bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-Sensitivity between Paroxetine and Sertraline
Authors: Warnock Caroline A , Azadian Abbas G 
Published: June 2003

OBJECTIVE: To report a case of possible cross-sensitivity between selective serotonin-reuptake inhibitors (SSRIs). CASE SUMMARY: A 20-year-old Southeast Asian man developed a maculopapular rash soon after starting paroxetine. Following resolution of this rash, another skin reaction with the same distribution and appearance occurred after sertraline therapy was started. DISCUSSION: Cross-reactivity between drugs with similar structures has been reported; however, cross-reactivity among SSRI antidepressants is unexpected given their differences in chemical structure. CONCLUSIONS: The possibility of cross-reactivity between SSRI antidepressants should be considered by clinicians who wish to switch from one SSRI to another due to a dermatologic reaction.
Fluoxetine in the Treatment of Premenstrual Dysphoric Disorder
Authors: Carr Roxane R , Ensom Mary HH 
Published: June 2003

OBJECTIVE: To examine the role of fluoxetine in the treatment of premenstrual dysphoric disorder (PMDD). DATA SOURCES: Search strategy included MEDLINE (1966–February 2002), Embase (1988–February 2002), HealthStar (1975–December 2000), Current Contents (1996–November 2001), and Copernic (November 2001). Search terms included fluoxetine, premenstrual dysphoric disorder, PMDD, late luteal-phase dysphoric disorder, and severe premenstrual syndrome. STUDY SELECTION: English-language human studies were selected and evaluated based on quality of evidence. DATA SYNTHESIS: Eight prospective trials (3 double-blind, placebo-controlled, crossover; 3 double-blind, randomized, controlled; 2 open-label), 1 case series, and 1 meta-analysis were identified. Although 6 of the studies involved small sample sizes (n < 50), all found fluoxetine to be effective in the treatment of PMDD. CONCLUSIONS: Despite limited data, fluoxetine 20 mg/d appears to be effective in the treatment of PMDD. However, adverse effects, particularly headaches and sexual dysfunction, are possible. Given the long half-life of fluoxetine and the short duration of PMDD symptoms per cycle, larger, well-designed clinical trials evaluating intermittent dosing for only 1 week or a few doses need to be performed.
Effect of Coffee Consumption on Intraocular Pressure
Authors: Avisar Rahamim , Avisar Erez , Weinberger Dov 
Published: June 2003

BACKGROUND: Many ophthalmologists instruct patients with glaucoma to avoid coffee, although data supporting this practice are insufficient. OBJECTIVE: To estimate the effect of drinking coffee on intraocular pressure (IOP). METHODS: In this crossover study, the effect of the consumption of regular (180 mg caffeine in 200 mL beverage) and decaffeinated coffee (3.6 mg caffeine in 200 mL beverage) was compared in patients with normotensive glaucoma (n = 6) or ocular hypertension (n = 22). IOP was monitored in both groups at 30, 60, and 90 minutes after coffee ingestion. RESULTS: In patients with normotensive glaucoma who drank regular coffee, the mean ± SD changes in IOP at 30, 60, and 90 minutes were 0.9 ± 0.5, 3.6 ± 1.1, and 2.3 ± 0.66 mm Hg, respectively; in those who drank decaffeinated coffee, they were 0.75 ± 0.36, 0.70 ± 0.4, and 0.4 ± 0.6 mm Hg, respectively. The corresponding values in patients with ocular hypertension were as follows: after regular coffee, 1.1 ± 0.7, 3.4 ± 1.0, and 3.0 ± 2.7 mm Hg; and after decaffeinated coffee, 0.6 ± 0.4, 0.9 ± 0.2, and 0.5 ± 0.5 mm Hg. The difference in the change in IOP from baseline after ingestion of regular versus decaffeinated coffee was statistically significant in each group at 60 and 90 minutes. Subjects who drank regular coffee demonstrated a greater elevation in IOP; this elevation may be clinically significant. CONCLUSIONS: Intake of caffeinated beverage (≥180 mg caffeine) may not be recommended for patients with normotensive glaucoma or ocular hypertension.
Efavirenz-Induced Skin Eruption and Successful Desensitization
Authors: Phillips Elizabeth J , Kuriakose Beena , Knowles Sandra R 
Published: June 2003

