Hepatotoxicity of therapeutic short-course paracetamol in hospital inpatients: impact of ageing and frailty.
J Clin Pharm Ther. 2011 Jun;36(3):327-35
Authors: Mitchell SJ, Hilmer SN, Murnion BP, Matthews S
Abstract
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Impact of a self-administration of medications programme on elderly inpatients’ competence to manage medications: a pilot study.
J Clin Pharm Ther. 2011 Feb;36(1):80-6
Authors: Lam P, Elliott RA, George J
WHAT IS KNOWN…

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Naloxone in the management of hepatic encephalopathy.

J Clin Pharm Ther. 2010 Jun;35(3):333-41

Authors: Jiang Q, Jiang G, Welty TE, Zheng M

This study aimed to assess the effectiveness and safety of naloxone in the management of hepatic encephalopathy (HE).

PMID: 20831534 [PubMed - indexed for MEDLINE]

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The role of carbamazepine and oxcarbazepine in alcohol withdrawal syndrome.

J Clin Pharm Ther. 2010 Apr;35(2):153-67

Authors: Barrons R, Roberts N

OBJECTIVE: The goal of this review is to evaluate the efficacy and safety of carbamazepine and oxcarbazepine in treatment of alcohol withdrawal syndrome (AWS) and determine the role in therapy of both agents. METHODS: Relevant literature was identified through a search of MEDLINE (1966-June 2008), PubMed (1966-June 2008); Cochrane database was performed to identify English-language publications. Search terms included carbamazepine, oxcarbazepine, AWS, alcoholism, substance syndrome withdrawal. RESULTS: In seven studies, including 612 patients, carbamazepine demonstrated significant reduction in alcohol withdrawal scores. However, in comparative trials with a benzodiazepine agent, carbamazepine’s ability to prevent alcohol withdrawal seizures (OR = 0.93; 95% CI = 0.06-14.97, P = NS) and delirium tremens (DTs; OR = 1.25; 95% CI = 0.28-5.64, P = NS) was uncertain as a result of insufficient patient enrollment. In three trials, carbamazepine failed to reduce alcohol withdrawal symptoms possibly as a result of delayed administration, inadequate dosage or inadequate sample size. At daily doses of 800 mg either fixed or tapered over 5-9 days, carbamazepine was well tolerated, and safely administered when blood alcohol concentration dropped below 0.15%. The role of oxcarbazepine in AWS is undefined because of inconsistent findings in two trials. CONCLUSION: Carbamazepine has demonstrated safety, tolerability and efficacy in treatment of moderate to severe symptoms of alcohol withdrawal in the inpatient setting. However, trials of carbamazepine provide inconclusive evidence for prevention of alcohol withdrawal seizures and DTs in comparison with benzodiazepines. Benzodiazepines remain the primary treatment of moderate to severe AWS.

PMID: 20456734 [PubMed - indexed for MEDLINE]

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A 3-year study of medication incidents in an acute general hospital.

J Clin Pharm Ther. 2008 Apr;33(2):109-14

Authors: Song L, Chui WC, Lau CP, Cheung BM

BACKGROUND AND OBJECTIVE: Inappropriate medication use may harm patients. We analysed medication incident reports (MIRs) as part of the feedback loop for quality assurance. METHODS: From all MIRs in a university-affiliated acute general hospital in Hong Kong in the period January 2004-December 2006, we analysed the time, nature, source and severity of medication errors. RESULTS: There were 1278 MIRs with 36 (range 15-107) MIRs per month on average. The number of MIRs fell from 649 in 2004, to 353 in 2005, and to 276 in 2006. The most common type was wrong strength/dosage (36.5%), followed by wrong drug (16.7%), wrong frequency (7.7%), wrong formulation (7.0%), wrong patient (6.9%) and wrong instruction (3.1%). 60.9%, 53.7% and 84.0% of MIRs arose from handwritten prescription (HP) rather than the computerized medication order entry in 2004, 2005 and 2006 respectively. In 43.1% of MIRs, preregistration house officers were involved. Most errors (80.2%) were detected before any drug was wrongly administered. The medications were administered in 212 cases (19.7%), which resulted in an untoward effect in nine cases (0.8%). CONCLUSIONS: The most common errors were wrong dosage and wrong drug. Many incidents involved preregistration house officers and HPs. Our computerized systems appeared to reduce medication incidents.

PMID: 18315775 [PubMed - indexed for MEDLINE]

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