PubMed Health⌕ Search

Biomedical subjects

L A Wanke

Publications and source records attributed to L A Wanke.

9 recordsLinked to original sources
PubMed1990

Problems encountered in using written criteria to assess drug information responses.

Problems encountered in using written criteria to evaluate drug information responses during a study designed to determine whether simple requests were being unnecessarily submitted to a drug information center are described. Drug information questions that had been answered by a drug information center from June 1985 to June 1986 using defined references were chosen for evaluation. The center's responses to the 156 questions were paired with those of senior pharmacy students, who used the same references. Two experienced drug information pharmacists used a 6-point scale to evaluate the correctness, appropriateness, and completeness of each response, as well as the amount of extraneous material it contained. Interrater agreement was acceptable with respect to appropriateness, completeness, and amount of extraneous material; it was unacceptable with respect to correctness. When the judges re-evaluated the responses by using more explicit criteria for correctness, interrater agreement improved. The analysis excluded 32 responses that the judges found difficult to evaluate. Difficulties in assessing drug information responses arose from a lack of objective evaluation criteria, the wording of the request, the scope of the reference sources used, a lack of consistency between equivalent references, evaluator bias, and incomplete documentation. Efforts to determine whether simple drug information requests were being unnecessarily submitted to the drug information center were confounded by difficulty in using written criteria to judge the quality of responses.

Drug Information Services↗
PubMed1988

Comparative usefulness of MEDLINE searches performed by a drug information pharmacist and by medical librarians.

The usefulness of MEDLINE searches conducted by a drug information pharmacist who had received online training was compared with the usefulness of searches conducted by medical librarians. Searches for literature pertinent to select drug information requests received at a university drug consultation service during a three-month period were conducted independently by the pharmacist and one of three reference librarians. The three librarians had received extensive online search training and were experienced in conducting MEDLINE searches; the pharmacist was trained by a fourth experienced librarian-searcher using National Library of Medicine (NLM) training materials. For each drug information request, the pharmacist and the librarian searched two MEDLINE files on the NLM service. The printouts generated by the two searchers were evaluated by two drug information pharmacists in terms of how useful each list of citations would be in enabling the drug information pharmacists to answer the related question. The majority of printouts in 48 sets of searches were judged to be useful. Of the 96 possible "best search" votes (two votes for each of the 48 sets of printouts), the pharmacist's searches received 34 votes, the librarians' searches received 28 votes, and there were 34 tie votes. The numbers of useful primary and alternate citations were found to be the best predictors of whether a given printout would receive the "best search" rating. MEDLINE searches performed by a drug information pharmacist with online training, in response to drug information requests, were judged by drug information pharmacists to be as useful as searches performed by librarians.

Drug Information Services↗
PubMed1988

Financial support for poison control centers: a unique partnership with a chain drug store corporation.

The Oregon Poison Center has developed a unique partnership with a chain drug store corporation which sponsors the Center's poison prevention, public awareness, and professional education programs. Termed the Poison Prevention and Public Awareness Program, this affiliation offers significant financial support to the Oregon Poison Center on a continuing basis. It establishes an integral role for the drug stores in poison control activities. In addition, the program provides a mechanism for customer capture and reaps significant public and professional relation benefits for the corporation. This presentation describes the materialization of the affiliation, including the development of the program proposal, its presentation to potential participants, and the selection of a chain drug store corporation.

Financing, Organized↗
PubMed1987

An outbreak of watermelon-borne pesticide toxicity.

The largest reported United States outbreak of illness caused by a foodborne pesticide was due to aldicarb-contaminated watermelons. In Oregon, where the first episodes of toxicity were reported, 264 reports were received, and 61 definite cases were identified. Residues of aldicarb, a cholinesterase inhibitor, were found in 10 of 16 tested melons which had been eaten by persons meeting the case definition. The outbreak demonstrates the need for enhanced physician vigilance with respect to anticholinesterase intoxication. It also demonstrates the value of an established system for reporting of unusual illness to public health officials.

Aldicarb↗
PubMed1985

9-1-1 implementation: implications for poison center access.

House Bill 3178, passed by the 1981 Oregon Legislature, requires state-wide participation in a 9-1-1 emergency telephone system by 1991. It further requires deletion of all emergency telephone numbers other than 9-1-1 from the front cover of all telephone directories. The gradual implementation of 9-1-1 provided a unique opportunity to study telephone access to the poison center. The impact of 9-1-1 implementation was assessed, in a two-month survey of calls from the general public, to determine awareness of 9-1-1 availability and the source used to gain access to the poison center. Results showed that most callers (72%) had access to and were aware of 9-1-1. Callers obtained the poison center number from the telephone directories (28%), health care providers (19%), poison symbols supplied by the poison center (15%), directory assistance (9%), or other sources. Only 3% of the callers were referred from 9-1-1. State-wide implementation of 9-1-1 will have a major impact on the public's access to the poison center. The results of this study will be used to develop strategies for cooperation with 9-1-1 agencies.

Information Services↗
PubMedDate not supplied

Gastric emptying. Risk versus benefit in the treatment of acute poisoning.

This review examines the various clinical options used to elicit gastric emptying, viz. drug-induced emesis, mechanical pharyngeal stimulation, gastric lavage, and catharsis. Apomorphine and syrup of ipecac are the 2 drugs most frequently used for induction of emesis. Both agents act centrally and, in addition, syrup of ipecac has a peripheral action. Toxins ingested or foods previously eaten may inhibit or enhance emetic action by interfering with mediating and conducting mechanisms. Studies indicate that both syrup of ipecac and apomorphine are similarly effective in inducing emesis; however, apomorphine has a shorter reaction time compared with syrup of ipecac. There are more risks involved with the use of apomorphine, since it causes central nervous system and respiratory depression. Syrup of ipecac has been shown to be relatively safe when used in its recommended dosage for emesis. However, several toxicities have been reported with the use of the fluid extract of ipecac. Emesis is contraindicated in patients who are obtunded or comatose, and in patients who have ingested stimulants, some hydrocarbons, or corrosives. Mechanical pharyngeal stimulation is a simple method of inducing emesis; however, it is often unsuccessful and rarely recovers a significant portion of the gastric contents. Gastric lavage is a procedure which has been relied upon for over a century. Its effectiveness is dependent on the nature, form, and dosage of the poison, latency between time of ingestion and lavage, and technique. In clinical experiments studying gastric lavage, it has been noted that the procedure is most beneficial 1 to 2 hours postingestion for the majority of poison ingestions. Lavage also provides an excellent route for activated charcoal and selected antidotes. Gastric lavage may pose several risks to the patient, including obstruction and contamination of the airways and oesophageal damage. Contraindications for gastric lavage are similar to those for emesis except that it may be safer to use in obtunded, comatose, or uncooperative patients. Cathartics used during initial poisoning therapy are usually the saline cathartics. They elicit an osmotic reaction in the small intestine which results in increased intraluminal fluid bulk, hyperperistalsis, and subsequent propulsion of contents. Cathartics have also been shown to stimulate the secretion of cholecystokinin, which is thought to have similar effects on the intestine. Cathartics have not been shown to significantly enhance drug elimination from the gastrointestinal tract.(ABSTRACT TRUNCATED AT 400 WORDS)

Cathartics↗