bluuebunny/crossref_metadata_2025 huggingface dataset:
The Hermeneutics of Purity in Mark's Gospel: Considerations for the AIDS Debate
Authors: Cadwallader Alan H.
Published: July 2017

The classical polarities of hermeneutics - the authoritative text and the present context - are seen in Mark's Gospel to be resolved in a quite distinct paradigm of what constitutes “sacred text”. The use of literary-critical analysis suggests that not only does Mark reveal a hermeneutical awareness, but that he intends the ongoing community of faith to be the necessary component that constitutes the text as sacred. This principle finds a pertinent example in Mark's handling of the issue of purity. In turn, to be true to the hermeneutical principle espoused by Mark, suggestions are made as to the (necessary) interaction of Mark with the current issue for the church in questions raised by AIDS.
Charles Hartshorne on Metaphysical Statements
Authors: Bromell David J.
Published: July 2017

This article supplements Wolfhart Pannenberg's Metaphysics and the Idea of God by offering a systematic introduction to the tasks and criteria of metaphysics through an exposition of various statements of Charles Hartshome on the subject, chiefly his Creative Synthesis and Philosophic Method. The article is focused around Hartshorne's understanding of the precise roles of empirical verification and falsification in relation to metaphysical statements, and his challenge to the empiricist dogmas that “necessary truths = a priori = analytic,” and that a statement is rendered contingent by the mere fact that it asserts existence. Some elaboration follows of the implications of Hartshorne's neoclassical metaphysics for theism, and for modal logic.
The Integrity of Creation: Catholic Social Teaching for an Ecological Age
Authors: Edwards Denis
Published: July 2017

All creatures have value in themselves because of their relationship to God. This article surveys four different attitudes of human beings to other creatures, explores the development of recent Catholic social teaching on the integrity of creation, and then offers reflections on the theological foundations for a commitment to the integrity of creation. It is argued that human beings are companions to other creatures in an earth community, that creation is the presence and self-expression of God, and that salvation in Jesus Christ embraces and transforms the whole universe.
Self-Love and Self-Acceptance
Authors: Moltmann-Wendel Elisabeth
Published: July 2017

Male images of God have alienated women from Christianity. This article explores themes which bring to life images for Christian women. The first is the tradition of wisdom-theology, followed by reflections on a new creation-theology and on a creation-spirituality.
Reconciliation with Nature
Authors: Moltmann Jürgen
Published: July 2017

The first part of this article argues that the ecological crisis of nature today is, at the same time, a religious crisis of the human race, at least of the Western world. In the second part, three perspectives from the Biblical-Christian traditions are offered which may overcome this religious crisis of the human race and the ecological crisis of nature.
Making One Family out of Strangers: Re-Imagining the Catholic Church
Authors: Jones Alan
Published: July 2017

In order to renew the Catholic Church, we need to re-imagine it as inclusive rather than exclusive, as offering to each of us, in community, healing for our shared neediness. Out of our individual frailty a whole community can be re-imagined, particularly in the context of worship and eucharistic sharing.
The Church and the Economy Some Doctrinal Perspectives
Authors: Simons Robert G.
Published: July 2017

The purpose of this article is to suggest that the Christian doctrines on God and the church are a significantly untapped resource for contributing to the broadening social conversation on the economy. The logic of the market economy is distinguished from the logic of God's economy. The conversion which the church has to undergo in order to give witness more credibly to God's economy is also discussed. Ours is an in-between time in which the church is invited to bring the strength of religious passion to bear upon the task of redefining economy in a humane fashion.
What Are the Gospels? Questioning Martin Kähler
Authors: Broadhead Edwin K.
Published: July 2017

The article offers a critical assessment of Kähler's maxim that the Gospels are “passion narratives with extensive introductions.” After sketching the maxim's historical context and its influence on later biblical study, the conclusion is drawn that, in the light of recent developments such as narrative criticism, Kähler was at best only partly right.
Veritatis Splendor: A Philosophical Critique
Authors: Scarlett Brian
Published: July 2017

The article first outlines the argument of the papal encyclical letter and treats in particular its understanding of the relationship between critical thought and ecclesiastical authority. It proceeds to examine the letter's use of natural law theory and Thomas Aquinas, concluding that the letter rests on an uncertain philosophical base.
The Trinity as Transforming Symbol: Exploring the Trinitarian Theology of Two Roman Catholic Feminist Theologians
Authors: Fox Patricia
Published: July 2017

The article explores the Trinity as a transforming symbol for the twenty—first century. It focuses on the recent work of Catherine Mowy LaCugna and Elizabeth Johnson who offer analyses for the “defeat” of the doctrine of the Trinity and also seek to retrieve core understandings of the mystery from Scripture and Christian tradition. The article suggests that the Church today is being challenged to reform itself in the image of the trinitarian God, to become a community for the world.
A Written Jerusalem Gospel “Y”: Reflections on the Socio—Politics of the Synoptic Problem
Authors: Jenkins Geoffrey
Published: July 2017

