Iran J Pharm Res
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Medication errors have important effects on increased length of hospitalization, increased mortality and costs. We assessed the incidence of medication errors and characterize the error types in an emergency department in a large teaching hospital in Tehran. We also investigated the effect of Emergency Department pharmacists on patient safety with regard to recovery of potentially harmful medication errors. ⋯ Seventy four point nine percent of errors were recorded as definitely an error. Most recorded errors were made by nurses (44.5%) and occurred in administrating stage (63.6%). Given that the rate of the errors was relatively high, it seems that the presence of clinical pharmacist can be beneficial.
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Severe sepsis and septic shock are major problems as the result of high rates morbidity and mortality in intensive care units (ICUs). In the presence of septic shock, each hour of delay in the administration of effective antibiotics is associated with a measurable increase in mortality. ⋯ Volume of distribution (Vd) and clearance (CL) of aminoglycosides in critically ill patients differs from general population and these parameters change considerably during the therapy. Pathophysiological changes during the sepsis alter the pharmacokinetic and pharmacodynamic profile of many drugs (increase in Vd and variable changes in CL have been reported for aminoglycosides during the sepsis), therefore, dosing regimen optimization is necessary for achieving therapeutic goal, and critically ill patients should receive larger loading doses of aminoglycosides in order to achieve therapeutic blood levels and due to the considerable variation in kinetic parameters, the use of standard doses of aminoglycosides or dosing nomograms is not recommended in these populations.