OBJECTIVE: To report a patient with efavirenz-induced hypersensitivity syndrome reaction who was successfully desensitized to efavirenz. CASE SUMMARY: A 37-year-old HIV-positive white man was placed on efavirenz, amprenavir, stavudine, lamivudine, and didanosine due to virologic failure with a previous regimen. Eight days into treatment, the patient developed a generalized rash and all medication was discontinued. Two weeks later, he was started on efavirenz, stavudine, didanosine, lamivudine, and lopinavir. The next morning, he awoke with red, itchy skin. All of the medications were discontinued. At the HIV Drug Safety Clinic, the patient was successfully restarted on amprenavir, stavudine, didanosine, lamivudine, and lopinavir. A 14-day desensitization to efavirenz was also undertaken; on day 12 of the desensitization, he once again developed a rash. He was treated symptomatically, and the desensitization protocol was extended. Sixteen months following the successful desensitization, he is tolerating full-dose efavirenz in combination with the other antiretroviral agents. DISCUSSION: The incidence of efavirenz-induced hypersensitivity ranges between 10% and 34%. Generally, an erythematous, maculopapular rash with or without fever develops 1–3 weeks after the initiation of therapy. In many patients without systemic manifestations, an attempt should be made to continue therapy and treat the rash symptomatically. If this fails, desensitization with the implicated drug can be tried. CONCLUSIONS: A history of antiretroviral-induced hypersensitivity reactions often limits the choices of medications that can be used in subsequent treatment regimens. Desensitization may allow for the continued use of previously restricted medications.
Colchicine-Induced Rhabdomyolysis
Authors: Boomershine Kellie H 
Published: June 2003

OBJECTIVE: To report a case of rhabdomyolysis occurring during treatment with colchicine. CASE SUMMARY: A 44-year-old African American man was admitted to the hospital due to persistent diarrhea, vomiting, and diffuse weakness. Past medical history was significant for renal failure requiring peritoneal dialysis, gout, and a new skin lesion. Approximately 2 months prior to admission, he had been started on colchicine and allopurinol. Creatine kinase concentration on admission was >14 000 U/L. Liver function tests were elevated 5 × the upper limit of normal. Colchicine was discontinued on admission. Creatine kinase concentrations decreased significantly, and strength and ambulation improved throughout hospitalization. DISCUSSION: Colchicine was thought to be the causative factor for rhabdomyolysis in conjunction with chronic renal failure and elevated liver function tests. After discontinuation of colchicine, creatinine kinase concentrations declined and the patient's ability to walk improved. Limited case reports of colchicine-induced rhabdomyolysis have been published. CONCLUSIONS: Chronic renal failure in conjunction with elevated liver function tests appear to increase the possibility of colchicine-induced toxicity, specifically, rhabdomyolysis.
Accuracy and Precision of the CoaguChek S versus Laboratory INRs in a Clinic
Authors: Havrda Dawn E , Hawk Toni L , Marvin Carrie M 
Published: June 2003

BACKGROUND: The CoaguChek S is the next-generation coagulation monitor for measuring the international normalized ratio (INR) that replaces the CoaguChek device. Studies are lacking comparing the CoaguChek S with local laboratory INR assessment to ensure its accuracy and precision for monitoring patients on anticoagulation. OBJECTIVE: To evaluate accuracy, precision, and technical ease-of-use of the CoaguChek S compared with laboratory measurements. METHODS: Accuracy was evaluated in 101 patients by parallel assessment of INRs (CoaguChek S and laboratory); precision was evaluated in 31 patients using duplicate INRs from CoaguChek S and laboratory and from liquid quality controls. Accuracy was determined using orthogonal regression, Bland—Altman plot, and clinical applicability (INRs discrepant in categorization of INR goal and resulting in different therapeutic decisions). Precision was examined by comparing mean difference ± SD between repeated INRs from CoaguChek S and laboratory, coefficient of variation (CV), and coefficient of repeatability (CR). The influence of low and elevated INRs on accuracy and precision was also examined. To assess ease-of-use of the monitor, the number of technical errors was recorded. RESULTS: The CoaguChek S significantly correlated to laboratory measurement (r = 0.93); 16.7% of INRs resulted in discrepant categorization and 24.5% would have required a different therapeutic plan. The CV and CR compared well between CoaguChek S and laboratory (6% vs. 4.9%; 0.455 vs. 0.346, respectively). When subgroups of INR values <4.0 and <3.0 were evaluated, the precision improved with both methods. Precision, based on liquid quality controls, was good (CV 4.6% = low-level; 3.3% = high-level). The CoaguChek S was found to have an error rate of 1.8%. CONCLUSIONS: The CoaguChek S is an accurate and precise alternative to laboratory assessment of the INR at values <4.0; it is an efficient device with a low likelihood of errors during testing.
Fluticasone versus Salmeterol/Low-Dose Fluticasone for Long-Term Asthma Control
Authors: Heyneman Catherine A , Crafts Rachel , Holland Jerry , Arnold Aaron D 
Published: June 2003

