Journal of pharmacy practice最新文献

One and Done? An Evaluation of the Clinical Outcomes of Single- and Multi-Dose Dalbavancin Use in the Pediatric Population. 一劳永逸？儿科人群使用单剂量和多剂量达尔巴万星的临床效果评估。

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-09-19 DOI: 10.1177/08971900241285521

Taylor Morrisette, Shahad Alghamdi, Megan B Maree, Terry C Dixon, Stephen A Thacker

{"title":"One and Done? An Evaluation of the Clinical Outcomes of Single- and Multi-Dose Dalbavancin Use in the Pediatric Population.","authors":"Taylor Morrisette, Shahad Alghamdi, Megan B Maree, Terry C Dixon, Stephen A Thacker","doi":"10.1177/08971900241285521","DOIUrl":"10.1177/08971900241285521","url":null,"abstract":"Staphylococcus aureus is a leading cause of invasive bacterial infections in the pediatric population. In general, data surrounding the use of newly approved antimicrobials within children are lacking. Dalbavancin is a long-acting lipoglycopeptide that shows promise for off-label use in adults given its unique pharmacokinetics and in vitro potency against common Gram-positive isolates; however, evidence to supports its use in children is limited. We report the use of dalbavancin in three pediatric cases in patients aged 17 months of age, 3 years of age, and 11 years of age. All infections were caused by S. aureus (66.7% methicillin-resistant S. aureus) representing varied disease, including an osteoarticular infection and catheter-related bloodstream infection. Furthermore, all patients had pediatric infectious diseases involvement. Following the utilization of DAL, high clinical success and low rates of adverse effects were observed with high patients' and parents' satisfaction. While larger, confirmatory real-world studies are needed, our findings support safe off-label DAL use in select pediatric patients.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"275-278"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prescription for Digital Evolution: Transformative Recommendations for Pharmacy Practice in the Digital Age. 数字进化处方：数字时代药学实践的变革性建议》。

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-08-29 DOI: 10.1177/08971900241277049

Ayomide Ogundipe, Tin Fei Sim, Lynne Emmerton

{"title":"Prescription for Digital Evolution: Transformative Recommendations for Pharmacy Practice in the Digital Age.","authors":"Ayomide Ogundipe, Tin Fei Sim, Lynne Emmerton","doi":"10.1177/08971900241277049","DOIUrl":"10.1177/08971900241277049","url":null,"abstract":"Increased administrative tasks, evolving expectations of care and advancement in practice scope have rapidly advanced digital health. Health policy has acknowledged the need for evaluation to determine the technological needs of clinicians, including pharmacists, to practice to full and top of scope. There is an emergent need for recommendations to address the technological transformation to enable community pharmacists' practice. This study aimed to develop digital health recommendations, through expert consensus, for the government, pharmacy professional associations, pharmacy enterprises and software vendors, to facilitate community pharmacists' practice. A modified Delphi survey was conducted online in February-March 2024. Pharmacists with digital health expertise were purposively recruited. Participants were asked to rate their level of agreement with the initial 24 research-derived statements in round 1. Consensus was defined a priori as ≥80% of participants strongly agreeing or agreeing with a statement and a standard deviation of ≤1.00. Review of participants' free-text comments progressively reduced and refined the statements. All 22 participants completed the modified Delphi study in 3 survey rounds. Participants represented every Australian jurisdiction. Eighteen participants had more than 10 years of professional experience. Sixteen recommendations emerged: 6 for government, 2 for pharmacy professional associations, 4 for pharmacy enterprises and 4 for software vendors. The majority of recommendations require financial investment and harmonization of legislation across jurisdictions. Adoption of these recommendations, with significant investment across partners in the healthcare system and technology providers, will enable pharmacists to more effectively and safely practice utilizing technology solutions.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"237-248"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108611","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}

引用次数: 0

Balanced Fluids Versus Normal Saline for Initial Fluid Resuscitation in Adults With Diabetic Ketoacidosis. 成人糖尿病酮症酸中毒患者初始液体复苏时使用平衡液体还是正常生理盐水？

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-08-16 DOI: 10.1177/08971900241273278

Justin W Carter, Patrick M Whaley, G Christina Gutierrez, Amanda L Fowler, Rebecca L Attridge, Darrel W Hughes, Kristi L Hargrove

