Linezolid: its role in the treatment of gram-positive, drug-resistant bacterial infections.
(2002)
Journal - American family physician (United States )
Abstract :
While the choices available for the management of gram-positive, drug-resistant bacterial infections are becoming limited, antimicrobial resistance is becoming increasingly problematic because of the widespread overuse of antibiotics. Linezolid is a synthetic antibiotic belonging to a new class of antimicrobials called the oxazolidinones. Linezolid disrupts bacterial growth by inhibiting the initiation process of protein synthesis--a mechanism of action that is unique to this class of drugs. It is well absorbed with high bioavailability that allows conversion to oral therapy as soon as the patient is clinically stable. It has been approved for certain gram-positive infections including certain drug-resistant enterococcus, staphylococcus, and pneumococcus strains. It is generally well tolerated, with myelosuppression being the most serious adverse effect. As a nonselective inhibitor of monoamine oxidase, caution is recommended when used with adrenergic or serotonergic agents (e.g., tyramine, dopamine, pseudoephedrine, and selective serotonin reuptake inhibitors). Judicious use of this medication should help physicians treat patients with multidrug-resistant infections.
| ISSN : | 0002-838X |
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| Mesh Heading : | Acetamides Anti-Infective Agents Drug Interactions Drug Resistance, Microbial Gram-Positive Bacterial Infections Humans Oxazolidinones adverse effects pharmacokinetics adverse effects pharmacokinetics adverse effects pharmacokinetics |
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| Mesh Heading Relevant : | therapeutic use therapeutic use drug therapy therapeutic use |
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Clinically significant drug interactions.
(2000)
Journal - American family physician (UNITED STATES )
Abstract :
A large number of drugs are introduced every year, and new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely on memory alone to avoid potential drug interactions. Multiple drug regimens carry the risk of adverse interactions. Precipitant drugs modify the object drug's absorption, distribution, metabolism, excretion or actual clinical effect. Nonsteroidal anti-inflammatory drugs, antibiotics and, in particular, rifampin are common precipitant drugs prescribed in primary care practice. Drugs with a narrow therapeutic range or low therapeutic index are more likely to be the objects for serious drug interactions. Object drugs in common use include warfarin, fluoroquinolones, antiepileptic drugs, oral contraceptives, cisapride and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Many other drugs, act as precipitants or objects, and a number of drugs act as both. Regularly updated manuals of drug interactions and CD-ROM-formatted programs are useful office references.
| ISSN : | 0002-838X |
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| Mesh Heading : | Drug Antagonism Drug Synergism Humans Pharmaceutical Preparations |
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| Mesh Heading Relevant : | Drug Interactions adverse effects |
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Drug interactions with the nonsedating antihistamines.
(1997)
Journal - American family physician (UNITED STATES )
Abstract :
The nonsedating antihistamines are frequently prescribed agents. Well-documented drug-drug interactions with two of these agents, terfenadine and astemizole, may result in serious adverse effects, including death, when they are prescribed along with macrolide antibiotics and/or the antifungal agents itraconazole or ketoconazole. Fexofenadine and loratadine appear to be the least likely nonsedating antihistamines to interact with other medications and to result in a life-threatening interaction. This article reviews the known drug-drug interactions involving nonsedating antihistamines and provides a basis from which the clinician can predict potential interactions.
| ISSN : | 0002-838X |
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| Mesh Heading : | Cytochrome P-450 Enzyme System Drug Interactions Drug Prescriptions Histamine H1 Antagonists Humans drug effects administration & dosage economics |
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| Mesh Heading Relevant : | adverse effects |
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Enoxaparin in the prevention of deep venous thrombosis.
(1994)
Journal - American family physician (UNITED STATES )
Abstract :
Enoxaparin, a low-molecular-weigth heparin, has recently been approved for use in the prevention of deep venous thrombosis following elective hip replacement surgery. Clinical trials have demonstrated enoxaparin to be superior to placebo, dextran and unfractionated heparin in deep venous thrombosis prophylaxis. However, no published studies have compared the efficacy of enoxaparin with that of warfarin in the prevention of deep venous thrombosis. Advantages of enoxaparin include less frequent dosing, reduced need for laboratory monitoring and a lower incidence of adverse effects, including hemorrhage. Although enoxaparin is more expensive than unfractionated heparin, its potential benefits may offset its higher cost.
| ISSN : | 0002-838X |
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| Mesh Heading : | Clinical Trials as Topic Drug Costs Enoxaparin Hip Prosthesis Humans Postoperative Complications Thrombosis economics pharmacology |
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| Mesh Heading Relevant : | therapeutic use prevention & control prevention & control |
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Famotidine-induced mixed hepatocellular jaundice.
(1994)
Journal - The Annals of pharmacotherapy (UNITED STATES )
Abstract :
OBJECTIVE: To report a case of probable famotidine-induced mixed hepatocellular jaundice. CASE SUMMARY: A 55-year-old man presented with a one-month history of mid-epigastric pain. Initial physical examination and laboratory studies, including liver enzyme concentration tests, were unrevealing. A diagnosis of gastritis was made and ranitidine was prescribed. Following one week of therapy, the patient's symptoms had not improved and therapy was changed to famotidine and sucralfate. Approximately one week later the patient presented with jaundice. Liver enzyme concentrations were elevated and the patient was hospitalized for further evaluation. Five days following discontinuation of famotidine, liver enzyme concentrations were normal and jaundice had resolved. Further tests did not reveal any pathologic etiology. DISCUSSION: Hepatic changes have occurred in patients receiving histamine2-antagonists; ranitidine and cimetidine have been cited most frequently. In general, the elevations are mild, transient, and return to baseline with continued therapy. This is one of the first case reports of probable famotidine-induced mixed hepatocellular jaundice. CONCLUSIONS: There was a temporal relationship between the patient's signs and symptoms and initiation of famotidine. No identifiable factors contributed to the elevated liver enzyme concentrations and jaundice.
| ISSN : | 1060-0280 |
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| Mesh Heading : | Cholestasis, Intrahepatic Famotidine Humans Male Middle Aged |
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| Mesh Heading Relevant : | chemically induced adverse effects |
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Setting up an automatic pharmacist-initiated pharmacokinetic dosing service.
(1993)
Journal - Hospital formulary (UNITED STATES )
Abstract :
At Latrobe Area Hospital, a 300-bed teaching-community hospital, a unique pharmacokinetic program is in place that permits the pharmacist to initiate and adjust an aminoglycoside or vancomycin regimen and schedule serum drug concentrations and renal function lab tests without contacting a physician for verbal approval. To avoid the perception of pharmacist prescribing, a detailed policy and procedure protocol was written that defined each step conducted in the pharmacokinetic evaluation. Using this approach, the service was readily approved by the medical staff and put into practice. The program has been operational for more than 1 year and has met with high physician and nursing acceptance. Although not specifically studied, the quality of patient care was thought to be improved.
| ISSN : | 0098-6909 |
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| Mesh Heading : | Aminoglycosides Clinical Protocols Hospital Bed Capacity, 300 to 499 Hospitals, Community Humans Pennsylvania Pharmacy Service, Hospital Professional Autonomy Vancomycin pharmacokinetics organization & administration standards pharmacokinetics |
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| Mesh Heading Relevant : | Patient Care Team Pharmacists administration & dosage organization & administration administration & dosage |
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