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Biomedical subjects

D Klapp

Publications and source records attributed to D Klapp.

6 recordsLinked to original sources
PubMed1984

Improving pharmacy and therapeutics committee operations.

A panel discussion of various aspects of the operations of pharmacy and therapeutics (P & T) committees is presented. Pharmacy and therapeutics committee operations in various types and sizes of hospitals are described. Ways of stimulating physicians' interest in P & T committee activities, difficult problems faced, scope of issues dealt with by P & T committees, functions of P & T subcommittees, the value of drug information from pharmaceutical representatives, and the influence of research funds from the pharmaceutical industry on committee decisions are discussed. Panel members also present their views on therapeutic alternates, FDA-nonapproved use of drugs, and counter-detailing. Finally, suggestions for improving P & T drug evaluations, cost-containment issues, and the authority of P & T committees are discussed. A well-prepared agenda, good educational material, active members, and strong leadership are important for successful P & T committee operations.

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PubMed1981

Computer-assisted antibiotic use review.

The use of a computer system for an antibiotic review program is described. A commercial system was selected as the software base for the development of the antibiotic use review (AUR) program. The AUR system is composed of three parts: (1) editing and verifying data from the patient's pharmacy profile card, (2) updating the data base, and (3) generation of reports. The system is flexible in its reporting capabilities. Potential functions of the system include identifying patterns of bacterial resistance. The computer system is an efficient tool for the clinical review of antibiotic use in a quality assurance program.

Anti-Bacterial Agents↗
PubMed1979

Evaluation of albumin use by medical audit.

The appropriateness of albumin prescribing and accuracy of records of albumin use were studied at a 476-bed hospital. Medical records of 15 adults who had undergone surgery within one week of albumin administration were compared with eight prescribing and charting criteria that were developed by pharmacists. Charts of patients who did not meet every criteria were reviewed by a committee to determine if exceptions to the criteria were justifiable. Albumin prescribing was empirical for approximately 60% of the patients. Albumin use as judged by laboratory values was inappropriate in three patients. Charting of the amount and rate of albumin administered was inaccurate, incomplete or difficult to interpret for eight (53%) of the patients. The dosage of albumin prescribed was inappropriate for two (13%) patients. Appropriate concomitant therapy (e.g., packed red blood cells) was not prescribed for two patients. For only three patients did the patient's charge correspond to the amount charted as being administered. On an annual basis, patient charges for albumin were projected to be $9,321 less than the hospital's cost for the product. The audit identified problems in albumin prescribing and charting that, when corrected, would result in cost savings and improved patient care.

Adolescent↗
PubMedDate not supplied

Accuracy of serum gentamicin concentration predictions generated by a personal-computer software system.

Predictions of serum gentamicin concentration and half-life, using a personal-computer software system (SIMKIN [simulated kinetics]), were compared for accuracy as increasing amounts of patient-specific data were supplied to the computer. Data for a two-year period were collected for patients of a hospital's pharmacokinetic consultation service; the study group included adults who had at least one serum concentration for which time of last gentamicin dose was recorded. Input variables were age, weight, height, sex, serum creatinine concentration, concomitant drugs and diseases, gentamicin dosage, time of infusion, dosing interval, number of doses on each regimen, and time and reported value of all serum gentamicin concentrations. Individualized dosing regimens were calculated on the basis of literature estimates, and half-life and serum concentrations were then estimated for these regimens and compared with actual values. One or two measured serum concentrations were then added to the input data. The computer-estimated half-lives (obtained from single-point or two-point analysis in different dosage intervals) were compared with the half-lives determined from actual serum concentration data. Gentamicin serum concentrations were similarly compared. The computer's ability to predict subsequent serum concentrations improved in sequence for literature-averaged prediction and single-point and multipoint analysis. Accuracy of predicting whether peak concentrations were therapeutic or subtherapeutic and whether trough concentrations were toxic also improved as more patient-specific data were input. SIMKIN appropriately evaluated demographic and laboratory data and adequately predicted gentamicin half-lives and serum concentrations.

Adolescent↗