shown its antiemetic efficacy for delayed emesis induced by cisplatin and non-cisplatin agents, whereas the role of 5-HT3 antagonists alone remains controversial. Metoclopramide has been shown to be as efficacious as 5-HT3 antagonists when combined with dexamethasone for the prevention of delayed emesis. As a result, 5-HT3 antagonists should be reserved as second-line agents to metoclopramide in addition to dexamethasone. NK1 receptor antagonists have shown some early promising results. However, many questions need to be addressed before their extensive use in clinical practice.
Case–Control Study Comparing Droperidol Plus Diphenhydramine with Conventional Treatment in Hyperemesis Gravidarum
Authors: Ferreira Ema , Bussières Jean-François , Turcotte Virginie , Duperron Louise , Ouellet Geneviève 
Published: September 2013

Background: In 1998, a protocol consisting of droperidol/diphenhydramine combination was established at Hospital Sainte-Justine to treat hyperemesis gravidarum. Objective: To compare the efficacy of the droperidol/diphenhydramine combination with other conventional treatments used before implementation of this protocol in the treatment of hyperemesis gravidarum (HG). Methods: A nonrandomized, prospective study was conducted using a historical control of 54 patients receiving conventional antiemetic treatment and 2 study groups: 67 patients treated with intravenous droperidol 1 mg/h plus diphenhydramine 25–50 mg every 6 hours and 34 patients treated with intravenous droperidol 0.5 mg/h plus diphenhydramine 50 mg every 6 hours. Study outcomes included length of hospital stay, readmission rate, intensity of nausea and vomiting according to the National Cancer Institute scoring system, maternal body weight variation, pregnancy outcomes, and adverse effects. Study Site: Sainte-Justine Hospital in Montréal, Québec, a tertiary care university teaching hospital affiliated with the University of Montréal. Study Population: Hospitalized patients diagnosed with HG. Results: The 3 groups, comparable in terms of maternal characteristics, showed no difference in terms of length of stay. The readmission rate was lower in the group that received droperidol 1 mg/h compared with the other 2 groups. Overall, droperidol use was associated with a reduction in daily nausea and vomiting scores (p < 0.001). The most common adverse effects were xerostomia, drowsiness, constipation, and hypotension. Extrapyramidal reactions were observed in 20% of the droperidol patients. Birth defects occurred in 2.4% of the control group and 7.5% of the study group (p = 0.52). Drugs could be excluded as causal agents for the majority of malformations in 5 of 7 cases. Conclusions: Droperidol/diphenhydramine is an effective alternative for treatment of refractory HG. A large, prospective, randomized study would be required to confirm the efficacy of this treatment as well as maternal and fetal safety.
Seizure Activity after Venlafaxine Overdose
Authors: Sarandöl Asli , Taneli Bilgen 
Published: September 2013

Objective: To report the findings from the case of a patient developing first-time seizure activity following an overdose of venlafaxine. Case Summary: A 27-year-old man with major depression ingested 60 venlafaxine 75-mg capsules in an apparent suicide attempt. The patient experienced generalized seizure activity 9 and 11 hours after ingestion. The electroencephalogram showed a pathologic pattern, with several generalized epileptiform discharges. Venlafaxine was discontinued, and no further sequelae were observed. Discussion: The Naranjo probability scale indicated a probable relationship between the seizures and venlafaxine overdose. The mechanism of seizures associated with venlafaxine overdose is unclear. Neurotransmitters play an important role in seizure genesis, and hepatic damage may occur. Conclusions: Clinicians should be aware of proconvulsant effect and the risk of hepatocellular injury from venlafaxine overdose when prescribing this drug.