Thermolabile drug storage in an ambulatory setting

AbstractMore thermolabile drugs are becoming available, and in most cases, these medications are dispensed to ambulatory patients. However, there is no regulation once medications are dispensed to patients and little is known with regard to what happens during transport and home storage. Previous studies suggest that these drugs are improperly stored. The present study was designed to determine the storage conditions of thermolabile drugs once they are dispensed to the patient in the Hospital Pharmacy Department. This is a prospective observational study to assess the temperature profile of 7 thermolabile drugs once they are dispensed to ambulatory patients at a tertiary care hospital. A data logger was added to the medication packaging. Temperature was considered inappropriate if one of the following circumstances were met: any temperature record less than or equal to 0 °C or over 25 °C; temperatures between 0–2 or 8–25 °C for a continuous period over 30 min. The time series of temperature measurements obtained from each data logger were analyzed as statistically independent variables. The data shown did not undergo any statistical treatment and must be considered directly related to thermal measurements. One hundred and fourteen patients were included and 107 patients were available for the analysis. On the whole, a mean of 50.6 days (SD 18.3) were measured and the mean temperature was 6.88 °C (SD 2.93). Three data loggers (2.8%) maintained all the measurements between 2 and 8 °C with less than 3 continuous data (< 30 min) out of this range but no data over 25 °C or below or equal to 0 °C. 28 (26.2%) data loggers had at least one measurement below zero, 1 data logger had a measurement greater than 25 °C and 75 (70.1%) were between 0 and 2 °C and/or between 8 and 25 °C for more than 30 min. In conclusion, once dispensed to patients, most thermolabile drugs are improperly stored. Future studies should focus on clinical consequences and possible solutions.

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Thermolabile Drug Storage in an Ambulatory Setting

10.21203/rs.3.rs-91145/v1 ◽

2020 ◽

Author(s):

Fernando do Pazo-Oubiña ◽

Bartomeu Alorda-Ladaria ◽

Ana Gómez Lobon ◽

Bàrbara Boyeras Vallespir ◽

Maria Margalida Santandreu Estelrich ◽

...

Keyword(s):

Tertiary Care ◽

Statistical Treatment ◽

Storage Conditions ◽

Ambulatory Setting ◽

Temperature Record ◽

Care Hospital ◽

Data Logger ◽

Data Loggers ◽

Ambulatory Patients ◽

Clinical Consequences

Abstract BackgroundMore and thermolabile drugs are becoming available, and in most cases, these medications are dispensed to ambulatory patients. However, there is no regulation once medications are dispensed to patients and little is known with regard to what happens during transport and home storage. Previous studies suggest that these drugs are improperly stored. The present study was designed to determine the storage conditions of thermolabile drugs once they are dispensed to the patient in the Hospital Pharmacy Department.MethodsThis is a prospective observational study to assess the temperature profile of 7 thermolabile drugs once they are dispensed to ambulatory patients at a tertiary care hospital. A data logger was added to the medication packaging. Temperature was considered inappropriate if one of the following circumstances were met: any temperature record less than or equal to 0ºC or over 25ºC; temperatures between 0-2ºC or 8ºC-25ºC for a continuous period over 30 minutes. The time series of temperature measurements obtained from each data logger were analyzed as statistically independent variables. The data shown did not undergo any statistical treatment and must be considered directly related to thermal measurements.ResultsOne hundred and fourteen patients were included and 107 patients were available for the analysis. On the whole, a mean of 50.6 days (SD 18.3) were measured and the mean temperature was 6.88ºC (SD 2.93). Three data loggers (2.8%) maintained all the measurements between 2ºC and 8ºC with less than 3 continuous data (< 30 minutes) out of this range but no data over 25ºC or below or equal to 0ºC. 28 (26.2%) data loggers had at least one measurement below zero, 1 data logger had a measurement greater than 25ºC and 75 (70.1%) were between 0ºC and 2ºC and/or between 8º and 25ºC for more than 30 minutes.ConclusionsOnce dispensed to patients, most thermolabile drugs are improperly stored. Future studies should focus on clinical consequences and possible solutions.

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Thermolabile Drug Storage in an Ambulatory Setting

10.21203/rs.3.rs-91145/v2 ◽

2020 ◽

Author(s):

Fernando do Pazo-Oubiña ◽

Bartomeu Alorda-Ladaria ◽

Ana Gómez-Lobon ◽

Bàrbara Boyeras Vallespir ◽

Maria Margalida Santandreu Estelrich ◽

...

