Glycopeptide Hypersensitivity and Adverse Reactions.

Glycopeptides, such as vancomycin and teicoplanin, are primarily used in the treatment of methicillin-resistant (MRSA) infections, such as cellulitis, endocarditis, meningitis, pneumonia, and septicemia, and are some of the most commonly prescribed parenteral antimicrobials. Parenteral glycopeptides are first-line therapy for severe MRSA infections; however, oral vancomycin is used as a first-line treatment of infections Also, we currently have the longer-acting lipoglycopeptides, such as dalbavancin, oritavancin, and telavancin to our armamentarium for the treatment of MRSA infections. Lastly, vancomycin is often used as an alternative treatment for patients with β-lactam hypersensitivity.

Low Sensitivity of Procalcitonin for Bacteremia at an Academic Medical Center: A Cautionary Tale for Antimicrobial Stewardship.

Background: Procalcitonin testing has been adopted by antimicrobial stewardship programs as a means of reducing inappropriate antibiotic use, including within intensive care units (ICUs). However, concerns regarding procalcitonin's sensitivity exist. The purpose of this study is to calculate the sensitivity of procalcitonin for bacteremia among hospitalized patients.

The Emerging Role of β-Lactams in the Treatment of Methicillin-Resistant Staphylococcus aureus Bloodstream Infections.

Methicillin-resistant (MRSA) bloodstream infections (BSI) are associated with substantial morbidity and mortality. Monotherapy with first-line antimicrobials such as vancomycin (VAN; glycopeptide) and daptomycin (DAP; lipopeptide) are inadequate in some cases due to reduced antibiotic susceptibilities or therapeutic failure. In recent years, β-lactam antibiotics have emerged as a potential option for combination therapy with VAN and DAP that may meet an unmet therapeutic need for MRSA BSI.

Safety outcomes of apixaban in patients with nonvalvular atrial fibrillation and severe renal impairment.

Apixaban is prescribed for stroke prevention in nonvalvular atrial fibrillation (NVAF) in patients with varying degrees of renal dysfunction. While pharmacokinetic data support apixaban in severe renal impairment, clinical safety outcomes data are limited. This retrospective cohort analysis was conducted to evaluate the safety of apixaban in patients with NVAF and renal impairment.

Evaluation of a peer- and self-grading process for clinical writing assignments.

Objectives: As class sizes in pharmacy education increase, faculty must develop new assessment strategies for essay writing assignments. This study evaluated accuracy and student perceptions of an innovative grading process that utilizes both peer- and self-assessment.

Methods: Four SOAP note sessions were evaluated.

Development of a tool to assess and advance the effectiveness of preceptors: The Habits of Preceptors Rubric.

Purpose: Present the research performed to identify and describe habits of effective pharmacy preceptors and provide a framework for targeted preceptor assessment and development.

Methods: A 5-round Delphi consensus-building process was used to refine the initial Habits of Preceptors Rubric (HOP-R) developed by the research team. Twenty experts in pharmacy experiential education participated.

Fecal microbiota transplantation for recurrent Clostridioides difficile infection.

Purpose: Randomized controlled trials investigating the efficacy and safety of fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (CDI) are reviewed, and practical issues for pharmacists to consider are discussed.

Summary: Eight randomized controlled trials evaluating the use of FMT for recurrent CDI were analyzed. The trials varied in the type of sample (fresh, frozen, lyophilized), route of administration (nasogastric tube, colonoscopy, enema, oral), and comparator agent (different type of FMT, vancomycin).

Estimated Cardiovascular Risk and Guideline-Concordant Primary Prevention With Statins: Retrospective Cross-Sectional Analyses of US Ambulatory Visits Using Competing Algorithms.

Introduction: The 2013 pooled cohort equations (PCE) may misestimate cardiovascular event (CVE) risk, particularly for black patients. Alternatives to the original PCE (O-PCE) to assess potential statin benefit for primary prevention-a revised PCE (R-PCE) and US Preventive Services Task Force (USPSTF) algorithms-have not been compared in contemporary US patients in routine office-based practice.

