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Biomedical subjects

R L Lucarotti

Publications and source records attributed to R L Lucarotti.

12 recordsLinked to original sources
PubMed1986

Patient-teaching program for home intravenous antimicrobial therapy.

The development of a home i.v. antimicrobial therapy program and associated procedures for patient teaching are described. The pharmacy department at a 940-bed, acute-care, general medical-surgical teaching hospital participated with four other departments in the development of standardized teaching methods for a home i.v. antimicrobial therapy program. The pharmacy and nursing departments each developed sections of a home antimicrobial therapy manual. Over a 16-month period, i.v. antimicrobial therapy was prescribed for 37 patients who were discharged from the hospital. Most patients or their care-givers were able to prepare and administer the medications. After the patient was discharged, the pharmacy department offered services such as supplying medications, coordinating pharmacokinetic dosing, providing drug information, and acting as a patient contact. Hospitals that provide home i.v. antimicrobial therapy should coordinate the resources of the various departments involved to develop standardized patient-teaching methods.

Anti-Infective Agents↗
PubMed1985

Improving patient-oriented pharmacy services: panel discussion.

A panel discussed ways to improve patient-oriented pharmacy services, drawing on the proceedings of a recent conference on directions for clinical practice in pharmacy. Clinical pharmacy should be defined in terms of responsibility rather than by a list of specific functions. Pharmacists are responsible for drug use, not just for dispensing; this implies responsibility for educating physicians and nurses to ensure optimal patient outcomes. Clinical practice cannot be separated from pharmacy practice; although pharmacy practice requires different kinds of tasks, all have the goal of patient care. Pharmacists can exercise their responsibility for control of drug use without prescriptive authority or mandated review of physician prescribing. Pharmacists can increase their influence on drug therapy through the formulary system and through their physical presence on patient-care units. A mission statement that recognizes responsibility for patient outcomes can serve as the basis for a management system that supports clinical practice. The panel members believed that pharmacy leaders at the conference were unified by a commitment to increase the profession's clinical orientation.

Humans↗
PubMed1984

Videotaped patient medication instruction program using closed-circuit television.

A program is described in which hospital patients receive videotaped medication instruction that is reinforced by printed information. In a 940-bed hospital, the pharmacy department developed a series of videotapes for closed-circuit television. Each tape covers a medication or drug class and includes use of the drug, precautions, administration instructions, and adverse effects. Pharmacists developed the basic test, and the patient education department revised the language to meet the needs of patients. Pharmacists presented the information on the tapes, which were produced by the hospital's video production department. File cards that paraphrased the script were designed to give patients written information to take home. Each tape is shown once daily. The tape includes the pharmacy phone number and encourages patients to call the pharmacy to obtain a card. A pharmacist delivers the cards and reviews the information. In this program, information can be presented to a large number of patients with minimal use of pharmacists' time.

Drug Therapy↗
PubMed1983

Gentamicin and tobramycin dosing guidelines: an evaluation.

The provision of pharmacokinetic dosing services has become a cornerstone of clinical pharmacy practice in many institutions. As these services expand, more pharmacists will become involved, and the need for a structured, uniform approach to the provision of these services may be necessary. Therefore, this article discusses specific approaches (i.e., guidelines) to the most common clinical conditions that the pharmacist may encounter. The goal is to promote consistent interpretation and application of clinical and kinetic data by the members of our aminoglycoside dosing service. The guidelines provide a structured yet adaptive approach to the clinical use of gentamicin and tobramycin. The major areas of controversy that were encountered in developing these guidelines are discussed, and the guidelines are presented. These guidelines currently are used to standardize our pharmacokinetic dosing service and as a tool for educating new pharmacists to their role and responsibilities as members of the pharmacokinetic consultation team. Additionally, these guidelines are being used as criteria for the assessment of quality assurance in the area of clinical pharmacokinetics.

Adult↗
PubMed1978

Training staff pharmacists for clinical positions.

A five-phase education and training program for establishing and maintaining the clinical competency of pharmacists in a 940-bed private, nonprofit hospital is described. In Phase 1 of the program, pharmacists are given selected textbook and journal materials in 15 study sections, each requiring 20--30 hours of the pharmacist's own time to complete. Phase 2 consists of two months of instruction in the daily clinical routine with emphasis on applying knowledge by investigating clinical problems through case presentation and by answering questions of health professionals. During Phase 3, the pharmacist is assigned to a patient-care area for two months to perform the duties of a clinical pharmacist. The pharmacist is assigned to the drug information center for two months during Phase 4. Phase 5, the year-round continuing education component of the program, consists of regularly scheduled clinical rounds, meetings and conferences. Upon completion of Phases 1--4, pharmacists selected for clinical positions provide clinical services for eight to 10 months and rotate to the pharmacy distribution area during the remaining two to four months per year. The education and training program described is important to the development and expansion of clinical services in this hospital.

Curriculum↗
PubMedDate not supplied

Controlled comparison of gentamicin and tobramycin nephrotoxicity.

317 patients with suspected or documented infections other than cystitis were randomly assigned to receive gentamicin or tobramycin dosed according to the Sawchuk/Zaske method or a modification of the McHenry method. 196 patients completed 6 days of therapy, had serial determinations of serum creatinine and were evaluated for nephrotoxicity. Within each dosing method group those patients receiving gentamicin and tobramycin had a similar mean age, initial serum creatinine level, total dose, duration of therapy and trough serum aminoglycoside concentration. Nephrotoxicity developed in 5 of 49 (10.2%) given gentamicin via the McHenry method compared to 9 of 49 (18.4%) given tobramycin. Similarily, 4 of 50 (8.0%) given gentamicin via the Sawchuk/Zaske method developed nephrotoxicity compared to 8 of 48 (16.7%) given tobramycin. Within the Sawchuk/Zaske and the modified McHenry dosing method groups, no significant difference was noted in the incidence of nephrotoxicity associated with gentamicin and tobramycin. 34% of patients with elevated trough serum aminoglycoside concentrations developed nephrotoxicity compared to 3.7% of those with nonelevated troughs (p less than 0.0005).

Anti-Bacterial Agents↗