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PubMed1982

Audit of telephone usage in a centralized intravenous admixture area.

An audit of telephone usage in an intravenous admixture area was performed. Over a two-day period (18 hours total) 252 calls were made or received. The average length of a call was 81 seconds. Surgery and medicine nursing units accounted for the majority of the cells. Missing orders or doses were the most frequent topic of calls. Telephone communication may require a large time commitment from pharmacists and prevent them from performing activities which are more easily documentable, such as compounding intravenous admixtures.

Efficiency↗
PubMed1984

Overfill of common piggyback admixture solutions.

The average final volume of 23 commonly used piggyback solutions was determined. Polyvinyl chloride (PVC) containers filled with 0.9% sodium chloride injection or 5% dextrose injection in 50 ml and 100 ml sizes were used for 20 of the piggybacks. A total of ten samples of each drug and dose were measured by draining the entire contents into a graduated cylinder and measuring the volume. The mean volumes, standard deviations, and ranges for each drug and dose were calculated. The volume found in each sample exceeded the volume in the original PVC container by at least 20% in the 50 ml size and 11% in the 100 ml size. The greatest percentage volume difference was 62% in the 50 ml size and 28% in the 100 ml size. The FasPak and the two Viaflex Plus Ready-To-Use containers, which did not require the use of the 50 and 100 ml PVC containers, had a percentage volume difference of 2.6%, 2.2%, and 3.4%, respectively. This information demonstrates the fact that the final volumes of some piggyback admixtures are significantly greater than that which may be presumed from the admixture label.

California↗
PubMed1987

Implementation and evaluation of a flexitime program involving pharmacy i.v. admixture technicians.

The purpose of this article is to describe the implementation of a flexitime program involving i.v. admixture personnel and to evaluate its impact on three work-related behaviors. Flexitime, also known as flex-time, is an alternative to the standard work schedule. Flexitime programs have been shown to have a positive effect on productivity, overtime, turnover, tardiness, absenteeism, and job satisfaction in various work settings. The i.v. admixture technicians and interns chose a flexitime program called the variable day. During both the baseline and the flexitime period, three work-related behaviors were measured: absenteeism, tardiness, and satisfaction. Tardiness was almost eliminated during the flexitime program; absenteeism decreased from 4.61% during the baseline period to 2.66% during the flexitime program, although this difference was not statistically significant. General job satisfaction did not significantly change during the flexitime program. Overall, all of the technicians favored the flexitime program and suggested that it be expanded to include the unit dose technicians. If future investigations support the usefulness of flexitime programs, pharmacy managers should consider its implementation as an additional strategy for reducing departmental costs.

Evaluation Studies as Topic↗
PubMed1987

Cost savings with a new combination clindamycin-gentamicin admixture policy.

Clindamycin and gentamicin are frequently prescribed by obstetricians and gynecologists (OB-GYN) for various pelvic infections in women. These two antibiotics maintain chemical stability when admixed in a small-volume parenteral. The institution of an admixture policy that recommends combining these agents when both drugs are prescribed in OB-GYN patients would decrease the frequency of administration, improve patient convenience, reduce risk of administration errors and intravenous line contamination, and reduce costs of antibiotic therapy. The authors analyzed antibiotic use in OB-GYN patients over a 3-month period and found that the anticipated cost savings appeared sufficient to warrant an admixture policy change. Six months after initiating the new policy, the authors found an increase in the use of clindamycin and gentamicin, but a decrease in the overall cost for providing antibiotic therapy to OB-GYN patients. Savings for the second quarter were due to the pharmacy providing less expensive clindamycin-gentamicin therapy.

Clindamycin↗
PubMedDate not supplied

Compatibility study of 5-fluorouracil with PVC bags after repackaging into two types of infusion admixtures.

