Journal of pharmacy practice最新文献

A Retrospective Reappraisal of Labetalol's Hemodynamic Effects. 拉贝他洛尔血流动力学效应的回顾性再评价。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-08-23 DOI: 10.1177/08971900251370870

Mary Margaret Rinker, Teresa Valadez, Renee Petzel Gimbar, Andrew Posen

{"title":"A Retrospective Reappraisal of Labetalol's Hemodynamic Effects.","authors":"Mary Margaret Rinker, Teresa Valadez, Renee Petzel Gimbar, Andrew Posen","doi":"10.1177/08971900251370870","DOIUrl":"10.1177/08971900251370870","url":null,"abstract":"Background: Labetalol is an adrenergic antagonist used to manage blood pressure. Current package labeling and drug databases describe intravenous (IV) labetalol's hemodynamic effects to have an alpha-to-beta potency relationship of 1:7, denoting a predominantly negative cardiotropic effect, which differs from our clinical experience. Objective: The purpose of this study was to describe the hemodynamic effects of IV labetalol in clinical practice and compare those results to official references. Methods: This was a retrospective, observational cohort study of patients undergoing evaluation and management for acute ischemic stroke in the emergency department. We included patients who received IV labetalol and excluded those experiencing intracerebral hemorrhage. The primary outcome was labetalol's alpha-to-beta relative clinical potency (RCP), calculated as the median ΔSBP / ΔHR, using nadir values within one hour of labetalol's administration. Results: Forty-two patients met criteria for analysis, with median age of 66 years and majority female sex (71%). Following a median dose of 10 mg, the median ΔSBP was -35 mmHg and ΔHR -9 beats per minute. The median alpha-to-beta RCP was approximately 7:2. Out of 42 patients, 10 experienced excessive reductions in SBP. This cohort exhibited neither new-onset bradycardia nor reflex tachycardia. Conclusions and Relevance: We clinically observed IV labetalol's alpha-to-beta potency ratio to be 7:2, significantly differing from the 1:7 ratio stated in official references. While this study has limitations, our findings highlight an inconsistency between real-world experience and nongeneralizable experimental results. We recommend revision of the official references that intend to guide clinician use of IV labetalol.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"179-183"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958389","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

Glucagon-like Peptide-1 Receptor Agonists and Reproductive Health: Current Evidence and Clinical Implications. 胰高血糖素样肽-1受体激动剂与生殖健康：目前的证据和临床意义。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-09-04 DOI: 10.1177/08971900251376795

Jordyn Kettner, Elizabeth Donnelly, Marina L Maes

{"title":"Glucagon-like Peptide-1 Receptor Agonists and Reproductive Health: Current Evidence and Clinical Implications.","authors":"Jordyn Kettner, Elizabeth Donnelly, Marina L Maes","doi":"10.1177/08971900251376795","DOIUrl":"10.1177/08971900251376795","url":null,"abstract":"Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have experienced rapid growth in recent years as treatments for type 2 diabetes mellitus and obesity. These medications offer promising benefits, including weight loss and improved glycemic control; however, their implications for reproductive health warrant attention. While tirzepatide has been shown to impact absorption of oral contraceptives due to delayed gastric emptying, other GLP-1RAs do not appear to have clinically significant interactions with oral contraception. Fertility outcomes may improve with GLP-1RAs and dual GLP-1/GIP agonists due to weight loss and related metabolic benefits. Despite their widespread use, data on GLP-1RAs in pregnancy and lactation remain limited, leaving significant gaps in guidance for clinicians. This review synthesizes current literature on GLP-1RAs to highlight reproductive health considerations, including their potential impacts on contraception, fertility, pregnancy, and lactation. Greater awareness and understanding of these factors can support informed decision-making and optimize care for individuals using GLP-1RAs.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"239-250"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000853","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

Evaluation of Bleeding and Thrombotic Outcomes of Anticoagulation Strategies Upon Intensive Care Unit Admission for Patients with Atrial Fibrillation on Direct Oral Anticoagulants. 房颤患者直接口服抗凝剂入住重症监护病房时抗凝策略的出血和血栓结局评价。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-09-06 DOI: 10.1177/08971900251376819

