Journal of pharmacy practice最新文献_第5页

Increasing the Rate of Venous Thromboembolism Chemoprophylaxis Administration Using the Electronic Medical Record. 利用电子病历提高静脉血栓栓塞预防药物的使用率。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2024-02-14 DOI: 10.1177/08971900241232565

Aaron B Pollock, Kevin N Harrell, M Victoria P Miles, Emily S Garrett, Breanna L Carter, Robert A Maxwell

{"title":"Increasing the Rate of Venous Thromboembolism Chemoprophylaxis Administration Using the Electronic Medical Record.","authors":"Aaron B Pollock, Kevin N Harrell, M Victoria P Miles, Emily S Garrett, Breanna L Carter, Robert A Maxwell","doi":"10.1177/08971900241232565","DOIUrl":"10.1177/08971900241232565","url":null,"abstract":"Introduction: Venous thromboembolism (VTE) remains a leading cause of preventable harm among hospitalized patients. Pharmacologic VTE prophylaxis reduces the rate of in-hospital VTE by 60%, but medication administration is often missed for various reasons. Electronic medical record (EMR) prompts may be a useful tool to decrease withholding of critical VTE chemoprophylaxis medications. Methods: In August 2021, an EMR prompt was implemented at a tertiary referral academic medical center mandating nursing staff to contact a provider for approval before withholding VTE chemoprophylaxis. A pre-intervention group from August 2020 to August 2021 was compared to a post-intervention group from August 2021 to August 2022. Rates of VTE chemoprophylaxis withholding were compared between the groups with a P < .01 considered significant. Results: A total of 16,395 patients prescribed VTE chemoprophylaxis were reviewed, with 13,395 (81.7%) receiving low molecular weight heparin. Of the 16,395 patients included, 10,701 (65.3%) were medical and 5694 (34.7%) were surgical. Patients in the pre-intervention cohort (n = 8803) and post-intervention cohort (n = 7592) were similar in hospital length of stay and duration of DVT prophylaxis. In the post-intervention group, the frequency of surgical patients with at least one missed dose had increased by 4.2% (P = .002), with the trauma and acute care surgery (TACS) show an increase of 6.6% (P < .001). However, the frequency of medical patients and non-TACS patients with missed doses decreased by 3.1% (P = .002) and 1.0% (<.001), respectively. Conclusions: EMR prompts appear to be a low-cost intervention that increases the rate of VTE prophylaxis administration among medical and elective surgery patients.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139735436","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

Comparison of Low Dose Recombinant Factor VIIa and 4-Factor Prothrombin Complex Concentrate for Treatment of Bleeding Related to Cardiac Surgery. 小剂量重组因子 VIIa 与 4 因子凝血酶原复合物浓缩物治疗心脏手术相关出血的比较。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2024-01-23 DOI: 10.1177/08971900241228766

Lauren Caldwell, Rima Bhakta, Neha Naik, B D Knowles, Jessica Parker, Megan Van Berkel Patel

{"title":"Comparison of Low Dose Recombinant Factor VIIa and 4-Factor Prothrombin Complex Concentrate for Treatment of Bleeding Related to Cardiac Surgery.","authors":"Lauren Caldwell, Rima Bhakta, Neha Naik, B D Knowles, Jessica Parker, Megan Van Berkel Patel","doi":"10.1177/08971900241228766","DOIUrl":"10.1177/08971900241228766","url":null,"abstract":"Background: Recombinant factor VIIa (rFVIIa) and prothrombin concentrate complex (PCC) are used for uncontrolled bleeding in cardiac surgery (CS), however, there are limited direct comparisons of these agents. Objective: To evaluate the efficacy and safety of rFVIIa and PCC in CS related bleeding. Methods: This retrospective study included adult CS patients who received either low dose rFVIIa (<30 mcg/kg) or 4-factor PCC. The primary outcome was transfusion requirements of packed red blood cells (pRBC) within 6 hours of factor administration. Secondary efficacy outcomes included transfusion requirements 0-18 hours, doses of additional factor product, thrombotic events, and acute kidney injury (AKI). Results: A total of 179 patients were included (n = 78 rFVIIa; n = 101 PCC). Of patients who received blood products, there was no difference in the requirement of pRBCs within 6 hours (73.8 vs 68.9%, P = .5359) or in the median amount of pRBC transfused (500 mL vs 640 mL, P = .0723) in the rFVIIa and PCC groups respectively. Patients in the PCC group were more likely to require additional factor products (24.4% vs 47.5%, P = .0015), develop AKI (12.8% vs 25.7%, P = .0325), have longer ICU lengths of stay [2 (IQR 1-5) vs 4 (IQR 2-6), P = .0487] and greater in-hospital mortality (2.6% vs 10.9%, P = .033). There was no difference in thrombotic events. Conclusion: Although, there was no difference in pRBC transfusion requirements between PCC and rFVIIa, more patients in the PCC group required additional factor products and had increased adverse effects. Further comparisons of PCC and rFVIIa are warranted.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542562","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

