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For Critical Care Agency Use Only Usage: To treat pre-existing infections or as a prophylactic measure in patients that are at high risk of developing an infection. Complications: Allergic reactions: rash, swelling, nausea, vomiting, diarrhea, chills, fever, laryngeal edema, anaphylaxis. Leukopenia. Ototoxicity, nephrotoxicity aminoglycocides ; . Adverse Reactions: Too rapid administration? Equipment Maintenance: IV antibiotics should be run through an infusion pump whenever possible. Antibiotics must be infused through a pump if run through a central venous catheter Standing Orders: 1 Initial doses of the IV antibiotics must be administered at the transferring hospital prior to transfer. 2. Known allergies must be assess prior to administering the antibiotics 3. Verify drug, dose, route and time of the administration from the transfer order sheet. 4. Infuse IV antibiotics over 30-60 minutes. Aminoglyeocides over 60 minutes unless otherwise specified on the physician's order or hospital pharmacy directions. 5. Monitor for signs and symptoms of an allergic response. If any symptoms are noted, s t op infusion and contact base station physician. 6. If IV antibiotics have finished infusing enroute, keep line open with NS KVO or LR KVO. 7. Review drug compatibility chart and diovan.

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[English] Ms. Bonnie Brown: Yes, I am. Thank you. I apologize to the witnesses for bringing a point of order, but we've been away for two weeks, and I was very surprised by today's agenda, although I wasn't surprised by anything you said. Can someone who's here on the panel tell me something? With the exception of Quebec, which never joined the common drug review, how many of our provinces are still carrying on their own reviews? Mr. Williams. Mr. Russell Williams: To your question, and I stand to be corrected, my understanding is that the general answer is most. Part of it is the reason I highlighted. One of my concerns is not just the rejections, but how long it takes after a positive recommendation. It ranges, in some cases, to several hundred days, so one would presume that there is something happening during all that time, and again, it's another review. That's why I talked about the three levels of review for the same drug. Ms. Bonnie Brown: I'm aware of that. Mr. Russell Williams: If there are any corrections from the other panellists-- Ms. Bonnie Brown: Okay. Now my question has always been about this. It's not whether it's appropriate for the federal government to be ruling on safety and efficacy. I wonder about a federal agency ruling on cost effectiveness when the federal government does not have a drug reimbursement plan for the general public. Do you have any opinions on that? Mr. Williams, you were a politician. Is it not usual for the person who pays the piper to call the tune? Mr. Russell Williams: To your question, most politicians, certainly, if they're paying the piper, as you say, like to make the decision. Again, we talk about a good idea that sounds good on paper, but ultimately, who makes the best decision? Who runs it and who pays? In many cases, it is the provincial government. It is very difficult. You heard presentations from two companies today about the precision of the medications we're talking about. It is difficult to actually come up with a macro decision at a very high level to say that this is good for everybody. Provinces know their own jurisdictions better than anybody else. Ms. Bonnie Brown: Excuse me, but that's unless that authority is paying. If they're paying, they have the right to say that. But what we have is a jurisdiction that's calling the shots but not paying the piper. It's the lower jurisdictions that pay, which was Mr. Brenders' point. Mr. Russell Williams: I'm not sure we can call it even a federal one. One of the issues is it seems to fall in between every level of government and the whole notion of appeal, transparency, accountability, and where the buck stops. I wouldn't quite call it a federal level; actually it's a creation of the FPT process. One of the concerns we've heard is that in fact it isn't accountable to any level. Ms. Bonnie Brown: I have another question here. The joint oncology drug review has now been contracted out to the Ontario government's cancer agency to make these decisions for everybody, I understand. Is that not the common drug review admitting it can't do and evista.

From the impressive mahogany bed in the master bedroom to the little glass flowers and the fine Arabian-quilted pillows, every detail of the house was unusual, requiring a second and third look. The building itself, designed over 10 years ago by architect Evan Williams of Redbones fame ; , was actually on the drawing board for eight years before its final construction. Interesting work for certain, and a radical contrast to the bizarre `techno-complex' he had shown us in Beverly Hills three days earlier complete with darkgreen, steel exoskeleton. "I think a house should always reflect the soul of the owner, " Mrs Tremblay muttered to nobody in particular before stopping in front of a canvas of mangoes and pointing her index finger at the illegible signature: "I wish he'd start painting again, that supermarket is going to kill him." 110 FIRST.
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