Search results for "Intensive Care Medicine"
showing 10 items of 2228 documents
Asthma Control: The Right Inhaler for the Right Patient
2015
Inhaled therapy is the cornerstone of asthma management in that it optimizes the delivery of the medication to the site of action. The effectiveness of inhaled therapy is affected by the correct choice of the device and proper inhalation technique. In fact, this influences the drug delivery and distribution along the bronchial tree, including the most peripheral airways. In this context, accumulating evidence supports the contribution of small airways in asthma, and these have become an important target of treatment. In reality, the “ideal inhaler” does not exist, and not all inhalers are the same. Advances in technology has highlighted these differences, and have led to the design of new d…
Elección del agente oral más apropiado, en monoterapia o en combinación, en el paciente anciano con diabetes
2010
The elderly patient with diabetes presents a series of features that we need to have in mind when considering drug therapy, such as quality of life, presence of chronic complications, major geriatric syndromes, and patient preferences. The limited evidence available due to the few studies performed in the elderly explains the limited existing recommendations in the most current clinical practice guidelines. Metformin is the drug of choice as monotherapy and its dosage should be adjusted to the degree of renal failure, a situation very common in the elderly. Other pharmacologic groups can also be used taking into account their limitations and contraindications. There is no consensus on what …
Pharmacogenetics and Forensic Toxicology: A New Step towards a Multidisciplinary Approach
2021
Pharmacogenetics analyzes the individual behavior of DNA genes after the administration of a drug. Pharmacogenetic research has been implemented in recent years thanks to the improvement in genome sequencing techniques and molecular genetics. In addition to medical purposes, pharmacogenetics can constitute an important tool for clarifying the interpretation of toxicological data in post-mortem examinations, sometimes crucial for determining the cause and modality of death. The purpose of this systematic literature review is not only to raise awareness among the forensic community concerning pharmacogenetics, but also to provide a workflow for forensic toxicologists to follow in cases of unk…
Drug-related cardiotoxicity for the treatment of haematological malignancies in elderly.
2010
Several publications have focused on the cardiotoxicity of specific classes of haematological therapeutic agents such as antracyclines and cyclofosfamide. Cardiotoxicity of cancer chemotherapeutics is a problem for patients of all ages, but it increases with age. Toxicity can also be developed months after the last chemotherapy dose, and late reactions can be seen years later when they present new-onset cardiomyopathy. No data are available about the cardiotoxicity of non-chemotherapy agents currently used as preferred therapy for haematological malignancy in elderly. In this review we have provided a summary of the cardiovascular toxic effects produced by different drugs and therapeutic ag…
Changing Trends in Drug Prescription and Causes of Treatment Discontinuation of First Biologic Over Ten Years in Psoriasis in the Spanish Biobadaderm…
2020
Background and objectives: Current psoriasis guidelines do not usually include recommendations about first line classical or biologic treatment. The objectives of this study were: to describe shifts in the prescription of the first biological treatment, and to compare treatment withdrawal and rates of adverse events over ten years. Material and methods: Biobadaderm registry was analyzed to describe: first biological prescription in bio-naive patients, adverse events rate and reasons for drug withdrawal comparing three periods of time (2008-2010, 2011-2014, 2015-2018). Results: Anti-TNF drugs were the most prescribed biological drug from 2008 to 2010. Ustekinumab has become the most prescrib…
Herbal Medicines: Boon or Bane for the Human Liver?
2016
Since ages, medicine is the most consistent companion of man. While in primeval time, disease was cured through natural preparations, onset of technology has made today’s formulations synthetic or nature derived. Across the ages, the plausibility of the “savior-turned-slayer” functionality of these drugs remained constant. With the increment in documentation, it becomes evident that many of the commonly used drugs are associated with toxicities. Thus, any drug, irrespective of its origin, needs to be thoroughly assessed. Rampant use of herbal drugs has often been a threat to human health owing to the scarcity in quality assessment. What needs to be understood is that everything natural is n…
Erstellung einer Kompatibilitätstabelle für die intravenöse Pharmakotherapie auf neonatologischen und pädiatrischen Intensivstationen
2007
Background Modern neonatal and pediatric intensive care includes a sophisticated pharmacotherapy with numerous drugs, mainly administered intravenously. Often, despite the use of multi-lumen central venous lines, more peripheral venous accesses are required. To reduce the necessity of numerous venous lines on one hand and on the other hand to avoid complications from incompatibilities of the administered drugs, we compiled a compatibility chart, encompassing more substances than covered in previously available charts. Methods Information on compatibility of commonly prescribed drugs was collected by analysis of manufacturers' information, medical and pharmaceutical handbooks, and a literatu…
Therapeutic Drug Monitoring for Drugs Used in the Treatment of Substance-Related Disorders: Literature Review Using a Therapeutic Drug Monitoring App…
2011
Background The efficacy of drugs for the treatment of substance-related disorders is moderate at best. Therapeutic drug monitoring (TDM) could be an instrument to improve outcomes. Because TDM for most of those drugs is not established, the authors reviewed the literature and built a rating scale to detect the potential added value of TDM for these pharmacologic agents. Methods A literature search was performed for acamprosate, bupropion, buprenorphine, clomethiazole, disulfiram, methadone, naltrexone, and varenicline. The rating scale included 22 items and was divided in five categories: efficacy, toxicity, pharmacokinetics, patient characteristics, and cost-effectiveness. Three reference …
Colorectal cancer: pharmacogenetics support for the correct drug prescription
2019
Pharmacogenetics (PGx) in clinical practice is a tool that the clinician can use to guide, in a personalized way, the most suitable treatment that will be administered to the patient. The objective of this review is to summarize in a practical and accessible rational way, the advances that currently exist for the application of PGx in colorectal cancer chemotherapy management through the study of the patients’ germline polymorphisms. To define the polymorphisms that can be applied, we rely on three fundamental cornerstones: the recommendations of drug regulatory agencies; the implementation guidelines prepared by expert consortia in PGx and information from clinical annotations (the drug/p…
SP0027 Biosimilars: Potential Clinical Differences and European Regulatory Aspects
2014
Although successful drugs, the use of anti-TNFs is limited by their high cost, and in the present climate of economic difficulty, there is pressure to find alternatives that reproduce their effects at a lower price. Due to their large molecular size and structural complexity, anti-TNFs are impossible to duplicate, unlike smaller, chemically-generated compounds, which can be copied. However, unlike generics, biosimilars are similar rather than identical to the original drugs. Determining the level of similarity that guarantees a comparable efficacy and safety represents a new test for the pharmacological market. Biosimilars of smaller biological molecules, such as somatotropin, EPO and GCSF …