Priya J Patel, Mariah I Sigala, Corey V Dinunno, Laura M Blackburn, Kevin R Donahue

{"title":"Evaluation of Bleeding and Thrombotic Outcomes of Anticoagulation Strategies Upon Intensive Care Unit Admission for Patients with Atrial Fibrillation on Direct Oral Anticoagulants.","authors":"Priya J Patel, Mariah I Sigala, Corey V Dinunno, Laura M Blackburn, Kevin R Donahue","doi":"10.1177/08971900251376819","DOIUrl":"10.1177/08971900251376819","url":null,"abstract":"Background: Critically ill adults are more commonly being admitted to intensive care units (ICU) with a recent history of direct oral anticoagulant (DOAC) use. No consensus guidance exists on optimal anticoagulation strategies in critically ill adults with non-valvular atrial fibrillation (NVAF) on DOAC's prior to ICU admission, and there is considerable variability in clinical practice. Objective: To evaluate rates of major bleeding and thrombosis between 2 anticoagulation strategies for NVAF upon ICU admission: package insert (continuation of oral or parenteral anticoagulation per manufacturer recommendations) vs non-package insert (prophylactic dosing or delayed therapeutic anticoagulation). Study design: This was a retrospective cohort study conducted from January 2019 to August 2023. Patients with NVAF and objective evidence of DOAC exposure within 48 hours of ICU admission were included. Those admitted to the ICU for a bleeding event or who received anticoagulation for indications other than NVAF were excluded. Results: A total of 353 patients met inclusion criteria (122 vs 231 in the package insert and non-package insert groups, respectively). There was no significant difference in the composite incidence of major bleeding and stroke or systemic embolism between groups (4.1% in package insert vs 6.1% in non-package insert; P = 0.437). Conclusion: This study demonstrated no difference in the incidence of major bleeding, in-hospital stroke, or systemic embolism with a package insert vs a non-package insert approach to anticoagulation in critically ill patients receiving DOAC therapy for atrial fibrillation. However, more studies are needed to develop evidence-based guidance on anticoagulation management in this population.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"193-203"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008390","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

Evaluation of Change in Medication Regimen Complexity-ICU (MRC-ICU) Score Following Implementation of a Virtual Intensive Care Model in a Multisite, Rural Health-System. 在多站点农村卫生系统中实施虚拟重症监护模式后药物治疗方案复杂性- icu （MRC-ICU）评分变化的评估

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-09-06 DOI: 10.1177/08971900251370888

David Mastro, Karen Williams, Joshua Campbell

{"title":"Evaluation of Change in Medication Regimen Complexity-ICU (MRC-ICU) Score Following Implementation of a Virtual Intensive Care Model in a Multisite, Rural Health-System.","authors":"David Mastro, Karen Williams, Joshua Campbell","doi":"10.1177/08971900251370888","DOIUrl":"10.1177/08971900251370888","url":null,"abstract":"Background: Telehealth in the ICU (Tele-ICU) may improve patient outcomes and optimize utilization of high acuity intensive care unit (ICU) beds. However, the relationship between tele-ICU and medication regimen complexity-ICU (MRC-ICU) score is unexplored. Objective: To assess the effect of tele-ICU on MRC-ICU score and describe pharmacists' work. Methods: Adult ICU encounters lasting at least 24 h were retrospectively compared pre- and post- implementation of tele-ICU services in a rural, five-hospital system. The primary outcome was MRC-ICU score 24 h after ICU admission. Prospectively, pharmacist interventions during ICU encounters were captured. Encounters were categorized on exposure to clinical pharmacist review. Results: The difference in mean MRC-ICU score between pre- and post-intervention encounters was -0.2032 (95% CI,-0.8253, 0.4188, P = 0.5217). Post-intervention encounters had a higher rate of thromboembolism prophylaxis (64.5% vs 54.9%, P = 0.001), higher adherence to stress-ulcer prophylaxis (74.1% vs 60.9%, P < 0.001), and a lower presence of glycemic control agent(s) (39.8% vs 46.2%, P = 0.017) 24 h after ICU admission. Tele-ICU services did not significantly change ICU LOS (3.261 vs 3.166 days, P = 0.536), nor ICU mortality (11.1% vs 12.7%, P = 0.377). In the prospective period (n = 196 encounters), 189 interventions were recorded on 80 encounters. There was no difference in median MRC-ICU score at 24 h in encounters with clinical pharmacist review and intervention vs without scheduled clinical pharmacist review (9 vs 8, P = 0.0596). Conclusion: Implementation of Tele-ICU did not change the MRC-ICU score at 24 h, although some ICU bundled care metrics improved. Many encounters lack opportunity for meaningful pharmacy interventions.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"184-192"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006244","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