OBJECTIVE: To evaluate the relative clinical superiority of increasing the dose of fluticasone propionate versus the addition of salmeterol to low-dose fluticasone propionate for long-term asthma control. DATA SOURCES: Literature was identified by a MEDLINE search (1966–October 2002). Key search terms included asthma, inhalation, corticosteroid, β-adrenergic agonist, and combination drug therapy. DATA SYNTHESIS: Current guidelines for long-term control of asthma include treatment with either inhaled corticosteroids (medium dose) or inhaled corticosteroids (low to medium dose) in combination with a long-acting bronchodilator. Previous studies evaluating salmeterol or formoterol combination therapy with beclomethasone or budesonide have generally produced superior results compared with increasing the dose of the inhaled corticosteroid. Four recent controlled clinical trials have compared the clinical utility of fluticasone propionate monotherapy versus salmeterol/low-dose fluticasone propionate for long-term asthma control in patients with moderate to severe persistent asthma. Based on spirometry data, rescue albuterol use, and symptom scores, the addition of salmeterol to low-dose fluticasone propionate was superior to increasing the dose of fluticasone propionate. CONCLUSIONS: Based on improvements in forced expiratory volume in 1 second, peak expiratory flow, and symptom control, the addition of salmeterol to low-dose fluticasone propionate provides better control of asthma than increasing the dose of fluticasone propionate.
Neonatal Cholestatic Hepatitis from Carbamazepine Exposure during Pregnancy and Breast Feeding
Authors: Frey Bernhard , Braegger Christian P , Ghelfi Daniela 
Published: June 2003

OBJECTIVE: To report a case of transient cholestatic hepatitis occurring in an infant between the third and seventh weeks of life, most likely due to carbamazepine exposure during pregnancy and breast feeding. CASE SUMMARY: A boy, born to an epileptic mother who had been treated with carbamazepine monotherapy throughout pregnancy and breast feeding, experienced asphyxia at birth with transient hepatic dysfunction in the first week of life. After full recovery from asphyxia, he experienced a second period of liver dysfunction, presenting as cholestatic hepatitis that lasted approximately 5 weeks. Infectious and metabolic etiologies as well as extrahepatic biliary atresia were excluded. DISCUSSION: Carbamazepine is known to induce hepatic damage in children and adults. As the drug crosses the placenta and is excreted into breast milk, infants of mothers taking carbamazepine might also develop liver dysfunction. In addition to the present case, there are 2 well-documented case reports of cholestasis in association with transplacental and transmammary carbamazepine exposure. CONCLUSIONS: Carbamazepine-induced hepatitis may occur in association with prenatal exposure and breast feeding. This may expose infants to unnecessary diagnostic procedures, and should therefore be mentioned in the company's product information.
Substitution of Generic Warfarin for Coumadin in an HMO Setting
Authors: Milligan Paul E , Banet Gerald A , Waterman Amy D , Gatchel Susan K , Gage Brian F 
Published: June 2003

