Bioavailability and dose proportionality of intramuscular diazepam administered by autoinjector.

A diazepam 10-mg autoinjector was evaluated in bioequivalence and dose proportionality studies; both involved 24 young, healthy subjects and used randomized, open-label, 2-treatment, 2-period crossover designs with a 3-week washout period between treatments. The bioequivalence study compared a single diazepam 10-mg autoinjector with a conventional needle and syringe containing 10 mg of diazepam injectable. The dose proportionality study compared the pharmacokinetics of a single diazepam 10-mg autoinjector with that of 2 diazepam 10-mg autoinjectors given simultaneously (20 mg). Injections were intramuscular in the midanterolateral thigh in both studies. The studies showed that the diazepam autoinjector produced consistent plasma diazepam levels, with a rapid onset of absorption. The diazepam 10-mg autoinjector given intramuscularly was bioequivalent to a conventional syringe containing diazepam 10 mg. A single (10-mg) autoinjector and 2 (20-mg) diazepam autoinjectors administered simultaneously produced plasma diazepam concentrations that were essentially dose proportional.

The future of home testing--implications for traditional laboratories.

Many realize today that the key to cost containment is better management of the patient. Health care payers (Medicare, Medicaid, HMOs, etc.) are seeking plans of actions that will reduce the number of patient encounters to the emergency department, hospital admissions and physician's office. As the graying population continues to grow, the need to provide health care outside the traditional walls of the hospital (e.g. clinics, home health) becomes more evident. This article has the purpose of presenting some insights on the growing home health care market and the use of telehealth, vital sign technology (VST) and point of care testing (POCT) in managing the patient outside the hospital.

Management of point-of-care testing in home health care.

There have been many strategic changes made in health care to address decreasing revenue. One successful strategy is the reduction of the patient's length of hospital stay. An outcome of early release from a hospital for some patients is that they still require medical assistance. Because of this requirement and the increasing aging population, the home health-care industry has been growing. In the past 20 years, the home health-care market has seen many changes. The latest has been a prospective payment system. This article will describe the past and present home health-care markets and future demands. New technologies in home health care, such as vital sign technology (telemedicine) and increased numbers of waived point-of-care tests, should decrease costs because of fewer visits to the home. A pilot study conducted at a home health-care agency in New York revealed that 7.3% of home visits offered laboratory testing. The study also revealed a 10% return visit to the home to recollect another sample because of specimen problems. Costs associated with these return visits are high for home health-care agencies, but can be altered via telemedicine technology. Telemedicine technology affords the homebound patient to send point-of-care testing results to any laboratory for review and storage, allowing the laboratory to take control of such testing.