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J W Cooper

Publications and source records attributed to J W Cooper.

At least 73 records · Page 4Linked to original sources
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Adverse drug reactions and interactions in a nursing home.

Adverse drug reactions (ADRs) and interactions were the third most common drug-related problem (DRP) found in a two-year study of DRPs in a 72-bed nursing home. Neurotropic drugs followed by antihypertensives, potassium supplements, potassium-sparing diuretics, diuretics, digoxin and nonsteroidal antiinflammatory drugs antacid interactions, and antiinfective rashes accounted for 88 percent (143 of 161) of the adverse reactions and interactions. A number of adverse reactions and interactions. A number of adverse drug reactions and interactions were preventable, in that careful attention to the patient's complete history, problem list, and relative-to-absolute contraindications to drugs should have resulted in drug changes/discontinuances in at least 61 percent (98 of 161) cases. An adverse reaction rate of 9.3 percent (161 of 1,728) drug regimen reviews was found. Adverse drug reaction is defined as any undesirable effect of drug therapy. Drug-drug interaction is a combination of drugs that may result in a beneficial or detrimental effect. For purposes of this study, only drug interactions of a detrimental nature were considered. The prior Legal Briefs column (May/June '85) in this series dealt with drug contra-indications, or the presence of some condition or historical fact in the patient that indicates that a drug should probably-to-absolutely not be used in the patient. This current column deals with the development of undesirable consequences when the prescriber, pharmacist, and those administering the drug may not have been aware of the historical events or predisposing conditions and adverse events occurred.

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Study shows inappropriate drug scheduling.

The study indicated that in one nursing home, problems of inappropriate drug scheduling and administration can commonly occur. If a consultant pharmacist or a provider pharmacist with hospital training schedules the drugs as they should be given, there still is cause for concern--when those orders and schedules are not adhered to in the facility. In the reported study, the consultant, who visited the nursing home monthly, discovered that most problems were due to poor follow-up with the scheduling and intended administration schedule. The PAC survey for medication errors and the federal standards, otherwise known as the indicators for drug monitoring and regimen review, must be followed and monitored by the consultant and provider pharmacists, administrator, director of nursing, and charge nurses-to ensure the safest and most efficacious use of medications. While the study cannot be assumed to be representative of all nursing homes, scheduling and administration of meds are a problem for consideration by nursing home administrators, medical directors, attending physicians, directors of nursing, and pharmacists working in long-term care facilities.

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