Hospital Pharmacy最新文献

{"title":"Use of 400 µg/mL Peripheral Phenylephrine Infusions During Anesthesia: A Safety Initiative.","authors":"Karolina Brook, Alexandra Tcherepanova, Flavio Gilio Andrade de Meneses, R Mauricio Gonzalez, William Vincent, Mohamed T Sarg","doi":"10.1177/00185787241286764","DOIUrl":"10.1177/00185787241286764","url":null,"abstract":"<p><p>During a general anesthetic case, a patient was administered a 400 µg/mL infusion of phenylephrine as opposed to the 40 µg/mL solution typically used in most operating rooms. The patient experienced iatrogenic hypertension, which resolved once the cause was discovered and the phenylephrine was discontinued. A root cause analysis was performed, with multiple factors contributing to the error. The Department of Pharmacy advocated switching to one concentration of phenylephrine hospital-wide. After performing a literature review regarding the safety of using 400 µg/mL phenylephrine peripherally, the decision was made to switch the operating room to this concentration of phenylephrine. The switch has been successful, with only one known medication error and no adverse events occurring since implementation. This quality improvement initiative demonstrates that 400 µg/mL phenylephrine can be used as an infusion in the operating room, which has potential implications for patient safety and efficiency. This safety initiative may serve as an example for other operating rooms.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241286764"},"PeriodicalIF":0.8,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619207","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":"Switching from Nusinersen to Risdiplam in Spinal Muscular Atrophy: A Comparative Analysis of Safety, Efficacy, and Economic Impact.","authors":"Eleonora Castellana","doi":"10.1177/00185787241282213","DOIUrl":"10.1177/00185787241282213","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241282213"},"PeriodicalIF":0.8,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619194","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":"Temperature Excursions in Cold Chain Management-Assessing the Accuracy of Refrigerator Temperature Probes.","authors":"Kayla Ferraz, Melissa Cato, Emma Fox, Matthew Rawlins, Jeanie Misko","doi":"10.1177/00185787241282245","DOIUrl":"10.1177/00185787241282245","url":null,"abstract":"<p><p><b>Background:</b> Medications requiring refrigeration for stability are commonly used across hospitals. Temperature-sensitive medications may not have their temperature requirements maintained due to breaches in the cold chain, especially refrigerator failure. This is usually caused by malfunction of the refrigerator unit or by power outage. After multiple power outages at our institution involving refrigerators with temperature probes located in different areas of the refrigerator, we hypothesised that the fixed temperature probe may not accurately reflect the temperature of the medications themselves. <b>Methods:</b> We conducted simulations of power outages in a commonly used medication refrigerator, using additional temperature data loggers, placed on the refrigerator shelf and inside a cardboard box to replicate the temperature inside medication containers to determine if there was a difference in the time to breach cold chain conditions (>8°C) and to return to appropriate refrigerated temperatures (<8°C) when power was restored. <b>Results:</b> All data loggers took a longer time to breach cold chain conditions than the refrigerator probe (12.5 minutes vs 23-26 minutes) but took longer to return to acceptable temperature after power was restored (17.5 minutes vs 70.5-89 minutes). <b>Conclusion:</b> This exploratory research suggests that temperatures vary within a refrigerator depending on the type and location of probe and that medications within may take longer to breach cold chain conditions but also take longer to return to cold chain conditions compared with fixed refrigerator temperature probes. Further research is required to determine whether these variations occur across different sizes/brands of refrigerators and the effect on stability on refrigerated medications.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241282245"},"PeriodicalIF":0.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619197","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":"Pharmacy-Physiotherapy Interprofessional Education and Practice.","authors":"Seif El Hadidi","doi":"10.1177/00185787241280240","DOIUrl":"10.1177/00185787241280240","url":null,"abstract":"<p><p>Interprofessional education (IPE) is an educational technique in which tutors and students from several healthcare disciplines, such as pharmacy and physiotherapy, collaborate to achieve a common goal. IPE has been shown to increase patient outcomes and professional growth among healthcare teams. Pharmacists and physiotherapists have different knowledge bases and skills, both of which are integral to the effectiveness of a collaborative healthcare team. By bringing their respective expertise together in an interprofessional context these healthcare professionals can work to develop increased understanding, respect for each other's roles, and the ability to collaborate more effectively.