Evaluation of metoprolol versus diltiazem for rate control of atrial fibrillation in the emergency department.

Objective: The purpose of this study was to compare the effectiveness and safety of the metoprolol and diltiazem administration in the Emergency Department (ED) for rate control of supraventricular tachycardia.

Methods: This was a retrospective cohort study of adult patients who presented to the ED with ventricular rates ≥120 beats per minute (bpm) and who received bolus doses of either intravenous metoprolol or intravenous diltiazem. The primary outcome was achievement of rate control, defined as heart rate < 110 bpm, at two hours after administration of the last bolus dose of metoprolol or diltiazem.

Community Pharmacists' Perceptions of Patient Care Services within an Enhanced Service Network.

Background: Pharmacists are positioned as an accessible source of patient care services (PCS). Despite the adversity community pharmacies continue to face, the expanding opportunity of offering PCS continues to be a pathway forward.

Objective: To identify community pharmacists' perceptions to deliver PCS within an enhanced service network.

COVID-19 pandemic: Challenges and solutions from the cardiology pharmacist's perspective.

The recent coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) challenges pharmacists worldwide. Alongside other specialized pharmacists, we re-evaluated daily processes and therapies used to treat COVID-19 patients within our institutions from a cardiovascular perspective and share what we have learned. To develop a collaborative approach for cardiology issues and concerns in the care of confirmed or suspected COVID-19 patients by drawing on the experiences of cardiology pharmacists across the country.

The Role of Serum Lithium Concentration on Pill Burden in Psychiatric Populations.

: Current research validates the use of lithium as a first-line agent in bipolar disorder, yet it remains underutilized. This might, in part, be the result of lithium's risk of toxicity. A lower serum lithium concentration would decrease the risk of toxicity.

Opportunities and Recommendations for Improving Medication Safety: Understanding the Medication Management System in Primary Care Through an Abstraction Hierarchy.

Background: Despite making great strides in improving the treatment of diseases, the minimization of unintended harm by medication therapy continues to be a major hurdle facing the health care system. Medication error and prescription of potentially inappropriate medications (PIMs) represent a prevalent source of harm to patients and are associated with increased rates of adverse events, hospitalizations, and increased health care costs. Attempts to improve medication management systems in primary care have had mixed results.

Potentially Inappropriate Medications Are Associated with Increased Healthcare Utilization and Costs.

Background/objectives: To examine the prevalence of potentially inappropriate medication (PIM) prescribing and its association with healthcare utilization and related expenditures utilizing nationally representative data from the United States.

Design: Retrospective cohort study.

Setting: The 2011-2015 Medical Expenditure Panel Survey (MEPS).

Implementation and evaluation of an advisement program focused on academic and career development.

Introduction: This research evaluated a formal academic and career advisement program implemented in a doctor of pharmacy program, which included a "Meet Your Advisor" luncheon and required faculty advisement sessions with an assigned faculty member.

Methods: The advising experience of students from two cohorts of first-year pharmacy students who received the formal advisement program (referred to as advisement cohort 1 and advisement cohort 2) were compared to the experience of a cohort of second-year students who entered prior to the formal advisement program (referred to as the pre-advisement cohort). All students completed a survey with both quantitative and qualitative questions regarding the advisement program.

Albumin and bleed risk in rivaroxaban treated patients.

Drugs exhibiting high protein binding have potential increased action in patients with hypoalbuminemia. Rivaroxaban is 92-95% protein bound, but the clinical effects of rivaroxaban in patients with low albumin are largely unknown. The purpose of this study was to evaluate the relationship between albumin and bleeding in rivaroxaban treated patients.

Optimal Sampling Strategies for Irinotecan (CPT-11) and its Active Metabolite (SN-38) in Cancer Patients.

