clinical pharmacology CLINICAL PHARMACOLOGISTS PROVE THEIR VALUE IN A HOSPITAL SETTING Their recommendations have a high success rate A serum drug l evel assay service and therapeutic consultation service was set up in a Texas hospital to monitor the use of drugs with. narrow therapeutic margin or with elimination kinetics which wert non-linear or significantly influenced by renal/hepatic impairment. Following an initial dose and serum level determination, recommendation was made where necessary for dosage adjustment to attain a defined therapeutic drug level. In the ftrst year 937 drug consultations, involvina; mainly digoxin, quinidine and phenytOin (diphenylhydantoin) were given fo r 364 patients. The initial dose prescribed attained a therapeutic level in 27] cases (56 %). Levels were subtberapeutic in 166 cases()4 %) and potentially toxic in 47 (1 0 %). Physicians complied with recommended changes in 12 %- of c;ases (J 35/ 1 87), ignoring the re mainilll 28 %. When the recommendations were followed 94 % achieved therapeutic plasma levels; when recommendations were ianored satisfactory l evels were attained in 33 %. These figures demonstrate thai an assay/consultation serv i ce is needed and is effective when the recommendations are followed. 1:he service was provided by 2 clinical pharmacists, 2 full time technologists, and 2-J hours per day of a clinical pharmacologist. With the addition of a funher 4 clinical pharmacists 50-60 consultations are bandIed weekly. Taylor. J.W. et Il.: Journal ofOi niell PbannKoIocY 19: I Oao 1979) 0156·2703/ 79/0 1 27-(1()13$OO.5O/0 oAOfSPms INPHARMA27Jan f979 13

CLINICAL PHARMACOLOGISTS PROVE THEIR VALUE IN A HOSPITAL SETTING

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clinical pharmacology

CLINICAL PHARMACOLOGISTS PROVE THEIR VALUE IN A HOSPITAL SETTING

Their recommendations have a high success rate A serum drug level assay service and therapeutic consultation service was set up in a Texas hospital to monitor the use of drugs with. narrow therapeutic margin or with elimination kinetics which wert non-linear or significantly influenced by renal/hepatic impairment. Following an initial dose and serum level determination, recommendation was made where necessary for dosage adjustment to attain a defined therapeutic drug level. In the ftrst year 937 drug consultations, involvina; mainly digoxin, quinidine and phenytOin (diphenylhydantoin) were given for 364 patients.

The initial dose prescribed attained a therapeutic level in 27] cases (56 %). Levels were subtberapeutic in 166 cases()4 %) and potentially toxic in 47 (1 0 %). Physicians complied with recommended changes in 12 %-of c;ases (J 35/ 187), ignoring the remainilll 28 %. When the recommendations were followed 94 % achieved therapeutic plasma levels; when recommendations were ianored satisfactory levels were attained in 33 %. These figures demonstrate thai an assay/consultation service is needed and is effective when the recommendations are followed. 1:he service was provided by 2 clinical pharmacists, 2 full time technologists, and 2-J hours per day of a clinical pharmacologist. With the addition of a funher 4 clinical pharmacists 50-60 consultations are bandIed weekly. Taylor. J.W. et Il.: Journal ofOiniell PbannKoIocY 19: I Oao 1979)

0156·2703/ 79/0 127-(1()13$OO.5O/ 0 oAOfSPms INPHARMA27Jan f979 13