Journal of pharmacy practice最新文献

{"title":"Review of Over the Counter and Prescription Continuous Glucose Monitoring.","authors":"Julia Arriazola, Joshua Wollen, Shantera Davis, Elisabeth M Wang, Gia Tran, Natalie Rosario","doi":"10.1177/08971900251328832","DOIUrl":"https://doi.org/10.1177/08971900251328832","url":null,"abstract":"<p><p>Patients with diabetes often self-monitor their blood sugars to assess whether their blood sugar levels are within goal, above goal (hyperglycemia), or below goal (hypoglycemia) based on provider or guideline recommendations. With advancements in diabetes technologies such as wearable glucose biosensors and continuous glucose monitors (CGM), many patients can reduce the number of times they must lance their fingers. The first over-the-counter wearable glucose biosensors for patients with diabetes who do not use insulin or for healthy adults wanting to track their health became available for purchase in 2024. Pharmacists must be equipped to answer patient questions regarding these new methods of self-monitoring blood sugars with wearable glucose biosensors whether the product is OTC or a prescription CGM. This commentary describes the landscape of wearable glucose biosensors with prescription and OTC devices.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251328832"},"PeriodicalIF":1.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657582","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}

{"title":"Thrombosis Secondary to Intravenous Dicyclomine Administration: A Case Report and Literature Review.","authors":"Melissa Santibañez, Nicole Lounsbury, Maricela Moreno, Devada Singh-Franco","doi":"10.1177/08971900251326808","DOIUrl":"https://doi.org/10.1177/08971900251326808","url":null,"abstract":"<p><p><b>Introduction:</b> Dicyclomine is an antimuscarinic agent approved for treatment of irritable bowel syndrome-associated abdominal pain. Intravenous (IV) administration should be avoided due to potential for thrombosis, but real-world evidence is generally lacking. This case report presents a thrombotic complication associated with inadvertent IV administration of dicyclomine. <b>Case:</b> A 43-year-old man with chronic colitis and recurrent <i>Clostridioides difficile</i> infections presented to a community hospital complaining of moderate-severe suprapubic abdominal pain and nausea/vomiting/diarrhea for 5 days. Computed tomography showed descending colonic wall thickening and proctitis, without perforation or abscess. Initial orders consisted of ketorolac 15 mg IV and dicyclomine 20 mg intramuscularly. The nurse inadvertently mixed ketorolac and dicyclomine in the same syringe and administered them simultaneously. Ultrasound subsequently confirmed a non-occlusive right axillary vein thrombosis and an occlusive superficial right basilic vein thrombosis. The patient was started on therapeutic enoxaparin subcutaneously. He was enrolled in a patient assistance program and was discharged on rivaroxaban dispensed from the hospital's outpatient pharmacy. <b>Discussion:</b> Dicyclomine is more selective for the M₁ and M₃ receptors, and the M₃ receptor causes nitric oxide activation. As dicyclomine was unintentionally administered IV, the inhibition of nitric oxide could potentially lead to clotting. The simultaneous administration of ketorolac promoted a pro-thrombotic state, via cyclo-oxygenase-2-mediation vasoconstriction. Naranjo algorithm assessment indicated \"possible\" potential for a drug-induced adverse event. The pharmacist submitted an adverse drug event report and revisions to barcode medication administration were implemented. <b>Conclusion:</b> Thrombotic complications are possible following IV dicyclomine administration and pharmacy personnel must implement safeguards to prevent inadvertent administration.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251326808"},"PeriodicalIF":1.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630496","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}

