Mary Lynn Moody

Drug therapy for nocturnal enuresis: Current treatment recommendations

SummaryIt is estimated that enuresis occurs in 5 to 7 million children in the United States. The treatment approach for enuresis is controversial, in large part due to a lack of consensus as to the exact cause of enuresis. Several factors either alone or together may contribute to this syndrome. In addition, there is strong evidence of a genetic component to enuresis.Pharmacotherapy continues to be the preferred treatment for both physicians and families. The most widely used drugs include antidepressants, anticholinergics, and desmopressin. The tricyclic antidepressant imipramine has been used extensively since the 1960s. The exact mechanism of action in enuresis is unknown although it appears to be related to the anticholinergic and antispasmodic effects of the drug. The most common adverse effects reported with imipramine include personality changes, insomnia, anorexia and anxiety.There has been renewed interest in antidiuretic treatment of enuresis. Researchers have found that enuretic children do not have the ability to reduce urine volume at night or concentrate the urine they produce during the night. Clinical trials with desmopressin administered by nasal inhalation report a marked reduction in enuretic episodes. Adverse effects were limited to nasal complaints, rhinitis, or epistaxis. Additional long term studies are needed to delineate desmo-pressin’s role in therapy.Although the number of options for treatment of enuresis is expanding, criteria to predict patient response need to be defined.

Second Consensus Development Conference on the Safety of Intravenous Drug Delivery Systems—2008

In 1999, the first Consensus Development Conference on the Safety of Intravenous Drug Delivery Systems was held to evaluate the relative safety and cost of available nonelectronic i.v. drug delivery systems for parenteral medications. Included in the evaluation were the use of manufacturer-prepared

Evaluation And Critical Appraisal Of A Random Sample Of Drug Information Practice In United States Academic And Industry Medical Information Centers

Capturing the best practices in an academic and pharmaceutical industry drug information center, and in turn, incorporating them into improved methodical work procedures and current services, is a goal for most drug information centers. The best practices should represent the most efficient and productive means of providing drug information. Knowing this information helps to improve workflow, decrease costs, increase overall productivity and proficiency, and improve employee and customer satisfaction. In order to critically evaluate the current situation and fully comprehend the established practice standards, an evaluation survey was conducted. Two separate surveys were sent electronically or faxed to both academic and industry drug information departments. The survey focused on utilization of the drug information center within the department, practice procedures and resources utilized in answering drug information requests, training and evaluation of employees, means of providing quality assurance, and technical and operational logistics. A description and results of this survey are described.

Consensus conference on prevention of central line-associated bloodstream infections: 2009.

Health care-acquired infections are a significant cause of morbidity and mortality in all patient care settings. In 2009, a consensus conference was held to evaluate practices and recommendations for the prevention and control of one specific type of health care-acquired infections, those associated with central catheter use. The conference had 2 purposes—-to provide a tool for quality changes within health care institutions regarding central catheter infections and to empower those who are responsible for implementing policies needed to reduce the risk of these infections. The findings of the expert panel assembled for the conference are presented in this article.

Evaluation of the clinical significance of nitroglycerin adsorption

identify those with CAD or systolic LV dysfunction. In patients with congenital or valvular disease, Brown et al2 noted that LVEDP consistently increased after the injection of contrast material into the left atrium, left ventricle or ascending aorta, but their group of 133 subjects contained none without demonstrable cardiac disease. In 29 patients without and 60 with CAD, Gensini et al4 demonstrated that the increase in LVEDP after coronary arteriography is greater in those with CAD and is especially marked in those with LV aneurysms. However, the difference in ALVEDP between those with and without CAD was small (7.6 and 4.5 mm Hg, respectively). In 40 patients, Kavanagh-Gray3 noted similar findings and implied that the magnitude of increase of LVEDP after angiography may be useful in elucidating both the presence and severity of CAD. This study contained only 7 patients without CAD and failed to show a statistically significant difference in ALVEDP among those with l2and 3-vessel CAD. Despite the limitations of these studies, many catheterization laboratories routinely measure and report a postventriculographic LVEDP. Our data, obtained prospectively in many patients without associated valvular or congenital disease, demonstrate that the magnitude of increase of LVEDP after left ventriculography bears no relation to the presence or severity of CAD or systolic LV dysfunction. Specifically, the increase in EDP was similar in those with and without CAD (Fig. l), and there was no relation between the increase in EDP and LVEF (Fig. 2), end-systolic volume index, cardiac index or LV dP/dt. Thus, we suggest that the measurement of LVEDP after angiography is of no value in identifying patients with CAD or systolic LV dysfunction.

Drugs to be used with a filter for preparation and/or administration

This chart is an update to the 2012 article published in Hospital Pharmacy on injectable drugs to be used with a filter. To update the chart, drugs approved from December 2011 to April 2019 were re...

Fee-for-Service Drug Information Centers

Many university and hospital-based drug information centers have implemented fee-for-service systems. However, it is unclear how the services are operated and contracted, and how clients are recruited. The purpose of this study was to evaluate university and hospital-based drug information centers in Canada, the United Kingdom, and the United States that had fee-for-service systems. A survey consisting of 14 questions (United States and Canada) or 15 questions (United Kingdom) was sent to 221 drug information centers. Ninety four drug information centers responded (43%), 17 (18%) of which had implemented a fee-for-service system. The data were entered and Microsoft Access and Excel programs were used to analyze them. The findings include that clients are usually recruited by word-of-mouth, and that fees charged vary among drug information centers and are highly dependent on the project and the situation.