Abstract:
PURPOSE:Preparation of parenteral medication in hospitals is a complex process with a risk of microbial contamination of the product, especially when inappropriately prepared. Contaminated parenteral medications can cause severe complications to patients and increase morbidity in hospitals. The aim of this literature review is to systematically evaluate the contamination rate of parenteral medications in hospitals prepared in a pharmacy environment and a clinical environment. METHODS:A literature search of PubMed and EMBASE from 2000 to 2018 was performed. Two different environments where preparation may be carried out were defined. Point estimates and 95% confidence intervals for contamination rates were calculated for each environment of medication preparation. The meta-analysis was performed using a random effects model. RESULTS:The contamination rates in the clinical environment (n = 13 studies) varied between 1.09 and 20.70%. In the pharmacy environment (n = 5), all contamination rates were 0.00% except for one study (0.66%). The point estimates (random effect model) for the overall contamination rate of doses prepared in the clinical environment was 7.47% (5.16-9.79%), and 0.08% for doses prepared in the pharmacy environment. The point estimates (random effect model) for the overall contamination rate of doses prepared by nursing/ medical staff was 7.85% (5.18-10.53%), and 0.08% for doses prepared by pharmacy staff. CONCLUSIONS:Significantly higher contamination rates were found for the preparation of parenteral medication in the clinical environment compared to pharmacy environment. In accordance with recent guidance, the almost 100-fold higher changes of contamination when reconstitution is performed in the clinical environment should urge hospitals to review their reconstitution process and apply risk-reducing measures to improve patient safety of parenteral therapy.
journal_name
Eur J Clin Pharmacoljournal_title
European journal of clinical pharmacologyauthors
Larmené-Beld KHM,Frijlink HW,Taxis Kdoi
10.1007/s00228-019-02631-2subject
Has Abstractpub_date
2019-05-01 00:00:00pages
609-617issue
5eissn
0031-6970issn
1432-1041pii
10.1007/s00228-019-02631-2journal_volume
75pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE:The aim of this study was to define the pharmacokinetic profile of free carbamazepine (F-CBZ) in adult Omani epileptic patients in order to improve on dosing schedules through population pharmacokinetic analysis using the NONMEM program. METHOD:Steady-state trough F-CBZ serum concentrations, carbamazepine (C...
journal_title:European journal of clinical pharmacology
pub_type: 临床试验,杂志文章
doi:10.1007/s002280100300
更新日期:2001-06-01 00:00:00
abstract:PURPOSE:To study the impact of gemfibrozil co-administration on the pharmacokinetics of sitagliptin in healthy Indian male volunteers. METHODS:A randomized open label two-period crossover study involving 12 healthy Indian male volunteers was conducted at a single center. In each phase, the volunteers were administered...
journal_title:European journal of clinical pharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00228-011-1177-2
更新日期:2012-05-01 00:00:00
abstract::Six women, 13 to 16 weeks pregnant, and 12 women at 38 to 40 weeks gestation, received oral oxazepam about 12 h before legal abortion, by hysterotomy in the former and before elective caesarean section in the latter group. The concentrations of free and conjugated oxazepam in maternal and fetal plasma were determined ...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF00625804
更新日期:1980-04-01 00:00:00
abstract::We have investigated the prevalence of poor metabolisers (PM) of S-mephenytoin in 373 unrelated, healthy Spanish Caucasian subjects, based on the enantiomeric S/R mephenytoin ratio in urine collected 0-8 h and 24-32 h after intake of the racemic drug. Five of the subjects were PM (1.34%, 95% confidence interval 0.18-2...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF02440867
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:The aim of this investigation was to clarify the stereoselective properties in lansoprazole metabolism by monitoring the metabolic consumption for each enantiomer and the formation of the main metabolites, lansoprazole sulfone and 5-hydroxylansoprazole, in the presence of human liver microsomal enzymes. METH...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/s002280100374
