Hospital PharmacyPub Date : 2025-06-29DOI: 10.1177/00185787251348377
Kristine Nguyen, Brian Murray, Stacy Campbell-Bright, Lee Ann Jones, Julia Fabricio Donahue, Quynh Nguyen, Theresa M Kline
{"title":"Adjusted Versus Total Body Weight Dosing for Intravenous Heparin Infusions and Target Attainment in Obese Patients.","authors":"Kristine Nguyen, Brian Murray, Stacy Campbell-Bright, Lee Ann Jones, Julia Fabricio Donahue, Quynh Nguyen, Theresa M Kline","doi":"10.1177/00185787251348377","DOIUrl":"10.1177/00185787251348377","url":null,"abstract":"<p><p><b>Background:</b> Intravenous unfractionated heparin is commonly used to treat venous thromboembolism; however, dosing in obese patients is challenging due to unpredictable pharmacokinetics and conflicting guidance. <b>Methods:</b> This single center, retrospective cohort study was conducted to evaluate the achievement of therapeutic heparin correlation values (HCV), a standardized version of the activated partial thromboplastin time (aPTT), with heparin infusions dosed utilizing total body weight (TBW) versus adjusted body weight (ABW) in obese patients. The primary outcome was to determine the percentage of initial HCV within the therapeutic range after heparin initiation. Key secondary outcomes included incidence of supratherapeutic HCV at any time and major bleeding events. <b>Results:</b> A total of 477 patients were included, with 94.9% (n = 453) of patients in the TBW cohort (mean body mass index (BMI) 36.8 ± 7.4 kg/m<sup>2</sup>) and 5.1% (n = 24) in the ABW cohort (mean BMI 42.1 ± 9.3 kg/m<sup>2</sup>). Initial HCV was within the therapeutic range in 41.9% (n = 190) and 54.2% (n = 13) of patients in the TBW cohort and ABW cohort, respectively (<i>P</i> = .238). Supratherapeutic HCV during any point in therapy occurred in 64.7% (n = 293) of the TBW cohort and 41.7% (n = 10) of the ABW cohort (<i>P</i> = .022). Major bleeding occurred in 15.2% (n = 69) of patients in the TBW cohort and 12.5% (n = 3) in the ABW cohort (<i>P</i> = .716). <b>Conclusions:</b> In obese patients receiving a heparin infusion, dosing based on ABW compared to TBW did not result in a higher likelihood of achieving a therapeutic initial HCV, but the rate of supratherapeutic HCV was reduced.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251348377"},"PeriodicalIF":0.8,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital PharmacyPub Date : 2025-06-27DOI: 10.1177/00185787251345806
Kannan Sridharan, Gowri Sivaramakrishnan
{"title":"Drug-Associated Alcohol Intolerance: A Real-World Disproportionality Analysis Study.","authors":"Kannan Sridharan, Gowri Sivaramakrishnan","doi":"10.1177/00185787251345806","DOIUrl":"10.1177/00185787251345806","url":null,"abstract":"<p><p><b>Background:</b> Alcohol intolerance, characterized by adverse reactions following alcohol consumption, can occur due to interactions between alcohol and certain medications. Despite its clinical significance, evidence for alcohol intolerance induced by commonly prescribed drugs remains limited. This study aimed to identify signals for drug-associated alcohol intolerance using the United States Food and Drug Administration (USFDA) Adverse Event Reporting System (AERS). <b>Methods:</b> A disproportionality analysis was conducted on the USFDA AERS spanning the first quarter of 2004 to the second quarter of 2024. Cases were identified using the Preferred Term \"alcohol intolerance\". Duplicate reports were excluded, and only drugs classified as primary suspects were analyzed. The key disproportionality measures included frequentists (reporting odds ratio [ROR]) and Bayesian methods. Top 10 drugs associated with alcohol intolerance were identified using volcano plot. Subgroup analyses by age and gender were performed, and clinical outcomes were evaluated. <b>Results:</b> Among 29 153 222 reports, 406 cases of drug-associated alcohol intolerance were identified, predominantly in adults aged 18 to 65 years. Multiple drug classes demonstrated significant signals including antimicrobials (metronidazole [ROR: 27.4], cefoperazone [ROR: 290.6]), and ketoconazole [ROR: 27.6]), respiratory medications (salmeterol [ROR: 6], mometasone [ROR: 6], and dupilumab [ROR: 6.1]), and psychoanaleptics (bupropion [ROR: 8.1] and several selective serotonin reuptake inhibitors). The Volcano plot analysis highlighted 10 drugs with particularly strong associations, including cefoperazone, spiramycin, metronidazole, and dupilumab. Outcomes included hospitalization (16%), disability (6.4%), and death (1.7%). <b>Conclusion:</b> This study highlights significant associations between several medications and alcohol intolerance, emphasizing the need for further research to confirm these findings and inform clinical guidelines to optimize patient safety.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251345806"},"PeriodicalIF":0.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital PharmacyPub Date : 2025-06-26DOI: 10.1177/00185787251348396