{"title":"Lurasidone-Induced Tardive Dyskinesia Reversed With Lithium Therapy: A Case Report.","authors":"Alice Gelman, Tamar Jacobsohn, Hyogun Yi, Aaron Pinkhasov","doi":"10.1177/08971900251326824","DOIUrl":"https://doi.org/10.1177/08971900251326824","url":null,"abstract":"<p><p>Tardive dyskinesia (TD) is a syndrome that causes chronic, involuntary, and disruptive movements of the body and/or face that is a severe, potentially irreversible adverse effect of long-term antipsychotic use. It has wide-reaching effects on patients' well-being, quality of life,¹ and treatment adherence.² Thus, TD is debilitating, leading to social withdrawal,³ and workplace absenteeism.¹ Current data on tardive dyskinesia treatment are limited, and prevention, primarily through the modification of antipsychotic regimens, remains the most effective strategy.⁴ Recent systematic review has shown valbenazine and vitamin E are the only treatments significantly more effective compared to placebo in treatment of TD, although valbenazine is associated with significant side effects.⁵ We present a case of a 76-year-old female with a diagnosis of Bipolar II Disorder (BD) who developed TD after treatment with lurasidone for 10 years. After struggling with both her BD and TD symptoms for 3 years, she sought care at our clinic where we prescribed 300 mg daily of lithium. At her follow-up visit 5 weeks later, her TD symptoms were greatly improved, with sustained benefits observed at following visits. This article reviews the literature discussing the interplay between lithium and TD and presents a case report of TD improvement after lithium augmentation for treatment-resistant depression. While this case suggests a potential role in TD treatment, the role of lithium in TD treatment remains controversial.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251326824"},"PeriodicalIF":1.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630470","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}

{"title":"Priapism Associated With the Rapid Titration of Prazosin: A Case Report.","authors":"Alexis Marcon, Archana Jhawar, Colleen Shields, Zane Elfessi","doi":"10.1177/08971900251326798","DOIUrl":"https://doi.org/10.1177/08971900251326798","url":null,"abstract":"<p><p>Priapism is a urologic emergency that is defined as a prolonged erection in the absence of sexual stimulation. Ischemic priapism is the most common form and is characterized by low arterial blood flow and absent venous outflow. Some potential triggers of ischemic priapism include malignancy, sickle cell disease, illicit drug use, and certain medications. Prazosin, an alpha-1 adrenergic antagonist, is used for the treatment of chronic hypertension, benign prostate hyperplasia, and (post-traumatic stress disorder (PTSD) related nightmares. The alpha-adrenergic antagonistic effect of prazosin results in decreased venous blood flow, including to the smooth muscle tissue located within the corpus cavernosum. Slowly titrating prazosin allows the body to adapt to the vasodilatory effects of the medication. Without titration, a dysregulation in blood flow to the penile vasculature can result in prolonged erection. We report a case of priapism that resulted due to rapid titration of prazosin.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251326798"},"PeriodicalIF":1.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630494","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}

{"title":"Pharmacist Integration to Support Continuous Glucose Monitoring Initiation: A Collaborative, Patient-Centered Approach.","authors":"James Thurston, Hanlin Li, Mangala Rajan, Yuliya Baratt, Amber Bradley, Fred Pelzman","doi":"10.1177/08971900251327078","DOIUrl":"https://doi.org/10.1177/08971900251327078","url":null,"abstract":"<p><p><b>Objective:</b> The development of continuous glucose monitoring (CGM) has allowed for improved glycemic control among patients with diabetes. Clinical pharmacists possess medication expertise and can provide support for increased CGM utilization through device education and affordability assistance, but there is limited evidence evaluating the effectiveness of clinical pharmacist-assisted CGM initiation. The objective of this study was to examine how clinical pharmacist-assisted CGM implementation can impact glycemic control for patients with diabetes. <b>Methods:</b> This is a retrospective pre-post study that evaluated change in A1c among patients who were assisted with CGM device implementation by a clinical pharmacist between January 1, 2019, and December 31, 2023. The primary outcome of this study was change in A1c from baseline (prior to CGM initiation) to the next subsequent A1c following CGM initiation. The study team also investigated change in A1c among a subgroup of patients followed independently by clinical pharmacists practicing under a collaborative drug therapy management (CDTM) agreement. <b>Results:</b> Pharmacist-assisted CGM initiation led to a statically significant decrease in mean A1c of -0.71 (CI 95% 0.41-1.00, <i>P</i> < 0.001) across all patients. Within the CDTM subgroup, the mean A1c difference was -1.60 (CI 95% 0.64-2.55, <i>P</i> = 0.002) while in the non-CDTM subgroup, the mean A1c difference was -0.50 (CI 95% 0.22-0.78, <i>P</i> < 0.001). <b>Conclusions:</b> Clinical pharmacists are effective at helping patients with diabetes reduce their A1c through assisting with CGM initiation, education, and follow-up. Among patients included in this study, those followed by pharmacists practicing under CDTM agreements saw the greatest amount of A1c reduction.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251327078"},"PeriodicalIF":1.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630492","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}

