Author
Grant E. Sklar
Bio: Grant E. Sklar is an academic researcher from National University of Singapore. The author has contributed to research in topics: Drug overdose & Cochrane Library. The author has an hindex of 8, co-authored 13 publications receiving 1204 citations.
Papers
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TL;DR: From the literature review, it would appear that the definition of therapeutic compliance is adequately resolved and the factors related to compliance may be better categorized as “soft” and “hard” factors as the approach in countering their effects may differ.
Abstract: Objective
To explore and evaluate the most common factors causing therapeutic non-compliance.
1,151 citations
TL;DR: Intravenous acetylcysteine should not be used routinely for treatment of non–acetaminophen-induced ALF and further large-scale studies are needed to evaluate clinical outcomes.
Abstract: OBJECTIVETo evaluate the effectiveness of intravenous acetylcysteine in the treatment of non–acetaminophen-induced acute liver failure (ALF).DATA SOURCESA search of MEDLINE (1966–March 2003), International Pharmaceutical Abstracts (1970–2003), and Cochrane Library (2003, issue 3) databases was conducted, using the search terms acetylcysteine, non–acetaminophen-induced hepatic failure, liver failure, intravenous, and treatment.DATA SYNTHESISAll of the studies found were small and do not provide conclusive evidence that acetylcysteine benefits this subgroup of patients. Microvascular regional benefits were seen, but clinical outcomes have not been studied.CONCLUSIONIntravenous acetylcysteine should not be used routinely for treatment of non–acetaminophen-induced ALF. Further large-scale studies are needed to evaluate clinical outcomes.
62 citations
TL;DR: OPAT is a viable alternative to inpatient care as it is safe, effective and results in lower daily costs, and the trend to longer treatment courses is worthy of further review.
50 citations
TL;DR: Quinidine concentrations should be monitored and patients should be assessed for signs and symptoms of quinidine toxicity, and clinicians should be aware of this potential interaction with ciprofloxacin and metronidazole.
Abstract: OBJECTIVE:To discuss a potential pharmacokinetic interaction between quinidine, ciprofloxacin, and metronidazole.CASE SUMMARY:A 51-year-old black woman was admitted for shortness of breath, abdominal pain, and atrial fibrillation. Procainamide and diltiazem were begun for the atrial fibrillation and ciprofloxacin and metronidazole for suspected diverticulitis. The therapy was switched to quinidine on day 5 because of adverse events associated with procainamide. A trough serum quinidine concentration (SQC) on day 7 was 6.3 μg/mL (normal 2–5) with normal QT and QTc intervals. On day 8, the patient was discharged in normal sinus rhythm. She took her last doses of antibiotics on day 15 and a follow-up SQC on day 18 was 2.3 μg/mL.DISCUSSION:The possible explanations for the changes in SQCs include: (1) laboratory error, (2) compliance with medication regimen, and (3) altered hepatic metabolism. The first two are not likely in this case. The laboratory verified the elevated SQC and the patient had her prescript...
37 citations
TL;DR: Most pharmacists in Singapore use reference texts when searching for general DI, and they find these texts more comprehensive and trustworthy than other available sources.
Abstract: Background:Given the rate at which new medications are introduced to the market, as well as the diversity of existing drugs, pharmacists frequently need to consult drug information (Dl) sources. Currently, there is a lack of information about pharmacists' needs for and sources of DI in Singapore.Objective:To examine where practicing pharmacists in Singapore usually obtain DI and how useful and satisfactory the source is to pharmacists and to determine the kind of drug-related questions pharmacists usually receive.Methods:An online survey was sent to registered hospital and community pharmacists who were members of the Pharmaceutical Society of Singapore. The survey consisted of questions about the pharmacists' demographics, what DI source they used most often, their satisfaction with that DI source, and how frequently they received various DI questions.Results:A total of 156 pharmacists responded to the survey, for a response rate of 27.4%. The majority (82.7%) of the respondents chose reference texts as ...
25 citations
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01 Jan 1999
TL;DR: It’s time to get used to the idea that words can have meanings.
Abstract: 《Ｏｘｆｏｒｄ Ａｄｖａｎｃｅｄ Ｌｅａｒｎｅｒ’ｓ Ｄｉｃｔｉｏｎａｒｙ ｏｆ Ｃｕｒｒｅｎｔ Ｅｎｇｌｉｓｈ》（ 以下简称ＯＡＬＤ） 是英语学习词典的先驱。它是第一部既重视词语释义，又重视词法、句法，配有大量例证的词典。我国英语学习者对其第二、三、四版（ 英汉双解版） 都十分熟悉。１９９５ 年，ＯＡＬＤ 第五次修订再版，又有了新的特色，但仍有不足
1,874 citations
Journal Article•
TL;DR: A defect in an enzyme called glucose-6-phosphate dehydrogenase causes red blood cells to break down prematurely, which results in the destruction ofRed blood cells, which carry oxygen from the lungs to tissues throughout the body.
Abstract: Glucose-6-phosphate dehydrogenase deficiency is a genetic disorder that occurs almost exclusively in males. This condition mainly affects red blood cells, which carry oxygen from the lungs to tissues throughout the body. In affected individuals, a defect in an enzyme called glucose-6-phosphate dehydrogenase causes red blood cells to break down prematurely. This destruction of red blood cells is called hemolysis.
1,006 citations
TL;DR: Of the more than 30 human isoenzymes identified to date, the major ones responsible for drug metabolism include CYP3A4, CYP1A2, and the CYP2C subfamily.
Abstract: Recent technologies have resulted in an explosion of information concerning the cytochrome P-450 isoenzymes and increased awareness of life-threatening interactions with such commonly prescribed drugs as cisapride and some antihistamines. Knowledge of the substrates, inhibitors, and inducers of these enzymes assists in predicting clinically significant drug interactions. In addition to inhibition and induction, microsomal drug metabolism is affected by genetic polymorphisms, age, nutrition, hepatic disease, and endogenous chemicals. Of the more than 30 human isoenzymes identified to date, the major ones responsible for drug metabolism include CYP3A4, CYP2D6, CYP1A2, and the CYP2C subfamily.
585 citations
University of Texas Southwestern Medical Center1, University of California, Davis2, University of Michigan3, Virginia Commonwealth University4, University of Washington5, University of California, San Francisco6, Baylor University Medical Center7, University of Nebraska Omaha8, National Institutes of Health9
TL;DR: Intravenous NAC improves transplant-free survival in patients with early stage non-acetaminophen-related acute liver failure and typically require emergency liver transplantation.
529 citations
TL;DR: The benefit of the incorporation of mucoadhesive polymers into the structure of these innovative pharmaceutical products to prolong their residence time in the administration site and the release of the drug cargo will be discussed with focus in the developments of the last decade.
388 citations