Hospital Pharmacy最新文献

{"title":"Adverse Drug Event Profile of Radiocontrast Iodine in Elderly: A Retrospective Focused Pharmacovigilance-Based Disproportionality Analysis Study.","authors":"Kannan Sridharan, Gowri Sivaramakrishnan","doi":"10.1177/00185787261427433","DOIUrl":"10.1177/00185787261427433","url":null,"abstract":"<p><strong>Background: </strong>Radiocontrast agents are widely used in imaging procedures; however, their safety profile in elderly patients remains inadequately characterized. This study aims to evaluate the adverse drug events (ADEs) reported with radiocontrast iodine in this vulnerable population.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the US FDA Adverse Event Reporting System database. Reports pertaining to adverse events linked to radiocontrast iodine in patients aged 65 and older were extracted. Signal detection was performed using frequentist and Bayesian methods to identify significant ADEs and their relationship with specific radiocontrast agents. Demographic characteristics and outcomes were also assessed.</p><p><strong>Results: </strong>Out of 29 153 222 reports in the AERS database, 2640 unique reports related to adverse events in the elderly population were included. Key findings revealed significant signals including hypersensitivity reactions, cardiac disorders, renal failure, pancreatitis, and neuropsychiatric events. Notably, distinct adverse effects were observed for individual agents: iodixanol was linked to pancreatitis and vasculitis, while iohexol was associated with hyperthyroidism. Additionally, the study noted that 11.6% of reported cases resulted in death, 22.1% of reported adverse events were life-threatening, and 34.8% of reported cases required hospitalization.</p><p><strong>Conclusion: </strong>This study underscores the importance of vigilance in monitoring ADEs associated with radiocontrast iodine in elderly patients. Although common reactions were identified, emergent signals such as pancreatitis and neuropsychiatric events warrant further investigation to establish causality and improve patient safety. Future research should focus on prospective studies and the development of risk assessment tools tailored for this demographic.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261427433"},"PeriodicalIF":0.9,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13013037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520968","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: Indication-Specific Cost-Effectiveness of Empagliflozin Versus Dapagliflozin: Implications for Clinical and Policy Decision-Making.","authors":"Andrej Belančić","doi":"10.1177/00185787261424863","DOIUrl":"10.1177/00185787261424863","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261424863"},"PeriodicalIF":0.9,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432482","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":"Probable Tirzepatide-Induced Rhabdomyolysis in an HIV-Positive Patient.","authors":"Drew A Wells, Kaulin Duncan, Sami Sakaan","doi":"10.1177/00185787261426980","DOIUrl":"10.1177/00185787261426980","url":null,"abstract":"<p><strong>Background: </strong>Tirzepatide, a dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, has gained widespread use for the treatment of type 2 diabetes mellitus, obesity, and obstructive sleep apnea. This report presents the first probable case of tirzepatide-associated rhabdomyolysis in a human immunodeficiency virus (HIV)-positive patient.</p><p><strong>Case: </strong>A 34-year-old male with a medical history of HIV, hypertension, and obesity presented with fatigue, muscle aches, and dark-colored urine. The symptoms had progressively worsened over the prior 2 weeks, coinciding with the recent initiation of tirzepatide therapy for weight loss. Laboratory tests revealed significantly elevated creatine kinase (CK) levels, transaminitis, and myoglobinuria, confirming the diagnosis of rhabdomyolysis. The patient reported no history of trauma, strenuous physical activity, or statins use. Tirzepatide was discontinued, the patient was managed successfully with aggressive intravenous fluids, discharged in stable condition.</p><p><strong>Discussion: </strong>This case represents a rare but serious adverse effect potentially associated with tirzepatide use, particularly in HIV-positive patients, who may be at increased risk for muscular disorders. While other common causes of rhabdomyolysis were ruled out, the timeline between tirzepatide initiation and symptom onset strengthens the case for a medication-induced etiology. This is one of only a few reported cases of tirzepatide-induced rhabdomyolysis, with no previous documentation in HIV patients.