Injection Prescription Research Articles

Adrénaline injectable à tous les allergiques alimentaires. « Pour »

The general severity of allergic reactions to foods, with natural progression tending towards aggravation rather than improvement, and the impossibility of predicting individually the severity of future reactions, have been established. It is also generally accepted that the non-administration or late administration of epinephrine (adrenaline) is a risk factor for the development of a potentially lethal reaction in a certain number of cases. Thus, although atopy and asthma are recognised risk factors for the appearance of a severe reaction, the following measures would appear to be advisable for all patients who have already presented an allergic reaction to foods: recommendation of an emergency kit including epinephrine; immediate prescription of an epinephrine injection at the first signs of allergy; and monitoring of compliance with recommendations, which should be clearly established.

In defence of the British system of injectable diamorphine prescription.

In defence of the British system of injectable diamorphine prescription.

Feasibility, safety, and efficacy of injectable heroin prescription for refractory opioid addicts: a follow-up study

Heroin-assisted substitution treatment for severely opioid-dependent drug users has been available in Switzerland since 1994. Our aim was to ascertain the feasibility, safety, and efficacy of this treatment. We did a cohort study in 21 community outpatient treatment centres. We assessed 1969 opioid-dependent drug users, who began heroin-assisted substitution treatment between January, 1994, and December, 2000, to ascertain admission and discharge patterns, and patient characteristics. We also followed up a subset of 237 patients who began treatment between Jan 1, 1994, and March 31, 1995, and who stayed with the programme for at least 18 months. We used questionnaires, interviews, and medical examinations done at entry and after 6, 12, and 18 months to assess somatic and mental health, social integration, and treatment outcomes. More than 70% (1378) of patients remained in treatment for more than a year. Treatment showed positive effects with respect to health and social outcomes. A long stay in treatment was related to a higher chance of starting abstinence-oriented therapy than a short stay. Heroin-assisted substitution treatment might be an effective option for chronically addicted patients for whom other treatments have failed.

チーム医療における薬剤師の役割 病棟薬局での一般輸液の混合

To facilitate mutual understanding between doctors and nurses, prevent errors, and assure quality control in the mixing intravenous drip solutions at Ikeda Municipal Hospital, the Department of Pharmacy manages changes in the mixing of solutions and provides appropriate information for drug use. We mix solutions for intravenous injection under uniform standards and also set up a satellite pharmacy to perform these functions in April 2000. This satellite pharmacy accepts prescriptions for manual intravenous injections and manages two laminar air follow cabinets and a laminar flow biological safety cabinet. A ward trial was started in April, another ward was added in June and all wards were included in October 2000. We mix solutions for intravenous injection from Monday till Friday, based on prescriptions received the previous day, from four divisions. The hours of operation are from 10 : 00 Am to 8 : 00 Pm excluding weekends and holidays. The preparation of anticancer and narcotic drugs is not performed by the satellite pharmacy. We mixed 60 to 70 bottles of intravenous injections per day, over a six-month period. Of the intravenous injections mixed, about 70 percent were mixed by the Department of Pharmacy. 95.3 percent were used, 1.8 percent diverted, 2.9 percent were not used.

Converting Stands of Low-Grade Hardwoods to Loblolly Pine: Stimulating Growth and Reducing Costs Through Litter Retention

Abstract Conversion of upland, low-grade hardwood stands to pine commonly includes hardwood competition control followed by burning of the site prior to planting. These practices risk erosion of sloped, thin soils. Litter retention provides mulch for newly planted seedlings, potentially increasing soil retention, moisture, and nutrient availability and reducing herbaceous competition without herbicides. This study assessed: (1) litter development, (2) levels of herbaceous biomass and soil moisture, and (3) pine seedling survival and growth resulting from litter retention incorporated into two approaches to stand conversion—inject and plant or underplant and release. A conventional preplant injection and burn prescription was the standard for comparison. When compared with conventional methods, conversion methods with litter retention significantly (1) reduced first- and second-year herbaceous biomass, (2) improved first-year soil moisture, (3) enhanced seedling growth and (4) eliminated the need for burning and first-year chemical reduction of herbs, thereby improving the economics of investment in these poor sites. South. J. Appl. For. 22(3):148-155.

