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American journal of hospital pharmacy最新文献

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Compatibility of haloperidol lactate with benztropine mesylate. 乳酸氟哌啶醇与甲磺酸苄托品的配伍性。
Pub Date : 1994-12-01 DOI: 10.1093/AJHP/51.23.2962
C. Jackson, K. Cunningham
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引用次数: 2
New project launched to track antibiotic resistance. 启动追踪抗生素耐药性的新项目。
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引用次数: 0
Proposed safety measures aimed at protecting children from iron poisoning. 提出旨在保护儿童免受铁中毒的安全措施。
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引用次数: 0
Expanded government program for childhood immunizations begins. 扩大的政府儿童免疫计划开始实施。
Pub Date : 1994-12-01 DOI: 10.1093/AJHP/51.23.2874
N. T. Landis
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引用次数: 2
Overview of the New York State program for prescription drug benefits. 概述纽约州处方药福利计划。
Pub Date : 1994-12-01 DOI: 10.1093/AJHP/51.23.2944
E. Lennard, P. Feinberg
New York State's prescription drug benefits program is described. The Empire Plan, a part of the New York State Health Insurance Program, includes a prescription drug benefits program. The prescription drug program began in 1986 and covers more than 700,000 people. In 1988 the state started a therapeutic drug-use-evaluation (DUE) program in correct with the supplier, Health Information Designs, a subsidiary of ValueRx Pharmacy Program. In 1991 the partnership with ValueRx was expanded to include patient profilling and physician education. In 1993 the state implemented a prior-authorization program for certain high-technology drugs, also administered by ValueRx. New York's public work force is heavily unionized, and the unions have been deeply involved in program design and vendor selection. Program participants have access to a large network of community pharmacies. The program also provides mail-order service. Quality is at the center of the state's and the unions' prescription drug program philosophy. Saving money is also a major objective; savings totaling $19.5 million were realized from 1988 through 1993 under the partnership between the state and ValueRx. The Empire Plan's prescription drug benefits program is building quality and saving money by integrating DUE, prior authorization, education, community pharmacy, and mail-order service.
描述了纽约州的处方药福利计划。帝国计划是纽约州健康保险计划的一部分,包括处方药福利计划。处方药项目始于1986年,覆盖了70多万人。1988年,该州与供应商健康信息设计公司(ValueRx Pharmacy program的子公司)共同启动了一项治疗性药物使用评估(DUE)计划。1991年,与ValueRx的合作扩大到包括患者分析和医生教育。1993年,该州对某些高科技药物实施了预先授权计划,同样由ValueRx管理。纽约的公共部门工作人员是高度工会化的,工会一直深入参与项目设计和供应商选择。项目参与者可以使用一个庞大的社区药房网络。该项目还提供邮购服务。质量是州政府和工会处方药项目理念的核心。省钱也是一个主要目标;1988年至1993年,在州政府与ValueRx的合作下,共节省了1,950万美元。帝国计划的处方药福利项目通过整合DUE、事先授权、教育、社区药房和邮购服务来提高质量并节省资金。
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引用次数: 2
Hassle-free documentation of work activities. 工作活动的无障碍文档。
C Aebi
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引用次数: 0
Patient autonomy and drug therapy adherence. 患者自主性和药物治疗依从性。
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引用次数: 0
Antipsychotic drug use in older adults. 老年人抗精神病药物的使用。
C R Zaleon, S K Guthrie

The pharmacology, pharmacokinetics, drug interactions, adverse effects, indications for use, efficacy, dosage, and pattern of use of antipsychotics in adults older than 65 years are reviewed. Most available antipsychotic agents block dopamine type 2 postsynaptic receptors. Antipsychotics also bind to cholinergic, alpha-adrenergic, histamine type 1, and serotonin receptors. The affinities of a given agent for receptors determine its adverse effects and probably its efficacy. There are many obstacles to therapeutic drug monitoring. Many antipsychotics are metabolized into multiple active compounds. Drug clearance from brain tissue may be slower than from plasma. Therapeutic steady-state concentrations are difficult to define. Age-related physiological changes alter the pharmacokinetic and pharmacodynamic characteristics of antipsychotics, placing the elderly adult at heightened risk for adverse effects. Agents that may interact with the antipsychotics include carbamazepine, phenytoin, phenobarbital, tricyclic antidepressants, and lithium. Adverse effects frequently observed in the elderly are orthostatic hypotension, anticholinergic effects, pseudoparkinsonism, and tardive dyskinesia. Neuroleptic malignant syndrome is a rare but potentially fatal reaction. The antipsychotics carry approved labeling for use in treating psychotic disorders; many antipsychotics are approved for use in treating other conditions as well, such as behavioral problems. The Omnibus Budget Reconciliation Act of 1987 established dosage and documentation guidelines for antipsychotic drug use in residents of nursing homes. The guidelines specify that antipsychotics should not be used in this population if the only indication is a problem behavior like wandering. Although antipsychotics are often prescribed for behavioral control in older adults, most studies show only modest efficacy, while some show worsening of symptoms. As-needed orders for antipsychotics are controversial. Antipsychotics can relieve symptoms in the older adult, but lower dosages and more frequent assessments are necessary than for younger adults.

本文综述了65岁以上成人抗精神病药物的药理学、药代动力学、药物相互作用、不良反应、使用适应症、疗效、剂量和使用模式。大多数可用的抗精神病药物阻断多巴胺2型突触后受体。抗精神病药物也与胆碱能、肾上腺素能、组胺1型和血清素受体结合。一种给定的药物对受体的亲和力决定了它的副作用,也可能决定了它的功效。治疗药物监测存在许多障碍。许多抗精神病药物被代谢成多种活性化合物。药物从脑组织的清除可能比从血浆的清除慢。治疗的稳态浓度很难确定。年龄相关的生理变化改变了抗精神病药物的药代动力学和药效学特征,使老年人面临更高的不良反应风险。可能与抗精神病药物相互作用的药物包括卡马西平、苯妥英、苯巴比妥、三环抗抑郁药和锂。在老年人中经常观察到的不良反应是直立性低血压、抗胆碱能作用、假性帕金森病和迟发性运动障碍。抗精神病药恶性综合征是一种罕见但可能致命的反应。抗精神病药物带有治疗精神障碍的批准标签;许多抗精神病药物也被批准用于治疗其他疾病,比如行为问题。1987年的《综合预算和解法案》为养老院居民使用抗精神病药物制定了剂量和文件指南。该指南明确指出,如果这类人群的唯一症状是游荡等问题行为,则不应使用抗精神病药物。虽然抗精神病药物经常被用于老年人的行为控制,但大多数研究显示只有适度的效果,而一些研究显示症状恶化。抗精神病药物的按需处方是有争议的。抗精神病药物可以缓解老年人的症状,但与年轻人相比,需要更低的剂量和更频繁的评估。
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引用次数: 0
Stability of mesalamine in rectal suspension diluted with distilled water. 用蒸馏水稀释直肠悬浮液中美沙拉胺的稳定性。
L M Henderson, C E Johnson, R R Berardi
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引用次数: 0
Metrizamide-ethanol for treatment of symptomatic vascular malformations. 甲胺乙醇治疗症状性血管畸形。
M B Zak, C A Szof, P J Munzenberger
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引用次数: 0
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American journal of hospital pharmacy
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