Clinical Pharmacy Articles

Objectives: To evaluate costs of medication administration of capsule-versus-tablet dilutions in long-term care facilities.
Design: Time study in an idealized long-term care environment.

Setting: A 180-bed long-term care facility.

Subjects: Nurses who were experienced in preparing medication dilutions for residents with mild difficulties in swallowing but who were alert and oriented.

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ACT ’s editor emulates public radio with an “encore presentation”

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As I surfed the Web this past month I came across an article titled “Naval Center Halts Research During Inquiry About Ethics” that appeared in the New York Times o­nline several weeks ago. Apparently the National Naval Medical Center suspended all orthopedic and radiology research o­n patients in September while it investigates a violation of standard ethical practice.

Applied Clinical Trials, Sep 1, 2002

The aim of this study was to investigate the excretion of irinotecan hydrochloride (CPT-11) and its metabolites into the gastrointestinal lumen via the biliary route after intravenous administration of lactone and carboxylate forms of CPT-11. METHODS: Biliary excretions of CPT-11 and its metabolites, SN-38 and SN-38-glucuronide, were investigated by an in vivo administration study using rats. The biliary excretion profiles for both the lactone and carboxylate forms of CPT-11 and its metabolites were determined. RESULTS: After the i.v. injection of the lactone form of CPT-11, the cumulative biliary excretion of SN-38-glucuronide was much greater than that of CPT-11 and SN-38, and biliary excretion of SN-38 was less than that of CPT-11. Further, CPT-11 and SN-38 were mainly excreted into bile as carboxylate forms.

Ignazio Di Giovanna and Gareth Hayes, Eds.

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Now that FDA is enforcing its Electronic Records, Electronic Signatures rule many pharmaceutical companies are reconsidering their data systems.

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The tables are being turned o­n our interviewer, Bob Leach. Here, Ian Harrison, health care consultant, speaks to him about his wide-ranging experience in pharmacyBob Leach's career spans a 40-year period, during which he has practised in several areas of pharmacy. During this time, he adapted well to each change in health care organisation. Younger pharmacists should find much from this interview to encourage them in their career development and survival strategies.Ian Harrison: Bob, many hospital pharmacy managers probably know you as the editor of Pharmacy Management. How did you get involved in editorial work?Bob Leach: I was invited to join the editorial board of Pharmacy Management from its inception in 1985 and, apart from the first o­ne, I have edited every edition to date.

Background: Among the various markers of myocardial injury, CK-MB subforms MB2, MB1 and their ratio (CKMBS) have been reported to be the most sensitive early marker of acute myocardial infarction. Hypothesis: The aim of this study was to determine if CKMBS is superior to troponin I in the prediction of major cardiac events in patients with acute coronary syndromes. Methods: The prognostic values of CKMBS and troponin I were compared in 100 consecutive patients with acute coronary syndromes. CKMBS and troponin I were measured o­n arrival to the emergency room and if the duration of chest pain was < 8 hours, a second measurement was done 8 hours later. In addition, CK-MB was measured every 8 hours for 24 hours.



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In this article an overview is given of the role therapeutic drug monitoring (TDM) can play inthe prevention of adverse drug reactions (ADR). Future developments are also discussed.Finally, this clinical service is placed in the light of healthcare economy and outcomes studies.It is shown that TDM has a clinically relevant role in the prevention of ADR. Also there isevidence that TDM has both economic and non-economic benefits.

KEY WORDS: Therapeutic drug monitoring, adverse drug reactions, healthcare economy,outcomes research, hospital pharmacy, history.

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