更新日期:2001-12-01 00:00:00
abstract::The opioid class of drugs, a large group, is mainly used for the treatment of acute and chronic persistent pain. All are eliminated from the body via metabolism involving principally CYP3A4 and the highly polymorphic CYP2D6, which markedly affects the drug's function, and by conjugation reactions mainly by UGT2B7. In ...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1007/s00228-008-0570-y
更新日期:2009-02-01 00:00:00
abstract::Procainamide was given to 20 patients with normal renal function as an i.v. bolus of 500 mg followed by 1.0 or 1.5 g eight-hourly by mouth in the form of a slow release preparation (Durules). 97.6 +/- 27.1 (SD)% of the oral procainamide was absorbed, the absorption half life being 1.54 h. The elimination half life fol...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF00560459
更新日期:1978-12-01 00:00:00
abstract::Individual variation in the half-life of caffeine in the body was measured by HPLC analysis of saliva samples. The mean for adult males and non-pregnant females was 3.4 h (range 2-5 h, n = 25), and 8.3 h (range 3-16 h, n = 57) for pregnant women. After delivery, in most cases the values returned to normal within one m...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF00637512
更新日期:1981-01-01 00:00:00
abstract::Unstable angina is a clinical syndrome characterized by increased rate and severity of angina pectoris attacks and, sometimes but not always, accompanied by ECG changes similar to those seen in coronary insufficiency. According to the present conception of the pathogenesis, ruptures at points of high-grade stenosis in...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1007/BF01417569
更新日期:1990-01-01 00:00:00
abstract::The bronchodilator effects of cumulative doses of terbutaline 0.125 mg, 0.125 mg and 0.250 mg administered as a pressurized aerosol via a pear shaped spacer were compared with those of terbutaline 1.25 mg, 1.25 mg and 2.50 mg administered as a nebulized solution via a PARI-inhaler Boy. FEV1.0 and flow-volume curves in...
journal_title:European journal of clinical pharmacology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1982-01-01 00:00:00
abstract:PURPOSE:Serotonin receptor 1B (HTR1B) is involved in the regulation of the serotonin system, playing different roles in specific areas of the brain. We review the characteristics of the gene coding for HTR1B, its product and the functional role of HTR1B in the neural networks involved in motivation and memory; the cent...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1007/s00228-009-0724-6
更新日期:2010-01-01 00:00:00
abstract::Bambuterol tablets, 10 and 20 mg, and terbutaline CR-tablets, 5 and 7.5 mg, have been compared for their capacity to produce subjectively determined tremor in a randomised, double-blind, cross-over study in 40 healthy volunteers. The duration of each treatment was one week, with an intervening washout period of at lea...
journal_title:European journal of clinical pharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00265945
更新日期:1993-01-01 00:00:00
abstract::The purpose of this study was to examine the influence of cigarette smoking and gender on the pharmacokinetics of metoprolol. Eighteen volunteers with no evidence of clinical disease each randomly received the following doses of metoprolol tartrate: 100 mg orally, 200 mg orally and 20 mg as a constant-rate intravenous...
journal_title:European journal of clinical pharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00637630
更新日期:1987-01-01 00:00:00
abstract::We have studied the pharmacokinetics of fluconazole in five patients on long-term haemodialysis. The single-pass extraction rate of the dialyzer was 59 (3.5)% (n = 4), and the serum concentration was reduced by haemodialysis for 3 or 4 h by 26 (3.2)% (n = 5) and 39 (2.2)% (n = 9) respectively. The estimated amount ext...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF00265934
更新日期:1992-01-01 00:00:00
abstract::Naftopidil exerts its antihypertensive action via alpha 1-adrenoceptor blockage and Ca2+ antagonism in vascular smooth muscle. Since the chemically similar 1-(1-naphthyl) piperazine is known to be a 5-hydroxytryptamine2 receptor antagonist, the 5-hydroxytryptamine (5-HT) antagonistic properties of naftopidil were test...
