ABSTRACT
Medication errors account for about 78% of serious medical errors in intensive care unit [ICU]. So far no study has been performed in Iran to evaluate all type of possible medication errors in ICU. Therefore the objective of this study was to reveal the frequency, type and consequences of all type of errors in an ICU of a large teaching hospital. The prospective observational study was conducted in an 11 bed internal ICU of a university hospital in Shiraz. In each shift all processes that were performed on one selected patient was observed and recorded by a trained pharmacist. Observer would intervene only if medication error would cause substantial harm. The data was evaluated and then were entered in a form that was designed for this purpose. The study continued for 38 shifts. During this period, a total of 442 errors per 5785 opportunities for errors [7.6%] occurred. Of those, there were 9.8% administration errors, 6.8% prescribing errors, 3.3% transcription errors and, 2.3% dispensing errors. Totally 45 interventions were made, 40% of interventions result in the correction of errors. The most common causes of errors were observed to be: rule violations, slip and memory lapses and lack of drug knowledge. According to our results, the rate of errors is alarming and requires implementation of a serious solution. Since our system lacks a well-organize detection and reporting mechanism, there is no means for preventing errors in the first place. Hence, as the first step we must implement a system where errors are routinely detected and reported
ABSTRACT
The aim of the present study was to evaluate the pattern of vancomycin administration in the hematology-oncology ward of Nemazee Hospital, Shiraz, Iran. Study criteria were developed to assess the several parameters involved in vancomycin therapy. These parameters include the appropriateness of drug usage, dosage, duration of therapy, monitoring for toxicity and serum concentration monitoring. The serum concentration was measured by an automated Fluorescence Polarization Immunoassay. Clinical and preclinical parameters such as Glomerular Filtration Rate [GFR], microbial culture, antibacterial sensitivity, WBC count and fever were collected and recorded for analysis. Sixty patients were enrolled in the study, consisting of 45 males and 15 females. The age range was 15 to 68 years. In this study, 68.63% of the vancomycin used for the patients with febrile neutropenia was compatible with the Infectious Disease Society of America [IDSA] guideline. The initial dosage of vancomycin in 68.63%, rate of infusion in 100%, and dilution of vancomycin in100%, were appropriate. Inappropriate use was more evident in the continuation of vancomycin in 50% of the patients. No appropriate dosage adjustment was done for 50% of the patients with increased serum creatinine. Based on the results, the indication of vancomycin in febrile neutropenia was satisfactory. However, there were some required factors such as continuation of vancomycin, adjustment of dosage or interval, microbial culture, antibiotic sensitivity test before the first dose administration, measurement of serum concentration and monitoring which had to be revised in order to achieve an effective treatment
ABSTRACT
A group of racemic 3-[[2-hydroxyethyl], [2-Methoxyethyl], [2-acetylethyl] or [2-cyanoethyl]], 5- methyl, ethyl or isopropyl-1, 4-dihydro-2, 6-dimethyl-4-[1-methyl-5-nitro-2-imidazolyl]-3, 5-pyridinedicarboxylates [XIV-XXV] were prepared by the reaction of 1-methyl-5-nitroimidazol-2-carboxaldehyde [X] with acetoacetic esters [VI-IX] and alkys 3-aminocrotonate [XI-XIII]. In vitro calcium channel antagonist activities of the tested compounds were determined by their effects on contraction of Guinea Pig Ileal Longitudinal Smooth Muscle [GPILSM] which was induced by carbacol [1.67