Efficacy of a Viokace Pancreatic Enzyme Protocol for Clearing Occluded Enteral Feeding Tubes: A Quality Assurance Evaluation.

A previous retrospective study documented restored patency to 48.2% of occluded enteral feeding tubes using alkalinized Creon pancreatic enzyme capsules. In light of the low efficacy rate, the institutional enteral feeding tube clearance protocol was subsequently revised to incorporate a newly marketed non-enteric-coated Viokace pancreatic enzyme tablet, despite the lack of published data for this indication.

Management of Cannabinoid Hyperemesis Syndrome: Focus on Capsaicin.

Cannabinoid hyperemesis syndrome is a condition characterized by cyclic severe nausea, vomiting, and abdominal pain associated with frequent, long-term marijuana use. The condition resolves with cessation of cannabis but may be temporarily relieved by bathing in hot water. Topical capsaicin cream may also alleviate symptoms, perhaps through antiemetic effects produced by activation of TRPV1 receptors, similar to that of hot water bathing.

Updating formulations for compounded oral liquid medications in a university health system.

Purpose: The development of a compounded oral liquid medication formulary and subsequent implementation of revised standard formulations in a university health system are described.

Methods: A standard assessment form was developed to direct evaluation of published literature and current compounding resources for all oral liquid formulations prepared by health-system pharmacies. Specific variables reviewed included concentration, components, beyond-use dating, and storage recommendations.

House Dust Mite Sublingual Immunotherapy for Pediatric Patients With Allergic Asthma.

Objective: To review the published literature evaluating administration of house dust mite (HDM) sublingual immunotherapy (SLIT) in pediatric patients with allergic asthma.

Data Sources: PubMed database search (1966 to November 2017) using the search terms allergy, allergic rhinitis, asthma, allergic asthma, house dust mite, allergen immunotherapy, subcutaneous immunotherapy, sublingual immunotherapy, MK-8237, children, and pediatric. Package labeling and references from identified articles were also reviewed.

Knowledge of appropriate acetaminophen use: A survey of college-age women.

Objectives: To evaluate college-age women's knowledge of appropriate doses and potential toxicities of acetaminophen, competency in interpreting Drug Facts label dosing information, and ability to recognize products containing acetaminophen.

Methods: In this cross-sectional prospective study, a 20-item written survey was provided to female college students at a University of Michigan fundraising event in March 2015.

Results: A total of 203 female college students, 18-24 years of age, participated in the study.

Methotrexate for the Management of Crohn's Disease in Children.

Objective: To review the literature evaluating methotrexate as a treatment option for Crohn's disease (CD) in pediatric patients.

Data Sources: A search of PubMed electronic database (1966 to August 2015) and secondary resources was performed using the terms methotrexate, Crohn's, and inflammatory bowel disease. Other relevant articles cited within identified articles were also utilized.

Team-based learning to improve learning outcomes in a therapeutics course sequence.

Objective: To compare the effectiveness of team-based learning (TBL) to that of traditional lectures on learning outcomes in a therapeutics course sequence.

Design: A revised TBL curriculum was implemented in a therapeutic course sequence. Multiple choice and essay questions identical to those used to test third-year students (P3) taught using a traditional lecture format were administered to the second-year pharmacy students (P2) taught using the new TBL format.

Efficacy of a Creon delayed-release pancreatic enzyme protocol for clearing occluded enteral feeding tubes.

Background: Alkalinized Viokase pancreatic enzyme tablets restored patency to 71.9% of occluded Dobhoff tubes in a prospective study. After removal of Viokase tablets from the US market, the hospital protocol for unclogging enteral feeding tubes was adapted to use Creon pancreatic enzyme delayed-release capsules, despite the lack of published data.

Finasteride treatment of hair loss in women.

Objective: To review available evidence on the safety and efficacy of finasteride in the treatment of alopecia in women.