This article explores the interface between earliest church history and its literary remains, especially the Synoptic Gospels. It is argued that the factionalised community in Jerusalem was more central to the production of the Gospels than is generally thought, and that those Gospels and Q may therefore be of an earlier date than the consensus allows.
The Wound in the Right Foot: A Second Opinion
Authors: Hill John
Published: July 2017

Antonio Rosmini and Garrett Sweeney have each contributed to the debate on the appointment of bishops in the Roman Catholic Church. Revisiting their arguments reminds us of the changes in the mode of appointment in the course of church history, and of the comparative recency of the current mode. The vigour of the debate in recent years may be traced to a shift in the self-perception of the church since Vatican II. This shift seems to demand a re-examination of the mode of appointment, and its adaptation to the times.
The Transient and the Absolute: The Historical Perception of Judaism
Authors: Roshwald Mordecai
Published: July 2017

Judaism, from its biblical beginnings, conveys a peculiar synthesis of historical and religious perception. Divine revelation to Israel is perceived as an historical event, and history is believed to be subject to divine interference, guided by ethical considerations. The moral failings of history will be resolved in the last days by an act of God. This approach has had far-reaching impact on Western civilisation.
Do We Need a More Adequate Theology of the Scriptures?
Authors: Thornhill John
Published: July 2017

This article reviews some recent key writings on the theology of the Scripture from Protestant and Roman Catholic perspectives, particularly the works of Barth, Schneiders, Hauerwas, Childs, and Kelly. The time is ripe for a dialogue in which each side is willing to acknowledge and learn from that which is life-giving in the convictions of the other. One of the main purposes of this article is to argue, following Barth, that the notion of “witness” provides one of the essential keys to an adequate theology of the scriptures.
Margin Writing and Marginal Communities: Between Belonging and Non-Belonging
Authors: Veling Terry A.
Published: July 2017

What does it mean to live “in the margins of tradition”? Many intentional Christian communities occupy this space of marginality, living on the edge of a tradition in which they feel both the need to belong and the impossibility of belonging. Marginal hermeneutics suggests that the interpretive space of “the margins” is a creative, productive, vital site of receptive and critical engagement with a tradition's enriching and distorting effects, and with our own contemporary questions and concerns.
The Defeat of Trinitarian Theology: An Alternative View
Authors: Reid Duncan
Published: July 2017

C. M. LaCugna argues that the modern “defeat” of trinitarian thinking can be attributed to the separation of speech about God's unity from speech about God's triunity, and that the Palamite distinction between essence and energies in God is a step in this process. It is argued here that the essence/energies distinction is made in a different theological context, and has neither the intention nor the effect of detracting from a trinitarian doctrine of God.
Derrida among the Teachers of the Law: Deconstruction and Biblical Studies
Authors: Dawes Gregory W.
Published: July 2017

The reception of Jacques Derrida's work among both literary critics and biblical scholars has frequently taken the form of “deconstructive” exegesis, that is, textual studies which imitate his style of reading. Such readings fail to recognise that Derrida's unique literary style forms part of his philosophical project. Derrida's aims as a philosopher are most clearly to be seen in his reading of the work of Edmund Husserl. Husserl argues that, for our knowledge to have any lasting validity, the objects of our knowledge must be “ideal” objects, independent (in principle) of any particular act of knowing. By calling into question Husserl's analysis, Derrida's work threatens all our attempts to identify textual meaning, and calls into question the interpreter's very raison d'être. Therefore, rather than imitating Derrida's exegetical style, biblical scholars would be better engaged grappling with this philosophical challenge.
Abiding in the Fourth Gospel: A Case-Study in Feminist Biblical Theology
Authors: Lee Dorothy A.
Published: July 2017

From a hermeneutical perspective, the method of examining the prominence and status of women and female characters in a given text is an important but partial way of dealing with biblical texts. Feminist theology needs to recover a sense of “biblical theology” (despite the problems associated with that term), a theology that is sensitive to women's experience and theological reflection. The Johannine notion of “abiding” provides an example of such biblical theology. It is focused on the centrality of relationship, intimacy, and reciprocity, challenging Enlightenment individualism and subject-object bifurcation.
“But Who Do You Say That I Am?” An Australian Feminist Response
Authors: Wainwright Elaine
Published: July 2017

Responses to the question about Jesus' identity have varied across history and culture. A contemporary Australian answer to this question requires attention to the fruits of feminist theological imagination. This essay thus first offers an overview of the key issues which this question raises within feminist theology generally, with particular attention to the maleness of Jesus, the symbolic universe of male titles, and the attempts made by women to “re-member Jesus”. Notes on recent Australian feminist responses to this question are then followed by a reading of Matthew 11:2–19 as a framework for a future understanding of the identity of Jesus.
The Procrustean Bed of Women's Spirituality: Reclaiming Women's Sexuality as an Integral Aspect of Christian Spirituality
Authors: Confoy Maryanne
Published: July 2017

