A Dive Into Oliceridine and Its Novel Mechanism of Action.

The current state of the opioid epidemic has revealed the need of utilizing proper pain management, especially in the postoperative setting where there is overuse of potent analgesics. However, the adequate treatment of pain is necessary to reduce mortality and cost of burden while increasing recovery and improving quality of life. Treatment of pain can be difficult to standardize as the guidelines from the American Pain Society discuss the importance of tailoring treatment options based on a patient's sensitivities and risk factors.

Evaluation of the use of chlorpromazine for agitation in pediatric patients.

Introduction: Chlorpromazine is a first-generation antipsychotic used for behavioral problems in pediatric patients. However, other therapies may demonstrate both improved outcomes and fewer side effects. Within our institution, chlorpromazine has been the standard medication used for treatment of pediatric agitation.

Emerging Therapies for Peanut Allergy.

Peanut allergy (PA) is a food allergy that causes an IgE-mediated type I hypersensitivity reaction. PA has become an increasing public health burden, with 2% of American children reported to have this condition in 2010. Current guidelines recommend allergen avoidance, patient education, and administration of H antihistamines, β-agonists, or epinephrine based on the severity of reaction.

Inadvertent iatrogenic insulin detemir 1000 units overdose in a hospitalised patient.

A 69-year-old woman with uncontrolled type 2 diabetes mellitus was admitted in the hospital for the management of urosepsis. Patient was overdosed with detemir insulin 1000 units inadvertently. Care provider was confused with volume and dose of the insulin by using insulin vial.

Evaluation of studies on extended versus standard infusion of beta-lactam antibiotics.

Purpose: To summarize the current literature on the use and clinical efficacy of extended-infusion (EI) beta-lactam antibiotics, including piperacillin-tazobactam, meropenem, and cefepime.

Summary: Gram-negative infections are a serious concern among hospitalized patients and require innovative pharmacokinetic dosing strategies to achieve clinical success, especially as the emergence of resistant gram-negative pathogens has outpaced the development of new antibiotics. Beta-lactam antibiotics exhibit time-dependent activity, which means that optimal efficacy is achieved when free drug concentrations stay above the minimum inhibitory concentration for an extended duration of the recommended dosage interval.

Effects of Pharmacist-Conducted Medication Reconciliation at Discharge on 30-Day Readmission Rates of Patients With Chronic Obstructive Pulmonary Disease.

Purpose: To analyze effect of pharmacist-conducted medication reconciliation on 30-day readmission rates in chronic obstructive pulmonary disease (COPD) and identify common medication errors among patient with readmissions.

Methods: Pharmacists were educated on discharge medication reconciliation for patients with COPD. A retrospective chart review was conducted on patients who underwent pharmacist-conducted discharge medication reconciliation to determine 30-day readmissions.

Satisfaction With Medication Reconciliation Completed by Pharmacy Technicians in an Emergency Department.

Purpose: To survey advanced nurse practitioners, physician assistants, nurses, physicians, and resident physicians involved with collecting and reconciling medication histories in the emergency department (ED) to measure their satisfaction with the current process involving pharmacy technicians.

Methods: Two sites within a large health system with pharmacy technician-driven medication reconciliation processes asked health care professionals to complete a survey of 20 multiple-choice questions. The data collected determined resources used and barriers faced when collecting medication histories, satisfaction before and after the involvement of pharmacy technicians in the ED, and the impact technology may have on this process in the future.

Evaluation of Risk Versus Benefit Information in Direct-To-Consumer (DTC) Prescription Drug Television Advertisements.

Background: The FDA's Presenting Risk Information draft guidance from May 2009 states that the time of risk versus benefit is a factor taken into consideration when evaluating audio and video direct-to-consumer (DTC) broadcasts. The objective of the study is to evaluate the proportion of risk narration on television (TV) advertisements in comparison to the actual proportion of serious adverse effects findings across select therapeutic areas.

Methods: The study reviews prescription drug TV advertisements between the years 2010 and 2015 separated by therapeutic class.

A Review of the Safety and Efficacy of Vaccines as Prophylaxis for Clostridium difficile Infections.

This review aims to evaluate the literature on the safety and efficacy of novel toxoid vaccines for the prophylaxis of infections (CDI) in healthy adults. Literature searches for clinical trials were performed through MEDLINE, ClinicalTrials.gov, and Web of Science using the keywords bacterial vaccines, , and vaccine.

Adverse effect profile comparison of pain regimens with and without intravenous acetaminophen in total hip and knee arthroplasty patients.

Background: The use of adjunct, non-opioid agents is integral for pain control following total hip and knee arthroplasty. Literature comparing safety profiles of intravenous acetaminophen versus opioids is lacking.

Objective: To determine whether there is a difference in frequency and type of adverse effects between intravenous acetaminophen-treated and non-intravenous acetaminophen-treated patients.

A Comparison of Medication Histories Obtained by a Pharmacy Technician Versus Nurses in the Emergency Department.

Purpose: To compare the medication history error rate of the emergency department (ED) pharmacy technician with that of nursing staff and to describe the workflow environment.

Methods: Fifty medication histories performed by an ED nurse followed by the pharmacy technician were evaluated for discrepancies (RN-PT group). A separate 50 medication histories performed by the pharmacy technician and observed with necessary intervention by the ED pharmacist were evaluated for discrepancies (PT-RPh group).

Adductor Canal Block With Bupivacaine Liposome Versus Ropivacaine Pain Ball for Pain Control in Total Knee Arthroplasty: A Retrospective Cohort Study.

Background: Appropriate postoperative pain control following total knee arthroplasty is important in patient recovery. Adductor canal block (ACB) is a novel method to deliver anesthesia. There are currently no studies using bupivacaine liposome with ACB while also taking into account cost.

Treatment of brodifacoum overdose with prothrombin complex concentrate.

Purpose: A case of brodifacoum overdose and its treatment with prothrombin complex concentrate (PCC) are reported.

Summary: A 44-year-old Caucasian woman weighing 62 kg arrived at the emergency department with a chief complaint of lower left leg pain for two days. A computed tomography (CT) scan of the abdomen revealed perihepatic fluid collection (likely a hematoma), a small-bowel intramural hematoma, and blood in the paracolic gutter.

Practice Guideline Development, Grading, and Assessment.

Published clinical practice guidelines (CPGs) are abundant and more easily accessible than ever because of advances in technology and communication and the widespread use of electronic medical literature. To make educated therapy recommendations based on published guidelines, it is important for clinicians to understand the process of guideline development and to be familiar with the resources used to assess guidelines. To do this, clinicians must know the commonly used systems for grading guideline recommendations and for evaluating guideline quality.

Pilot and Revision of a Basal-Bolus Dosing Guideline for the Management of Hyperglycemia in Noncritically Ill Adult Patients.

The use of basal-bolus insulin (BBI) regimens for the treatment of inpatient hyperglycemia has become standard of care. The purpose of this study was to develop and evaluate a newly piloted dosing guideline and utilize the results to adjust it prior to its implementation hospital-wide. This was an institutional review board approved, prospective, and multiphase study.