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Journal of Pharmacy Practice

Paul O Lewis, Abigail Jones, Rachel J Amodei, Dima Youssef
Treatment of enterococcal endocarditis requires up to 6 weeks of intravenous (IV) antimicrobial therapy. When susceptible, an ampicillin-based regimen is preferred. Studies evaluating ampicillin stability utilizing high-pressure liquid chromatography have indicated enhanced stability (greater than 24 hours at room temperature), supporting outpatient administration. Thus, we report the successful treatment of a 30-year-old male with tricuspid valve enterococcal endocarditis in an outpatient setting using continuous infusion ampicillin via an ambulatory infusion pump...
October 16, 2018: Journal of Pharmacy Practice
Anny D Nguyen, Alice Lam, Iouri Banakh, Skip Lam, Tyron Crofts
BACKGROUND: The medication lists in pre-admission clinic (PAC) questionnaires completed by patients prior to surgery are often inaccurate, potentially leading to medication errors during hospitalization. Studies have shown pharmacists are more accurate when obtaining a medication history and transcribing prescription orders, thereby reducing errors. OBJECTIVE: To evaluate the impact of a PeRiopErative and Prescribing (PREP) pharmacist on postoperative medication management...
October 8, 2018: Journal of Pharmacy Practice
Junyi Ma, Li Wang
BACKGROUND: There is a paucity of research on the population characteristics of mail-order pharmacy users. OBJECTIVE: This study utilized a nationally representative sample to examine the characteristics of mail-order pharmacy users. METHODS: This study used data from the 2012 Medical Expenditure Panel Survey (MEPS). The outcome variable was defined as whether the participant had used a mail-order pharmacy during the study year. Logistic regression was conducted to determine the factors which influence mail-order pharmacy use...
October 2, 2018: Journal of Pharmacy Practice
El Bitar Sandy, Chanudi Weerasinghe, Terenig Terjanian
In the area of multiple myeloma (MM) therapy, proteasome inhibitors (PI) have emerged with promising responses both in the first- and second-line setting. Carfilzomib (CFZ) is a second-generation, selective PI approved in 2012 for the treatment of relapsed/refractory multiple myeloma (RRMM) in patients who received 2 prior therapies or have evidence of disease progression within 60 days of completion of last therapy. Its safety profile reported adverse events (AEs) ranging from drug-related AEs (nausea and vomiting), hematologic AEs (neutropenia and thrombocytopenia), and nonhematologic AEs (electrolyte imbalances)...
October 2, 2018: Journal of Pharmacy Practice
Tianrui Yang, B Tate Cutshall, Alexandra Tatara, Melanie Ruegger
The US Food and Drug Administration recently approved 2 combination products containing a basal insulin and a glucagon-like peptide 1 receptor agonist: insulin glargine/lixisenatide and insulin degludec/liraglutide. These agents were shown to be noninferior in lowering hemoglobin A1c compared to basal insulin and are indicated for patients inadequately controlled on basal insulin or glucagon-like peptide 1 receptor agonists alone. The clinical implications of these agents are unclear due to limitations in the clinical trials and limited recommendations in current guidelines...
October 1, 2018: Journal of Pharmacy Practice
Bejoy P Maniara, Lauren E Healy, Thien-Ly Doan
BACKGROUND: Polymyxin B's package insert recommends renal adjustment. Contemporary studies suggest it does not require renal adjustment. OBJECTIVE: To determine whether time to acute kidney injury (AKI) differs between renally adjusted and nonadjusted intravenous (IV) polymyxin B. METHODS: This retrospective chart review compared time to AKI after renally adjusted and nonadjusted IV polymyxin B administration. It included patients who were 18 years or older, received IV polymyxin B, and had creatinine clearance below 80 mL/min, and excluded ones who had AKI, received renal replacement therapy, or were pregnant...
September 25, 2018: Journal of Pharmacy Practice
Leslie D Moore, Megan G Smith
OBJECTIVE: To determine the effect of using a technician-driven medication therapy management (MTM) program on quality performance measures for a community pharmacy chain. METHODS: A technician-driven MTM program was incorporated in 35 stores of a regional supermarket pharmacy chain. The overall chain percentage score for the 4 quality measures used in Medicare Part D Star Ratings-proportion of days covered (PDC) for cholesterol, diabetes, renin-angiotensin system antagonists (RASA), and high-risk medication use-was compared pre- and postimplementation of the technician-driven MTM program...
