Abstract:
:Midazolam is a commonly used sedative in critically ill, mechanically ventilated patients in intensive care unit (ICU) settings worldwide. We used a nine-step decision-making algorithm to determine whether therapeutic monitoring of midazolam in the ICU is warranted. Midazolam has a higher clearance and shorter half-life than other benzodiazepines, and prolonged sedation is achieved with continuous infusion. There appears to be very good correlation between plasma concentrations of both midazolam and its active metabolite, alpha1-hydroxymidazolam, and the degree of sedation. However, due to high interpatient variability, it is not possible to predict the level of sedation in any given individual based on plasma concentration of midazolam or its metabolites. Moreover, no simple and practical assay is available to quantitate midazolam plasma concentrations in the acute ICU setting. Many scales are available to assess the sedative effects of midazolam. Because the plasma concentration of midazolam required to achieve a constant level of sedation is highly variable, it is usually more prudent for the clinician to monitor for sedation with a validated clinical scale than by plasma concentrations alone. Various physiologic parameters, including age-related effects, compromised renal function, and liver dysfunction affect the pharmacokinetics of midazolam and alpha1-hydroxymidazolam. Although routine drug monitoring for all critically ill patients receiving midazolam is not recommended, this practice is likely beneficial in patients with neurologic damage in whom sedation cannot be assessed and in patients who have renal failure with a prolonged time to awakening.
journal_name
Pharmacotherapyjournal_title
Pharmacotherapyauthors
Spina SP,Ensom MHdoi
10.1592/phco.27.3.389subject
Has Abstractpub_date
2007-03-01 00:00:00pages
389-98issue
3eissn
0277-0008issn
1875-9114journal_volume
27pub_type
杂志文章,评审相关文献
PHARMACOTHERAPY文献大全abstract::Olanzapine has been associated with insulin resistance and new-onset diabetes mellitus. A 27-year-old African-American man developed new-onset severe hyperglycemia-glucose 1240 mg/dl, with ketonuria and acidosis, but no weight gain-2 years after starting olanzapine. Although his diabetes was stabilized with insulin, h...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.21.17.1448.34421
更新日期:2001-11-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the activity of CYP2D6, N-acetylation, and xanthine oxidase, three drug-metabolizing enzyme systems, in patients with cystic fibrosis and compare the findings with those in individuals without the disease. DESIGN:Prospective cohort study. SETTING:General pediatrics service. PATIENTS:Fift...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::This article on pharmacoepidemiology, the second of two parts, is a more focused discussion of the methodology of cohort studies and case-control studies, the basic methodologies of which were discussed in part I. The nested case-control study incorporates the strengths of both the cohort and case-control studies but ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.24.13.1105.38083
更新日期:2004-09-01 00:00:00
abstract::Substantial error occurs when individual saliva theophylline concentrations are used to predict serum theophylline concentrations. However, the use of saliva theophylline concentrations to determine product bioavailability has never been evaluated. Subjects in this study were 18 stable patients (20-51 yr) with a histo...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1002/j.1875-9114.1983.tb03263.x
更新日期:1983-07-01 00:00:00
abstract::Hospital pharmacists are often consulted for their knowledge about coagulation and therapeutic interventions for the management of critical bleeding. Many pharmacotherapies are available for this purpose, both systemic and topical, and others are in development. These agents and their mechanisms of action are reviewed...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.27.9part2.69S
更新日期:2007-09-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate claims-related treatment adherence, health care resource utilization, and associated costs of therapy conversion from an insulin vial and syringe to a premixed biphasic insulin analog pen device among privately insured patients with type 2 diabetes mellitus. DESIGN:Retrospective, longitudin...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.27.7.948
更新日期:2007-07-01 00:00:00
abstract::The death rate from coronary heart disease (CHD) declined by 25% in the United States during 1987-1997, but the actual number of deaths fell by only 9%. Modifiable risk factors for CHD include hypertension, elevated low-density lipoprotein cholesterol, reduced high-density lipoprotein cholesterol, cigarette smoking, a...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.21.14.195s.34602
