Among patients starting warfarin for the first time, daily consultation by a pharmacist significantly decreased the length of hospital stay and the number of patients who received excessive anticoagulation therapy. These findings translate into improved quality of care and potentially significant cost savings.
There is a sufficient amount of fentanyl available for abuse and misuse after 3 days of therapeutic use. Adequate disposal policies currently are not established and need to be implemented.
A mathematical description of the dose-response curve of heparin to the activated coagulation time is applied retrospectively to 20 patients treated with continuous heparin infusion. The adjusted heparin dose was compared with a calculated prediction using the theoretical mathematical model. The main actual dose was 28 U/kg/h, and the mean predicted dose was 25.8 U/kg/h. The correlation coefficient was 0.862 (p3 0.05). These data are used to develop a dosing adjustment chart. Special considerations prior to using the calculation or dosing adjustment chart are discussed. The use of this model may allow the clinician to determine more rapidly a therapeutic heparin dosage than previous empiric approaches.
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