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H L Kirschenbaum

Publications and source records attributed to H L Kirschenbaum.

36 records · Page 2Linked to original sources

Directory of pharmacist-operated drug information centers in the United States.

A directory was compiled consisting of pharmacist-operated drug information centers (DICs) that handle a broad range of calls from outside their own institution. Questionnaires were mailed in early 1980 to 154 DICs. The survey results were reviewed by officers of the ASHP SIG on Drug and Poison Information. A notice to centers that did not respond to the survey was published in the ASHP Newsletter. Each center identified was called by the surveyors during October 1981 to confirm its current service. Addresses, directors' names, hours of operation, and phone numbers are included for the 112 centers identified.

Directories as Topic↗

Stability and compatibility of lidocaine hydrochloride with selected large-volume parenterals and drug additives.

The stability of lidocaine hydrochloride in six commonly used large-volume parenterals when stored for 14 days and the visual compatibility of lidocaine hydrochloride in admixtures with eight frequently used drugs were studied. Lidocaine hydrochloride admixtures of 2 mg/ml were prepared in both glass and plastic containers of 5% dextrose injection, 0.9% sodium chloride injection, lactated Ringer's injection, 5% dextrose and lactated Ringer's injection, 0.45% sodium chloride injection (plastic container only), and 0.45% sodium chloride and 5% dextrose injection. The admixtures were examined visually and stored for 14 days at 25 +/- 0.5 degrees C under fluorescent light. Lidocaine hydrochloride concentrations were determined spectrophotometrically at times 0, 0.25, 1, 3, 8, and 24 hours, and at 24-hour intervals thereafter. Spectrophotometric assays were confirmed with high-pressure liquid chromatography. Admixtures of lidocaine hydrochloride were prepared with aminophylline, bretylium tosylate, calcium gluconate, digoxin, dopamine hydrochloride, regular insulin, phenytoin sodium, and procainamide hydrochloride in 5% dextrose injection, 0.9% sodium chloride injection, and lactated Ringer's injection. The admixtures were examined visually for 24 hours. Admixtures of lidocaine hydrochloride were stable for 14 days. All admixtures of lidocaine hydrochloride with other drugs were visually compatible except those containing phenytoin sodium. It is concluded that lidocaine hydrochloride is stable in the solutions studied for 14 days at 25 degrees C and visually compatible for 24 hours in admixtures containing all drugs studied except phenytoin sodium.

Drug Combinations↗

Stability of dobutamine hydrochloride in selected large-volume parenterals.

Stability of dobutamine hydrochloride when mixed with large-volume parenteral solutions was assessed. Dobutamine hydrochloride was added to large-volume solutions of 5% dextrose injection, 0.9% sodium chloride injection, lactated Ringer's injection, and 5% dextrose and 0.45% sodium chloride injection, in both glass and polyvinyl chloride containers; the initial concentration was 1 mg/ml. After 0.25, 1, 3, 8, 24, and 48 hours, the concentration of dobutamine hydrochloride was determined by high-pressure liquid chromatography assay, and each solution was visually examined for evidence of haze, precipitation, color change, or evolution of gas. Concentration of dobutamine hydrochloride in the samples did not exhibit any appreciable change over the 48-hour period, and no HPLC peaks indicating degradation products were noted. Color changes were observed in some of the solutions, but no other visual changes occurred. There were no apparent differences in stability between the admixtures packaged in glass and those in polyvinyl chloride bags. At the concentration studied, dobutamine hydrochloride is stable in the admixtures tested for a minimum of 48 hours.

Catecholamines↗

Pharmacist-manned drug information centers in the United States.

Pharmacist-manned drug information centers (DICs) were surveyed in early 1976 to obtain current information concerning the status, availability and scope of their services. Eight-six institutions believed to be active in disseminating drug information were surveyed; 74 responses were usable. Descriptive information on the respondents is tabulated. It appears that DICs make constructive contributions to enhancing drug therapy. Respondents at 63 of the centers believed, and 31 DICs said they have demonstrated, that physicians who used their services often changed their drug therapy based on answers supplied by the centers.

Drug Information Services↗

Treatment regimens for patients with toxoplasmic encephalitis.

Toxoplasma gondii is an obligate intracellular parasitic protozoan that infects a variety of warm-blooded animals, including humans. Infection is usually asymptomatic in immunocompetent individuals but may be devastating in immunocompromised individuals such as those with acquired immunodeficiency syndrome (AIDS). Clinical manifestations of infection in immunocompromised patients include the development of encephalitis. It has been estimated that approximately 30% of patients with AIDS who are latently infected will eventually develop toxoplasmic encephalitis. The most common regimen used to treat toxoplasmic encephalitis is a combination of pyrimethamine 50 to 100 mg/d and sulfadiazine 4 to 8 g/d, with or without folinic acid 10 mg/d. This regimen, however, commonly leads to adverse effects or relapses. Other pharmacologic approaches include the use of clindamycin rather than sulfadiazine, the macrolide antibiotics, atovaquone, 5-fluorouracil, trimethoprim/sulfamethoxazole, minocycline or doxycycline, trimetrexate with folinic acid, dapsone, rifabutin, pentamidine, and diclazuril. None of these alternative regimens has been proven to be more effective than the standard pharmacologic therapy. An evolving approach is the use of immunotherapy, such as interleukin-2, -6, and -12; interferon-gamma; and alpha-tumor necrosis factor. Restoring a competent immune system may be the only cure for toxoplasmosis and other opportunistic infections.

AIDS-Related Opportunistic Infections↗

Clinical experience with sotalol in the treatment of cardiac arrhythmias.

The treatment of cardiac arrhythmias has changed over the past several years, as concerns have grown about proarrhythmias and increased mortality associated with certain antiarrhythmic agents. Sotalol, a unique racemic compound with both Class II (beta-blocking) and Class III (repolarization-prolonging) properties, effectively controls life-threatening arrhythmias and has a favorable safety profile, especially when compared with traditional antiarrhythmic drugs. A review of clinical trials demonstrates that sotalol is an effective treatment for premature ventricular complexes, ventricular tachycardia, and ventricular fibrillation. Moreover, it significantly reduces cardiac and all-cause mortality in these patient populations. Although sotalol currently is approved in the United States only for the treatment of life-threatening ventricular arrhythmias, it also is active against several supraventricular arrhythmias. Sotalol is safe and generally well tolerated; most of the adverse effects experienced with its use are related to its beta-blocking activity. However, sotalol has been associated with life-threatening proarrhythmias, including torsades de pointes, but the incidence of this adverse effect is low. Unlike pure Class II agents, sotalol usually is well tolerated in patients with mild-to-moderate left ventricular dysfunction and rarely causes new or worsening congestive heart failure. Sotalol represents an advance in the treatment and prevention of symptomatic ventricular arrhythmias and appears to be a reasonable first-line choice when the arrhythmia is life threatening.

Animals↗