September 19, 2018: Journal of Pharmacy Practice
Anthony J Pattin, Nathan Devore, Jonathan Fowler, David Weldy
In physician practices and pharmacies, staff members work to process prescription renewals so that patients receive a steady supply of medications. These functions are essential to ensure patients have continuous access to medications and remain adherent to prescribed therapies. Despite the incorporation of e-prescribing software programs to ease management of these processes, barriers to effective management of the prescription renewal process exist. Mismanagement of pharmacy adherence programs can ultimately lead to patients receiving inappropriate medications and excessive use of staff resources...
September 16, 2018: Journal of Pharmacy Practice
Erica R Davidson, Melissa J Snider, Kelly Bartsch, Andrea Hirsch, Junan Li, John Larry
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been shown to lower atherogenic lipid markers in patients with statin intolerance; however, external validity of these findings is unclear in patients with self-reported statin intolerance. OBJECTIVE: The objective of this study was to describe the tolerability of evolocumab and alirocumab in patients with self-reported statin intolerance. Secondary objectives were to describe their efficacy and obtainability...
September 16, 2018: Journal of Pharmacy Practice
Susan E Smith, Daniel C Johnson
BACKGROUND: Current guidelines recommend consideration of thrombosis as a reversible cause of cardiac arrest. The use of thrombolytic therapy during cardiac arrest, however, is controversial. OBJECTIVE: We sought to characterize the use of thrombolytic therapy during cardiac arrest and to evaluate the rate of return of spontaneous circulation (ROSC) in a "real-word" setting. METHODS: A single-center, retrospective, cohort study of adult patients who received alteplase during cardiac arrest between 2010 and 2015 were performed at a tertiary academic medical center...
September 13, 2018: Journal of Pharmacy Practice
Ellen M Uppuluri, Meghan N McComb, Nancy L Shapiro
BACKGROUND: How and when to monitor direct oral anticoagulants (DOACs) for safety and efficacy is a question many anticoagulation clinics are trying to answer. A pharmacist-led antithrombosis clinic (ATC) initiated a clinical service to provide oversight for all prescribed DOACs. OBJECTIVE: Describe the implementation and outcomes of a DOAC screening service. METHODS: The service was initiated utilizing a daily electronic prescribing report of DOAC prescriptions...
September 13, 2018: Journal of Pharmacy Practice
Lori T Mor, Kristina Holley
PURPOSE: To report a case of acquired hemophilia secondary to levofloxacin and provide a guide for the use of anticoagulation in acute coronary syndrome. CASE SUMMARY: A 75-year-old female treated with levofloxacin presented with spontaneous bruising of the upper extremities. Levofloxacin was discontinued and the symptoms resolved. Thereafter, the spontaneous bruising recurred and progressed over a few weeks. The patient was treated with recombinant factor VIIA with a time to recuperation of 3 months...
September 6, 2018: Journal of Pharmacy Practice
Kathlyn Lim, Hai Tran, Angela Hirai-Yang, Niyati Vakil, Gregory Marks, Ellen Klapper
PURPOSE: To raise awareness of cefotetan-induced hemolytic anemia, a known rare but serious side effect that occurred in 5 patients at our medical center. SUMMARY: Five cases of cefotetan-induced hemolytic anemia, which presented over the period of a single year at our center, are described. In each case, hemolytic anemia was confirmed by testing for the presence of anti-cefotetan antibodies. Each case occurred approximately 1 to 2 weeks following exposure to the drug...
September 6, 2018: Journal of Pharmacy Practice
Joshua Garcia, Megan Pintens, Amanda Morris, Paul Takamoto, Laura Baumgartner, Chelsea L Tasaka
BACKGROUND: Using a reduced dose of 5 units of regular insulin has been proposed as a strategy to mitigate the risk of hypoglycemia when treating hyperkalemia. The comparative efficacy and safety of this strategy to conventional 10 units is not well established. OBJECTIVE: To compare the effectiveness of reduced and conventional dosed insulin for hyperkalemia treatment. METHODS: Electronic medication administration reports of conventional or reduced doses of insulin given for hyperkalemia treatment were reviewed from July 2013 to September 2015...
