RESUMO
BACKGROUND: Older patients suffer more often from drug-induced complications. OBJECTIVE: What are the precise recommendations pharmacists can give to geriatricians? MATERIAL AND METHODS: Two pharmacists conducted clinical rounds on 2 geriatric wards over a period of 54 weeks. Protocols of conspicuous medications for geriatric patients were analyzed and suggestions were made. RESULTS: Particularly frequent were the questionable medical indications for proton pump inhibitors, allopurinol, pregabalin and gabapentin. Adjustment of the dosage of heparin and its analogs to impaired renal function of patients was often lacking. This was also occasionally the case for metformin, some antibiotics and simvastatin. There were several interactions of drug combinations with a high risk for QT prolongation. The inhibition of resorption of bisphosphonates and Lthyroxin by the simultaneous intake of magnesium and calcium seemed to be probable. Furthermore, it was noticed that for some medications for patients treated by percutaneous endoscopic gastrostomy (PRG) administration by feeding tubes was not possible and combinations of different eye drops which should not be applied simultaneously but at delayed time intervals. CONCLUSION: An additional medication-related visit provides an interventional option for avoidance of medication errors.
Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Geriatria , Departamentos Hospitalares , Comunicação Interdisciplinar , Colaboração Intersetorial , Erros de Medicação/prevenção & controle , Farmacêuticos , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha , Humanos , Prescrição Inadequada/prevenção & controle , Masculino , Encaminhamento e Consulta , Fatores de Risco , Visitas de PreceptoriaRESUMO
A method that explains how to quantify the amount of order in "ordered" and "highly ordered" porous arrays is derived. Ordered arrays from bee honeycomb and several from the general field of nanoscience are compared. Accurate measures of the order in porous arrays are made using the discrete radial distribution function (RDF). Nanoporous anodized aluminum oxide (AAO), hexagonal arrays from functional materials, hexagonal arrays from nanosphere lithography, and square arrays defined by interference lithography (all taken from the literature) are compared to two-dimensional model systems. These arrays have a range of pore diameters from approximately 60 to 180 nm. An order parameter, OP( 3 ) , is defined to evaluate the total order in a given array such that an ideal network has the value of 1. When we compare RDFs of man-made arrays with that of our honeycomb (pore diameter approximately 5.89 mm), a locally grown version made by Apis mellifera without the use of foundation comb, we find OP( 3 )=0.399 for the honeycomb and OP( 3 )=0.572 for man's best hexagonal array. The nearest neighbor peaks range from 4.65 for the honeycomb to 5.77 for man's best hexagonal array, while the ideal hexagonal array has an average of 5.93 nearest neighbors. Ordered arrays are now becoming quite common in nanostructured science, while bee honeycombs were studied for millennia. This paper describes the first method to quantify the order found in these arrays with a simple yet elegant procedure that provides a precise measurement of the order in one array compared to other arrays.