Vivek Kataria, Sammy Daas, Kelsey Kohman
{"title":"Comparison of Weight Based Parenteral Calcitonin Dosing Strategies: Total Versus Ideal Body Weight.","authors":"Vivek Kataria, Sammy Daas, Kelsey Kohman","doi":"10.1177/00185787251348396","DOIUrl":"10.1177/00185787251348396","url":null,"abstract":"<p><p><b>Background:</b> Current guidelines and the package insert do not define the appropriate body weight to dose calcitonin and there is a lack of literature evaluating dosing via ideal body weight (IBW). <b>Objective:</b> The objective of this study is to compare calcium reduction among patients with severe hypercalcemia treated with calcitonin via total body weight (TBW) versus IBW. <b>Methods:</b> This was a single-center retrospective analysis of data gathered within a quality improvement project to standardize parenteral calcitonin utilization. The primary outcome was to compare calcium reduction within 24 hours of treatment initiation. Secondary outcomes included calcium reduction within 48, 72, and 96 hours, the incidence of hypocalcemia, the incidence of rebound hypercalcemia, and the average wholesale price (AWP) expenditure. <b>Results:</b> A total of 48 patients met inclusion criteria, with 25 patients in the TBW group and 23 patients in the IBW group. The primary outcome of change in corrected calcium within 24 hours was not statistically significant between groups (1.1 mg/dL vs 1.7 mg/dL, <i>P</i> = .12). Serum calcium levels and change from baseline were followed up to 96 hours, and no difference was noted between groups. Additional secondary outcomes were not significant, with the exception of AWP expenditure, which was statistically lower in the IBW group ($11 274.0 vs $7516.0, <i>P</i> = .02). While no difference was found in the total number of doses administered or total units consumed (600.0 units vs 400.0 units, <i>P</i> = .06), a significant difference was found in the average dose (364.0 units vs 239.0 units, <i>P</i> < .00001). <b>Conclusion:</b> This study suggests that dosing parenteral calcitonin via IBW achieved a similar reduction in calcium compared to TBW. Moreover, dosing via IBW resulted in a significant reduction in average dose and in AWP expenditure when compared to TBW. This approach offers an alternative dosing strategy that uses less medication, without compromising efficacy.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251348396"},"PeriodicalIF":0.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital PharmacyPub Date : 2025-06-20DOI: 10.1177/00185787251337611
Jeffrey Garavaglia, Anthony DeBastiani, Jessica Peaslee, Nicholas Brandmeir
{"title":"Chemical Stability Testing of Solutions for Intraventricular Irrigations via IRRA<i>flow</i> Ventricular Drain System.","authors":"Jeffrey Garavaglia, Anthony DeBastiani, Jessica Peaslee, Nicholas Brandmeir","doi":"10.1177/00185787251337611","DOIUrl":"10.1177/00185787251337611","url":null,"abstract":"<p><p><b>Purpose:</b> Advances have been made with delivery of medications via continuous intrathecal irrigating ventricular drains such as IRRAflow (IRRAS). Medications including vancomycin, tobramycin, daptomycin and nicardipine are currently being used as ventricular irrigations via the IRRAflow device. The purpose of this study was to evaluate the chemical stability of minute concentrations of daptomycin, nicardipine, tobramycin, and vancomycin for administration via IRRAflow intrathecal catheters. <b>Methods:</b> Commercially available formulations of daptomycin, nicardipine, tobramycin, and vancomycin were each diluted in separate normal saline (NS) 1000 mL bags to final concentrations of daptomycin 2 mg/1000 mL NS, nicardipine 2.5 mg/1000 mL NS, tobramycin 4 mg/1000 mL NS, and vancomycin 4 mg/1000 mL NS. Samples from each compound were transferred into 2.5 mL glass vials and evaluated in triplicate fashion using ultra-performance liquid chromatography and tandem mass spectrometry (LC-MS/MS). Each injection was analyzed in comparison to its respective calibration curve and a mean result for each time point was determined. The concentration of the samples was tested at 0, 6 and 12-hours for vancomycin, daptomycin, and tobramycin and 0, 4 and 8-hours for nicardipine. All irrigations were kept at room temperature and were not protected from light. <b>Results:</b> All samples tested were found to be chemically stable at various testing time points. Daptomycin retained a mean of 94.3% of initial concentration at 12 hours while tobramycin retained 93.1% of its initial concentration at 12 hours. Vancomycin samples were found to be 92.9% of initial concentration at 12 hours and nicardipine maintained a mean of 90.6% of initial concentration at 8 hours. Future studies could assess these conditions to potentially further stability data. <b>Conclusion:</b> With use of LC-MS, we demonstrated that dilute concentrations of vancomycin, daptomycin, and tobramycin maintain at least 90% of initial concentration for 12 hours at room temperature, whereas nicardipine remained chemically stable for 8 hours at room temperature.