Statin-Induced Myopathy in a Patient with Schwartz-Jampel Syndrome. 一例Schwartz-Jampel综合征患者的他汀类药物诱导的肌病。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2023-11-06 DOI: 10.1177/08971900231213694

Mandeep K Rajpal, Farah K Sedki, Tony J Eid

引用次数: 0

Hydroxychloroquine-Induced Hypoglycemia in a Patient Without Diabetes. 羟氯喹诱发一名无糖尿病患者的低血糖症。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2024-01-19 DOI: 10.1177/08971900241228762

Madison Mcknight, B Tate Cutshall, Sami Sakaan, Nisreen Abu Al Hommos, Drew A Wells

引用次数: 0

Safety and Feasibility of Opening Tamsulosin Capsules for Enteral Feeding Tube Administration. 打开坦索罗辛胶囊用于肠内饲管给药的安全性和可行性。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2024-02-20 DOI: 10.1177/08971900241233615

Victoria Fazio, Jerry Altshuler, Yong-Bum Song

{"title":"Safety and Feasibility of Opening Tamsulosin Capsules for Enteral Feeding Tube Administration.","authors":"Victoria Fazio, Jerry Altshuler, Yong-Bum Song","doi":"10.1177/08971900241233615","DOIUrl":"10.1177/08971900241233615","url":null,"abstract":"Purpose: Tamsulosin is formulated as sustained release beads within a capsule to prevent rapid absorption and associated hypotension. The package insert advises the capsule is swallowed whole; not crushed, chewed, or opened. To our knowledge, there are no current data on opening capsules for adults with enteral tube feeds. Given the unidentified safety and efficacy of administration via enteral tubes, alternative alpha blockers with less selectivity for alpha1A are often used. Methods: A single center retrospective chart review was conducted at two hospital sites. Adult patients that received at least one dose of tamsulosin or doxazosin while an enteral feeding tube was placed were included. Safety outcomes evaluated were the number of documented tube obstructions and incidence of medication associated hypotension. Results: 169 patients were included. Ten enteral feeding tube obstructions were reported, 4 of 110 (3.64%) in the tamsulosin arm and 6 of 59 (10.17%) in the doxazosin arm (RR .36, 95% CI .11 to 1.22, P = .099). At least 1 episode of medication associated hypotension occurred in 22 of 98 (22.45%) in the tamsulosin arm and 20 of 49 (40.82%) in the doxazosin arm (RR .55, 95% CI .33 to .91, P = .019). Conclusion: There was no statistically significant difference in the number of tube obstructions between patients receiving tamsulosin or doxazosin via enteral tube feeds. Patients receiving doxazosin were at increased risk of experiencing medication related hypotension. Tamsulosin capsules may be opened and administered via enteral feeding tubes if administered with content integrity intact.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912904","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 Angiotensin Blockade on Development of Chronic Lung Allograft Dysfunction. 血管紧张素阻断对慢性肺移植物功能障碍发展的影响。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2023-11-03 DOI: 10.1177/08971900231213699

Spenser E January, Julie Hubbard, Keith A Fester, Casey A Dubrawka, Rodrigo Vazquez Guillamet, Hrishikesh S Kulkarni, Ramsey R Hachem

{"title":"Impact of Angiotensin Blockade on Development of Chronic Lung Allograft Dysfunction.","authors":"Spenser E January, Julie Hubbard, Keith A Fester, Casey A Dubrawka, Rodrigo Vazquez Guillamet, Hrishikesh S Kulkarni, Ramsey R Hachem","doi":"10.1177/08971900231213699","DOIUrl":"10.1177/08971900231213699","url":null,"abstract":"Background: The renin-angiotensin-aldosterone system (RAAS) is responsible for a multitude of physiological functions, including immunological effects such as promotion of TGF-β and upregulation of IL-6 and IL-8 which are also implicated in the development of chronic lung allograft dysfunction (CLAD). Blockade of the RAAS pathway in pre-clinical models has demonstrated a decrease in these cytokines and pulmonary neutrophil recruitment. Objective: This study sought to evaluate whether use of RAAS inhibitor (RAASi) in lung transplant recipients impacted CLAD-free survival. Methods: In this retrospective, single-center study, 35 lung transplant recipients who received a RAASi post-transplant were compared to 70 lung transplant recipients not exposed to a RAASi and were followed for up to 5 years post-transplant. Results: The incidence of CLAD did not differ based on RAASi treatment (34.3% in RAASi vs 38.6%, P-value .668). This was confirmed with a multivariable Cox proportional hazards model with RAASi initiation as a time-varying covariate (RAASi hazard ratio of 1.01, P-value .986). Incidence of hyperkalemia and acute kidney injury were low in the RAASi group. Conclusions: This study demonstrated no association between post-transplant RAASi use and decreased risk of CLAD development. RAASi were also well tolerated in this patient population.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482777","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

Novel Drug-Drug Interaction of Potential Rifabutin-Induced Edoxaban Failure: A Case Report. 瑞福汀可能导致依多沙班失效的新药相互作用：一例报告。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2023-11-06 DOI: 10.1177/08971900231213702

Cameron Lanier, Madeline Fuller, Blair Abelson Reece

{"title":"Novel Drug-Drug Interaction of Potential Rifabutin-Induced Edoxaban Failure: A Case Report.","authors":"Cameron Lanier, Madeline Fuller, Blair Abelson Reece","doi":"10.1177/08971900231213702","DOIUrl":"10.1177/08971900231213702","url":null,"abstract":"Purpose: To report an incident of a breakthrough deep vein thrombosis (DVT) and potential example of a drug-drug interaction in a patient treated with edoxaban and rifabutin who was being treated for respiratory tuberculosis. Case: A 76-year-old male presented with anemia requiring transfusion and subsequent shortness of breath that was later diagnosed to be respiratory tuberculosis. He experienced a prolonged hospital stay due to persistently positive Mycobacterium tuberculosis respiratory samples and a complicated social situation that required continuous hospitalization for approximately five months. During his treatment the patient was transitioned from apixaban to edoxaban due to a drug-drug interaction with rifabutin. He subsequently had a DVT while on edoxaban after two months of therapy that would require him to transition to warfarin. Conclusion: This case represents an example of a potentially significant drug-drug interaction between edoxaban and rifabutin. Other direct oral anticoagulants (DOACs) exhibit a potential drug-drug interaction that limit their effectiveness when used with rifamycins. This report describes the first known case of a patient experiencing a DVT after prolonged edoxaban use in combination with rifabutin. Treatment with DOACs for patients taking concomitant cytochrome P450 (CYP) inducers such as rifabutin may be more complicated than previously believed.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482778","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

A Continuing Pharmacy Education (CPE) Program Assessing Cannabidiol (CBD) Knowledge and Confidence Among Practicing Pharmacists. 评估执业药剂师对大麻二酚（CBD）知识和信心的继续药学教育（CPE）计划。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2023-11-07 DOI: 10.1177/08971900231213938

Sarah E Farmer, John A Arnold, Peter J Hughes, Kevin Pan, Greg S Gorman

{"title":"A Continuing Pharmacy Education (CPE) Program Assessing Cannabidiol (CBD) Knowledge and Confidence Among Practicing Pharmacists.","authors":"Sarah E Farmer, John A Arnold, Peter J Hughes, Kevin Pan, Greg S Gorman","doi":"10.1177/08971900231213938","DOIUrl":"10.1177/08971900231213938","url":null,"abstract":"Background: Increased patient utilization of cannabidiol (CBD) leads to potential drug interactions with various medications and questions posed to pharmacists. Objective: To quantify the knowledge gap of pharmacists on CBD and CBD-containing products and assess the degree a continuing pharmacy education (CPE) program alters pharmacist confidence and competency on CBD knowledge. Methods: A 1-h CPE activity was offered as a home study from May 9, 2022, through September 30, 2022. Subjects were practicing pharmacy preceptors in Alabama who completed the pre-survey and post-survey for inclusion in matched-pair analyses. The primary outcome measure was participant score improvement between the pre-post surveys. Secondary measures involved pre-post comparisons on self-rated Likert questions concerning participant confidence in counseling, answering drug information questions, and ensuring patient safety regarding CBD. Results: A total of 124 participants completed the course. After matched pairing, 64 and 56 individuals were included in the knowledge-based and confidence ranking analyses, respectively. Participant scoring improved on the knowledge-based questions between the pre-post surveys (50.0% vs 87.8%, P < .001). There was a significant confidence improvement of participants from baseline on counseling patients about prescription or over-the-counter CBD products, answering questions from other healthcare professionals about these products, and ensuring patient safety while using these products (Average 5-level Likert scale increases of 1.75, 1.73, 1.70, respectively; all P < .001). Conclusion: Implementation of a CPE program improved practicing pharmacists' knowledge on information about CBD, which lead to increased competency on counseling patients, answering drug information questions, and promoting patient safety.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482775","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

Elevated Anti-Xa in the Setting of Prophylactic Unfractionated Subcutaneous Heparin Administration. 预防性注射皮下注射肝素后抗 Xa 升高。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2024-01-18 DOI: 10.1177/08971900241228951

Tatiana Weinstein, Diana Altshuler, Elyse Lafond, Alyson Katz

引用次数: 0

A Comparison of Vancomycin Area Under the Curve and Trough Concentration in Specific Populations. 比较万古霉素在特定人群中的曲线下面积和低浓度。

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Journal of pharmacy practice Pub Date : 2024-09-30 DOI: 10.1177/08971900241287274

Kadaajah L T Johnson-Louis, My-Linh Nguyen, Rosemary K Zvonar

{"title":"A Comparison of Vancomycin Area Under the Curve and Trough Concentration in Specific Populations.","authors":"Kadaajah L T Johnson-Louis, My-Linh Nguyen, Rosemary K Zvonar","doi":"10.1177/08971900241287274","DOIUrl":"https://doi.org/10.1177/08971900241287274","url":null,"abstract":"Background: Vancomycin is an antibiotic known to cause nephrotoxicity, particularly when a vancomycin trough of 15 to 20 mg/L, a surrogate for an area under the curve (AUC) of at least 400 mgh/L, is targeted. Although monitoring vancomycin AUC is more resource intensive, it may especially benefit populations expected to be at higher risk of nephrotoxicity. Objective: To describe the proportion of discordance between vancomycin AUC and trough concentration in targeted high-risk populations. Methods: A prospective observational review was conducted on adults receiving intravenous vancomycin for more than 48 hours from May 9 to June 3, 2022. Patients included were elderly, obese, had renal dysfunction, and/or received 4 grams or more of vancomycin daily with a pending vancomycin trough concentration. A peak concentration was ordered by a project team member to calculate AUC to assess discordance. Results: A total of 47 patients were included with 87 vancomycin minimum concentration (Cmin)/AUC pairs analyzed. Discordance was observed in 52.9% of Cmin/AUC pairs in the entire cohort. The majority (79%) of the 43 Cmin levels <15 mg/L had an associated AUC >400 mgh/L and 57% of 21 Cmin levels within the 15 to 20 mg/L range had an AUC >600 mgh/L. Conclusion: A high degree of discordance between vancomycin Cmin and AUC was present in patients considered to be at high risk of nephrotoxicity. Monitoring vancomycin AUC in these patients may reduce the risk of nephrotoxicity.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348904","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