Information was received from a manufacturer's representative (rep) via a healthcare provider (hcp) regarding a patient with a implantable infusion pump with lioresal (baclofen) concentration 2000 mcg/ml is and dose is 417.5 mcg/day for intractable spasticity.It was reported that the reason for call was for assistance with decreasing a patient's flex dose.The rep stated that the patient is in icu and conference on the icu hcp who is ordering the decrease in the 24 hours dose.The icu physician states that he would like a 15% deduction of the basal rate from 12.4 mcg to 10.5 mcg and a 30% decrease for each step.The patient has three steps at 4 am, 12 pm, and 9 pm that are all 4 minutes and are a dose of 79.9 mcg within 4 minutes.Technical services confirmed that he would like each step to drop to 55.9 mcg and he agreed.The icu hcp ordered this decrease because the patient has been in icu with decrease respirations, decreased blood pressure, decreased respiratory rate, lethargic, and sleeping.The icu physician states that the patient's symptoms occur at near when the flex boluses are administered at 4 am, 12 pm, and 9 pm, so he suspects once they decrease the flex dose that her symptoms will alleviate.24 hour dose went from 534.8 mcg/day to 417.6 mcg/day.Technical services assisted them in programming these changes.
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