更新日期:2001-09-01 00:00:00
abstract::After the introduction of penicillin G into therapeutics, bacteria became increasingly resistant to this penicillin and subsequent beta-lactam antibiotics. The major cause of this resistance is beta-lactamase, an enzyme produced by the bacterium, that destroys the antibiotic before it reaches its target within the bac...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Good admissions decisions are essential for identifying successful students and good practitioners. Various parameters have been shown to have predictive power for academic success. Previous academic performance, the Pharmacy College Admissions Test (PCAT), and specific prepharmacy courses have been suggested as acade...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.21.9.842.34566
更新日期:2001-07-01 00:00:00
abstract::Patient-controlled analgesia is a relatively new method of administering intravenous narcotics for postoperative pain relief. The technique involves the self-administration of a given analgesic in a bolus dose with the aid of a timed infusion and sequencing device. Ten morbidity obese patients undergoing elective gast...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/j.1875-9114.1982.tb03172.x
更新日期:1982-01-01 00:00:00
abstract::Hodgkin lymphoma (HL) and systemic anaplastic large cell lymphoma (sALCL), which is a subtype of non-Hodgkin lymphoma, are relatively uncommon lymphoproliferative types of cancer. These malignancies are highly curable with initial treatment. Nonetheless, some patients are refractory to or relapse after first- and seco...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1170
更新日期:2013-01-01 00:00:00
abstract::Meropenem-vaborbactam is a new β-lactam/β-lactamase inhibitor combination designed to target Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae. Meropenem-vaborbactam was United States Food and Drug Administration-approved for complicated urinary tract infections in patients 18 years of age or olde...
journal_title:Pharmacotherapy
pub_type:
doi:10.1002/phar.2187
更新日期:2018-12-01 00:00:00
abstract::During the past decade, the incidence and severity of Clostridium difficile infection (CDI) have significantly increased, leading to a rise in CDI-associated hospitalizations, health care costs, and mortality. Although treatment options exist for CDI, recurrence is frequent following treatment. Furthermore, patients w...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1990
更新日期:2017-10-01 00:00:00
abstract::Calcium channel blockers, nitrates, and beta blockers are the primary agents used for the treatment of angina. Calcium has a central role in excitation-contraction, action potential generation, and ischemic cell death. The three currently available calcium antagonists are nifedipine, verapamil, and diltiazem. Second-g...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/j.1875-9114.1987.tb04052.x
更新日期:1987-01-01 00:00:00
abstract::Antimicrobial lung penetration is thought to be predictive of efficacy in the treatment of lower respiratory tract infections. Lung penetration studies are commonly conducted with new antimicrobial agents to elucidate their potential utility in treating such infections. Although some very useful information may emerge...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract:STUDY OBJECTIVE:To categorize institutional review board (IRB) challenges and solutions encountered in a multicenter practice-based research network (PBRN) study and to assess the impact of IRB requirements on the willingness of individual principal investigators (PIs) to participate in future PBRN studies. DESIGN:Des...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1276
更新日期:2013-09-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the effectiveness of darbepoetin alfa with epoetin alfa (recombinant human erythropoietin [rHuEPO]) for achieving transfusion independence and increasing hemoglobin concentrations in critically ill patients. DESIGN:Retrospective, descriptive study. SETTING:Level I trauma center intensive ca...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章
doi:10.1592/phco.27.4.535
更新日期:2007-04-01 00:00:00
abstract::Methemoglobin, a form of hemoglobin that does not bind oxygen, is produced when iron in red blood cells is oxidized from the ferrous state to the ferric state. Methemoglobinemia develops in the presence of oxidizing agents, such as benzocaine-containing topical anesthetic sprays, and it is characterized by cyanosis. I...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.27.8.1206
更新日期:2007-08-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the pharmacokinetics and use of intravenous human cytomegalovirus immune globulin (CytoGam) in allogeneic bone marrow transplantation (BMT). DESIGN:Prospective, nonrandomized, nonblinded, single-center study. SETTING:University teaching hospital. PATIENTS:Five consecutive patients with he...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.20.15.1175.34592
