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Trustworthiness and professional ethics. 诚信和职业道德。
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029481
A. Haddad
Earlier this year, Kansas City, Mo., pharmacist Robert Courtney admitted to charges that he had adulterated, tampered with, and mislabeled the chemotherapy drugs Taxol (paclitaxel—Bristol-Myers Squibb) and Gemzar (gemcitabine—Lilly) prescribed for 34 patients with cancer. Courtney pleaded guilty to 20 federal counts in an agreement with the government that avoided a
今年早些时候,密苏里州堪萨斯城的药剂师罗伯特·考特尼(Robert Courtney)承认,他在34名癌症患者的化疗药物紫杉醇(紫杉醇-百时美施惠宝)和吉西他滨-礼来(Gemzar)中掺假、篡改和贴错标签。考特尼在与政府达成的一项协议中承认了20项联邦罪名
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引用次数: 1
Autoimmune rheumatic diseases in women. 女性自身免疫性风湿病
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029599
A. Schuna
OBJECTIVETo review the presenting symptoms, possible complications, treatment options, and reproductive considerations for rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and Sjogren's syndrome.DATA SOURCESArticles retrieved from MEDLINE and OVID using the search terms women and female in combination with autoimmune disease, rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and Sjogren's syndrome. References identified from citations in these articles were also reviewed.DATA SYNTHESISAutoimmune rheumatic diseases are more common in women than in men and are most likely to manifest during the reproductive years. The reasons for this incidence pattern remain unclear but appear to be related to sex hormones and microchimerism. These diseases have varied clinical presentations that may be local or systemic and range from mild to severe. There is no cure for these autoimmune rheumatic diseases; treatments focus on managing symptoms. Many of the agents used for treating these diseases are contraindicated in pregnancy, posing special considerations for women who develop these diseases during their childbearing years.CONCLUSIONKnowledge of the presenting symptoms of, treatment options for, and reproductive considerations with these diseases is important for pharmacists who counsel women with them.
目的回顾类风湿关节炎、系统性红斑狼疮、系统性硬化症和干燥综合征的表现症状、可能的并发症、治疗方案和生殖方面的考虑。数据来源从MEDLINE和OVID检索的文章,检索词为女性和女性合并自身免疫性疾病、类风湿性关节炎、系统性红斑狼疮、系统性硬化症和干燥综合征。还审查了从这些文章的引文中确定的参考文献。自身免疫性风湿病在女性中比在男性中更常见,并且最有可能在生育年龄表现出来。这种发病率模式的原因尚不清楚,但似乎与性激素和微嵌合有关。这些疾病有不同的临床表现,可能是局部的或全身性的,范围从轻微到严重。这些自身免疫性风湿病无法治愈;治疗的重点是控制症状。用于治疗这些疾病的许多药物在怀孕期间是禁忌症,对育龄期间患这些疾病的妇女提出了特殊考虑。结论了解这些疾病的症状、治疗方案和生殖方面的考虑对药师为患有这些疾病的妇女提供咨询是很重要的。
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引用次数: 24
Medicaid managed care prescription use and cost savings. 医疗补助管理医疗处方使用和成本节约。
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029562
T. Shireman, R. Hornung, M. Ho, C. Moomaw, R. Jang
OBJECTIVETo evaluate the impact of Medicaid managed care (MC) enrollment on prescription use and costs.DESIGNRetrospective, cross-sectional analysis of claims submitted over a 6-month period.SETTINGOhio Medicaid.PATIENTS AND OTHER PARTICIPANTSStratified, random selection of 2,932 MC and 1,335 fee-for-service (FFS) recipients.MAIN OUTCOME MEASURESDependent variables were the probability of any prescription use and 6-month prescription counts and costs. Independent variables included age, plan enrollment (MC or FFS), county enrollment status (mandatory or voluntary), presence of a chronic comorbidity, and any outpatient medical visit.RESULTSAfter adjusting for comorbidities and outpatient medical visits, plan enrollment effects depended on age. FFS enrollees 8 to 12 and 12 to 18 years old were less likely (adjusted odds ratios 0.56 and 0.58, respectively) to receive a prescription, while enrollees over 30 years of age were 2.98 times more likely to receive a prescription. Among prescription users, level of use and costs were consistent across all ages for MC enrollees. FFS enrollees had 25% to 218% higher levels of prescription use than MC enrollees, depending on age. Prescription costs were 8% lower for FFS enrollees ages 4 to 8 but higher for all enrollees in other age groups (range, 22% to 311% higher).CONCLUSIONPrescription use and costs were lower for Medicaid MC enrollees than they were for patients in traditional FFS plans. Further research is needed to examine the quality of care for both FFS and MC enrollees.
