Hospital Pharmacy最新文献

{"title":"Letter to the Editor: Lean-Body Mass-Guided Heparin Dosing: A Pharmacokinetic Imperative.","authors":"Andrej Belančić, Almir Fajkić, Hesham Al-Sallami","doi":"10.1177/00185787251381596","DOIUrl":"https://doi.org/10.1177/00185787251381596","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251381596"},"PeriodicalIF":0.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232168","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":"Over-the-Counter Antibiotics in Vietnam: A Public Health Crisis.","authors":"Huynh Tran Bao Chau, Hoang Bao Tran Van, Can Nguyen Thi, Tho Duong Van, Khanh Nguyen Duong Gia, Thai Ngoc Dang, Huan Phan Thieu, Pham Thi Dung, Zhilin Zhang, Nguyen Tien Huy","doi":"10.1177/00185787251372425","DOIUrl":"10.1177/00185787251372425","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251372425"},"PeriodicalIF":0.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212568","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":"Letter to the Editor: Unlocking Antibiotic Stewardship Potential Through Penicillin Allergy De-labelling.","authors":"Andrej Belančić, Iva Mikulić, Robert Likić","doi":"10.1177/00185787251378709","DOIUrl":"10.1177/00185787251378709","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251378709"},"PeriodicalIF":0.7,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199248","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":"Artificial Intelligence as a Drug Information Resource: Limitations and Strategies to Optimize in Pharmacy Practice.","authors":"Christopher Soujah, Carole Bejjani, Nour Adra, Laura Blackburn","doi":"10.1177/00185787251372424","DOIUrl":"10.1177/00185787251372424","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251372424"},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185734","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":"Missed Doses, Missed Opportunities: Readmission Due to GLP-1RA Interruption Inspires Algorithms to Improve Reinitiation of Therapy at Discharge.","authors":"Adrienne Michelet, Maksudul Mowla, Baaba A Amo-Brown, Natalie Rodriguez, Marissa Cavaretta","doi":"10.1177/00185787251372054","DOIUrl":"10.1177/00185787251372054","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of this case report are to describe the hospitalization of a patient due to a preventable adverse event caused by dulaglutide after restarting therapy following a previous hospitalization where it was held, and to summarize suggested guidance on managing glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) during transitions of care.</p><p><strong>Case summary: </strong>A 70-year-old female was admitted with epigastric pain that began a week before admission. One month prior, she was hospitalized for chest pain and diagnosed with a left anterior descending artery occlusion, requiring a 3-vessel CABG. The pharmacy transitions of care service discovered that during her prior stay, she missed 2 doses of dulaglutide and resumed it at the previous dose of 4.5 mg on discharge. After a comprehensive workup, she was diagnosed with gastritis. Her pain improved over the course of 4 days, and she was discharged with instructions to hold the dulaglutide upon discharge and consult her primary care physician for re-titration.</p><p><strong>Conclusion: </strong>This case highlights the need for clearer guidance on the reinitiation of GLP-1 RAs after missed doses while in the hospital. Using available literature, algorithms were generated to provide recommendations when more than 1 weekly GLP-1 RA dose is missed. These algorithms provide guidance for providers during transitions of care and may be studied prospectively to validate their application in a real-world setting.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251372054"},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185748","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":"A Single Health System Retrospective Qualitative Analysis of Inpatient Apixaban and Rivaroxaban Calibrated Anti-Xa Level Monitoring and Clinical Implications.","authors":"Bailey McCarville, Jennifer Osborn","doi":"10.1177/00185787251372413","DOIUrl":"10.1177/00185787251372413","url":null,"abstract":"<p><strong>Introduction: </strong>The ability to obtain a quantitative drug level for apixaban and rivaroxaban exists using drug-specific calibrated anti-Xa assays; however, no standard exists defining when to obtain direct oral anticoagulant (DOAC) concentrations or how to adjust medication regimens based on the results.</p><p><strong>Objective: </strong>Describe the incidence of DOAC levels obtained, identify trends in prescribing DOAC levels in clinical practice, and qualitatively assess level appropriateness and actions taken based on level results.