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Karissa Y. Kim PharmD CACP ; Kelly Epplen PharmD CACP ; Farzin Foruhari MD ; Hattie Alexandropoulos PharmD 《Progress in cardiovascular nursing》2006,21(2):1-4
A 79-year-old man with a history of deep vein thrombosis and pulmonary embolism received anticoagulation therapy with warfarin 5 mg daily for 8 months. He was diagnosed with osteomyelitis and underwent partial metatarsal resection of his right foot. After surgery, antibiotics were initiated including ertapenem sodium 1 g intravenously every 24 hours, vancomycin 1400 mg intravenously every 24 hours, and rifampin 300 mg by mouth twice daily. Achieving a therapeutic level of anticoagulation was difficult despite escalating doses of warfarin, because of the interaction with rifampin. A 5- to 6-fold increase in warfarin dose was prescribed to reach therapeutic international normalized ratios (INRs), but even these increases were insufficient to maintain his INR in the therapeutic range. After rifampin was discontinued, warfarin doses were gradually reduced over the next 2 months. When concurrent warfarin-rifampin therapy is necessary, vigilant monitoring is imperative and significant increases in warfarin doses are likely. 相似文献
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Creation and Implementation of an Outpatient Pathway for Atrial Fibrillation in the Emergency Department Setting: Results of an Expert Panel 下载免费PDF全文
Christopher W. Baugh MD MBA Carol L. Clark MD MBA Jason W. Wilson MD MA Ian G. Stiell MD MSc FRCPC Abraham G. Kocheril MD Krista K. Luck PharmD CACP CPP Troy D. Myers MD Charles V. Pollack MA MD Jr. Steven K. Roumpf MD Gery F. Tomassoni MD James M. Williams MS DO Brian B. Patel MD Fred Wu MHS PA‐C Jesse M. Pines MD MBA MSCE 《Academic emergency medicine》2018,25(9):1065-1075
Atrial fibrillation and flutter (AF) is a common condition among emergency department (ED) patients in the United States. Traditionally, ED care for primary complaints related to AF focus on rate control, and patients are often admitted to an inpatient setting for further care. Inpatient care may include further telemetry monitoring and diagnostic testing, rhythm control, a search for identification of AF etiology, and stroke prophylaxis. However, many patients are eligible for safe and effective outpatient management pathways. They are widely used in Canada and other countries but less widely adopted in the United States. In this project, we convened an expert panel to create a practical framework for the process of creating, implementing, and maintaining an outpatient AF pathway for emergency physicians to assess and treat AF patients, safely reduce hospitalization rates, ensure appropriate stroke prophylaxis, and effectively transition patients to longitudinal outpatient treatment settings from the ED and/or observation unit. To support local pathway creation, the panel also reached agreement on a protocol development plan, a sample pathway, consensus recommendations for pathway components, sample pathway metrics, and a structured literature review framework using a modified Delphi technique by a technical expert panel of emergency medicine, cardiology, and other stakeholder groups. 相似文献
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The impact of an appointment‐based medication synchronization programme on chronic medication adherence in an adult community pharmacy population 下载免费PDF全文
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