Methods: We performed retrospective, cross-sectional analysis of a nationally representative, US sample of office visits made from 2011 to 2014.

Utilization of Augmented Renal Clearance in Trauma Intensive Care Scoring System to Improve Vancomycin Dosing in Trauma Patients at Risk for Augmented Renal Clearance.

The Augmented Renal Clearance in Trauma Intensive Care (ARCTIC) scoring system is a validated system to predict augmented renal clearance in trauma patients. This study examined the ability of the ARCTIC score to identify patients at risk for subtherapeutic vancomycin trough concentrations relative to estimated creatinine clearance (eCrCl) alone. Trauma patients admitted to the intensive care unit from September 2012 to December 2017 who received vancomycin and had a vancomycin trough concentration recorded were included.

High-risk opioid prescribing trends in the outpatient setting prior to issuance of federal guidance.

Co-prescription of opioid and benzodiazepine products increases the risk of overdose-related mortality four-fold due to respiratory depression. Accordingly, prevention of high-risk opioid prescribing (HROP) has become a focus over the past two decades and was the subject of a black-box warning (BBW) issued by the U.S.

Evaluation of the leadership strengths of the officers serving within an APhA-ASP chapter: Implications for the profession.

Background And Purpose: To evaluate the strengths of the officers who recently served within an American Pharmacists Association Academy of Student Pharmacists (APhA-ASP) chapter and to discuss the potential impacts of these strengths upon the pharmacy profession.

Educational Activity And Setting: The chapter officers from the Classes of 2010-2016 (n = 67; 66% female) voluntarily participated in a variety of leadership development programs created by the chapter advisors. Each of these programs included activities based upon the book, Strengths Based Leadership, and the determination of each officer's top five strengths using the StrengthsFinder 2.

Developing emotionally intelligent leaders within a chapter of a student pharmacist organization.

This article was migrated. The article was marked as recommended. Emotional intelligence (EI) refers to an individual's awareness, management, and use of emotions, which has been shown to correlate with successful leadership.

Implementation and evaluation of a women's reproductive health pharmacy elective.

Background And Purpose: To create, implement and evaluate an elective course for pharmacy students focusing on women's reproductive health topics.

Educational Activity And Setting: A course was developed that included lectures discussing contraception, infertility, preconception care, pregnancy, and postpartum health. Active learning provided in the forms of journal article review and review of drug information resources for medication use in pregnancy were utilized.

Gabapentin use, abuse, and the US opioid epidemic: the case for reclassification as a controlled substance and the need for pharmacovigilance.

The abuse potential of gabapentin is well documented; with gabapentin having been noted as an agent highly sought after for use in potentiating opioids. When combined with opioids, the risk of respiratory depression and opioid-related mortality increases significantly. In the US, gabapentin was approved by the Food and Drug Administration as a non-controlled substance.

Evaluation of multidisciplinary and pharmacy-only student-run clinics on student's perceptions of interprofessional roles.

Background And Purpose: To determine how participation in multidisciplinary training workshops and student-run clinics impacts students' perceptions of the role of other health professions. Student perceptions from pharmacy-only versus multidisciplinary smoking cessation clinics were also compared.

Education Activity And Setting: Students from pharmacy, osteopathic medicine, physician assistant, and clinical psychology programs participated in two multidisciplinary smoking cessation training sessions, then provided smoking cessation services to the underserved population in either a multidisciplinary or pharmacy-only student-run smoking cessation clinic.

Promoting a growth mindset in pharmacy educators and students.

Commentary: Mindsets are implicit theories that influence how individuals think, act, and respond. Those with a fixed mindset tend to resist learning opportunities; those with a growth mindset embrace learning opportunities. It is important that pharmacy educators work to shift the mindsets of their students toward a growth mindset in order to promote resilience, improve personal outcomes, and enhance attitudes toward learning.

