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Stacey Lemus, BS, became a compounding technician in 2000

Dosing Adjustments Patients with mild or moderate liver disease: Starting dose should be reduced to approximately one-third of the usual initial dose (0.625 ng/kg/min of ideal body weight) Requires close monitoring during dose titration Remodulin has not been studied in patients with severe liver disease When to Call Your Doctor Immediately Seek medical attention right away if you experience: Signs of bloodstream infection (IV patients): fever, chills, confusion, rapid heart rate Worsening PAH symptoms: increased shortness of breath, chest pain, fainting, blue lips Signs of bleeding: blood in urine/stool, severe bruising, uncontrolled bleeding Severe hypotension: fainting, severe dizziness, confusion Pump malfunction: any interruption in medication delivery Severe infusion site problems: signs of infection, severe pain requiring narcotics Allergic reactions: difficulty breathing, swelling of face/lips/tongue/throat, severe rash Any symptom that feels severe or life-threatening How to Manage Side Effects Successfully Work Closely with Your Healthcare Team Successful Remodulin therapy requires partnership between you and your healthcare providers

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But when the fires start too frequently or the fire department is understaffed, the damage spreads

Sinclair, L