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drugs

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Drug-induced myopathies may present in varying degrees of severity from mild muscle weakness to rhabdomyolysis with acute renal failure. Drugs may cause myopathic symptoms by directly affecting a muscle organelle, inducing immunological or inflammatory myopathy, altering systemic functions leading to electrolyte disturbances or via nutritional deprivation, and this in turn affects muscle function. Many toxic myopathies are reversible, thus prompt detection of the offending agent is essential. These are some common drugs implicated in this condition

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Information is Beautiful is one of my favourite blogs. Interesting data in beautiful and easy to take in visual presentations.

A recent post looked at the poisoning deaths in the UK and then compared them to the number of press reports the drug deaths received.
deadliest drugs 1

It was very interesting. Some drugs received an extraordinary number of mentions when a death occured as a result of misadventure. Deaths due to heroin had only 9% of deaths reported. Cocaine with a little over a quarter of the number of deaths compared to heroin had 66% of all deaths reported. The number of press reports for cocaine doubled those of heroin.

deadliest drugs 2

My personal favourites are aspirin and cannabis where the press reported more often than people died. In the case of cannabis almost five times as much.

Media Hysteria or public interest?

Unfortunately I believe these results would be replicated in Australia.

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Data Loggers

by Robbo on 12/01/2009

Warning: This post is for those with a fetish for dataloggers.

I had a couple of enquiries about what sort of data loggers I use for Quality Assurance. So here we go.

I have yet to find the perfect data logger. I have used several and haven’t been 100% happy with any of them.It seems I will have to use different loggers for different tasks.

We have 11 clinics with multiple fridges in each clinic. Loggers are to go at random in fridges and also be placed on stock shelves. Loggers are also in the doctor emergency bags which spend a lot of time in and out of hot vehicles. We source pharmacy supplies from several different pharmacies/pharmacy departments depending on item and destination of delivery and our internal mail bags also carry some items. I have already posted about the temperatures our cold chain needs to handle while in light aeroplanes and also how we are starting to move refrigerated drugs around the lands

What do I want in a Data Logger?

    1. Store data from six weeks of readings every couple of minutes.
    2. Alert light (when close to max/min)
    3. Warning light for when temperature moves below or over the required temperature
    4. Warning alarm (optional)
    5. Splashproof
    5. On/off button
    6. Reasonable price
    7. Handle a wide range of temperatures (most loggers can do up to 50C)

TinyTag Loggers

(from Hasting Data Loggers)

These are splashproof and have no plugs, rather using an induction pad. They can be started on delay or using a magnet and they automatically stop after a certain number of readings, or when full. Unfortunately they only take 8000 readings so do not suit my needs monitoring drug rooms and fridges.

Being splashproof they are ideal for use in eskies as we bring refrigerated items onto the lands. However, an inability to switch the item off when received at the clinic makes them of no use. My aim is not to have extra software and plugs at clinics as I use the data for quality control purposes, not just to monitor the temperature integrity during transport. There is also no alarm to indicate the temperature has been too high or low.

TransiTempII

(from Madgetech)

These are good value. Unfortunately they have no push button start/stop but rely on computer software or a magnet to commence and cease temperature recording. This makes them unacceptable for use with third parties starting them in a pharmacy and then a nurse stopping the logger before forwarding it on to have the data used for Quality Assurance purposes.

They do hold over 32000 readings and are splashproof. There are warning and alert lights. A green light signifies the logger has stored temperatures between the set temperatures. There is amber warning light and red alert light. For refrigerated items I have them set for a warning light at 3 and 7C and the alert light to flash below 2C or 8C.

I will continue to use these for long term monitoring where I can download data on a regular visit.

Temp 100

(from Madgetech)

These have an on/off switch! However they are not splashproof so cannot be used in fridges or refrigerated items in transit. We have used these in a drug room data logging project. High and low limits can be set with an LED going from green to red should the limits be exceeded. They are also a lot more expensive than the TransitempII. we will not be using these again.

It seems to have the benefit of an on/off switch and be splashproof I may be up for several hundreds of dollars each meter which will limit the numbers we be able to use to monitor goods in transit.

Using a variety of loggers means there is a variety of software and a variety of cables required, even sometimes if the profit is from the same company. Purchasing from one company will make it easier to have the loggers recalibrated on a regular basis.

Unfortunately the use of the loggers will not replace the use of the chemical heat and freeze indicators in the drug fridges. I have come across several incidences where the fridge temperature readings have been normal, but items frozen, or overheated at the top or bottom of the fridge. This can occur due to fan failures or temperature probe failures.

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Cold Chain

by Robbo on 28/08/2008

Daniel Grabek

Daniel Grabek

For some time I had been trying to have some research done on our cold chain. Not only for our refrigerated items, but items stored on the shelf in drug rooms.
Honours student, Daniel Grabek from UTAS came to the rescue with his honours thesis “Stability of medicines stored in remote outback settings”.

We had some monitors for a while sitting in our drug rooms faithfully recording all the temperature spikes as community generators started failing in different communities. The most interesting though was the temperature reached when goods were flown in an out (our only access for medications).

A data logger was not switched off and recorded temperatures as it bounced off down to Tassie with Australia Post. The highest spike was in transit by plane from the community. It reached 56C and took over 8 hours to fall below 25C when placed in a cool room.

These are the temperatures our refrigerated products have to handle in transit. We have very few breaches of the cold chain.

However the temperatures reached should be of concern for mail-order pharmacy and even delivery of goods on the back of trucks in summer, particularly in the country.

I have just taken possession of 8 data loggers and are going to use them to monitor everything from doctors bags to drugs in transit as part of our QA.

I look forward to seeing Daniel’s completed thesis

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