Data Sources: A literature search was conducted through PubMed (1948-March 2010) and MEDLINE (1950-March 2010) using the search terms finasteride and alopecia. References cited in relevant publications were reviewed.

Treatment of selective mutism: focus on selective serotonin reuptake inhibitors.

Abstract Selective mutism is a pediatric psychiatric disorder that occurs when a child consistently fails to speak in specific situations in which speaking is expected, such as at school and social gatherings, but speaks appropriately in other settings. Selective mutism often is diagnosed when a child starts school and does not talk to teachers or peers, but talks to family members at home; the condition is frequently accompanied by anxiety and shyness. Although the underlying etiology of the condition remains unclear, psychotherapy is the preferred initial treatment, with the support of parents and teachers.

Pharmacist recognition of and adherence to medication-use policies and safety practices.

Purpose: Pharmacist recognition of and adherence to medication-use policies and safety practices were assessed.

Methods: Simulation testing was used to assess the performance of pharmacists in hypothetical scenarios simulating real-life situations. Fifty test case medication orders were developed, some requiring specific intervention and some requiring no special action.

Deferasirox.

Purpose: The pharmacology, clinical efficacy, adverse effects and toxicities, and the economic issues that should be considered in using deferasirox are reviewed.

Summary: Iron overload is a complication of the chronic blood transfusions used to treat several hematologic disorders. To date, management of transfusional iron overload has consisted of chelation therapy with parenteral deferoxamine.

Knowledge of appropriate acetaminophen doses and potential toxicities in an adult clinic population.

Objective: To evaluate the knowledge of appropriate doses and potential toxicities of acetaminophen and assess the ability to recognize products containing acetaminophen in an adult outpatient setting.

Design: Cross-sectional, prospective study.

Setting: University adult general internal medicine (AGIM) clinic.

Effect of glucosamine on glucose control.

Objective: To review the literature regarding the effect of glucosamine on glucose control.

Data Sources: English-language articles on the effects of administration of exogenous glucosamine on glucose control were identified through a search of MEDLINE (1966-March 2006), EMBASE (1988-March 2006), and International Pharmaceutical Abstracts (1970-March 2006) databases using the search terms glucosamine, blood glucose, and diabetes mellitus. Abstracts of articles were then reviewed to determine relevance to the topic.

Safety of Angiotensin-converting enzyme inhibitors in patients with insect venom allergies.

Objective: To review the literature with respect to the safety of angiotensin-converting enzyme (ACE) inhibitors in patients allergic to insect venom and those undergoing venom immunotherapy (VIT).

Data Sources: A MEDLINE search was conducted (1966-March 2006) using the following search terms: bee sting, venom, insect stings, ACE inhibitors, angiotensin II receptor blockers, immunotherapy, and desensitization. The bibliographies of qualifying articles were also searched for relevant references.

Venous thromboembolism prevention in acutely ill nonsurgical patients.

Objective: To review recent advances in the prevention of venous thromboembolism (VTE) in acutely ill nonsurgical inpatients.

Data Sources: A MEDLINE search (1966-March 2005) was done to identify relevant articles relating to prevention of VTE in acutely ill nonsurgical inpatients.

Study Selection And Data Extraction: Four major prophylaxis trials, one registry, one guideline, and supporting articles representative of the subject matter from the last few years were included.

Usefulness of herbal and dietary supplement references.

Objective: To describe the usefulness of some of the most common tertiary references that healthcare professionals employ to answer requests about herbal and dietary supplements.

Methods: All requests for information on herbal and dietary supplements received by the drug information service between April and September 2000 were evaluated. Each question was independently reviewed by 4 clinicians using a 4-point scale; 14 references were searched for appropriate answers.

Building a better online formulary.

The history of and improvements made to the University of Michigan Health System (UMHS) inpatient online formulary are described. The current formulary at UMHS is the third version of the Web-based formulary. The original effort in 1997 consisted of converting word-processing documents to HTML format and exporting this information to the university's intranet.