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1.
J Infus Nurs ; 40(1): 26-40, 2017 Jan/Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28030480

RESUMO

Infiltration of a vesicant medication, defined as extravasation, may result in significant patient injuries. The first step in preventing extravasation is the identification and recognition of vesicant medications and solutions. Because there is no list of noncytotoxic vesicants as established by a professional organization, the Infusion Nurses Society, as the global authority in infusion nursing, identified the need to address this gap. A task force was formed for the purpose of creating an evidence-based list of noncytotoxic vesicant medications and solutions.


Assuntos
Enfermagem Baseada em Evidências , Irritantes/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos , Humanos , Segurança do Paciente , Soluções
2.
J Infus Nurs ; 39(5): 273-9, 2016 Sep-Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27598066

RESUMO

Venipuncture is generally associated with some degree of pain, discomfort, and/or apprehension. Yet most patients accept it with tolerance, even nonchalance. A few, not only pediatric patients, exhibit a higher degree of anxiety and face the procedure with tears, tension, and a variety of bargaining techniques (ie, stick on the count of 3; use only this vein). But for 1 group of people, venipuncture is associated with such fear that avoidance of the procedure is practiced. The end results are detrimental to the patient and may have an impact on society as well. These are patients the American Psychiatric Association classifies as needle phobic. What can a nurse with no training in psychiatry do to assist these patients? To form an appropriate professional response, it's beneficial for practitioners to recognize the different pathways that lead to needle phobia and the issues related to the disorder.


Assuntos
Agulhas/efeitos adversos , Transtornos Fóbicos/diagnóstico , Anestésicos Locais , Ansiedade/etiologia , Humanos
3.
J Infus Nurs ; 36(1): 26-36, 2013 Jan-Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23271149

RESUMO

Vascular air embolism as a medically induced complication may be associated with numerous treatments and therapies. In infusion therapy, the risk is associated with venous and arterial catheterization as well as various other invasive procedures and much of the equipment used for them. The manner of air entry and the presentation of symptoms may vary greatly. Appropriate treatment options are dependent on air entry routes. Nurses need to be aware of the common and seldom-considered causes of air embolism to be able to guard against this complication, yet adequately support the patient if it occurs.


Assuntos
Embolia Aérea/etiologia , Infusões Intravenosas/efeitos adversos , Adulto , Embolia Aérea/diagnóstico , Embolia Aérea/patologia , Embolia Aérea/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade
4.
J Med Chem ; 55(21): 9208-23, 2012 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-23030502

RESUMO

This report describes the discovery and optimization of a BACE-1 inhibitor series containing an unusual acyl guanidine chemotype that was originally synthesized as part of a 6041-membered solid-phase library. The synthesis of multiple follow-up solid- and solution-phase libraries facilitated the optimization of the original micromolar hit into a single-digit nanomolar BACE-1 inhibitor in both radioligand binding and cell-based functional assay formats. The X-ray structure of representative inhibitors bound to BACE-1 revealed a number of key ligand:protein interactions, including a hydrogen bond between the side chain amide of flap residue Gln73 and the acyl guanidine carbonyl group, and a cation-π interaction between Arg235 and the isothiazole 4-methoxyphenyl substituent. Following subcutaneous administration in rats, an acyl guanidine inhibitor with single-digit nanomolar activity in cells afforded good plasma exposures and a dose-dependent reduction in plasma Aß levels, but poor brain exposure was observed (likely due to Pgp-mediated efflux), and significant reductions in brain Aß levels were not obtained.


