https://rapm.bmj.com/content/rapm/43/3/225.full.pdf

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications: Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of Pain

The purpose of this update of the European Society of Anaesthesiology (ESA) guidelines on the pre-operative evaluation of the adult undergoing noncardiac surgery is to present recommendations based on the available relevant clinical evidence. Well performed randomised studies on the topic are limite

Pre-operative evaluation of adults undergoing elective noncardiac surgery: Updated guideline from the European Society of Anaesthesiology.

This article provides an overview of the clinical evidence of interactions between herbal and conventional medicines. Herbs involved in drug interactions – or that have been evaluated in pharmacokinet

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Interactions between Herbs and Conventional Drugs: Overview of the Clinical Data

Enabling Medication Management Through Health Information Technology

Background: Diseases caused by bacteria remain a major challenge globally and particularly in sub-Saharan Africa. The plants used in this study have been used in South Africa to treat helminth infections in livestock and humans. In a previous study we found a correlation between antifungal and anthelmintic activity in some cases. In this study we examined other potential uses of these thirteen plant species by determining the antibacterial and antioxidant activity of the leaf acetone extracts. The antibacterial activity was determined by using a serial microdilution method against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Enterococcus faecalis. Bioautography was used to determine the number of antibacterial compounds. The antioxidant activity was determined using the ABTS and DPPH methods. Results: Maesa lanceolata and Leucosidea sericea with an MIC of 0.02 mg/ml had excellent antibacterial activity against Enterococcus faecalis and Pseudomonas aeruginosa. There was a poor correlation between antioxidant activity and antibacterial activity with R 2 = 0.143. This is because antibacterial activity is mainly related to non-polar compounds and antioxidant activity to polar compounds. Maesa lanceolata extracts had a low cytotoxicity with a selectivity index of 5.2, 2.6, 2.6 and 1.3 for P. aeruginosa, E. faecalis, E. coli and S. aureus respectively. Strychnos mitis extracts had a therapeutic index of 1.1 for E. coli. Conclusions: This study shows that plant extracts of some species used in ethnoveterinary medicine as anthelmintic may also have excellent antibacterial activity.

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The antibacterial activity, antioxidant activity and selectivity index of leaf extracts of thirteen South African tree species used in ethnoveterinary medicine to treat helminth infections

Medication Reconciliation and Medication Safety are two themes emphasized in a variety of healthcare organizations. As a result, health care facilities have established methods for obtaining a patient's medication history. However, these methods may vary among institutions or even among the health care professionals in a single institution, and studies have shown that patients are reluctant to disclose their complementary and alternative medicine use to any health care professional. This lack of disclosure is important in surgical patients because of potential herbal interactions with medications and drugs used during the surgical procedure; and the potential for adverse reactions including effects on coagulation, blood pressure, sedation, electrolytes or diuresis. Therefore, the objectives of this study are to identify patterns of natural product use, to identify potential complications among patients scheduled for surgery, to improve existing medication reconciliation efforts, and to develop discontinuation guidelines for the use of these products prior to surgery. A retrospective review of surgery patients presenting to the Anesthesia Preoperative Evaluation Clinic (APEC) at the University of Kansas Hospital was conducted to identify the prevalence of natural product use. The following data was collected: patient age; gender; allergy information; date of medication history; number of days prior to surgery; source of medication history; credentials of person obtaining the history; number and name of prescription medications, over-the-counter medications and natural products; and natural product dosage. Following the collection of data and analysis of the most common natural products used, possible complications and interactions were identified, and a protocol regarding the pre-operative use of natural products was developed and implemented. Approximately one-fourth of patients seen in the APEC indicated the use of natural products. Patients taking natural products were significantly older, were more likely to undergo cardiac or chest surgery, and were more likely to be taking more prescription and non-prescription medications (all p < 0.001). Based on the results of this study, it is concluded that there is a need for established guidelines regarding discontinuation of selected natural products prior to surgery and further education is needed concerning the perioperative implications of natural products.

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Evaluation and implications of natural product use in preoperative patients: a retrospective review

Hospital Pharmacy presents this feature to keep pharmacists abreast of new publications in the medical/pharmacy literature. Articles of interest regarding a broad scope of topics are abstracted monthly. Suggestions or comments may be addressed to Flint Russett, St. Claire Regional Medical Center, 222 Medical Circle, Morehead, KY 40351, or e-mail: FSRussett@st-claire.org.

Recent Publications on Medications and Pharmacy

Hospital Pharmacy presents this feature to keep pharmacists abreast of new publications in the medical/pharmacy literature. Articles of interest regarding a broad scope of topics are abstracted monthly.

Flint Russett

Papers

Evaluation and implications of natural product use in preoperative patients: a retrospective review

Recent Publications on Medications and Pharmacy

Hospital Pharmacy Pulse - Recent Publications on Medications and Pharmacy

Multifactorial Approach to Fall Reduction in the Acute Care Setting: A Role for Pharmacists: