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Biomedical subjects

L J Pesko

Publications and source records attributed to L J Pesko.

9 recordsLinked to original sources

Time-motion study of intravenous ranitidine admixtures.

This study determined the total preparation time, cost, and contamination rate associated with preparing 50-mL admixtures of ranitidine 50 mg from each of the following commercial source vials: 50 mg/2 mL unit-dose vial (treatment A), 50 mg/2 mL 10 mL multidose vial (treatment B), and 50 mg/2 mL 40 mL multidose vial (treatment C). The study consisted of two separate phases: phase I extemporaneous compounding and phase II batch manufacturing. Twelve technicians prepared ten admixtures from each source vial during each phase. All admixtures were tested for sterility; bacterial contamination was not observed. Multidose vials saved approximately $197 per 200 admixtures. Drug and personnel costs were reduced when batch manufacturing with 40-mL multidose vials was compared with extemporaneous compounding with unit-dose vials. Our study showed that multidose vials decreased the total preparation time and cost for making ranitidine admixtures during both extemporaneous compounding and batch manufacturing by reducing setup time, preparation time, and drug procurement cost.

Drug Compounding↗

Cost and acceptability of three syringe-pump infusion systems.

The fiscal impact and acceptability of implementing a syringe-pump infusion system at a 900-bed university teaching hospital where the minibag system has been in use is reported. Researchers selected three models of syringe pumps for evaluation: the Bard Harvard Mini-Infuser 150XL, the Becton Dickinson 360 Infuser, and the Strato Stratofuse System. Each pump was evaluated for three weeks on a medical-surgical unit and a hematology-oncology unit. Drugs to be infused were chosen after a literature review to determine which drugs had been successfully infused via syringe pump; 22 formulary medications were selected. Syringes were prepared as singly packaged doses or as doses prepared in bulk and packaged frozen. Control of the syringe pumps and microbore tubing was assigned to the inpatient pharmacy staff. Nurses and pharmacy personnel were apprised of the study and taught how to use the syringe pumps. Time-and-motion studies were performed in the sterile products preparation area, and a cost analysis was done. Nurses preferred syringe pumps over the minibag system because the pumps reduced the nursing time needed to infuse a drug, administered less fluid, provided consistent infusion rates, had alarms, and were relatively easy to use. The time required to prepare syringes did not differ substantially among syringe-pump models. It was estimated that using any of the evaluated pumps in place of the minibag system would save $126,500 during the three-year period 1988-91, primarily because of differences in the cost of disposable items. The syringe-pump infusion system is an acceptable and cost-effective alternative to the minibag system.

Costs and Cost Analysis↗

Stability of carbamazepine suspension after repackaging into four types of single-dose containers.

The stability of carbamazepine in commercially available suspension that had been repackaged in various single-dose containers was studied. Carbamazepine suspension was repackaged in 2-mL and 8-mL aliquots in amber glass vials, polypropylene vials, and amber polypropylene syringes and in 2-mL aliquots in amber glass oral syringes. Containers were stored at room temperature and continuously exposed to fluorescent light for up to 12 weeks. Samples from each container type and volume were assayed for carbamazepine content by high-performance liquid chromatography at various intervals during storage. Carbamazepine concentrations in the samples were compared with the carbamazepine concentration in the original manufacturer's container. The pH of the samples was also determined, and the suspensions were inspected for color, odor, and large particles. There was no significant decrease in carbamazepine concentration of more than 10% in samples stored for up to eight weeks. After 12 weeks, significant decreases in concentration were observed in all but one container type. No changes in color, odor, or consistency were observed during the 12 weeks, and there were no significant changes in pH. In commercially available suspension repackaged in volumes corresponding to common pediatric doses, carbamazepine (20 mg/mL) is stable for at least eight weeks when stored at room temperature in the containers tested.

Carbamazepine↗

Microbial growth patterns in intravenous fat emulsions.

Microbial growth patterns were studied in intravenous fat emulsions under conditions that simulated touch contamination before or during administration. Commercially available emulsions of 10% and 20% soybean oil and 10% safflower oil in 500-ml bottles were inoculated with two concentrations of each of four organisms: a coagulase-negative Staphylococcus isolated from a venipuncture site, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans. The bottles were kept at room temperature, and samples were taken by direct puncture of the i.v. port at 0, 3, 6, 12, 24, 48, and 72 hours, diluted, and plated. Emulsions were visually inspected daily. Growth of the coagulase-negative Staphylococcus was minimal for 48 hours. E. coli showed substantial growth within 12 hours in all three emulsions. Growth patterns for Ps. aeruginosa were similar in all emulsions, and growth approximated that of E. coli within 48 hours. The growth rate of C. albicans was intermediate between that of Staphylococcus and those of E. coli and Ps. aeruginosa. Growth of C. albicans was greater in 10% safflower oil emulsion than in the other emulsions. No physical changes were observed. The coagulase-negative Staphylococcus showed less growth than C. albicans, Ps. aeruginosa, and E. coli. Substantial growth within 12 hours was seen only with E. coli. C. albicans exhibited preferential growth in 10% safflower oil emulsion.

Bacteria↗

Stability of cefazolin sodium admixtures in plastic bags after thawing by microwave radiation.

The effect on antibiotic stability of thawing, with microwave radiation, cefazolin sodium admixtures frozen in polyvinyl chloride minibags was studied. Two brands of cefazolin sodium (Ancef and Kefzol) were reconstituted and placed in 50-, 100- and 250-ml polyvinyl chloride minibags of 5% dextrose in water or 0.9% sodium chloride. The resulting solutions were assayed for antibiotic stability, using an agar disk diffusion technique, and for pH. The solutions were then stored at -20 degrees C for 48 hours, thawed to room temperature in a microwave oven, and kept at room temperature for four hours, after which they were reassayed for potency and pH. The results indicated that after the freeze-thaw process, the cefazolin sodium minibag admixtures retained at least 90% of their initial antimicrobial activity. The minimal pH changes could not be related to changes in antimicrobial activity, and no color changes could be detected visually. Using a microwave oven can greatly reduce thawing time of antibiotic admixtures. To maintain solution stability and prevent accidents, it is important to calibrate the oven, avoid solution overheating, and observe full precautions in oven operation.

Biological Assay↗