A Narrative Review of Pain in Pediatric Oncology: The Opioid Option for Procedural and Surgical Pain.

This narrative review examines the evolving role of opioids in managing procedural and surgical pain in pediatric oncology patients. The review evaluates studies on opioid use across various oncological surgeries including thoracic, abdominal, orthopedic, and neurosurgical procedures, as well as for common painful procedures such as bone marrow aspirations and lumbar punctures. While opioids remain important for acute procedural and postoperative pain management in pediatric oncology patients, there is an increasing emphasis on multimodal, opioid-sparing approaches.

Predictors of Success in Obtaining Postgraduate Residency or Fellowship.

Objective: As more pharmacy students are pursuing postgraduate training, colleges of pharmacy are investigating ways to predict success in matching for residency or fellowship. While data have been published about characteristics predictive of matching, we sought to study student scores, rotation types, and rotation evaluations as predictors of success.

Methods: Data were collected from students in the graduating classes of 2021, 2022, and 2023.

A Narrative Review of Pain in Pediatric Oncology: The Opioid Option.

Opioid therapy is the mainstay for managing pain in pediatric oncology. This narrative review describes the current literature regarding opioids for pediatric cancer pain. The review explores the multifaceted landscape of opioid utilization in this population, including the role of opioids in certain clinical circumstances, modalities of opioid delivery, unique opioids, outpatient and at-home pain management strategies, and other key concepts such as breakthrough pain.

Drug-Induced Hepatitis in an Adolescent During Concomitant Use of Azithromycin and Lisdexamfetamine Dimesylate.

This case report describes a 14-year-old male with signs and symptoms of drug-induced hepatotoxicity after receiving azithromycin and lisdexamfetamine dimesylate. The patient was admitted to the hospital and a liver biopsy revealed findings suggestive of drug-induced hepatitis. In this patient, it is unclear whether 1 agent individually or a combination of azithromycin and lisdexamfetamine was the cause of hepatitis.

Evaluation of Academic and Nonacademic Factors of First-Generation Students Transitioning to a Pharmacy Program.

Objective: To evaluate the academic transition of first-generation (FG) students to a Doctor of Pharmacy program and the impact of early intervention/outreach.

Methods: The retrospective study evaluated the first semester performance in three classes of student pharmacists (beginning fall 2020, 2021, 2022) at a public university in the mid-South. Student demographics (age, sex, race, relationship status), nonacademic factors (Grit, impostor syndrome, testing anxiety, perceived stress), and academic factors (grade point average, academic probation, early intervention) were assessed.

Improvement in Pharmacy Student Responses to Medication-Related Problems with and without Clinical Decision Support Alerts.

Objective: To assess pharmacy student responses to medication problems with and without clinical decision support (CDS) alerts during simulated order verification.

Methods: Three classes of students completed an order verification simulation. The simulation randomized students to a different series of 10 orders with varying CDS alert frequency.

Impact of a stroke interprofessional simulation on health professional students.

Introduction: The objective was to describe the interprofessional stroke simulation delivered across three campuses with seven types of health professions students and the impact the activity had on the students.

Methods: An interprofessional stroke simulation event was completed with pharmacy, medical, nursing, physician assistant, occupational therapy, physical therapy, and speech pathology students across a multi-site campus. Pre-activity, demographic information was requested including age, gender, discipline, year in respective program, number of experiences in prior interprofessional events, and comfort working with other health care professionals.

Comparison of student performance in therapeutics and communications courses to outcomes of objective structured clinical examinations: A retrospective analysis.

Introduction: The objective was to examine the association between course grades and objective structured clinical examination (OSCE) performances in a pharmacy student cohort.

Methods: A retrospective analysis of demographics, final grades in the Therapeutics I through IV and Communications courses, and multiple OSCE scores (therapeutic knowledge and general communication skills [GCS]) was performed for two cohorts.

Results: Female students scored higher than male students on the warfarin OSCE therapeutic knowledge (P = .

A Comprehensive Review of Vaping Use in Pediatric Patients and Recent Changes in Regulatory Laws.

The use of electronic cigarettes (e-cigarettes), also known as vapes, by adolescents and young adults has dramatically increased over the past several years. E-cigarettes continue to be the most used form of tobacco among youth. As a result of this concerning trend, policies at both the state and federal levels have been implemented to limit availability in this population.

Analysis of Community-Acquired Urinary Tract Infection Treatment in Pediatric Patients Requiring Hospitalization: Opportunity for Use of Narrower Spectrum Antibiotics.

The most narrow-spectrum antibiotic possible should be used for empiric and definitive treatment of pediatric urinary tract infections (UTIs). The objectives of this study were to determine an appropriate narrow-spectrum antibiotic for empiric UTI treatment, factors differentiating empiric first-generation cephalosporin (FGC) versus third-generation cephalosporin (TGC) coverage, and factors associated with unnecessarily broad-spectrum definitive antibiotic treatment. This was a retrospective chart review of children admitted from 2013 to 2015 who were diagnosed with a UTI and received treatment.

Importance of Reviewing Antibiotic Courses by 48 Hours: Risk Factors for Third-Generation Cephalosporin Resistance Among AmpC Harboring Organisms in Urine and Respiratory Cultures.

