Journal of pharmacy practice最新文献_第9页

Comparison of Fixed Dosing vs Train of Four Titration of Cisatracurium in COVID-19 ARDS Patients. COVID-19 ARDS 患者中顺阿曲库铵固定剂量与四次滴定的比较。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2023-12-12 DOI: 10.1177/08971900231220438

Oyshik Banerjee, Jessica L Elefritz, Bruce A Doepker, Sara A Atyia, Nathan E Brummel, Rachel M Smith, Demond Handley, Kari M Cape

{"title":"Comparison of Fixed Dosing vs Train of Four Titration of Cisatracurium in COVID-19 ARDS Patients.","authors":"Oyshik Banerjee, Jessica L Elefritz, Bruce A Doepker, Sara A Atyia, Nathan E Brummel, Rachel M Smith, Demond Handley, Kari M Cape","doi":"10.1177/08971900231220438","DOIUrl":"10.1177/08971900231220438","url":null,"abstract":"Background: Early neuromuscular blockade with cisatracurium has been associated with improved outcomes in moderate-severe acute respiratory distress syndrome (ARDS). Previous studies have demonstrated increased drug utilization without benefits in oxygenation using fixed dose cisatracurium compared to train-of-four (TOF) titration. Objective: We sought to compare a novel, lower fixed dose cisatracurium protocol to TOF titration evaluating the impact on PaO2:FiO2 ratio (P/F). Methods: We conducted a single-center retrospective cohort study comparing fixed dose cisatracurium to TOF titration. We included patients aged 18-89 treated for COVID-19 ARDS with a baseline P/F≤200 who received a cisatracurium infusion for ≥12 h. The primary outcome was change in P/F at 48 h from baseline. Secondary outcomes included change in P/F at 24 h and 7 days, need for mechanical ventilation at day 28, and cisatracurium utilization. Results: Analyses included 125 patients (fixed dose = 65, TOF = 60). Severe ARDS was common with a baseline median P/F of 73.7 vs 79.5, P = .133. The change in P/F at 48 h was larger in the TOF cohort in the adjusted analysis (24.9 vs 70.8, P < .005). The rate and total cumulative dose of cisatracurium were higher in the fixed dose cohort (5 vs 3 mcg/kg/min, P < .001; 1034 vs 612 mg, P < .001) despite similar infusion durations (44.1 h vs 48.5 h, P = .642). Conclusions: Patients in the TOF cisatracurium cohort had improved P/F at 48 h compared to the fixed dose cohort, while also using only 60% of the cumulative dose. Future directions should include analysis of the implications of increased cisatracurium exposure on patient outcomes.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"1082-1090"},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805496","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 Antibiotic Allergy in the Ambulatory Setting Using a Standardized Questionnaire. 使用标准化问卷评估门诊环境中的抗生素过敏症。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2024-01-18 DOI: 10.1177/08971900241227977

Sarah M Yi, Mary Barsanti-Sekhar, Amy W Wozniak, Maressa Santarossa, Jenna Adams, Fritzie Albarillo

