Implementation of implicit bias awareness and action training in a pharmacy residency program.

Purpose: To implement an implicit bias awareness and action seminar program for the University of Utah Health pharmacy residency program and measure knowledge, awareness, and comfort around race-related topics.

Summary: An implicit bias awareness training program was implemented with a pre- and post-training survey to measure knowledge, comfort, and confidence around understanding and addressing biases. Fifty-one residents and preceptors participated in the implicit bias training, and 47 (92.

Phenytoin Serum Concentrations in Patients With Left Ventricular Support Devices: A Case Series.

Purpose: Achieving therapeutic levels of phenytoin is critical to its efficacy and safety. Free serum levels represent pharmacologically active phenytoin due to the high protein binding of the drug. Predicting free serum levels in patients with left ventricular support devices can be challenging, as the pharmacokinetics (PK) can be significantly altered, and equations to correct total levels have not been validated in this population.

Fibrinolytic and Anticoagulation Therapy in Patients Undergoing Ultrasound-Assisted Catheter-Directed Thrombolysis for Pulmonary Embolism.

Background: Ultrasound-assisted, catheter-directed thrombolysis (UA-CDT) relieves right ventricular stress without a significant increase in the risk of bleeding compared to systemic thrombolysis. Although concomitant anticoagulation is provided to prevent thrombus expansion, the optimal anticoagulation regimen in patients receiving UA-CDT remains unknown.

Objective: We sought to describe anticoagulation practices for patients receiving UA-CDT.

Prospective evaluation of inappropriate unable-to-assess CAM-ICU documentations of critically ill adult patients.

Background: Delirium occurs in the intensive care unit and identification is often performed using a validated assessment tool such as the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) patients. The CAM-ICU has three ratings: positive, negative, and unable to assess (UTA). Patients may often be assigned UTA when it is inappropriate given the level of sedation or medical condition.

Regulatory, legislative, and policy updates with anticoagulant use.

Thromboembolism afflicts millions of patients annually in the United States and is associated with a significant cost burden. Recent advances in oral anticoagulation have provided clinicians with more options for management of these diseases. Accordingly, regulatory, legislative, and policy-making organizations have intervened with the aim of improving patient outcomes, ensuring patient safety, and reducing costs.

Evaluating the transition from dexmedetomidine to clonidine for agitation management in the intensive care unit.

Objectives: Limited literature exists examining the use of enteral clonidine to transition patients from dexmedetomidine for management of agitation. The aim of this study was to evaluate dexmedetomidine discontinuation within 8 h of enteral clonidine administration in addition to the rates of dexmedetomidine re-initiation in patients who failed clonidine transition.

Methods: A single-center, retrospective analysis evaluated critically ill adult patients from 1 February 2013 to 28 February 2014, who used dexmedetomidine and clonidine for sedation management.

Conversion of protein farnesyltransferase to a geranylgeranyltransferase.

Posttranslational modifications are essential for the proper function of a number of proteins in the cell. One such modification, the covalent attachment of a single isoprenoid lipid (prenylation), is carried out by the CaaX prenyltransferases, protein farnesyltransferase (FTase) and protein geranylgeranyltransferase type-I (GGTase-I). Substrate proteins of these two enzymes are involved in a variety of cellular functions but are largely associated with signal transduction.

Crystallographic analysis of CaaX prenyltransferases complexed with substrates defines rules of protein substrate selectivity.

Post-translational modifications are essential for the proper function of many proteins in the cell. The attachment of an isoprenoid lipid (a process termed prenylation) by protein farnesyltransferase (FTase) or geranylgeranyltransferase type I (GGTase-I) is essential for the function of many signal transduction proteins involved in growth, differentiation, and oncogenesis. FTase and GGTase-I (also called the CaaX prenyltransferases) recognize protein substrates with a C-terminal tetrapeptide recognition motif called the Ca1a2X box.

Structure of mammalian protein geranylgeranyltransferase type-I.

Protein geranylgeranyltransferase type-I (GGTase-I), one of two CaaX prenyltransferases, is an essential enzyme in eukaryotes. GGTase-I catalyzes C-terminal lipidation of >100 proteins, including many GTP- binding regulatory proteins. We present the first structural information for mammalian GGTase-I, including a series of substrate and product complexes that delineate the path of the chemical reaction.