{"title":"Balanced Fluids Versus Normal Saline for Initial Fluid Resuscitation in Adults With Diabetic Ketoacidosis.","authors":"Justin W Carter, Patrick M Whaley, G Christina Gutierrez, Amanda L Fowler, Rebecca L Attridge, Darrel W Hughes, Kristi L Hargrove","doi":"10.1177/08971900241273278","DOIUrl":"10.1177/08971900241273278","url":null,"abstract":"Background: Normal saline (NS) has been the choice fluid for volume resuscitation in diabetic ketoacidosis (DKA) for decades. Large volume resuscitation with NS can lead to hyperchloremic metabolic acidosis and is associated with a higher incidence of major adverse kidney events compared to balanced fluids (BF). Objective: Compare safety and effectiveness of fluid resuscitation with BF vs NS in adult patients with DKA. Methods: Single-center retrospective cohort study evaluated patients who received NS or BF for DKA treatment between July 2020 and August 2021. Primary endpoint was time to DKA resolution. Secondary endpoints included time to anion gap ≤12, HCO3 ≥15 and ≥18 mmol/L, acute kidney injury, and hospital and intensive care unit length of stay. Results: 110 patients were included (NS 55% (n = 60), BF 45% (n = 50)). Time to DKA resolution was faster in patients who received BF vs NS (13 (10 - 19) hours vs 17 (11 - 25) hours, P = 0.02). Treatment with NS was associated with a longer time to resolution of DKA when adjusted for initial bicarbonate and AKI at admission. Conclusion: BF was associated with a shorter time to DKA resolution compared to NS.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"225-230"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk Factors Associated With Acute Kidney Injury in Traumatic Brain Injury Patients Treated With Hypertonic Saline: A Retrospective Study. 使用高渗盐水治疗脑外伤患者急性肾损伤的相关风险因素：一项回顾性研究。

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-08-30 DOI: 10.1177/08971900241279631

Jessica Briscoe, Megan Van Berkel Patel, R Chace Hicks, Nadia Froehling, Darren Hunt, Jessica Parker, Breanna Carter

{"title":"Risk Factors Associated With Acute Kidney Injury in Traumatic Brain Injury Patients Treated With Hypertonic Saline: A Retrospective Study.","authors":"Jessica Briscoe, Megan Van Berkel Patel, R Chace Hicks, Nadia Froehling, Darren Hunt, Jessica Parker, Breanna Carter","doi":"10.1177/08971900241279631","DOIUrl":"10.1177/08971900241279631","url":null,"abstract":"Background: Hypertonic saline (HTS) is essential pharmacologic treatment for traumatic brain injury (TBI). Previous studies associate HTS with acute kidney injury (AKI), however evidence in TBIs is limited. Objective: This study examines factors associated with AKI in patients requiring HTS for TBI. Methods: This retrospective study was performed at a Level-1 Trauma, Academic Medical Center. Inclusion criteria were TBI, age ≥12 years, ICU length of stay ≥72 hours, and administration of ≥24 hours of continuous HTS or 500 mL of HTS boluses. The primary outcome was identifying factors associated with AKI. Secondary outcomes included correlation between chloride load and level with development of AKI. Chloride load was calculated from HTS and non-HTS sources. Results: Of 129 patients included, 18 (14%) developed AKI. Maximum sodium level was higher in the AKI group (P < 0.0001). Hyperchloremia (Cl ≥ 115 mEq/L) was more common in the AKI group (100% vs 81%, P = 0.0428). Maximum and change in serum chloride were higher in the AKI group (median 128 vs 123 mEq/L, P = 0.0026 and +24 mEq/L vs +17 mEq/L, P = 0.0084, respectively). Logistic regression analysis indicated an OR 1.095 times higher [95% CI (1.022, 1.172)] for developing AKI for every one mEq/L increase in maximum chloride level and an OR 1.032 [95% CI (1.006, 1.058)] for developing AKI for every 1-year increase in age. There was no difference in total chloride load between groups (P = 0.2143). Non-HTS sources provided more than 40% of total chloride load in both groups. Conclusion: Chloride level, and age may be associated with AKI in TBI patients treated with HTS.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"249-255"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Clevidipine Versus Nicardipine on Time in Range when Lowering Blood Pressure. 氯维地平与尼卡地平对降压时间在范围内的影响

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-09-10 DOI: 10.1177/08971900241279638

Kaitlin J Armstrong, Kelly Shepard, Michelle Horsfield, Alexander R Levine, David M O'Sullivan, Abigail L Zeiner