The stability and compatibility of 5-fluorouracil (5-FU) in admixtures for continuous intravenous infusion using PVC bags and administration sets were studied. 5-fluorouracil was reconstituted and diluted to 1.8 mg/ml for infusion in polyvinyl chloride and glass containers, and to 1 mg/ml to 16 mg/ml for storage in polyvinyl chloride bags containing 5 per cent dextrose or 0.9 per cent sodium chloride injections. Admixtures were stored at +4 degrees C and with protection from light, for 7 days. Analyses were performed by HPLC. No significant drug loss was observed during simulated infusions using PVC infusion bags and administration sets vs glass bottles and administration sets, over an infusion period used in hospitals (24 h). The solution stored at +4 degrees C with protection from light in PVC bags showed that at 1 mg/ml to 16 mg/ml, 5-fluorouracil was stable at least for 7 days in 0.9 per cent sodium chloride and 5 per cent dextrose.

Antimetabolites, Antineoplastic↗
PubMed2000

GM, KM immunoglobulin allotypes and other serum genetic markers (HP, GC, PI, and TF) among South American populations living at different altitudes (Jujuy Province, Argentina): admixture estimates.

A total of 154 individuals belonging to three populations located at different altitude levels in northwest Argentina (San Salvador de Jujuy, 1,200 m; Tilcara, 2,500 m; Abra Pampa, 3,500 m) were studied for the GM, KM, HP, GC, PI and TF genetic systems. Individuals were selected on the basis of ethnocultural affiliation. Gene frequency values were found to be comparable to those reported for other South American populations. The populations studied showed a close genetic identity and an absence of interpopulation heterogeneity. Distribution of the GM phenotypes and haplotypes corresponds to historical data on human settlements in Jujuy Province. The presence of some alleles and the anthropological significance of the allele distribution are discussed, as are the effects of the admixture with Africans and Spaniards. The genetic pattern appears to be the result of a varying admixture due to the genetic isolation in populations located at various altitude levels.

Adolescent↗
PubMed2000

[Radiation safety in work with chemicals containing admixtures of natural radionuclides].

The authors analyze results obtained in their own research of radiation situation in several enterprises of Nuclear Energy Department. Those enterprises treat chemicals containing admixtures of natural radionuclides in production of substances previously considered safe--tantalum, zirconium, strontium carbonate. The article necessitates regulation of radiation factor in working environment and control over products and waste materials. The authors base methods providing radiation safety during work with substances containing higher levels of natural radionuclides admixtures.

Humans↗
PubMed1975

[Methods of determining admixtures in commercial preparations of tetracycline].

The results and conditions of separation and quantitative determination of the admixtures of epi- and anhydro-derivatives of tetracycline in its market products were compared and analyzed using the following chromatographic methods: chromatography in a thin layer of a sorbent in 2 modifications, circular paper chromatography, chromatography on a column of gel Sephadex G-25. The comparison of the results of the study provided recommendation of the column chromatography with gel Sephadex G-25 for separate or summation quantitative determination of 4-epitetracycline. The method of chromatography in a thin layer of a sorbent may be successfully used for semiquantitative determination of the admixture levels in tetracycline market drugs.

Chromatography, Gel↗
PubMedDate not supplied

[Removal of harmful admixtures from a surrogate atmospheric condensate of a closed habitat with the help of a cultivated bacterial association].

Tested was an idea to eliminate six harmful admixtures reside in a surrogate of atmospheric condensate of closed habitats by a cultivated bacterial association. The purpose was to select members of the bacterial associations that would assimilate acetone, acetic acid, ethanol, ethyl acetate, methylamine and ammonia as free, so immobilized on insoluble cellular polyvinylformal. The resulted association of three bacterial species showed the ability to transform into end products a six-component surrogate of atmospheric condensate. Methylopila capsulata VKM V-1606 metabolized methylamine, Paracoccus denitrificans VKM V-1324--acetone. Pseudomonas esterophilus VKM V-1736 D was found to act as an ethyl acetate destructor decomposing the admixture to ethanol and acidic acid which were oxidized also by this species to carbon dioxide and water. Each of these bacterial strains in the test association metabolized ammonia as a source of nitric nutrition.

Acetaldehyde↗
PubMed2005

The effect of structured triglycerides on the kinetic stability of total nutrient admixtures.

