Drug intelligence & clinical pharmacy最新文献

{"title":"Possible interaction of ranitidine with phenytoin.","authors":"D Bramhall,&nbsp;M Levine","doi":"10.1177/106002808802201210","DOIUrl":"https://doi.org/10.1177/106002808802201210","url":null,"abstract":"<p><p>Clinical and animal studies have shown that cimetidine and ranitidine can inhibit hepatic cytochrome P-450-mediated metabolism of a variety of other drugs. This occurs to a lesser extent with ranitidine than with cimetidine at doses commonly used to treat gastric acid-related disorders. We recently observed a 66-year-old man whose steady-state serum phenytoin concentration increased 40 percent during one month after the addition to his regimen of ranitidine 150 mg bid. Because the ranitidine had been prescribed postsurgically for prophylaxis, it was discontinued and the patient's serum phenytoin concentration declined to the previous steady-state level with no change in dose or other drug therapy. This case indicates that the serum phenytoin concentration should be monitored for the first month after the addition of ranitidine to the regimens of patients on chronic phenytoin therapy. As well, further clinical investigation of factors affecting the interindividual inhibitory action of ranitidine is warranted.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"979-80"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14371091","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":"Phenytoin chronic toxicity and associated psychosis.","authors":"W I Miller","doi":"10.1177/106002808802201218","DOIUrl":"https://doi.org/10.1177/106002808802201218","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":"1003-4"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201218","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370231","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":"Intravenous self-administration of elemental mercury: efficacy of dimercaprol therapy.","authors":"K M Murray,&nbsp;J C Hedgepeth","doi":"10.1177/106002808802201208","DOIUrl":"https://doi.org/10.1177/106002808802201208","url":null,"abstract":"<p><p>Deliberate parenteral self-injection of mercury is extremely rare, and is associated with a high degree of mortality and morbidity. Because mercury depresses cellular enzymatic mechanisms by combining with sulfhydryl groups, soluble mercuric salts are toxic to all cells. Embolization of mercury in the lungs has been reported with varying degrees of changes in pulmonary function. Mercury causes urticaria progressing to weeping dermatitis, leukopenia, anemia, diarrhea, salivation, liver damage, and renal damage progressing to acute renal failure with anuria. Dimercaprol is an effective antidote in acute heavy metal intoxication because its two sulfhydryl groups successfully compete with tissue enzyme sulfhydryl groups for the offending metal. Experience with dimercaprol therapy months after the original exposure to mercury is not available. We describe the hospital course of a patient after intravenous elemental injection and the results of dimercaprol therapy months after the original exposure.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"972-5"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14371089","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":"Profile of prescription medication in a pediatric population.","authors":"J O Olubadewo,&nbsp;A Ikponmwamba","doi":"10.1177/106002808802201215","DOIUrl":"https://doi.org/10.1177/106002808802201215","url":null,"abstract":"<p><p>This retrospective study describes the prescription medication profile in an outpatient pediatric population (n = 510) retrieved from a hospital pharmacy computer file. The survey covers a three-month period. The study population included 281 male and 229 female patients divided according to age into three groups: infant (age 0-12 months); children (age 1-12 years); and adolescents (age 13-18 years). Medications prescribed were classified according to their pharmacotherapeutic properties as described in the American Hospital Formulary Service Drug Information 87. The findings pointed out that three pharmacotherapeutic categories (the antiinfective/chemotherapeutic, central nervous system (CNS), and respiratory agents) constituted 78.1 percent of the 1402 prescribed medications. The most frequently prescribed agents in each of these categories were, respectively, amoxicillin, aminophylline, and acetaminophen. These agents represent recent advances in drug usage because they became most frequently used only within the past ten years. The age-dependent medication profile indicated that there was a higher prescription rate of antiinfectives and respiratory disorder agents in the younger age groups; in the adolescent group CNS agents were more often prescribed.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"999-1002"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14371094","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":"Physicians' review of significant interventions by clinical pharmacists in inpatient care.","authors":"H T Hatoum,&nbsp;R A Hutchinson,&nbsp;L R Elliott,&nbsp;D L Kendzierski","doi":"10.1177/106002808802201211","DOIUrl":"https://doi.org/10.1177/106002808802201211","url":null,"abstract":"<p><p>Clinical pharmacists in this study hospital reported 1027 interventions in patient drug therapy over two time periods of three and two weeks each. When peer-reviewed for clinical significance, 36 of these interventions were deemed significant in terms of saving patients' lives or preserving major organ functions; 983 were judged to improve drug therapy to an acceptable level based on standards of the professional literature (8 recommendations were informational i.e., not clinically significant). These 36 interventions were subjected to an independent, blind review by three practicing physicians who were given the same ranking system for clinical relevance as the one used by the peer reviewers. The physicians independently concurred with the peer reviewers on the two interventions initially ranked as 6 (lifesaving in nature). Of the interventions ranked 5 (preserving major organ functions) by the peer-review group, 53 percent were given a rank of 5 by the physicians. However, the remaining 47 percent were given a rank of 4 (upgrading patient drug therapy to the most appropriate level based on professionally accepted standards). In this era of program evaluation and justification, the process of encouraging other health professionals to review pharmacists' contribution to patient care should not be overlooked.