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Biomedical subjects

J A Kotzan

Publications and source records attributed to J A Kotzan.

At least 19 recordsLinked to original sources
PubMed1989

Influence of age, sex, and race on prescription drug use among Georgia Medicaid recipients.

Interactions among patients' age, sex, and race that influence prescription drug use in a state Medicaid population are described. A database containing information about all 574,762 Medicaid prescriptions dispensed in Georgia during December 1985 was sorted and summarized so that each record represented one Medicaid recipient. The following data were included for each recipient: the total number of Medicaid prescriptions received by that patient during that month, the total payments made by the state for those prescriptions, and the patient's age, sex, and race. Analyses were conducted on a 10% random sample representing 17,128 patients. The age variable was broken down as follows: Child, 0-5 years; Youth, 6-23 years; Adult, 24-64 years; and Old, 65 years of age or older. Race was recorded as white or nonwhite, and sex as male or female. The average white patient received significantly more prescriptions than did the average nonwhite patient. The largest percentage (41.6%) of the patients in the sample were classified as Old, and this group received the greatest mean number of prescriptions. The differences between mean numbers of prescriptions for white and nonwhite patients increased as the age of the patients increased. Gender influenced drug use only through its interaction with age and race. Patients in the white female Old category had the greatest mean number of prescriptions per patient, and patients in the nonwhite male Youth category had the fewest. The peak period of prescription drug use occurred between the ages of 70 and 80 years, and thereafter use decreased. In this Medicaid population a patient's age and race significantly influenced the number of prescription drugs that he or she used.

Adolescent↗
PubMed1984

An in vivo single- and multiple-dose study of several marketed brands of conventional and controlled-release theophylline.

In a single-dose study, 18 healthy adult males consumed each of six dosage forms of theophylline. A conventional-release tablet, a syrup, and four competing brands of controlled-release theophylline were studied. Serial serum samples were obtained and analyzed via high pressure liquid chromatography (HPLC). After achieving steady state, 15 healthy adult males consumed each of five dosage forms of theophylline in a multiple-dose study. Serial blood samples were obtained between 0 and 72 hours and subjected to analysis with HPLC. The results indicated that the controlled-release products were not bioequivalent, although they achieved longer time-to-peak values than did the immediate-release syrup and the conventional-release tablet. A single sustained-release product was uniquely different on most pharmacokinetic parameters when compared with the remaining three controlled-release products. In general, the dosage form variation exceeded the individual subject variation on the single-dose study, but the opposite was true for the multiple-dose study.

Adult↗
PubMed1983

The effectiveness of auxiliary prescription labels: a pilot study.

Affixed auxiliary prescription labels are widely used in the practice of pharmacy because they supposedly provide the patient with pertinent information that is not contained within the prescription signature. Yet, whether the labels are effective is not known, nor is it known whether the label's elements, such as color, form, and logo, affect perception of the written text. Sound scientific analyses of these questions are limited. Therefore, a pilot study involving a series of experiments was designed to determine whether individual perception of pertinent information is affected by the use of affixed auxiliary prescription labels. The second objective of this study was to evaluate how color and logo differences affected perception of the label's written text. Participants were selected for the experiments after being screened for color blindness, corrected vision, and, in some cases, previous pharmacy employment. Subjects viewed labels affixed to prescription vials via a two-channel tachistoscope. The tachistoscopic methodology measured perception, and its accuracy was verified through a forced-choice instrument. Results from the pilot study were threefold: (1) a sound scientific analysis found affixed auxiliary labels to be effective, (2) significant variance could be attributed to both individual and subject differences, and (3) the unique effects of color and logo could not be determined.

Adult↗
PubMed1982

Bioavailability of regular and controlled-release chlorpheniramine products.

The bioavailability of chlorpheniramine regular-release versus controlled-release products was compared using 15 human subjects. The dosage forms evaluated were an 8-mg barrier coated-bead capsule, an 8-mg repeat action tablet, two 4-mg tablets, and 4- and 8-mg syrups. Single doses of each product were administered orally in a 5-way crossover study, plasma samples were collected at specific time intervals, and chlorpheniramine levels assayed by HPLC. Pharmacokinetic analysis was based on a two-compartment open model. The average plasma elimination half-life of chlorpheniramine was calculated to be approximately 18.3 hr. The controlled-release products gave a higher Cmax than the 4-mg syrup, but less than two 4-mg tablets. The controlled-release products also extended the time necessary to attain peak drug levels compared to the 4- and 8-mg syrups. The area under the curve (AUC) data for the controlled-release products was not equivalent to equal amounts of the regular-release products. The study indicated that while the controlled-release chlorpheniramine products were successful in prolonging the time course of absorption, this was at the expense of incomplete bioavailability of the drug.

Adolescent↗
PubMed1982

Factors affecting medication-order processing time.

The factors affecting medication-order processing time at one hospital were studied. The order processing time was determined by directly observing the time to process randomly selected new drug orders on all three work shifts during two one-week periods. An order could list more than one drug for an individual patient. The observer recorded the nature, location, and cost of the drugs ordered, as well as the time to process the order. The time and type of interruptions also were noted. The time to process a drug order was classified as six dependent variables: (1) total time, (2) work time, (3) check time, (4) waiting time I--time from arrival on the dumbwaiter until work was initiated, (5) waiting time II--time between completion of the work and initiation of checking, and (6) waiting time III--time after the check was completed until the order left on the dumbwaiter. The significant predictors of each of the six dependent variables were determined using stepwise multiple regression. The total time to process a prescription order was 58.33 +/- 48.72 minutes; the urgency status of the order was the only significant determinant of total time. Urgency status also significantly predicted the three waiting-time variables. Interruptions and the number of drugs on the order were significant determinants of work time and check time. Each telephone interruption increased the work time by 1.72 minutes. While the results of this study cannot be generalized to other institutions, pharmacy managers can use the method of determining factors that affect medication-order processing time to identify problem areas in their institutions.

