Biomedical subjects
G T Jay
Publications and source records attributed to G T Jay.
Monitoring drug use in an IPA-model HMO.
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Interaction of epinephrine and beta-blockers.
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Comment: change in prescribing patterns of intravenous histamine2-receptor antagonists.
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Procedure for evaluating nonformulary drug orders.
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Stability of famotidine in an extemporaneously prepared oral liquid.
The stability of famotidine in an extemporaneously prepared oral liquid stored at 4 and 24 degrees C for 30 days was studied. Famotidine liquid was prepared by pulverizing and suspending 12 40-mg tablets in distilled water. This mixture was diluted with cherry syrup to a total volume of 60 mL, resulting in a famotidine concentration of 8 mg/mL. The liquid was divided into two 30-mL amber glass bottles and stored at 4 degrees C and at room temperature (24 degrees C). Samples from each of the two bottles were assayed for famotidine content by high-performance liquid chromatography. Each sample was assayed in duplicate at time 0 and on days 2, 5, 10, 15, 20, 25 and 30. The concentration of famotidine remained above 90% of original concentration for 20 days at 4 degrees C and for 15 days at room temperature. After 30 days, famotidine concentration was reduced by 15% and 24% at 4 degrees C and room temperature respectively. Famotidine liquid 8 mg/mL compounded extemporaneously from tablets was stable for 20 days at 4 degrees C and for 15 days at 24 degrees C.
Simplification of antibiotic dose adjustments in renal insufficiency: the DREM system.
Many clinicians, unassisted by reference books, are unable to make the required dose adjustment of antibiotics needed when a patient has renal insufficiency. We describe the DREM (dosing in renopathy by easy-to-use multipliers) system, which simplifies the understanding and the process of dose adjustment. DREM is a two-step process: Cockcroft and Gault estimation of creatinine clearance (CLcr) from age, sex, and serum creatinine and calculation of the adjusted dose or dosing interval by multipliers. If the normal dose is multiplied by the dose multiplier (CLcr/100) and the dosing interval by the interval multiplier (100/CLcr), the adjusted dose and interval, respectively, are obtained. Theoretical trough concentrations calculated with the DREM system correlated closely (r = 0.9) with actual concentrations obtained from doses calculated by the Hull and Sarubbi method in 23 patients. With DREM, gentamicin or tobramycin trough concentrations above 2 micrograms/ml were less likely to occur. The DREM system is a simple and easily remembered method for dose adjustments of certain anti-infective agents in renal insufficiency. Dose estimates with this method are reasonably accurate and compare favourably with other standard methods of correction.
Strategy for developing a safe and cost-effective H2-receptor antagonist program.
The pharmacy staff of a community tertiary-care hospital evaluated efficacy and safety before addressing cost considerations in the transition to a capitation program with cimetidine as the preferred H2-receptor antagonist. Safety concerns were resolved by permitting the use of an alternative drug certain patients considered to be at high risk. Despite initial resistance to mandatory participation in the program, the physician and nursing staffs have grown supportive, and the annual cost savings, which include the costs of labor and supplies as well as acquisition, have been substantial.
Visual compatibility of famotidine with commonly used critical-care medications during simulated Y-site injection.
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