To understand women's spirituality within the Christian framework it is essential to look at traditional cultural attitudes which have contributed to the (de-?)formation of women's sexuality. This article presents an overview of some significant historical influences that have shaped the contemporary western understanding of women's sexuality; it offers a critique of these influences through an analysis of three movements in the liberating understanding of women's spirituality; it also proposes elements of an integral Christian spirituality for women that takes account of the reclaiming of women's sexuality
Struggle is a Name for Hope: A Critical Feminist Interpretation for Liberation
Authors: Fiorenza Elisabeth Schüssler
Published: July 2017

The author attempts to find a way between defence of religion and the bible on the one hand and the exodus from religion and church on the other. In reclaiming the authority of wo/men as religious-theological subjects for interpreting biblical texts, the act of biblical interpretation emerges as a moment in the global struggle for liberation. This essay has four parts: Scripture as a site of struggle over theological authority; the bible as a site of struggle over religious meaning; wo/men's struggles as a site of biblical interpretation; and reclaiming a radical democratic feminist tradition.
Tertullian and the Crucified God
Authors: Rankin David
Published: July 2017

The Christological doctrine of the “communicatio idiomatum” requires that whatever is predicated of one nature of Christ — human or divine — may be predicated of either. It was a major feature of the thought of Cyril of Alexandria and the Alexandrian school generally but denied by most of the Antiochene school. It was accepted in a restricted sense by Leo of Rome but largely ignored in the documents of the mid-fifth century Council of Chalcedon. It appears nowhere in that council's Definition of Faith. This paper suggests that an early form of the doctrine is evident in the works of Tertullian of Carthage, writing in the early years of the third century. Whether Tertullian understood the full, logical implications of what he wrote in relation to the “communicatio”, however, cannot be said with any certainty.
Seeking the Feminine: An Exploration of the Spiritual Writings of Hildegard of Bingen and Julian of Norwich
Authors: Crisp Beth R.
Published: July 2017

The enthusiastic reception which has greeted the rediscovery of the writings of Julian of Norwich and Hildegard of Bingen has been attributed to the explicitly feminine nature of their works. This article explores why the writings of these women can be considered feminine and argues coexisting models of the divine are not only possible but necessary for an understanding of a God who is not unidimensional.
Cracking the Code: Minjung Theology as an Expression of the Holy Spirit in Korea
Authors: Bretzke James T.
Published: July 2017

Minjung theology's development in Korea, as an indigenous theology of liberation, is a genuine response to the Holy Spirit in Asia's fastest growing Christian population, though not without its problematic elements and critics. This article reflects on the inculturation of minjung theology in terms of a five-stage framework suggested by the Pentecost account in Acts 2:1–42.
Church, Anti-Types and Ordained Ministry: Systematic Perspectives
Authors: Ormerod Neil
Published: July 2017

The author develops a systematic approach to ecclesiology and the theology of ministry through a consideration of Lonergan's scale of values. This leads to the development of four anti-types to authentic Church, and a discussion of the role of ministry as corrective of the distortions evident in these anti-types. An intrinsic link is then made between ordained ministry and the eucharistic celebration. This paper is part of a larger project which seeks to develop, in outline at least, the elements of a systematic ecclesiology. As a systematic, it inevitably draws on a particular foundation, here the work of Lonergan and Doran, and remains hypothetical and tentative. The value of such a project lies in its testing of its foundations, not just in dialectic debate against other foundational possibilities, but through an examination of the systematics which can be built upon them.
Contextualising Australian Theology: An Enquiry into Method
Authors: Lilburne Geoffrey
Published: July 2017

Recent efforts to contextualise Australian theology need to be the subject of critical dialogue between Catholic and Protestant theologians. In a spirit of postmodernity, the author critiques the methodology of Tony Kelly's A new imagining, and then moves on to propose elements of an alternative methodology which draws upon the theology of Karl Barth. A recent work by Norman Habel, This land is mine, promises a rich contextual reflection, and the method here proposed is applied to theological issues emerging from this study to outline a way forward for Australian contextualising.
The Path to Perfection in Pseudo-Macarius and John Wesley
Authors: English John C.
Published: July 2017

John Wesley read Macarius' Homilies no later than 30 July 1736. He probably read them in a German translation provided by one of his pietist friends. Wesley was deeply impressed. He tried to give Macarius' ideas a wider circulation by publishing portions of his Homilies in the Christian Library. In 1736, however, Macarius helped Wesley to clarify his attitude toward “mysticism” and reinforced some of his cherished ideas regarding Christian perfection.
Touching the Sacred Text: The Bible as Icon in Feminist Reading
Authors: Lee Dorothy A.
Published: July 2017

This article proposes that the understanding of icons within Eastern Orthodoxy provides a model for feminist hermeneu tics in developing a poetics of sacred reading. The two major periods of icon dispute within church history are briefly reviewed (the icon controversies of the eighth and ninth centuries and the Protestant Reformation) and iconoclasm and iconophilia are discussed as competing yet ultimately complementary dynamics in theology. Christian feminism can acknowledge the value of both in understanding the place of the Bible avoiding either fundamentalist or expulsive readings of the text Icon-veneration has an important place, alongside iconoclasm (as distinct from icono-phobia), in developing a feminist biblical poetics.
Locating Readers: A Response to Frank Moloney
Authors: Brett Mark G.
Published: July 2017

