RESUMEN
The combination of a criteria-based drug utilization evaluation and a comprehensive drug literature review can be effectively used to reach therapeutically sound, cost-efficient formulary decisions. This report describes the approach to evaluating the available H2-receptor antagonists used by the Pharmacy & Therapeutics Committee of Memorial Medical Center, a 550-bed, community-based teaching hospital affiliated with the Southern Illinois University School of Medicine in Springfield.
Asunto(s)
Utilización de Medicamentos , Formularios de Hospitales como Asunto , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Cimetidina/economía , Cimetidina/uso terapéutico , Ahorro de Costo , Recolección de Datos , Costos de los Medicamentos , Utilización de Medicamentos/economía , Famotidina/economía , Famotidina/uso terapéutico , Control de Formularios y Registros , Antagonistas de los Receptores H2 de la Histamina/administración & dosificación , Antagonistas de los Receptores H2 de la Histamina/efectos adversos , Antagonistas de los Receptores H2 de la Histamina/economía , Hospitales con más de 500 Camas , Humanos , Illinois , Comité Farmacéutico y TerapéuticoRESUMEN
These projects have realized significant control of drug costs while also serving as a basis for future project implementation. In general, communication through the P&T, medical department heads, and senior hospital administrators has positively impacted on the ability to achieve these cost savings. The forms of communication have incorporated written and posted information along with oral presentations for the purposes of enhancing positive and progressive service in the cost-efficient delivery of pharmacotherapy.
Asunto(s)
Antibacterianos/uso terapéutico , Servicios de Información sobre Medicamentos , Utilización de Medicamentos/economía , Cuerpo Médico de Hospitales/educación , Control de Costos/métodos , Toma de Decisiones , Industria Farmacéutica , Estudios de Evaluación como Asunto , Hospitales con más de 500 Camas , Illinois , Estados UnidosRESUMEN
Cimetidine, a histamine2-receptor antagonist, is used in the treatment and prophylaxis of peptic ulcer disease. Its use is relatively free of serious adverse reactions and only a few accounts of hypersensitivity exist. We report a case of intravenous cimetidine-associated adverse reaction characterized by junctional rhythm, bradycardia, and hypotension apparently not secondary to rapid intravenous cimetidine infusion. The adverse reaction was reproduced upon rechallenge. No previous accounts of this reaction appear clearly defined in the literature nor have such reactions been confirmed by rechallenge.
Asunto(s)
Cimetidina/efectos adversos , Anciano , Análisis de los Gases de la Sangre , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/fisiopatología , Cimetidina/administración & dosificación , Cimetidina/uso terapéutico , Femenino , Humanos , Infusiones Intravenosas , Úlcera Péptica/tratamiento farmacológico , Úlcera Péptica/fisiopatologíaRESUMEN
During the last 5 years we believe that the prescribing of dobutamine has increased over that of the older agent dopamine. The literature reports advantages such as less tachycardia, less peripheral vasoconstriction, and fewer increases in intracardiac pressures with dobutamine as opposed to dopamine. After a thorough review of the literature, we were unable to find conclusive evidence of these initial findings, and present several studies to show potential flaws in their interpretation that may help explain the increased use of dobutamine over dopamine. The overuse of dobutamine, if it does exist, must be dealt with by pharmacy departments in an informed, yet unbiased fashion, to aid in preventing the continued escalation of health care costs.