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 · Nov 2009
Comparative StudyMicrobial contamination of syringes during preparation: the direct influence of environmental cleanliness and risk manipulations on end-product quality.
The direct influence of environmental cleanliness and risk manipulations on prepared syringes was evaluated. ⋯ High contamination rates were measured when the hub of syringes touched nonsterile environmental surfaces and fingers, whereas the drawn-air manipulation was associated with a lower risk of contamination. Working within a properly operating unidirectional airflow primary engineering control in an ISO class 5 cleanroom in accordance with USP chapter 797 requirements was demonstrated to be the best way to avoid bacterial or fungal contamination of injectable drugs directly resulting in patient infections.
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Am J Health Syst Pharm · Nov 2009
Metformin use in renal dysfunction: is a serum creatinine threshold appropriate?
The relationship among metformin use, plasma lactate levels, and lactic acidosis in patients with type 2 diabetes mellitus and the appropriateness of metformin use in patients with renal dysfunction are discussed. ⋯ Current studies point to a weak causal relationship between metformin and lactic acidosis. In patients without comorbid conditions that would predispose them to lactic acidosis, elevated serum creatinine levels should be considered a risk factor for the development of lactic acidosis but not an absolute contraindication.
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Am J Health Syst Pharm · Nov 2009
Effect of a weight-based prescribing method within an electronic health record on prescribing errors.
The effect of a weight-based prescribing method within the electronic health record (EHR) on the rate of prescribing errors was studied. ⋯ An automated weight-based dosing calculator integrated into an EHR system in the outpatient setting significantly reduced medication prescribing errors for antipyretics prescribed to pediatric patients. This effect appeared to be strongest for reducing overdose errors.
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Am J Health Syst Pharm · Nov 2009
Physicochemical stability of oxaliplatin in 5% dextrose injection stored in polyvinyl chloride, polyethylene, and polypropylene infusion bags.
The physicochemical stability of extemporaneous dilutions of oxaliplatin in 5% dextrose injection stored in polyvinyl chloride (PVC), polypropylene, and polyethylene infusion bags was studied. ⋯ Oxaliplatin solutions diluted in 5% dextrose injection to 0.2 and 1.3 mg/mL were stable in PVC and PVC-free infusion bags for at least 14 days at both 4 degrees C and 20 degrees C without regard to light exposure.
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Am J Health Syst Pharm · Nov 2009
Implementing a comprehensive, 24-hour emergency department pharmacy program.
The implementation of a comprehensive, 24-hour emergency department pharmacy program (EDPP) is described. ⋯ A tertiary care teaching hospital successfully implemented a 24-hour, comprehensive ED pharmacy service that enhanced the efficiency and delivery of patient care and resulted in significant cost savings.