更新日期:2000-10-01 00:00:00
abstract::Fifteen percent of premenopausal women, 10-40% of postmenopausal women, and 10-25% of women receiving systemic hormone therapy experience urogenital atrophy. The most common symptoms are dryness, burning, pruritus, irritation, and dyspareunia. Estrogen loss, drugs, and chemical sensitivities are causes. Estrogen or ho...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.21.5.464.34486
更新日期:2001-04-01 00:00:00
abstract::The frequency of type 2 diabetes mellitus is increasing at an alarming rate. Prediabetes, also referred to as impaired glucose tolerance (IGT) and/or impaired fasting glucose, is a major risk factor for development of type 2 diabetes mellitus. In addition, IGT has been associated with an increased risk of cardiovascul...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1592/phco.24.4.362.33170
更新日期:2004-03-01 00:00:00
abstract::Staphylococcus aureus (S. aureus) has proven to be a major pathogen with the emergence of methicillin-resistant S. aureus (MRSA) infections and recently with heteroresistant vancomycin-intermediate S. aureus (hVISA) and vancomycin-intermediate S. aureus (VISA) infections. Although vancomycin is traditionally a first-l...
journal_title:Pharmacotherapy
pub_type: 杂志文章,评审
doi:10.1002/phar.1577
更新日期:2015-04-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the population pharmacokinetics and pharmacodynamic target attainment of ampicillin in neonates with hypoxic-ischemic encephalopathy (HIE) undergoing controlled hypothermia (CH). DESIGN:Prospective, open-label pharmacokinetic study. SETTING:A 189-bed, freestanding children's tertiary care ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1916
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To identify and describe the scope of practice that characterizes the critical care pharmacist and critical care pharmacy services. Specifically, the goals were to define the level of clinical practice and specialized skills characterizing the critical care pharmacist as clinician, educator, researcher, and m...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of an evidence-based, systematic approach to hypertension care involving comanagement of patients by primary care physicians and clinical pharmacists versus usual care in reducing blood pressure in patients with uncontrolled hypertension. METHODS:Patients in a staff model medical...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1592/phco.23.2.209.32096
更新日期:2003-02-01 00:00:00
abstract::The American College of Clinical Pharmacy (ACCP) published an initial white paper on herbal products in 2000. Since then, the global market for natural products has continued to expand, with tens of millions of consumers using such products on an annual basis in the United States alone. However, despite this expansion...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1002/phar.1874
更新日期:2017-01-01 00:00:00
abstract::Addressing the issue of unintended pregnancy is a national priority. One proposed strategy to reduce unintended pregnancy is to improve access to oral contraceptives by changing them to over-the-counter (OTC) status. Existing data indicate that oral contraceptives meet safety criteria required of OTC products. Availab...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.31.4.424
更新日期:2011-04-01 00:00:00
abstract::A 12-year-old girl with cystic fibrosis was diagnosed with a high-grade glioma after radiographic and biopsy results confirmed the primary intracranial lesion. She was treated with single-agent erlotinib during and after daily localized radiation therapy. Pharmacokinetic studies were conducted to assess the effect of ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.29.7.858
更新日期:2009-07-01 00:00:00
abstract::The statins are widely used to treat dyslipidemias. They are generally associated with mild adverse effects, but rarely, more serious reactions may occur. A 51-year-old man experienced delayed-onset, progressive memory loss while receiving simvastatin for hypercholesterolemia. His therapy was switched to pravastatin, ...
journal_title:Pharmacotherapy
pub_type: 杂志文章
doi:10.1592/phco.21.7.767.34577
更新日期:2001-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the appropriate compartmental and noncompartmental pharmacokinetic parameters for intravenous piperacillin and tazobactam. DESIGN:Sequential selection of patients entered into a randomized, open-label clinical efficacy trial. SETTING:Los Angeles County-University of Southern California Me...
journal_title:Pharmacotherapy
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-07-01 00:00:00