Drug intelligence & clinical pharmacy最新文献

{"title":"Cefsulodin","authors":"","doi":"10.32388/7oxg2q","DOIUrl":"https://doi.org/10.32388/7oxg2q","url":null,"abstract":"","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69625618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacoeconomic impact of critically ill surgical patients.","authors":"J F Dasta,&nbsp;D K Armstrong","doi":"10.1177/106002808802201214","DOIUrl":"https://doi.org/10.1177/106002808802201214","url":null,"abstract":"<p><p>Financial information on 131 patients and drug-related information on 176 patients admitted to a surgical intensive care unit (ICU) were prospectively collected. The average stay was nearly five days and patients received 8.6 drugs per day for a total average exposure of 12.2 different drugs. Antibiotics and analgesics were used in over 90 percent of patients. The patients' diagnoses fit into 53 different diagnosis-related groups (DRG). Hospital costs were significantly greater than DRG payment for an average revenue loss of $17,803 per patient. Patients with a primary diagnosis of sepsis had the largest revenue loss, averaging $54,738. One hundred patients were revenue losers. Total hospital stay was statistically longer than DRG-projected length of stay. Pharmacy charges averaged 13.6 percent of total hospital charges. Patients receiving systemic antifungals, triple antibiotics, catecholamines, and total parenteral nutrition had high hospital and pharmacy costs. This study suggests that ICU patients are costly to hospitals and that drug use is expensive. We suggest that increased pharmacy involvement in the care of ICU patients may help curtail escalating drug costs in these patients.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"994-8"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14280930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piroxicam-induced agranulocytosis.","authors":"S García,&nbsp;J Belda,&nbsp;M Linares,&nbsp;A Miguel-Garcia,&nbsp;A Miguel-Sosa,&nbsp;M Navarro,&nbsp;J M Miguel-Borja","doi":"10.1177/106002808802201216","DOIUrl":"https://doi.org/10.1177/106002808802201216","url":null,"abstract":"TO THE EDITOR: The nonsteroidal antiinflammatory drugs are common causes of agranulocytosis. However, agranulocytosis has not been reported as a complication of piroxicam therapy.':\" We report a case of piroxicam-induced agranulocytosis. Our patient was a 65-year-old woman, with a several-year history of arthrosis. Three months before admission, she presented with tonsillitis and was treated with penicillin and erythromycin for one month. After that, she remained asymptomatic, and drugs were discontinued. Tendays before admission, she suffered painful arthrosis, and piroxicam 20 rng/d was administered for three days. She was not taking any other drugs. Twodays before admission, she developed fever and a sore throat due to necrotic ulcerative lesions of oral mucous membranes. On admission, her white cel1 count was 800/mm' (2\"70 neutrophils, 90% lymphocytes, 8% monocytes), hemoglobin was 13.4 g/dl., and platelet count was 255 OOO/mm'. Chest X-ray, electrocardiogram, urinalysis, serum electrolytes, creatinine, and liver enzymes were normal. Urine, blood, and throat cultures obtained on admission were negative. Bone marrow aspiration showed normal red cel1 and platelet production, but only myeloblasts and promyelocytes were found, in the absence of mature myeloidcel1s. Treatment was instituted with cefoxitin, amikacin, and acetaminophen. Within 12days the granulocyte count was 4800/mm' (50\"70 neutrophils, 48% lymphocytes, 2% monocytes), and she wasdischarged. Over two months follow-up, her blood count remained stable and she had no newcomplaints or problems. The risks of agranulocytosis in relation to analgesic drug use were evaluated in the International Agranulocytosis and Aplastic Anemia Study' and revised by Laporte.\" However, piroxicam could not be evaluated because of the small number of cases treated with this drug. This case suggests that piroxicam can cause reversible myelosuppression similar to that seen with other nonnarcotic analgesics.","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"1003"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment: blind peer review of journal articles.","authors":"A F Shaughnessy","doi":"10.1177/106002808802201223","DOIUrl":"https://doi.org/10.1177/106002808802201223","url":null,"abstract":"TOTHE EDITOR:I was surprised by the results of the study by Cleary and Alexander (DICP 1988;22:601-2) which found that less than 20 percent of the medical journals surveyed do not blind reviewers to the source of manuscripts submitted for publication. I admire the integrity of the publisher for choosing to print a paper on this delicate subject. This study raises several issues important to pharmacists. As clinical pharmacy matures as an academic pursuit, increasing pressure is placed on faculty to publish. Although there are several clinically oriented pharmacy journals, there are thousands of medical journals from which to choose when submitting research. Are those medical journals that do not blind reviewers less open (with or without intent) to publication by pharmacists? In their classic