Frank Moloney's appropriation of Nicodemus is more justifiable if it is considered in the light of the original socio-historical context of John's Gospel. The world behind the text can be seen to provide an analogy with the world in front of the text. There are, indeed, more layers of practical relevance which could be considered, and it may well be the case that the future of biblical studies in Australia will depend on our capacity to relate the narrow and technical features of the discipline to the wider concerns of religion and society
Towards an Inclusive Vision for Moral Theology
Authors: Keenan James F.
Published: July 2017

In this article the author argues that moral theologians must seek to overcome the separation between moral and ascetical theology. Such a distinction entered practical theology comparatively recently. The first part of the article consists chiefly of a historical survey, beginning with the writings of the twelfth century, pointing to the close connection between evangelical and spiritual activity that found in conscience the voice of God. By emphasising a scripture based, holistic, self-directed, embodied and relational practical theology, ascetical theology offers moral theology a way of exploring a broadened and positive agenda for examining the ethical life. The second part of this work, “An Agenda for the Future” will appear in the February 2000 issue of Pacifica
Narrative as Ideology: Synchronic (Narrative Critical) and Diachronic Readings of Jeremiah 37–38
Authors: Boyle Brian
Published: July 2017

While synchronic and diachronic readings of Old Testament texts are generally taken as methodologically diverse, there have been recent attempts to explore how the two readings may in fact be complementary. Taking the narrative of Jeremiah's final audience with Zedekiah in Jeremiah 37–38, this article offers just such a reading of the text. One episode from this narrative, Jer 37:11–16, is taken as an example of a synchronic (narrative critical) reading of the text. Two examples of diachronic readings are then offered, drawing on the work of Seitz and Stipp. The article argues that a diachronic reading of this narrative is necessary and complementary to a synchronic reading. The ideological nature of this story of Jeremiah's imprisonment becomes clearer.
Predicting Use of Child Welfare Services after Intensive Family Preservation Services
Authors: Unrau Yvonne A.
Published: July 2017

This study explored whether selected client and service characteristics could help predict families' use of other child welfare services after receiving intensive family presentation services (IFPS). Of 192 families, over three quarters did not use out-of-home child placement services for up to 6 months after receiving IFPS. Additionally, well over half of the families ended all service agreements with child welfare in the same period Polytomous logistic regression was used to develop prediction models. The findings of this study have implications for the development and service delivery of IFPS programs. Specifically, the role of IFPS needs to be re conceptualized to more accurately reflect its place on the child welfare services continuum.
A Survey of Social Work Research Centers
Authors: Nutter Richard W. , Hudson Joe
Published: July 2017

A survey of Social Work Research Centers (SWRCs) in North America produced results from 8 Canadian and 37 U.S. SWRCs. The number of SWRCs and the proportion directed by women has increased since Estes's survey. Most SWRCs have small budgets and staff complements. The most reported purpose was to improve social work practice by applying and transferring knowledge. Center membership was largely social work faculty and students. SWRC policy and administration was usually shared among SWRC directors, social work heads, and other university officials. Most respondents agreed that SWRCs should have separate budgets to increase their ability to plan and carry out activities. SWRC priorities were about the same as reported by Estes, and their research priorities reflected faculty interests. A high proportion of SWRC directors strongly agree with many of the recommendations originally offered by Estes in 1979. Nearly all agreed that SWRCs should have a stable set of resources to direct toward generating additional funds to build SWRC operations.
The Institute for Multicultural Research and Social Work Practice
Authors: Takahashi Rita , Sung Susan , Reisch Michael
Published: July 2017

This article addresses the significant role multicultural social work institutes can play in the development of social work practice. Such an institute can be a powerful source for researching, evaluating, and expanding social work knowledge and practice, educating and training human service professionals, analyzing and disseminating information critical to policy and professional development, and initiating and participating in change processes that reflect heightened awareness of and appreciation for diversity. The case of San Francisco State University's Institute for Multicultural Research and Social Work Practice is used to illustrate how each of the above-mentioned points were achieved. This article traces the three major phases the institute went through during its first 7 years of history: initiation and establishment, development, and maintenance and growth. It reveals that to be successful, institutes must engage in strategic planning and continuously evolve and change to meet new challenges and developments.
The Family Practitioner-Clinical Pharmacist Group Practice—A Model Clinic
Authors: Juhl Randy P. , Perry Paul J. , Norwood G. Joseph , Martin L. Robert
Published: July 2017

The establishment, organization, and operation of a pharmaceutical component within a primary care facility is delineated. This setting allows the pharmacist an opportunity to provide innovative clinical services. A mechanism of reimbursement is suggested which rewards the pharmacist for performing functions not directly related to the dispensing activity. The indications are that this arrangement could be financially feasible for a group practice including a pharmacist and one or two physicians.
Acute Renal Failure in a Multisystem Allergic Reaction to Sulfamethoxazole
Authors: Evans William E. , Weishurst Mark , Self Timothy H.
Published: July 2017

A case of acute renal failure, hepatic dysfunction and skin and mucous membrane eruption following a course of sulfamethoxazole therapy is reported. Although several cases of multisystem reactions to long acting sulfonamides have been reported, this case describes the first such reaction to sulfamethoxazole.