Management of children with potential anaphylactic reactions in the community: a training package and proposal for good practice

The increase in potentially dangerous food allergic reactions (e.g. to peanuts and nuts) in children had lead to an increase in the prescription of adrenaline, including adrenaline for self- or parent-injection. This raises problems in the management of these children in schools. Our experience in response to this is described. To develop a training package to ensure that each child can continue at school but receive optimum emergency treatment in a safe environment. To provide education, training and support to school staff, and to support parents. This paper describes a model of good practice in the support of children with potentially fatal anaphylactic reactions. The following points are emphasized. Children with a history of anaphylactic reactions should be expertly assessed prior to the prescription of adrenaline injection. A written treatment plan is essential. Parents need expert support in managing the child. Schools need training and support. Children should lead a normal life, and not be stigmatized or labelled by their problem. Close liaison between primary care, acute services, community services and education services are essential for the successful management of this problem. Data from a questionnaire showed the training package was of benefit, with considerable reduction in anxiety in school staff and parents. A broad training package is essential: training in administration of adrenaline is only one aspect, and emphasis is placed on education, recognition of allergic reactions and prevention. The presence of children in school needing access to adrenaline is no longer perceived as a problem in our area. We recommend other health authorities provide a similar service.

注射薬処理監査システム

In order to guarantee more effective and safer parenteral therapy for inpatients, the checking system for prescription of injections using personal computer were developed in Yamaguchi University Hospital.The system is formed by the following three components.(1) First checking system offers epitomized information of incompatibility, stability, administration routes and methods on the display of personal computer.(2) Second checking system offers the detailed information of each medication, if necessary, on the first checking system.(3) Message delivering system prints out information of stability and adverse reaction for doctors and nurses.We believe that the system has contributed to dispensing injections.

看護婦を対象とした混注業務に関するアンケート調査

To develop the checking system for prescription of injections by pharmacists, a questionnaire of intravenous admixture on nurses of 7 hospitals in Yamaguchi Prefecture was carried out.It became clear that nurses had many problems in the ward which is not clean.It seems dengerous for the nurses to mix many injections, because they must perform with various other works. The nurses strongly expected pharmacists admix injections.The information such as easily incompatible injections, adverse reaction for injections when those are administered, has been required.

‘Horse trading’: prescribing injectable opiates to opiate addicts. A descriptive study

The clinical audit of 40 opiate-dependent individuals who were prescribed injectable drugs (heroin or methadone) between June 1987 and June 1989 is described. These subjects were characterized by the chronicity of their injecting and dependent opiate use, and by their refusal to comply with a treatment programme involving oral-only prescribing. The key aim was to attract entrenched injectors into contact with treatment services and to promote movement away from injecting drug use and reduce HIV risk behaviour. On review 35 of the original 40 were either still receiving an injectable prescription or injecting illicit drugs. Despite this 14 (35%) were rated as making positive life changes. Nine (22.5%) had been admitted to the in-patient unit and became drug free during their stay. The stability of the lives of eight (20%) had deteriorated. The benefits and drawbacks of this form of intervention are discussed with comparison to the other studies of injectable drug prescribing.

Insulin injection technique and diabetic control

AbstractA major cause of unreliable and variable insulin absorption may be ‘scar’ formation at the site of repeated injection, revealed as lipohypertrophy. 60 patients with poor diabetic control (HbA1, ⪖11%), increased insulin requirements (⪖1u/kg/24 hrs) and poor injection sites were initially studied. Intensive reeducation improved 34 patients within 2 months; 26 patients continued to be poorly controlled. These patients were further studied following re‐instruction in injection technique and prescription of ‘disposable’ injection equipment.Analysis of BM 20–800 readings, HbA1, and insulin dosage was performed at change‐over, 2 months, 6 months and 12 months. Mean daily dosage fell from 83u/24 hrs initially to 51u at 2 months, 53u at 6 months and 47u at 12 months. At the same time intervals, mean HbA1 was 12.0%, 10.4%, 10.7%, 10.1% (P<0.05), frequency of symptomatic hypoglycemia per week was 2.0, 0.5, 0.4, 0.6 (P<0.01) and BM 20‐800 stick readings ⪖22 mmol/l were 5.0, 1.0, 0.0, 0.5 (P< 0.01). Specific instruction on injection technique with disposable equipment produced improved control with less frequent hypoglycemic episodes and reduced insulin requirements. Strict attention to injection sites improved diabetic control.