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337611"},"PeriodicalIF":0.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital PharmacyPub Date : 2025-06-18DOI: 10.1177/00185787251337620
Michele Favia, Elena Lupi, Michela Sperandeo, Lidia Di Cerbo, Antonella Sabia, Barbara Ruozi, Ilaria Ottonelli, Antonietta Curatola, Davide Zanon, Rina Campopiano, Marcello Pani, Domenico Tarantino
{"title":"LAT Gel: from the Galenical Laboratory to the Paediatric Emergency Room - A Fondazione Policlinico Gemelli IRCCS Experience.","authors":"Michele Favia, Elena Lupi, Michela Sperandeo, Lidia Di Cerbo, Antonella Sabia, Barbara Ruozi, Ilaria Ottonelli, Antonietta Curatola, Davide Zanon, Rina Campopiano, Marcello Pani, Domenico Tarantino","doi":"10.1177/00185787251337620","DOIUrl":"10.1177/00185787251337620","url":null,"abstract":"<p><p><b>Objectives:</b> Lacerations are one of the most widespread and common emergencies among children, addressed by doctors in emergency room admissions. The aim of this study was to optimize the formulation of a pre-existing anaesthetic gel known as LAT gel (Lidocaine 4%, Adrenaline 0.05%, Tetracaine 0.5% gel), in order to allow the paediatric emergency department of the Policlinico A. Gemelli (Rome) to improve the management of lacerations, while avoiding the mandatory use of infiltrative anaesthesia. The aim of the study was also to assess the stability over time of the active ingredients (lidocaine, adrenaline, tetracaina) in the galenic preparation. <b>Methods:</b> LAT gel is a formulation prepared using: a poloxamer, Lutrol F127 (or Kolliphor P407), two anaesthetics (lidocaine and tetracaine), together with adrenaline. The formulation was prepared in a Grade A laminar flow hood and in a Grade B environment for microbial load. Batches were subjected to microbiological analysis by hospital hygiene as indicated in FU XII (\"Official Italian pharmacopoeia XII edition\"). The chemical stability of the gel was assessed by high-performance liquid chromatography. <b>Results</b>: Analysis showed that the lidocaine, tetracaine and adrenaline content in the LAT gel remained constant when stored in a refrigerator at 2 to 8°C for up to 120 days. The non-need for additional anaesthetic methods was considered as a parameter of effectiveness. 83 children were evaluated. In the cases recorded, 83.1% (69/83) of patients did not require an additional anaesthesia. Patients who required additional anaesthesia 16.9% (14/83) were those with deep and extensive lacerations. The results show that an effective, sterile, stable preparation with excellent applicability was prepared. <b>Conclusion:</b> This product lends itself to application to the wound surface with a better anaesthetic and haemostatic effect and, unlike injectable lidocaine, is an optimal treatment for increasing compliance in paediatric emergency rooms.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337620"},"PeriodicalIF":0.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital PharmacyPub Date : 2025-06-12DOI: 10.1177/00185787251348385
Shamala Balan, Tan Shirlyn, Norhayati Musa, Siew Lee Jin
{"title":"Development of Protected Research Time Guideline for Practitioner Pharmacists: Points to Consider.","authors":"Shamala Balan, Tan Shirlyn, Norhayati Musa, Siew Lee Jin","doi":"10.1177/00185787251348385","DOIUrl":"10.1177/00185787251348385","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251348385"},"PeriodicalIF":0.