Journal of clinical and hospital pharmacy最新文献

Isosorbide dinitrate is shown to be absorbed onto PVC bags and administration sets, resulting in a fall in potency to about 70-80% of its initial value in the first 15-30 min of an i.v. infusion. The drug was not absorbed by glass or polypropylene.

A sensitive and rapid high performance liquid chromatographic method was developed for the determination of Cyclosporin A in plasma. Cyclosporin A was isolated from methanol-precipitated plasma using miniature compressed silica reverse-phase columns (Sep-Paks). In the method, 1 ml serum is precipitated in 3 ml methanol. After centrifugation 2 ml of supernatant is diluted in 1 ml water and the sample flushed through a washed Sep-Pak. The sample on the miniature column is washed with water and 75% v/v methanol, and Cyclosporin A is eluted in 1 ml methanol. At least 80% of the drug is recovered. Samples are analyzed on a reverse-phase column, the mobile phase is methanol:water (95:5) and detection is conducted at 205 nm. The detection limits were less than 100 ng/ml, but in plasma some interference was observed, especially at concentrations below 1000 ng/ml.

An evaluation of a ward pharmacy service showed: 1. Its introduction led to a 40-50% reduction in errors and ambiguities of prescribing. 2. It assisted in the safe and more effective use of medicines in hospitals. 3. Medical staff particularly valued the safety checking applied to their prescriptions and the patient's total medication profile, and the opportunity of seeking information about drugs. Nursing staff most appreciated the checking and clarifying elements which assisted during the administration of drugs, the promotion of the most effective use of medicines and the opportunity of discussing problems of drug therapy.

Four investigatory procedures are described for the detection of patients with possible adverse drug reactions. These were evaluated using computer data from the Hereford Hospital Prescribing Study. 120 patients receiving Indomethacin were studied from the total data base of 2,852 admissions during 1977. From this study, two of the methods involving the identification of the discontinuation of drug therapies and the prescribing of 'antidotes' seemed to be the most useful. These methods were also applicable to the routine monitoring of prescription sheets by ward pharmacists.

Beta-blockers, originally introduced into clinical practice for the treatment of cardiovascular disorders, are being increasingly advocated in the treatment of diverse neurological and psychiatric conditions. Thus, propranolol and certain other beta-blockers have been shown to be effective, and may be the drugs of choice, in the treatment of benign essential tremor and the prevention of recurrent migraine attacks. These drugs also have a useful role to play in the treatment of anxiety and alcohol withdrawal states, although beta-blockers have not come into general use in these conditions. The action of propranolol and related drugs in these neurological and psychiatric conditions is generally considered to be mediated by blockade of peripheral beta-adrenergic receptors, although other effects, either central or peripheral, may also be involved. The use of beta-blockers in the treatment of psychosis remains controversial. Current evidence does not support the use of propranolol in schizophrenia, but further studies in mania are warranted.

This study aimed to provide data on the characteristics of the drug literature abstracting service 'Inpharma'. Journal coverage, article yield and timeliness for a 3-year period were examined; the reliability and information content of 100 abstracts were also assessed. It was found that although 'Inpharma' is claimed to monitor a very large number of journals, over 98% of the abstracts were from 'core' journals of which there are approximately 350. Over 80% of the abstracts appeared within 4 months of publications of the original and abstracts from some of the American journals were available in the United Kingdom before the relevant primary journal. Sixteen errors were detected in 100 abstracts; five of these were typographical errors and nine deviations in accuracy. The publication is a good 'current awareness tool' but it should not be used where a comprehensive coverage of the literature is required. It is also important that the primary journal is consulted when detailed information is required.

This study consisted of a comparison of the release rates of six commercial brands of prolonged-release vincamine. The pH of the dissolution medium was found to be highly significant. Due to the low solubility of vincamine in media close to the neutral point, all of the preparations tested, with the exception of one, showed highly variable release curves under the three pH conditions chosen.

The development of a rational and comprehensive training scheme for preregistration graduate pharmacists in a metropolitan health region is described. The conceptual basis is an analysis of requirements of the training in terms of training theory, supported by detailed surveys. These are applied to produce an integrated scheme involving: a practical checklist, study days; self-assessment; monitoring, assessment and appraisal; and the training of responsible pharmacists.