Internet medical resources: evaluating Internet search engines for drugs and disease inquiries

Internet is now used by the general organizations such as universities, research centers, hospitals and commercial organizations for research, information exchange, trading and for entertainment. Several search engines, such as Infoseek, Excite and Yahoo, can be used to help the Internet users to find specific sites of interest. However, quantitative and qualitative comparative evaluation of these engines in the field of pharmacy [for drug searching] and medicine [for disease searching] has not studied extensively. Therefore, this study was conducted to assist health care providers [HCP] in choosing some fast and comprehensive search engines that offered medical and pharmaceutical data through the Internet. Both qualitative and quantitative comparative data of the commonly used search engines on the Internet were presented for drugs and disease inquiries

Evaluation of clinical pharmacy service impact on therapeutic drug monitoring of digoxin at a teaching hospital

A retrospective study was run to review serum digoxin concentration [SDC] orders during two years. A total of 1110 SDC determinations was used to identify hospital wards to highest request of SDC order and to report the number of digoxin over and under dose requests per ward. Also, studies were the outcomes of clinical pharmacy intervention on the number of serum digoxin orders, appropriateness of ordering SDC level and the clinical pharmacist's influence on appropriate h and ling and interpretation of the reported levels

Warfarin resistance in a patient with prosthetic valve endocarditis treated with cloxacillin

Systemic anticoagulation with warfarin is the mainstay therapy for patients with valve prosthesis. Such drug therapy is of crucial importance in patients with prosthetic valve endocarditis [PVE] because of higher incidence of thrombo-embolism. We are reporting a case of PYE where the patient developed warfarin resistance due to Cloxacillin administration in spite of concomitant administration of I.V. Heparin. Warfarin dose was increased from a baseline of 5 mg daily before Cloxacillin was started to 30 mg daily during Cloxacillin treatment. Six weeks after completion and discontinuing the antibiotic course, the patient's International Normalized ratio [INR] value gradually increased and Warfarin dose was tapered down over eight days. Cloxacillin-Warfarin interaction seems to be due to rapid metabolism in susceptible subjects leading to a reduction in the hypoprothombinemic effect of warfarin. Our finding is consistent with the reported cases which documented such interaction with other members of Penicillinase-resistant Penicillins such as NafcilIin and Dicloxacillin