SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Our hospital successfully implemented a drug review program which met JCAHO standards. This was accomplished by analyzing our current situation to identify opportunities for improvement and then developing a drug review plan consistent with JCAHO requirements. The establishment of a DUE pharmacist to coordinate the program and the cooperation of the medical staff has been crucial to the success of our program.
Explore the source record for details and available documents.
Drug use patterns observed in an intensive care unit (ICU) at a large tertiary teaching hospital (Brigham & Women's Hospital [BWH], Boston) were documented and compared with patterns reported from ICUs of hospitals at two other sites. Antibiotics, analgesics, and H2 antagonists were the most frequently prescribed classes of drugs. Despite the variability in ICU populations studied, similar patterns of drug use (drug classes and frequency of use) were seen at all three institutions. Pharmacy charges for ICU care at BWH were calculated with respect to total hospitalization charges and were found to account for 10% of total charges. Identifying drug use patterns in ICUs--an area of potentially high drug use, risk, and cost--provides valuable information for P & T Committees as well as for medical staff quality assurance and usage evaluation functions.
As a result of many investigations, the role of adrenergic drugs in cardiopulmonary resuscitation (CPR) has been identified, but the choice of drug and drug dosage are yet to be defined. It has been suggested that the successful return of circulation following cardiac arrest is linked with the ability to achieve a diastolic arterial pressure of 30 to 40 mm Hg. Since the turn of this century, the addition of epinephrine to resuscitation procedures has been shown to increase greatly diastolic arterial pressures and resuscitation success. The key to epinephrine's action lies in its alpha agonist properties (which promote peripheral vasoconstriction, leading ultimately to increased coronary perfusion) rather than its direct beta effects (which increase the workload of the fibrillating myocardium). Indeed, pure alpha agonist drugs work as effectively as epinephrine in restoring the circulation, and beta agonists are totally ineffective when used during the arrest period. The hypothesis that pure alpha agonists may be superior to epinephrine during CPR is the subject of current investigations. To date, drug dosage has been largely empirical. During CPR other factors play a role in drug effectiveness, including the injection site, rate of blood flow, and current metabolic status. Because the early use of effective alpha agonists can improve survival, the search for the best drug, via the best route and at the best dosage deserves additional investigation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
During a 3-month period, determinants of psychotropic drug utilization (sex, age, length of stay, reason for admission, disease severity) and data on psychotropic consumption (type of medication--antidepressants, benzodiazepines and antipsychotics--dosage and length of treatment) were retrospectively collected in a general intensive care unit of a Dutch university hospital. Daily exposure to psychotropics was standardized in number of Defined Daily Doses (DDD). Benzodiazepines were used by 35.8% of all patients (137) during their stay in the ICU whereas 17.5% of all patients used a neuroleptic agent. Antidepressants were hardly prescribed. High doses of benzodiazepines (9.9 DDDs) and low doses of antipsychotics (0.5 DDDs) were prescribed, which probably reflect the unusual nature of this critically ill group of patients compared with the reference group for DDD's. Clear patterns of determinants of psychotropic drug use in ICU patients were found and both benzodiazepines, antipsychotics and combined use of these agents could be associated with the determinants assessed. The time patterns we found in terms of length of stay give clues for further investigations in order to rationalize psychotropic drug use in the management of severely ill and complex patients.
A declining number of American workers are testing positive for drugs, according to one of the leading substance abuse testing companies in the United States. Smith-Kline Beecham Clinical Laboratories, King of Prussia, PA, conducts urinalysis for corporate clients and has tested more than six million people for drugs since 1987. In 1991, for the fifth consecutive year, it found a declining percentage of Americans on drugs at work. What is behind this apparent decline? Is it becoming easier to "beat" drug tests? What drugs are most used? Who is most likely to be on drugs? In this report, we'll present some of the conclusions about drugs in the workplace that have emerged after several years of testing and treatment experience.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The definition of appropriate use of drugs is questioned in oncology. Daily therapeutic practices were compared to official labelling and to published scientific data in this retrospective study. It was carried out in two respective specialised centers, from January to September 2004. All chemotherapies administered for adult solid tumours and including one of the eleven studied drugs were evaluated. The analysis of use was performed by drug : conformity to the validated labelling and level of scientific evidence (at the period study). The study included 1,561 drug uses in 1,211 patients. The overall rate of conformity to official labelling was 81.7 % (67.1 % of strict conformity). In 73.8 % of cases, the indications were supported by at least one randomized phase III trial. The results appeared to be significantly different in rare tumours. The potential economic stake of the "contrat de bon usage" was estimated as less than 5 % in our study. This analysis showed an appropriate and controlled use of onerous drugs in solid tumours. The official labelling of drugs are unable to answer to all clinical situations. The definition of a sufficient level of evidence is mandatory for the use of scientific data in clinical practice. This process has to be adapted for rare tumours.
Explore the source record for details and available documents.
Explore the source record for details and available documents.