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Journal of Pharmacy Practice

Abrar K Thabit, Mordechai Grupper, David P Nicolau, Joseph L Kuti
OBJECTIVES: To evaluate the pharmacodynamic exposure of piperacillin/tazobactam across the renal function range using 4.5 or 3.375 g dosing regimens. METHODS: A 5000-patient Monte Carlo simulation was conducted to determine the probability of achieving 50% free time above the minimum inhibitory concentration ( fT > MIC) for piperacillin. Proposed regimens, using solely 4.5 or 3.375 g strengths, were compared with regimens listed in piperacillin/tazobactam prescribing information over creatinine clearance (CrCl) ranges of 120 mL/min to hemodialysis...
December 2017: Journal of Pharmacy Practice
Montgomery F Williams, Emily P Doss, Maggie Montgomery
OBJECTIVE: To report a case of hemolytic anemia in a patient who received trimethoprim/sulfamethoxazole (TMP-SMX) for a urinary tract infection (UTI). SUMMARY: A 47-year-old woman recently diagnosed with uncomplicated UTI received 3 doses of TMP-SMX. She developed yellowing of the skin and eyes, lethargy, mild abdominal pain, and dry mucous membranes. Laboratory testing demonstrated significant anemia with red blood cells (RBCs) of 1.99, hemoglobin (Hgb) of 6.3 g/dL, and hematocrit (Hct) of 18...
December 2017: Journal of Pharmacy Practice
Gerald T Cochran, Rafael J Engel, Valerie J Hruschak, Ralph E Tarter
BACKGROUND: Opioid misuse imposes a disproportionately heavy burden on individuals living in rural areas. Community pharmacy has the potential to expand and coordinate with health professionals to identify and intervene with those who misuse opioids. OBJECTIVE: Rural and urban community pharmacy patients were recruited in this pilot project to describe and compare patterns of opioid misuse. METHODS: We administered a health screening survey in 4 community pharmacies among patients filling opioid medications...
October 2017: Journal of Pharmacy Practice
Scott T Benken, Alexandra Goncharenko
This report describes a patient case utilizing a nontraditional sedative, continuous infusion ketamine, as an alternative agent for intensive care unit (ICU) sedation. A 27-year-old female presented for neurosurgical management of a coup contrecoup injury, left temporal fracture, epidural hemorrhage (EDH), and temporal contusion leading to sustained mechanical ventilation. The patient experienced profound agitation during mechanical ventilation and developed adverse effects with all traditional sedatives: benzodiazepines, dexmedetomidine, opioids, and propofol...
October 2017: Journal of Pharmacy Practice
(no author information available yet)
No abstract text is available yet for this article.
August 2017: Journal of Pharmacy Practice
(no author information available yet)
No abstract text is available yet for this article.
August 2017: Journal of Pharmacy Practice
(no author information available yet)
No abstract text is available yet for this article.
August 2017: Journal of Pharmacy Practice
Krystal L Edwards, Ryan L Hadley, Nidhu Baby, Julianne C Yeary, Lisa M Chastain, Crystal D Brown
OBJECTIVE: To show that clinical pharmacy specialists (CPSs) can be utilized in remote facilities to provide appropriate diabetes outcomes along with potential cost savings. METHODS: A retrospective cohort chart review conducted at the Veterans Affairs North Texas Healthcare System (VANTHCS) evaluated outcomes in patients with type 2 diabetes mellitus referred to CPSs at Fort Worth Outpatient Clinic (FWOPC) or the endocrinologist-managed specialty clinic at the Dallas VA Medical Center (DVAMC)...
August 2017: Journal of Pharmacy Practice
Shannon M L Furbish, Miranda E Kroehl, Danielle F Loeb, Huong Mindy Lam, Carmen L Lewis, Jennifer Nelson, Zeta Chow, Katy E Trinkley
INTRODUCTION: Benzodiazepines are prescribed inappropriately in up to 40% of outpatients. The purpose of this study is to describe a collaborative team-based care model in which clinical pharmacists work with primary care providers (PCPs) to improve the safe use of benzodiazepines for anxiety and sleep disorders and to assess the preliminary results of the impact of the clinical service on patient outcomes. METHODS: Adult patients were eligible if they received care from the academic primary care clinic, were prescribed a benzodiazepine chronically, and were not pregnant or managed by psychiatry...
August 2017: Journal of Pharmacy Practice
Zubair Afzal, Elizabeth Pogge, Virginia Boomershine
PURPOSE: To evaluate the efficacy of a smoking cessation program led by a pharmacist and a nurse practitioner. METHODS: During a 6-month period, patients attended 7 one-on-one face-to-face smoking cessation counseling sessions with a pharmacist and 1 to 2 one-on-one face-to-face smoking cessation counseling sessions with a nurse practitioner. The primary outcome was smoking cessation point prevalence rates at months 1, 3, and 5 post-quit date. Secondary outcomes included medication adherence rates at months 1, 3, and 5 post-quit date, nicotine dependence at baseline versus program end, and patient satisfaction...
August 2017: Journal of Pharmacy Practice
Sarah S Evans, Arpita S Gandhi, Amber B Clemmons, David L DeRemer
BACKGROUND: Etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (EPOCH)-containing regimens are frequently utilized in non-Hodgkin's lymphoma, however, the incidence of febrile neutropenia (FN) in patients receiving inpatient versus outpatient EPOCH has not been described. Additionally, no comparisons have been made regarding financial implications of EPOCH administration in either setting. This study's primary objective was to compare hospital admissions for FN in patients receiving inpatient or outpatient EPOCH...
