An evaluation was undertaken to determine the effectiveness of patient record plans which had been in use in two community pharmacies for periods of 6 and 9 years. A retrospective study of potential tetracycline interactions demonstrated that, numerically, the nonprescription drugs represented the greatest potential danger. Although in the past, non-prescription medications were not routinely recorded, it is concluded that both prescribed and non-prescribed drugs should be entered on patient record charts and screened for potential interactions. The routine recording and screening of patient allergies and disease states on the patient record plan was shown to be of value in several instances in one pharmacy. A comparison of drug sensitivities 'flagged' on pharmacy records and physician's records showed that the pharmacist often had on record more allergies than did the physician. Using the patient record plan to determine the theoretical time of the last dose of an antibiotic, two surveys were undertaken to determine if a written reinforcement of verbal instructions and patient involvement in a follow-up interview could help improve self-administration habits in ambulatory patients. It was found that more patients did, in fact, follow, their dosage regimen and fewer patients discontinued their course of therapy without justification. Seventeen steps were defined in a dispensing procedure used in one of the pharmacies operating with a patient record plan. These could be further divided into those functions which could be performed by a non-professional assistant and those which were to be done only by a pharmacist. The time required for the individual pharmacist to perform all 17 steps was compared to the time required for a (pharmacist and non-professional assistant) team to do the same functions. Pharmacist time per prescription appeared to be reduced 40 to 50% by the team approach. / Pharmaceutical Sciences, Faculty of / Graduate

Through the years, various studies (1-5) have been done regarding the prevalent practice of adding one or more drugs to parenteral fluids. The greater variety of drugs being used intravenously, plus the formulation of newer and more complex parenteral fluids, has led to an increased awareness of potential incompatibilities existing between drug and solution. Recognition of the hazards of such extemporaneous combinations has necessitated the study of drug stability in solution. The objective of this report is to determine compatibility characteristics of admixtures prepared from a series of balance intravenous electrolyte solutions and a group of commonly used therapeutic agents. Visual, spectrophotometric and microbiological assay techniques are to be used to establish the compatibility profiles of these admixtures.

The benefits of intravenous therapy have become more and more apparent over the years. Medications can be given rapidly with an expectant rapid onset of action. The response to the drugs or fluids can often be closely controlled by regulating the dose or rate of administration. Frequently, adequate blood and tissue levels needed to eradicate many serious infections can be reached only by this route. Intravenous therapy is an especially appropriate method when the use of the oral tract, for one reason or another, cannot be used. The development of intravenous therapy, however, did not proceed without its difficulties. Problems of allergic reactions, incompatible blood groups, bacterial contamination, particulate matter, thrombophlebitic syndromes, stability of solutions, and incompatibilities of admixtures soon became apparent. The purpose of this paper is to explore certain aspects of the latter problem, i.e., intravenous incompatibilities.