{"title":"Impact of Clevidipine Versus Nicardipine on Time in Range when Lowering Blood Pressure.","authors":"Kaitlin J Armstrong, Kelly Shepard, Michelle Horsfield, Alexander R Levine, David M O'Sullivan, Abigail L Zeiner","doi":"10.1177/08971900241279638","DOIUrl":"10.1177/08971900241279638","url":null,"abstract":"Background: Two intravenous medications commonly used as first-line therapy for rapid blood pressure control are nicardipine and clevidipine, both of which are available as titratable infusions. Despite pharmacokinetic differences, no data clearly support a preferred agent. Objective: To evaluate efficacy and safety outcomes associated with current use of these medications across a variety of indications in a hospital system. Methods: This study was a multi-center, retrospective chart review conducted within a hospital system from June 1, 2020 to June 30, 2021. Records of patients were matched in a one-to-one fashion based on indication for blood pressure control and similar pre-intervention blood pressure. The primary outcome was time within target blood pressure range. Results: A total of 569 patients were screened, resulting in 100 matched pairs. The percent of time in blood pressure range was similar between nicardipine and clevidipine when stratified by location of care (51.5% vs 51.7%, P = 0.970 for ED; 68.1% vs 68.8%, P = 0.913 for ICU). Overall, the median (IQR) time to target blood pressure range was significantly faster with clevidipine than nicardipine [20 (7-43) min. vs 34 (14.5-57) min., resp.; P = 0.013). There were numerically higher rates of hypotension with nicardipine than clevidipine, but this finding was not significant (17% vs 10%; P = 0.093). Conclusions: This study shows a statistically significant difference in time to target blood pressure range with clevidipine compared to nicardipine. Although there was no difference in the percentage of time in blood pressure range, nicardipine was associated with a non-significant increase in the incidence of hypotension.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"256-263"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Very High Warfarin Dosing Requirements in a Patient With Tuberculosis and a Pulmonary Embolism: A Case Report. 一名肺栓塞肺结核患者的华法林超高剂量需求：病例报告。

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-09-19 DOI: 10.1177/08971900241285226

Marcus Mize, Carrie Baker, Riley D Bowers

引用次数: 0

Utilization of the PEN-FAST Clinical Decision-Making Tool to Update Penicillin Allergies and Identify Low-Risk Patients. 利用 PEN-FAST 临床决策工具更新青霉素过敏症并识别低风险患者。

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-11-19 DOI: 10.1177/08971900241302394

Hien Lam, Katie Parsels, Jeffrey M Steele, Wesley D Kufel, Ryan Andrew, Christopher Miller, William Darko, Robert Seabury

引用次数: 0

Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in the Medical Intensive Care Unit (ICU): A Retrospective Cohort Study. 内科重症监护室（ICU）中苯巴比妥与苯二氮杂卓治疗酒精戒断：回顾性队列研究

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-09-11 DOI: 10.1177/08971900241273144

Megan Ingebrigtson, Sarah Schang, Robert C Hyzy, Jakob I McSparron, Xi Chen, Elliot B Tapper, Michael T Kenes

{"title":"Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in the Medical Intensive Care Unit (ICU): A Retrospective Cohort Study.","authors":"Megan Ingebrigtson, Sarah Schang, Robert C Hyzy, Jakob I McSparron, Xi Chen, Elliot B Tapper, Michael T Kenes","doi":"10.1177/08971900241273144","DOIUrl":"10.1177/08971900241273144","url":null,"abstract":"Background: Phenobarbital (PHB) is a safe and efficacious alternative to benzodiazepines (BZD) for treating severe alcohol withdrawal (AWS). However, the safety of utilizing PHB for patients initially treated with BZD is unknown. Objective: To evaluate the safety and efficacy of PBH compared to BZDs in severe AWS in the medical intensive care unit (ICU). Methods: This was a retrospective cohort study comparing critically ill patients admitted for AWS who received BZDs or PHB. The primary outcome was time to persistent resolution of altered mentation. Secondary outcomes included development and duration of delirium, need for mechanical ventilation, development of withdrawal seizures, and ICU and hospital length of stay. Results: Ninety-five patients were evaluated (53 in PHB group, 42 in BZD group). Before study medication, less BZD patients demonstrated abnormal mentation compared with PHB patients (RASS < -2: 2.39% vsvs. 28.12%, respectively, and RASS > +2: 9.9% vsvs. 48.76%; P <0.001 for both). No difference was seen between groups for the primary outcome (1.8 hours for BZD cohort vsvs. 13.81 hours for PHB cohort; P =0.22). More patients in the BZD cohort developed a seizure after study medication administration (5.67% vs 0%, respectively; P =0.02). No significant difference was seen in other secondary outcomes. Conclusions: This study provides support for use of PHB after BZD if patients remain in uncontrolled withdrawal. Despite significant doses of BZDs before PHB, patients in the PHB cohort demonstrated similar clinical and safety outcomes compared to BZD alone.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"231-236"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Xylazine Adulteration in Illicit Fentanyl: A Threat to Public Health. 非法芬太尼中的恶嗪掺假：对公众健康的威胁。