Managing Resistant Hypertension in Rural Veterans: A Pharmacist-Led Telehealth Approach. 管理顽固性高血压在农村退伍军人：药剂师主导的远程医疗方法。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-06-26 DOI: 10.1177/08971900251356009

Jordan Burnette, Taylor Maynard

{"title":"Managing Resistant Hypertension in Rural Veterans: A Pharmacist-Led Telehealth Approach.","authors":"Jordan Burnette, Taylor Maynard","doi":"10.1177/08971900251356009","DOIUrl":"10.1177/08971900251356009","url":null,"abstract":"This case study explores the role that pharmacists can have managing resistant hypertension (RH) in rural Appalachian veterans, where health care access is limited. RH, defined as blood pressure above target despite adherence to multiple antihypertensive medications, presents challenges in chronic disease management. The Department of Veterans Affairs (VA) has integrated CPPs to improve medication adherence, reduce hospitalizations, and enhance blood pressure control, particularly in underserved areas. The patient, a 65-year-old male veteran with hypertension, obstructive sleep apnea, depression, and PTSD, had struggled with poorly controlled hypertension for years, experiencing adverse reactions to multiple antihypertensive medications. Living more than 60 minutes from the nearest VA facility, he had not seen his primary care provider since early 2021, exacerbating his condition. Despite initial reluctance to restart medications, the CPP implemented a stepwise management approach, utilizing telehealth for remote blood pressure monitoring and regular follow-ups. Over several months, pharmacologic therapy combined with lifestyle modifications led to significant blood pressure improvement. This case highlights the crucial role of CPPs in rural health care, offering accessible, continuous care and personalized management of complex conditions. Telehealth and remote monitoring further facilitated care, overcoming geographic barriers and enhancing patient engagement. The collaboration between pharmacists and specialists ensured comprehensive care and optimized treatment. This case demonstrates the potential for expanding CPP roles in rural areas to improve chronic disease management, reduce health care disparities, and enhance patient outcomes through telehealth and team-based care.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"235-238"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506047","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

Greater HIV Viral Load Suppression in Patients Using an Integrated Health System Specialty Pharmacy. 使用综合卫生系统专业药房的患者更大的HIV病毒载量抑制。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-09-04 DOI: 10.1177/08971900251376796

Karen Salomon-Escoto, Martha Stutsky, George Reed, Monica Y Hinestroza Jordan, Jonathan Kay, Mireya Wessolossky

{"title":"Greater HIV Viral Load Suppression in Patients Using an Integrated Health System Specialty Pharmacy.","authors":"Karen Salomon-Escoto, Martha Stutsky, George Reed, Monica Y Hinestroza Jordan, Jonathan Kay, Mireya Wessolossky","doi":"10.1177/08971900251376796","DOIUrl":"10.1177/08971900251376796","url":null,"abstract":"PurposeThis study assessed the impact of an integrated health system specialty pharmacy (HSSP) on viral load (VL) suppression in HIV patients, compared to patients utilizing non-health system specialty pharmacies (non-HSSPs).MethodsThis was a single-center, retrospective observational cohort study of patients ≥18 years with a HIV diagnosis and an encounter in the outpatient HIV clinic at an academic medical center associated with a HSSP, at least one order for an antiretroviral (ARV) medication, and at least one HIV-1 RNA VL result between January 2018 and May 2022. Outcomes included average rate of VL suppression and socio-demographic factors associated with VL suppression. Comparison of VL suppression between groups was tested using a generalized estimating equation logistic regression.ResultsFrom January 2018 to May 2022, 889 patients met the inclusion criteria; 326 provided VL results while filling at the HSSP and 681 had results while filling through a non-HSSP (118 patients provided results in both groups). Of the 5295 VL results, 90.6% reflected VL suppression, with the average rate of 91.0% in the HSSP group vs 86.0% in the non-HSSP group (adjusted OR = 1.89 95% CI: [1.40, 2.56]). Sex, ethnicity, and race were not associated with VL suppression. However, VL suppression decreased significantly with Charleson Comorbidity Index 1-3; increased with age; and increased over time from VL index date.ConclusionsHIV patients filling ARV therapy through a HSSP had a higher rate of VL suppression than those filling through non-HSSPs, highlighting the potential clinical benefit of this specialty pharmacy model.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"204-210"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000846","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

