American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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Am J Health Syst Pharm · Jan 2000
Lack of latex allergen contamination of solutions withdrawn from vials with natural rubber stoppers.
The effect on latex allergen contamination and microbial growth of a latex-allergy precaution technique for preparing injectable products was studied. The study consisted of three parts: (1) preparation of 20 samples from vials with latex-containing stoppers in accordance with conventional guidelines, (2) preparation of 20 samples in accordance with latex-allergy precaution guidelines, and (3) preparation of 5 latex-free samples and 1 latex-contaminated sample as negative and positive controls, respectively. The conventional method involved swabbing a vial top with an alcohol prep pad, puncturing the dry natural rubber stopper with an 18-gauge needle attached to a latex-free syringe, and withdrawing the contents of the vial into the syringe. ⋯ None of the samples prepared with the standard method supported any microbial growth. One sample prepared with the latex-allergy precaution method grew bacteria. Removal of the dry rubber stopper from vials did not yield solutions with less latex allergen than solutions prepared according to conventional guidelines.
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Am J Health Syst Pharm · Dec 1999
Toxicology cart for stocking sufficient supplies of poisoning antidotes.
Within a three-month period, the University of New Mexico Health Sciences Center (UNMHSC) encountered three toxicological emergencies in which antidotes were either unavailable or inadequately stocked. Patient A was a patient with ethylene glycol intoxication. The emergency department (ED) physician ordered a 10% ethanol infusion. ⋯ In each of these three cases, it was necessary to compound the required medication or to obtain it from other local facilities. These cases underscore the need for pharmacies to stock adequate amounts of poisoning antidotes in one immediately accessible location. A similar problem with understocking of poisoning antidotes exists throughout the United States.
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Am J Health Syst Pharm · Dec 1999
ReviewPractical, reliable, comprehensive method for characterizing pharmacists' clinical activities.
A method for rating the value of pharmacists' clinical services was studied. An instrument was developed to measure the severity of medication errors and the value of pharmacists' clinical interventions. Pharmacists at a hospital pharmacy department used the instrument at the time they made an intervention. ⋯ Services can be identified as high value even when there are no prescribing errors. Pharmacists found the instrument usable and practical. A literature-based instrument for simultaneously assessing the severity of errors in medication orders and the value of pharmacists' interventions was constructed, tested in a hospital, and determined to be reliable.
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Am J Health Syst Pharm · Dec 1999
ReviewUse of proton-pump inhibitors in complicated ulcer disease and upper gastrointestinal tract bleeding.
The use of proton-pump inhibitors in the management of complicated peptic ulcer disease and upper gastrointestinal bleeding is described. Treatment of peptic ulcers in patients who are Helicobacter pylori positive should include antimicrobial therapy to eradicate the infection; based on considerations of primary antimicrobial resistance and safety, one recommended regimen is the combination of a proton-pump inhibitor (lansoprazole 30 mg or omeprazole 20 mg), clarithromycin 500 mg, and amoxicillin 1 g, each twice daily for 14 days. The proportion of H. pylori-negative ulcers has increased in the United States, now accounting for 39% of patients with ulcers who report no intake of nonsteroidal anti-inflammatory drugs (NSAIDs). ⋯ Preliminary data suggest a role for proton-pump inhibitors in the prevention of stress ulcers among critically ill patients. Proton-pump inhibitors play an important role in the treatment of both H. pylori-negative and H. pylori-positive peptic ulcers, as well as in upper gastrointestinal tract bleeding. Further study is needed regarding their role in preventing stress ulcers in critically ill patients.
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Am J Health Syst Pharm · Nov 1999
Stability of levofloxacin in an extemporaneously compounded oral liquid.
The stability of levofloxacin in an extemporaneously compounded oral liquid was studied. A suspension of levofloxacin 50 mg/mL was prepared from commercially available 500-mg levofloxacin tablets and equal amounts of Ora-Plus and Strawberry Syrup, NF, to make a final volume of 60 mL. Six identical volumes of the suspension were prepared in amber plastic prescription bottles. ⋯ At least 99% of the initial levofloxacin concentration remained in all samples throughout the study period. The color, odor, and pH of all the samples did not change appreciably. An extemporaneously compounded oral liquid formulation of levofloxacin 50 mg/mL in a 1:1 mixture of Ora-Plus and Strawberry Syrup, NF, was stable at 23-25 or 3-5 degrees C for up to 57 days.