Irinotecan (CPT-11) is an anticancer agent widely used in the treatment of a variety of adult solid tumors. The objective of this study was to develop an optimal sampling strategy model that accurately estimates pharmacokinetic parameters of CPT-11 and its active metabolite, SN-38. This study included 221 patients with advanced solid tumors or lymphoma receiving CPT-11 single or combination therapy with 5-fluorouracil (5-FU)/leucovorin (LV) (FOLFIRI) plus bevacizumab from 4 separate clinical trials.

Pharmacy Students' Ability to Identify Fall Risk-Increasing Drugs Using an Innovative Assessment Tool.

To evaluate change in the ability of third-year pharmacy students to identify drugs that increase fall risk after training in and experience using the Medication Falls Risk Assessment Tool (MFRAT). An assessment was administered to students prior to MFRAT use and after MFRAT use. The assessment consisted of 10 medication regimens for various chronic conditions (50 distinct drug choices with 30 correct answers and 20 distractors), and students were to identify fall risk increasing drugs (FRIDs).

Impact of Community Pharmacist Interventions With Managed Care to Improve Medication Adherence.

Background: Nonadherence to medications is a concern due to adverse outcomes and higher costs of care. The Centers for Medicare and Medicaid Services has made adherence a key measurement for Star ratings.

Objective: To evaluate the impact of a collaborative pilot program between a third-party payer, local pharmacy organization, and academic institution focusing on improving medication adherence with community pharmacies.

Training the trainers: A preceptor development program targeting interprofessional collaboration competencies.

Introduction: Faculty and preceptor development have been noted to be areas of need within the expansion of interprofessional education (IPE). The primary objective of this pilot study was to evaluate the impact of a preceptor development program on pharmacy preceptors' self-reported competence toward interprofessional collaboration.

Methods: Pharmacy preceptors were invited to participate in a two-hour preceptor development program followed by a brief survey.

Comparative Effectiveness of Vancomycin Versus Linezolid for the Treatment of Acute Pulmonary Exacerbations of Cystic Fibrosis.

Data are limited regarding the preferred antibiotics for treatment of acute pulmonary exacerbations (APEs) of cystic fibrosis (CF), when methicillin-resistant (MRSA) is suspected. To compare the rate of return to baseline lung function among individuals with APEs of CF treated with either vancomycin or linezolid. This retrospective study included individuals hospitalized for APEs of CF from May 1, 2015, to April 30, 2017 who were infected with MRSA and treated with vancomycin or linezolid.

Common bacterial infections and their treatment in hospitalized pediatric patients.

Purpose: Common bacterial infections in pediatric patients that the hospital pharmacist may encounter are reviewed, and guidance on the safe and effective use of antibiotics to treat those infections is provided.

Summary: Pharmacists play a key role in evaluating and creating antibiotic treatment plans for patients with infections. Bacterial infections are a common reason for hospital admission in pediatric patients, and pharmacists working in hospitals may be consulted to provide treatment and monitoring recommendations.

Evaluation of Mobile Applications Intended to Aid in Conception Using a Systematic Review Framework.

This review identified and evaluated apps intended to aid women in conception that were available across major mobile platforms; secondary objectives were to highlight additional criteria and considerations when evaluating conception-related apps. Apple iTunes and Google Play stores were searched using the keywords , and . Included apps were as follows: contained in the first 50 search results; presented in English; intended for layperson use; updated July 1, 2018, or after; marketed as a conception aid; and used a defined fertility tracking method.

Exploring the Effectiveness of Team-based Enablement Interventions to Improve Antibiotic Prescribing within a Psychiatric Hospital.

Antimicrobial resistance threatens the effective prevention and treatment of many types of infections. Infection occurs more frequently in patients diagnosed with psychiatric illness due to a number of risk factors. Urinary tract infections (UTI) are among the most common infections in this patient population.

Immunization Education in US Pharmacy Colleges and Schools.