BACKGROUND: Substitution of generic warfarin for Coumadin presents safety concerns due to warfarin's narrow therapeutic index and because a prior generic formulation was removed from the US market after it was associated with adverse events. OBJECTIVE: To determine whether a health maintenance organization (HMO) can add generic warfarin to its formulary without adversely affecting warfarin management or increasing adverse events. DESIGN: In a prospective, observational study, an HMO that formerly dispensed only Coumadin added a generic warfarin preparation (Barr Laboratories, Pomona, NY) to its formulary. SETTING: An anticoagulation service (ACS) affiliated with an HMO that was based in St. Louis, MO. PARTICIPANTS: The cohort consisted of 182 enrollees in the ACS as of May 1, 1999. At the start of the study, these participants were taking Coumadin; by October 31, 2000, all had switched to Barr warfarin. MEASUREMENTS AND MAIN RESULTS: We collected data 8 months prior to and 10 months after the introduction of generic warfarin for the following endpoints: international normalized ratio (INR) control, frequency of INR monitoring, number of dose changes, and rate of thrombotic and hemorrhagic events. Statistical process control charts were used to differentiate between random variation in the endpoints and changes due to different warfarin formulations, and we used the Wilcoxon signed-rank test to look for a change in any endpoint after patients changed to generic warfarin. No significant differences were found in any endpoint. CONCLUSIONS: Substitution of Barr warfarin for Coumadin did not significantly affect INR control, warfarin management, or adverse events. Our findings suggest that HMOs can safely substitute at least 1 generic formulation of warfarin without extra monitoring.
Exploring Prescription Drug Coverage and Drug Use for Older Americans
Authors: Mott David A , Schommer Jon C 
Published: June 2003

OBJECTIVE: To describe existing prescription drug insurance coverage for older Americans, to describe out-of-pocket payment levels per prescription associated with service benefit prescription drug plans used by older persons, and to examine the association of prescription drug coverage types with the reported use of prescription drugs by older persons. PATIENTS AND METHODS: Data were obtained from a national survey of 1570 community-dwelling older persons (≥65 y) conducted in June 1998. A 2-part utilization model was estimated using logistic regression and ordinary least-squares regression. RESULTS: Data from 310 respondents were used for analysis. Overall, 66.1% of respondents reported having prescription drug insurance coverage. A majority (76.6%) of respondents having private drug coverage reported having a service benefit plan (requiring copayment or coinsurance amount to be paid for each prescription). The median copayment per brand name and generic prescription for persons reporting having coverage by service benefit plans was $10 and $5, respectively. CONCLUSIONS: Overall, a majority of older persons reported paying relatively small amounts out-of-pocket per prescription during 1998. Among persons who reported having drug insurance coverage, there were no statistically significant differences in the reported number of drugs used daily, regardless of out-of-pocket payment amount per prescription. Patient need and level of past drug use were significantly associated with both the likelihood of using any prescription drugs and the level of use among users. More research is needed to examine differences in drug expenditures and characteristics of drugs used across prescription drug insurance types for older persons.
Development and Evaluation of an Electronic Drug and Therapeutics Bulletin
Authors: Alderman Christopher P 
Published: June 2003

OBJECTIVE: To describe the development, implementation, and initial evaluation of a paperless drug and therapeutics bulletin that is distributed by electronic mail from the pharmacy department of an Australian teaching hospital. OUTCOMES: A standardized format for the bulletin was designed and approved in February 2001. The aim of the bulletin is to facilitate the timely dissemination of concise, factual information about issues of current interest in therapeutics, drug safety, and the cost-effective use of medicines. A simple and attractive graphic design was chosen, and the hospital's clinical pharmacists and drug information staff developed an initial bank of content during the period immediately preceding the launch. The bulletin is presented as a 1-page, read-only file in Word for Windows format and was initially distributed by electronic mail to all users of the hospital's computerized communication network. As the popularity of the bulletin increased, healthcare practitioners from outside of the hospital began to request permission for inclusion on the circulation list, and the content was frequently forwarded by E-mail to workers in other hospitals and community-based settings. The bulletin is now distributed to pharmacists around Australia via 2 separate moderated discussion lists, one of which provides an archive site for previous editions. Healthcare workers in Singapore, the US, Canada, and New Zealand also receive the bulletin, which is now also abstracted by a major Australian pharmacy journal. A readership survey (also electronically distributed) was used to seek feedback after the publication of the first 12 editions. Readers indicated a high level of satisfaction with the content, format, and frequency of distribution of the materials. CONCLUSIONS: Although the concept and execution of this project was relatively simple, an extensive literature review did not reveal any previously published reports describing this type of approach to the distribution of a pharmacy bulletin. The development and implementation of the electronic drug and therapeutics bulletin has provided an opportunity to use modern communication technology to promote safe and effective medication use and appears to have been well received.
Headache Education in Colleges of Pharmacy
Authors: Wenzel Richard G , Neidich Mindy R 
Published: June 2003