Key Articles and Guidelines in the Management of Chronic Coronary Disease. 慢性冠状动脉疾病管理的关键文章和指南。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-10-29 DOI: 10.1177/08971900251394069

Dave L Dixon, Tomasz Jurga, Michael Kelly, Dejan Landup, Yun Lu, Tracy Macaulay, Mark Munger, Nicholas Norgard, Kelly C Rogers, Toby Trujillo

引用次数: 0

Supporting Pharmacists with Legislative Changes: Pharmacist Knowledge and Comfort with Contraception Prescribing. 支持药剂师与立法变化：药剂师的知识和舒适的避孕处方。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-07-17 DOI: 10.1177/08971900251356350

Emily J Zielinski, Todd A Walroth, Kala L Sanders, Christopher J Wickesberg, Todd Bailey Cox, Rajarpreet Sandhu, Charity Cicak, Ashley H Meredith

{"title":"Supporting Pharmacists with Legislative Changes: Pharmacist Knowledge and Comfort with Contraception Prescribing.","authors":"Emily J Zielinski, Todd A Walroth, Kala L Sanders, Christopher J Wickesberg, Todd Bailey Cox, Rajarpreet Sandhu, Charity Cicak, Ashley H Meredith","doi":"10.1177/08971900251356350","DOIUrl":"10.1177/08971900251356350","url":null,"abstract":"BackgroundDue to contraceptive access scarcity and other variables, the U.S. exhibits high rates of unintended pregnancy, and Healthy People 2030 has a goal to address this through increased use of birth control. In 2023, Indiana passed legislation allowing pharmacists to prescribe self-administered contraception. Uptake of pharmacist contraceptive prescribing has been limited, and many states are not utilizing this opportunity to advance reproductive equity. We aimed to address significant gaps in literature assessing pharmacists' comfortability and knowledge regarding the implementation and utilization of this protocol.ObjectivesThe purpose of this study was to evaluate pharmacists' comfort and knowledge level before and after a formal education program on conducting contraceptive care via a pharmacist-driven protocol.MethodsThis was a retrospective, cohort study conducted at a safety-net, academic medical center in Indianapolis, Indiana. A formal education program with associated pharmacist surveys took place over two training sessions in November and December 2023.ResultsA total of 30 paired pre- and post-pharmacist surveys were included in analysis (63% response rate). The median [IQR] composite score (knowledge and comfort level) increased pre- vs post-survey from 38 [34,57] to 86 [81,91] (P < .001). Overall correct median [IQR] knowledge scores increased from 40% [40,50] to 70% [60,80] (P < .001). Overall median [IQR] comfort level scores increased from 36% [27,68] to 95% [86 100] (P < .001).ConclusionFollowing completion of a formal education program, pharmacists demonstrated an increase in knowledge and comfort level with prescribing contraception. Intentional training opportunities should be provided to pharmacists prior to implementation. Other health-systems could benefit from offering a similar program.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"165-171"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649801","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

Beyond the Bedside: Utilization of an On-Call Pharmacist to Bridge Gaps in Clinical Coverage for Select Critically ill Populations. 超越床边：利用一个随叫随到的药剂师，以弥合差距，在临床覆盖的选择重症人群。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-09-04 DOI: 10.1177/08971900251376800

Alyssa S Meester, Erica Caffarini, Mariela Cardona Gonzalez, Michael Young, Jordan DeWitt

