American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists最新文献

{"title":"AHFS®  firstRelease™.","authors":"","doi":"10.1093/ajhp/zxaf079","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf079","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236721","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 authors reply.","authors":"Alicia E Mattson, Caitlin S Brown, Benjamin Sandefur, Daniel Cabrera, Steven T Haywood","doi":"10.1093/ajhp/zxaf145","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf145","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236722","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":"Trends in pediatric emergency medicine: Focus on behavioral health, substance use, and safety.","authors":"Heather Tilley, Anthony Enderby, Elizabeth VanWert, Sara Choi","doi":"10.1093/ajhp/zxaf127","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf127","url":null,"abstract":"<p><strong>Purpose: </strong>Recent studies have indicated that medication errors, behavioral health emergencies, and substance use remain a significant concern for children and adolescents within and outside the emergency department (ED). This clinical review will evaluate recent trends and literature to provide guidance for these specific areas of concern, with an emphasis on optimizing pharmacotherapeutic care in this high-risk population.</p><p><strong>Summary: </strong>National surveys have demonstrated that the quality of pediatric emergency care varies significantly across the US and most children are treated in EDs within nonchildren's hospitals by providers without specialized training in pediatrics. Variations in care quality emphasize concerns about pediatric medication safety. The rising rate of opioid overdose deaths, reports of harm associated with cannabis use, and behavioral health emergencies in the pediatric population highlight these as areas for intervention. Higher levels of pediatric readiness have been associated with reductions in short- and long-term mortality rates, suggesting that improved pediatric readiness may prevent pediatric deaths. In the American Academy of Pediatrics' policy statement on pediatric readiness in the ED, adding pharmacists with pediatric competency to ED teams was recommended as a practice to improve patient and medication safety.</p><p><strong>Conclusion: </strong>Higher levels of pediatric readiness provide an opportunity to improve outcomes for pediatric patients across the US. Medication errors, behavioral health emergencies, and substance use are some of the most pertinent issues affecting pediatric patients seeking emergency care today. By evaluating trends and recent literature within these areas, this clinical review highlights numerous opportunities to improve healthcare practices and pharmacotherapeutic care for pediatric patients.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218522","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":"Implementation of the VancomycIn per Pharmacy Education tRaining (VIPER) program for pharmacists at a children's hospital.","authors":"Laura Bio, Shabnam Gaskari, Hayden T Schwenk, Jeffrey Moss, Adam Frymoyer","doi":"10.1093/ajhp/zxaf142","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf142","url":null,"abstract":"<p><strong>Purpose: </strong>Pharmacists play a vital role in supporting the safe and efficacious use of vancomycin in children. However, vancomycin dosing in children is challenging, and recent recommendations for implementation of 24-hour area under the curve (AUC24)-based dosing and model informed precision dosing (MIPD) approaches introduce additional complexity. Herein, we describe the development and implementation of a \"VancomycIn per Pharmacy Education tRaining\" (VIPER) program that supports a pharmacy-led vancomycin therapeutic drug monitoring (TDM) service at a children's hospital.</p><p><strong>Summary: </strong>Our children's hospital implemented a formal VIPER program to educate and evaluate the competency of pharmacists on vancomycin therapeutic principles in children, including AUC24-based dosing and use of a commercially available MIPD tool. Pharmacists were required to complete the VIPER core program prior to managing TDM independently in children. VIPER maintenance programs were delivered annually to sustain and expand knowledge. Pharmacists' perceptions of VIPER were captured annually via survey. Since implementation of VIPER in 2020, over 100 pharmacists have received training. Overall, pharmacists rated the VIPER program highly, with 89% (96/108) agreeing or strongly agreeing that VIPER was an effective strategy for delivering institutional guideline updates and 84% (91/108) agreeing or strongly agreeing they felt more confident in vancomycin dose adjustments in children after VIPER. Competency assessment also demonstrated that pharmacist postcourse knowledge was high (a median score of ≥85% for each year).</p><p><strong>Conclusion: </strong>VIPER, a formal, yearly educational program, was successfully implemented at our hospital to help support a pharmacist-led vancomycin TDM service in children. The pharmacists reported high satisfaction with VIPER and agreed the program was a successful format for delivering education and improving skills.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228386","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":"Beyond the black and white: The nuances of RSI induction agents.","authors":"Steven T Haywood","doi":"10.1093/ajhp/zxaf144","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf144","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218520","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":"Selected infectious disease topics in the ED: Optimizing logistics to optimize care.","authors":"Tara Flack, Gavin T Howington","doi":"10.1093/ajhp/zxaf126","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf126","url":null,"abstract":"<p><strong>Purpose: </strong>Emergency medicine pharmacists (EMPs) are involved in many clinical decisions made at the bedside in the emergency department (ED). Along with answering clinical questions, pharmacists are often relied on to optimize logistical issues requiring coordination among multiple departments and clinical applications, such as the electronic medical record and automated dispensing cabinets. This article discusses 3 common infectious disease-related issues that pharmacists can assist with to ensure care is optimized during and after a patient's ED visit.