Economic consequences of unused medications in Houston, Texas.

Background: It is likely that a large amount of unused and outdated medications exists in households throughout the US; however, the amount and potential costs of these medications are unknown.

Objective: To determine the amount, types, and costs of unused medications present in a neighborhood surrounding a community pharmacy in Houston, Texas.

Methods: A community trial was conducted between April and September 2002.

Involvement of immunization-certified pharmacists with immunization activities.

Background: Immunization certification courses allow pharmacists to directly administer vaccines to their patients. However, the demographics and level of immunization involvement of immunization-certified pharmacists compared with those noncertified are unknown.

Objective: To document the demographics, professional activities, and job satisfaction of immunization-certified pharmacists compared with pharmacists not certified for immunization.

Effects of six-week clarithromycin therapy in corticosteroid-dependent asthma: A randomized, double-blind, placebo-controlled pilot study.

Background: Although corticosteroids such as prednisone are efficacious for the treatment of severe asthma, chronic administration of oral corticosteroid therapy is associated with significant adverse effects. Previous studies have shown that clarithromycin is effective in reducing bronchial hyperresponsiveness and allergen-induced bronchoconstriction. However, the effect of long-term clarithromycin therapy in patients with prednisone-dependent asthma is uncertain.

In vitro bactericidal activities of ABT-773 against ermB strains of Streptococcus pneumoniae.

The bactericidal activities of ABT-773, a new ketolide, were compared to those of cefuroxime and amoxicillin-clavulanate against 10 strains of Streptococcus pneumoniae containing the ermB gene. MICs and time-kill curves were determined in duplicate per NCCLS guidelines with cation-adjusted Mueller-Hinton broth with 3% lysed horse blood. Viable counts were done at 0, 2, 6, and 24 h.

Antibiotic resistance among gram-negative bacilli in US intensive care units: implications for fluoroquinolone use.

Context: Previous surveillance studies have documented increasing rates of antimicrobial resistance in US intensive care units (ICUs) in the early 1990s.

Objectives: To assess national rates of antimicrobial resistance among gram-negative aerobic isolates recovered from ICU patients and to compare these rates to antimicrobial use.

Design And Setting: Participating institutions, representing a total of 43 US states plus the District of Columbia, provided antibiotic susceptibility results for 35 790 nonduplicate gram-negative aerobic isolates recovered from ICU patients between 1994 and 2000.

Tissue reparative effects of macrolide antibiotics in chronic inflammatory sinopulmonary diseases.

It is well established that macrolide antibiotics are efficacious in treating sinopulmonary infections in humans. However, a growing body of experimental and clinical evidence indicates that they also express distinct salutary effects that promote and sustain the reparative process in the chronically inflamed upper and lower respiratory tract. Unlike the anti-infective properties, these distinct effects are manifested at lower doses, usually after a relatively prolonged period (weeks) of treatment, and in the absence of an identifiable, viable pathogen.

Comparison of Etest, chequerboard dilution and time-kill studies for the detection of synergy or antagonism between antifungal agents tested against Candida species.

Currently, there is considerable debate regarding the best in vitro method for testing antifungal combinations against Candida spp. In this study, we compared the results obtained by chequerboard dilution, time-kill studies and Etest for several antifungal combinations against Candida spp. Three Candida albicans isolates (fluconazole MICs of 1.

Consumer involvement: effects on information processing from over-the-counter medication labels.

The objective of this study was to evaluate the effects of consumer involvement on information processing from over-the-counter (OTC) medication labels. A sample of 256 students evaluated simulated OTC product labels for two product categories (headache and cold) in random order. Each participant evaluated labels after reading a scenario to simulate high and low involvement respectively.

Management of acute exacerbations of chronic obstructive pulmonary disease.

Patients with chronic obstructive pulmonary disease are at high risk for acute exacerbations. Strategies that may prevent exacerbations are smoking cessation, pulmonary rehabilitation, and influenza vaccination. Therapy includes bronchodilators, corticosteroids, and antibiotics.

Postantibiotic effects of ABT-773 and amoxicillin-clavulanate against Streptococcus pneumoniae and Haemophilus influenzae.

This study determined the postantibiotic effect (PAE) of ABT-773 versus that of amoxicillin-clavulanate against clinical isolates of Streptococcus pneumoniae and Haemophilus influenzae. The PAEs of ABT-773 and amoxicillin-clavulanate ranged from 2.3 to 6.

Rationale for combination antifungal therapy.

The relentless increase of invasive fungal infections and poor outcomes associated with available antifungal agents prompted the search for better therapeutic strategies. Combining antifungal drugs was recommended as a means to enhance efficacy in a variety of invasive infections including cryptococcosis, candidiasis, and aspergillosis. With the exception of cryptococcal meningitis, data from controlled clinical trials supporting such combinations are sparse.

Effect of a dual-lumen peripheral catheter on the delivery of known incompatible medications.

Objective: To determine the degree to which a dual-lumen peripheral catheter prevented precipitation of solutions known to be incompatible due to pH during simultaneous infusion in an in vitro model.

Methods: An in vitro model was devised to simulate peripheral venous blood flow from an antecubital source to systemic circulation. Ondansetron was simultaneously infused with fluorouracil, aminophylline, sodium bicarbonate, and ampicillin sodium in concentrations reflective of clinical conditions into the Twin Cath 20/22 (the dual-lumen catheter used in this experiment).

Pharmacotherapy for elderly women.

Age-related physiological changes alter the response of elderly individuals to drug therapy, placing them at heightened risk for adverse effects and drug interactions. Other factors influencing the therapeutic outcome of drug treatment include compliance, self-medication, multiple medications, functional impairment, and economics. This article reviews the principles of geriatric pharmacotherapy, specifically as they relate to elderly women.

The overregulation of pharmacy practice.

Many professions are highly regulated, yet few are regulated to the degree pharmacy is. Not only are there large numbers of regulations, but the regulations are so detailed they dictate precisely how pharmacists are to perform both dispensing and clinical services. As a result, pharmacists end up trying to meet the requirements of the regulations rather than exercising professional judgment and providing true pharmaceutical care.

Can a physician sue a pharmaceutical manufacturer when a drug harms a patient?

Patients who suffer harm from a prescription drug often sue both the prescribing physician and the drug manufacturer, seeking recovery for failure to warn of the drug's potential harm. In many of these cases, the drug manufacturer is relieved of liability under the "learned intermediary" doctrine. If, however, a drug manufacturer misrepresents information or fails to adequately warn a physician about a drug's potential dangers, it may be possible for a physician to maintain a legal cause of action against the manufacturer.

Advertising, computers, and pharmacy liability. A Michigan court's decision has ramifications for pharmaceutical care.

Arbor Drugs, Inc., advertised that its computer could detect dangerous drug interactions. A pharmacist failed to warn a patient accordingly and the patient suffered a stroke as a result of an interaction between tranylcypromine and a decongestant.