Keyword(s):

Tertiary Care ◽

Statistical Treatment ◽

Storage Conditions ◽

Ambulatory Setting ◽

Temperature Record ◽

Care Hospital ◽

Data Logger ◽

Data Loggers ◽

Ambulatory Patients ◽

Clinical Consequences

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Catastrophic Concomitant Arterial and Venous Thrombosis in a Mild COVID-19-Positive Patient

International Journal of Angiology ◽

10.1055/s-0041-1735200 ◽

2021 ◽

Author(s):

Raka A. Nugraha ◽

Hary S. Muliawan ◽

Nyityasmono T. Nugroho ◽

Muhammad Ikhsan ◽

Suko Adiarto

Keyword(s):

Critical Illness ◽

Venous Thrombosis ◽

Lower Limb ◽

The Other ◽

Ambulatory Setting ◽

Current Evidence ◽

Global Burden ◽

Significant Morbidity ◽

Ambulatory Patients ◽

Clinical Consequences

AbstractSince its first discovery in late 2019, coronavirus disease 2019 (COVID-19) has been a global burden associated with significant morbidity and mortality. COVID-19 has been correlated with the development of hypercoagulable state that predisposes the patients to a higher risk of thromboembolism. Current evidence suggests higher incidence of thrombosis, particularly venous thrombosis, among hospitalized COVID-19 patients, mostly with critical illness. On the other hand, there is currently no data regarding the incidence of vivid thrombosis in ambulatory patients with mild COVID-19 and the incidence of concomitant arterial and venous thrombosis in COVID-19 is extremely rare. Herein, we describe catastrophic outcomes of concomitant lower limb arterial and venous thrombosis in a patient with mild COVID-19. This report highlights the occurrence of concomitant arterial and venous thrombosis in ambulatory setting and that this phenomenon resulted in catastrophic clinical consequences.

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A questionnaire based study to assess the interns’ knowledge about the brand names of drugs routinely prescribed in a tertiary care hospital in Kerala, India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20183945 ◽

2018 ◽

Vol 7 (10) ◽

pp. 2042

Author(s):

Divya G. Krishnan ◽

Shaikh Ubedulla ◽

Anukesh Vasu Keloth

Keyword(s):

Patient Safety ◽

Correct Response ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Brand Names ◽

Care Hospital ◽

Ensure Patient Safety ◽

Clinical Consequences ◽

Good Percentage

Background: The gap in the knowledge of interns between brand names, generic name and indication of a drug can lead to unwanted clinical consequences. This study was conducted to assess the knowledge of interns at a tertiary care hospital regarding the generic name and indications of the routinely prescribed brand names of drugs.Methods: In this study, interns were required to write whether they prescribed the brand names mentioned in the questionnaire in the preceding six months, their generic name and the indication for their use. Results were expressed using descriptive statistics.Results: All brands except Zovobact SB was prescribed by more than 50% of interns in the preceding six months. The generic equivalents were correctly identified by good percentage of interns for Hicet (100%), Asthalin (95%), Cifran (90%) but the percentage of correct answers was low for other brands. For combination brands, correct generic names of all components were identified by more than 50% of interns for oflox TZ (93%), Septid D (68%) and Losar H (68%). The percentage of correct response for the indication of the brands was satisfactory for Hicet (100%), Asthalin (98%), Cifran (98%), Zerodol P (100%), Cyclopam (100%), oflox TZ (100%), Losar H (98%), Septid D (98%) but was inadequate for Taxim O (48%), Betaloc (33%), Valium (23%), Diamox (0%), Quadriderm (31%) and Zovobact SB (31%).Conclusions: This study identified lacunas in the knowledge of interns regarding generic equivalents and indications of brand names. Strategies to overcome the problem should be devised to ensure patient safety.

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Awareness and Use of Benzodiazepines in Healthy Volunteers and Ambulatory Patients Visiting a Tertiary Care Hospital: A Cross Sectional Survey

PLoS ONE ◽

10.1371/journal.pone.0001804 ◽

2008 ◽

Vol 3 (3) ◽

pp. e1804 ◽

Cited By ~ 4

Author(s):

Mustafa Raoof ◽

Haq Nawaz ◽

Rabeeya Nusrat ◽

Aqueel Hussain Pabaney ◽

Ali Raza Randhawa ◽

...