study, Peters and Ceci evaluated 12 psychology journals that used non blind review by resubmitting manuscripts that had previously been published in the same journal two years before, changing only the names of the authors and their institutions. Only 2 out of 16 reviewers felt that the previously published but unrecognized papers were suitable for publication.' Would the same thing have happened if medical journals were evaluated and the only alterations were in degree-from M.D. to Pharm.D.? A second concern is that perhaps some papers are published because of the reputation of the authors or institutions, that editors or reviewers let inferior papers \"slide\" if they are submitted from a prestigious researcher or institution. Despite what we would like to think, most health care professionals do not critically evaluate all published studies; we rely on the peer-review system to do that for us. Publication based on reputation rather than the attributes of the work presented is a disturbing thought. It seems to be a fairly easy and inexpensive task to remove the author identification page before sending a manuscript out for review. This measure does not guarantee anonymity, but it is a first step. Medical journals do not simply report on medical matters; their editorial decisions help shape the course of medicine. The process of publication is as important as the data published and this process should be made as objective as possible.","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"1006"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SI units in drug therapeutics.","authors":"D C McLeod","doi":"10.1177/106002808802201213","DOIUrl":"https://doi.org/10.1177/106002808802201213","url":null,"abstract":"LE SYSTEME INTERNATIONAL D'UNITES (International System of Units) (SI) has been in existence since 1954. The World Health Organization recommended its adoption in 1977. In the U.S., the Metric Conversion Act passed by Congress in 1975endorsed the use of SI. I Although much of the medical world has changed to this coherent system of metric units, the U.S. has muddled along with the older conventional units, particularly in clinical chemistry and hematology. The major SI change in drug therapeutics is that drug concentrations in body fluids are reported in molar terms rather than mass units. In time, even drug doses may be expressed in molar quantities, a change further enlightening drug therapeutics.","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"990-3"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14371093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment: dosing lithium.","authors":"F K Siemsen,&nbsp;D R Pasley","doi":"10.1177/106002808802201220","DOIUrl":"https://doi.org/10.1177/106002808802201220","url":null,"abstract":"TO THE EDITOR: The case report indicating a possible link between controlled-release morphine and dyspnea (DICP 1988;22:397-9) is of interest. The patient's dyspnea mayor may not have been due to controlled-release tablets. What is most unfortunate, however, is the apparent confusion between dyspnea and respiratory depression. The case report includes a long discourse on respiratory depression and even concludes by stating\"... careful consideration of its [controlled-release morphine sulfate's] possible respiratory depressant effects should be made when it is prescribed for elderly patients.\" In fact, there is absolutely no evidence of respiratory depression in this case. The patient's blood gases exhibited an acute respiratory alkalosis secondary to hyperventilation, precisely the opposite of respiratory depression. Furthermore, it is most unfortunate that the author chose to have a long discussion about respiratory depression without noting the extreme rarity of the adverse reaction when morphine is properly titrated in patients with pain. It has been well documented that pain is a powerful antidote to respiratory depression. 1.2 As long as morphine is properly titrated, this adverse reaction is exceedingly rare. This case is not an illustration of this adverse phenomenon. FRANKK. SIEMSEN,B.S. Pharm. DON R. PASLEY, B.S.Pharm. Staff Pharmacists Department ofPharmacy Oregon Health Sciences University Portland, Oregon 97201","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"1005"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically significant diuretic-induced glucose intolerance.","authors":"N K Lowder,&nbsp;H I Bussey,&nbsp;N J Sugarek","doi":"10.1177/106002808802201207","DOIUrl":"https://doi.org/10.1177/106002808802201207","url":null,"abstract":"<p><p>Diuretic-induced glucose intolerance is cited frequently as a problem of only limited clinical significance. In certain populations, such as Mexican-Americans, this effect may be much more dramatic. A 50-year-old obese Mexican-American woman presented with a three-month history of increased thirst and frequent urination. A fasting blood glucose concentration of 365 mg/dL prompted initiation of chlorpropamide therapy. A review of her medical history revealed that a thiazide diuretic was started six months previously. A reduction in thiazide dose and potassium supplementation together with chlorpropamide therapy controlled the patient's blood glucose. Subsequently, all three medications were discontinued, and the patient remained normoglycemic during a full year of follow-up. The temporal relationship between symptomatic diabetes and hydrochlorothiazide therapy incriminates the diuretic as the most probable cause.