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Biomedical subjects

M M Tschampel

Publications and source records attributed to M M Tschampel.

4 recordsLinked to original sources

Considerations of drug therapy in patients receiving enteral nutrition.

Some basic principles to consider in giving medications to patients receiving enteral nutrition include: 1. If the patient is able to take medication by mouth, this is the preferred route. 2. Liquid medications are the preferred dosage form. 3. The use of oral medications that are not meant to be crushed for enteral tube administration should be avoided. 4. For individual doses of most medications, the tube should be flushed with at least 30 ml of water before and after administration of medications. 5. Highly concentrated solutions should be diluted with 60 ml of water. 6. When several medications are to be administered to the same patient, all medications should be delivered separately and the tube flushed with at least 5 ml of water after each dose. 7. Medications should not be added directly to the feeding formulation. 8. Drug-nutrient interactions should be considered. 9. GI side effects are the most common adverse effects that occur with enteral feedings, and treatment depends on the cause.

Dosage Forms

Pharmaceutical continuing-education program based on a core curriculum.

The use of a core curriculum concept in the establishment of a comprehensive continuing-education program is described. A departmental staff development committee was selected to develop a core curriculum of topics for professional continuing education. Six core curriculum areas of interest and importance were identified: cardiology; infectious disease; total parenteral nutrition, acid-base balance, and fluid and electrolytes; pharmacy management; critical-care medicine; and pharmacokinetics. Coordinators were selected from the staff to identify topics and speakers in each core curriculum area. The drug information center was assigned responsibility for logistical aspects of the program such as scheduling, evaluations, objectives, information support, and providing continuing-education credit. A survey of staff perceptions revealed a very positive view of the program. The staff rated the program highly as meeting their needs for continuing-education credit, as an employee benefit, and in covering topics related to their practice. The core curriculum concept has been shown to be a successful and effective approach to the establishment of a comprehensive continuing-education program.

Curriculum

Comparison of visual and turbidimetric methods for determining short-term compatibility of intravenous critical-care drugs.

Visual and turbidimetric methods for determining the short-term compatibility of critical-care i.v. drugs were compared. In phase 1, serial dilutions of calcium chloride and magnesium sulfate were examined visually and turbidimetrically to test the sensitivity of the spectrophotometric method used. In phase 2, i.v. solutions of dobutamine, dopamine, lidocaine, nitroglycerin, and nitroprusside were prepared and studied in all possible combinations of two, three, four and five drugs, for a total of 26 different combinations. In phase 3, 45 two-drug combinations previously reported as physically incompatible were studied. Visual inspection was conducted against a dark and a light background; changes were graded as slight, moderate, or gross. Absorbance was determined at 650 nm; an absorbance value of greater than 0.010 was considered to be evidence of turbidity. Visual, turbidimetric, and pH measurements were done at zero, one, and three hours after mixing. Samples of the calcium chloride-magnesium sulfate mixture that were graded visually as having a slight precipitate had absorbance readings less than 0.010. No physical evidence of incompatibility was observed by either method for dobutamine, dopamine, lidocaine, nitroglycerin, and nitroprusside in any combination. In phase 3, 19 drug combinations were shown to be incompatible; however, only 6 of these (31%) had absorbance readings greater than 0.010 when the visual incompatibility was first observed. There was no physical evidence of incompatibility for several drug combinations that have been listed as incompatible in commonly used references. Turbidimetry does not appear to be as reliable a method for determining the compatibility of drugs as is visual inspection against a dark and a light background.

Chemistry, Pharmaceutical