Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are known to delay gastric emptying, which has raised concerns about their safety during the perioperative period. This systematic review assesses the association between GLP-1RAs exposure and anesthetic-related adverse outcomes in patients undergoing surgery or esophagogastroduodenoscopy (EGD). Methods: In accordance with PRISMA guidelines, we conducted a systematic search of PubMed, Embase, the Cochrane Library, CNKI, WanFang Data, and SinoMed from their inception until August 31, 2025. The search encompassed RCTs and cohort studies that examining the impact of GLP-1RAs on anesthetic risk in patients undergoing surgery or EGD. The primary outcomes were incidence of aspiration events and the presence of residual gastric content (RGC). Two reviewers independently extracted the data, and we conducted the meta-analysis using a random-effects model. Results: A total of 21 cohort studies involving 275,282 patients were included. The meta-analysis indicated that preoperative exposure to GLP-1RAs was associated with a significantly higher risk of RGC compared with non-use (OR 5.11,95% CI 3.67-7.11, P<0.00001, I 2=66%). However, there was no statistically significant difference in the incidence of aspiration events between the two groups (OR 1.03, 95% CI 0.87-1.23, P=0.70, I 2=0%). Conclusion: The use of GLP-1RAs prior to procedures is associated with increased RGC and higher rates of aborted procedures, though not with significantly elevated the risk of aspiration. Our findings inform the preoperative management of GLP-1RAs, supporting discontinuation in elective settings and underscoring the need for prospective studies to strengthen evidence-based guidelines.

Thrombocytopenia can cause substantial morbidity and mortality in critically ill patients. There are multiple etiology factors and various mechanisms associated with thrombocytopenia, of which drug-induced thrombocytopenia (DITP) deserves attention. Herein, we describe a case of severe thrombocytopenia during intensive care unit (ICU) hospitalization that was probable to be associated with vancomycin. In addition, clinical studies evaluating thrombocytopenia caused by vancomycin were systematically reviewed and 6 studies with acceptable quality were included and analyzed. By revealing the process of identifying this case of DITP and reviewing relevant clinical studies, a risk alert of vancomycin related severe hematotoxicity should be focused on.

Malignant hyperthermia (MH) is a rare life-threatening response that triggered by exposure to specific anesthetics commonly used during surgery interventions. Dantrolene is a well-known drug which used as first-line therapy for MH. A 14-year-old Chinese boy with a mutation in RYR1 whose muscle biopsy diagnosis was central core disease (CCD) occurred MH after cervical spine surgery underwent general anesthesia without volatile anesthetics or succinylcholine. The MH crisis treatment workflow was started and intravenous dantrolene was used soon which combined with sequent continuous veno-venous hemofiltration (CVVH) and plasma exchange (PE) therapy. We explored the pharmacokinetics of dantrolene during the treatment and the results showed that a one-compartment model with first-order absorption and elimination was sufficient to characterize dantrolene pharmacokinetics. The clearance estimate for dantrolene was 0.43 mL/(min*kg) and volume of distribution was 0.61 L/kg. The clearance of dantrolene was significantly affected by CVVH and PE.

Antibiotic concentration in pancreas tissue is very important for the treatment of severe acute pancreatitis (SAP) with infection. We report a case of a 44-year-old female with SAP on treatment of vancomycin. The time courses of vancomycin concentration in serum and pancreas tissue of the patient was described. This case demonstrated that it took about 30 minutes for vancomycin to get through from serum to pancreas tissue and about 76% of vancomycin could move into pancreas tissue for SAP patients.

Aim To identify common drug-related problems (DRPs) during pharmaceutical intervention and consultation in an intensive care unit (ICU); to explore the gap between physicians and pharmacists on their understanding of each other’s capabilities and needs. Method A single-center prospective study was conducted in the ICU of a tertiary academic hospital for 21 months. A pharmaceutical care (PC) model was implemented by pharmacy care team, and data was collected during pharmaceutical intervention and consultation. Data analysis was performed on identified DRPs, causes and their relationships. DRPs’ frequency during intervention and consultation was compared. Problem-level descriptive analysis and network analysis were conducted using R 3.6.3. Result Implementation of PC model greatly improved the efficacy of pharmacists in both interventions proposed to solve DRPs (from 13.6 to 20.1 cases per month) and number of patients being closely monitored (from 7.7 to 16.9 per month). Pharmacists identified 427 DRPs during pharmaceutical intervention with primarily adverse drug events (ADEs, 34.7%) and effect of treatment not optimal (25.5%), and 245 DRPs during consultation (mainly ADEs, 58.4%). About three-fifths DRPs were caused by antibiotics. Comparing DRPs identified during pharmaceutical intervention and consultation, physicians consulted pharmacists more on questions related to medication safety, while pharmacists also paid attention to treatment effectiveness being consulted less commonly. Conclusion Implementation of PC model is beneficial in guiding pharmacy practice and improving efficacy especially under limited human resources. Physicians and pharmacists shall continue ensuring drug safety and be familiar with the scope of PC and clinical need for a better cooperation.