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R J Baptista

Publications and source records attributed to R J Baptista.

28 records · Page 2Linked to original sources
PubMed1985

Stability of cimetidine hydrochloride in a total nutrient admixture.

The stability of cimetidine hydrochloride in a total nutrient admixture was studied. A total nutrient admixture composed of 5% amino acid injection, 20% dextrose injection, and 3% intravenous fat emulsion was prepared aseptically in four 2-L ethylene-vinyl acetate bags. Cimetidine hydrochloride injection was added to three of the admixtures to yield final cimetidine concentrations of 600, 1200, and 1800 mg per 1500 mL of admixture; the fourth admixture served as a control. At 0, 24, and 48 hours, cimetidine content was measured by high-performance liquid chromatography, and the admixtures were tested for pH and visually inspected for signs of creaming, oiling out, or phase separation. Particle-size distribution in the admixtures was compared with that in 20% intravenous fat emulsion. No appreciable changes in cimetidine concentration or pH occurred over 48 hours, and no visual changes were observed. Particle sizes were comparable to those in the 20% intravenous fat emulsion control except in the admixture containing cimetidine hydrochloride 600 mg, which had significantly more particles larger than 9.9 microns at 48 hours. In the total nutrient admixture studied, cimetidine hydrochloride in concentrations up to 1800 mg per 1500 mL was stable for 24 hours at room temperature, and the lipid emulsion was apparently not altered during this period by cimetidine.

Chromatography, High Pressure Liquid↗
PubMed1984

Utilizing selenious acid to reverse selenium deficiency in total parenteral nutrition patients.

The ability of selenious acid to reverse selenium deficiency in eight adult home TPN patients was assessed. Initially, deficiency was documented by comparing both plasma selenium levels in patients (means = 0.035 micrograms/g) to those of 10 controls (means = 0.117 micrograms/g) (p less than 0.001) and by comparing erythrocyte glutathione peroxidase (GSHPx) activity, as mumol NADPH oxidized/g Hb/min, in patients (means = 8.93) to controls (means = 31.76) (p less than 0.002). Subsequently, patients added 100 micrograms/day of selenious acid to their total parenteral nutrition solutions. Postsupplementation selenium status demonstrated a mean plasma level of 0.101 micrograms/g and a mean erythrocyte GSHPx activity of 17.56. Statistically, patients' plasma selenium levels were significantly different (p less than 0.001) when compared to pretreatment levels. Additionally, there was no significant difference between the restored levels and the levels of the controls. Postsupplementation erythrocyte GSHPx activity (means = 17.56) was not significantly different from the initial patient values, although activity did double. Additionally, there existed a significant difference between the postsupplementation enzyme activity and the controls (p less than 0.03). We conclude that selenious acid is able to normalize deficient plasma levels but not deficient erythrocyte GSHPx activity.

Female↗
PubMed1984

Utilizing the clinical pharmacist to modify tobramycin dosage regimens: accuracy of prediction and potential cost effectiveness.

At our institution, tobramycin serum drug assays are reasonably expensive. In an effort to reduce institutional expenses and further rationalize the cost benefits of clinical pharmacy services, we assessed the accuracy of the clinical pharmacist in predicting tobramycin serum levels. Subsequently, physician acceptability of the pharmacist's recommendations for dosage regimen modification was assessed.

Boston↗
PubMed1983

More efficient system for preparing total parenteral nutrient solutions.

