ABSTRACT
Background: L-carnitine may prevent the incidence of AKI by its antioxidant effects and improving circulation in ischemic conditions. The goal of this trial was to evaluate the impact of L-carnitine on contrast-induced nephropathy in patients undergoing elective PCI
Methods: totally, the patients were randomly allocated to 2 groups. The treatment group received 1 g of L-carnitine orally 3 times a day, 24 hours before the procedure [3 g before PCI] and 2 g after PCI, whereas the control group did not receive L-carnitine. In both groups, the plasma level of neutrophil gelatinase-associated lipocalin [NGAL] was measured at baseline and 12 hours after PCI
Results: our study was conducted on 202 patients [including 91 vs. 111 patients in the treatment and the control group; 31 [34.1%] vs 33 [29.7%] female in carnitine and control group; and ages include 62.0 +/- 9.0 vs 57.0 +/- 11.2 years]. The median plasma levels of NGAL were not different between the carnitine and control groups at baseline [57 [IQR: 22 - 255] vs. 54 [IQR: 29 - 324]; p value = 0.155] and 12 hours after PCI [71 [IQR: 52 - 129] vs. 70 [IQR: 46 - 153]; p value = 0.925], but the changes in the plasma NGAL from baseline to 12 hours after PCI were different between the 2 groups [5 [IQR:-147 - 30] vs. 17 [IQR: -21 - 41]; p value = 0.010]
Conclusion: our results showed that oral L-carnitine was able to prevent an increase in NGAL following contrast medium administration in patients undergoing PCI. More studies should be performed to fully elucidate the nephroprotective effects of L-carnitine
ABSTRACT
The aim of this study was to determine the frequency of medication errors happened during the preparation and administration of intravenous [IV] drugs. This study was designed as prospective cross-sectional evaluations by direct unconcealed observation in a setting consisted of orthopedic, general surgery and gastroenterology wards of a teaching hospital. Participants were those patients hospitalized in these wards along with nurses responsible for preparation and administration of IV medications. Medication errors occurred in the process of preparation and administration of IV drugs, were recorded by a pharmacist. The frequency of medication errors with suggesting a solution to overcome was the main outcome of this study. Details of the preparation and administration stages of the observed drugs were compared to an instructed checklist prepared by an expert clinical pharmacist. From a total of 357 preparation and administration episodes, the most common type of error [%20.6] was the injection of bolus doses and infusion faster than the recommended rate. Metronidazole had the highest rate of error [%24.3]. IV rounds conducted at 12 p.m. had the most rate of error [%26.3]. Errors happened in the administration process were more prevalent than those in the preparation. No significant correlation was found between the frequency of errors and nurses' demographic data. This study revealed that the errors happened in the preparation and administration of IV drugs is prevalent. Improving the medication safety by the implementation of clinical pharmacists' prepared protocols at the point of care is an important concern