Medication Systems, Hospital↗
PubMed1981

Pharmacokinetics and bioavailability of hydromorphone following intravenous and oral administration to human subjects.

In a relatively small pilot study, the half-life of elimination of hydromorphone in six subjects was 2.64 +/- 0.88 hours and the drug had a high volume of distribution, 1.22 l./kg. In addition, the drug was rapidly but incompletely absorbed after oral administration. An equation to predict the plasma concentration of hydromorphone on oral administration was developed from the data of these six subjects.

Administration, Oral↗
PubMed1980

Plasma levels of clobazam after 10-, 20-, and 40-mg tablet doses in healthy subjects.

It is evident that substantial intersubject and intrasubject varition in the bioavailability of clobazam exists following ingestion of 10, 20 and 40 mg doses in these 12 volunteers. Peak concentrations and area under the plasma level-time curve were directly proportional to the dose of clobazam and the mean plasma half-life of clobazam was about 18 hours regardless of dose administered. The t1/2 value was less than that previously reported, as the current results allow differentiation of parent drug from metabolites. This 18 hr t1/2 compares favorably with the half-life of other benzodiazepines.

Adolescent↗
PubMed1979

Effect of obtrusive measures on antibiotic compliance.

The influence of compliance measurement activities on patient behavior was studied. The project measured the relationship among physical capsule counts, patient interviews, and the amounts of excreted ampicillin. The capsule counts and patient interviews were conducted in a manner that disguised their intent. Sixty college-age patients were assigned to one of three experimental groups: a telephone interview, a personal interview and capsule count, or a control group. Stimulation (interviews) occurred on the 2nd day of the prescribed regimen, and urine was collected on random days thereafter. Results indicated that both stimulation types were associated with more positive compliance rates. The influence diminished rapidly. The reactive influence of experimentor intervention associated with personal and phone communication was demonstrated.

Adult↗
PubMed1979

Examination of blood clobazam levels and several pupillary measures in humans.

The State-Trait Anxiety Inventory was administered to 15 subjects before initiation of the experiment. Three subgroups of five subjects were defined by computing the unweighted sum of the state and trait anxiety scores. A 40-mg dose of clobazam, a 1.5-benzodiazepine, was administered to each subject and repeated with two additional dosage forms following a 2-week washout period. Blood samples were withdrawn, and blood levels were determined by fluorometric analysis. Additionally, pupillary measures of critical flicker fusion, constriction, and dilation in response to a cognitive task were obtained at 0, 2, 4, and 6 hr. A repeated measures analysis of variance revealed that blood levels were, as expected, statistically different over time and dosage form. The pupillary constriction mirrored the blood levels in statistical patterns. The pupillary measure of cognition related to the anxiety state after the performance effects of the cognitive task were statistically removed. The results suggest that clobazam has less immediate human effect than does diazepam.

Anxiety↗
PubMed1979

Comparison of two methods of observing work areas in a hospital pharmacy.

Two methods of observing the work area within a pharmacy of an acute care, 140-bed hospital were compared. A work activity recording form was developed from the literature and from discussion with the pharmacy staff. The instrument was coded, tested, and refined in a pilot study. One hospital pharmacy department work area was personally observed for a period of time equal to an entire work week. A time-motion camera was placed in the pharmacy which recorded the activities in the same pharmacy work area for a second work week. The results indicated that the two methods of observation were approximately equivalent for observing the work activities of the nonpharmacists but not for the work activities of the pharmacists. The camera method of observing work areas of a hospital pharmacy appeared to be reliable and inexpensive, but it lacked the precision obtained with the personal observation mode. Further use of time-motion cameras within the hospital pharmacy setting are indicated.

Evaluation Studies as Topic↗
PubMed1978

Plasma levels of clobazam after three oral dosage forms in health subjects.

As can be seen from the tables, the terminal half-life of clobazam is about 50 hours, and from a solid dosage form the peak plasma level occurs approximately 1.5 hours after ingestion. Thus, there is a significant, yet relatively short, dosage form delay effect when the solid dosage forms are compared to the rapidly available solution of the drug. However, based on the areas under the curve, comparison of the solid dosage forms with the solution indicates that the fraction of clobazam absorbed is 1. Pupil diameter measurement at 2, 4, and 6 hours after ingestion of clobazam correlated well with the plasma levels at these times. Pupils were constricted to the highest degree at 2 hours and approached the initial pupillary diameter at the 6-hour measurement.

Administration, Oral↗
PubMed1978

Effect of diazepam on cognition via pupillometry.

Continuous pupillary readings in response to a random-digit cognition task were obtained for 20 male subjects. Ten subjects were given 10 mg of diazepam, and 10 subjects were given placebos. Additional pupillary curves were recorded for both groups at 1 and 2 hr and compared to the initial curve. Subjects were required to repeat the exact sequence of verbalized randomized digits as a measure of performance. The results indicated that the diazepam treatment group differed significantly from the placebo group in terms of a depressed pupillary response. Furthermore, the performance recall measure was significantly reduced in the diazepam group. The relationships were clarified by an analysis of covariance and variance.

Adolescent↗