American journal of hospital pharmacy
-
The use of a nursing-workload-index indicator generated by the Medicus patient classification system was explored as a means of simplifying and validating a manual pharmacy-workload-reporting system. The pharmacy department of this 290-bed hospital monitors 14 activities in its productivity-measurement process. In an effort to validate this process, a 20-week study was conducted to evaluate the relationship between the nursing-workload-index data and the number of hours required to provide pharmaceutical services. ⋯ A significant correlation was found between the nursing index and the number of hours earned for pharmacy activities (with or without hours earned for processing admissions and discharges). Significant correlations were also found when the patient-days indicator was used, but those relationships were not as strong. The nursing-workload-index indicator studied was useful in validating the workload data generated by the pharmacy department.
-
Basic cardiac electrophysiology and how it applies to antiarrhythmic drug therapy are reviewed. Normal impulse propagation through the heart proceeds in sequence from the sinoatrial (SA) node, through the atrial specialized conducting system, the atrioventricular (AV) node, the His-Pur-kinje system, and into the ventricles. The cardiac cell maintains a resting membrane potential until an electrical stimulus depolarizes the cell and generates an action potential. ⋯ The electrophysiology of quinidine, procainamide, disopyramide, lidocaine, tocainide, phenytoin, flecainide, amiodarone, and bretylium tosylate is discussed to detail the relationship between drug action and antiarrhythmic efficacy. The electrophysiologic effects of beta-blocking agents and calcium-channel antagonists are also presented. This basic primer on cardiac electrophysiology should provide the practitioner with an improved understanding of the effects, indications, and limitations of antiarrhythmic drugs.