Assuntos
Secretases da Proteína Precursora do Amiloide/antagonistas & inibidores , Ácido Aspártico Endopeptidases/antagonistas & inibidores , Guanidinas/síntese química , Bibliotecas de Moléculas Pequenas , Secretases da Proteína Precursora do Amiloide/química , Peptídeos beta-Amiloides/metabolismo , Precursor de Proteína beta-Amiloide/genética , Animais , Ácido Aspártico Endopeptidases/química , Encéfalo/metabolismo , Linhagem Celular , Cristalografia por Raios X , Guanidinas/farmacocinética , Guanidinas/farmacologia , Humanos , Isoxazóis/síntese química , Isoxazóis/farmacocinética , Isoxazóis/farmacologia , Modelos Moleculares , Estrutura Molecular , Mutação , Fragmentos de Peptídeos/metabolismo , Ligação Proteica , Ensaio Radioligante , Ratos , Técnicas de Síntese em Fase Sólida , Soluções , Relação Estrutura-Atividade
5.
J Infus Nurs ; 33(2): 81-8, 2010 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20228645

RESUMO

In the United States, phlebotomies are most often performed for reinfusion of blood to a designated or nondesignated recipient at a later time. These are known, respectively, as autologous or allogenic donations. For a few rare blood disorders, however, phlebotomy is performed as a medical intervention for disease management. These are referred to as therapeutic phlebotomies. Four classifications of blood disorders are discussed here for which symptoms and complications can be managed by the use of therapeutic phlebotomy. The article also offers considerations for setting up a therapeutic phlebotomy program.


Assuntos
Doenças Hematológicas/terapia , Flebotomia , Sangria/história , Hemocromatose/terapia , História do Século XVII , História do Século XVIII , História Antiga , Humanos , Flebotomia/efeitos adversos , Flebotomia/história , Flebotomia/métodos , Flebotomia/enfermagem , Policitemia/terapia , Porfirias/terapia
6.
J Biomol Screen ; 14(5): 476-84, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19483144

RESUMO

Preserving the integrity of the compound collection and providing high-quality materials for drug discovery in an efficient and cost-effective manner are 2 major challenges faced by compound management (CM) at Bristol-Myers Squibb (BMS). The demands on CM include delivering hundreds of thousands of compounds a year to a variety of operations. These operations range from single-compound requests to hit identification support and just-in-time assay plate provision for lead optimization. Support needs for these processes consist of the ability to rapidly provide compounds as solids or solutions in a variety of formats, establishing proper long- and short-term storage conditions and creating appropriate methods for handling concentrated, potent compounds for delivery to sensitive biological assays. A series of experiments evaluating the effects of processing compounds with volatile solvents, storage conditions that can induce freeze/thaw cycles, and the delivery of compounds were performed. This article presents the results of these experiments and how they affect compound integrity and the accuracy of compound management processes.


Assuntos
Bioensaio , Descoberta de Drogas , Estabilidade de Medicamentos , Bioensaio/instrumentação , Bioensaio/métodos , Bioensaio/normas , Descoberta de Drogas/instrumentação , Descoberta de Drogas/métodos , Preparações Farmacêuticas/química , Reprodutibilidade dos Testes
8.
J Infus Nurs ; 30(5): 267-73, 2007 Sep-Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17895805

RESUMO

A review of 50 years of research on catheter tip placement indicates an overwhelming preference for the lower third of the superior vena cava as the appropriate tip location. Despite this evidence, there are still practitioners, physicians, and nurses who advocate tip placement within the axillo-subclavian-innominate vein (also referred to as the midclavicular). This article looks at the arguments presented by practitioners who support midclavicular tip placement. It also reviews some of the research from which the recommendations for superior vena cava placement are derived.


Assuntos
Cateteres de Demora/efeitos adversos , Clavícula , Cateterismo/métodos , Cateterismo/enfermagem , Cateteres de Demora/normas , Coração/efeitos dos fármacos , Humanos , Segurança , Trombose/epidemiologia , Veia Cava Superior
9.
Home Healthc Nurse ; 25(8): 523-31; quiz 532-3, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17828007

RESUMO

Infusion therapy in the home has been common for many years. The therapies appropriate for home infusion are numerous. The type of access device provided for the infusion is an important consideration for safe and effective care. That choice will take into consideration physician and patient preference and length of therapy. However, paramount to this decision are the characteristics of the infusate. It is essential to know the pH and osmolality of the drug as well as its potential vesicant properties. The nurse needs to act as the patient advocate to ensure that proper catheter selection is made. Patient teaching should be aimed at recognition of complications and immediate interventions to avoid problems.


