Document Detail


A nationwide survey of prescribing patterns for thrombolytic drugs in acute myocardial infarction.
MedLine Citation:
PMID:  2107535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In November 1988, 164 hospitals enrolled in the Drug Surveillance Network participated in a nationwide survey of prescribing patterns for thrombolytic drugs for patients with an acute myocardial infarction. The results indicated that alteplase has made dramatic inroads, being used exclusively in 14.6% of the hospitals; in 64% of the hospitals both alteplase and streptokinase were on the formulary. Overall, however, only 17% of patients admitted with an acute myocardial infarction were treated with a thrombolytic, and use of these agents varied markedly across institutions. One of the reasons for this low figure may be the current maximum allowable time from onset of symptoms to administration of a thrombolytic. This time limit was less than 6 hours in the majority of hospitals in spite of recent evidence suggesting that these drugs may be effective up to 24 hours after onset of symptoms. The low and variable use of the agents for acute myocardial infarction suggests the need to identify patient- and physician-related obstacles so that overall attitudes and professional practice can be modified to reverse this trend. Given large number of institutions reporting the presence of formal, prospective, pharmacy-initiated monitoring programs, we suggest that clinical pharmacists will play a major role in implementing the necessary changes.
Authors:
T H Grasela; J A Green
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pharmacotherapy     Volume:  10     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  1990  
Date Detail:
Created Date:  1990-04-24     Completed Date:  1990-04-24     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  35-41     Citation Subset:  IM    
Affiliation:
Center for Pharmacoepidemiology Research, School of Pharmacy, State University of New York, Buffalo 14260.
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MeSH Terms
Descriptor/Qualifier:
Aged
Demography
Fibrinolytic Agents / therapeutic use*
Humans
Middle Aged
Myocardial Infarction / drug therapy*
Prospective Studies
Questionnaires
Streptokinase / therapeutic use
Thrombolytic Therapy / utilization*
Time Factors
Tissue Plasminogen Activator / therapeutic use
Urokinase-Type Plasminogen Activator / therapeutic use
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.-/Streptokinase; EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.73/Urokinase-Type Plasminogen Activator

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