Biomedical subjects
D D Mar
Publications and source records attributed to D D Mar.
Compatibility of amphotericin B with drugs used to reduce adverse reactions.
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Exacerbation of respiratory failure by paregoric.
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Side effects of ibuprofen.
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Pharmacists as instructors of health education in community colleges.
The public is demanding quality information on the appropriate use of medicinal agents. The pharmacist is a potential source of this information; however, lack of time and appropriate environment often limit this interaction. An educational model has been developed, used, and evaluated in order to increase public knowledge on nonprescription medications, increase pharmacist professional visibility in the community, and provide a practical means of creating this interaction. Using the setting of four California community colleges, consumer education courses were developed during 1972 to 1977. Instructional syllabi, written and audiovisual materials, and evaluations were developed at these colleges by five pharmacists. The courses were presented in an aggregate of 17 semesters to 514 enrollees. Results from objective examination on presented topics showed a mean score increase from 18 to 82% among 62 enrollees. Subjectively, participant response was enthusiastic, with frequent reports of daily usefulness and increased awareness of the pharmacist as a health information resource person. The described model has proven to be an effective means of providing lay persons access to important health care information, while providing pharmacists with an effective means of meeting professional responsibilities, increasing professional visibility in the community, and gaining professional satisfaction.
Optimal dosing of epinephrine in acute asthma.
The safety and efficacy of 0.1-, 0.3- and 0.5-mg doses of epinephrine hydrochloride in the initial treatment of an acute asthma attack were compared in a double-blind study. Epinephrine hydrochloride 1:1000 was injected subcutaneously in 45 emergency room patients suffering from an acute asthma attack. The patients randomly received 0.1, 0.3 or 0.5 mg of the drug. Arterial blood gases, pulmonary function, blood pressure and heart rate were measured before, and at 10 and 20 minutes after dosing. Bronchodilation, as measured by peak expiratory flow rate, occurred at all doses but was significantly greater (p < 0.05) with the 0.5-mg dose than with the 0.1-mg dose (at 10 and 20 minutes) and the 0.3-mg dose (at 20 minutes). Arterial blood gases, heart rate and blood pressure were not significantly different for the three groups (p > 0.05). The study suggests that a 0.5-mg subcantaneous dose represents optimal epinephrine dosing for the initial therapy of acute asthma.
Evaluation of a training program to improve clinical competencies of pharmacists serving skilled nursing facilities.
Forty-eight pharmacists from the New York area were selected for specialized training in consultant clinical services to skilled nursing home facilities. A skills curriculum was developed, and the pharmacists participated in 15 training sessions which included lectures by nationally recognized experts, audiovisual presentations, and on-site clinical workshops. Evaluations were based upon clinical preprogram v. clinical postprogram testing, comparisons with clinical pharmacy experts, and attitudinal pre- and postprogram testing. It was found that the training course did improve the skills of the trainees but they still performed at a level below recognized clinical pharmacy experts. Future programs should stress fewer topics, but in more detail, and should focus upon monitoring techniques, laboratory results, and more on-site experiences.
Reversible oliguric renal failure associated with ibuprofen treatment.
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Improved emergency room medication distribution.
A system developed to improve drug distributions, safety and control in the emergency room of a 400-bed hospital is described. The system centers around the use of a special cabinet containing medication bins which store selected and limited quantities of medications packaged in single-unit containers. A dditionally, intravenous solutions, irrigating solutions, eye tray medications, medications for cardiopulmonary resuscitation and refrigated drugs are kept in areas of ready access. Punched cards containing information on the drug are stored with the medication and are used for billing and reordering purposes. A 24-hour supply of medications that may be dispensed after the pharmacy closes are packaged in prelabeled, zipper-locked plastic bags. The system results in improved safety as well as long-term cost savings.