Evaluation of adverse drug reaction formatting in drug information mobile phone applications.

Objective: To evaluate the differences in presentation (formatting) of adverse drug reaction (ADR) information within drug monographs in commonly used drug information (DI) mobile device applications.

Methods: A cross-sectional analysis of ADR formatting of twenty commonly prescribed oral medications within seven DI mobile applications was performed. Databases were assessed for ADR information, including presence of placebo comparisons, severity of ADR, onset of ADR, formatting of ADRs in percentile (quantitative) format or qualitative format, whether references were used to cite information, and whether ADRs are grouped by organ system.

Deviant Dosing: A Post hoc Analysis of Pharmacist Characteristics Related to Renal Dosing Decisions.

Background: A recent study demonstrated that pharmacists presented with multiple estimating equations deviated from recommended dosing guidance more often than pharmacists who were presented with a single estimate on clinical vignettes.

Objectives: To identify characteristics associated with an increased tendency to deviate from approved recommendations.

Methods: Participant data were split into 2 cohorts: pharmacists who chose a dose that was inconsistent with dosing recommendations on at least 1 of the 4 vignettes and pharmacists who did not deviate on a single case.

Evaluation of adverse drug reaction formatting in drug information databases.

Objective: The research evaluated the differences in formatting of adverse drug reaction (ADR) information in drug monographs in commonly used drug information (DI) databases.

Methods: A cross-sectional analysis of formatting of ADR information for twenty commonly prescribed oral medications in seven commonly used DI databases was performed. Databases were assessed for presentation of ADR information, including presence of placebo comparisons, severity of ADR, onset of ADR, formatting of ADRs in percentile (quantitative) format or qualitative format, whether references were used to cite information, whether ADRs are grouped by organ system, and word count of the ADR section.

Prophylactic unfractionated heparin and hemorrhage in neurocritically ill underweight patients: A case series and review of the literature.

Purpose: Three cases of major bleeding associated with thromboprophylactic unfractionated heparin (UFH) therapy in underweight neurocritically ill patients are reported.

Summary: Three underweight patients (body mass index of <18.5 kg/m2) were treated in the intensive care unit with major bleeds associated with UFH thromboprophylaxis.

The Impact of Multiple Renal Estimates on Pharmacist Dosing Recommendations: A Randomized Trial.

Background: Numerous equations are used for estimation of renal function, and many electronic medical records report multiple clearance estimates to assist with drug dosing. It is unknown whether the presence of multiple clearance estimates affects clinical decision-making.

Objective: To determine whether the presence of multiple renal clearance estimates affects pharmacist drug dosing decisions.

Clearance Confusion: An Exploratory Analysis of Inpatient Dosing Discordances Between Renal Estimating Equations.

Background: Numerous equations exist for estimating renal clearance for drug dosing, and discordance rates may be as high as 40% in certain populations. However, the populations and types of equations used in these studies may not be generalizable to broader pharmacy practice.

Objectives: To determine the dosing discordance rate between Cockcroft-Gault (C-G), Chronic Kidney Disease Epidemiology (CKD-EPI), and Modification of Diet in Renal Disease (MDRD) equations in a community hospital population.

Evaluation of a multidisciplinary approach to reduce internal medicine readmissions using a readmission prediction index.

Purpose: Readmission prediction indices are used to stratify patients by the risk of hospital readmission. We describe the integration of a 30-day hospital readmission prediction index into the electronic medical record (EMR) and its impact on pharmacist interventions during transitions of care (TOC).

Methods: A retrospective cohort study was conducted to compare 30-day readmission rates between adult internal medicine inpatients admitted by a multidisciplinary team providing TOC services (the TOC group) and those who received usual care (the control group).

Adverse drug reactions in drug information databases: does presentation affect interpretation?

Objective: Formatting of adverse drug reaction (ADR) information differs among drug information (DI) resources and may impact clinical decision-making. The objective of this study was to determine whether ADR formatting impacts adverse event interpretation by pharmacy practitioners and students.

Methods: Participants were randomized to receive ADR information in a comparative quantitative (CQUANT), noncomparative quantitative (NQUANT), or noncomparative qualitative (NQUAL) format to interpret 3 clinical vignettes.

Therapeutic Enoxaparin in the Morbidly Obese Patient: A Case Report and Review of the Literature.

Enoxaparin is a low molecular weight heparin commonly used in the treatment of venous thromboembolisms (VTEs); however, evidence on optimal empiric dosing recommendations are lacking in patients with morbid obesity. Utilization of an absolute dose cap, anti-Xa monitoring, and reduced empiric dosing are among the techniques used in this population. We describe a case of a morbidly obese man (body-mass index, BMI: 68.

Development of an iterative validation process for a 30-day hospital readmission prediction index.

Purpose: A study was conducted to determine if an iterative validation process could maintain or improve the discriminative and predictive capabilities of a 30-day hospital readmission prediction index over 2.5 years.

Methods: Patient admissions were retrospectively identified using the electronic medical record.

Efficacy of Capsaicin for the Treatment of Cannabinoid Hyperemesis Syndrome: A Systematic Review.

Cannabinoid hyperemesis syndrome (CHS) is characterized by cyclic vomiting, abdominal pain, and alleviation of symptoms via hot showers in chronic cannabinoid users. Capsaicin is recommended as a reasonable first-line treatment approach for CHS despite limited clinical evidence regarding its use. The objective of this study is to systematically review the efficacy data for capsaicin in CHS.

Pharmacotherapy in Acutely Anemic Jehovah's Witnesses: An Evidence-Based Review.

Objective: To determine the pharmacological treatment methods available to anemic Jehovah's Witnesses (JW).

Data Sources: MEDLINE and PubMed were searched from inception through February 2018 using the search terms Jehovah's Witnesses, treatment, erythropoietin, hemoglobin-based oxygen carrier, Sanguinate, Hemopure, bleeding, and anemia.

Study Selection And Data Extraction: All clinical trials, cohort studies, case-control studies, and observational trials involving pharmacotherapy in anemic JW patients were evaluated.

Biologic-Induced Infections in Inflammatory Bowel Disease: The TNF-α Antagonists.

Objective: To review the mechanism and association of infectious risk among the tumor-necrosis factor α (TNF-α) antagonists used in inflammatory bowel disease.

Data Sources: A PubMed literature search was performed using the following search terms: infliximab, adalimumab, certolizumab, golimumab, inflammatory bowel disease, crohn's, ulcerative colitis, adverse effects, adverse events, safety, and infection.

Study Selection And Data Extraction: Meta-analyses and cohort studies with outcomes pertaining to quantitative infectious risk were reviewed.

New direct-acting antivirals in hepatitis C therapy: a review of sofosbuvir, ledipasvir, daclatasvir, simeprevir, paritaprevir, ombitasvir and dasabuvir.

Hepatitis C is a chronic infection associated with considerable morbidity and mortality. In recent years, there has been a shift in treatment paradigm with the discovery and approval of agents that target specific proteins vital for hepatitis C replication. The NS3/4A inhibitors simeprevir and paritaprevir, the NS5A inhibitors ombitasvir, ledipasvir, and daclatasvir, and the NS5B inhibitors sofosbuvir and dasabuvir have been newly FDA approved and incorporated as first-line agents into the latest IDSA-AASLD guidelines for Hepatitis C treatment.