Clinical pharmacy: looking 20 years back... looking 20 years forward.
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Biomedical subjects
Publications and source records attributed to M A Koda-Kimble.
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In 1985, investigators reported that four months of pentoxifylline therapy resulted in a significant decrease in proteinuria (46 percent reduction) and plasma fibrinogen concentrations (18 percent reduction) in patients with diabetes. Our study evaluated four normotensive patients with diabetes and documented proteinuria who were treated with pentoxifylline 400 mg tid for four months. A consistent decrease in proteinuria (as measured by the urine protein/creatinine ratio) and plasma fibrinogen concentrations was not observed. Therapy with pentoxifylline was discontinued after four months.
The results of a 1982 survey of graduates of the University of California at San Francisco (UCSF) doctor of pharmacy degree program were re-analyzed to explore whether cultural differences between Asian and Caucasian PharmD graduates affected professional practice patterns, attitudes and activities. Of the 732 respondents, 408 (56 percent) were Caucasians and 262 (36 percent) were Asians. Asian females had significantly fewer years of college education before entering pharmacy school and spend significantly fewer hours in the practice of pharmacy or related activities. Caucasians had a slightly higher grade point average than Asians. The mean score on the California State Board of Pharmacy Licensure Examination did not differ between the groups. For their first position following graduation, Asians predominated in operational positions, while Caucasians held clinical positions more frequently. Thirty-eight percent of Caucasians vs. 18 percent of Asians were taking or had completed postgraduate residency or fellowship training. An analysis of current jobs revealed that Asian males had the greatest increase in clinical positions when compared to the first position. Males of both ethnicities made the greatest gains in annual salary and in management positions compared to females.
In response to increasing numbers of women entering pharmacy, a course was developed at the University of California, San Francisco, School of Pharmacy, addressing issues facing women in the profession. Our purpose was to prepare female students for their future careers by discussing career planning and management; the complexities of balancing career and family life; and career commitment. The technique of structured role-model analysis was used to encourage students to seek out, listen to, and learn from successful role-models. This technique enabled students to identify recurrent themes, advice and strategies among successful pharmacists who participated as guest speakers. Students were assisted in formulating their own career plans and developing a strategy for accomplishment. Courses of this type can increase a young woman's sophistication as she enters the profession and enable her to make more intelligent career decisions.
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Graduates of the University of California at San Francisco (UCSF) doctor of pharmacy degree program were surveyed to determine the effect of postgraduate pharmacy residency or fellowship training on the professional outcomes of these graduates. In 1982, a 39-item questionnaire was sent to 1061 UCSF School of Pharmacy alumni who had graduated in the years 1970 through 1981. The survey addressed several issues, including the graduates' general attitudes toward the profession of pharmacy, their practice patterns, and their professional activities. The response rate of the survey was 72%. Of the survey respondents, 30% had completed or were currently involved in a residency or fellowship program. Both postgraduates (PGs) and non-postgraduates (NPGs) indicated an overall satisfaction with life and the pharmacy profession as a whole. A greater fraction of PGs than NPGs worked in the hospital setting and held positions with varied job components (i.e., clinical, managerial, teaching, and operational activities). First-position salaries for both groups were the same regardless of postgraduate training status. Gender, rather than postgraduate status, was the major determinant of annual changes in salary, especially among men PGs. For managers, both men PGs and men NPGs had a greater change in mean salary per year of experience than their women counterparts. Of those graduates who did not hold management positions, men had a greater change in mean salary per year of experience than women. PGs had greater involvement in professional, educational, and publication activities than NPGs, and a smaller percentage of PGs than NPGs left the profession.(ABSTRACT TRUNCATED AT 250 WORDS)
Graduates of the University of California at San Francisco (UCSF) Doctor of Pharmacy program from 1970 to 1981 were surveyed to determine their practice patterns, professional activities, and attitudes toward the profession of pharmacy. Of 1061 surveys mailed in September 1982, 752 (72%) were returned. A majority of respondents indicated that they would choose pharmacy as a profession again if starting over and that they would advise a friend to enter the profession. The private hospital setting was the practice site cited most frequently by respondents. Over one third of practicing pharmacists were actively enrolled in or had completed advanced pharmacy training. California was the practice location for 84% of respondents; only one third indicated that salary was very important or somewhat important in their decision to practice at their current location. A large percentage of respondents were involved in teaching, community service activities, and professional associations. Most entry-level UCSF Pharm.D. graduates are satisfied with their professional status and find opportunities for advancement.
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Many drugs have been reported to interfere with copper-reduction or glucose oxidase tests used to measure urine glucose. However, only a few drugs or drug classes have been well documented to clinically interfere with these tests. The interfering drugs include ascorbic acid, beta-lactam antibiotics (e.g., cephalosporins and penicillins), levodopa, and salicylates. Several other drugs may also interfere with certain urine glucose tests, but the interactions are poorly documented. These drugs include chloral hydrate, hyaluronidase, nalidixic acid, nitrofurantoin, p-aminosalicylic acid, phenazopyridine, probenecid, and X-ray contrast media. Drugs or their metabolites that are strong reducing substances produce false-positive results by the copper-reduction method and false-negative results by the glucose oxidase method. The beta-lactam antibiotics interfere with copper-reduction tests by producing copper compounds of various colors that confuse interpretation of test results. Tables are provided that summarize the drug interferences discussed.
Although the precise events preceding insulin-dependent diabetes mellitus (IDDM, type 1 diabetes) have not yet been elucidated, it is known that IDDM results from a slow, progressive, immune process directed against pancreatic islet beta cells. Disrupting this autoimmune process has been the focus of research aimed at preventing or slowing the disease progression. Technologic advances in predicting the onset and likelihood of developing IDDM have made it possible to study the effects of early immune intervention. The National Institutes of Health recently launched a large-scale, multicenter trial to evaluate the effectiveness of insulin as preventive therapy. Although many different immunosuppressive and immunomodulating agents have been investigated, the use of insulin as a prophylactic agent is a fairly recent concept. Several methods have been used to halt the autoimmune destruction of the pancreas, with animal and human studies serving as the basis for insulin in preventing IDDM.