目的评价医疗补助管理医疗(MC)入组对处方使用和成本的影响。设计对6个月期间提交的索赔进行回顾性、横断面分析。SETTINGOhio医疗补助。患者和其他参与者分层,随机选择2,932名MC和1,335名服务收费(FFS)接受者。主要结局指标:因变量为任何处方使用的概率和6个月的处方计数和费用。独立变量包括年龄、计划登记(MC或FFS)、县登记状况(强制或自愿)、是否存在慢性合并症以及任何门诊就诊。结果调整合并症和门诊就诊后,计划入组效果与年龄有关。8至12岁和12至18岁的FFS参保者获得处方的可能性较低(调整后的比值比分别为0.56和0.58),而30岁以上的参保者获得处方的可能性是其2.98倍。在处方使用者中,MC参保者的使用水平和费用在所有年龄段都是一致的。根据年龄的不同,FFS参保者的处方使用率比MC参保者高25%至218%。4至8岁FFS参保者的处方费用降低了8%,但其他年龄组所有参保者的处方费用较高(范围,高出22%至311%)。结论医疗补助MC计划参保者的处方使用和费用低于传统FFS计划参保者。需要进一步的研究来检查FFS和MC注册者的护理质量。
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引用次数: 2
Time savings associated with dispensing unit-of-use packages. 节省与分配使用单元包装相关的时间。
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029544
E. Lipowski, DeArcy E Campbell, D. Brushwood, Debbie L. Wilson
OBJECTIVESTo determine how much time can be saved with the use of unit-of-use packaging in a community pharmacy, the distribution of work between the pharmacist and the pharmacy technician when unit-of-use packaging is used, and the number of errors that occur when either unit-of-use or bulk packaging is used in dispensing prescriptions.DESIGNA simulation comparing count-and-pour dispensing with unit-of-use package dispensing.SETTINGAn independent community pharmacy.PARTICIPANTSTwo teams, each composed of one pharmacist and one pharmacy technician.INTERVENTIONEach team prepared 50 typical prescription orders, once using unit-of-use packaging and once by transferring medication from a bulk container.MAIN OUTCOME MEASURESTime needed to dispense 50 prescriptions, dispensing activities performed by technicians and pharmacists, and number of dispensing errors.RESULTSThe time saved with unit-of-use packaging compared with count-and-pour dispensing was 46.5 minutes per 100 prescriptions, which represents an average time savings of more than 27 seconds per prescrition. In the bulk package dispensing simulation, the pharmacists assisted in retrieving and counting medication for 26% of the prescriptions. This percentage dropped to 4% when unit-of-use packaging was used because the technicians dispensed prescriptions at a rate that occupied the pharmacist with verifying the prescription orders and dispensed products. Each team committed two counting errors when executing the bulk package trial and no errors when using unit-of-use packaging.CONCLUSIONUnit-of-use packaging can reduce the time needed for and increase the efficiency of pharmacists' dispensing activities. Unit-of-use packaging may also reduce the number of counting errors.
目的了解社区药房使用单件包装可节省多少时间,使用单件包装时药师和药学技术人员的工作分配情况,以及使用单件包装和散装包装配药时发生的差错数量。设计一个模拟,比较计数和浇注点胶与单位使用包装点胶。一个独立的社区药房。参与者分为两组,每组由一名药剂师和一名药学技术人员组成。干预:每个小组准备50个典型的处方单,一次使用单位使用包装,一次从散装容器转移药物。主要观察指标:配发50张处方所需时间、技术人员和药剂师的配发活动、配发错误次数。结果单位使用包装与数灌配药相比,每100张处方节省时间46.5分钟,平均每张处方节省时间27秒以上。在大包装配药模拟中,26%的处方由药师协助提取和计数。当使用单位使用包装时,这一比例下降到4%,因为技术人员分配处方的速度占用了药剂师验证处方单和分配产品的时间。每个团队在执行批量包装试验时犯了两个计数错误,而在使用单元包装时没有错误。结论单件包装可减少药师调剂时间,提高调剂效率。使用单位包装也可以减少计数错误的数量。
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引用次数: 11
American pharmaceutical education, 1952-2002. 美国药学教育,1952-2002。
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029490
R. Buerki
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引用次数: 3
Hyperlipidemia in Native Americans: evaluation of lipid management through a cardiovascular risk reduction program. 美洲原住民的高脂血症:通过心血管风险降低计划对脂质管理的评估。
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029634
Randy Burden, Ritesh N. Kumar, D. Phillips, M. Borrego, J. Galloway
For more than 40 years, cardiovascular disease (CVD) has been the leading cause of death in the United States. However, in the general population, there has been a significant reduction in mortality associated with CVD sincethe mid-1960s. 1 Until recently, CVD was uncommon in Native Americans. Today, CVD has become the leading causeof death in Native Americans, with incidence rates and associated mortality higher than in other U.S. populations. 2,3
40多年来,心血管疾病(CVD)一直是美国人死亡的主要原因。然而,在一般人群中,自20世纪60年代中期以来,与心血管疾病相关的死亡率显著降低。直到最近,心血管疾病在美洲原住民中并不常见。今天,心血管疾病已成为美洲原住民的主要死因,其发病率和相关死亡率高于其他美国人群。2、3
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引用次数: 7
Accuracy of float testing for metered-dose inhaler canisters. 计量吸入器罐浮子试验的准确性。
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029553
T. Brock, Andrea M. Wessell, Dennis Williams, J. Donohue
OBJECTIVETo characterize and evaluate canister floating patterns of three commercially available metered-dose inhalers (MDIs) with varying amounts of medication remaining.DESIGNFour canisters each of three asthma medications were studied. MDIs were actuated every 30 seconds to 60 seconds, and canisters were weighed and floated at 100%, 75%, 66%, 50%, 33%, 25%, 10%, and 0% of remaining labeled actuations. Position of the canisters and percentage submersion in water were recorded.SETTINGControlled laboratory.RESULTSWe observed differences among the products with regard to canister floating behavior at varying levels of fullness. All canisters were completely submerged with the nozzle up at two-thirds full and greater. The canisters remained nozzle-up and were submerged to varying levels at the half-full point. When observed at less than half full, canisters inverted and floated nozzle down. Positions of the canisters varied among products at less than half full. No canister was fully tilted when all labeled actuations were used.CONCLUSIONFloat characteristics are product-specific and a function of canister size, design, content, and method of testing. Clinicians and asthma educators should not advise patients to use a float test to assess the amount of medication remaining in an MDI. Recommendations from the National Asthma Education and Prevention Program of the National Heart, Lung, and Blood Institute suggest that the only reliable method for determining the number of doses remaining in a canister is to subtract the number of doses used from the number available.
