The impact of push-dose phenylephrine use on subsequent preload expansion in the ED setting.

Background: The utilization of bolus-dose phenylephrine (PHE) has transitioned to the emergency department (ED) for the treatment of acutely hypotensive patients, despite a paucity of literature in this setting.

Methods: This was a single center retrospective chart review of the utilization of bolus-dosed PHE for acute hypotension in the ED at an academic non-forprofit hospital. The primary objective of this study is to report the frequency of patients that were initiated on a continuous vasopressor infusion (CVI) within 30 minutes after the first administration of bolus-dose PHE.

Impact of prescription drug-monitoring program on controlled substance prescribing in the ED.

Objective: In 2009, Florida initiated a statewide prescription drug-monitoring program (PDMP) to encourage safer prescribing of controlled substances and reduce drug abuse and diversion. Data supporting the utility of such programs in the emergency department (ED) is scarce. This study sought to determine the effect of PDMP data on controlled substance prescribing from the ED.

Evaluation of an antimicrobial stewardship approach to minimize overuse of antibiotics in patients with asymptomatic bacteriuria.

An antimicrobial stewardship educational initiative provided to physicians and pharmacists was evaluated at an academic medical center to minimize inappropriate treatment of asymptomatic bacteriuria (ASB). A significant decrease in empirical antimicrobial use for ASB was observed after education. Multifaceted educational initiatives can reduce inappropriate antimicrobial treatment of ASB.

Medication errors in HIV-infected hospitalized patients: a pharmacist's impact.

Background: Treatment with highly active antiretroviral therapy (HAART) decreases morbidity and mortality associated with HIV infection. Unfortunately, HAART medication errors are prevalent in hospitalized patients with HIV infection. Appropriate regimen administration and adherence are essential for treatment success.

Refractory hypotension due to Rogaine® (minoxidil) ingestion managed with midodrine.

Background: Minoxidil (Rogaine®) is a direct vasodilator that can cause significant toxicity when ingested. We report a case of ingestion of topical minoxidil [Rogaine® (Johnson & Johnson Healthcare Products, Division of McNeil-PPC, Inc)] resulting in refractory hypotension that was successfully managed with the oral α (1) agonist midodrine.

Case Report: A 48-year-old male who ingested an eight ounce bottle of Rogaine® presented to the emergency department.

Evaluation of intramuscular fosphenytoin vs intravenous phenytoin loading in the ED.

Objective: A comparison of length of stay in an emergency department (ED) after loading patients at risk for seizures with either intravenous (IV) phenytoin or intramuscular (IM) fosphenytoin was studied.

Methods: This was a retrospective observational cohort study that was conducted over a 24-month period in an academic teaching hospital (693 beds). Patients included were 18 years or older, discharged from the ED without hospital admission, and loaded with either IV phenytoin or IM fosphenytoin.