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Die lewering van 'n farmakokinetiese diens deur aptekers in 'n milit^ere hospitaal

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dc.contributor.advisor Serfontein JHP, Prof en
dc.contributor.advisor Dreyer AC, Prof en
dc.contributor.advisor Rheeders M, Mrs en
dc.contributor.author Wallis H en
dc.date.accessioned 2016-09-22T07:22:27Z
dc.date.available 2016-09-22T07:22:27Z
dc.date.submitted 1991 en
dc.identifier.uri http://hdl.handle.net/20.500.11892/17693
dc.description.abstract The discipline of clinical pharmacokinetics has evolved over the past twenty years. The aim of clinical pharmacokinetics is to enhance the advantages of pharmacotherapy while minimising toxic reactions. This can be achieved by establishing correlations between serum drug concentrations and pharmacologic and toxic effects for a variety of drugs. <br><br> Chapter 1: The aim of this study is outlined in this Chapter as to show that rendering a pharmacokinetic service by pharmacists at 1 Military Hospital, can fulfill an important need and can be accomplished in a cost-effective manner. <br><br> Chapter 2: The pharmacist responsible for rendering a pharmacokinetic service has to possess in depth knowledge of the physiologic processes which affect pharmacokinetic parameters, while the user of such a service should possess a basic knowledge of pharmacokinetics. A literature study of the pharmacokinetic principles is performed in this Chapter. <br><br> Chapter 3: The specialised study of the mathematical relationships between drug doses and the resultant serum drug concentrations is utilised in the individualising of drug dosing regimens. In order to characterise the pharmacokinetic parameters of bioavailability, distribution and clearance, studies are normally conducted in patient populations. Serum drug versus time data are fitted to various models and statistical methods are employed to obtain the best possible fit. In this Chapter model-dependent pharmacokinetic principles and their practical application within the clinical environment, are discussed. <br><br> Chapter 4: The relationship between the serum drug concentration and pharmacologic response of a drug facilitates the utilisation of serum concentrations in the prediction of drug effectiveness and toxicity. Monitoring of serum concentrations is indicated for drugs with small therapeutic indices and when pharmacologic response can be predicted from serum concentrations. Since this study was conducted with different drugs and drug groups, the pharmacokinetics of each drug is discussed briefly. It is shown that these drugs possess the above mentioned characteristics and are thus eligible for inclusion in this study. <br><br> Chapter 5: With the implementation of a pharmacokinetic service in a military hospital, it is important that the management approach as well as the role of the pharmacist responsible for rendering the service be evaluated within the context of present authority structures. The effects, advantages and disadvantages of pharmacokinetic services, the factors which affect the implementation of such services and the future of pharmacokinetic services are discussed in this Chapter and a literature/ study performed in order to place these factors into perspective. <br><br> Chapter 6: The research methodology is outlined and particulars given on how results were obtained and assessed. Data was obtained by monitoring drug serum concentrations and information obtained from structured questionnaires. <br><br> Chapter 7: The results of the study are presented together with suitable tables and graphs. The existence of the pharmacokinetic service had a positive effect on serum concentrations of most drugs and drug groups included in this study and it was shown that the service reduced the number of requests for serum drug concentration determinations. The cost implication of the pharmacokinetic service was analysed and it was shown to decrease reagent costs. The involvement of pharmacists on the managerial level resulted in cost savings. The views of physicians regarding the necessity and quality of the service were analysed, and it was established that the service had a favourable effect on the quality of patient care and fulfilled a definite need. It was shown that the presence of a pharmacokinetic service did not improve physicians' knowledge regarding pharmacokinetics. <br><br> Chapter 8: The findings of the study are restated and recommendations made regarding the improvement of the service, the implementation of such services at the other military hospitals and for the training of physicians and pharmacists. Recommendations are also made regarding future research to be conducted. en
dc.language Afrikaans en
dc.subject Medical sciences: Pharmacology and therapeutics en
dc.title Die lewering van 'n farmakokinetiese diens deur aptekers in 'n milit^ere hospitaal en
dc.type Doctoral degree en
dc.description.degree PhD en

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