Mikio Nishikawa

Problems and Efficiencies of PC-order Entry System for Prescription.

We have converted our hospital information system used in Hamamatsu University School of Medicine from a host on-line system to a client-server system (PC-ordering). Problems and efficiencies in the use of this new order entry system for prescriptions were subsequently evaluated.Several merits were identified such as contraindicational drug use, drug interaction and duplication checking systems, but many problems still remain to be overcome in the PCordering system package produced by NEC.We classified these problems into three categories:(1) data transfer problems, (2) system conversion problems, and (3) client-server system problems.

The concentration of benzyl alcohol in the blood after the injection of ethanolamine oleate.

The concentration of benzyl alcohol (BA) in the blood of the patients after the intravariceal injection of ethanolamine oleate (EO) with meglumine amidotrizoate (EO-MA) for endoscopic sclerotherapy of esophageal varices was determined by GLC method. BA appeared in the peripheral blood immediately after the interavariceal injection of EO-MA, therefore it was found that the leak of BA from the varix occurred very early. But BA disappeared rapidly from the blood (t1/2= 10 minutes). The hemolysis after the intravariceal injection had no relation to the concentration of BA in the blood.The actions of BA and EO on erythrocytes were examined in vitro, and the hemolyzing effect of EO was much stronger than that of BA. From these results, it is thought that the effect of BA on the hemolysis after the intravariceal injection of EO-MA is only a little and the hemolysis probably results from EO.

Quality test of ethanolamine oleate injection.

Quality tests were made on two kinds of oleic acids as raw materials (OA), JIS extra pure reagent (OA-JIS) and guaranteed reagent with content of about 99%(OA-GR), which were used for the material of ethanolamine oleate injection (EO-i). Furthermore, the effect of the difference of OA on the quality of EO-i was studied.The content of peroxide in OA-JIS was higher when it was stored at room temperature than in a cold place. Therefore, it is necessary to store OA-JIS in consideration not only of light and air but of temperature.The pH of EO-i with OA-GR was same as that with OA-JIS, while the viscosity of EO-i with OA-GR was higher. EO-i with OA-GR remained colorless before and after sterilization, whereas in the case of OA-JIS, the pale yellow color became more intense by sterilization. Light and temperature had no effect on the stability of EO-i, e. g., production of peroxide, the content of oleic acid and pH.Although the further comparative study on effectiveness and safety of OA-GR and OA-JIS as the sclerosing agent for esophageal varix is necessary, it is thought, from the above results, that the use of OA-GR is desirable in pharmaceutical aspect.

Compatibility of Bricef Dry Syrup with Mixed Solutions

Compatibilty of Bricef Dry Syrup (cefatrizine oral suspension) with mixed solutions which were often pre scribed in our hospital was investigated in terms of changes in external appearance pH and residual potency of cefatrizine (CFT). These changes were checked immediately after and 1, 3, 5, 7 and 14 days after mixing. The results showed lowering, to some extent, of CFT potency in relatively high pH region. Especially, when dry syrup was mxed with an alkaline solution, CFT potency reduced significantly within 24 hours at room temperature. These results suggest that careful attention should be paid to the above combination since a risk of incompatibility may be involved.Color of suspensions of a few preparations changed during the storage. The change in color should be avoided to prevent anxiety in patients, though its correlation with stability of CFT is not clear. In combiantions with other solutions, the change in appearance, pH and potency of CFT was small, suggesting that such combinations be clinically recommendable.