Stephen J Shalansky

Providence Health Care · Pharmacy

The use of complementary and alternative medicine (CAM), including orally administered herbals, botanicals, vitamins, and supplements, may pose a risk to patients on warfarin therapy. To estimate the prevalence of CAM use among patients taking warfarin and evaluate the impact of CAM exposure on the risk of warfarin-related adverse effects. A survey...

British Columbia's central prescription database, PharmaNet, is often used for both clinical and research applications. However, PharmaNet details prescription transactions, not actual medication consumption, resulting in many potential sources of inaccuracy when the information is assumed to reflect population or individual drug utilization. To as...

To identify the health beliefs and patient characteristics associated with medication non-adherence in patients attending a heart failure outpatient clinic. A survey was administered to 350 consenting clinic patients. Questions focused on relevant demographic and clinical characteristics, the Health Belief Model, the Beliefs About Medicines Questio...

Use of oral N-acetylcysteine for preventing radiographic contrast material-induced nephropathy (RCIN) has become widespread, despite conflicting results from clinical trials and meta-analyses. The variability in study results may reflect differences in baseline risks in study patients, hydration regimens, choice of contrast agent, definition of RCI...

Dose and route of administration of N-acetylcysteine are key factors to consider when evaluating whether this agent is effective in preventing radiocontrast induced nephropathy.

The Morisky medication adherence scale is a commonly used adherence screening tool. It is composed of 4 yes/no questions about past medication use patterns and is thus quick and simple to use during drug history interviews. To evaluate the use of the self-reported Morisky score as a screening tool for identifying patients who have been nonadherent...

The diagnosis of heparin-induced thrombocytopenia (HIT) in critically ill patients is complicated by lack of information on the frequency of HIT relative to thrombocytopenia from other causes. In addition, results from HIT diagnostic tests have not been clearly evaluated for clinical utility. In this prospective study, we estimated the frequency of...

Access to new therapies in hospitals depends upon both clinical trial evidence and local Pharmacy and Therapeutics (P&T) committee approval. The process of formulary evaluation by P&T committees is not well-understood. To describe the formulary decision-making process in Canadian hospitals for cardiovascular medications recently made available on t...

Increasing regimen complexity is generally assumed to result in lower medication adherence, but there is conflicting evidence. This study determined the relationship between the number of medications dispensed and adherence with chronic cardiovascular regimens. A survey was administered to 367 patients who had taken an angiotensin-converting enzyme...

To identify independent risk markers for thrombocytopenia in critically ill patients. Prospective, observational study. Eleven-bed intensive care unit-coronary care unit (ICU-CCU) in a community hospital. Three hundred sixty-two consecutive patients meeting inclusion criteria during 1 year. Potential risk marker data were collected on admission to...

To determine the role of growth factors in nonchemotherapy drug-induced agranulocytosis, we reviewed 118 published reports of administration of colony-stimulating factors for the disorder. Main outcomes were total duration of neutropenia and mortality. The mean time to neutrophil recovery was 4.6 +/- 3.2 days and 7.7 +/- 5.1 days in patients with a...

We critically reviewed English-language articles indexed on MEDLINE from 1966-1998 and those cited in indexed articles describing or investigating administration of nitric oxide (NO) in adult respiratory distress syndrome (ARDS). Studies evaluating NO exclusively in the pediatric population and in conditions other than ARDS (chronic obstructive pul...

This study compared the costs and benefits of using propofol/fentanyl versus thiopental/fentanyl for induction of anaesthesia in short procedures. A prospective, cohort trial was conducted in conjunction with a patient survey. The study population included a consecutive sample of American Society of Anaesthesiologists. Class I or II patients who un...

The ability of flumazenil to reverse benzodiazepine-induced respiratory depression is discussed through a review of the relevant literature. Flumazenil has been shown to be effective in reversing benzodiazepine-induced sedation, but its ability to reverse benzodiazepine-induced respiratory depression is controversial. Part of this controversy stems...