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Electrophoretic Delivery of γ-aminobutyric Acid GABA into Epileptic Focus Prevents Seizures in Mice
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Strategies for Rotation between Gabapentinoids in the Inpatient Setting.

Madison N Irwin1, Kyle Quirk1, Andrea Banner1

  • 1Madison N. Irwin, PharmD is with Department of Pharmacy, Michigan Medicine, Ann Arbor, Michigan, USA and College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA. Kyle Quirk, PharmD is with Department of Pharmacy, Michigan Medicine, Ann Arbor, Michigan, USA, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA and Department of Pharmacy, Ohio State University James Cancer Hospital, Columbus, Ohio, USA. Andrea Banner, BS is in College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA. Kevin Hosseini, PharmD Candidate is in College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA. Michael A. Smith, PharmD, BCPS is with Department of Pharmacy, Michigan Medicine, Ann Arbor, Michigan, USA and College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA.

Journal of Pain & Palliative Care Pharmacotherapy
|February 18, 2021
PubMed
Summary
This summary is machine-generated.

Rotating between gabapentinoids can use direct switch or cross-taper strategies. Both methods are effective for inpatient gabapentinoid rotation, with direct switching showing slightly higher success rates in patients with normal kidney function.

Keywords:
Gabapentingabapentinoid rotationpregabalin

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Pain Management

Background:

  • Limited evidence exists for optimal gabapentinoid rotation strategies.
  • Gabapentinoids are commonly prescribed, necessitating effective switching protocols.

Purpose of the Study:

  • To describe and evaluate direct switch versus cross-taper strategies for gabapentinoid rotation.
  • To assess the success rates and adverse effects of different rotation methods.

Main Methods:

  • Retrospective cohort study of 67 inpatients undergoing gabapentinoid rotation.
  • Comparison of direct switch and cross-taper strategies based on pain scores and adverse events.

Main Results:

  • Direct switch strategy was used in 87% of rotations.
  • Successful rotation rates were 95% for direct switch and 78% for cross-taper.
  • No significant difference in adverse effects between strategies.

Conclusions:

  • Both direct switch and cross-taper strategies appear reasonable for gabapentinoid rotation in inpatients.
  • Direct switch may be more successful in patients with normal renal function (eGFR ≥ 50 mL/min/1.73 m²).