Application of the Layered Learning Practice Model in an Academic Medical Center.

The layered learning practice model (LLPM) is a teaching strategy designed to train residents to precept students and other residents with the oversight of a seasoned clinical pharmacist. This model serves as a tool for residency programs to implement quality precepting opportunities and learning experiences as they look for new ways to integrate multiple learners into the practice setting. The levels of the LLPM include a senior preceptor, resident, and student.

Evaluation of pharmacy services in emergency departments of Veterans Affairs Medical Centers.

Objective: In 2008, the American Society of Health-System Pharmacists (ASHP) published a national survey that revealed only 6.8% of hospitals surveyed had a pharmacist assigned to the emergency department (ED) for any period of time. This survey was distributed among general and children's medical-surgical hospitals in the United States and did not include any Veterans Affairs (VA) Medical Centers.

Methods to Promote Preceptor Scholarship through Resident Collaboration.

Preceptor participation in scholarly endeavors is recognized in the American Society of Health-System Pharmacists's (ASHP) residency accreditation standards as a method to demonstrate commitment and contribute to the profession of pharmacy. Although workplace demands and position responsibilities may not allow adequate time for preceptors to pursue scholarly activities, collaboration with pharmacy residents in a structured environment can be mutually beneficial and aid in the professional development of the resident and preceptor. The goal of this article is to provide preceptors with a description of activities suitable for collaboration with residents and with tips to ensure success within the residency year.

Combination of inhaled corticosteroid and bronchodilator-induced delirium in an elderly patient with lung disease.

Steroid psychosis has been well described with oral glucocorticoids, however, our search of the literature did not identify an association between delirium and the combination of inhaled glucocorticoids and long-acting beta-agonists. We describe the occurrence of delirium with the combination of an inhaled glucocorticoid and bronchodilator. An elderly male described confusion and hallucinations within 1 week after initiation of budesonide/formoterol for chronic obstructive pulmonary disease.

Modafinil for the treatment of multiple sclerosis-related fatigue.

Objective: To review the efficacy and safety of off-label use of modafinil in the treatment of multiple sclerosis (MS)-related fatigue.

Data Sources: Literature was accessed via MEDLINE (1966-January 2010) and International Pharmaceutical Abstracts (1960-2010), using the medical subject heading terms modafinil, multiple sclerosis, and fatigue.

Study Selection And Data Extraction: All English-language, peer reviewed publications were analyzed for relevance.

Class effect of erythropoietin therapy on hemoglobin A(1c) in a patient with diabetes mellitus and chronic kidney disease not undergoing hemodialysis.

In patients with diabetes mellitus, hemoglobin A(1c) (A1C) is commonly interpreted as a measure of long-term glycemic control, reflecting a mean glucose level over the previous 2-3 months. Although some reports suggest that treatment with recombinant erythropoietin may affect A1C values in patients undergoing hemodialysis, we know of no evidence to support this interaction in patients with chronic renal insufficiency who are not undergoing hemodialysis. In addition, we know of no evidence specific to the treatment effect of epoetin alfa and/or darbepoetin alfa on A1C.