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vancomycin-Induced DRESS Syndrome: A Systematic Review of Case Reports.","authors":"Siva Krishna Adithya Bhumireddy, Sai Shashank Gudla, Anil Kumar Vadaga, Meher Satyavani Nandula","doi":"10.1177/00185787251341739","DOIUrl":"10.1177/00185787251341739","url":null,"abstract":"<p><p><b>Background:</b> Vancomycin-induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe hypersensitivity reaction. It presents with rash, eosinophilia, fever, lymphadenopathy, and multi-organ involvement, most often leading to misdiagnosis and delayed treatment. This systematic review aims to identify risk factors, clinical presentations, and optimal management strategies for vancomycin-induced DRESS. <b>Methods:</b> Systematic search with PRISMA 2020 was conducted in PubMed, Scopus, Web of Science, and Google Scholar. Case reports from 2015 to 2025 were screened and demographic information, clinical presentation, risk factors, diagnostic assessment, and outcomes were extracted. Quality of included reports was evaluated with Joanna Briggs Institute (JBI) Critical Appraisal Checklist. <b>Report:</b> The most common symptoms were rash, fever, eosinophilia, and hepatic/renal dysfunction, which typically appeared 2 to 9 weeks following exposure. Genetic predisposition (HLA associations), renal dysfunction, concomitant medications, and viral reactivation were significant risk factors. Rise of AST was shown after a time, and so diagnosis was difficult. Discontinuing vancomycin, administering corticosteroids, and supportive care were the most preferable interventions, with severe conditions requiring IVIG, plasmapheresis and immunosuppressants. Despite interventions, mortality remains high in elderly and immunocompromised patients. <b>Conclusion:</b> Vancomycin is one of the most frequent causes of antibiotic-induced DRESS syndrome, rarely accompanied by severe organ failure and mortality. Early detection, following consistent diagnosing criteria, and tailored treatment regimens are needed to improve patient outcomes and reduce the risk of mortality and improve wellbeing. More research is needed to explore genetic patterns and develop optimal treatment regimens.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251341739"},"PeriodicalIF":0.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital PharmacyPub Date : 2025-05-21DOI: 10.1177/00185787251340645
Wasim S El Nekidy, Haneen Hasan, Emna Abidi, Layth Al Sayegh, Ruba Z Dajani, Samer El-Kaissi, Safa B Hegazin, Jihad Mallat
{"title":"Comparing the Efficacy of Liraglutide and Semaglutide on Weight Loss: Experience from the Middle East Gulf Region and Literature Review.","authors":"Wasim S El Nekidy, Haneen Hasan, Emna Abidi, Layth Al Sayegh, Ruba Z Dajani, Samer El-Kaissi, Safa B Hegazin, Jihad Mallat","doi":"10.1177/00185787251340645","DOIUrl":"10.1177/00185787251340645","url":null,"abstract":"<p><p><b>Objective:</b> Available data comparing the efficacy of liraglutide and semaglutide in managing weight loss is limited. The objective of this study was to compare efficacy of both drugs on weight loss. <b>Methods:</b> A retrospective observational cohort study conducted at our quaternary care hospital from June 2018 to July 2022. The study included adults who received either liraglutide or semaglutide during the study period. The primary outcome was weight loss, while secondary outcomes included effects on HbA1c levels and lipid profile. <b>Results:</b> A total of 366 patients were analyzed (122 on liraglutide, 244 on semaglutide). The groups were comparable in mean age (51.00 ± 11.55 vs 51.16 ± 12.35 years, <i>P</i> = 0.521) and baseline mean weight (94.7 ± 19.5 vs 94.6 ± 19.9 kg, <i>P</i> = 0.989). After a median follow-up of 10 (6-17) months for the liraglutide group and 7.5 (6-11) months for the semaglutide group (<i>P</i> < 0.001), the resultant weights were 90.8 ± 19.6 kg for the liraglutide group and 91.1 ± 19.8 kg for the semaglutide group (<i>P</i> < 0.001) when comparing each group to its baseline separately. When comparing the weight loss achieved in each group, liraglutide achieved a median weight loss of -4 (-7 to 0) kg versus -3 (-6 to 0) kg for semaglutide (<i>P</i> = 0.867). The reduction in HbA1c levels with liraglutide was significantly less than with semaglutide: -0.2 (-0.5 to 0.3) versus -0.5 (-1.1 to 0.1), respectively, (<i>P</i> = 0.003). Both drugs significantly lowered LDL and triglycerides. Multivariable linear regression analysis confirmed no significant difference between the drugs [<i>B</i> -0.577, 95% CI -1.87 to 0.7; <i>P</i> = 0.38], while baseline weight, diabetes, and SGLT2 inhibitors were significant factors affecting weight. <b>Conclusion:</b> Both liraglutide and semaglutide were effective in reducing weight, with no significant difference between the two drugs. However, semaglutide was more effective in reducing HbA1c levels.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251340645"},"PeriodicalIF":0.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital PharmacyPub Date : 2025-05-20DOI: 10.1177/00185787251339360
Justin Grahl, Megan Mills, Amit Singh, Carolyn Oxencis, Alexander Mohr, Taylor Mancuso, Bi Qing Teng, Ruta Bajorunaite, Thomas Carver, William J Peppard