</p><p><strong>Methods: </strong>A qualitative, retrospective analysis was conducted using the electronic medical record to identify adult inpatients within a 10-hospital health system with a calibrated apixaban or rivaroxaban anti-Xa level result from April 1, 2020, to November 1, 2022. The primary endpoint was the incidence of DOAC levels drawn. Secondary outcomes included the percentage of DOAC concentrations that prompted a dose change, association between dose or agent change and concentrations outside the on-therapy range, and association between indication for obtaining DOAC levels and resultant concentrations.</p><p><strong>Results: </strong>One-hundred thirty-two calibrated anti-Xa levels were obtained in 101 inpatients during the study period, representing a level drawn in 0.48% of all apixaban and rivaroxaban orders. Eighty-three (63%) patients were on apixaban. Primary reasons to draw DOAC levels were extreme body weight (35%), treatment failure concerns (23%), bleeding concerns (18%), and drug interactions (14%). Only 42 (31.8%) of all levels were drawn appropriately as a peak. Seventeen (40.4%) of the peak levels were within the on-therapy range. Of the 25 levels outside the on-therapy range, 14 (56%) resulted in no change in therapy. For all levels drawn, 70 (53%) resulted in no change to therapy.</p><p><strong>Conclusions: </strong>DOAC concentrations are often drawn at inappropriate times and seldom influence a dose or agent change. Future research is needed to determine if DOAC concentrations may be clinically meaningful in a select subgroup of patients.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251372413"},"PeriodicalIF":0.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185812","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":"Four-Factor Prothrombin Complex Concentrate Administration Timing in Oral Anticoagulant-Associated Intracranial Hemorrhage.","authors":"Michael Scott, Jennifer Schultheis, Shawn Kram, Jana Sigmon, Hui-Jie Lee, Keith Dombrowski","doi":"10.1177/00185787251372052","DOIUrl":"10.1177/00185787251372052","url":null,"abstract":"<p><strong>Background: </strong>Oral anticoagulant (OAC) associated intracranial hemorrhage (ICH) is associated with significant morbidity and mortality. While rapid administration of an appropriate hemostatic agent is recommended, the optimal timeframe for administration has not been identified.</p><p><strong>Purpose: </strong>The purpose of this study was to evaluate if 4-factor prothrombin complex concentrate (4F-PCC) time to administration (TTA) impacts hematoma expansion or mortality within 48 hours of ICH diagnosis in patients taking warfarin, apixaban, or rivaroxaban.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated patients who received 4F-PCC for OAC-associated ICH at a 3-hospital academic health system between July 2013 and September 2019. Patients were divided into 3 cohorts based on ICH diagnosis location: (1) Emergency Department (ED), (2) inpatient, and (3) outside hospital (OSH). The primary outcome was hematoma expansion or mortality within 48 hours of ICH diagnosis.</p><p><strong>Results: </strong>Sixty-six patients were included in this study (ED: n = 53; Inpatient: n = 3; OSH: n = 10). The primary outcome occurred in 18 (27.3%) patients (48-hour hematoma expansion: n = 18; 48-hour mortality: n = 0). 4F-PCC administration timing was not significantly different between patients with and without hematoma expansion (median TTA 107 vs 115 minutes, respectively; <i>P</i> = .81).</p><p><strong>Conclusion: </strong>Time to 4F-PCC administration was not associated with 48-hour hematoma expansion or mortality in patients with OAC-associated ICH. These results may reflect delayed administration, as 4F-PCC may not have been administered early enough to influence outcomes. Further research is warranted to evaluate the clinical impact of 4F-PCC administration timing.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251372052"},"PeriodicalIF":0.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185739","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":"Impact of Clinical Pharmacists' Interventions on Medication Use and Direct Cost Savings in an Inpatient Medical Oncology Setting.","authors":"Nour Faqeer, Razan Sawalha, Banan Al Hamad, Shatha Elshayib, Sewar Salmany","doi":"10.1177/00185787251372038","DOIUrl":"10.1177/00185787251372038","url":null,"abstract":"<p><strong>Introduction: </strong>There are limited studies evaluating the impact of clinical pharmacists' interventions (CPIs) and pharmacist-driven cost savings in the inpatient oncology settings. This study aimed to assess the clinical impact of CPIs and direct cost savings from deprescribing-related interventions in an inpatient oncology service.