Underdosing in obesity-an epidemic: Focus on anticoagulation
June 1st 2013Obesity is a growing problem in the United States. Currently, 68% of adult Americans are overweight (BMI >25 kg/m2).1 Of those, 35% are obese (BMI >30 kg/m2) and 6% are morbidly obese (BMI >40 kg/m2). It is estimated that by 2030, 51% of the population will be obese and 11% will be morbidly obese.1 We are often confronted with dosing drugs in an obese patient. Unfortunately, many clinical trials exclude or have limited overweight patients enrolled; thus, optimal dosing for both safety and efficacy in this population is lacking. Pharmacokinetic studies in obese patients have shown that the volumes of distribution of lipophilic drugs and the clearance of hydrophilic drugs can be increased. For this reason, dosing in obesity should be patient- and drug-specific.
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Disinfecting all ICU patients significantly reduces MRSA
May 30th 2013Decolonization of all intensive care unit (ICU) patients with antimicrobial soap and ointment significantly reduces all bloodstream infections, including methicillin-resistant Staphylococcus aureus (MRSA), according to a study published in the New England Journal of Medicine.
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Long-term high-dose opioids for pain can result in ED
May 28th 2013Men using long-term, high dose prescription opioids for back pain were about 50% more likely to be using medications for erectile dysfunction than men with back pain who were not using opioids, according to a study published in a recent issue of Spine.
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Following CDC protocols reduces dialysis bloodstream infections
May 28th 2013Outpatient hemodialysis facilities realized a 32% decrease in overall bloodstream infections and a 54% decrease in vascular access-related bloodstream infections after Centers for Disease Control and Prevention (CDC) guidelines were used, according to a new study.
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FDA panel OKs Merck insomnia agent suvorexant at lower doses
May 23rd 2013Soon after FDA expressed concerns over the higher dosages and safety profile, including daytime drowsiness, of the proposed sleep agent known as suvorexant (Merck), the Agency’s Peripheral and Central Nervous System Drugs Advisory Committee voted 13-3, with 1 abstention, in favor of the safety of 2 proposed starting doses of suvorexant - 15 mg in patients over the age of 65 and 20 mg in patients under the age of 65.
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Injectable methotrexate recalled
May 22nd 2013Sandoz is conducting a voluntary nationwide recall at the U.S. hospital/user level of 2 lots of its injectable methotrexate sodium, USP, 25 mg/mL, 40 mL vials, as a result of the discovery of particulate matter during routine quality examination of vials included among the manufacturer’s retention samples.
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Managed care approach to substance abuse treatment
May 20th 2013An examination of people’s behaviors as they relate to drug use in the 20th century has shown that people will expend a large amount of energy to acquire any agent that has the ability to alter their minds, bodies, or behaviors in order to achieve a euphoric effect.
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FDA concerned about higher doses of investigational sleep agent
May 20th 2013The proposal of the investigational sleep agent called suvorexant (Merck), is believed to target sleep disturbances and insomnia through a different mechanism compared to the agents that are currently on the market, but FDA has concerns over the higher dosages of the drug and its safety profile.
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