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Biomedical subjects

J Iazzetta

Publications and source records attributed to J Iazzetta.

8 recordsLinked to original sources
PubMed2001

Efficacy and safety of desensitization to allopurinol following cutaneous reactions.

OBJECTIVE: To evaluate the long-term efficacy and safety of slow oral desensitization in the management of patients with hyperuricemia and allopurinol-induced maculopapular eruptions. METHODS: A retrospective evaluation of an oral desensitization regimen using gradual dosage-escalation of allopurinol in 32 patients (30 with gout and 2 with chronic lymphocytic leukemia) whose therapy was interrupted because of a pruritic cutaneous reaction to the drug. RESULTS: Twenty-one men and 11 women with a mean age of 63 years (range 17-83 years), a mean serum urate level of 618 micromoles/liter (range 495-750) (or, mean 10.4 mg/dl [range 8.3-12.6]), and a mean serum creatinine level of 249 micromoles/liter (range 75-753) (or, mean 2.8 mg/dl [range 0.8-8.5]) were studied. Desensitization failed in 4 patients because of unmanageable recurrent rash. Twenty-eight patients completed the desensitization procedure to a target allopurinol dosage of 50-100 mg/day, 21 without deviation from the protocol for a mean of 30.5 days (range 21-56 days) and 7 requiring dosage adjustments because of a recurrent rash over 53.8 days (range 40-189 days). Seven of these 28 patients developed late cutaneous reactions 1-20 months postdesensitization, 4 responding to dosage modification and 3 discontinuing the drug. Twenty-five of the 32 patients (78%) continued to take allopurinol; their mean duration of followup was 32.6 months (range 3-92 months) and the mean postdesensitization serum urate level was 318 micromoles/liter (range 187-452) (or, mean 5.3 mg/dl [range 3.0-7.5]). CONCLUSION: The study confirms the long-term efficacy and safety of slow oral desensitization to allopurinol in patients with maculopapular eruptions, particularly in those with gout, who cannot be treated with uricosurics or other urate-lowering drugs. Although pruritic skin eruptions may recur both during and after desensitization, most of these cutaneous reactions can be managed by temporary withdrawal of allopurinol and dosage adjustment.

Adolescent↗
PubMed1994

Chemotherapy waste reduction through shelf-life extension.

Minimization of total drug expenditures within the health care system, without affecting patient outcome has become a rational goal in today's economic, environment. The objective of this study was to observe the effect of extending the shelf-life for three chemotherapy medications, [doxorubicin, epirubicin and mitoxantrone] on wastage of these medications. Prior to and following the introduction of new, longer, shelf-lives for these three medications, prospective, non-randomized, unblinded four-month chemotherapy wastage audits for all chemotherapy medications were completed at 18 institutional sites within Ontario (six Ontario Cancer Treatment and Research Foundation clinics, ten Ontario hospitals and two preparation sites in a large cancer treatment centre). Data were provided by 18 sites in 1989 but from only 12 sites in 1990. Ten of the 12 sites extended their shelf-lives for each of doxorubicin, epirubicin and mitoxantrone, and on average, waste at these sites was reduced to less than 1% of the 1989 total for epirubicin, less than 15% for doxorubicin and 35% for mitoxantrone. Many sites eliminated waste entirely for these drugs. For sites which did not extend their shelf-lives, the waste remained unchanged. We conclude that appropriate extension of the shelf-life for chemotherapy medications can reduce waste, and is a relatively simple method of reducing expenditures without affecting health outcomes or adding additional complications to IV chemotherapy.

Analysis of Variance↗
PubMed1991

Compatibility of dexamethasone sodium phosphate with hydromorphone hydrochloride or diphenhydramine hydrochloride.

The stability and compatibility of dexamethasone sodium phosphate and hydromorphone hydrochloride or diphenhydramine hydrochloride at various concentrations at room temperature was studied. Solutions containing equal volumes in the following ranges of concentrations were prepared: dexamethasone sodium phosphate 0-10 mg/mL, diphenhydramine hydrochloride 0-50 mg/mL, and hydromorphone hydrochloride 0-40 mg/mL. Samples of each combination were analyzed immediately after mixing and at 7 and 24 hours using a stability-indicating high-performance liquid chromatographic assay. The pH of each solution was measured, and each combination was visually inspected. Precipitation occurred in solutions containing dexamethasone and hydromorphone hydrochloride or diphenhydramine hydrochloride when equal volumes of the most concentrated solutions were mixed. Some of the combinations at lower concentrations were visually compatible, and more than 90% of the initial concentrations of both drugs (i.e., dexamethasone-hydromorphone and dexamethasone-diphenhydramine) remained in these compatible solutions. Dexamethasone is visually compatible with diphenhydramine or hydromorphone but only within specific concentration ranges. In visually compatible solutions, both drug combinations are stable for up to 24 hours at room temperature.

Chromatography, High Pressure Liquid↗
PubMedDate not supplied

Dexamethasone phosphate stability and contamination of solutions stored in syringes.

The stability of 10 mg/mL dexamethasone sodium phosphate injection was evaluated using a validated, stability-indicating liquid chromatographic method during 91 days storage in glass and 55 days storage in plastic syringes with rubber plungers. The presence of accelerators, commonly used in the manufacture of rubber, mercaptobenzothiazole (MBT), tetramethyl thiuram disulfide (TMTD) and tetraethyl thiuram disulfide (TETD), was monitored on day 101 and after 18 months storage. During the 91-day study period there was no significant trend for dexamethasone phosphate concentrations in Glaspak syringes to decrease in solutions stored at room temperature or 4 degrees C. The concentration remaining in each syringe on the final day of analysis was greater than 95% of the initial concentration. In Monject plastic syringes there was no significant decrease in the dexamethasone phosphate concentration over 35 days with 1 mL syringes or 55 days with 3 mL syringes at either room temperature or 4 degrees C. The concentration remaining in each syringe on the final day of analysis was greater than 93% of the initial concentration. Analysis of samples for leachates on day 101 failed to demonstrate any contamination. However, re-analysis of the syringes following 18 months storage indicated contamination by a number of compounds. The results indicate that sorption of dexamethasone phosphate to the syringe barrel or plunger did not occur to a clinically important degree. We conclude that dexamethasone phosphate solutions (10 mg/mL) stored at 4 degrees C or 23 degrees C for up to 91 days in Glaspak syringes or 55 days in plastic Monject syringes will retain more than 93% of the initial dexamethasone concentration. Furthermore after 101 days there was no measurable contamination of the dexamethasone phosphate solution, although after 18 months considerable contamination was observed.

Chromatography, Liquid↗