The subsequent fatal outcome of this case demonstrates the potential significance of sulfamethoxazole hypersensitivity reactions.
Medication Data Sheets— An Aid to Patient Education
Authors: Paulson Patrick Thomas , Bauch Robert , Paulson Margaret Lamont , Zilz David A.
Published: July 2017

The effect on patient knowledge of self-administration of medications was evaluated for verbal instruction versus verbal instruction reinforced with written Medication Data Sheets.

Significant improvement in self-administration was noted with the use of written reinforcement of the pharmacist's verbal explanations concerning the proper way to correct for a missed dose of the medication (p<0.0005), foods or drinks to avoid while taking the prescribed medication (p<0.05), understanding of the purpose for taking the medication (p<0.005), and whether or not the prescribed medication was refillable (p<0.0005).

In addition it was shown that informing patients in writing of the potential side effects of the medication did not increase the incidence of their occurrence (p = N.S.).
Reduced Bioavailability of Digoxin by Magnesium Perhydrol
Authors: van der Vijgh W. J. F. , Fast J. H. , Lunde J. E.
Published: July 2017

A patient who exhibited decreased bioavailability of digoxin during simultaneous administration of the antacid magnesium perhydrol is described. It was shown that digoxin is decomposed by hydrogen peroxide which is liberated from magnesium perhydrol by gastric juice. Therefore, simultaneous administration of digoxin and magnesium perhydrol must be avoided.
Worldwide Regulatory Requirements and their Effects on the Clinical Study and Transport of Investigational New Drugs
Authors: Haines Bernard A.
Published: July 2017

Worldwide politico-socioeconomic factors greatly influence the regulations and legislation that govern the clinical study of investigational new drugs. The increase in worldwide potential for pharmaceutical products, along with the escalating research and development expenditures, place an increased responsibility on R&D to produce new and improved products with worldwide clinical utility. Worldwide regulatory agencies play a significant role in the design and study of new drugs and in the transport of clinical drug supplies. The extent and influence of worldwide regulations on the clinical development of drugs for worldwide markets and on the transport of clinical drug supplies both now and in the future are presented.
The Cost of Medical Care
Authors: Summerfield Marc R. , Lamy Peter P.
Published: July 2017

Health care costs continue to spiral at a rate faster than the general economic sector, due to factors which uniquely affect the health care industry. Several of these factors are discussed. The effect of the spiraling costs are felt throughout all departments of the hospital. Recognition of the need for cost containment measures, by health professionals in addition to governmental laws and regulations and consumer pressures, have stimulated the search for more efficient methods of operation. If cost containment measures are not to affect the quality of care adversely, increases in productivity must be achieved and wasteful operations eliminated. The need for further research in these areas is cited.
An Overview and Prospect for the Future
Authors: Ruger James R. , Durgin Jane M.
Published: July 2017

The need and demand for improved adverse drug reaction reporting; literature access, control and dissemination; and student-literature exposure has been evident for many years. Drug information attempts to manage these perplexities by performing specific functions (i.e., by the communication of information, designing improved retrieval systems and offering individualized services). The drug information specialist is clinically-oriented and endeavors to surmount long-existing barriers to information transmission (e.g., the “invisible college” or colleague consultation). As a documentalist he is concerned with bibliographic control and systems improvement and design. Both functions require specialized education which is obtainable in schools of graduate pharmacy and in schools of library and information science. The properties of such programs are presented.
Evaluation of Three Methods for Determining Initial Vancomycin Doses
Authors: Ackerman Bruce H.
Published: July 2017

Dosing methods proposed by Matzke et al., Moellering et al., and Lake and Peterson were used to predict initial doses of vancomycin for serum concentration simulation using a two-compartment open model. Previously reported pharmacokinetic data from 25 of 28 patients were used to simulate steady-state serum vancomycin concentrations for doses derived from the three methods. The Matzke method failed to provide simulated one-hour postinfusion levels < 30 μg/mL in 48 percent and troughs > 5 μg/mL in more than 88 percent of the patients. The Moellering method succeeded in achieving this goal in 96 percent of the simulated one-hour levels, and in 72 percent of the troughs when a six-hour dosing interval was selected. For the 8 mg/kg Lake-Peterson doses, one-hour levels > 30 μg/mL occurred in 28 percent of the simulations, and for the 10 mg/kg doses this increased to 40 percent. The 8 mg/kg doses resulted in trough simulations < 5 μg/mL in 28 percent and the 10 mg/kg reduced this to only 20 percent. These simulations indicated that the Moellering nomogram with the six-hour dosing interval was the most successful method for initial dose selection, but early serum concentration monitoring and adjustment of initial empirical and nomogram-derived doses is necessary to assure safe and effective vancomycin serum concentrations.
Carbamazepine Clearance in Hemodialysis and Hemoperfusion
Authors: Kandrotas Robert J. , Oles Karen S. , Gal Peter , Love James M.
Published: July 2017