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Journal of pharmacy practice Pub Date : 2025-04-01 Epub Date: 2024-09-05 DOI: 10.1177/08971900241279635

Samuel A Marshall, Leigh Anne Nelson

{"title":"Xylazine Adulteration in Illicit Fentanyl: A Threat to Public Health.","authors":"Samuel A Marshall, Leigh Anne Nelson","doi":"10.1177/08971900241279635","DOIUrl":"10.1177/08971900241279635","url":null,"abstract":"Background: Xylazine-adulterated fentanyl (FAAX) is a critical public health concern in the United States (US), and the White House Office of National Drug Control Policy designated FAAX as an emerging drug threat in April 2023. Between 2020-2021, fatal xylazine-positive overdoses increased by 100-1127% depending on geographic region in the US. Objectives: This narrative review informs pharmacists about the clinical concerns, potential treatment strategies, and harm reduction approaches directed at FAAX. The objective is to provide pharmacists with the knowledge necessary to contribute to public health efforts in addressing this crisis. Results: Xylazine is commonly found as an adulterant in illicit drug combinations with fentanyl. Significant hypotension, and respiratory and CNS depression are associated with xylazine toxicity, and these effects may be synergistic with opioids. Standard naloxone doses are ineffective for xylazine toxicity, and there is no FDA-approved antidote for xylazine overdose in humans. Chronic use may lead to physiological dependence, withdrawal symptoms, and severe skin ulcerations. Pharmacists are crucial in addressing this crisis through patient education, advocating for testing and treatment, and promoting harm reduction measures. Conclusion: Xylazine and FAAX pose a substantial threat to public health. The synergistic effects of opioids increase the risk of fatal overdoses, highlighting the need for effective harm-reduction strategies. A comprehensive approach involving healthcare professionals, law enforcement, policymakers, and community organizations is required to address this public health issue, and pharmacists have an active role in mitigating the drug threat of FAAX.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"264-269"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Oral Fluconazole Absorption in a Complicated Post-Roux-en-Y Gastric Bypass Patient: A Case Report.

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Journal of pharmacy practice Pub Date : 2025-03-20 DOI: 10.1177/08971900251328787

Diana R Langworthy, Jennifer K Ross

{"title":"Oral Fluconazole Absorption in a Complicated Post-Roux-en-Y Gastric Bypass Patient: A Case Report.","authors":"Diana R Langworthy, Jennifer K Ross","doi":"10.1177/08971900251328787","DOIUrl":"https://doi.org/10.1177/08971900251328787","url":null,"abstract":"Introduction: Roux-en-Y gastric bypass (RYGB) is a surgical weight-loss procedure that combines gastric restriction with malabsorption for weight reduction. There is currently a paucity of data to guide pharmacists and healthcare providers in optimizing oral medication therapy in patients with a history of bariatric surgery. Fluconazole is a commonly used triazole antifungal with high oral bioavailability. The literature is limited regarding how RYGB affects oral fluconazole absorption. Case: We investigated fluconazole oral bioavailability in a patient with a history of RYGB status-post revision with esophagojejunal anastomosis. The patient had been maintained on combination therapy with intravenous (IV) micafungin and oral fluconazole due to persistent candidemia prior to source control and concerns regarding fluconazole absorption. On admission, the patient was switched to IV fluconazole in the setting of possible small bowel obstruction. Steady-state fluconazole trough levels obtained during IV and oral therapy were 41.9 μg/mL and 44.4 μg/mL, respectively. Conclusion: We were able to demonstrate oral fluconazole maintains high bioavailability in a patient with RYGB. Fluconazole displays linear pharmacokinetics, therefore the degree of oral absorption reduction would directly correspond to a decreased trough level. Pharmacists and providers should continue to be vigilant when evaluating drug efficacy in patients who have undergone gastric bypass procedures, especially those with malabsorptive mechanisms.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251328787"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0