Ambient Stimuli Perpetuate Nighttime Sleep Disturbances in Hospital Patients With TBI.

Background And Objectives: The effect of the ambient environment, sound, light, and movement, on the nighttime rest-activity of patients hospitalized with moderate-severe traumatic brain injury (TBI) is poorly understood. The purpose of this study was to examine how sound, light, and movement in these patients' hospital rooms may contribute to nighttime awakenings.

Methods: An observational design was used with 18 adult participants on a neuroscience step-down unit diagnosed with moderate-severe TBI.

Pharmacogenomics and Morphine.

Morphine is an opioid analgesic indicated in the treatment of acute and chronic moderate to severe pain. From a pharmacodynamic standpoint, morphine exerts its effects by agonizing mu-opioid receptors predominantly, resulting in analgesia and sedation. Pharmacokinetically, morphine is primarily metabolized in the liver via glucuronidation by the enzyme uridine diphosphate glucuronosyltransferase family 2 member B7 and encounters the transporter proteins organic cation transporter isoform 1 and P-glycoprotein (adenosine triphosphate-binding cassette subfamily B member 1) as it is being distributed throughout the body.

Analysis of fentanyl pharmacokinetics, and its sedative effects and tolerance in critically ill children.

Introduction: Fentanyl pharmacokinetic and pharmacodynamic data are limited in mechanically ventilated children. This study aimed to assess the fentanyl pharmacokinetics (PK), the sedation outcome, and the development of tolerance in children receiving fentanyl continuous infusion.

Methods: This study included children admitted to the pediatric or cardiovascular intensive care unit between January 1 and October 31, 2016, who were >30 days to <18 years of age, receiving ventilatory support via endotracheal tube or tracheostomy, and receiving a fentanyl infusion.

A1C Reduction in Patients Who Declined Pharmacist-Led Diabetes Management Services.

Introduction: The purpose of this research is to assess the mean change in A1C associated with patients who declined a pharmacy-led diabetes management program and to evaluate effects of predictor variables on the odds of achieving improved A1C in these patients.

Study Design: Retrospective, single-center, single-group, cohort study.

Methods: Patients 18 years or older with uncontrolled type 2 diabetes (defined as A1C ≥ 9%) who declined pharmacy-led diabetes management services were included in the study.

Frequency and Severity of Chlorothiazide-Induced Hyponatremia in the Neonatal Intensive Care Unit.

Objective: Although thiazide diuretics are commonly used in the neonatal intensive care unit (NICU), the risk of thiazide-induced hyponatremia in infants has not been well documented. The primary objective of this study was to determine the frequency and severity of hyponatremia in neonates and infants receiving enteral chlorothiazide. Secondary objectives included identifying: (1) percent change in serum sodium from before chlorothiazide initiation to nadir, (2) time to reach nadir serum sodium concentration, and (3) percentage of patients on chlorothiazide receiving sodium supplementation.

Preceptor tips for navigating generational differences with introductory and advanced pharmacy practice experience students.

Ideally, precepting during introductory and advanced pharmacy practice experiences should be tailored to meet the individualized needs of learners. Understanding generational similarities and differences that exist between both learners and educators will facilitate meaningful interaction and improve learning outcomes. A common pitfall among preceptors is to judge the values of their pharmacy learners based on the stereotypes of the generations.

Ampicillin Dose for Early and Late-Onset Group B Streptococcal Disease in Neonates.

Ampicillin is frequently used in neonates for early- and late-onset group B streptococcal (GBS) disease. In 2019, the American Academy of Pediatrics (AAP) published guidelines for GBS which included updated dosing recommendations for ampicillin for bacteremia and provided specific dosing recommendations for meningitis. The dosing recommendations in the guidelines were based off the 2018 Report of the Committee on Infectious Diseases (i.

Possible role for acetylcysteine as a treatment for acute liver failure secondary to antitubercular medication use.

Purpose: Drug-induced liver injury (DILI) that progresses to acute liver failure (ALF) has a high mortality rate, and therapeutic options are limited. Acetylcysteine has a labeled indication for use as an antidote for acetaminophen toxicity and has also been used with limited success in treatment of non-acetaminophen-induced liver injury, with small clinical trials indicating an increase in transplant-free survival. Recommendations for management of non-acetaminophen-induced DILI include withdrawal of the offending agent and supportive care.

Barriers to the Treatment of Hepatitis C among Predominantly African American Patients Seeking Care in an Urban Teaching Hospital in Washington, D.C.

Background: In the United States, it is estimated that 2.4 million people are currently infected with the hepatitis C virus (HCV). In order to address HCV infection management in the U.

Evaluation of human immunodeficiency virus curricular content in schools of pharmacy in the United States.

Introduction: Human immunodeficiency virus (HIV) is an important educational topic for student pharmacists given extended patient life expectancy and expanding pharmacist roles in HIV treatment and prevention. Data are lacking in regard to curricular content and type of training received by faculty to provide didactic and experiential HIV training.