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"969-72"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ursodiol: a cholesterol gallstone solubilizing agent.","authors":"C L Rosenbaum,&nbsp;R J Cluxton","doi":"10.1177/106002808802201202","DOIUrl":"https://doi.org/10.1177/106002808802201202","url":null,"abstract":"<p><p>Ursodiol, a naturally occurring bile acid, has gained Food and Drug Administration approval for the dissolution of cholesterol gallstones. Ursodiol inhibits hepatic cholesterol synthesis and secretion. Lithocholic acid, a potentially hepatotoxic metabolite of ursodiol and chenodiol, may accumulate to a lesser extent with ursodiol than with chenodiol. Enterohepatic recirculation of ursodiol and its metabolites occurs and is essential to the dissolution of cholesterol gallstones. Complete dissolution has been achieved in 17 percent of patients with noncalcified, radiolucent, floating, cholesterol gallstones. Recurrence of cholesterol gallstones may occur in over one-half of initial responders. Diarrhea reported in up to 50 percent of the patients on chenodiol has been reported in only 4 percent of patients treated with ursodiol. Increased mean aspartate aminotransferase levels to more than twice the pretreatment level seen with chenodiol therapy have not been reported with ursodiol. Reportedly fewer adverse reactions may give ursodiol a major advantage over chenodiol in hospital formulary considerations.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"941-5"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14204497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a patient-completed versus health professional-conducted medication history.","authors":"L M Montpetit,&nbsp;M T Roy","doi":"10.1177/106002808802201206","DOIUrl":"https://doi.org/10.1177/106002808802201206","url":null,"abstract":"<p><p>Medication histories are considered an essential component of clinical pharmacy practice, but they are time-consuming. A study was undertaken to determine how reliable and time-saving a patient-completed medication history form alone could prove to be compared with the amount of information recorded in the medical chart and with a pharmacist-patient form review. Within 24 hours of admission, the patient was given the form to fill out. The pharmacist returned 24 hours later and reviewed the form with the patient. Of 13 questions asked, the form was significantly superior in obtaining information to the chart in 11 and to the review in 6 (p less than 0.05 per question). The review rated better than the chart on all questions (p less than 0.05 per question). The amount of time required to hand out and review the form (mean 7.35 min) was not significantly different from the time required of a pharmacist to conduct a conventional medication history, according to the Canada Workload Measurement Study statistics. It can therefore be concluded that the patient-completed form is not an effective or time-saving method of conducting a medication history.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"964-9"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201206","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment: dyspnea with controlled-release morphine sulfate tablets.","authors":"P D Goldenheim","doi":"10.1177/106002808802201221","DOIUrl":"https://doi.org/10.1177/106002808802201221","url":null,"abstract":"TO THE EDITOR: The case report indicating a possible link between controlled-release morphine and dyspnea (DICP 1988;22:397-9) is of interest. The patient's dyspnea mayor may not have been due to controlled-release tablets. What is most unfortunate, however, is the apparent confusion between dyspnea and respiratory depression. The case report includes a long discourse on respiratory depression and even concludes by stating\"... careful consideration of its [controlled-release morphine sulfate's] possible respiratory depressant effects should be made when it is prescribed for elderly patients.\" In fact, there is absolutely no evidence of respiratory depression in this case. The patient's blood gases exhibited an acute respiratory alkalosis secondary to hyperventilation, precisely the opposite of respiratory depression. Furthermore, it is most unfortunate that the author chose to have a long discussion about respiratory depression without noting the extreme rarity of the adverse reaction when morphine is properly titrated in patients with pain. It has been well documented that pain is a powerful antidote to respiratory depression. 1.2 As long as morphine is properly titrated, this adverse reaction is exceedingly rare. This case is not an illustration of this adverse phenomenon. FRANKK. SIEMSEN,B.S. Pharm. DON R. PASLEY, B.S.Pharm. Staff Pharmacists Department ofPharmacy Oregon Health Sciences University Portland, Oregon 97201","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"1005-6"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}