</p><p><strong>Conclusion: </strong>Rhabdomyolysis may be a rare but significant adverse effect of tirzepatide, particularly in at-risk populations, such as those with HIV. Clinicians should remain vigilant for rhabdomyolysis in patients presenting with nonspecific symptoms such as muscle pain, fatigue, and dark urine in patients on tirzepatide or other GLP-1 agonists.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261426980"},"PeriodicalIF":0.9,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12932128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147305208","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":"Comments on \"Stage-Specific Predictors and Outcomes of Colistin-Associated Acute Kidney Injury in Surgical and Medical ICU Patients\".","authors":"Ankur Sharma, Sushma Narsing Katkuri, Varshini Vadhithala, Arun Kumar, Sushma Verma, Dhanya Dedeepya","doi":"10.1177/00185787251407054","DOIUrl":"10.1177/00185787251407054","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251407054"},"PeriodicalIF":0.7,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275476","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":"Comparative Clinical Outcomes of Iron Sucrose and Ferric Carboxymaltose in the Treatment of Iron Deficiency Anemia.","authors":"Wasim S El Nekidy, Khaled Aldhanhani, Lavinia Salama, Emna Abidi, Abdullah Shatnawei, Ziad Sadik, Muriel Ghosn, Zaher Koutoubi, Fadi Hijazi, Jihad Mallat","doi":"10.1177/00185787261419041","DOIUrl":"10.1177/00185787261419041","url":null,"abstract":"<p><strong>Objective: </strong>Data comparing clinical outcomes of different intravenous iron products is limited. The purpose of this study was to compare the efficacy and safety of iron sucrose (IS) and ferric carboxymaltose (FCM) on hemoglobin levels.</p><p><strong>Methods: </strong>This retrospective study was conducted at our quaternary care hospital between May 2015 and June 2019. Adults who received either of the study drugs were included in the analysis. Only the first encounter was used for patients who received multiple iron courses. Wilcoxon signed-rank test was used to compare outcomes versus baseline medians in each group separately, while Mann-Whitney <i>U</i> test was used to compare the change between baseline and outcome medians between both groups.</p><p><strong>Results: </strong>A total of 643 patients were included in the analysis, with 311 receiving iron sucrose (IS) and 332 receiving ferric carboxymaltose (FCM). The median Charlson Comorbidity Index (CCI) was 1 (0-5) for IS and 4 (0-7) for FCM (<i>P</i> < .001). Both iron products significantly increased hemoglobin levels by the end of the study compared to baseline, from 93 (84-105) to 114 (99-127) g/L (<i>P</i> < .001) in the IS group and from 92 (81-103) to 103 (87-117) g/L (<i>P</i> < .001) in the FCM group. Additionally, the change in hemoglobin was significantly more pronounced with IS 16.5 (5-29) g/L versus 6.5 (-1 to 21) g/L for FCM (<i>P</i> < .001). Stepwise multivariable linear regression analysis revealed that baseline hemoglobin [β = 0.52 (0.4-0.6); <i>P</i> < .001], erythrocyte stimulating agents use [β = -7.4 (-11 to -3.8); <i>P</i> < .001], total iron product dose [β = 0.01 (0.01-0.02); <i>P</i> < .001], blood transfusion [β = -9.5 (-12 to -6.6); <i>P</i> < .001], CCI [β = -0.6 (-1 to -0.12); <i>P</i> = .013], and FCM [β = -9.5 (-12 to -6.6); <i>P</i> < .001] were the main predictors of hemoglobin level at the end of the study.</p><p><strong>Conclusion: </strong>Multiple factors were shown to affect hemoglobin levels, which need to be considered when managing anemia, including the type of iron formulation used. Our findings need to be verified in larger prospective studies.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261419041"},"PeriodicalIF":0.9,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283503","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":"Amphotericin B Formulation Selection During Veno-Venous Extracorporeal Membrane Oxygenation: Two Case Reports Illustrating Clinical Dilemmas in the Absence of Data.","authors":"M Gabriela Cabanilla, Joseph A Iovine","doi":"10.1177/00185787261422120","DOIUrl":"10.1177/00185787261422120","url":null,"abstract":"<p><p>The use of amphotericin B (AmB) in patients requiring extracorporeal membrane oxygenation (ECMO) remains poorly characterized because of concerns about drug sequestration within the circuit, particularly with liposomal formulations. We describe 2 patients with life-threatening coccidioidomycosis who received different AmB formulations during veno-venous (VV) ECMO support. The first patient, a 23-year-old male with disseminated disease involving massive splenomegaly and multi-organ failure, received liposomal AmB at 5 mg/kg/day but died within 8 days of antifungal initiation due to progressive critical illness before treatment efficacy could be assessed. The second patient, a 37-year-old male with pulmonary disease, was transitioned from liposomal to conventional AmB at 1 mg/kg/day upon VV-ECMO initiation due to theoretical