A 47–year-old woman with endstage renal disease and dialysis-induced encephalopathy was being treated with carbamazepine for myoclonus. Her carbamazepine serum concentration appeared to be therapeutic at 5.1 μg/ml. She experienced a seizure while on hemodialysis/hemoperfusion that was possibly related to the removal of carbamazepine during dialysis. The elimination of carbamazepine on a dialysis day was compared with elimination on a nondialysis day. The half-life and apparent clearance were the same for each day, indicating that hemodialysis/hemoperfusion had little effect on the overall removal of carbamazepine from the body. The possible reasons for this lack of effect are discussed.
Heinz-Body Hemolytic Anemia Associated with Phenazopyridine and Sulfonamide
Authors: Ponte Charles D. , Lewis Michael J. , Rogers John S.
Published: July 2017

A 27–year-old white woman developed Heinz-body hemolytic anemia following multiple courses of oral phenazopyridine and trimethoprim-sulfamethoxazole. Her diagnosis was supported by the finding of bite cells on peripheral blood smear. The patient's rapid recovery and reversal of abnormal laboratory parameters were consistent with an acquired hemolytic disorder. This case should sensitize the clinician to the development of drug-induced oxidative hemolysis, its clinical features, and its reversibility. It is also important that the clinician recognize those drugs capable of causing this disorder and appreciate the methods available to establish the diagnosis.
A Clinical Pharmacy-Oriented Drug Surveillance Network: Results of a Nationwide Antibiotic Utilization Review of Bacterial Pneumonia–1987
Authors: Grasela Thaddeus H. , Schentag Jerome J. , Boekenoogen Steven J. , Crist Kenneth D. , Lowes William L. , Lum Bert L.
Published: July 2017

One hundred eighteen pharmacists enrolled in the Drug Surveillance Network completed a survey of antibiotic prescribing patterns for bacterial infections. A total of 319 hospitalized patients being treated for suspected or documented bacterial pneumonia were monitored, and this paper summarizes the data collected on this specific subpopulation. Two hundred three patients (64 percent) were treated for community-acquired pneumonia and 116 patients (36 percent) were treated for nosocomial pneumonia. Seventy-three percent of the nosocomial pneumonias were culture-positive, with a gram-negative microorganism as the predominant isolate.

Forty-eight percent of the community-acquired pneumonias were culture-positive with a mixture of gram-positive and gram-negative organisms. Fifty percent of patients were treated with a single agent, 33 percent with two antibiotics, and the remaining 17 percent with a combination of three or more antibiotics. A satisfactory response was noted for 62 and 76 percent of the patients with nosocomial and community-acquired pneumonias, respectively. Twenty percent of the pneumonia patients were switched to oral drug after an average of five days of therapy and discharged from the hospital. Twenty-five adverse events that were possibly or probably related to the antibiotic regimen were reported in 23 of the 350 patients for an overall incidence of 6.5 percent. The results of this survey provide a cross-sectional view of antibiotic prescribing patterns for the treatment of bacterial pneumonia and the outcome of therapy under actual clinical conditions of use.
Suspected Ciprofloxacin-Induced Interstitial Nephritis
Authors: Murray Kim M. , Wilson Malissa G.
Published: July 2017

Interstitial nephritis is a rare but serious adverse effect of many drugs and usually is diagnosed by clinical signs and symptoms of hematuria, proteinuria, eosinophilia, fever, azotemia, and rash. Ciprofloxacin is one drug that has been reported to cause interstitial nephritis. Renal toxicities have been reported in less than one percent of the patients receiving ciprofloxacin therapy. Limited documentation of this adverse effect exists in the literature. This article describes a patient with suspected ciprofloxacin-induced interstitial nephritis.
Omeprazole: A Novel Antisecretory Agent for the Treatment of Acid-Peptic Disorders
Authors: Lampkin Thomas A. , Ouellet Daniele , Hak Lawrence J. , Dukes George E.
Published: July 2017

Omeprazole represents the first agent of a unique class of acid inhibitory drugs, the proton pump inhibitors. Omeprazole inhibits basal gastric acid secretion, as well as gastrin-, histamine-, or pentagastrin-stimulated secretion, which results in decreased gastric acidity, decreased gastric acid output, and decreased gastric volume. Omeprazole is acid labile, necessitating its oral administration in an enteric-coated formulation. Bioavailability appears to be dose-dependent, with more drug being absorbed with increasing dosage as well as after repeated dosing. This is probably secondary to decreased gastric acidity and, therefore, less degradation of the administered drug. Despite its relatively short half-life (1–2 h), omeprazole's pharmacologic action is prolonged. Clinical trials have shown omeprazole to be at least as effective as histamine2-receptor antagonists in the treatment of gastric ulcers, duodenal ulcers, gastroesophageal reflux, and Zollinger-Ellison syndrome. Adverse reactions have been minimal. Omeprazole has been approved by the Food and Drug Administration for short-term therapy of severe erosive esophagitis, poorly responsive symptomatic gastroesophageal reflux disease, and long-term management of Zollinger-Ellison syndrome.
Should Anticholinergics Be Used in Acute Severe Asthma?
Authors: Kelly H. William , Murphy Shirley
Published: July 2017

