Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/administración & dosificación , Moringa oleifera/química , Extractos Vegetales/administración & dosificación , Glucemia/análisis , Glucemia/efectos de los fármacos , Ensayos Clínicos Controlados como Asunto , Diabetes Mellitus Tipo 2/sangre , Humanos , Hipoglucemiantes/efectos adversos , Extractos Vegetales/efectos adversos , Resultado del TratamientoRESUMEN
PURPOSE: Randomized controlled trials investigating the efficacy and safety of fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (CDI) are reviewed, and practical issues for pharmacists to consider are discussed. SUMMARY: Eight randomized controlled trials evaluating the use of FMT for recurrent CDI were analyzed. The trials varied in the type of sample (fresh, frozen, lyophilized), route of administration (nasogastric tube, colonoscopy, enema, oral), and comparator agent (different type of FMT, vancomycin). Efficacy rates ranged from 43.8% to 96.2% with FMT, and safety data were relatively similar. With these favorable data, pharmacists are likely to be involved at multiple steps in the delivery of FMT to patients with recurrent CDI, including the procurement, documentation, and administration of various products and patient education. CONCLUSION: FMT is an option for recurrent CDI that is supported by findings of randomized controlled trials, although a preferred method for the delivery remains to be defined. Pharmacists can play an important role in the successful management of patients with recurrent CDI who may benefit from FMT.
Asunto(s)
Clostridioides difficile/aislamiento & purificación , Infecciones por Clostridium/terapia , Trasplante de Microbiota Fecal/métodos , Farmacéuticos/organización & administración , Infecciones por Clostridium/microbiología , Trasplante de Microbiota Fecal/efectos adversos , Humanos , Educación del Paciente como Asunto/organización & administración , Rol Profesional , Ensayos Clínicos Controlados Aleatorios como Asunto , Recurrencia , Recolección de Tejidos y Órganos/métodos , Obtención de Tejidos y Órganos/organización & administración , Resultado del TratamientoAsunto(s)
Fármacos Antiobesidad/farmacología , Garcinia cambogia , Extractos Vegetales/farmacología , Pérdida de Peso/efectos de los fármacos , Animales , Fármacos Antiobesidad/aislamiento & purificación , Fármacos Antiobesidad/uso terapéutico , Ensayos Clínicos como Asunto/métodos , Humanos , Obesidad/diagnóstico , Obesidad/tratamiento farmacológico , Obesidad/metabolismo , Extractos Vegetales/aislamiento & purificación , Extractos Vegetales/uso terapéutico , Pérdida de Peso/fisiologíaAsunto(s)
Síndrome del Colon Irritable/tratamiento farmacológico , Aceites Volátiles/administración & dosificación , Aceites de Plantas/administración & dosificación , Animales , Antieméticos/administración & dosificación , Antieméticos/efectos adversos , Antieméticos/farmacocinética , Ensayos Clínicos como Asunto/métodos , Formas de Dosificación , Enfermedades Gastrointestinales/inducido químicamente , Humanos , Síndrome del Colon Irritable/diagnóstico , Síndrome del Colon Irritable/metabolismo , Mentha piperita , Aceites Volátiles/efectos adversos , Aceites Volátiles/farmacocinética , Aceites de Plantas/efectos adversos , Aceites de Plantas/farmacocinética , Comprimidos Recubiertos , Resultado del TratamientoRESUMEN
This case reports on a patient whose International Normalized Ratio (INR) increased after ingestion of cranberry sauce while stabilized on warfarin. It is followed by a review of the published literature on the potential interaction between the two.An 85-year-old woman on chronic warfarin therapy for atrial fibrillation experienced INR elevations of two- to three-fold after two separate ingestions of cranberry sauce. In each case, her INR values decreased after withholding three to four doses and resuming a similar maintenance dose of warfarin. Although the majority of the pharmacokinetic and pharmacodynamic studies did not find a significant interaction between cranberry and warfarin, several case reports indicate that cranberry products may increase INR values in patients on warfarin. Practitioners should consider cranberry usage as a potential contributor in the evaluation of supratherapeutic INR values in patients on warfarin.