sequestration concerns and survived to hospital discharge, although he developed acute kidney injury potentially attributable to conventional AmB nephrotoxicity. These cases highlight medication use dilemmas associated with AmB formulation selection during VV-ECMO, including potential underexposure with liposomal formulations and nephrotoxicity with conventional AmB. Our experience highlights that formulation selection requires an individualized risk-benefit assessment that balances potential drug underexposure against nephrotoxicity in already vulnerable patients. These cases contribute to the limited literature on AmB use during ECMO but, more importantly, highlight the urgent need for systematic pharmacokinetic studies with therapeutic drug monitoring to transform clinical decision making from expert opinion to evidence-based practice.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261422120"},"PeriodicalIF":0.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12924767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275482","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":"Daratumumab in the Treatment of Multiple Myeloma: Real World Evidence (2018-2024) at the a. Gemelli Polyclinic (Rome) and Comparison With Registration Studies.","authors":"Michele Favia, Michela Sperandeo, Lidia Di Cerbo, Antonella Sabia, Felice Musicco, Tommaso Za, Rina Campopiano, Elena Rossi, Marcello Pani, Domenico Tarantino","doi":"10.1177/00185787261417153","DOIUrl":"10.1177/00185787261417153","url":null,"abstract":"<p><strong>Objectives: </strong>Multiple myeloma is a malignant neoplasm characterised by uncontrolled growth of monoclonal plasma cells in the bone marrow, leading to the overproduction of nonfunctional intact immunoglobulins or immunoglobulin chains with several complications, including anaemia, bone lesions, infections, hypercalcaemia, renal failure, fatigue, and pain. In recent years, treatment with daratumumab, a monoclonal antibody that binds to the CD38 protein, has proved to be the most effective in slowing the progression of the disease. This mAb acts by inducing the destruction of target cells that express CD38, which are highly prevalent in patients with multiple myeloma. The following study aims to evaluate the response to treatment with daratumumab in patients treated at the Haematology Day Hospital of the Agostino Gemelli Polyclinic in Rome and to compare the overall survival results obtained using Kaplan-Meier curves for patients treated at our hospital with those in registration studies, to evaluate any variability in response.</p><p><strong>Methods: </strong>First, data was extracted from the Policlinico's anti-cancer therapy management portal, extrapolating all infusions carried out between June 2018 and April 2024. The data for each individual patient was completed also taking additional information from the AIFA (Italian Medicines Agency) portal. Once this database was obtained, we proceeded with the processing of the data, evaluating parameters such as treatment persistence, dose intensity or treatment adherence, follow-up, budget impact, and pharmacovigilance.</p><p><strong>Results: </strong>Real-world OS was generally lower than in clinical trials, highlighting complexities in an unselected patient population with advanced age and comorbidities. Treatment adherence varied markedly with some patients showing persistence up to 2100 days. In relapsed/refractory MM patients treated with DRd protocol, 63-month OS was around 30%, compared to about 50% in corresponding clinical trials (MMY3004), while newly diagnosed patients not eligible for transplant had 30-month OS nearing 75% compared to about 80% in corresponding clinical trials (MMY3007).</p><p><strong>Conclusion: </strong>Real-world data therefore offer a more realistic view of the efficacy and safety of treatments because they reflect the use of drugs in everyday clinical practice, on patients who are more heterogeneous than those in trials and allow evidence to be collected more quickly and at lower cost.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261417153"},"PeriodicalIF":0.9,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270854","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":"Insights from the First Cardiology Pharmacist Registrar Training Programs in Australia.","authors":"Kate Ziser, Keshia De Guzman, Adam Livori, Beryl Lai, Judy Duong, Grace Nguyen, Bree Murphy, Stella Setiyawan, Dimity Williams, Kylee Hayward","doi":"10.1177/00185787251414364","DOIUrl":"10.1177/00185787251414364","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251414364"},"PeriodicalIF":0.9,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201398","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":"Poorer Clinical Outcomes and Longer Hospitalization with Beta Blocker Discontinuation in Acute Decompensated Heart Failure Wet and Warm: A Retrospective Study.","authors":"Mochamad Yusuf Alsagaff, Dian Afrilla, Desi Jannati, Wenny Putri Nilamsari, Irma Maghfirah, Halim Priyahau Jaya","doi":"10.1177/00185787251410044","DOIUrl":"10.1177/00185787251410044","url":null,"abstract":"<p><strong>Background: </strong>According to clinical guidelines, individuals with acute decompensated heart failure (ADHF) wet and warm without contraindications should continue and optimize their beta-blocker (BB) therapy. However, its implementation in clinical practice remains inconsistent, and clinicians still frequently discontinue BB therapy. The discontinuation is defined as the absence of BB therapy for at least 24 hours following hospital admission.