August 2017: Journal of Pharmacy Practice
Levita Hidayat, Charnicia E Huggins, Veena Venugopalan, Evangelina Berrios-Colon
PURPOSE: Exposure of pharmacy students to postgraduate training prior to clinical practice is currently endorsed by national professional organizations. To meet this goal, colleges and schools of pharmacy are developing residency preparation programs. In this descriptive report, we review published studies of curricular activities and structured programs from academic institutions across the United States aimed at preparing students for residency training and promoting postgraduate education...
August 2017: Journal of Pharmacy Practice
Amanda K Duman, Patricia Pecora Fulco
Strong cytochrome P450 (CYP) 3A4 inhibitors may induce Cushing syndrome and subsequent adrenal insufficiency when administered concurrently with corticosteroids. This drug-drug interaction has been well described with HIV protease inhibitors. A similar drug-drug interaction with corticosteroids and other strong CYP 3A4 inhibitors (antifungals [imidazoles]) has recently been reported but remains less well known. To our knowledge, we report the first case of probable drug-induced Cushing syndrome with subsequent adrenal insufficiency as a result of concomitant oral voriconazole with intranasal mometasone and inhaled fluticasone administration as well as a review of the current literature supporting this drug-drug interaction...
August 2017: Journal of Pharmacy Practice
Elizabeth B McNeely
Heart failure is associated with increased risk of morbidity and mortality, resulting in substantial health-care costs. Clinical pharmacists have an opportunity to reduce health-care costs and improve disease management as patients transition from inpatient to outpatient care by leading interventions to develop patient care plans, educate patients and clinicians, prevent adverse drug reactions, reconcile medications, monitor drug levels, and improve medication access and adherence. Through these methods, clinical pharmacists are able to reduce rates of hospitalization, readmission, and mortality...
August 2017: Journal of Pharmacy Practice
Lauren Haggerty, Deanna Tran
OBJECTIVE: To summarize the literature on cholesterol point-of-care tests (POCTs). This article would serve as a resource to assist community pharmacists in developing cholesterol point-of-care (POC) pharmacy services. DATA SOURCES: A literature search was performed in MEDLINE Ovid, PubMed, EMBASE, and Cochrane database using the following medical subject headings (MeSH) terms: point-of-care test, cholesterol, blood chemical analysis, rapid testing, collaborative practice, community pharmacy, and ambulatory care...
August 2017: Journal of Pharmacy Practice
Megan M Moore, Abby M Bailey, Alexander H Flannery, Regan A Baum
Rabson-Mendenhall syndrome is a rare genetic disorder resulting from mutations in the insulin receptor and is associated with high degrees of insulin resistance. These patients are prone to complications secondary to their hyperglycemia including diabetic ketoacidosis (DKA). We report the case of a 19-year-old male with Rabson-Mendenhall syndrome presenting with DKA who required doses of up to 500 U/h (10.6 U/kg/h) of insulin. The patient's insulin infusion was originally compounded with U-100 regular insulin, although to minimize volume, the product was compounded with U-500 insulin...
August 2017: Journal of Pharmacy Practice
Sheena E Mathew, Craig J Beavers, Elizabeth McNeely
BACKGROUND: The rates of venous thromboembolism (VTE) post-cardiothoracic surgery are not well understood. The american college of chest physicians (CHEST) guidelines report weak recommendations for starting VTE prophylaxis post-cardiothoracic surgery. It is suspected that due to the increase in bleed risk, postsurgery initiation of pharmacologic VTE prophylaxis is limited. OBJECTIVE: The study sought to investigate the use of VTE prevention in US hospitals performing cardiac surgery and the use of mechanical/chemical prophylaxis postoperatively...
August 2017: Journal of Pharmacy Practice
Cassandra R White, Tomasz Z Jodlowski, Dylan T Atkins, Nicole G Holland
OBJECTIVE: To report on a patient with a symptomatic, polymicrobial Escherichia coli and multidrug-resistant (MDR), extended-spectrum β-lactamase (ESBL)-positive Klebsiella pneumoniae urinary tract infection (UTI) who was successfully treated with oral doxycycline hyclate. CASE SUMMARY: A 70-year-old white male inpatient with a history of recurrent UTI, type 2 diabetes, hypertension, obesity, and diverticular disease was diagnosed with UTI and empirically treated with oral ciprofloxacin...
August 2017: Journal of Pharmacy Practice
Michael J Scalese, Dominick J Salvatore
Since its isolation in the 1930s, digoxin has played a pivotal role in the treatment of cardiac conditions including heart failure and supraventricular tachyarrhythmias. The parasympathomimetic activity makes digoxin a reasonable option for controlling ventricular rate in atrial fibrillation (AF). However, the unique pharmacokinetic properties, electrolyte-dependent effects, and P-glycoprotein drug interactions influence the clinical use of digoxin. In addition, the delayed onset and narrow therapeutic index can make digoxin utilization cumbersome and often necessitates serum drug monitoring...
August 2017: Journal of Pharmacy Practice
Jenny H Kang, Quynh-Nhu Nguyen, Juleann Mutka, Quang A Le
No abstract text is available yet for this article.
June 2017: Journal of Pharmacy Practice
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