Disclaimer
In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
Purpose
Pharmacists oversee parenteral drug preparation and administration in hospitals, clinics, infusion centers, and home infusion settings. Infusion-related phlebitis (IRP), the most common complication of intravenous infusion therapy, significantly impacts therapeutic outcomes, patient satisfaction, cost of care, and provider workload. Here we review the major etiologies of IRP and describe potential pharmacological and nonpharmacological interventions for preventing and managing the condition as well as for improving vascular access health in multiple-drug administration settings.
Summary
Many parenterally administered drugs cause phlebitis due to mechanical, chemical, or infectious etiologies. Pharmacists can recommend nonpharmacological strategies to mitigate phlebitis, including judicious device selection and placement; adjustment of the drug concentration, flow rate, or formulation; infusion site rotation; and use of inline filters to minimize contaminant particulates. Pharmacological treatments for phlebitis include topical, local, and systemic anti-inflammatory and analgesic agents that can reduce symptom severity and prevent further treatment complications or delays.
Conclusion
Pharmacists can contribute a unique perspective to interprofessional teams tasked with making policy and formulary decisions that minimize the negative impacts of IRP on drug delivery and patient outcomes.
High energy ion implantation applications are moving beyond the original low dose requirements of retrograde and triple wells. Collector regions for bipolar and BiCMOS circuits are increasingly formed by high energy implantation. Compared to'the previous method of low energy implantation followed by epitaxial layer growth, high energy implantation saves both process steps and cost. Since collectors require low resistivity to give high output currents, relatively high implant doses (2x10'4cm'2-2x10'5cm~2) are needed for a successful epireplacement process. In the MeV energy range, softbaked photoresist is very susceptible to lifting and popping at doses >2~10'~cm'*, causing resist failure and high particle contamination. We examined the stability of 2.7-3.5p.m photoresist during phosphorus implantation at energies of 900-1200 keV. Photoresist pretreatment with heat and UV light prior to implantation greatly increases the dose that can be implanted before resist hardening or lifting occurs, as compared to hardbaked or softbaked pretreatment. These results are explained in terms of UV-induced cross-linking of the polymer chains in the resist. Heating the resist to >200°C during UV treatment is crucial for maximizing resist integrity, a high oxygen ambient is also beneficial. Our results indicate that UV pretreatment is an important process technology for moderate and high dose MeV implants.
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