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C C Capers

Publications and source records attributed to C C Capers.

8 recordsLinked to original sources
PubMed1994

Pharmacokinetics services in Department of Veterans Affairs medical centers.

The provision of pharmacokinetics services in Veterans Affairs (VA) medical centers was studied. In October 1992 a questionnaire was mailed to the chief of pharmacy at each of the nation's 160 VA medical centers. The survey was designed to determine the percentage of centers providing pharmacokinetics services, the general characteristics of pharmacokinetics services provided, and whether the presence of these services was associated with specific characteristics of the medical centers. Of the 160 questionnaires mailed, 148 (93%) were returned and analyzed. Pharmacokinetics services were provided by 104 (70%) of the respondents. Of the 104 services, 58 (56%) had existed for less than five years. Of the 44 VA medical centers without a pharmacokinetics service, almost two thirds planned to start one in the future. Aminoglycosides, vancomycin, and theophylline were the drugs most frequently monitored. Fifty-four percent of the pharmacokinetics services evaluated 1-24 patients per month, and another 24% evaluated 25-49 patients monthly. VA medical centers with a pharmacy residency program were more likely to have a pharmacokinetics service than centers without such a program; an association with geographic region was also identified. Nearly three fourths of responding VA medical centers indicated that they provided pharmacokinetics services.

Drug Monitoring↗
PubMed1993

Vancomycin pharmacokinetics in neonates and infants: a retrospective evaluation.

OBJECTIVE: To evaluate the frequency with which current loading and maintenance vancomycin dosages achieve target serum concentrations based on pharmacokinetic parameters obtained after the initial dose. Also, to identify the daily vancomycin dosage necessary to achieve target serum concentrations at steady-state and to determine if any relationships exist between vancomycin pharmacokinetic parameters and various patient characteristics. SETTING: Neonatal intensive care unit (NICU) at Georgia Baptist Medical Center. PATIENTS/METHODS: Twenty-three infants with suspected or documented gram-positive infection who received intravenous vancomycin between July 1990 and November 1991 were included in this retrospective analysis. Gestational age range from 23 to 41 weeks and postconceptional age (PCA) at the time of the study ranged from 26 to 46 weeks. Vancomycin therapy was initiated with a loading dose of 15 mg/kg, followed by a maintenance dosage of 20-30 mg/kg/d, which was usually given as 10 mg/kg q8-12h. All vancomycin doses were administered using a syringe pump. Peak and trough serum concentrations were obtained following the first dose. Vancomycin pharmacokinetic parameters were determined using a one-compartment model. Infants receiving indomethacin within two weeks prior to study were analyzed separately (group 2, n = 4). All other infants were included in group 1 (n = 19). RESULTS: For group 1, vancomycin clearance (Cl), volume of distribution (Vd), and half-life were (mean +/- 1 SD) 0.072 +/- 0.032 L/kg/h, 0.52 +/- 0.08 L/kg, and 5.6 +/- 1.6 hours, respectively. For both groups, loading doses provided 1-hour postinfusion peak concentrations of 25-35 mg/L in one of every two infants studied, whereas only three percent of initial maintenance doses were projected to provide desired peak and trough concentrations at steady-state. For group 1, the mean daily dosage necessary to provide target peak (25-35 mg/L) and trough (5-10 mg/L) concentrations at steady-state was larger than that initially prescribed (29.6 +/- 13.1 vs. 22.2 +/- 4.7 mg/kg/d). For group 2, the mean daily dosage required to achieve target peak and trough concentrations at steady-state was smaller than that initially prescribed (14.8 +/- 4.3 vs. 20.0 +/- 0.1 mg/kg/d) and was exactly half of that required for group 1. Excellent correlations were observed between PCA and vancomycin Cl (L/h) (r = 0.92; p < 0.0001), body weight and Vd(L) (r = 0.94; p < 0.0001), body weight and vancomycin Cl (L/h) (r = 0.85; p < 0.0001), PCA and Vd (L) (r = 0.89; p < 0.0001), and body surface area and Vd (L) (r = 0.93; p < 0.0001) for group 1. Moderate correlations were also noted between PCA and Cl relative to body weight (L/kg/h), postnatal age and Cl (L/kg/h), and PCA and vancomycin dosage requirements (mg/kg/d). No linear correlation was observed between any patient characteristic and Vd standardized for body weight. CONCLUSIONS: Our data demonstrate the need for a more accurate method of estimating initial vancomycin dosage requirements in this NICU population. Although some of the relationships revealed in this study could be used to determine vancomycin dosage for infants in the range of approximately 30-36 weeks PCA, we hesitate to suggest this approach presently because of the potential limitations of our study design. Further prospective study is needed to confirm these observations. In addition, further study is necessary to describe the time course of the interaction between vancomycin and indomethacin in infants with successful and unsuccessful closure of their patent ductus arteriosus.

Female↗
PubMed1993

Antibiotic surveillance: the results of a clinical pharmacy intervention program.

One of the major goals of any medical center is to provide safe, cost-effective drug therapy. To ensure rational antimicrobial therapy and control hospital drug costs, a criteria-based antibiotic surveillance program was developed. This method of antibiotic restriction provided exceptional cost savings in our institution. Clinical pharmacy interventions resulted in physician education and an 18% increase in compliance with the program criteria producing in a one-year period a $43,000 cost avoidance for antibiotic expenditures.

Anti-Bacterial Agents↗
PubMed1992

Use of theophylline in neonates as an aid to ventilator weaning.

Respiratory diseases are major causes of morbidity and mortality in premature neonates. Theophylline has been utilized as an adjunct in facilitating ventilator weaning and in the management of apnea with or without bradycardia. Patient characteristics associated with improved outcome from theophylline have not been determined. The purpose of this study was to evaluate parameters associated with improved outcome in neonates with respiratory diseases receiving theophylline. The study population consisted of premature neonates that were studied retrospectively. Criteria for entry into the study were (1) less than 40 weeks gestation, (2) a diagnosis of respiratory distress syndrome (RDS), apnea of prematurity, hyaline membrane disease (HMD), or bronchopulmonary dysplasia (BPD), (3) dependence on intermittent mandatory ventilation, (4) failure to wean from the ventilator 24 h or more before the study, or (5) receiving theophylline. In this study, we found no correlations between time to wean from the ventilator and postnatal age at the time theophylline was initiated, 5-min APGAR score, and final theophylline serum concentration before complete weaning from the ventilator. However, there were significant negative correlations between birthweight and gestational age with respect to time to wean from the ventilator. The average theophylline serum concentration before weaning from the ventilator for this population of neonates was approximately 5-10 micrograms/ml, indicating that theophylline is not beneficial as an aid to ventilator weaning at serum concentrations < 10 micrograms/ml.

Apgar Score↗
PubMed1991

A statewide survey of pharmacokinetic service provision in Georgia.

A survey of pharmacokinetic service (PKS) provision and characteristics of the service was conducted in Georgia's 223 hospitals. The survey's questionnaire, returned by 133 (59.6%) institutions, showed that 23.3% currently had a PKS and that 47% of those without a PKS had plans to establish one in the future. Services were primarily provided by pharmacists (93%) who were certified to provide the consultations in only 40% of the institutions and the PKS was run through either the pharmacy (93%) or pathology laboratory. All services used calculators and/or computers with a variety of software programs to assist in pharmacokinetic evaluations. Patients were charged for the service in 38% of the institutions.

Adolescent↗