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INTRODUCTION
The distribution of drug samples by the pharmaceutical industry and by physicians and certain other health care professionals is permitted, in certain situations, under Canadian and US federal laws. In Canada, under the Food and Drugs Act, the distribution of drug samples is generally banned, with certain exceptions allowing physicians, dentists, veterinarians, or pharmacists who are duly registered and authorized to practise their profession in a given province to request drug samples from manufacturers, by specifying the brand name, proper name or usual name, and quantity of a drug to be used as a sample. The pharmaceutical representative who receives such a request may distribute the drug as a sample to the physician, dentist, veterinarian, or pharmacist, if the drug is labelled in accordance with the regulations. In Canada, professional practice falls under provincial jurisdiction, such that the provincial bodies governing each profession may also govern the use of drug samples. In the province of Quebec, both the College des medecins du Quebec and the Ordre des pharmaciens du Quebec (the provincial regulatory bodies for physicians and pharmacists, respectively) condemn the inappropriate use of samples, especially for resale to patients or for personal use, while recognizing their suitability for patients who could not otherwise afford the medications.
- In: Drugs
- Tags: drugs samples, health care facilities, inventory management
Previous work describing the compatibility of a mixture of ketamine and propofol in a 50:50 ratio, using a reformulation of the original product containing EDTA, reported that the combination was stable for up to 1 h at room temperature. Another study,12 which used the original formulation (without EDTA), reported the formation of globules after h. The reformulated original brand contains a purified egg phosphatide and EDTA, whereas generic brands contain egg lecithin and no EDTA. The EDTA was added to the formula
tion to address a problem with microbial contamination of the product; however, the effect of EDTA on stability is unknown. The impact of the difference in purity of the emulsifying agent is also unknown. No compatibility or stability data could be found for any other proportions.
- In: Drugs
- Tags: compatibility, ketamine, mixture, propofol emulsion, stability, syringe
There was no significant change in the pH of either solution after 1 or 3 h of storage at room temperature and exposure to light. The average pH of the 50:50 mixture was initially 4.98 and was nearly the same (4.99) 3 h later. For the 30:70 mixture, the average pH was 5.16 initially and 5.15 after 3 h of storage. There were no visible signs of separating or cracking of the emulsion after 3 h of storage in polypropylene syringes. Furthermore, there was no apparent change in the white milky colour and no evidence of gas formation after 3 h.
- In: Drugs
- Tags: compatibility, ketamine, mixture, propofol emulsion, stability, syringe
Sample Preparation
Propofol 1% emulsion (10 mg/mL; Novopharm Ltd, Toronto, Canada, lot 06K325, expiry August 2008) was combined in a ratio of either 50:50 or 70:30 with ketamine solution (10 mg/mL; Sandoz Inc, Boucherville, Quebec, lot 132425). Ten-millilitre samples of the mixture were then transferred to each of three 20-mL polypropylene syringes (Becton Dickinson and Company, Franklin Lakes, New Jersey), which were sealed with syringe caps (Baxa Corporation, Markham, Ontario, reference number 66001). The syringes were stored at room temperature (23°C) with exposure to light.
- In: Drugs
- Tags: compatibility, ketamine, mixture, propofol emulsion, stability, syringe
INTRODUCTION
Procedural sedation and analgesia for painful procedures is the standard of care in emergency medicine. The ideal agent for procedural sedation and analgesia should be safe and easy to administer, should provide analgesia and amnesia with rapid onset, and should allow quick recovery and cause a minimum of adverse effects. Common agents include propofol, ketamine, fentanyl—midazolam, and etomidate.
- In: Drugs
- Tags: compatibility, ketamine, mixture, propofol emulsion, stability, syringe
This prospective randomized study did not support the hypothesis that low-dose ketamine and morphine, administered in combination, would result in less pain than morphine alone. In addition, the combination therapy was not associated with less nausea and vomiting or fewer psychotomimetic effects than morphine alone, and there was no difference in the total amount of drug required.
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- In: Drugs
- Tags: ketamine, morphine, Pain, randomized study
A total of 30 women enrolled and completed the study, 15 in each treatment group. There were no differences between the 2 groups with regard to age, height, weight, or body mass index (Table 1). None of the patients required PCA for more than 2 postoperative days. All of the patients were included in the analysis, and descriptive statistics were used to report the number of patients experiencing pain and other adverse effects on postoperative days 1 and 2 (Tables 2 and 3, respectively).
- In: Drugs
- Tags: ketamine, morphine, Pain, randomized study