Tapentadol hydrochloride: a centrally acting oral analgesic.

Background: Tapentadol hydrochloride is a centrally acting oral analgesic approved by the US Food and Drug Administration in November 2008 for the treatment of moderate to severe acute pain. It is available as immediate-release 50-, 75-, and 100-mg tablets.

Objective: The purpose of this article is to review animal studies, pharmacokinetic studies, drug-drug interaction studies, and Phase II/III trials of tapentadol in various conditions producing moderate to severe pain.

Cost-effectiveness of dalteparin versus unfractionated heparin as venous thromboembolism prophylaxis in malignant gynecologic surgery.

Venous thromboembolic events (VTEs) are serious complications that may occur in the patient undergoing surgery for gynecologic malignancies. The American College of Chest Physicians recommends unfractionated heparin or low-molecular weight heparin as prophylaxis for deep vein thrombosis and pulmonary embolism in this patient population. Cost-effectiveness analyses comparing unfractionated heparin 3 times a day versus once daily dalteparin using published efficacy and safety data demonstrate cost savings if dalteparin were routinely utilized as VTE prophylaxis.

Comparison of estimated glomerular filtration rate with estimated creatinine clearance in the dosing of drugs requiring adjustments in elderly patients with declining renal function.

Background: The National Kidney Foundation's practice guidelines for chronic kidney disease recommend using the Modification of Diet in Renal Disease (MDRD) equation for calculating the estimated glomerular filtration rate (GFR).

Objective: The purpose of this article was to compare the use of this estimated GFR with estimated creatinine clearance (CrCl) calculated using the Cockcroft-Gault equation (CG(CrCl)-Eq) in the dosing of drugs requiring adjustments in elderly patients with declining renal function. Existing as well as new serum creatinine assay standards were used.

Fondaparinux sodium in the prophylaxis and treatment of deep vein thrombosis and pulmonary embolism.

Fondaparinux sodium is the first in a new class of anticoagulants that selectively inhibits Factor Xa. It produces a predictable pharmacologic response, obviating the need for coagulation monitoring. Additionally, this agent does not bind to platelet Factor 4, thereby reducing the risk of thrombocytopenia.

New serum creatinine assay standardization: implications for drug dosing.

Objective: To describe the development of new serum creatinine assay standards and discuss their implications for various drug dosing scenarios.

Data Sources: A MEDLINE search (1990-August 2006) was performed to identify literature on newly developed serum creatinine assay standards and the impact those standards will have on drug dosing.

Study Selection And Data Extraction: Data on the development of new creatinine assay procedures and the effect that these new values will have on drug dosing were extracted from identified references.

Cost analysis of fondaparinux versus enoxaparin as venous thromboembolism prophylaxis in elective hip replacement surgery.

Patients undergoing hip arthroplasty are at high risk for developing venous thromboembolic events (VTE) postoperatively in the absence of prophylaxis. In this study, a cost analysis comparing efficacy and safety data from a published trial evaluating fondaparinux and enoxaparin as VTE prophylaxis in hip replacement patients was performed. Incremental cost effectiveness ratios were calculated to determine cost per VTE avoided.

Chronic aspartame affects T-maze performance, brain cholinergic receptors and Na+,K+-ATPase in rats.

This study demonstrated that chronic aspartame consumption in rats can lead to altered T-maze performance and increased muscarinic cholinergic receptor densities in certain brain regions. Control and treated rats were trained in a T-maze to a particular side and then periodically tested to see how well they retained the learned response. Rats that had received aspartame (250 mg/kg/day) in the drinking water for 3 or 4 months showed a significant increase in time to reach the reward in the T-maze, suggesting a possible effect on memory due to the artificial sweetener.

Cost analysis of fondaparinux versus enoxaparin as venous thromboembolism prophylaxis in hip fracture surgery.

Hip fracture patients are at high risk of developing venous thromboembolic events (VTEs) postoperatively. Efficacy and safety data from a clinical trial comparing fondaparinux and enoxaparin as VTE prophylaxis were used to perform a cost assessment of these 2 agents. Incremental cost calculations demonstrate that enoxaparin offers advantages over fondaparinux when dosed for 7 days postoperatively in this patient population.