{"title":"Seizures Associated With High-Dose Cefazolin in a Patient With Renal Dysfunction: A Case Report.","authors":"Kulwant Kingra, Robert E Ariano, Aditya Sharma","doi":"10.1177/08971900251326735","DOIUrl":"https://doi.org/10.1177/08971900251326735","url":null,"abstract":"<p><p><b>Introduction and Objective:</b> Cefazolin-induced encephalopathy and seizures are possibly related to excessive dosing; especially in those with renal dysfunction. This report aims to highlight the importance of dose adjustments of cefazolin in patients with diminished renal function. <b>Case Presentation:</b> An 87-year-old female with a history of cognitive impairment, remote cerebellar infarcts, hypertension, and hypothyroidism presented with acute delirium associated with a urinary tract infection. Her condition worsened and she was found to have a methicillin-sensitive <i>Staphylococcus aureus</i> bacteremia for which she was started on cefazolin 2 grams intravenously every 4 hours. Based on her renal function, recommended dosing would have been 2 grams intravenously every 12 hours. After 3 days on this regimen her mentation declined and she suffered a tonic-clonic seizure. She did not regain consciousness and was transitioned to comfort care prior to her death. <b>Discussion:</b> Supratherapeutic dosing of cefazolin may have led to significant neurotoxic effects. Neurotoxicity and seizures can occur with drug accumulation from an increase in excitatory neurotransmitters along with a decrease in inhibitory neurotransmitter activity. The effect is potentiated by older age, pre-existing central nervous system conditions, and renal failure. Therapeutic drug monitoring is a potential strategy to limit the risk of drug toxicity. <b>Conclusion:</b> This case outlines a poor outcome in the context of high-dose cefazolin. It serves as a reminder to clinicians for ongoing pharmacovigilance in adhering to treatment guidelines.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251326735"},"PeriodicalIF":1.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615822","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}

{"title":"Single-Dose Gentamicin vs Standard Care for Treatment of Acute Uncomplicated Cystitis in Premenopausal Women: A Randomized Trial.","authors":"Vincent Peyko, Jacob Sieger, Joseph Dombroski","doi":"10.1177/08971900251322368","DOIUrl":"https://doi.org/10.1177/08971900251322368","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTI) are a disease of serious impact on every country in the world. Growing resistance has decreased the efficacy of many antimicrobial options. Aminoglycosides, like gentamicin, have long been used to treat gram-negative bacteria including UTIs.</p><p><strong>Objectives: </strong>The goal of this study was to compare single dose gentamicin to standard oral seven-day treatment in the emergency department for uncomplicated cases of acute uncomplicated cystitis in premenopausal women.</p><p><strong>Methods: </strong>This was a randomized, open-label clinical trial of women at least 18 years of age, that were premenopausal, non-pregnant, with clinical signs of UTI and nitrite positive urine in the emergency department. Patients received either single-dose gentamicin or standard care for 7 days. Patients were contacted by telephone at 7 and 30 days and asked about clinical resolution of their UTI. The primary outcome of this study was symptom resolution at 7 days.</p><p><strong>Results: </strong>Among those with 7-day telephonic follow-up, self-reported symptom resolution was 83.3% (25/30) among gentamicin treated patients and 48.1% (13/27) in the standard care group (X² = 7.917, <i>P</i> = .005).</p><p><strong>Conclusion: </strong>Single-dose gentamicin for acute uncomplicated cystitis in premenopausal, nitrite positive women was an appropriate UTI treatment and more effective than standard care for symptom resolution at 7-days in our patient population. This strategy has the potential to revolutionize treatment by offering an antibiotic with high sensitivities, high efficacy, simple administration in many different healthcare settings, 100% compliance, and increased patient satisfaction for acute cystitis treatment.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251322368"},"PeriodicalIF":1.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440929","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}

{"title":"Methemoglobinemia in the Setting of Hemolysis: A Case Report Suggesting Reflex Lab for Patients with Oxygen Saturation Gap for Early Detection and Diagnosis.","authors":"Christine Pham, Nicole Williams, Sarah Zavala","doi":"10.1177/08971900251321701","DOIUrl":"https://doi.org/10.1177/08971900251321701","url":null,"abstract":"<p><p>Methemoglobinemia typically presents as functional anemia and hypoxemia. It is often recognized by a discordance between the pulse oximeter reading and the oxygen saturation measured on arterial blood gas. Methemoglobinemia can be inherited or acquired, with some commonly-used medications recognized as causative agents. In patients with hemolytic anemia such as in glucose-6-phosphate dehydrogenase deficiency, hemolysis may be the main clinical presentation, with acquired methemoglobinemia after exposure to oxidizing agents. We present a case report of methemoglobinemia in the setting of hemolysis, with a new approach to coordinate with laboratory services to create a reflex lab to test for methemoglobinemia under certain conditions. This may improve time to recognition and treatment for patients with methemoglobinemia, as patient presentation as well as SpO2 and PaO2 discordance may be missed by less experienced providers.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251321701"},"PeriodicalIF":1.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433358","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}