OBJECTIVE: To assess primary headache education in colleges of pharmacy during the 2000–2001 academic year. DESIGN: A survey seeking to quantify students' primary headache education was mailed to all 82 American Association of Colleges of Pharmacy member schools. RESULTS: A usable response was obtained from 65 of 74 answering schools. Per professional year, the average pharmacy student receives 1 headache core course contact hour and no headache elective course contact hours. Two schools offer clerkships devoted exclusively to headaches. Six schools offer clerkships in which a student could expect to focus on headache therapy at least 25% of the time. Seven schools plan to alter their current curriculum to include more headache education, all via additional lectures. CONCLUSIONS: Few opportunities exist for students to learn about primary headaches in colleges of pharmacy. Given the high prevalence and poor medical management of primary headache disorders along with the commonality of pharmacist—headache patient interactions occurring in practice, pharmacy schools should evaluate and alter their curriculum to include more primary headache education.
Acute Renal Failure in Hospitalized Patients: Part I
Authors: Pruchnicki Maria C , Dasta Joseph F 
Published: June 2003

BACKGROUND:Acute renal failure (ARF) is a common condition in hospitalized patients. Morbidity, mortality, and health resource use are considerable, but the true magnitude of the problem is not well described in the literature.OBJECTIVE:To provide a detailed discussion of the epidemiology, economic costs, and classification of ARF.DATA SOURCES:A MEDLINE search (1996–December 2001) was conducted using the search terms kidney and acute kidney failure: epidemiology, etiology, and drug therapy/drug effects. Bibliographies of selected articles were also examined to include all relevant investigations. Economic data were identified using the terms costs and cost analysis and cost of illness.STUDY SELECTION AND DATA EXTRACTION:Review articles, meta-analyses, and clinical trials describing epidemiology and classification of hospital-acquired ARF were identified. Results from prospective, controlled trials were given priority when available.CONCLUSIONS:ARF occurs in up to 25% of critically ill patients, resulting in significant morbidity and high mortality. Characterization of ARF is difficult due to multiple etiologic factors and variable definitions. Limited cost data describe the extensive economic burden associated with the disorder, although further pharmacoeconomic research is needed. Epidemiology and classification of ARF allow prospective management of at-risk patients.
Postfertilization Effect of Hormonal Emergency Contraception
Authors: Kahlenborn Chris , Stanford Joseph B , Larimore Walter L 
Published: June 2003

OBJECTIVE: To assess the possibility of a postfertilization effect in regard to the most common types of hormonal emergency contraception (EC) used in the US and to explore the ethical impact of this possibility. DATA SOURCES AND STUDY SELECTION: A MEDLINE search (1966–November 2001) was done to identify all pertinent English-language journal articles. A review of reference sections of the major review articles was performed to identify additional articles. Search terms included emergency contraception, postcoital contraception, postfertilization effect, Yuzpe regimen, levonorgestrel, mechanism of action, Plan B. DATA SYNTHESIS: The 2 most common types of hormonal EC used in the US are the Yuzpe regimen (high-dose ethinyl estradiol with high-dose levonorgestrel) and Plan B (high-dose levonorgestrel alone). Although both methods sometimes stop ovulation, they may also act by reducing the probability of implantation, due to their adverse effect on the endometrium (a postfertilization effect). The available evidence for a postfertilization effect is moderately strong, whether hormonal EC is used in the preovulatory, ovulatory, or postovulatory phase of the menstrual cycle. CONCLUSIONS: Based on the present theoretical and empirical evidence, both the Yuzpe regimen and Plan B likely act at × by causing a postfertilization effect, regardless of when in the menstrual cycle they are used. These findings have potential implications in such areas as informed consent, emergency department protocols, and conscience clauses.