</p><p><strong>Methods: </strong>A retrospective study was conducted by assessing CPIs extracted from the pharmacy documentation system in the medical oncology service between January 2022 and December 2023. The clinical impact of these CPIs was evaluated through including interventions accepted by physicians and resulted in therapy changes, along with their significance levels. Direct cost savings were calculated for deprescribing interventions, including drug discontinuation and intravenous-to-oral (IV-PO) conversions, based on the cost saved per intervention over a 24-hour period.</p><p><strong>Results: </strong>During the study period, 9995 CPIs were identified, of which, 99.0% (n = 9887) were accepted by physicians and included in the analysis. The most frequent interventions were recommendations for drug additions/dose change (n = 3603, 36.4%), followed by drug discontinuations (n = 2886, 29.0%). Antimicrobials were the most frequently involved drug class (n = 4017, 40.7%). Significant CPIs that improved standard of care accounted for 7274 (73.6%) interventions, while very significant and extremely significant interventions were 2595 (26.3%) and 14 (0.14%), respectively. The overall direct cost savings from deprescribing were $102 710, with drug therapy discontinuations and IV-PO conversions contributing $99 305 and $3405, respectively.</p><p><strong>Conclusion: </strong>CPIs showed significant clinical and financial impact, with a high rate of accepted interventions resulting in therapy changes. Further prospective studies are required to analyze the clinical outcomes and indirect cost savings.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251372038"},"PeriodicalIF":0.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086176","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":"Ethical Failures in the Digital Age: Social Media's Role in Vietnam's Herbal and Dietary Supplement Crisis.","authors":"Huynh Tran Bao Chau, Dang Phuc Vinh, Tran Thanh Long, Tran Thi Anh Thu, Truong Ngoc Tham, Van Mai Do, Nguyen Tien Huy","doi":"10.1177/00185787251372036","DOIUrl":"10.1177/00185787251372036","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251372036"},"PeriodicalIF":0.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086237","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":"Effect of Preoperative Budesonide on Postoperative Sore Throat: A Systematic Review and Meta-Analysis.","authors":"Helal Metwalli, Mohammad Najm Dadam, Gam Hong Pham, Minh Dung Nguyen, Omar Khalid Samir Abdelkader, Le Hoang Duc, Nguyen Minh Anh, Thanh Vuong Ngoc Thien, Ayatallah Farrag, Randa Elsheikh, Abdelrahman M Makram, Phillip Tran, Nguyen Tien Huy","doi":"10.1177/00185787251356137","DOIUrl":"10.1177/00185787251356137","url":null,"abstract":"<p><p><b>Background:</b> Postoperative sore throat (POST) is a common complication following endotracheal intubation. Various pharmacological interventions have been explored for POST prevention, with budesonide emerging as a promising option due to its anti-inflammatory properties. <b>Methods:</b> PubMed, Scopus, Web of Science and the Cochrane Library were searched following PRISMA guidelines. The primary outcomes were POST incidence and severity. Incidence data were pooled using random- or fixed-effects models. Severity analysis focused on budesonide versus saline studies, applying an ordinal logistic regression (mild, moderate, severe) with group assignment as the predictor, and predicted probabilities were computed in R. <b>Results:</b> Budesonide significantly reduced the incidence of POST compared to placebo (OR 0.28, 95% CI: 0.18-0.41, <i>P</i> < .001, <i>I</i> ² = 52%) and no intervention (OR 0.09, 95% CI: 0.05-0.14, <i>P</i> < .001, <i>I</i> ² = 0%). It demonstrated similar efficacy to magnesium sulfate and ketamine (<i>P</i> > .05). Budesonide also reduced POST severity, increasing the likelihood of mild symptoms while decreasing moderate and severe cases (OR 0.46, 95% CI: 0.26-0.81). Additionally, budesonide combined with dexamethasone was more effective than budesonide alone in reducing POST incidence and severity. <b>Conclusion:</b> Preoperative budesonide is an effective prophylactic agent for reducing the incidence and severity of POST. Its localized anti-inflammatory action, cost-effectiveness, and minimal systemic side effects make it a viable option for clinical use. However, variations in dosing and administration require further high quality RCTs to establish standardized guidelines.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251356137"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000482","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}