Improved health-related quality of life with SSRIs and other antidepressants.

Study Objective: To document the health-related quality of life (HRQOL) of depressed patients receiving antidepressant drugs.

Design: Cross-sectional study.

Setting: Community pharmacy-based setting.

The expanding role of pharmacy and therapeutics committees. The 1990s and beyond.

Traditionally, pharmacy and therapeutics (P&T) committees have been responsible for overseeing the drug use process, using formulary systems to control drug costs. Primarily, these committees act in an advisory capacity as policy-recommending bodies within healthcare systems, for the specific purpose of promoting rational drug therapy. Methodologies utilised by these committees include drug use evaluation, medical staff education, continuous quality improvement, formulary restriction and therapeutic interchange.

Laboratory tests recommended by pharmacists in a skilled-nursing facility.

The types of laboratory tests recommended by pharmacists in a 185-bed skilled-nursing facility, the rate of physician acceptance of the recommendations, the reasons for and costs of the tests, and the outcomes of the tests were determined. Patients for whom laboratory tests had been recommended by a pharmacist from 1982 to 1987 were identified; this information had been taken from patients' charts during routine review by a pharmacist and entered into a computer database. The following information was recorded: type of laboratory test recommended, physician response to the recommendation, cost of the test, and outcome of the test.

Recovery of phenytoin from solutions of caseinate salts and calcium chloride.

The recovery of phenytoin from solutions of intact protein components of enteral nutrition products was studied. Diluted phenytoin oral suspension was added to 10 1-mL samples of solutions of sodium caseinate, calcium caseinate, a mixture of sodium and calcium caseinates, and calcium chloride as well as to 10 1-mL samples of a distilled water control to produce theoretical concentrations of 10 micrograms/mL. The samples were filtered using an ultrafiltration technique and assayed for phenytoin concentration by high-performance liquid chromatography.

Pressure sores in the elderly. A systematic approach to management.

Pressure sores are a serious but often avoidable problem. The best management plan focuses on early identification of high-risk patients, appropriate allocation of resources, and adequate techniques of pressure relief. A standardized treatment plan that is familiar to care givers should be followed.

Drug therapy communications to family physicians in a nursing home.

The investigation described in this paper evaluated the effectiveness of written drug-therapy communications to family physicians working in a nursing home. Data analysis tracked the nature of the recommendation, as well as physician acceptance/rejection. The most frequent recommendations involved drug-level determinations, drug withdrawal and dosage modifications.

The abdomen.

This article describes the normal anatomy and physiology of the abdomen. Physical examination techniques illustrate the evaluation of the abdominal structures. The text describes physical presentation of selected diseases and discusses their pathophysiology.

Current concepts in clinical therapeutics: pressure sores.

The etiology, pathophysiology, clinical presentation, prevention, management, and complications of pressure sores are reviewed. Three specific patient populations are at high risk of developing pressure sores: spinal-cord-injury, geriatric long-term-care, and orthopedic patients. Pressure sores usually develop at bony prominences on the body as a result of four etiologic elements: pressure, shearing forces, friction, and moisture.

Recovery of phenytoin from an enteral nutrient formula.

The recovery of phenytoin from phenytoin oral suspension dispersed in an enteral nutrient formula was determined. The study was conducted in two phases. In phase 1, diluted phenytoin oral suspension was added to 10 1-mL samples of full-strength Osmolite and 10 1-mL samples of a distilled water control solution to produce a theoretical concentration of 10 micrograms/mL.

Evaluation of pharmacy and therapeutics committee drug evaluation reports.

Pharmacy and therapeutics (P & T) committee drug evaluation reports prepared by pharmacies and drug information centers (DICs) and product package inserts were compared with standard guidelines to evaluate their quality. Letters were sent to 143 hospital pharmacies asking them to submit a previously prepared drug evaluation report on temazepam, moxalactam disodium, or atenolol. The reports and package inserts for these three drugs were evaluated by the presence of 40 elements derived from the published ASHP guidelines for drug evaluation report preparation.

Peripheral vascular and lymphatic systems.

This article discusses normal anatomy and physiology of the peripheral vascular and lymphatic systems. Physical examination techniques are described and monitoring principles are illustrated by a case study.

Physical assessment. The heart.

This article discusses normal and abnormal anatomy and physiology of the heart and the techniques used in physical assessment. Specific adverse drug effects are discussed and a case study is provided to illustrate key concepts.

An evaluation of a medication history method.

The purpose of this study was to evaluate a drug history method. The method consisted of a review of systems (ROS) history format, which utilized common symptoms/diseases per organ system matched with corresponding drug treatments. Findings of this method were compared with drug histories documented in the medical record.

Physical assessment series: the thorax and the lungs.

The anatomy of the thorax and lungs and the physiology or respiration are complex. The physical assessment techniques which, on the surface, appear relatively easy to master, require hours of practice of observation, palpation, percussion, and auscultation before the examiner becomes familiar with the more subtle changes of disease process and the wide variations of normal that may be confused with illness. These are skills that may be quickly lost if not regularly applied.

Particulate contamination in selected parenteral drugs.

The particulate contamination of five frequently prescribed drugs was studied. Samples were obtained in a laminar flow workbench according to millipore technique. The dry sample filters were examined with a binocular microscope at 50x and 100x.

Medication delivery time requirements in centralized and decentralized unit dose drug distribution systems.

Medication delivery time requirements in centralized and decentralized unit dose drug distribution systems were compared. Four stages in the receipt of medication orders and the delivery of doses were identified, and the time required to perform each stage was recorded by pharmacist observers for seven days in each system. In the centralized system, it required 138--220 minutes to deliver doses after orders were ready to be collected at the nursing station, with the time varying according to order type.

Errors remaining in unit dose carts after checking by pharmacists versus pharmacy technicians.

The accuracy of pharmacists and pharmacy technicians in checking unit dose carts was compared. One-half of the unit dose patient medication drawers, for a 92-bed medicine service in a 450-bed teaching hospital, were checked by pharmacy technicians and the remaining by pharmacists. These drawers then were checked again to determine the number and type of checking errors committed by technicians and pharmacists.