A cost analysis of fondaparinux versus enoxaparin in total knee arthroplasty.

Several hundred thousand total knee replacement (TKR) surgeries are performed in the United States each year. The American College of Chest Physicians has classified TKR patients in the "highest-risk" category for developing venous thromboembolic events. Recommended prophylactic agents following TKR surgery include unfractionated heparin and low-molecular weight heparins.

Determining institution-specific costs of thromboembolic events with an algorithm and spreadsheet.

A systematic process whereby an institution may perform a pharmacoeconomic analysis of all direct medical costs associated with the diagnosis and treatment of venous thromboembolic events (VTEs) that reflects both institution-specific costs and clinical practice patterns is described. Current Content, International Pharmaceutical Abstracts, and MEDLINE were searched to identify English-language articles addressing procedures for diagnosing and treating symptomatic deep-vein thrombosis and pulmonary embolism. From the information gathered, a diagnostic algorithm and a resource spreadsheet were developed.

Cost analysis: fondaparinux versus preoperative and postoperative enoxaparin as venous thromboembolic event prophylaxis in elective hip arthroplasty.

Patients undergoing hip arthroplasty in the absence of prophylaxis for venous thromboembolic events (VTEs) are at high risk for experiencing postoperative VTEs. In the study reported here, we performed cost analyses involving efficacy and safety data from clinical trials evaluating fondaparinux and enoxaparin as VTE prophylaxis. Incremental cost-effectiveness ratios were calculated to determine cost per VTE avoided.

Achievement of anticoagulation by using a weight-based heparin dosing protocol for obese and nonobese patients.

The need for different heparin dosing protocols for obese and nonobese patients was studied. A chart review was performed for all patients who received heparin over an eight-month period at an acute care hospital. Data collected included age, sex, height, actual body weight (ABW), ideal body weight (IBW), initial activated partial thromboplastin time (aPTT), initial heparin bolus dose, initial heparin i.

Cost comparison of tinzaparin versus enoxaparin as deep venous thrombosis prophylaxis in spinal cord injury: preliminary data.

Thromboembolic events are major causes of morbidity and mortality in patients with spinal cord injuries. Low molecular weight heparins are recommended as prophylaxis against such events. The purpose of the current study was to perform a cost analysis of tinzaparin versus enoxaparin using published efficacy and safety data as deep vein thrombosis and pulmonary embolism prophylaxis in this population.

Three Michaelis-Menten pharmacokinetic dosing methods compared with physician dosing of phenytoin in an outpatient neurology practice.

We compared predicted phenytoin serum concentrations using three Michaelis-Menten pharmacokinetic dosing methods with actual concentrations obtained from physician dosing in an outpatient neurology practice. Method 1 used population estimates for the Michaelis-Menten constant (Km) and maximum velocity (Vmax), method 2 used one dose and serum concentration pair to determine Vmax, and method 3 used two dose-concentration pairs to determine both Km and Vmax. In addition, physician doses were compared with pharmacokinetically calculated doses.

PDA establishes position statement on cola contracts in schools.

The soft drink industry promises that it will do everything possible to persuade even more Americans to drink even more soda pop more often. Parents and health-care providers need to recognize soft drinks for what they are--liquid candy--and do everything possible to return these beverages to their former, reasonable role as an occasional treat. School districts should not auction themselves off to the highest bidder for exclusive pouring rights contracts with soft drink companies.

Improved health-related quality of life with SSRIs and other antidepressants.

Study Objective: To document the health-related quality of life (HRQOL) of depressed patients receiving antidepressant drugs.

Design: Cross-sectional study.

Setting: Community pharmacy-based setting.

Formulary management of low molecular weight heparins.

Low molecular weight heparins (LMWHs) are increasingly being utilised as anticoagulants in healthcare settings. These agents offer several advantages over standard unfractionated heparin. Indications for LMWHs include deep vein thrombosis and pulmonary embolism prophylaxis, deep vein thrombosis treatment, use in coronary procedures associated with a high risk for bleeding, and in acute coronary syndromes.