Is the number of surgical day cases a good indicator of rising drug costs?

There have been various attempts to reduce the expenditure on drugs-limited lists, drug formularies, prescribing policies, etc. The number of occupied beds in hospitals has fallen, and other indicators of hospital work have altered little. In spite of this, the expenditure on drugs by the hospitals in Wales has continued to rise. Taking two groups (antibiotics and anaesthetic agents) as examples of the high-cost drugs, the expenditure has been related to a number of indicators of the workload of a hospital. No clear relationship between any one indicator has been demonstrated although the number of surgical day cases is an important factor.

Functionally crossed pipelines. An intermittent condition by a faulty ventilator.

Unexpectedly high blood oxygen tension in intensive care patients occurring over a 5-year period were found to have been caused by an apparently normally functioning ventilator which was intermittently acting as a conduit between the oxygen and air pipelines. Responses to a circular letter sent to Quality Control Pharmacists in England and Wales suggest that similar faults may have occurred at least five times in the past 10 years. Recommendations are given for the prevention of this problem, including monitoring of gas pipeline composition.

Maintenance therapy for duodenal ulcer--a trial comparing cimetidine with a prostaglandin synthetase promoter.

The effect of treatment on maintenance of remission was examined in 90 patients with healed duodenal ulcer shown by endoscopy. They were randomized to take treatment for 6 months with a prostaglandin synthetase promoter (263E) 500 mg three times daily or cimetidine 400 mg at night or an identical placebo. Sixty-five patients completed the trial or had a relapse of symptoms. The percentage of patients who had recurrent ulcers or duodenitis alone on endoscopy was 29% on 263E, 36% with cimetidine, and 50% on placebo. These figures did not differ significantly. Trials of this design are now difficult to conduct because patients take and H2 receptor antagonist soon after recurrence of symptoms, before their next clinic appointment.

Absorption of isosorbide dinitrate by PVC infusion bags and administration sets.

Isosorbide dinitrate is shown to be absorbed onto PVC bags and administration sets, resulting in a fall in potency to about 70-80% of its initial value in the first 15-30 min of an i.v. infusion. The drug was not absorbed by glass or polypropylene.