Drug intelligence & clinical pharmacy
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Financial information on 131 patients and drug-related information on 176 patients admitted to a surgical intensive care unit (ICU) were prospectively collected. The average stay was nearly five days and patients received 8.6 drugs per day for a total average exposure of 12.2 different drugs. Antibiotics and analgesics were used in over 90 percent of patients. ⋯ Patients receiving systemic antifungals, triple antibiotics, catecholamines, and total parenteral nutrition had high hospital and pharmacy costs. This study suggests that ICU patients are costly to hospitals and that drug use is expensive. We suggest that increased pharmacy involvement in the care of ICU patients may help curtail escalating drug costs in these patients.
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Drug Intell Clin Pharm · Sep 1988
Flow rate variability from selected syringe and mobile infusion pumps.
Alterations in response to pharmacological agents have been attributed to flow rate variation produced by intravenous infusion devices during drug delivery. A wide range of variation has been shown to occur with large-volume infusion devices. The intent of this investigation was to examine flow variation resulting from the use of selected small-volume syringe and mobile infusion devices and determine whether these devices have greater flow continuity than large-volume infusion pumps. ⋯ When compared with large-volume, microrate infusion devices, no significant differences could be observed. Therefore, no clear advantage to delivering drug solutions on a continuous basis can be expected from the use of small-volume devices. Specific infusion devices may be preferable for certain clinical applications; flow continuity data may be valuable when selecting an infusion device.
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Drug Intell Clin Pharm · Jul 1988
Cardiopulmonary resuscitation documentation: a survey of 135 medical centers.
The pharmacist is an active member of the cardiopulmonary resuscitation (CPR) team in many hospitals, dispensing medications, maintaining records, providing drug information, calculating doses, and mixing intravenous fluids. We surveyed 135 emergency department nursing directors across the country to assess the methods of and persons responsible for documentation during CPR. Ninety-five (70 percent) completed surveys were returned, showing that documentations was usually done by a nurse (81 percent), by a nurse and pharmacist (9 percent), by a pharmacist (7 percent), or by others (ward clerks, paramedics, or physicians) (3 percent). ⋯ A majority of respondents (57 percent) felt that an automated recording system would be useful. We conclude that there appears to be considerable variability in the method of documentation of events during CPR in emergency departments throughout the country. Future efforts in emergency care should include the involvement of pharmacists in the development and implementation of a uniform database for use by field and hospital personnel during CPR.
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Adult respiratory distress syndrome (ARDS) culminates in inadequate oxygen delivery to the tissues. There are numerous inciting factors for this syndrome. Several therapies including the prophylactic use of antibiotics and steroids are controversial; even mechanical ventilatory support has controversial elements. The cornerstone of treatment remains supportive care until the cause of ARDS has resolved.