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 1997
Stability of tacrolimus in an extemporaneously compounded oral liquid.
The stability of tacrolimus in an extemporaneously compounded oral liquid formulation was studied. A suspension was prepared by mixing the contents of commercially available 5-mg capsules of tacrolimus with equal amounts of Ora-Plus and Simple Syrup, NF, to make a final volume of 60 mL. The final concentration of tacrolimus in the suspension was 0.5 mg/mL. ⋯ At least 98% of the initial tacrolimus concentrations remained in all suspensions throughout the study period. Color, order, and pH did not change appreciably over the study period. Tacrolimus 0.5 mg/mL compounded extemporaneously in equal amounts of Ora-Plus and Simple Syrup, NF, was stable at 24-26 degrees C for at least 56 days in both glass and plastic amber prescription bottles.
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Am J Health Syst Pharm · Dec 1996
Antimicrobials prescribed for otitis media in a pediatric Medicaid population.
Antimicrobial prescribing patterns for Tennessee Medicaid children having their first case of otitis media (OM) in at least nine months were studied. Tennessee Medicaid claims data for patients under 11 years whose first documented OM diagnosis in 1993 occurred in the fourth quarter and who had had an antimicrobial claim filed within two days of diagnosis were studied to determine antimicrobial prescribing patterns. Of 7357 children meeting the study criteria, 70% were less than three years of age, 65% were Caucasian, and 60% had a rural address. ⋯ The savings to the state were estimated at +300,000 or more in 1993 had first-line therapy been used for most first occurrences of OM in all four quarters plus even a small percentage of the estimated 30,000 remaining repeat OM cases. Amoxicillin was prescribed 53% of the time, and all first-line therapies 64% of the time, for children with their first case of OM in at least nine months. In children without recent antimicrobial therapy, URI, or sinusitis, first-line therapy was still used only 72% of the time.
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Fosphenytoin sodium is reviewed, and its safety is compared with that of phenytoin. After i.v. or i.m. injection, fosphenytoin, a phenytoin prodrug, is rapidly hydrolyzed to phenytoin. Free-phenytoin concentrations equivalent to those obtained with i.v. phenytoin can be achieved with fosphenytoin given at equimolar loading doses by selecting the appropriate rate of fosphenytoin administration. ⋯ Intravenous fosphenytoin has been associated with less soft-tissue injury and fewer adverse effects in general than phenytoin. Fosphenytoin, when administered i.m., is completely absorbed, is relatively well tolerated, and provides more predictable serum drug concentrations than i.m. phenytoin. Fosphenytoin offers practical and clinical advantages over i.v. phenytoin.
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Am J Health Syst Pharm · Nov 1996
Stability of thiotepa (lyophilized) in 5% dextrose injection at 4 and 23 degrees C.
The stability of thiotepa (lyophilized) 0.5 and 5 mg/mL in 5% dextrose injection was studied. Vials of lyophilized thiotepa were reconstituted with sterile water for injection to yield a solution with a nominal 10-mg/mL drug concentration. The reconstituted solution was filtered and diluted in 5% dextrose injection in polyvinyl chloride and polyolefin bags to nominal thiotepa concentrations of 0.5 and 5 mg/mL. ⋯ Thiotepa in the 5-mg/mL admixtures was stable for 3 days at 23 degrees C and 14 days at 4 degrees C in both container types. Thiotepa (lyophilized) 0.5 mg/mL in 5% dextrose injection was stable for eight hours at 4 or 23 degrees C. Thiotepa (lyophilized) 5 mg/mL in 5% dextrose injection was stable for 3 days at 23 degrees C and 14 days at 4 degrees C.
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Propofol and thiopentone are physiochemically compatible when mixed.
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