American Pharmacists Association

About: American Pharmacists Association is a other organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Pharmacist & Pharmacy. The organization has 2413 authors who have published 1969 publications receiving 30470 citations. The organization is also known as: APhA & American Pharmaceutical Association.

A centralized Pharmacy Unit for cytotoxic drugs in accordance with Italian legislation.

Abstract: Rationale In May 2002, a centralized Unit for cytotoxic drug preparations [Unita Farmaci Antiblastici (UFA)] was established at the Centro di Riferimento Oncologico, Aviano, Italy. The Unit was created following provisions under Law 626/94 (Legislative Decree – Ministry of Health), governing the safe handling of cytotoxic drugs. New guidelines governing drug preparation (‘NBP’ standards of preparation) published in Italian Pharmacopoeia (2002, XI Edition) have been mandatory since 2004 and set out rules for proper pharmacy practice applicable also to antineoplastic drug preparations. Aims and objectives To review legislation on cytotoxic drug preparation and compliance within our Unit, to assess current quality levels and identify those areas requiring improvement. Methods The study reviewed: (1) the organization and equipment of the Unit UFA and its working methodology; (2) written documentation concerning work procedures; (3) the stability and sterility of injectable drug formulations; (4) staff training, occupational exposure and risk management; (5) accidents and mistakes occurring in the UFA service. Results The study showed up the strengths of our Unit and identified those areas which need improvement to guarantee product quality excellence. Conclusions A critical evaluation of the whole cytotoxic preparation process is a useful method for quality improvements to be initiated. Knowledge regarding risks, techniques, and procedures for handling antineoplastic drugs is growing. Ongoing analysis will ensure greater patient and health care worker safety.

Community pharmacy-based research in Spain (1995-2005): A bibliometric study

Abstract: Only one study evaluated the scientific activity in community pharmacies in Spain, and it was restricted to articles published in just two journals.Objective: To assess the scientific activity in community pharmacies in Spain through a bibliometric analysis of the original papers published during the years 1995-2005.Methods: IPA, MEDLINE, CSIC database and the journals Seguimiento Farmacoterapeutico y Pharmaceutical Care Espana were used as data sources. Production indicators, consumption indicators and the impact factor (IF) as a repercussion index were analyzed.Results: 122 articles were included in the review. The articles were published in 12 journals, 78.7% of them in Pharmaceutical Care Espana and Seguimiento Farmacoterapeutico. The mean number of authors per article was 4.2 (SD=2.1). The transitivity index was 71.3%. The total number of references cited in the articles was 2110. The mean number of references per article was 17.3 SD=9.3. The value of the insularity index was 57.6%. Self citation was 6.8% and the Price index was 66.5%. No impact factor was available for 6 journals.Conclusions: Publication of articles on community pharmacy-based research in Spain has undergone an important increase in the last 5 years. The existence of authors who publish very few studies, the high insularity index and the lack of randomized, controlled trials may be considered as negative indicators in community pharmacy-based research in Spain.

Residual neuromuscular blockade in critical care.

Abstract: Neuromuscular blockade is a pharmacological adjunct for anesthesia and for surgical interventions. Neuromuscular blockers can facilitate ease of instrumentation and reduce complications associated with intubation. An undesirable sequela of these agents is residual neuromuscular blockade. Residual neuromuscular blockade is linked to aspiration, diminished response to hypoxia, and obstruction of the upper airway that may occur soon after extubation. If an operation is particularly complex or requires a long anesthesia time, residual neuromuscular blockade can contribute to longer stays in the intensive care unit and more hours of mechanical ventilation. Given the risks of this medication class, it is essential to have an understanding of the mechanism of action of, assessment of, and factors affecting blockade and to be able to identify factors that affect pharmacokinetics.

Methylene Blue for Vasoplegic Syndrome Postcardiac Surgery.

Abstract: Objectives cardiopulmonary bypass (CPB) can be complicated by vasoplegia that is refractory to vasopressors. Methylene blue (MB) represents an alternative in such cases. Patients and methods Retrospective observational historical control-matched study. From 2010 to 2015, all patients who received MB for vasoplegia post-CPB were included in this study. Historical controls from the period of 2004 to 2009 were matched. End-points were the time till improvement of vasoplegia (Ti), 30-day mortality, cardiac surgical Intensive Care Unit (CSICU) morbidity, and length of stay (LOS). Results Twenty-eight patients were matched in both groups. There were no statistically significant differences between the two groups in demographic, laboratory data on admission, or hemodynamic profile before use of MB. Ti and time to complete discontinuation of vasopressors were statistically significant less in MB group (8.2 ± 2.6 vs. 29.7 ± 6.4, P = 0.00 and 22.6 ± 5.2 vs. 55.3 ± 9.4, P = 0.00) respectively. Mortality at day 30 was significantly higher in controls compared to MB (1 patient [3.6%] vs. 6 patients [21.4%], long rank P = 0.04). CSICU, hospital LOS, and incidence of renal failure was significantly higher in control group (12.4 ± 3.7 vs. 7 ± 1.4, P = 0.03), (19.5 ± 2.4 vs. 10.9 ± 3.2, P = 0.05) and (9 patients [32.1%] vs. 2 patients [7.1%], P = 0.04), respectively. Duration of mechanical ventilation was less in MB patients; however, did not reach statistical significance. Conclusions the use of MB for vasoplegia postcardiac surgery was associated with rapid recovery of hemodynamics, shorter need for vasopressors, less ICU mortality, less incidence of renal failure, and shorter LOS.

Calcium chloride; a reminder

Abstract: Rocuronium has been recently introduced into clinical practice to allow rapid onset muscle relaxation of an intermediate duration. In all the studies published, there has been little reference to the pain that occurs when rocuronium is administered to the awake patient [l]. In clinical use, even when patients are asleep and rocuronium is administered after the induction agent, hand withdrawal often occurs, suggesting pain on injection. In several studies, rocuronium has been shown to produce an increase in heart rate [2, 31 and sometimes an increase in arterial pressure [4]. The explanation of these reactions was thought to be a vagolytic or even a sympathomimetic effect. Perhaps the simpler explanation of these cardiovascular effects is that under steady state (light) general anaesthesia, the pain of injection of rocuronium (usually into a peripheral vein) can cause an increase in heart rate and even an increase in arterial pressure. Academisch Zeikenhuis, 6500 HB, Nijmegan E.N. ROBERTSON