An improved system for preparing total parenteral nutrient (TPN) solutions is described. The new system uses a personal computer, a three-station volumetric pump, and empty polyvinyl chloride (PVC) containers. The computer's order-entry screen facilitates data entry by displaying a format similar to the physician's order sheet. After calculating the volumes of i.v. solutions and additives and the total cost of the TPN solution, the computer prints labels containing this information. Using the volumetric pump, the required volumes of crystalline amino acids, dextrose injection, and sterile water for injection are added simultaneously to either one-liter or three-liter PVC containers. Each bag contains the patient's entire daily TPN requirements. Approximately 30 liters of TPN solution are prepared daily by specially trained technicians in a centralized i.v. room. Compared with the previous method of preparing TPN solutions using evacuated one-liter glass bottles, the average time required to prepare and determine the cost of each patient's TPN solutions has decreased from 35 to 21 minutes daily. Total savings resulting from reduced materials and labor costs is approximately $28,240 annually. The new system for preparing TPN solutions is efficient and cost effective.

Drug Compounding↗
PubMedDate not supplied

Suboptimal selenium status in home parenteral nutrition patients with small bowel resections.

The selenium status of 13 adult home parenteral nutrition (HPN) patients was evaluated using 12 healthy adult volunteers as controls. Patients had been maintained on HPN for a mean of 36 months and averaged 121 cm of residual small bowel. Prospective diet surveys in patients indicated a mean oral caloric intake of 902 kcal/day. The mean plasma selenium concentrations (microgram/g) were 0.044 in patients and 0.117 in controls (p less than 0.01). The erythrocyte glutathione peroxidase activities, as mumol of NADPH oxidized/g hemoglobin/min, averaged 11.01 in patients and 31.76 in controls (p less than 0.01). Four patients exhibited myalgic symptomatology suggestive of clinical selenium deficiency. No correlations could be ascertained between plasma selenium levels and glutathione peroxidase activities in either patients or controls. Additionally, in the patient group, no significant correlations could be ascertained between selenium status and oral caloric intake, residual small bowel length, symptomatology suggestive of deficiency or HPN duration. However, since sample size was not large, lack of correlations might best be considered suggestive not conclusive. The data indicate that HPN patients with small bowel resections exhibit suboptimal selenium status and may be at risk of developing clinically evident selenium deficiency. HPN patients should be prophylactically supplemented with selenium regardless of oral intake, duration of HPN, or residual length of resected small bowel.

Adult↗
PubMedDate not supplied

Periodic reassessment for improved, cost-effective care in home total parenteral nutrition: a case report.

Home parenteral nutrition (HPN) patients need periodic reassessment for compliance, appropriateness of parenteral formulation, infusion regimen, bowel adaptation, and effective oral nutrient intake. Additionally, new technological advances need to be considered for potential use in the home parenteral nutrition population. Since costs for home parenteral nutrition therapy are substantial, cost-effective options should be exercised whenever reasonable. The following case illustrates our approach to the reassessment process, subsequent modifications, and resultant impact on the lifestyle, adequacy, and cost of home parenteral nutrition therapy.

Adult↗
PubMedDate not supplied

Stability and compatibility of cimetidine hydrochloride and aminophylline in dextrose 5% in water injection.

A controlled study was conducted to assess the physical compatibility of cimetidine hydrochloride (HCl) and aminophylline and the chemical stability of an admixture of the two medications in dextrose 5% in water (D5W) injection, over 48 hours at room temperature. Three one-liter admixtures were prepared, each containing cimetidine HCl 1200 mg and aminophylline 500 mg in D5W. One liter of only cimetidine HCl 1200 mg in D5W and one liter of only aminophylline 500 mg in D5W served as controls. Samples drawn from the five admixtures and immediately frozen were analyzed for cimetidine and theophylline content at times 0, 1, 6, 24, and 48 hours using high-performance liquid chromatography. Chemical stability of each drug was assessed relative to its time-zero concentration. Samples were also drawn from each test and control solution at every time interval to assess the pH. Admixtures were stored at room temperature out of direct sunlight for the duration of the study, and were visually inspected for color change, turbidity, cloudiness, and precipitation. Recovery of cimetidine and theophylline at all test intervals, pH assessments, and visual inspections of the admixtures showed that cimetidine HCl and aminophylline are both chemically stable and physically compatible for 48 hours at room temperature in one liter of D5W.

Aminophylline↗