Keyword(s):

Healthy Volunteers ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Ambulatory Patients

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A clinico-mycological study of onychomycosis at a tertiary care center

Asian Journal of Medical Sciences ◽

10.3126/ajms.v8i1.15849 ◽

2017 ◽

Vol 8 (1) ◽

pp. 48-57

Author(s):

Attar Farhana Iqbal ◽

Tendolkar Uma Mahesh ◽

Baveja Sujata Mukesh ◽

Dhurat Rachita ◽

Phiske Meghna

Keyword(s):

Candida Species ◽

Potassium Hydroxide ◽

Fungal Infections ◽

Care Center ◽

Tertiary Care ◽

Laboratory Diagnosis ◽

Care Hospital ◽

Large Bulk ◽

Causative Agents ◽

Clinical Consequences

Background: Onychomycosis continues to be worldwide problem constituting a large bulk of cases attending the dermatology outpatient department. Fungal infections of nails have been partly studied,because it has been considered more of a cosmetic problem than a health problem. Although not life threatening, onychomycosis may have significant clinical consequences such as secondary bacterial infection, chronicity, therapeutic difficulties and disfigurement, in addition to serving as reservoir of infection. Aims and Objectives: To find out the prevalence, etiology and clinico-mycological correlation of onychomychosis among clinically suspected cases.To compare the microscopy findings using potassium hydroxide (KOH) preparation with potassium hydroxide- dimethyl sulfoxide (KOH-DMSO/DMSO) preparation.To compare demographic and clinical data inonychomycosis and fungus negative groupsMaterial and Methods: The study was conducted from October 2011 to October 2013, in the department of Microbiology of a tertiary care hospital in Mumbai, including 204 patients clinically suspected of onychomycosis. Nail scrapings were collected depending upon site, type of nail involvement and subjected for microscopic examination using 20% KOH and KOH DMSO (10-40%), followed by fungal culture.Results: Out of 204 patients, 78 (38.2 %) were diagnosed having onychomycosis, 72 (92.3%) patients were positive by direct microscopy and 45 (57.7%) by culture. DMSO preparation offered a faster clearing of background but in KOH preparation fungal morphology was better maintained even after 24 hours. In culture positive cases, isolation of dermatophytes was most common (42.2%), followed by Candida species (31.1%) and nondermatophytes (26.7%).Conclusion: This concludes that laboratory diagnosis of onychomycosis is essential as many conditions of nail mimic onychomycosis. Though commonest causative agents of onychomycosis are dermatophytes, number of cases caused by Candida species and nondermatophytesare on the rise.Asian Journal of Medical Sciences Vol.8(1) 2017 48-57

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Clinical & Microbiological profile of Fourniers Gangrene in a Tertiary Care Hospital in Bangladesh : A prospective observational study

Bangladesh Critical Care Journal ◽

10.3329/bccj.v5i1.32539 ◽

2017 ◽

Vol 5 (1) ◽

pp. 28-32

Author(s):

Tapash Kumar Maitra ◽

Mahmud Ekramullah ◽

Nilufar Shabnam ◽

Sharmistha Roy ◽

Samiran Kumar Mondol

Keyword(s):

Tertiary Care ◽

Cross Sectional Study ◽

Risk Indicator ◽

Care Hospital ◽

Microbial Infection ◽

Cross Sectional ◽

Systemic Complications ◽

Clinical Consequences ◽

Study Population ◽

Monomicrobial Infection

Background: Fourniers gangrene is the necrotising fasciitis of the genitalia and perineum, with associated poly microbial infection. Evidence based data in the very recent years suggest that it is associated with significant and potential risk of organ failure or death.Aim: This study was designed to be conducted among the patients suffering from Fourniers gangrene with a view to assess the probable prevalence rate of potentially adverse clinical consequences during course of treatment, overall mortality and to observe the microbiological pattern in our surgical practice.Method & materials: This cross sectional study was conducted among the 69 patients of Fourniers gangrene in BIRDEM General Hospital, Dhaka, Bangladesh from Jan 10.2013 to Sept 01 .2016, using the purposive sampling method.Results: The results of this study reflects that majority (43.4%) of the study population were in 51 to 60 years age group( Mean age 43±1.7 years) in study population. By using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, it was found that in most of the patients (approx 56.5%), a suspicious score ranging 06-08 was observed and only in 10.1% patients, a specific score of ?08 was observed. In 27.5% patients systemic complications like DIC, ARDS, MODS, MSOF and severe sepsis were observed in 1.4%, 4.3%, 10.1%, 4.3% and 5.7% cases respectively. Mortality rate was approximately 4.3%. Majority (84.1%) of the patients were associated with type 1 (Polymicrobial) bacterial infection, whereas in case of 15.9% patients, it was associated with type 2 (Monomicrobial) infection. Escherichia coli was the most frequently observed micro-organisms associated with approximately 39.1% of all cases. S. aureus, Staphylococcus pyogenes, Enterococci species, E.coli and Pseudomonas species were recorded to be associated with 17.4%, 27.5%, 21.7%, 39.1 and 10.1% cases respectively.Conclusion: This study suggests that Fourniers gangrene is associated with significant systemic complications. Poly microbial infections are most predominant and E coli infection was commonest organism involved.Bangladesh Crit Care J March 2017; 5(1): 28-32

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