journal_title:European journal of clinical pharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00192561
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:The present study was undertaken to investigate the possible effects of various agents on thiopurine methyltransferase (TPMT) activity in red blood cells (RBCs) from patients with chronic inflammatory bowel disease (IBD). METHODS:In three groups of patients with very high, normal and intermediate TPMT activi...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/s00228-005-0950-5
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:We investigated whether interindividual differences in the pharmacokinetic disposition of lansoprazole are attributed to the genetic polymorphism of CYP2C19 which occurred by two mutations. CYP2C19m1 and CYP2C19m2, in 20 Japanese subjects. METHODS:Polymerase chain reaction (PCR) restriction fragment length p...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/s002280050307
更新日期:1997-01-01 00:00:00
abstract::Differences in the plasma concentrations of drugs after oral administration are caused by two main factors: variation in absorption ratios and in the distribution processes in the body. A new method for the dissection of both types of factors is discussed. The method uses a reference regression of the AUC-values to th...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
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abstract::The cardiovascular and respiratory actions of the adrenergic beta adrenoceptive drug sotalol have been studied in an open, short term trial. Fifteen patients with angina performed standardized orthostatic and exercise tests before and after injection of 20 mg sotalol intravenously. Although there was a significant red...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF00562313
更新日期:1975-08-14 00:00:00
abstract:AIMS:To determine whether the variability in cytochrome P(450) (CYP)3A4 metabolic function is exhibited at both transcription and translation levels and to examine the population distribution of CYP3A4 enzyme kinetics, protein, and mRNA. METHODS:Enzyme kinetics of testosterone 6beta-hydroxylation, immunoblot CYP3A4 pr...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/s00228-002-0487-9
更新日期:2002-08-01 00:00:00
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journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
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更新日期:2016-09-01 00:00:00
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journal_title:European journal of clinical pharmacology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00228-006-0150-y
更新日期:2006-08-01 00:00:00
abstract::The acute effects on monophasic action potentials (MAP), QT interval, and right ventricle effective refractory period (V-ERP) of propranolol 0.2 mg.kg-1 body weight have been studied in 10 patients with coronary artery disease. The median duration of MAP at 90% repolarization (MAP90) was shortened from 238 to 228 ms a...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF00280044
更新日期:1990-01-01 00:00:00
abstract::The pharmacokinetics of midazolam has been studied in patients recovering from cardiac surgery, who required sedation for postoperative mechanical ventilation. Twelve males (mean age 64.5 years) with severe heart disease received an infusion of midazolam 15 mg.h-1 for 4 h, starting 1 to 3 h post surgery. Multiple bloo...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF00558225
更新日期:1989-01-01 00:00:00
abstract:PURPOSE:We investigated the role of genetic, physiological, environmental, and epigenetic factors in regulating CYP2A6 expression and nicotine metabolism. METHODS:Human livers (n = 67) were genotyped for CYP2A6 alleles and assessed for nicotine metabolism and CYP2A6 expression (mRNA and protein). In addition, a subset...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/s00228-009-0762-0
更新日期:2010-03-01 00:00:00
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journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
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更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Spinal-cord injury (SCI) is a leading cause of neuropathic pain (NP). Current pharmaceutical treatments for NP in SCI patients are not effective. Two promising options are gabapentin (GP) and pregabalin (PB). Their predominant mechanism of action is believed to be the inhibition of calcium currents, leading ...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章,评审
doi:10.1007/s00228-008-0523-5
更新日期:2008-09-01 00:00:00
abstract::Changes in venous haemodynamics were studied after administration of a single dose of 3 g Heptaminol Adenosine Phosphate (HAP) to 30 subjects with primary varicose veins. Strain gauge plethysmography was used to observe changes in venous volume and in maximal venous outflow, 1, 2, 3 and 4 h after dosing. A significant...
journal_title:European journal of clinical pharmacology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00609421
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To study the distribution of the thiopurine methyltransferase (TPMT) genotype among azathioprine (Aza)-tolerant and -intolerant patients with various disorders, and to investigate a possible relationship with the Aza metabolite levels. METHODS:Forty-six Aza-tolerant and six Aza-intolerant patients had the TP...
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pub_type: 杂志文章,多中心研究
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更新日期:2004-01-01 00:00:00
abstract::The metabolism of hydralazine in a group of slow acetylator patients with the drug-induced lupus syndrome was compared with the metabolism in asymptomatic control subjects. There were no toxicologically significant difference in metabolite excretion between the groups which reached statistical significance, although t...
journal_title:European journal of clinical pharmacology
pub_type: 杂志文章
doi:10.1007/BF00556891
更新日期:1984-01-01 00:00:00