{"title":"Evaluation of Antibiotic Allergy in the Ambulatory Setting Using a Standardized Questionnaire.","authors":"Sarah M Yi, Mary Barsanti-Sekhar, Amy W Wozniak, Maressa Santarossa, Jenna Adams, Fritzie Albarillo","doi":"10.1177/08971900241227977","DOIUrl":"10.1177/08971900241227977","url":null,"abstract":"Patients are sometimes mislabeled as having an immune-mediated antibiotic allergy in their medical records. Therefore, the aim of this study was to investigate the prevalence of subjects with non-immune mediated reactions to antibiotics using a standardized questionnaire. Subjects aged 18 years and older with a documented antibiotic allergy were identified and recruited from 2 outpatient clinics in the greater Chicago area. Subjects completed a standardized questionnaire during a single visit regarding their previous adverse reaction to an antibiotic. For subjects with multiple documented antibiotic allergies, 1 questionnaire was filled out for each antibiotic allergy. Investigators subsequently evaluated the questionnaire responses to determine whether the adverse reaction was a true immune-mediated allergic reaction or an adverse drug reaction. A total of 98 subjects were recruited with completion of 159 questionnaires. Eighteen subjects (18.37%, 95% CI: 10.7%, 26.3%) had antibiotic allergy labels with no corresponding immune-mediated reaction history. There were 35 allergy labels (22.0%, 95% CI: 14.7%, 29.4%) that were unlikely to be immune-mediated. Antibiotics with the highest percentage of clinical histories that were unlikely to be immune-mediated were macrolides (8 of 11 subjects), nitrofurantoin (1 of 2 subjects), and amoxicillin/clavulanate (2 of 8 subjects). The most common antibiotic allergy labels were penicillin (43 of 159 subjects), sulfonamides (25 of 159 subjects), and fluoroquinolones (21 of 159 subjects). Identification of adverse reactions to antibiotics that are unlikely to be immune-mediated can be accomplished using a standardized questionnaire in the outpatient setting. Improved identification of low-risk antibiotic allergy labels can guide de-labeling initiatives to improve antibiotic prescribing.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"1121-1126"},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139491677","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

Outcomes in Variceal Bleeding Associated With Continuous Octreotide in Patients With Delayed Endoscopy. 内镜检查延迟患者持续使用奥曲肽治疗静脉曲张出血的疗效

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2024-01-19 DOI: 10.1177/08971900241228948

Matthew B Laws, Rebekah Wahking, Erin Blackburn, Whitney Williams, Aric Schadler, Megan Kunka Fritz

{"title":"Outcomes in Variceal Bleeding Associated With Continuous Octreotide in Patients With Delayed Endoscopy.","authors":"Matthew B Laws, Rebekah Wahking, Erin Blackburn, Whitney Williams, Aric Schadler, Megan Kunka Fritz","doi":"10.1177/08971900241228948","DOIUrl":"10.1177/08971900241228948","url":null,"abstract":"Background: Variceal hemorrhage treatment includes endoscopy within 12 hours of admission and octreotide therapy for 2-5 days post-endoscopy. Duration of pre-endoscopy octreotide can be prolonged when intervention is delayed. Objective: This study aimed to evaluate the impact of extended pre-endoscopy octreotide on rebleeding after endoscopy when comparing short vs long durations of post-endoscopy octreotide. Methods: This was a single center, retrospective cohort evaluating adult cirrhotic patients with esophageal variceal hemorrhage admitted between July 1, 2017 and June 30, 2020. Study groups included patients receiving octreotide ≥12 hours prior to endoscopy followed by ≤ 48 (short course) or >48 hours (standard course) after endoscopy. The primary outcome was post-endoscopy rebleeding, defined as hemoglobin decrease of ≥2 g/dL from baseline or the requirement of ≥1 unit of packed red blood cells. Results: Of the 169 patients included, 88 patients received short course octreotide after endoscopy, and 81 patients received standard course octreotide after endoscopy. Twenty-nine (33%) patients in the short course group and 43 (53.1%) in the standard course group experienced the primary endpoint (OR 2.3, 95% CI 1.24 - 4.29; P = .008). Conclusion: Extended pre-endoscopy octreotide may be beneficial in preventing rebleeding when intervention is delayed. Further studies are needed to determine the necessary octreotide duration in delayed endoscopy and varying bleeding risk.","PeriodicalId":16818,"journal":{"name":"Journal of pharmacy practice","volume":" ","pages":"1107-1115"},"PeriodicalIF":1.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139491686","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

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":" ","pages":"1157-1163"},"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

The Utah Pharmacy Summit: Collaborating to Optimize Patient Care. 犹他州药房峰会：合作优化患者护理。

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Journal of pharmacy practice Pub Date : 2024-10-01 Epub Date: 2024-01-23 DOI: 10.1177/08971900241228806

Weston Schmutz, Andre Hejazi, Diana Brixner, Caitlin Arnwine, Jonathan Magness

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":" ","pages":"1149-1156"},"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":" ","pages":"1164-1169"},"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

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":" ","pages":"1048-1054"},"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