Comparative trial of oral clotrimazole and nystatin for oropharyngeal candidiasis prophylaxis in orthotopic liver transplant patients.

A prospective randomized study was conducted to assess the effectiveness of clotrimazole troches and nystatin suspension to prevent oral candidiasis in immunosuppressed orthotopic liver transplant patients. Thirty-four patients received either clotrimazole troches, 10 mg, five times daily, or nystatin suspension, 500,000 units, four times daily. Prophylaxis was initiated after extubation after transplantation and continued throughout the hospitalization. One of 17 patients in each treatment group developed clinical and microscopic evidence of an oropharyngeal Candida infection. This gave an intragroup and an overall infection rate of 5.9%. It appears that either nystatin or clotrimazole may be used for candidiasis prophylaxis in orthotopic liver transplant patients.

Chemotherapy administration precheck verification.

Inappropriate administration of antineoplastics can result in severe adverse reactions or potential therapeutic failure. This article reports the formation and evaluation of a program designed to assure appropriate antineoplastic administration and the creation of a continuous teaching document. The primary goal was to achieve and document safe and appropriate administration of antineoplastic medications. The program was organized, initiated, and evaluated by the clinical pharmacist and assistant director of nursing. Use of available resources allowed program development without additional cost to hospital departments. A teaching series and provision of reference data were made available, and completion of a chemotherapy verification form was required before the nurse administered the antineoplastic. Over 1,500 forms have been completed in a little more than 2 years. Nurses report a high level of compliance with form completion. One chemotherapy error report has been filed in the last 28 months, compared with three error reports in the 8 weeks prior to initiation of the program. Use of the chemotherapy verification form has achieved a high standard of correct administration without errors as defined by our institution and fostered continually conscientious and acceptable antineoplastic administration.

Stability of methacholine chloride in bronchial provocation test solutions.

The stability of methacholine chloride (5 mg/ml) in 0.9% sodium chloride solution was measured. A reliable colorimetric assay (530 nm) based on the formation of a hydroxamic acid-iron complex was used. At appropriate time intervals, samples were removed from solutions stored at 4, 20, 37, 60, or 80 degrees C and assayed. The degradation of methacholine chloride followed apparent first-order kinetics of methacholine chloride followed apparent first-order kinetics at all temperatures, with observed half-lives ranging from 29.3 days at 80 degrees C to 693 days 4 degrees C. Methacholine chloride in 0.9% sodium chloride solution does not degrade as rapidly as previously suggested. According to an Arrhenius plot, storage of such solutions at 30 or 4 degrees C would result in not more than 10% degradation over a period of approximately two or five months, respectively. Thus, it should be possible to prepare stock solutions of this deliquescent drug.