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Hospital work experience: clinical trials and antimicrobial use monitoring

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I met a clinical trials technician who told me that they hadapproximately 50 clinical trials at the time ranging from double-blind to openlabel, from drug company sponsored (i.e. they get paid to organise them) touniversity trials where they don’t get paid for dispensing.  Many checks take place when dispensing thedrugs and this process can take up to an hour. For randomised double-blind trials a nurse rings a voice recognitionnumber which randomly and blindly allocates a drug pack to a patient.  When the item is dispensed the dispenser hasto ring up the number once more and check that a second number on the packcorresponds to the phone data.

I then met an antimicrobial technician who gave me a brieftalk about her role in preventing the overuse of antimicrobials and about theproblems which can be encountered if doses are missed; some patients haveindeed died through missing a dose.  Onesolution to prevent this from happening is to have an emergency antibioticsupply on each ward which saves antibiotics having to be ordered from thePharmacy.  These technicians also have alist of antibiotics for restricted use such as co-amoxiclav which theymonitor.  They don’t expect to see muchco-amoxiclav prescribed as it is only meant to be used to treat human and dogbites!

Finally, I met a newly qualified pharmacist on a ward forthe elderly where there was a patient with an international normalised ratio(INR) of 8.2 which is high indicating slow blood clotting.  Normally patients with an INR above 8 aregiven vitamin K to bring down the INR and this is something she suggested.  Something which surprised me is that apatient can stop taking Warfarin suddenly if need be!

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