The level of understanding of taking medicine was examined at the start and the end of medicine-taking guidance, based on the estimation by pharmacists and inpatients. Six items for the estimation, such as``the way of taking medicines'' were evaluated using aˆve-grade system. The signiˆcant improvement was observed in all items, suggesting that inpatients' understanding is improved by the guidance. A markedly positive correlation was found between the estimation by inpatients and that by pharmacists ( p<0.001). This conˆrms the appropriateness of estimation by pharmacists. Inpatients whose estimation was signiˆcantly diŠerent from that by pharmacists (diŠerence of two grades or more) were examined to identify clear and potential problems with taking medicine. The problems were classiˆed into such seven categories as``types of medicine''. For each item with diŠerences in estimation (two grades or more), problems were biased in some speciˆc categories. On the basis of such a bias, a ‰ow chart was prepared to clarify problems. In addition, a standard pharmaceutical management and guidance services program was drafted, in which measures in observation, treatment and education against problems by pharmacists were described according to the frequency of occurrence. Information about the program available on the Internet enables its use by other hospitals.
Levocarnitine chloride is used for the therapeutic purpose of levocarnitine deˆciency. For infants, however, levocarnitine chloride tablets must be crushed to avoid di‹culties associated with swallowing, and also to administer an appropriately low dosage. Since the tablet is extremely hygroscopic and sour, it is dissolved in water containing simple syrup after crushing. In this study we investigated the stability of the drug after dissolution to optimize its preparation for clinical use. It was shown to be stable for at least 90 days after preparation, and microbes did not grow in 1-10% (w /v) solutions (pH 2.0-2.5) regardless of the presence or absence of simple syrup. Furthermore, the autoclaved levocarnitine chloride solution was as stable as the non-autoclaved one. In conclusion, the method employed in our hospital for the preparation of levocarnitine chloride for infants is appropriate and is recommended as a standard medicine supply method among diŠerent facilities.
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