Evaluation of a mock interview session on residency interview skills.

Background And Purpose: To evaluate the impact of student pharmacist participation in a mock interview session on confidence level and preparation regarding residency interview skills.

Educational Activity And Setting: The study setting was a mock interview session, held in conjunction with student programming at the American College of Clinical Pharmacy (ACCP) Annual Meeting. Prior to the mock interview session, final year student pharmacists seeking residency program placement were asked to complete a pre-session survey assessing confidence level for residency interviews.

An evaluation of student performance and perceptions within an integrated pharmaceutics course sequence.

Background And Purpose: To describe the design of an integrated pharmaceutics course sequence and to assess the sequence by evaluating both student performance and perceptions.

Educational Activity And Setting: The non-sterile products portion of a pharmaceutics course sequence was designed to integrate the disciplines of physical pharmacy, dosage forms, pharmacy compounding, and pharmaceutical calculations and to include the respective topics deemed most relevant to doctor of pharmacy curriculum. The appropriate course content was organized in a modular format that began with the general concepts of drug product administration, preparation, stability, and performance and then specifically applied these concepts to a variety of non-sterile dosage forms.

Evaluation of a best practice alert to reduce unnecessary Clostridium difficile testing following receipt of a laxative.

Introduction: This study examined the effect of an alert notifying providers ordering Clostridium difficile PCR when their patient received a laxative within 24 hours at four hospitals.

Methods: All patients whose provider received the laxative alert when ordering C. difficile testing were examined.

Concomitant use of opioid medications with triptans or serotonergic antidepressants in US office-based physician visits.

Background: Opioids are not recommended for routine treatment of migraine because their benefits are outweighed by risks of medication overuse headache and abuse/dependence. A March 2016 US Food and Drug Administration (FDA) safety communication warned of the risk of serotonin syndrome from using opioids concomitantly with 5-hydroxytryptamine receptor agonists (triptans) or serotonergic antidepressants: selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Epidemiological information about co-prescribing of these medications is limited.

A Pilot Study on an Interprofessional Course Involving Pharmacy and Dental Students in a Dental Clinic.

To assess the effect of a dental clinical rotation program involving pharmacy students and dental students. An interprofessional education (IPE) course was offered as an elective to second-year pharmacy students and required for third-year dental students. The course included two in-class sessions, one online lecture, and five clinic sessions.

Lesinurad: A Novel Agent for Management of Chronic Gout.

Objective: To review the pharmacology, efficacy, and safety of lesinurad and determine its role relative to other agents in the management of chronic gout.

Data Sources: A PubMed search (1946 to February 2018) using the terms lesinurad and RDEA594 was conducted to identify relevant articles.

Study Selection And Data Extraction: In vitro or in vivo evaluations of lesinurad published in the English language were eligible for inclusion.

VMAT2 Inhibitors for Tardive Dyskinesia-Practice Implications.

Tardive dyskinesia is a potentially irreversible, debilitating, hyperkinetic movement disorder that can result from dopamine receptor antagonists. Prompt recognition and resolution of symptoms are instrumental in preventing disease irreversibility, though current treatment options have fallen short of robust, effective, and long-term symptom control. In April 2017, the Food and Drug Administration (FDA) approved 2 new vesicular monoamine transporter 2 (VMAT2) inhibitors, deutetrabenazine and valbenazine, for chorea related to Huntington's disease and tardive dyskinesia, respectively.

Evaluating the Safety and Tolerability of Sacubitril/Valsartan for HFrEF Managed Within a Pharmacist Clinic.

Objective: The objective of this research was to describe the use of pharmacist-managed sacubitril/valsartan therapy in a multi-center, outpatient cardiac group.

Background: Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNi), is a novel agent for the treatment of heart failure. An ARNi is recommended by national guidelines to be used in place of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) therapy for patients who remain symptomatic.