Non-Sterile to Sterile Compounding: An Unconventional Response During the COVID-19 Pandemic.

The drug supply chain has suffered many interruptions over the past decade. The COVID-19 pandemic exacerbated an already fragile infrastructure for supplying critical medications to hospitals and health-systems. The purpose of this paper is to provide insight to the history, thought-processes, and response to critical medication shortages during the COVID-19 pandemic, with a focus on hydromorphone infusions and the action steps taken to engage in non-sterile to sterile (NSTS) compounding.

Evaluation of Cost, Workflow, and Safety of Implementing a Vial Transfer Device for Ready-to-Mix Drugs at an Academic Medical Center.

Objective: To evaluate the cost, workflow, and safety of implementing a vial transfer device system.

Methods: In this retrospective analysis, pharmacy systems and electronic health record reports identified high-volume and high-cost medications prepared by a Vial2Bag (V2B) system from July 2017 to June 2018. The major outcome was the extrapolated yearly cost avoidance (EYCA) from utilization of a V2B system, calculated by subtracting total costs of the V2B system from total cost of ready-to-use products and locally compounded sterile products.

Utilization of an Integrated Electronic Health Record in the Emergency Department to Increase Prospective Medication Order Review by Pharmacists.

Purpose:: The objective of this study is to evaluate the impact of an integrated medical record system on prospective medication order verification by pharmacists in the emergency department (ED) of a level I trauma center.

Methods:: This was a single-center retrospective analysis comparing medication orders verified by a pharmacist during a 7-day period in 2013 (phase I) versus 2015 (phase II). Outcome measures include the percentage of medication orders reviewed by a pharmacist prior to administration and time from order entry to each of the following: pharmacist review, medication procurement from an automated dispensing cabinet (ADC), and medication administration.

Intravenous Immune Globulin Stewardship Program at a Tertiary Academic Medical Center.

Background: In October 2010, a pharmacist-driven stewardship program was implemented at the Brigham and Women's Hospital to ensure continued adherence to the prescribing guideline, focusing on indications for intravenous immune globulin (IVIG) use and dosing per ideal body weight.

Objective: The primary objective was to describe an IVIG stewardship program at a tertiary academic medical center.

Methods: This was a prospective, observational study from January 2013 through December 2014.

The Effect of Concomitant Sirolimus and Propofol Therapy on Triglyceride Concentrations in Critically Ill Patients.

Background: Sirolimus and propofol are both independently associated with the development of hypertriglyceridemia (HTG) during therapy. To date, there are no published reports describing synergistic or additive drug interaction resulting in HTG with concomitant use of these medications.

Study Question: To identify the occurrence of HTG in patients receiving concomitant sirolimus and propofol infusion therapy.

Evaluation of glucose management during therapeutic hypothermia at a Tertiary Academic Medical Center.

Study Aim: Alterations in metabolic function during therapeutic hypothermia (TH) decrease responsiveness to insulin and increase the risk of hyperglycemia. Glycemic control is associated with improved outcomes in selected patients; however, glycemic management strategies during TH are not defined. The objective of this analysis was to evaluate the glycemic metrics and IV insulin administration in critically ill patients during the cooling and rewarming phases of TH.

Pharmacy Response to the Boston Marathon Bombings at a Tertiary Academic Medical Center.

Objective: Effective crisis response requires multidisciplinary communication and rapid action. Our goals are to highlight the experience of a pharmacy department's response to the 2013 Boston Marathon bombing, to discuss the role of the pharmacist in a crisis response, and to identify potential learning opportunities for a future mass casualty event.

Case Summary: Our initial response targeted 3 general areas: staffing, supplies, and communication.

Evaluation of the maximum beyond-use-date stability of regular human insulin extemporaneously prepared in 0.9% sodium chloride in a polyvinyl chloride bag.

Background: Regular human insulin 100 units added to a sufficient quantity of 0.9% sodium chloride, to yield a total volume of 100 mL within a polyvinylchloride bag, is accepted to be stable for 24 hours due to physical denaturation and chemical modification. The objective of this study was to evaluate the extended stability of such extemporaneously prepared regular human insulin, stored under refrigeration, to the maximum beyond-use-date allowed by United States Pharmacopeia chapter 797.