DOsing Strategy Effectiveness of Diltiazem in Atrial Fibrillation With Rapid Ventricular Response.

Study Objective: To evaluate the dose-dependent comparative safety and effectiveness between weight-based and alternative dosing strategies for diltiazem in atrial fibrillation with rapid ventricular response.

Methods: This retrospective cohort study included adult patients presenting to the emergency department (ED) with atrial fibrillation with rapid ventricular response who received treatment with intravenous diltiazem. Groups were retrospectively categorized according to the initial dose: low (<0.

Effect of Default Order Standardization on Opioid Prescribing Patterns.

Background: Opioid misuse, overprescribing, dependency, and overdose remains a significant concern in the United States. A quality improvement study was conducted at the University of Illinois Hospital & Health Sciences System to determine the effect of standardizing the default orders for hydrocodone-acetaminophen products implemented on June 22, 2016.

Methods: Prior to the intervention, default orders had variable dose tablet numbers (1 or 2) and dosing frequencies (every 4 or 6 hours), and no default dispense quantity.

Encouraging pharmacist intervention and standardization of labeling and dispensing of oral liquid medications.

Objectives: To initiate a call to action for community pharmacists and key-pharmacy stakeholders in the standardization of oral-liquid dosage forms.

Data Sources: Not applicable.

Summary: Unintentional overdose of medication due to administration error results in thousands of pediatric hospitalizations yearly.

Automatic Errors: A Case Series on the Errors Inherent in Electronic Prescribing.

The adoption of electronic prescribing is on the rise, as it reduces medication errors compared to handwritten orders. The inadvertent dispensing of discontinued medications is a type of medication error that is less well described, but one that can lead to adverse events. Software for electronic prescriptions transmits orders for refills or new prescriptions, but not discontinuations, to the pharmacy.

Rhabdomyolysis Secondary to Clenbuterol Use and Exercise.

Background: The literature regarding rhabdomyolysis secondary to illicit drug use is sparse. Clenbuterol is a bronchodilator approved for veterinary use, which in high doses can increase protein deposition and lipolysis similarly to anabolic steroids, and is thereby abused for bodybuilding and weight loss effects. Clenbuterol has previously been described in case reports to be cardiotoxic, with patient presentations similar to overdoses of sympathomimetic substances, but reports of rhabdomyolysis are limited to a single case series in horses.

Probable interaction between Lycium barbarum (goji) and warfarin.

Lycium barbarum (also called goji berry), a Chinese herb used as a supplement for health benefits, is traditionally consumed by the Chinese in the form of a tea. Goji juice, a widely available beverage in the United States, also contains this herb. We describe a 71-year-old Ecuadorean-American woman who was taking warfarin and was hospitalized for a markedly elevated, indeterminate international normalized ratio (INR) (prothrombin time > 120 sec) after consumption of goji juice.