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"980-2"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14371092","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":"Fibrin glue: a review of its preparation, efficacy, and adverse effects as a topical hemostat.","authors":"D F Thompson,&nbsp;N A Letassy,&nbsp;G D Thompson","doi":"10.1177/106002808802201203","DOIUrl":"https://doi.org/10.1177/106002808802201203","url":null,"abstract":"<p><p>Fibrin glue is composed of two separate solutions of fibrinogen and thrombin. When mixed together, these agents mimic the last stages of the clotting cascade to form a fibrin clot. Fibrin glue is available in Europe but is not commercially available in the U.S.; therefore, investigators have extemporaneously compounded their own fibrin glue. Fibrinogen can be obtained from pooled, single-donor, and autologous blood donors and is usually isolated by the process of cryoprecipitation. The thrombin component is generally derived from commercial bovine sources. Some investigators have added calcium chloride and/or antifibrinolytics (i.e., aminocaproic acid, aprotinin) to their preparations. Fibrin glue can be applied using a double-barrel syringe or by spray application. Although fibrin glue has been used in a variety of surgical procedures, it has been especially useful in heparinized patients undergoing cardiovascular procedures requiring extracorporeal circulation, as it does not require an intact hemostatic system to be effective. Fibrin glue also has been evaluated in presealing woven or knitted Dacron vascular grafts. The major drawback to its use is the risk of transmitted serological disease from pooled and single-donor blood donors. The safest preparations use the patient's own blood to prepare fibrin glue. Overall, fibrin glue is a useful adjunct to other methods to control bleeding in selected surgical patients.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"946-52"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13612736","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: pharmacy in India.","authors":"S Guharoy","doi":"10.1177/106002808802201224","DOIUrl":"https://doi.org/10.1177/106002808802201224","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/10.1177/106002808802201224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370236","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":"Comparative human bioavailability study of macrocrystalline nitrofurantoin and two prolonged-action hydroxymethylnitrofurantoin preparations.","authors":"P J Guelen,&nbsp;J B Boerema,&nbsp;T B Vree","doi":"10.1177/106002808802201205","DOIUrl":"https://doi.org/10.1177/106002808802201205","url":null,"abstract":"<p><p>This single-blind crossover study compared the human bioavailability of macrocrystalline nitrofurantoin (Furadantine MC) and two prolonged-action hydroxymethylnitrofurantoin formulations (Urfadyn PL, bid, and Uridurine, tid), based on plasma nitrofurantoin concentrations and urinary nitrofurantoin excretion. The drugs were administered to 16 healthy females for a single day according to the recommended daily dosages. For comparison, Furadantine MC was administered both at the qid dosage recommended by the manufacturer and at tid dosage. Pharmacokinetic parameters determined were maximum plasma concentration after first dose, minimum plasma concentration after first dose, area under the plasma concentration-time curve (AUC), cumulative renal excretion over 30 hours (ARE), overall renal clearance, total body clearance, and bioavailability relative to Furadantine MC qid, based on plasma AUC (F) and ARE (Fren). F for Furadantine MC 100 mg tid was 108 +/- 25 percent (mean +/- SD); for Uridurine 100 mg tid and Urfadyn PL 100 mg bid, F equalled 86 +/- 33 percent and 53 +/- 20 percent (p less than 0.05), respectively. A similar relationship was observed between Fren for Furadantine MC 100 mg qid and the respective Fren of Furadantine MC 100 mg tid, Uridurine 100 mg tid, and Urfadyn PL 100 mg bid. No significant difference was found between the respective F and Fren of each of the drugs studied. Although bioavailability was comparable for Furadantine MC tid and qid, the single-day design of these studies precludes inferring that these dosage schedules are therapeutically equivalent. However, the significantly lower relative bioavailabilities for the prolonged-action hydroxymethylnitrofurantoin formulations suggest that Urfadyn PL 100 mg bid and Uridurine 100 mg tid are not pharmacokinetically equivalent to Furadantine MC.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"959-64"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14370238","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":"Famotidine-associated mental confusion in elderly patients.","authors":"N E Henann,&nbsp;D U Carpenter,&nbsp;S M Janda","doi":"10.1177/106002808802201209","DOIUrl":"https://doi.org/10.1177/106002808802201209","url":null,"abstract":"<p><p>Central nervous system effects, such as mental confusion and hallucinations, have been reported with both cimetidine and ranitidine. Elderly patients with renal or hepatic dysfunction are more susceptible to these adverse reactions. We report two cases of reversible mental confusion in elderly patients with mild renal insufficiency following intravenous famotidine therapy, possibly explained by an increased permeability of the blood-brain barrier in patients with decreased renal function.</p>","PeriodicalId":77709,"journal":{"name":"Drug intelligence & clinical pharmacy","volume":"22 12","pages":"976-8"},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/106002808802201209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14371090","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":"Glyburide and possible Somogyi effect.","authors":"S M Watling,&nbsp;J A Lusk","doi":"10.1177/106002808802201217","DOIUrl":"https://doi.org/10.1177/106002808802201217","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/10.1177/106002808802201217","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14280929","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}