Journal of clinical pharmacy and therapeutics
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Over the last 5-10 years, there has been significant growth in the knowledge and strategies of pain management in children. Investigations are required to discern whether concomitant improvements in clinical practice have occurred. The purpose of this study was to identify the nurses' administration of a traditional analgesic (acetaminophen) with regard to appropriate doses and time intervals. ⋯ The prevalence of pain amongst the children was high both before and after analgesics, indicating that acetaminophen in the doses used did not provide any significant measure of pain relief. Current practice is still not optimal. Educating nurses on the effective use of traditional pain therapies may improve paediatric pain management.
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Case Reports Comparative Study
Clearance of phenytoin and valproic acid is affected by a small body weight reduction in an epileptic obese patient: a case study.
The interaction between clearance of phenytoin, valproic acid, phenobarbital and carbamazepine, and changes in body weight was determined in a 19-year-old obese woman with epilepsy (body weight 93 kg, BMI 36.3 kg/m2). The patient, who was given daily oral doses of 100 mg phenobarbital, 350 mg phenytoin, 800 mg valproic acid and 800 mg carbamazepine over 5 months was hospitalized for obesity treatment. The daily dosage of each drug was held constant during treatment of the obesity. ⋯ Estimation of the pharmacokinetic parameters in each drug was performed by Higuchi's Bayesian program, PEDA Pearson's correlation coefficient (r) between clearance and body weight was calculated for each drug. High positive correlations were found between clearance and body weight for phenytoin (r = 0.800) and valproic acid (r = 0.785), but not for phenobarbital (r = -0.227) and carbamazepine (r = 0.152). Clearance of phenytoin and valproic acid may be potentially affected by small changes in body weight.
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Treatment of psoriasis is rapidly changing with improved understanding of the pathogenesis of the disease. Newer topical preparations such as calcipotriol and immunosuppressive agents such as cyclosporin A and FK506 are having a major impact on the therapy of psoriasis. This article reviews the conventional therapies and newer agents used in the treatment of this common dermatosis.
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The purpose of these investigations was to determine the stability and adsorption behaviour of succinylcholine chloride (SCC) when stored in plastic syringes. Drug degradation was monitored using the USP high-pressure liquid chromatography method. Solutions containing 20 mg/ml of SCC in 5% dextrose, and in normal saline, were studied at 5, 25 and 40 degrees C. ⋯ The manufacturer's recommended expiry period was found to be too conservative. If protected from light, storage at room temperature for up to 3 months can be safely recommended, without significant loss of chemical stability. However, microbiological quality assurance will need to be implemented and an appropriate shelf-life assigned on the basis of both microbiological and chemical stability data.
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Comparative Study
Stability of lorazepam diluted in bacteriostatic water for injection at two temperatures.
Lorazepam is commonly used to produce sedation in infants. As errors may occur with the measurement of small volumes of concentrated drugs, we studied the stability of lorazepam diluted from 4 mg/ml to 1 mg/ml in bacteriostatic water for injection at two temperatures. The diluted lorazepam was stored in 10 glass vials (five at 22 degrees C and five at 4 degrees C). ⋯ Crystals appeared after 4 weeks of storage at 22 degrees C and after 2 weeks of storage at 4 degrees C. At 3 months the mean lorazepam concentration was 6.1% and 7.5% of the original concentration at 22 degrees C and 4 degrees C, respectively. Thus, lorazepam diluted in bacteriostatic water for injection and stored in glass vials is stable for less than 7 days at 22 degrees C and for 7 days at 4 degrees C.