{"title":"Improvements in Asthma Control After Pharmacist Involvement in an Outpatient Pediatric Asthma Clinic.","authors":"Lauren Anthony, Sandra Axtell, Bianca Nixon","doi":"10.1177/08971900251320740","DOIUrl":"https://doi.org/10.1177/08971900251320740","url":null,"abstract":"<p><p><b>Background:</b> Asthma is one of the most common pediatric disease states. However, current literature about outpatient pharmacy appointment effectiveness on pediatric asthma control is not widely available. <b>Objective:</b> To determine whether outpatient pharmacist visits in pediatric patients with asthma result in a measurable difference in asthma control, utilizing the validated asthma control test (ACT) and childhood asthma control test (C-ACT) scoring tools. <b>Methods:</b> This study enrolled 16 children ages 6-17 years old at an outpatient primary care clinic (November 2023-April 2024). The patients visited the outpatient pharmacist 2 to 3 times over a 12-week period. The primary outcome was the change in the patient's ACT or C-ACT from the baseline to the final study visit. Additional outcomes of interest included improvement in inhaler technique using a Vitalograph AIM® device, medication adherence rates, and change in emergent interventions from 6 months before enrollment compared to 3 months after the final visit. <b>Results:</b> The median improvement in asthma control test was 3 at the final study visit (4 or 12 weeks after counseling), which was statistically significant (<i>P</i> = 0.0348). This was an improvement from 50% of patients controlled at baseline to 100% at the final visit (<i>P</i> = 0.0053). Emergent interventions including oral steroid courses, emergency department visits, and hospitalization for asthma were less common after pharmacist intervention than before enrollment (<i>P</i> = 0.0464). Improvements in technique were seen at the initial visit using Vitalograph AIM® to visualize counseling points. <b>Conclusion:</b> Our study supports that outpatient pharmacist visits can have a measurable impact on pediatric asthma control.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251320740"},"PeriodicalIF":1.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425627","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}

{"title":"The Safety and Tolerability of High Dose Intravenous Push Levetiracetam.","authors":"Melissa Brandes, Tara Flack, William B Hays","doi":"10.1177/08971900251320159","DOIUrl":"https://doi.org/10.1177/08971900251320159","url":null,"abstract":"<p><p><b>Objective:</b> Levetiracetam (LEV) is a guideline-recommended antiepileptic that has been shown to be effective in the termination of status epilepticus. Traditionally, LEV is diluted in 100 mL of compatible fluid and administered as an intravenous (IV) piggyback over 15-60 minutes. Recent data supports the administration of LEV as an undiluted IV push. However, there is limited literature supporting the safety and tolerability of undiluted IV push administration of high dose LEV (2500 mg to 4500 mg). The purpose of this study was to further investigate safety and tolerability of IV push levetiracetam at doses 2500 mg and greater. <b>Methods:</b> A retrospective chart review was conducted to evaluate adverse drug reactions following IV push administration of levetiracetam at a dose of 2500 mg or greater between the dates 8/5/2021 to 6/30/2022. During chart review, each patient was evaluated for any adverse events that occurred utilizing provider documentation, significant event forms, and/or allergy list documentation following administration of IV push LEV. <b>Results:</b> Throughout the study period, 340 doses of LEV 2500 mg and greater were evaluated. Most common total dose was 3000 mg and weight-based dose was 50-59.99 mg/kg. 119 doses of 4000 mg or greater were evaluated. 338/340 (99.4%) doses were considered to be well-tolerated. One patient experienced erythema at the injection site and another patient was noted to have nystagmus. <b>Significance:</b> This study adds to the body of literature that rapid administration of undiluted LEV, including doses of 2500 mg to 4500 mg is safe and tolerable.</p>","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"8971900251320159"},"PeriodicalIF":1.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425629","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}