Assuntos
Cateterismo Venoso Central/instrumentação , Cateterismo Periférico/instrumentação , Cateteres de Demora/provisão & distribução , Enfermagem em Saúde Comunitária/métodos , Terapia por Infusões no Domicílio/instrumentação , Seleção de Pacientes , Cateterismo Venoso Central/enfermagem , Cateterismo Periférico/enfermagem , Comportamento de Escolha , Necessidades e Demandas de Serviços de Saúde , Terapia por Infusões no Domicílio/enfermagem , Terapia por Infusões no Domicílio/psicologia , Humanos , Concentração de Íons de Hidrogênio , Papel do Profissional de Enfermagem , Avaliação em Enfermagem/métodos , Concentração Osmolar , Defesa do Paciente , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Soluções
10.
J Med Chem ; 49(23): 6819-32, 2006 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-17154512

RESUMO

2-aminothiazole (1) was discovered as a novel Src family kinase inhibitor template through screening of our internal compound collection. Optimization through successive structure-activity relationship iterations identified analogs 2 (Dasatinib, BMS-354825) and 12m as pan-Src inhibitors with nanomolar to subnanomolar potencies in biochemical and cellular assays. Molecular modeling was used to construct a putative binding model for Lck inhibition by this class of compounds. The framework of key hydrogen-bond interactions proposed by this model was in agreement with the subsequent, published crystal structure of 2 bound to structurally similar Abl kinase. The oral efficacy of this class of inhibitors was demonstrated with 12m in inhibiting the proinflammatory cytokine IL-2 ex vivo in mice (ED50 approximately 5 mg/kg) and in reducing TNF levels in an acute murine model of inflammation (90% inhibition in LPS-induced TNFalpha production when dosed orally at 60 mg/kg, 2 h prior to LPS administration). The oral efficacy of 12m was further demonstrated in a chronic model of adjuvant arthritis in rats with established disease when administered orally at 0.3 and 3 mg/kg twice daily. Dasatinib (2) is currently in clinical trials for the treatment of chronic myelogenous leukemia.


Assuntos
Anti-Inflamatórios não Esteroides/síntese química , Pirimidinas/síntese química , Tiazóis/síntese química , Quinases da Família src/antagonistas & inibidores , Administração Oral , Animais , Anti-Inflamatórios não Esteroides/química , Anti-Inflamatórios não Esteroides/farmacologia , Artrite Experimental/tratamento farmacológico , Proliferação de Células/efeitos dos fármacos , Doença Crônica , Dasatinibe , Feminino , Humanos , Técnicas In Vitro , Inflamação/sangue , Inflamação/induzido quimicamente , Interleucina-2/antagonistas & inibidores , Lipopolissacarídeos , Proteína Tirosina Quinase p56(lck) Linfócito-Específica/antagonistas & inibidores , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Modelos Moleculares , Ligação Proteica , Pirimidinas/química , Pirimidinas/farmacologia , Ratos , Ratos Endogâmicos Lew , Relação Estrutura-Atividade , Linfócitos T/citologia , Linfócitos T/efeitos dos fármacos , Tiazóis/química , Tiazóis/farmacologia , Fator de Necrose Tumoral alfa/metabolismo
11.
J Infus Nurs ; 26(5): 296-303, 2003 Sep-Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14506362

RESUMO

Infusion therapy specialists are recognized for their technical expertise and their knowledge of the anticipated reactions and adverse effects of many complicated therapies. But when asked the rationale for intravenous fluid selection, many infusion nurses can only shrug their shoulders. Although intravenous fluid selection may seem a complex principle, it is really quite simple. Once the flow of body fluids among fluid compartments is understood, it is easy to follow the intended path of IV fluids. But infusion specialists should be cautious of the manner in which IV fluids are categorized prior to infusion (isotonic, hypotonic, and hypertonic) because these are not always consistent with how they react in the body.


Assuntos
Hidratação/métodos , Hidratação/enfermagem , Soluções para Reidratação/administração & dosagem , Humanos , Infusões Intravenosas
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