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241280240"},"PeriodicalIF":0.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635743","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":"The Strategic Roles of Satellite Pharmacies in Hospital Settings.","authors":"Amin Sharifan","doi":"10.1177/00185787241279416","DOIUrl":"10.1177/00185787241279416","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241279416"},"PeriodicalIF":0.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619199","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":"Assessment of the Workflow and Time to Antibiotic Dose Adjustment for Critically Ill Patients Starting Continuous Renal Replacement Therapy.","authors":"Megan Fulbright, Robert Sbertoli, Christian M Gill","doi":"10.1177/00185787241274779","DOIUrl":"10.1177/00185787241274779","url":null,"abstract":"<p><p><b>Background:</b> Acute kidney injury (AKI) remains a common sequela of sepsis necessitating use of continuous renal replacement therapy (CRRT). In the setting of AKI, renally adjusted antimicrobials (eg, β-lactams) are dose reduced to prevent toxicity; however, the extracorporeal clearance of CRRT may lead to subtherapeutic exposures of dose reduced antimicrobials. The present study sought to evaluate the time to dose adjustment to CRRT appropriate doses of antimicrobials after initiation of CRRT. <b>Methods:</b> A retrospective cohort study of patients on CRRT and anti-pseudomonal β-lactams was conducted. CRRT was conducted as continuous veno-venous hemodialysis (CVVHD) per institutional standards. Baseline characteristics were collected including dialysate flow rate. The primary outcome was time to CRRT appropriate dose adjustment. Secondary outcomes included the pharmacist shift (ie, day, evening, or night shift) that CRRT was ordered and initiated. Continuous data were reported as median (IQR). <b>Results:</b> Forty-four patients were included in the analysis. The median dialysate flow rate was 2.3 L/hour (2, 3.1). Of included patients, 75% received cefepime therapy while 25% received meropenem. The median time to CRRT appropriate dosing was 13 hours (6, 20). CRRT was most commonly ordered during day shift (68%) but not started until evening (59%). The observed delay in appropriate dose adjustment may predispose patients to suboptimal antimicrobial exposure and subsequently therapeutic failure. CRRT was often ordered during the day shift but not initiated until evening which led to identification of potential procedural improvements. <b>Conclusions:</b> These data led to the initiation of a pharmacy in basket consult to alert pharmacists in real time of CRRT orders so that once CRRT was started, doses could be appropriately adjusted. Future studies to assess the impact of this process change on both time to appropriate dose and clinical outcomes are warranted.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241274779"},"PeriodicalIF":0.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619046","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":"Evaluation of the Physical Compatibility of Intravenous Methocarbamol in Lactated Ringer's, 0.45% Normal Saline, and Plasma-Lyte A.","authors":"Aaron T Twardzik, Justin P Reinert, Gabriella Baki, Mariann D Churchwell, Mitchell S Howard","doi":"10.1177/00185787241279375","DOIUrl":"10.1177/00185787241279375","url":null,"abstract":"<p><p><b>Background:</b> The need to determine physical compatibility of intravenous admixtures is directly related to patient safety and patient outcomes. While the provision of multi-modal analgesic strategies has increased over the past decade, a paucity of data exists regarding physical compatibility of select medications. <b>Objectives:</b> To evaluate the physical compatibility of methocarbamol in Lactated Ringer's (LR), 0.45% normal saline (0.45% NaCl), and Plasma-Lyte A (PLA) at concentrations of 4, 10, and 20 mg/mL. <b>Methods:</b> Admixtures were prepared and evaluated using previously validated methods under a laminar flow hood using aseptic technique. Samples were prepared in a triplicate manner, 3 mL aliquots were placed into polymethyl methacrylate cuvettes for evaluation at time points 0, 1, 5, 8, and 24 hours. Visual inspection of samples included assignment of a number: 0-no precipitation, 1-trace evidence of precipitation, 2-slight haze, 3-medium haze, and 4-heavy precipitation. Any evidence of precipitation was considered significant. A variable wavelength spectrophotometer set at 547 nanometers was used to measure absorbance. A change in absorbance of ±0.010 was considered significant. A change in pH of ±0.1 was considered significant. <b>Results:</b> No significant changes occurred relating to visual inspection or absorbance across all concentrations and time points for LR; however, there was a significant change in pH across all concentrations at hour 5. In 0.45% NaCl and PLA, no remarkable changes occurred across all concentrations and time points regarding visual observation, spectrophotometric absorbance, and pH analysis. <b>Conclusions:</b> Methocarbamol at concentrations of 4, 10, and 20 mg/mL is physically compatible for up to 1 hour in LR. Methocarbamol is physically compatible in 0.45% NaCl and PLA for up to 24 hours. Chemical stability tests are warranted to confirm these findings.