Background: Citrobacter, Enterobacter, Morganella, and Serratia (AmpC organisms) species can exhibit third-generation cephalosporin (TGC) resistance after TGC exposure. We aimed to assess if institutional TGC utilization correlated with institutional AmpC organism susceptibility and if prior TGC exposure ≤48 hours were associated with TGC resistance in the first culture of a future infection episode caused by an AmpC organism.

Methods: A 5-year retrospective cohort study was performed, including AmpC organisms isolated from pediatric urinary and respiratory tract cultures at an institution with TGC courses reviewed by the antimicrobial stewardship program at 48 hours.

Persistent Hypersomnolence Following Clobazam in a Child With Epilepsy and Undiagnosed CYP2C19 Polymorphism.

We describe an 11-year-old female who presented with severe hypersomnolence after receiving 1 week of modest doses of clobazam (CLB). In reviewing the above case, we considered that the hypersomnolence could be related to a pharmacodynamic, pharmacokinetic, or pharmacogenomic issue associated with CLB or to a combination of these factors. Although serum concentrations of CLB and its active metabolite are sensitive to factors that affect cytochrome-dependent metabolism, drug-drug interactions were omitted as a cause of the hypersomnolence.

Antimicrobial stewardship impact on Pseudomonas aeruginosa susceptibility to meropenem at a tertiary pediatric institution.

An antimicrobial stewardship program was implemented throughout 2012 at a tertiary pediatric institution with guideline development preceding prospective audit and feedback starting in 2013. Meropenem use decreased over 62% during the next 5 years. Non-cystic fibrosis Pseudomonas aeruginosa isolate susceptibility to meropenem increased from 89% in 2011 to 98% in 2017 (P < .

Examining the Association of GPA and PCAT Scores on Objective Structured Clinical Examination Scores.

To examine the association between certain demographic and admission measures and Objective Structured Clinical Examination (OSCE) performance in a cohort of pharmacy students. A retrospective review of demographic characteristics, admissions data [cumulative and science admission Grade Point Average (GPA), Pharmacy College Admissions Test (PCAT) scores], and OSCE scores was performed for the Class of 2017 at the University of Tennessee College of Pharmacy. Female students scored significantly higher than male students on the Warfarin OSCE - Standardized Patient (SP) rated General Communication Skills and on the Warfarin OSCE - Faculty rated Patient Interviewing Skills.

Impact of Drug Interactions on Clobazam and N-Desmethylclobazam Concentrations in Pediatric Patients With Epilepsy.

Background: Clobazam (CLB) is approved as adjunctive treatment for seizures associated with Lennox-Gastaut syndrome in patients aged 2 years and older. It is converted to an active metabolite N-desmethylclobazam (NCLB) by CYP3A4, which is then broken down to an inactive metabolite by CYP2C19. This study characterizes the impact of CYP3A4 and CYP2C19 drug interactions on CLB and NCLB serum concentrations (Cp) and concentration/dose (Cp/D) ratios in pediatric patients with epilepsy.

A Review of Pneumococcal Vaccines: Current Polysaccharide Vaccine Recommendations and Future Protein Antigens.

This review describes development of currently available pneumococcal vaccines, provides summary tables of current pneumococcal vaccine recommendations in children and adults, and describes new potential vaccine antigens in the pipeline. Streptococcus pneumoniae, the bacteria responsible for pneumonia, otitis media, meningitis and bacteremia, remains a cause of morbidity and mortality in both children and adults. Introductions of unconjugated and conjugated pneumococcal polysaccharide vaccines have each reduced the rate of pneumococcal infections caused by the organism S.

Enteral topiramate in a pediatric patient with refractory status epilepticus: a case report and review of the literature.

We describe the use of topiramate in a healthy 12-year-old (88-kg) male who developed refractory generalized convulsive status epilepticus. Seizures persisted despite aggressive use of benzodiazepines (intravenous lorazepam; oral clorazepate), barbiturates (i.e.

Bumetanide continuous infusions in critically ill pediatric patients.

Objective: Limited data exist for the use of bumetanide continuous infusions in children. The purpose of this study was to evaluate the use of bumetanide continuous infusions in critically ill pediatric patients.

Design: This study was an institutional review board approved, single-center, retrospective chart review of 95 patients.

Glomerular filtration rate equations do not accurately predict vancomycin trough concentrations in pediatric patients.

Background: The Bedside Chronic Kidney Disease in Children (CKiD) equation was developed using data from children with chronic kidney disease. Some institutions are using this equation in all pediatric patients, regardless of renal function, to adjust medications. No data have shown that the Bedside CKiD equation is equivalent or better than the Schwartz equation in estimating glomerular filtration rate (GFR) in pediatric patients with normal renal function.

Limb swelling in a pediatric sickle cell patient after revaccination with pneumococcal vaccine.

Case (description): This report describes an incident of limb swelling after revaccination with the 23-valent pneumococcal polysaccharide vaccine (PPSV23). A 5-year old female with sickle cell disease experienced severe arm swelling with edema to the extent that it was difficult to put a shirt over the arm. The day prior, she received PPSV23 concomitantly with the meningococcal vaccine.

Geographic location of antiretroviral clinical trials in HIV infected pediatric patients.

Background: Some medicines regulatory authorities are encouraging research in pediatrics. However, children are a vulnerable population, and previous studies have suggested that research is increasingly being conducted outside of developed countries.

Objective: The purpose of this study is to determine the location of trials in the pediatric population with human immunodeficiency virus (HIV).