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Your Meaningful Distress-Appraisal Scale: Scale improvement and affirmation review.
Objective The objective of the study was to establish the compatibility of injectable meropenem with 101 other drugs during Y-site administration. Methods Meropenem (50 mg/mL, 10 mL) was combined with 101 undiluted injectable drugs (10 mL each) at room temperature. Each preparation was performed twice. The first sample underwent a visual evaluation and a particle count test by light obstruction immediately after mixing. These tests were repeated 4 hours after mixing using the second preparation. Incompatibility was defined as precipitation or other visual change (turbidity, crystal formation, gas formation, color change) or failure to meet United States Pharmacopeia (USP) particle counter. The gross incompatibility of the other 17 drugs was determined by visual observation. One mixture complied with the specifications, but showed an increase of temperature upon mixing and was removed from the study. Conclusion Of the 101 drugs tested, 83 were found to be compatible while the remaining 17 were incompatible. One drug was removed from the study as its compatibility was unclear.Objectives To compare 3 methods of detecting potential diversion of controlled substances (CS) by health care personnel from inpatient units in a large, academic medical center. Methods Three different reports were retrospectively analyzed and evaluated to determine which employees are "high-risk" for diversion over a 30-day period using defined criteria. Reports were derived from automated dispensing machines (ADMs), purchased third-party software (TPS), and the electronic health record (EHR). The primary outcome was the percentage of employees in each report who were deemed to be high-risk for CS diversion (positive predictive value [PPV]). Secondary outcomes included the number of false positives and description of high-risk users on each report. Descriptive statistics were used to analyze differences between methods. Results The PPV was highly variable between reports. The PPVs among the ADM, TPS, and EHR reports were 3.28%, 6.82%, and 23.88%, respectively. False positives were high among all reports (96.72%, 93.18%, and 76.12% for the ADM, TPS, and EHR reports, respectively). Conclusions A report from the EHR has the highest PPV to detect high-risk employees who may be diverting CS. However, false positives were high for all reports, indicating that significant improvements are needed in the development of accurate and reliable software to detect potential and actual CS diversion.Objectives To develop and to study the physicochemical and microbiological stability of omeprazole liquid oral formulations used as therapeutic agent in many acid-related disorders, for pediatric use. Furthermore, to optimize and validate a stability-indicating high-performance liquid chromatography (HPLC) method for the analysis of omeprazole in the studied formulations. Method Oral liquid suspensions of omeprazole were prepared at 2 mg/mL using crushed omeprazole pellets (formulation A) and pure omeprazole (formulation B) with a complete vehicle including humectant, suspending, sweetening, antioxidant, and flavoring agents. Samples were stored at 4°C and 25°C. Omeprazole content of each formulation was analyzed in triplicate using micro-HPLC at 0, 3, 7, 14, 30, 60, 90, 120, and 150 days. Other parameters were also determined, such as appearance, pH, resuspendibility, and viscosity. Microbiological studies were conducted according to the United Stated Pharmacopeia (USP) guidelines for non-sterile products. Results Formulation A stayed physicochemical and microbiologically stable at refrigerated (4°C) conditions during at least 150 days and it only stayed stable during 14 days at 25°C. Formulation B was stayed physicochemical and microbiologically stable at refrigerated (4°C) conditions at least 90 days, but it is not recommended to store at 25°C for more than 1 day. Conclusions Formulation A and formulation B can be stored for at least 150 and 90 days, respectively, at refrigerated conditions. Formulation A can be stored at room temperature for 14 days. Both formulations are perfectly suitable for pediatric patients who are usually notable to swallow solid oral formulations. The proposed analytical method was suitable for the study of stability of different formulations.Purpose The aim of this study was to evaluate the prescription and transcription processes in hospital settings in Jeddah city, Saudi Arabia. Method A customized version of the original American Society of Health-System Pharmacists (ASHP) survey was distributed to a total of 26 hospitals in Jeddah city that fits our criteria starting from December 2017. Hospitals' names were adopted from the Ministry of Health and Jeddah Municipality websites. All questionnaires were collected in June 2018. After that, they were classified according to the type of care provided by the hospital, size, ownership, teaching affiliation, and accreditation. Data were entered electronically using Google forms, and then Microsoft Excel was used to conduct descriptive statistics. Results The survey had a response rate of 57%. A strict formulary system was adopted in 53.3% of hospitals, and clinical practice guidelines were used to optimize medication use in 86.7% of hospitals. Pharmacists do not have the authority to write medication orders in about 86.7% of hospitals and only 40.0% of hospitals have pharmacists routinely assigned to patient care units. However, Pharmacists actively provided consultation, mostly in drug information (80.0%). Computerized prescriber order entry (CPOE) is used to receive medication orders electronically in 80.0% of hospitals, and electronic health record (EHR) is used in about 53.3% of hospitals and 50.0% of those hospitals have pharmacists who document their clinical intervention in EHR. Conclusion Survey results suggest that pharmacists in hospital settings have not yet been positioned to improve the prescribing and transcribing components of the medication-use process.Background Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that results from regurgitation of acid from the stomach into the esophagus. Treatment available for GERD includes lifestyle changes, antacids, histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and anti-reflux surgery. Aim The aim of this review is to assess the cost-effectiveness of the use of PPIs in the long-term management of patients with GERD. selleck kinase inhibitor Method We searched in PubMed to identify related original articles with close consideration based on inclusion and exclusion criteria to choose the best studies for this narrative review. The first section compares the cost-effectiveness of PPIs with H2RAs in long-term heartburn management. The other sections shall only discuss the cost-effectiveness of PPIs in 5 different strategies, namely, continuous (step-up, step-down, and maintenance), on-demand, and intermittent therapies. Results Of 55 articles published, 10 studies published from 2000 to 2015 were included.
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