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News 16/04/2551


Evaluation of Calcium and Vitamin D Supplementation in Bisphosphonate Therapy

Accuracy of Oral Liquid Measuring Devices: Comparison of Dosing Cup and Oral Dosing Syringe


Evaluation of Calcium and Vitamin D Supplementation in Bisphosphonate Therapy


Dawn N. Rush; Martha W. Jones; Debra P. Futrell; William R. Futrell; Joseph O. McDowell; Stefanie P. Ferreri

J Am Pharm Assoc. 2007;47(6):725-728.  ©2007 American Pharmacists Association

Abstract

Objective: To assess the calcium and vitamin D intake of osteoporosis patients on bisphosphonate therapy.
Design: Prospective study.
Setting: Two independent pharmacies (Futrell Pharmacy Services, Jackson N.C., and McDowell's Pharmacy, Scotland Neck, N.C.) and one ambulatory care clinic (Scotland Neck Family Medical Center, Scotland Neck, N.C.) in eastern rural North Carolina from December 2005 to February 2006.
Patients: 29 osteoporosis patients on bisphosphonate therapy.
Interventions: Patients were assessed on calcium intake and counseled on the appropriateness of supplementation with bisphosphonate therapy.
Main outcome measure: Degree to which osteoporosis patients on bisphosphonate therapy use concomitant calcium supplements.
Results: Of the 29 patients surveyed, 17 patients were using calcium supplements during bisphosphonate therapy. Reasons cited for not using calcium included constipation (7 patients), polypharmacy (3), forgetfulness (1), and deemed unnecessary (1). Types of calcium supplements used were 71% calcium carbonate (12 patients), 24% calcium citrate (4), and 5% unknown (1). Calcium doses used were 500 mg/day (4 patients), and 1,000 mg/day (3), and 1,200-1,400 mg/day (13). Also, 13 patients were taking vitamin D in addition to their calcium, with 8 patients taking 400 IU and the rest 200 IU. Among the patients surveyed, 8 reported taking a proton-pump inhibitor, and 6 were taking calcium carbonate, which is not absorbed well in those taking agents that increase gastric pH. All patients separated their bisphosphonate dose from other medications and meals.
Conclusion: Patients do not recognize the need to supplement calcium at the recommended dosage of at least 1,200 mg/day or 1,500 mg/day for postmenopausal women with osteoporosis along with vitamin D 400 IU for osteoporosis treatment while on bisphosphonate therapy.

To view the article, go to:
http://www.medscape.com/viewarticle/572245


Accuracy of Oral Liquid Measuring Devices: Comparison of Dosing Cup and Oral Dosing Syringe


Parisa Sobhani, PharmD; Jaydi Christopherson, PharmD; Peter J Ambrose, PharmD FASHP; Robin L Corelli, PharmD

Ann Pharmacother. 2008;42(1):46-52. ©2008Harvey Whitney Books Company

Abstract

Background: Previous studies have found that teaspoons are commonly used to administer liquid medications to children. The capacity of household teaspoons ranges from 1.5 mL to 9 mL, potentially leading to errors in dosing. There are few studies evaluating alternative measuring devices.
Objective: To assess adult consumers' previous experience with measuring devices for oral liquids, compare the accuracy of an oral syringe with that of a dosing cup, and determine consumer perceptions of accuracy and ease of use of an oral syringe and a dosing cup.
Methods: Individuals at least 18 years of age were shown a picture of 5 commonly used measurement devices and asked their perceptions of and experience with the devices. They were then asked to measure a 5 mL (1 teaspoon) dose of Tylenol (acetaminophen) suspension, using the EZY Dose oral syringe and the dosing cup provided by the manufacturer. An acceptable dose was defined as 5.0 ± 0.5 mL. Following the measurement, participants completed a 5 item survey that assessed their perceptions of the accuracy and ease of use of the syringe and dosing cup.
Results: A total of 96 subjects completed the study. Participants more commonly reported use of droppers (68%), dosing cups (67%), and teaspoons (62%) versus cylindrical spoons (49%) or oral syringes (49%) for measuring oral liquids. Sixty-four (66.7%) subjects measured an acceptable dose using the syringe versus 14 subjects (14.6%) using the cup (p < 0.001). The mean volumes ± SD measured with the syringe and cup were 4.5 ± 0.7 mL and 6.3 ± 0.7 mL, respectively (p < 0.001). After using both devices, the majority of subjects believed that the syringe (80%) and cup (71%) would measure an accurate dose. Most (87%) participants perceived that the cup was easy to use; 63% believed that the syringe was easy to use.
Conclusions: Droppers and dosing cups were the most commonly used devices in the home for measuring liquid medications. Subjects were more likely to measure an acceptable dose with an oral syringe when compared with a dosing cup. However, a large proportion of study participants were unable to measure an accurate dose with either device. Community pharmacists should educate caregivers on the selection and proper use of measuring devices to improve the accuracy of medication administration in the home.

To view the article, go to:
http://www.medscape.com/viewarticle/571811


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