These abstracts have been accepted for publication by the Dutch Society of Clinical Pharmacology and BiopharmacyNihon Kohden® and Cambridge Electronic Design (CED®) hardware and Spike2® software at 1 : 35 post drug administration. Results were statistically evaluated using GLM in SPSS® 11.5. Results:Results are presented in table 1. Saccadic peak velocity was increased after MDMA (p = 0.000). Co-administration showed significant increase in peak saccadic velocity compared to placebo (p = 0.004), although significantly less then the increase as observed after MDMA alone (p = 0.003). Smooth pursuit was significantly impaired after ethanol compared to placebo (p = 0.000) and MDMA (p = 0.000), co-adminstration also impaired score compared to placebo (p = 0.000) and MDMA (p = 0.000).Conclusions: MDMA induced arousal as measured by the saccadic peak velocity when administered alone and, to a lesser degree, in combination with ethanol. Co-administration of MDMA with ethanol however could not ameliorate the deterioration of psychomotor accuracy by ethanol as measured by smooth pursuit eye movements. These findings suggest that although MDMA might ameliorate ethanol induced sedation it does not ameliorate impaired psychomotor skills. This might give a false sense of improved performance while intoxicated and thus increases risks of for example road accidents. Introduction: A considerable percentage of young people expose themselves to 3,4-methylenedioxy-methamphetamine (MDMA or 'ecstasy'). Alcohol is relatively commonly used in combination with MDMA (Barrett et al., 2005). As a percentage of MDMA users admit to driving under influence (Riley et al., 2001), the assessment of the effects of co-administration of these substances on psychomotor performance is warranted. Hypothesis:We hypothesized that the co-administration of MDMA and ethanol would ameliorate the impairment induced by ethanol alone. Methods:We performed a double-blind, randomized, placebocontrolled study in 16 healthy volunteers (9 male, 7 female) in the age of 18-29 years. MDMA 100 mg was given orally and blood alcohol concentration (BAC) was maintained at 0.6‰ by a three hour 10% alcohol infusion regime (adjustment of infusion rate according to regular sampled breath alcohol concentration). Saccadic and smooth pursuit eye movements, a validated measure of ethanol induced sedation (van Steveninck et al., 1999), were recorded using Objectives: This study firstly aimed to identify the percentage of nursing home patients who were prescribed more than nine drugs (polypharmacy) and compared prescribing patterns of this patient group to patients who were prescribed fewer drugs. Secondly, teams of hospital pharmacists and nursing home physicians aimed to identify the drug related problems of the polypharmacy patients and the extent to which it was feasible to optimise their medication profiles.Methods: Characteristics of the polypharmacy population were illustrated by retrospective point measurements in five Dutch nursing homes (total of 742 beds) over the years ...
Objective:The objective of this study was: (1) to develop and validate an electronic clinical rule for 'Opioid-Laxative Use' and to implement this rule in clinical pharmacy practice; (2) to improve guideline compliance by using this refined clinical rule; and (3) to investigate if opioid-induced constipation (OIC) can be reduced in hospitalised patients by the application of this clinical rule.Methods: Interventions using clinical rule alerts were performed between June and September 2009. We compared guideline compliance before and after the intervention to determine the difference. Interventions consisted of telephone consultations by a clinical pharmacist advising physicians to add a laxative to opioid therapy. Patient files were matched to a historical control group using an opioid without a laxative to examine the difference between intervention-and control patients in the presence of OIC.Results: Prospective validation of the rule resulted in several refinements. In the intervention period, 140 alerts were generated, 60 of which (43%) led to co-prescription of a laxative. Therefore, guideline compliance increased from 70% to 83%. A significant difference in OIC was found between the intervention group (12%) and the control group (56%). Conclusions:This study showed that pharmacy intervention based on an electronic clinical rule for ´Opioid-Laxative Use´ led to more adequate co-prescription of opioids and laxatives. This led to a better compliance with the guideline as well as a better outcome, as measured by the significant decrease in the prevalence of OIC.
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