Notation of allergies and body weight on patient profiles.

The purpose of this study was to increase the documentation of allergy and body weight information on pharmacy medication profile cards for pediatric patients. The intent was to facilitate pharmacist evaluation of medication dosages ordered for these patients. A plastic allergy/weight imprinting card was supplied to each nursing unit and was used to imprint all admitting physician's order sheets. Allergy and weight information was to be filled in by the physician and/or nurse before routing a copy of these orders to the satellite pharmacy. Inservice education was presented and follow-up phone calls were made. During an 18-day control period, baseline data on documentation of allergies and weight were collected. During an 18-day study period, the allergy/weight card was used and follow-up phone calls were made. During an 18-day post-study period, the card and phone calls were removed. Percent of profiles having allergies and weight were, respectively: control period, 33 percent and 28 percent; study period, 80 percent and 76 percent; post-study period, 47 percent and 46 percent. Imprinting "allergy/weight" with space for filling in this information can result in an increased number of pharmacy patient profiles having these data so that medications can be checked prior to dispensing the first dosages of medication.

Acute massive chloral hydrate intoxication treated with hemodialysis: a clinical pharmacokinetic analysis.

A 38-year-old female became comatose and exhibited signs of cardiac toxicity 2 hours after ingestion of approximately 38 Gm chloral hydrate. Hemodialysis was initiated 21 hours after ingestion, using twin coils in series, and was continued for 4.5 hours. Trichloroethanol, the active metabolite of chloral hydrate, was measured in plasma and dialysate. Two hours after ingestion, the plasma level was 330 micrograms/ml (average therapeutic level is 12 micrograms/ml or less). The predialysis level was 216 micrograms/ml and after dialysis declined to 141 micrograms/ml. The pre- and post-plasma half-life values were 35 hours, while on dialysis the half-life was only 6 hours. The average dialysis clearance was 120 ml/minute, and the amount of chloral hydrate removed by dialysis was 5.79 Gm. By the end of dialysis, the patient could respond to verbal commands and was ambulatory 36 hours later. In conclusion, hemodialysis can be a clinically important method of treating chloral hydrate overdose.