Anticholinergic drugs have been used in Western medicine for the treatment of asthma since the early 19th century. Studies evaluating drug efficacy in acute severe asthma over the last decade have renewed interest in the optimal use of anticholinergics in this condition. Unlike other bronchodilators (i.e., beta2-agonists and methylxanthines), the anticholinergics produce bronchodilation only by inhibiting cholinergic-mediated bronchospasm. Therefore, anticholinergic drugs are more dependent on the mechanism of bronchospasm than other bronchodilators. The 18 clinical trials of anticholinergics in acute severe asthma are critically reviewed for design and endpoint measurements. Anticholinergics alone produce a modest bronchodilation in acute severe asthma but are not as consistently effective as beta2-agonists. Anticholinergics consistently produce an added bronchodilation to aerosolized beta2-agonists in single- and multiple-dose studies. This bronchodilation appears to be greater in the more severely obstructed patients. This bronchodilation is generally modest (10–20 percent), has not yet been shown to produce greater overall outcome, and has not been evaluated against high-dose frequent administration of aerosolized beta2-agonists. Currently, only the quaternary amine derivatives are recommended for use in acute asthma. These agents should be reserved as second-line agents for acute severe asthma except possibly for those patients presenting with more severe obstruction (peak expiratory flow rate <35 percent of predicted).
A Model of Methods for Influencing Prescribing: Part I. A Review of Prescribing Models, Persuasion Theories, and Administrative and Educational Methods
Authors: Raisch Dennis W.
Published: July 2017

The purpose of this literature review is to develop a model of methods to be used to influence prescribing. Four bodies of literature were identified as being important for developing the model:

(1) Theoretical prescribing models furnish information concerning factors that affect prescribing and how prescribing decisions are made. (2) Theories of persuasion provide insight into important components of educational communications. (3) Research articles of programs to improve prescribing identify types of programs that have been found to be successful. (4) Theories of human inference describe how judgments are formulated and identify errors in judgment that can play a role in prescribing. This review is presented in two parts. This article reviews prescribing models, theories of persuasion, studies of administrative programs to control prescribing, and sub-optimally designed studies of educational efforts to influence drug prescribing.
Impact of College of Pharmacy-Based Educational Services within the Hospital
Authors: Mueller Bruce A. , Abel Steven R.
Published: July 2017

Using a pharmacy intervention form, we measured the influence that university-based pharmacy educational personnel had on the pharmacy department's drug costs and on patient charges over a three-month period. A total of 278 interventions were made; 88.8 percent were implemented. Implemented interventions decreased drug costs by $1661.99 and decreased patient charges by $5938.37. The average implemented intervention decreased drug cost by $6.73 and patient cost by $24.04. Regardless of economic benefits, 218 of the 247 implemented interventions were considered to have positive clinical effects on patient care. Educational personnel were responsible for generating $6028.27 of fee revenues to the pharmacy department through generation of pharmacokinetic drug dosing consults. We conclude that the educational programs provided by the pharmacy department through affiliation with a college of pharmacy directly contributed $7690.26 to the pharmacy department in the form of cost-avoided dollars and revenue generation over a three-month period. The provision of educational services by a hospital pharmacy department results in financial rewards as well as other benefits that have been previously described.
Ivermectin: A Long-Acting Microfilaricidal Agent
Authors: Ette Ene I. , Thomas Wilkinson O.A. , Achumba Judy I.
Published: July 2017

Ivermectin is a macrocyclic lactone (fermentation) product and actinomycete ( Streptomyces avermitilis) that possesses an unusually broad spectrum of potent activity against several species of nematodes, arachnids, and insects that parasitize domestic animals. From clinical trials in humans it has been found to be microfilaricidal, killing microfilariae of Onchocerca volvulus (the parasite causing onchocerciasis), and interrupting its transmission by the black fly vector. Dermal microfilariae density in patients are reduced to near zero levels for 6–12 months after a single oral dose of ivermectin 0.15–0.2 mg/kg. Its precise mechanism of action is unknown. It has a time to maximum concentration of 2.7–4.3 h, and an elimination half-life of 28 ± 10 h. When compared with an oral solution the tablet dosage form has a relative bioavailability of approximately 60 percent. Not much is known about its metabolism in humans, and the unchanged drug is not detected in the urine. Controlled clinical trials have shown ivermectin to be associated with milder side effects than diethylcarbamazine, the current drug of choice for onchocerciasis therapy. It does not cause the severe Mazzoti-type (anaphylactoid) reactions that are associated with diethylcarbamazine use. Ivermectin is effective, safer, and more tolerable than diethylcarbamazine. It should, therefore, replace diethylcarbamazine as the drug of choice for onchocerciasis therapy.
Effect of Naproxen and Sulindac on Blood Pressure Response to Atenolol
Authors: Abate Marie A. , Layne Richard D. , Neely Jeffrey L. , D'Alessandri Robert
Published: July 2017