PURPOSE: The physical stability of two types of total parenteral nutrient (TPN) admixtures was studied as a function of storage time and temperature. One of them contained only structured triglycerides and the other exclusively long-chain triglycerides as lipid components. METHODS: Droplet size of the mixtures was followed by photon correlation spectroscopy for 10 days. Zeta potential and dynamic surface tension measurements were carried out to evaluate the possible changes in the charge and interfacial surface tension of the emulsion droplets during the storage. pH values were monitored in order to follow the possible decomposition processes in the course of storage. RESULTS: Droplet size of emulsions prepared with lipids containing exclusively long-chain triglycerides showed remarkable increase after 4 days of storage in contrast with that of the mixtures containing structured lipids. CONCLUSIONS: The obtained results indicate that besides the advantageous metabolic effects of structured triglycerides, their application is recommended to improve the physical stability of TPN admixtures.

Drug Stability↗
PubMed2005

[Tumor cell proliferative activity in aggressive human lymphomas: the influence of reactive cell admixture on the assessment of proliferative indices].

Uncontrolled proliferation is one of the main features of tumor cells, and therefore proliferative indices provide prognostic information, which might be valuable for treatment selection. However, in aggressive human lymphoid tumors, an admixture of normal (reactive) cells may be available in all organs infiltrated by neoplastic cells. We have presented data on determining proliferative activity using Ki-67 immunostaining, and demonstrated that an admixture of reactive cells could exert significant influence on the assessments of proliferative indices. We developed an experimental approach, which makes it possible to select neoplastic cells from the overall lymphoid population and to assess their proliferative activity - tumor cell proliferative indices. Tumor cell proferative indices determined in large cell lymphomas might be significantly higher than proliferative indices of overall populations, and the use of tumor cell proliferative indices will result in a more accurate assessment of disease prognosis.

Burkitt Lymphoma↗
PubMed2006

Effects of inbreeding, endogamy, genetic admixture, and outbreeding on human health: a (1001 Dalmatians) study.

AIM: (1001 Dalmatians) research program collects biomedical information from multiple small isolated populations ((metapopulation)) on Adriatic islands, Croatia, and investigates health effects of human population isolation, inbreeding, admixture, and outbreeding. METHODS: We collected random samples of 100 individuals from 9 island settlements and an additional sample of 101 immigrants to the islands, pooled from all study populations. According to their personal genetic histories, the examinees were categorized as inbred, autochthonous, admixed, and outbred. A total of 76 inbred individuals from a total sample of 1001 examinees were matched to 76 autochthonous, 76 admixed, and 76 outbred controls by gender, age (+/-5 years), village of residence, education, and socio-economic status. We investigated the effects of presumed individual genome-wide heterozygosity predicted from personal genetic histories on the following 10 traits: systolic and diastolic blood pressure, body mass index, high and low density lipoproteins and total cholesterol, triglycerides, uric acid, creatinine, and blood glucose. RESULTS: Personal genetic history significantly affected systolic blood pressure (Spearman rho=0.157, P=0.006), while the effect on cholesterol (rho=0.105, P=0.069), and high density lipoprotein cholesterol (rho=0.104, P=0.071) was suggestive. Admixed individuals and immigrants consistently showed values associated with lower health risk. When inbred and autochthonous samples were merged and compared with the admixed and outbred samples to increase the power of the study, the effects on the three traits above and also on body mass index and diastolic blood pressure became statistically significant. The medians for all 10 medically relevant traits in inbred and autochthonous group, with lower values of presumed individual genome-wide heterozygosity, were less favorable in terms of health. CONCLUSION: The combined effects of founder effect, genetic drift, and inbreeding can increase the frequency of detrimental rare variants in human metapopulations, leading to overall worsening of population health, whereas admixture and outbreeding appear to have the opposite effect.

Adult↗
PubMed1991

Update on the physical-chemical compatibility of cromolyn sodium nebulizer solution: bronchodilator inhalant solution admixtures.

Cromolyn sodium nebulizer solution, 1% (wt/vol), is physically and chemically compatible (stable) for at least 90 minutes when mixed in vitro with a new formulation (metabisulfite-free) of metaproterenol sulfate solution, an inhalant solution of albuterol sulfate or an atropine sulfate inhalant solution. Similarly, cromolyn sodium does not adversely affect the stability of the individual bronchodilator drugs in the admixtures. Since cromolyn sodium is compatible in admixtures with these bronchodilator drugs, adding these agents to cromolyn sodium nebulizer solution should have no negative influence on the effectively administered dose of either active ingredient.

