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Pharmacovigilance01:19

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Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
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Dosage Regimens: Designs and Approaches01:28

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Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
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Dosage Regimens: Partial Pharmacokinetic Parameters01:01

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It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
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Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Improving IV Insulin Administration in a Community Hospital
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Medication audit and feedback by a clinical pharmacist decrease medication errors at the PICU: An interrupted time

Jolanda M Maaskant1,2,3, Marieke A Tio4, Reinier M van Hest4

  • 1Department of Pediatric Intensive Care, Emma Children's Hospital Academic Medical Center Amsterdam The Netherlands.

Health Science Reports
|January 10, 2019
PubMed
Summary
This summary is machine-generated.

Structured medication audits and clinical pharmacist feedback significantly reduced medication errors (MEs) in critically ill children. This intervention improved medication safety in a pediatric intensive care unit setting.

Keywords:
ITSPICUharmmedication errormultifaceted interventionpharmacist

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Area of Science:

  • Pediatric Critical Care Medicine
  • Clinical Pharmacy
  • Patient Safety

Background:

  • Medication errors (MEs) are common adverse events in hospitalized patients, posing greater risks to children.
  • Improving medication safety in pediatric intensive care units (PICUs) is crucial.

Purpose of the Study:

  • To evaluate the impact of structured medication audit and feedback by a clinical pharmacist on MEs in critically ill children.
  • To enhance medication safety within a multidisciplinary team approach.

Main Methods:

  • An interrupted time series analysis was conducted in a tertiary PICU.
  • Data from 6 preintervention (July-December 2013) and 6 postintervention (July-December 2014) periods were analyzed.
  • MEs were identified through clinical records and incident reporting, with causality and preventability assessed by a pediatrician-intensivist and clinical pharmacist.

Main Results:

  • The prevalence of MEs decreased from 2.27 per 100 prescriptions preintervention to 1.71 per 100 prescriptions postintervention.
  • Autoregressive integrated moving average (ARIMA) analyses showed a significant change in slopes between periods (β = -0.21, P = 0.04).
  • No significant immediate decrease in MEs was observed postintervention (P = 0.07).

Conclusions:

  • Structured medication audit and feedback by a clinical pharmacist, as part of a multidisciplinary team, effectively reduced MEs in a tertiary PICU.
  • This intervention demonstrates a successful strategy for improving medication safety in critically ill pediatric patients.