To determine the extent to which immunization is covered at US colleges and schools of pharmacy and to characterize what immunization- and vaccine-related content is taught. An invitation to complete a 23-question online survey instrument was sent to 128 accredited US pharmacy colleges and schools. Frequency and descriptive statistics were used to characterize the data, and the Fisher exact test was used to compare opportunities for students to engage in introductory and advanced pharmacy practice experiences (IPPEs and APPEs) at schools located in states that did or did not allow pharmacy students and interns to vaccinate.

A Multimodal Approach to Teaching Cultural Competency in the Doctor of Pharmacy Curriculum.

To assess first-year pharmacy students' grades and preferred teaching styles within a multimodal teaching approach for developing cultural competency during a required Pharmaceutical Care I course. A lecture, two active-learning exercises (global bead and trading places), and an in-class quiz were used to teach students about cultural competency in preparation for a practicum. A four-hour practicum consisting of videos, structured discussion, counseling, and a survey were used in this multimodal approach.

Awareness, knowledge, and attitudes towards human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) among pharmacy students.

Introduction: The purpose of this study was to assess pharmacy students' awareness, knowledge, and perceptions towards human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), confidence and intentions to counsel patients on PrEP, and preferred PrEP training.

Methods: A web-based cross-sectional survey was conducted with pharmacy students. Descriptive statistics and multivariate logistic regressions were performed.

Treatment of prolonged tacrolimus toxicity using phenytoin in a haemodialysis patient.

What Is Known And Objective: Treatment of tacrolimus toxicity includes holding tacrolimus and supportive care. The objective is to describe considerations for pharmacologic induction of tacrolimus metabolism.

Case Description: A 52-year-old male with a failed renal transplant on chronic haemodialysis developed tacrolimus toxicity due to a drug-drug interaction with darunavir/ritonavir.

Successful cure of daptomycin-non-susceptible, vancomycin-intermediate Staphylococcus aureus prosthetic aortic valve endocarditis directed by synergistic in vitro time-kill study.

Infectious complications following surgical valve replacements are extremely difficult to treat, often requiring prolonged antimicrobials therapy with or without surgery. Vancomycin-intermediate Staphylococcus aureus is an infrequent pathogen, with an estimated prevalence of less than 0.3%, but presents even greater challenges.

Adjuvant β-Lactam Therapy Combined with Vancomycin for Methicillin-Resistant Bacteremia: Does β-Lactam Class Matter?

We analyzed the impact of vancomycin (VAN) combined with adjuvant β-lactam therapy (Combo) on persistent (≥5 days) methicillin-resistant bacteremia versus VAN alone by using pooled data from two previously published observational studies ( = 156). Combo was inversely associated with persistent bacteremia (adjusted odds ratio, 0.460; 95% confidence interval, 0.

Fecal microbiota analysis of polycystic kidney disease patients according to renal function: A pilot study.

The heterogeneity of the renal disease, therapeutic interventions, and the original cause of the renal failure, all directly affect the microbiota. We delineate in this report the direct effect of decreased renal function on the bacterial composition following stringent criteria to eliminate the possibilities of other confounding factors and dissect the direct effects of the uremic milieu. We analyzed the microbiome following three different approaches to further evaluate the effects of mild, moderate and advanced renal insufficiency on the microbiome.

Definition and Validation of a Novel Metric of Erythropoiesis-Stimulating Agent Response in Hemodialysis Patients.

Erythropoiesis-stimulating agents (eg, epoetin alfa) are the primary treatment for anemia in patients with end-stage renal disease. Hemoglobin variability in and out of a narrow target range is common and associated with higher morbidity and mortality risk. More robust erythropoiesis-stimulating agent response metrics are needed to define optimal dosing and their association with clinical outcomes.

Impact of Sleeve Gastrectomy on Psychiatric Medication Use and Symptoms.

Background: Sleeve gastrectomy (SG) has become the primary bariatric surgery procedure in the U.S. Over 50% of people presenting for surgery have psychiatric diagnoses.