Methods: A cross-sectional, population-based survey of United States (US) pharmacy schools was conducted using a 15-item questionnaire.

Descriptive study of discharge medications in pediatric patients.

Background: Limited studies have evaluated medications in children discharged from hospitals. Knowledge of the number of medications and dosage forms could provide a baseline to establish a medication discharge prescription program.

Objectives: To identify the median number of discharge prescriptions per patient.

Impact of Nasal Swabs on Empiric Treatment of Respiratory Tract Infections (INSERT-RTI).

Methicillin-resistant (MRSA) polymerase-chain-reaction nasal swabs (PCRNS) are a rapid diagnostic tool with a high negative predictive value. A PCRNS plus education "bundle" was implemented to inform clinicians on the utility of PCRNS for anti-MRSA therapy de-escalation in respiratory tract infections (RTI). The study included patients started on vancomycin with a PCRNS order three months before and after bundle implementation.

Pharmacist Interventions in Improving Clinical Outcomes in Patients with Type 2 Diabetes Mellitus Among the Underrepresented Population: A Collaborative Ambulatory Care Pharmacy Practice (CAPP) Approach.

Objective: The objective of this study was to evaluate the impact of pharmacist's interventions through a collaborative ambulatory care pharmacy practice (CAPP) model in patients with type 2 diabetes mellitus (T2DM) among the underrepresented population.

Methods: Eligible patients were 18 years and older with a diagnosis of T2DM with or without comorbid cardiovascular disease risk factors. Patients were enrolled through routine primary care provider referrals.

Evaluation of dosing and safety outcomes of low-dose prophylactic warfarin in children after cardiothoracic surgery.

Purpose: Prophylactic warfarin with an International Normalized Ratio (INR) goal of 1.5 to 2.0 is one antithrombotic therapy utilized in children after cardiothoracic surgery (CTS); published sources suggest a dose of 0.

Evaluating pharmacy student perceptions and effectiveness of procrastination prevention events.

Background And Purpose: Procrastination is common among collegiate students and has been associated with negative academic performance. Avoidance of procrastination may improve learning efficiency and outcomes, especially in course-intensive doctor of pharmacy (PharmD) programs. This study investigated the perceptions of pharmacy students on student-organized procrastination prevention events (PPEs) and determined whether participation in these events affected assessment grades.

Program evaluation of a pharmacy run resident teaching and learning curriculum.

Problem Description: The questions evaluated are: To what extent does the program meet the needs and expectations of the participants?; To what extent are the program outcomes being met?; In what ways does the program need to be modified to better meet the expectations and needs of the target audience?; In what ways does the program need to be modified to better fulfill its intended outcomes?; How accepting are the current residency programs of the modifications proposed for the 2018-2019 year?

Quality Improvement Methods: The new teaching and learning curriculum (TLC) program coordinator and Assistant Dean conducted a practical participatory evaluation. The plan was: complete initial data collection and review, create a new syllabus, and review new syllabus with all residency program directors.

Results Of Cqi Inquiry: All stakeholders felt the program was meeting their needs and expectations and the program was meeting its outcomes.

Integration of Latin American Complementary and Alternative Medicine Topics Into a Doctor of Pharmacy Curriculum and Survey of Student Attitudes and Behaviors.

One in 3 adults report using complementary and alternative medicine (CAM) and as many as 7 in 10 Hispanic patients report CAM use. Pharmacists often encounter patients who use CAM products and therefore college of pharmacy curricular standards require both CAM and cultural competence training; however, there is little guidance for colleges on how to best deliver this material. In Fall 2017, Larkin University College of Pharmacy implemented a curricular change wherein first professional (P1) year pharmacy students selected, researched, and presented on a CAM product from Latin America.

Model-Based Analysis of Cannabidiol Dose-Exposure Relationship and Bioavailability.

Introduction: There is a large variation in cannabidiol (CBD) pharmacokinetics and little information on its bioavailability. This study aims to establish the CBD dose-exposure relationship and to evaluate the effects of dosage forms, food, and doses on CBD absorption.

Methods: Single-dose (range: 5-6000 mg) CBD plasma concentration-time profiles administered as oral solution (OS), oral capsule (OC), or oromucosal spray/drop (OM) from healthy volunteers were extracted from 15 published clinical studies.

Management of Acute Idiopathic (Viral) Pericarditis in the Emergency Department: A Review for the Nursing Professional.

Acute pericarditis is an inflammatory disorder that contributes to chest pain admissions in the emergency department (ED). Nursing professionals can play a vital role in the differential, triage and management of acute pericarditis in the ED. First-line pharmacotherapy to specifically treat acute pericarditis of viral or idiopathic origin is paramount in improving patients' quality of life and reducing the risk of further recurrences of pericarditis and consists of combination therapy with aspirin (acetylsalicylic acid [ASA]) or a nonsteroidal anti-inflammatory drug (NSAID), in combination with colchicine.