September 6, 2018: Journal of Pharmacy Practice
Vincent Peyko, Henry Cohen
PURPOSE: To determine whether or not polymyxin B needs dose adjustments based on renal function by comparing the incidence of acute kidney injury (AKI) in patients whose polymyxin B doses were adjusted versus not adjusted according to renal function. METHODS: This was a single-center, prospective study with a retrospective cohort taking place in an acute care community hospital. Forty-two patients treated with polymyxin B were evaluated between April 2012 and December 2015...
September 6, 2018: Journal of Pharmacy Practice
Vivian Do, Emily Behar, Caitlin Turner, Michelle Geier, Phillip Coffin
BACKGROUND: The San Francisco Department of Public Health initiated naloxone prescribing at 6 safety net clinics. We evaluated this intervention, demonstrating that naloxone prescribing from primary care clinics is feasible and acceptable. OBJECTIVE: To evaluate acceptability of naloxone dispensing to patients prescribed opioids among pharmacists serving clinics participating in a naloxone intervention. METHODS: We surveyed 58 pharmacists from November 2013 through January 2015 at pharmacies that serviced San Francisco safety net clinics...
September 4, 2018: Journal of Pharmacy Practice
Bryan G Shaw, Inela Masic, Nancy Gorgi, Niree Kalfayan, Elise M Gilbert, Viktorija O Barr, Michael G Ison, Milena M McLaughlin
BACKGROUND: Many patients with a self-reported penicillin allergy go on to tolerate beta-lactam antibiotics. Allergy specialists may be consulted to determine the nature and extent of the allergy. However, electronic allergy records must be appropriately updated such that recommendations are carried forward. OBJECTIVE: To determine the percentage of patients who have their electronic allergy record updated after an allergy service consult (ASC). METHODS: This was a retrospective study of patients with at least 1 documented beta-lactam allergy and had an ASC during (inpatient) or prior to (outpatient) hospital admission at Northwestern Memorial Hospital and Prentice Women's Hospital in Chicago, Illinois...
September 4, 2018: Journal of Pharmacy Practice
Robert William Barrons, Liem T Nguyen
PURPOSE: A case of succinylcholine (SCh) and sevoflurane as a probable cause of rhabdomyolysis in an adult is presented, along with a review of the relevant literature and strategies for prevention. SUMMARY: A nondiabetic, morbidly obese 32-year-old female developed rhabdomyolysis after administration of SCh and sevoflurane for diagnostic procedures of 30 minutes' duration. Thirty-three hours following anesthesia, the patient developed diffuse muscle tenderness and progressive weakness with a creatinine kinase (CK) of 4319 U/L...
August 29, 2018: Journal of Pharmacy Practice
Matthew W Calnan, Alexis N Crawford
Although premature discontinuation of dual antiplatelet therapy (DAPT) is associated with an increased risk of ischemic complications, patients may present with an urgent need for surgery that would require interruption of DAPT. Antiplatelet bridge therapy using cangrelor, an intravenous P2Y12 inhibitor, has been studied as a potential option to ensure continuation of DAPT perioperatively. However, limited evidence exists supporting the off-label use of cangrelor bridge therapy to noncardiac procedures. We describe the case of a 67-year-old class 3 obese female on DAPT (aspirin and ticagrelor) for recent drug-eluting stent placement who required a bronchoscopy with biopsy for suspected lung cancer...
August 23, 2018: Journal of Pharmacy Practice
Martin J Biggs, Timothy C Biggs
PURPOSE: Independent prescribing pharmacists are able to independently prescribe medications following additional postgraduate training. This study examined their use in completing medical discharge summaries, normally completed by junior doctors, in order to assess their impact on expedited hospital discharge times. METHODS: In total, 163 patients were studied through a 2-stage audit. The first cycle evaluated junior doctors completing medical discharge summaries (as is normal practice)...
August 23, 2018: Journal of Pharmacy Practice
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