Economic impact of ambulatory care formulary restrictions at a large county health system.

Purpose: Study results documenting substantial cost savings achieved by an outpatient indigent-care pharmacy program through formulary modifications and optimized purchasing practices are presented.

Methods: Wholesale purchasing data were retrospectively evaluated to compare drug expenditures before and after a large Florida hospital's adoption of a tiered formulary system for three ambulatory care facilities serving mostly uninsured patients. The outcomes assessed included the average cost per prescription and total medication purchases before and after implementation of the tiered formulary, which was phased in over several months and accompanied by intensive educational programs targeting physicians and pharmacy staff.

Stability of cefazolin sodium admixtures in plastic bags after thawing by microwave radiation.

The effect on antibiotic stability of thawing, with microwave radiation, cefazolin sodium admixtures frozen in polyvinyl chloride minibags was studied. Two brands of cefazolin sodium (Ancef and Kefzol) were reconstituted and placed in 50-, 100- and 250-ml polyvinyl chloride minibags of 5% dextrose in water or 0.9% sodium chloride.

Potential hypocholesteremic derivatives of styrylacetic acid II: cis- and trans-3-methyl-4-phenyl-3-butenoic acid analogs.

The synthesis and preliminary biological testing for in vitro cholesterol biosynthesis inhibitory activity of 2-indeneacetic acid, 2-methyl-1,2-dihydro-2-naphthoic acid, and their 5- and 7-chloro derivatives, respectively are described. These compounds were prepared as trans- and cis-analogs of the known antilipemic agent 3-methyl-4-phenyl-3-butenoic acid. Although both series of compounds showed cholesterol biosynthesis inhibitory properties, chloro substitution enhanced potency only in the cis-system.