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Biomedical subjects

R M Elenbaas

Publications and source records attributed to R M Elenbaas.

30 records · Page 2Linked to original sources
PubMed1980

Influence of clinical pharmacist consultations on the use of drug blood level tests.

The effect of a controlled-ordering program (prior authorization by a clinical pharmacist) on the number and cost of drug blood level assays performed at the Truman Medical Center (Kansas City, MO) was studied. Drug assay orders for aminoglycosides, phenobarbital, phenytoin, quinidine, theophylline, salicylate, thiocyanate, and propranolol, laboratory costs, and hospital census were reviewed retrospectively. The programs compared were: (1) control (July to December 1977)--drug blood level assays were ordered at physicians' discretion, and (2) study (January 16, 1978 to January 15, 1979)--all pharmacokinetic assays had to be approved by a pharmacist. A significant (p less than 0.001) reduction in the number of assays performed per month (40%) and in the assay cost per month (44%) occurred during the study period. The program was estimated to save $12,086.61 annually. The policy of requiring pharmacist approval of drug assay orders reduced the improper use and cost of pharmacokinetic monitoring.

Costs and Cost Analysis↗
PubMed1977

Drug therapy reviews: management of the disulfiram-alcohol reaction.

A review of the proposed mechanisms of the disulfiram-alcohol interaction and recommended management of the interaction is presented. The efficacy of disulfiram in the management of alcoholism, the signs and symptoms of the disulfiram-alcohol interaction, and other agents with disulfiram-like activity are discussed. Recommended treatment consists of supportive measures such as Trendelenberg posture, administration of oxygen and intravenous infusion of fluid, solute, colloid, and, if needed, a pressor agent such as norepinephrine. Iron salts, ascorbic acid, antihistamines and phenothiazines are of no established benefit.

Acetaldehyde↗
PubMed1977

The clinical pharmacist in emergency medicine.

The function of a pharmacist in emergency medicine, encompasing clinical practice, education and research, are described, and an evaluation of physicians' and nurses' attitudes toward pharmacist involvement in these areas is presented. In July 1974, a pharmacist joined the staff of a department of emergency health services in a medical center. In June 1976, a 14-item questionnaire was administered to physicians and nurses associated with the department. Seventy-two percent of the questionnaires were completed and returned. All respondents felt the pharmacist was an important component of the department and a benefit to its patient care and educational programs. Eighty-seven percent of the physicians stated that the pharmacist is capable of offering primary care to certain patients once the diagnosis has been made by a physician; 95% felt the role of the pharmacist is transferrable to other emergency room facilities and 83% were willing to have their patients charged for his services.

Attitude of Health Personnel↗
PubMed1976

Abscess formation as a complication of parenteral methylphenidate abuse.

Case reports of five patients suffering from either skin abscesses or cellulitis following parenteral methylphenidate abuse are presented. Four patients had similar lesions consisting of abscesses or cellulitis which demonstrated typical signs and symptoms of an infective process and were treated with local symptomatic therapy, incision and drainage if indicated, and systemic antibiotics. The fifth patient suffered from a circular, necrotic, nonpurulent ulcer on the dorsum of the right foot which produced no local or systemic toxic effects. Attempts to culture a responsible organism yielded Streptococcus viridans, an organism which is normal flora of the skin and, although opportunistic, is generally considered nonpathogenic. These cases further substantiate the belief that local vasospasm, chemical irritation, or both, produced by the methylphenidate solution may primarily cause a necrotic ulcer susceptibble to secondary bacterial infection.

Abscess↗
PubMed1976

Management of insulin allergy and resistance.

The pathophysiologic basis and therapy of insulin insensitivity and insulin allergy are discussed. Topics covered include primary and secondary causes of insulin insensitivity, management of insulin resistance (elimination of diabetogenic factors; use of less antigenic insulin, oral hypoglycemic agents, immunosuppression, or nonmammalian insulin), and insulin allergy and its treatment. A pharmacist's knowledge of insulin products and the pharmacologic activity of the oral hypoglycemic and immunosuppressive agents may aid in the care of patients who are allergic or resistant to insulin.

Animals↗
PubMedDate not supplied

Subcutaneous epinephrine vs. nebulized metaproterenol in acute asthma.

The efficacy and side effects of subcutaneous epinephrine (E) and aerosolized metaproterenol (M) were compared in acute asthma. Adults randomly received E 0.3 mg sub-Q q20min (max 0.9 mg; n = 20) or M 15 mg in 3.0 ml NaCl 0.9% nebulized over 10 minutes (n = 20) in a double-blind fashion. Vital signs and peak expiratory flow rate (PEFR) were measured every ten minutes for one hour. The two groups were comparable in age, weight, baseline theophylline concentration, PEFR, heart rate, and systolic and diastolic blood pressure. PEFR improved in both groups within ten minutes (p less than 0.01; analysis of variance). There was no difference in PEFR between the groups over the one-hour observation period following treatment. Heart rate decreased following treatment in M patients (p less than 0.05), but remained unchanged in E patients. Systolic blood pressure rose slightly in E patients (p less than 0.01), but remained unchanged in M patients. Subcutaneous E and nebulized M are equally effective as initial therapy in acute asthma.

Acute Disease↗