Albuterol↗
PubMed1991

[A study on factors influencing the stability of total nutrient admixture].

To study the stability of total nutrient admixture, glucose, amino acid, fat emulsion, electrolyte, and other nutrients in different combinations and concentrations were admixed and infused into 16 3-liter polyvinyl chloride bags, which at last were stored at 4 degrees C, 22-25 degrees C, 32 degrees C, respectively. Samples were inspected at 0, 12, 24 and 48 hours. The results showed that the admixture was stable when total concentration of mono cation was lower than 150 mmol/L, Mg2+ less than 3.4 mmol/L, and Ca2+ less than 1.7 mmol/L, stored at 4 degrees C for 48 hours, or at 22-25 degrees C for 24 hours. We conclude that PVC 3L container is safe for storage of TNA at least within 24 hours.

Amino Acids↗
PubMed1990

Bacterial and fungal contaminations in parenteral nutrition admixtures.

Parenteral nutrition admixtures prepared in the incubator for sick newborn infants from three wards were cultured for bacteria and fungi. Of the total samples of parenteral nutrition solution being studied, 4.7 per cent had fungi and 14.1 per cent had bacteria. Solutions prepared in the intensive care unit, in the ward for sick newborn, and in the ward for sick preterm revealed fungal contaminations at about 11.1, 5.8 and 0.0 per cent respectively. Bacterial contaminations were higher and had a percentage of 11.1 from the intensive care unit, 23.5 from the ward for sick newborn and 10.3 from the ward for sick preterm. It was concluded that another more sterilized technique should be implemented for reduction of such a high rate of bacterial and fungal contaminations in the parenteral nutrition admixtures.

Amino Acids↗
PubMed1987

Peripheral blood admixture in bone marrow aspirates.

A simple method is described by which the degree to which a bone marrow aspirate is diluted with peripheral blood, the admixture of peripheral blood leukocytes in the aspirate, and the true cellularity of bone marrow at the aspiration site can be estimated quantitatively. A highly significant correlation is shown to exist between the true bone marrow cellularity and the number of hemopoietic cells in the bone marrow aspirate. This correlation can be described by an exponential regression equation (r = 0.6997; p less than or equal to 0.001). The degree of bone marrow dilution with peripheral blood does not depend on the initial bone marrow cellularity and is devoid of diagnostic value. It fluctuates over a wide range (1.2- to 6.3-fold). The admixture of peripheral blood leukocytes has been found to be small (0.05%-9.7%) in most cases studied and much higher in those cases where the cellularity is low while the dilution is high.

Biopsy, Needle↗
PubMed1989

Stability of concentrated trimethoprim-sulfamethoxazole admixtures.

The stability of trimethoprim-sulfamethoxazole (TMP-SMX) at various concentrations in 5% dextrose injection or 0.9% sodium chloride injection was studied. Appropriate volumes of TMP-SMX formulation (80 mg TMP and 400 mg SMX/5 mL) were mixed with 5% dextrose injection or 0.9% sodium chloride injection to provide dilutions of 1:25 v/v, 1:20 v/v, 1:15 v/v, and 1:10 v/v. Aliquots were removed at 0, 0.5, 1, 2, 4, 8, 14, 24, and 48 hours and filtered. The pH of the samples was determined, and the samples were assayed for trimethoprim and sulfamethoxazole content by high-performance liquid chromatography. Admixtures were visually inspected for precipitate before each sample was removed. The concentration of SMX in all admixtures did not change during the study period. The stability of TMP was dependent on concentration and vehicle. At a 1:25 v/v dilution, TMP was stable for 48 hours in 5% dextrose injection and 0.9% sodium chloride injection. At a 1:20 v/v dilution, TMP was stable for 24 hours in 5% dextrose injection and 14 hours in 0.9% sodium chloride injection. At a 1:15 v/v dilution, TMP was stable for four hours in 5% dextrose injection and two hours in 0.9% sodium chloride injection. At a 1:10 v/v dilution, TMP was stable for one hour in 5% dextrose injection and 0.9% sodium chloride injection. Concentrated solutions of TMP-SMX should be prepared in 5% dextrose injection, infused within one hour of preparation, and visually inspected for precipitation before and during infusion.

Drug Combinations↗