{"title":"Pharmacogenetic Evaluation of Hospitalized Patients Requiring Naloxone for Reversal of Acute Opioid Toxicity.","authors":"Justin Grahl, Megan Mills, Amit Singh, Carolyn Oxencis, Alexander Mohr, Taylor Mancuso, Bi Qing Teng, Ruta Bajorunaite, Thomas Carver, William J Peppard","doi":"10.1177/00185787251339360","DOIUrl":"10.1177/00185787251339360","url":null,"abstract":"<p><p><b>Background:</b> Opioids are utilized for acute pain in hospitalized patients and carry the risk of unintentional toxicity. The relationship between unintentional toxicity within a hospital setting and genetic polymorphisms has not been fully evaluated within the literature to date. Assessment and utilization of pharmacogenetic data may be a way to prevent unintentional toxicity in hospitalized patients and reduce the need for naloxone administration. <b>Objective:</b> This study aimed to provide proof of concept for the comparison of allele frequencies of hospitalized patients who received naloxone for opioid reversal with lab control data allele frequencies to identify variations between groups. <b>Methods:</b> This single-center, exploratory, pilot study enrolled 15 patients. Genotype samples were collected via buccal swab and analyzed using a custom 13 gene panel of genes which impact opioid metabolism. Genes assessed include <i>CYP1A2, CYP3A4/A5, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, UGT2B7, UGT1A3, ABCB1, COMT, OPRM1</i>. The 15 patients were compared to an internal lab control group of 100 patients and separated into preventable and not preventable events for further analysis. <b>Results:</b> <i>CYP3A5</i> genotype was found to be statistically significantly different between the experimental and control groups (<i>P</i> = .004). This statistically significant difference was also seen in <i>CYP3A5</i> phenotypes (<i>P</i> = .038). When comparing preventable and not preventable events, a statistically significant difference was found in both the genotype (<i>P</i> = .030) and phenotype (<i>P</i> = .029) of <i>CYP2C19</i>. Other assessed risk factors included mean MME in the 24 hours preceding naloxone being higher among preventable events and hospital or emergency department admission percent risk being higher among not preventable events. <b>Conclusion:</b> Factors other than pharmacogenetics, including opioid route of administration, medication formulation, and overall hospital admission risk, may play an additive role in unintentional toxicity risk. Future research of genotype-guided opioid dosing in pain management services further adds to calculating the risk of unintentional opioid-related adverse effects with standard dosing of this drug class.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251339360"},"PeriodicalIF":0.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital PharmacyPub Date : 2025-05-20DOI: 10.1177/00185787251337596
Roland N Dickerson, Titilola M Afolabi, Angela L Bingham, Todd W Canada, Lingtak Neander Chan, Sarah V Cogle, Anne M Tucker, Vanessa J Kumpf
{"title":"Significant Published Articles in 2024 for Pharmacy Nutrition Support Practice.","authors":"Roland N Dickerson, Titilola M Afolabi, Angela L Bingham, Todd W Canada, Lingtak Neander Chan, Sarah V Cogle, Anne M Tucker, Vanessa J Kumpf","doi":"10.1177/00185787251337596","DOIUrl":"10.1177/00185787251337596","url":null,"abstract":"<p><p><b>Purpose:</b> The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. <b>Methods:</b> Several board-certified nutrition support pharmacists aggregated a list of articles relevant to pharmacy nutrition support that was published in 2024. The list was compiled into a spreadsheet whereby the authors were asked to assess whether the article was considered important. A culled list of publications was then identified whereby at least 5 out of the 8 author participants considered the article to be important for pharmacists practicing in nutrition support. Guideline and consensus papers, important to practice but not ranked, were also included. <b>Results:</b> A total of 160 articles were identified; 7 from the primary literature were voted by the group as being of high importance. Twelve guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were summarized and a narrative regarding its implications to pharmacy nutrition support practice were provided. <b>Conclusion:</b> We recommend that pharmacists engaged in nutrition support therapy be familiar with these articles as they pertain to their practice.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251337596"},"PeriodicalIF":0.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}