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241279375"},"PeriodicalIF":0.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619153","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":"Drug Shortage in Italy: Retrospective Analysis from 2018 to 2024.","authors":"Eleonora Castellana","doi":"10.1177/00185787241278142","DOIUrl":"10.1177/00185787241278142","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241278142"},"PeriodicalIF":0.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619150","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":"Rapid Desensitization to Antitumoral Agents. Result from a Retrospective Study, DESARCh.","authors":"Roberto Tessari, Andrea Ossato, Francesca Realdon, Valentina Montresor, Giuseppe Giovagnoni, Michele Giannini, Debora Gandini, Alessandra Modena, Alessandro Inno, Stefania Gori","doi":"10.1177/00185787241278702","DOIUrl":"10.1177/00185787241278702","url":null,"abstract":"<p><p>Antitumoral drugs (ADs) can induce drug hypersensitivity reactions (DHRs). Rapid drug desensitization (RDD) protocols represent an important option to mitigate recurrent DHRs thus allowing the safe administration of ADs at therapeutic doses. The aim of this retrospective study was to assess the effectiveness of the RDD protocols performed at our institution. The \"DESARCh\" study was a retrospective, observational study that included consecutive patients who underwent RDD protocols from January 2011 to December 2022 at IRCCS Ospedale Sacro Cuore Don Calabria in Negrar di Valpolicella, Verona, Italy. The RDD protocol consisted of a 5-step protocol with 5 different concentrations of the drugs at 1:1, 1:10, 1:100, 1:1,000 and 1:10,000 dilution given intravenously over a 1-hour infusion each, with concentrations increasing from the most diluted to the most concentrated form, preceded by a 30-min premedication regimen. A total of 66 RDD protocols were administered to 25 female patients with ovarian (64%; n = 16/25), breast (12%; n = 3/25), endometrium (8%; n = 2/25), cervix (8%; n = 2/25), uterine (4%; n = 1/25) and fallopian tubes (4%; n = 1/25) cancers. A known history of atopy/allergy was reported by 36% (n = 9/25) of patients. Patients received RDD protocols because of DHRs to carboplatin (n = 23/66, 34.85%), paclitaxel (n = 18/66, 27.27%), pegylated liposomal doxorubicin (n = 3/66, 4.55%), and trastuzumab (n = 22/66, 33.33%). DHRs were mild-moderate, severe and life-threatening in 60.72%, 28.57% and 10.71% of cases, respectively. The success rate of RDD protocols, defined as the rate of complete administration of full target dose with no breakthrough reactions, was 81.82% (n = 54/66). Success rate was lower for carboplatin compared to other drugs (65.22% vs 90.7%; <i>P</i> = .017678). The RDD protocol used in our institution was found to be safe, with a meaningful success rate. However, further research is needed to better understand the underlying mechanisms of DHRs and to enhance effectiveness, particularly for patients experiencing DHRs to platinum compounds. This study was approved by the ethics committee of Verona and Rovigo (Italy) with approval number 15476 on 10/03/2023 and it was registered with the Register of Observational Studies of the Italian Medicines Agency (AIFA) (available since 31 January 2023), with ID n. 109, on 28/02/2023 (https://www.aifa.gov.it/en/registro-studi-osservazionali).</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241278702"},"PeriodicalIF":0.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667498","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":"Resmetirom.","authors":"Terri L Levien, Danial E Baker","doi":"10.1177/00185787241278571","DOIUrl":"10.1177/00185787241278571","url":null,"abstract":"<p><p>Each month, subscribers to <i>The Formulary Monograph Service</i> receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy and Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of <i>The Formulary, Hospital Pharmacy</i> publishes selected reviews in this column. For more information about <i>The Formulary Monograph Service</i>, contact Wolters Kluwer customer service at 866-397-3433.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787241278571"},"PeriodicalIF":0.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667503","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}