</p><p><strong>Summary: </strong>This article first discusses antibiotic prophylaxis in injuries resulting in an open fracture. An open fracture sustained after a traumatic injury is a common ailment seen in the ED requiring prompt administration of antibiotics to prevent infectious complications. Barriers to timely administration and ways to optimize time to antimicrobial therapy are reviewed. Next, rabies postexposure prophylaxis is discussed, with a focus on appropriate administration of rabies immune globulin and a review of barriers to the attainment of follow-up rabies vaccine doses with suggested ways to optimize the care being delivered. Lastly, the treatment of sexually transmitted infections, specifically Chlamydia trachomatis and Neisseria gonorrhoeae, is discussed with a focus on guideline updates, medication administration logistics, and medication adherence opportunities.</p><p><strong>Conclusion: </strong>EMPs have an excellent understanding of both pharmacy practice and emergency medicine practice. Therefore, they are uniquely positioned to assist with improving workflows involving multiple departments, which ultimately optimizes patient care. While the opportunities are many, this article describes 3 areas within infectious diseases where an EMP can improve logistics and the overall patient experience.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210704","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":"Creating and expanding emergency medicine pharmacy services: What really moves the C-suite?","authors":"Preeyaporn Sarangarm, Megan Musselman","doi":"10.1093/ajhp/zxaf138","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf138","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218521","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":"Toxicology updates in emergency medicine.","authors":"Ryan Feldman, Jeremy Lund, Jessica Rivera Pescatore, Mathew Stanton","doi":"10.1093/ajhp/zxaf129","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf129","url":null,"abstract":"<p><strong>Purpose: </strong>Emergency medicine (EM) pharmacists play an important role in managing a wide range of toxicities, including overdoses, illicit substance use, chemical exposures, and envenomations. Their specialized expertise in pharmacotherapy, resuscitation, and drug mechanisms equips them to assess toxins, predict overdose effects, and collaborate with toxicologists and poison centers to optimize patient care. However, the rapidly evolving field of toxicology presents ongoing challenges, such as staying current with new toxins, addressing antidote shortages, and adapting to shifting treatment paradigms.</p><p><strong>Summary: </strong>This article offers a comprehensive review of key toxicology topics relevant to EM pharmacists, with an emphasis on topics where their expertise is not only essential but often sought out. It highlights recent guidelines impacting management of common overdoses, reviews available evidence for established antidotes such as intravenous lipid emulsion, N-acetylcysteine, fomepizole, and antivenin while providing a rationale for their evolving roles, and addresses toxicities associated with the ever-evolving landscape of illicit substances.</p><p><strong>Conclusion: </strong>This article aims to equip readers with the knowledge and insights necessary to provide informed recommendations not just at the bedside through clinical management and education but also at the institution level through protocol development and formulary management.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210705","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":"Implementation of an innovative PGY2 pharmacy residency led by a virtual precepting team with a focus on telehealth.","authors":"Julie Garcia, Aaron Null, Catherine Palladino, Laura Spoutz, Jessica Litke, Ianitza Bankova, Shelby White, Michael Burkett, Addison Ragan, Lori Golterman, Scott E Mambourg, Lindsey Hunt","doi":"10.1093/ajhp/zxaf128","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf128","url":null,"abstract":"<p><strong>Purpose: </strong>Remote work and telehealth expanded with the COVID-19 pandemic. Allowances prompted programs to explore innovative ways to expand residency training opportunities. This article describes the development and implementation of the first telehealth-focused, virtual pharmacy residency program in the VA.</p><p><strong>Summary: </strong>This article describes the background, premise, development, and outcomes of a virtual residency program within a large healthcare system. The benefits and challenges of implementing a telehealth-focused residency and experiences during the first 2 years of the program are reported. Relevant clinical outcomes were compared to outcomes of a traditional, on-site VA postgraduate year 2 (PGY2) ambulatory care residency program, showing experiences were comparable for residents in the primarily virtual program.</p><p><strong>Conclusion: </strong>The experiences described may serve as a framework for health systems to expand access for residents through novel virtual PGY2 pharmacy residency programs focused on providing telehealth training and expertise.</p>","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210701","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":"Turn data into action: How to negotiate evidence-based decision-making in the emergency department.","authors":"Kyle A Weant, Haili Gregory","doi":"10.1093/ajhp/zxaf139","DOIUrl":"https://doi.org/10.1093/ajhp/zxaf139","url":null,"abstract":"","PeriodicalId":520552,"journal":{"name":"American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218523","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}