Twenty-eight patients with mild to moderate essential hypertension well controlled by atenolol entered a five-week, double-blind, placebo-controlled trial of the effects of sulindac and naproxen on blood pressure (BP) control. Atenolol alone was administered during weeks 1, 3 5. Naproxen or sulindac was administered with atenolol during week 2, with crossover during week 4. Data were analyzed for 27 of the patients (one dropped out after developing a skin rash). Naproxen significantly increased the systolic BP compared with placebo (mean 4.0 mm Hg; 95 percent confidence interval, 1.1–7.0; p<0.05). There were no significant differences in systolic BP during sulindac administration compared with placebo or naproxen. No significant effects on diastolic BP were observed. Weight was increased by naproxen and sulindac compared with placebo (mean 0.6–0.8 kg, p<0.05), although not to a clinically significant extent. One-week therapy with naproxen has a greater potential than sulindac to increase systolic BP in well-controlled hypertensive patients receiving atenolol; however, the increase is minor and unlikely to be of clinical significance.
Cerebellar Syndrome Caused by Isoniazid
Authors: Blumberg Emily A. , Gil Ramon A.
Published: July 2017

Treatment of tuberculosis in a hemodialysis patient with isoniazid, rifampin pyrazinamide resulted in the development of acute cerebellar dysfunction. This resolved rapidly following the discontinuation of isoniazid and pyrazinamide, reinstitution of isoniazid at a lower dose addition of pyridoxine. We discuss why we believe this syndrome was caused by isoniazid. Patients with renal failure who undergo antituberculous therapy with isoniazid should receive supplemental pyridoxine to reduce the likelihood of isoniazid-related neurotoxicity.
Prescribing and Dispensing Practices for Oral Iron Tablets: A Canadian Experience
Authors: Delorme Michael A. , Gwadry-Sridhar Femida H. , Inwood Martin J.
Published: July 2017

The formulation of an oral iron tablet may influence its therapeutic efficacy in correcting iron deficiency. In order to determine the oral iron preparations patients in a Canadian urban center were receiving, a questionnaire was circulated to family physicians, internists, surgeons obstetrician-gynecologists to determine their prescribing practices. A survey of pharmacies in the city was also conducted to determine which brand of each iron salt (sulfate, gluconate, fumarate) they dispensed for a generic oral iron prescription. Most physicians (74 percent) chose ferrous sulfate as their drug of first choice. The majority of prescribers would not specifically request either enteric-coated/slow-release or nonenteric-coated preparations as first or second choices (71 and 64 percent, respectively). Enteric-coated or slow-release preparations were specified by 10 and 19 percent of physicians as first and second choices, respectively. Most pharmacies (96 percent) dispensed an enteric-coated preparation of ferrous sulfate for a generic prescription. We believe that many patients are receiving iron tablets with altered release properties (enteric-coated/slow-release). These tablets may fail to provide the desired therapeutic benefit based on the known physiology of iron absorption.
Evaluation of an Imipenem/Cilastatin Target Drug Program
Authors: Abel Steven R. , Guba Elizabeth A.
Published: July 2017

This article describes an imipenem/cilastatin (I/C) target drug program. The program, developed following completion of a drug usage evaluation study, was designed to improve I/C dosing, reduce central nervous system (CNS) adverse effects, and reduce antibiotic costs. Following completion of an inservice education program for the medical and pharmacy professional staffs, ongoing monitoring of I/C usage was accomplished through the pharmacy-based drug-dosing service. Pharmacists evaluated I/C dosage based upon culture/sensitivity results and indicators of renal function. If deemed inappropriate, the pharmacist contacted the prescribing physician with a dosage recommendation. Two hundred ten courses of I/C therapy were prescribed in the nine-month period following implementation of the target drug program; 26 cases (12 percent) required dosage adjustment. The incidence of CNS adverse effects including seizures decreased from 15 to 1 percent (p = 0.0015). A $6033 drug cost avoidance also resulted from pharmacist intervention.
Seizure Activity Associated with Imipenem Use: Clinical Case Reports and Review of the Literature
Authors: Leo Raphael J. , Ballow Charles H.
Published: July 2017

Two patients with multiple organ systems failure developed seizures after receiving imipenem/cilastatin (I/C) despite dose adjustment for poor renal function. Neither patient had a past history of seizures, nor had experienced seizures after receiving high doses of other beta-lactam antibiotics. Simple dose adjustment of I/C based on low creatinine clearances may not be adequate to prevent seizures.
In Vivo Inactivation of Tobramycin by Piperacillin
Authors: Uber Walter E. , Brundage Richard C. , White Roger L. , Brundage Dianne M. , Bromley Howard R.
Published: July 2017

In vivo inactivation of aminoglycosides by antipseudomonal penicillins in patients with renal failure can be a significant problem when these drugs are used together in certain gram-negative infections. Our article illustrates the possible magnitude of this interaction and the resultant effect on aminoglycoside pharmacokinetic parameters. Penicillin concentrations remain relatively unaffected by this interaction. This article stresses the need for close monitoring of aminoglycoside concentrations when combined with antipseudomonal penicillins in this patient population.