{"title":"Beyond the Bedside: Utilization of an On-Call Pharmacist to Bridge Gaps in Clinical Coverage for Select Critically ill Populations.","authors":"Alyssa S Meester, Erica Caffarini, Mariela Cardona Gonzalez, Michael Young, Jordan DeWitt","doi":"10.1177/08971900251376800","DOIUrl":"10.1177/08971900251376800","url":null,"abstract":"PurposeTo describe the utilization of an on-call critical care pharmacist to bridge gaps in clinical coverage for subspecialized critically ill populations.MethodsIn October 2022, a 24/7 on-call team of medical and cardiac ICU pharmacists was established to field questions regarding patients with mechanical circulatory support and pulmonary hypertension. On-call pharmacists were available via centralized telephone number Monday through Friday from 4:00 p.m. to 8:00 a.m., and at all hours on weekends. Information characterizing calls received was collected in an electronic database. A review of all database entries through March 2025 was conducted and descriptive statistics were used to quantify calls received, time spent, multidisciplinary team member engagement, and types of interventions.ResultsOn-call pharmacists received 207 calls and documented 218 interventions. Calls were most often received between the hours of 4:00 p.m. and 8:00 a.m., and the median time spent per call was 10 minutes (IQR 5-20 minutes). On-call critical care pharmacists received the most calls for ECMO patients (38.2%), followed by pulmonary hypertension (26.1%) and Impella® patients (20.8%). The majority of inquiries were from pharmacists (35.7%), followed by advanced practice providers (33.3%) and physicians (21.3%). Anticoagulation and hemostasis was the most commonly cited intervention category (56.4%).ConclusionIn the absence of an onsite critical care pharmacist, a 24/7 on-call critical care pharmacist was utilized by members of the multidisciplinary team to bridge gaps in clinical coverage. Further research is needed to determine the pharmacoeconomic and clinical impacts of on-call critical care pharmacists when onsite resources are unavailable.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"211-218"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992833","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

Asymptomatic Subcutaneous Semaglutide Overdose: A Case Report and Literature Review. 无症状皮下注射西马鲁肽过量1例报告及文献复习。

IF 1.1

Journal of pharmacy practice Pub Date : 2026-06-01 Epub Date: 2025-04-15 DOI: 10.1177/08971900251335111

Courtney B Diec, Elizabeth A Cook, Nguyet T Nguyen

{"title":"Asymptomatic Subcutaneous Semaglutide Overdose: A Case Report and Literature Review.","authors":"Courtney B Diec, Elizabeth A Cook, Nguyet T Nguyen","doi":"10.1177/08971900251335111","DOIUrl":"10.1177/08971900251335111","url":null,"abstract":"Semaglutide is a glucagon-like-peptide-1 receptor agonist (GLP-1 RA) that is approved for the treatment of type 2 diabetes mellitus (T2DM) and obesity. Common adverse drug reactions (ADR) of semaglutide include nausea, vomiting, abdominal pain, constipation, and diarrhea, which are often dose-dependent in nature. Select ADRs that are less common, but may result in more significant concerns, include development of acute pancreatitis, gallbladder and biliary tract diseases, acute kidney injury, and ileus. Limited clinical literature exists at present regarding management of GLP-1 RA overdose, particularly for subcutaneous semaglutide. This report describes an 80-year-old male with T2DM and mild cognitive impairment who self-administered subcutaneous semaglutide 1 mg daily over the span of 7 days. The patient denied any ADRs, including those related to gastrointestinal upset or hypoglycemia. Blood glucose readings from the patient's glucometer ranged from 100 - 180 mg/dL. The patient declined to present for medical evaluation until 5 weeks after the overdose incident. No clinically significant changes were noted in his renal function, hepatic function, nor his pancreatic enzymes upon laboratory follow-up. Published reports concerning GLP-1 RA overdoses describe mixed presentation of patients following such events. Treatments detailed in the case reports included primarily supportive care measures. Based on the mechanism of action of GLP-1 RAs, and those case reports detailed, we recommend close monitoring and supportive care in the form of providing antiemetics, correcting fluid and electrolyte imbalances from gastrointestinal losses, and monitoring for hypoglycemia in the event of an overdose.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"219-224"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064101","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