</p><p><strong>Aim: </strong>The purpose of this study was to examine how clinical outcomes and length of stay are affected when BB therapy is discontinued in ADHF wet and warm patients without contraindication.</p><p><strong>Methods: </strong>Patients with ADHF from two hospitals participated in this retrospective observational cohort research. The inclusion criteria were aged ≥18 years, having received chronic beta-blocker therapy before hospitalization, and having a Left Ventricular Ejection Fraction (LVEF) of ≤40%. The study excluded patients with incomplete data and those who were contraindicated for beta-blocker medication. The data obtained were analyzed using descriptive and statistical analyses.</p><p><strong>Results: </strong>The inclusion criteria resulted in 243 patients: 168 (69.1%) men and 75 (30.9%) women. On average, the age range was 56.2 ± 12.9 years, with mean ages of 54.8 ± 12.1 years in the beta-blocker continuation group and 57.1 ± 13.4 years in the discontinuation group. From the total, 60.1% discontinued the BB therapy, and 39.9% continued receiving it during their hospitalization. The results show that patients who stopped taking BBs experienced a noticeably greater rate of heart failure deterioration than those who continued taking them (10.3% vs 2.1%, <i>P</i> = 0.027). Patients receiving BBs had significantly lower in-hospital mortality rates, as well as both cardiovascular mortality (8.2% vs 1.0%, <i>P</i> = 0.04) and all-cause mortality (10.3% vs 1.0%, <i>P</i> = 0.021). Furthermore, patients who discontinued BB therapy experienced a longer hospitalization (6.5 ± 3.5 vs 5.8 ± 3.5 days, <i>P</i> = 0.023).</p><p><strong>Conclusion: </strong>In the case of ADHF, beta-blocker discontinuation is linked to poorer clinical outcomes.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787251410044"},"PeriodicalIF":0.9,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165208","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":"Real-World Safety and Efficacy Data Comparing Dosing Strategies of Eravacycline: A Retrospective Cohort Study.","authors":"Natalie M McCourt, Martin Krsak, Karrine Brade, Michael Casias","doi":"10.1177/00185787261417158","DOIUrl":"10.1177/00185787261417158","url":null,"abstract":"<p><strong>Background: </strong>Limited data exists to assess the efficacy and safety outcomes of alternative eravacycline dosing strategies.</p><p><strong>Methods: </strong>We conducted a single center, retrospective, cohort study to compare the outcomes of 2 different eravacycline dosing regimens for various eravacycline-susceptible non-mycobacterial infections between September 2019 and June 2024.</p><p><strong>Main point summary: </strong>Eravacycline 1.5 mg/kg q24h demonstrated no worse odds of clinical success and a statistically significant reduction in mortality compared to 1 mg/kg q12h. The once-daily regimen may increase healthcare convenience; however, it likely results in higher rates of nausea.</p><p><strong>Results: </strong>The study analyzed 133 patients who received eravacycline for at least 50% of the recommended indication-based duration of therapy, comparing 2 groups: 24 patients on eravacycline 1.5 mg/kg q24hrs and 109 on eravacycline 1 mg/kg q12hrs. The patients who received once-daily dosing were older (64.5 vs 53 years old) with more comorbidities. Both groups showed similar clinical success rates (54% once-daily dosing vs 46% twice-daily dosing), however, the once-daily dosing of eravacycline had lower mortality (4% vs 26%). Once-daily dosing was associated with an increased incidence of nausea and a trend toward fewer infection-related readmissions.</p><p><strong>Conclusion: </strong>The use of eravacycline 1.5 mg/kg q24h demonstrated similar odds of clinical success compared with the 1 mg/kg q12h regimen and may result in a reduction in 30-day mortality but resulted in higher rates of adverse effects. However, further studies are needed to confirm these findings.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261417158"},"PeriodicalIF":0.9,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165250","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}