Purpose: Gabapentin has increasingly been identified as a drug of abuse, especially when used concurrently with opioids. Rescheduling gabapentin as a schedule V controlled substance may strengthen monitoring and prescribing restrictions. The purpose of this study was to characterize the impact of rescheduling gabapentin from a nonscheduled to a schedule V substance in Virginia on discharge prescribing patterns in a health system.
View Article and Find Full Text PDFThis article has been withdrawn due to a publisher error that caused the article to be duplicated. The definitive version of this article is published under DOI 10.1093/ajhp/zxab293.
View Article and Find Full Text PDFJ Pain Palliat Care Pharmacother
September 2021
This was a multicenter retrospective analysis comparing intravenous push (IVP) analgesia versus patient-controlled analgesia (PCA) in patients admitted for sickle cell pain crisis. The primary objective was to compare the analgesic management, measured in total daily morphine milligram equivalents (MME). Secondary objectives included length of hospitalization, 30-day hospital readmissions and pain scores.
View Article and Find Full Text PDFContinuous-flow left ventricular assist device (LVAD) placement has become a standard of care in advanced heart failure treatment. Bleeding is the most frequently reported adverse event after LVAD implantation and may be increased by antithrombotic agents used for prevention of pump thrombosis. This retrospective cohort included 85 adult patients implanted with a Heartmate II LVAD.
View Article and Find Full Text PDFThe association between time in therapeutic range (TTR) and clinical outcomes in patients with left ventricular assist devices (LVADs) on chronic warfarin therapy is not well understood. This study assessed TTR using the Rosendaal Method prior to suspected or confirmed pump thrombosis or ischemic stroke. Each patient served as their own control.
View Article and Find Full Text PDFThe optimal management of recurrent painful episodes in individuals living with sickle cell disease (SCD) remains unclear. Currently, the primary treatment for these episodes remains supportive, using fluids and intravenous opioid and anti-inflammatory medications. Few reports have described the use of adjunct subanesthetic doses of ketamine to opioids for treatment of refractory pain in SCD.
View Article and Find Full Text PDFPump thrombosis (PT) is a severe complication of left ventricular assist device (LVAD) support. This study evaluated PT and bleeding after LVAD placement in patients responsive to a standard aspirin dose of 81 mg using platelet inhibition monitoring compared with initial nonresponders who were then titrated upward to achieve therapeutic response. Patients ≥ 18 years of age with initial placement of HeartMate II LVAD at our institution and at least one VerifyNow Aspirin test performed during initial hospitalization were included.
View Article and Find Full Text PDFStudy Objective: To evaluate the time to achieve therapeutic activated partial thromboplastin time (aPTT) values and occurrence of bleeding based on standard unfractionated heparin (UFH) weight-based dosing recommendations compared with an aggressive weight-based UFH dosing strategy using higher maximum doses and infusion rates in both obese and nonobese patients who presented with non-ST-segment elevation myocardial infarction or unstable angina (NSTEMI/UA) or atrial fibrillation.
Design: Retrospective cohort study.
Setting: Academic medical center.
J Pain Palliat Care Pharmacother
January 2017
Use of ketamine in patients requiring extracorporeal membrane oxygenation (ECMO) has rarely been reported, and the optimal dosing strategy remains unclear. A patient admitted with hypoxic respiratory failure required ECMO in addition to continuous infusion of low-dose ketamine following titration of opioid and sedative medications to high doses. After initiation of ketamine, infusion rates of opioids and/or sedatives were maintained or decreased.
View Article and Find Full Text PDFJ Thorac Cardiovasc Surg
December 2015
Background: Limited data suggest that potentially inappropriate medications (PIMs) impact outcomes in critically ill elderly patients. No data are available on the association between PIM use as well as drug burden index (DBI), which is a measure of PIM use, and clinical outcomes in neurocritical care elderly patients. This study evaluates whether PIM use and a higher DBI are associated with poor clinical outcomes in neurocritical care elderly patients.
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