Very low birth weight and other critically ill neonates require prolonged vascular access, which is achieved in current practice with central venous catheters. The initiation of adequate parenteral nutrition and prolonged intravenous medications represent the most important applications. Central vascular access in neonates is associated with a high risk for mechanical, infectious and thrombotic...

INTRODUCTION Enteral nutrition (EN) is preferable to parenteral nutrition (PN) in critically ill patients due to a reduction in infectious complications, a decreased stress response with EN compared to PN, maintenance of enterocyte viability and growth, and the promotion of a strong gut mucosal barrier (1). However, considerable controversy exists regarding the role of EN in hypotensive, critic...

As part of a review of substance abuse deaths in Dutchess County, New York, the Dutchess County Medical Examiner's Office identified 3 cases of angiocentric systemic foreign-body granulomatosis discovered at autopsy. Our investigation disclosed that in all 3 cases patients surreptitiously injected crushed oral prescription medication. Of the patients, 2 obtained intravenous access through centr...

❚ Evidence summary The prevalence of migraine headache is 6% among men and 15% to 17% among women. However, no standardized approach exists for the treatment of acute migraine headache. Systematic reviews of randomized controlled trials (RCTs) summarized that oral sumatriptan (Imitrex), Medications collectively referred to as “triptans” (eg, sumatriptan, naratriptan, etc) have been shown to be ...

The response to severe burns is characterized by hypermetabolism (the most hypermetabolic existing model of aggression) and hypercatabolism, with a high degree of destruction of the skeletal musculature. Metabolic disorders are most evident in the first two weeks after the burn, although they can be prolonged in direct relation to the complications that these patients develop. Nutritional-metab...

Background Acute migraine headaches can last from 4 hours to 3 days if untreated. Migraines often require bed rest, pain medications, and time off from work and other activities, thus reducing an individual’s productivity and quality of life. Seven percent of U.S. migraine patients reported using an ED or urgent care center for treatment within the previous 12 months. Of patients who use an ED ...

Adult patients undergoing hematopoietic cell transplantation (HCT) vary widely in terms of their requirement for nutrition intervention and assessment of nutrient needs. Multiple factors throughout the HCT process impact nutritional status and the need for nutrition intervention such as type of conditioning regimen, degree of regimen-related toxicity, infection and graft-versus-host disease (GV...

Advances in intrathecal analgesia and intrathecal drug delivery systems have allowed for a range of medications to be used in the control of pain and spasticity. This technique allows for reduced medication doses that can decrease the side effects typically associated with oral or parenteral drug delivery. Recent expert panel consensus guidelines have provided care paths in the treatment of noc...

Pharmaceutical companies are manufacturers of both solid and liquid formulations. Solid formulations may be tablets, dry powers, confectionary and solid injectables; liquid formulations may be eye drops, ointments, I.V. and other parenteral solutions. Parenteral solutions are packed as large volume parenteral (LVP) solutions, small volume parenteral (SVP) solutions and dry powders requiring rec...