Results of a survey to assess residency preceptor development methods and precepting challenges.

Purpose: The results of a survey to (1) assess the current status of preceptor development within pharmacy residency programs, (2) understand challenges to preceptor development, and (3) identify directions for future preceptor development opportunities are presented.

Methods: In June 2012, pharmacy residents and preceptors listed in the ASHP online residency directory were surveyed. The survey was developed from a review of the literature and underwent expert review.

Unusual presentation of spinal lipomatosis.

Spinal epidural lipomatosis (SEL) is a rare condition characterized by overgrowth of normal adipose tissue in the extradural space within the spinal canal that can lead to significant spinal cord compression. It is most commonly reported in patients receiving chronic glucocorticoid therapy. Other causes can include obesity and hypercortisolism.

Extended-infusion eptifibatide to prevent stent thrombosis in a patient undergoing orthopedic surgery.

Objective: To report the use of extended-infusion eptifibatide in a patient who had undergone placement of a drug-eluting stent and required repeat intervention of a hip fracture following mechanical failure.

Case Summary: An 82-year-old female with an extensive history of coronary disease who had undergone placement of a drug-eluting stent was admitted following continued problems with her surgically repaired right hip. Radiographic imaging of the area revealed mechanical failure of the surgically repaired hip, requiring intervention.

Use of argatroban as a procedural and bridging anticoagulant in a patient undergoing carotid endarterectomy with concomitant atrial fibrillation.

Objective: To describe the use of argatroban as a procedural and bridging anticoagulant in a patient with a previous history of heparin allergy and atrial fibrillation undergoing carotid endarterectomy.

Case Summary: A 78-year-old female with a history of heparin-induced thrombocytopenia (HIT) and multiple medical comorbidities, including atrial fibrillation requiring chronic anticoagulation with warfarin, was found to have greater than 70% stenosis of her left carotid artery by standard duplex imaging. Her warfarin therapy was discontinued as an outpatient approximately 48 hours prior to an elective left carotid endarterectomy and she was started on argatroban 2 μg/kg/min for bridging therapy.