目的描述和评价三种市售计量吸入器(MDIs)在不同药物残留量下的浮罐模式。设计研究了三种哮喘药物各四罐。每隔30秒至60秒启动一次mdi,称重并以剩余标记驱动量的100%、75%、66%、50%、33%、25%、10%和0%进行漂浮。记录罐的位置和浸在水中的百分比。SETTINGControlled实验室。结果:我们观察到不同产品在不同饱足程度下的罐漂浮行为的差异。所有的罐子都被完全淹没,喷嘴升到三分之二满或更大。气罐保持喷嘴朝上的状态,在半满时被淹没到不同的高度。当观察到不到半满时,罐子倒置,喷嘴向下浮动。在不到半满的情况下,罐的位置因产品而异。当使用所有标记的驱动器时,没有罐完全倾斜。结论浮剂的特性是产品特有的,与罐的尺寸、设计、含量和检测方法有关。临床医生和哮喘教育者不应该建议患者使用浮动试验来评估MDI中剩余的药物量。国家心脏、肺和血液研究所的国家哮喘教育和预防计划建议,确定药罐中剩余剂量的唯一可靠方法是用可用剂量减去已使用剂量。
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引用次数: 17
Observations of pharmacy practice in the Dmitrov Raion, Russia. 俄罗斯德米特罗夫地区药学实践观察。
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029508
M. Indritz
A pharmacist presents her impressions of a society striving to maintain standards for patient care in turbulent times.
一位药剂师展示了她对社会在动荡时期努力维持病人护理标准的印象。
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引用次数: 4
Safe" considerations: burglary- and fire-resistant devices for the pharmacy. 安全考虑:药房的防盗和防火装置。
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029517
Virgil Van Dusen
Every night, the pharmacist confidently puts her cash and charge receipts, as well as her computer backup tapes, into the safe before setting the alarm and going home. The safe had been purchased second-hand several years ago. It was big, heavy, and obviously very old. The casters beneath it would scarcely turn any more, and the name of the bank in which it had once stood could still be read above the huge door. If a bank used it, the pharmacist reasoned, it has to be a good safe One night, burglars broke into the pharmacy, cracked the safe, and emptied it before police could respond to the alarm call— which was less than 3 minutes after entry was first detected by the security system. What happened? The pharmacist was relying on a safe that was simply no longer adequate for the job. As a result, the pharmacist experienced a roller coaster ride of emotions as she dealt with insurance company representatives, local police, and the Drug Enforcement Administration. And more was lost than costly pharmacy items and several irreplaceable personal items: The pharmacist’s sense of security in her workplace was also sorely compromised.
每天晚上,药剂师都会自信地把她的现金和收费收据,以及她的电脑备份磁带放进保险箱,然后设置闹钟回家。这个保险柜是几年前买的二手货。它又大又重,显然很古老。它下面的脚轮几乎不再转动了,它曾经所在的银行的名字仍然可以在巨大的门上看到。药剂师推断,如果银行使用它,它一定是一个很好的保险柜。一天晚上,窃贼闯入药房,打开保险柜,并在警察对报警电话作出反应之前将其清空——这是在安全系统首次检测到进入后不到3分钟。发生了什么事?药剂师所依赖的保险柜已经完全不能胜任他的工作了。结果,这位药剂师在与保险公司代表、当地警察和缉毒局打交道时,情绪像坐过山车一样起伏不定。损失的不仅仅是昂贵的药品和一些不可替代的个人物品:药剂师在工作场所的安全感也受到严重损害。
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引用次数: 1
APhA's Proposed Name Change and House of Delegates 2002 2002年,APhA提议更名和众议院
Pub Date : 2002-07-01 DOI: 10.1331/108658002763029472
A. Kibbe, V. Prince, Heather R. Ferguson
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引用次数: 0
期刊
Journal of the American Pharmaceutical Association
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