bluuebunny/crossref_metadata_2025 huggingface dataset:
Medications that Need Hepatic Monitoring
Authors: Tice Sally A. , Parry Dean
Published: January 2018

Following is a list of drugs, which require hepatic monitoring, and which first appeared in our drug information newsletter. This is not intended to be an all inclusive list but is a result of research and data compiled from our drug information department based on commonly asked questions. Much, if not all of this information, is available in the package insert and other sources of information. There are not any clinical pearls here, it is simply a compilation of most of the drugs where monitoring of liver function tests (LFTs) is recommended. As always, there is a great deal of clinical judgment inherent in deciding when a particular patient needs LFTs; therefore, monitoring depends on the particular patient's needs and circumstances. Readers are welcome to email additions, corrections, deletions, and comments.
Rituximab plus Cyclophosphamide, Hydroxydaunomycin (Doxorubicin), Oncovin (Vincristine), and Prednisone (R-CHOP) Regimen for Non-Hodgkin's Lymphomas
Authors: Waddell J. Aubrey , Solimando Dominic A.
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column reviews various issues related to the preparation, dispensing, and administration of cancer chemotherapy, both commercially available and investigational.
Evaluating Internet Drug Information
Authors: Erbele Sara M. , Riggins Jennifer L. , Williams Cara L. , Heck Amy M.
Published: January 2018

For many consumers, the Internet has become a primary resource for health-related information. A study was conducted to evaluate the reliability and validity of consumer drug-information sites on the Internet. To assess reliability, the researchers identified sites with an “ask the pharmacist” option. Questions about the education and experience of the drug-information personnel, volume of inquiries received, reference utilization, and characteristics of inquirers were submitted to each of the sites. To assess validity, a drug information question was submitted to each of the sites. The responses received were evaluated by comparing them with responses from trained drug-information specialists working in established institutional services. Fewer than 70% of the sites answered the drug information question correctly. The conclusion: Drug information communicated via “ask the pharmacist” Internet sites may be unreliable.
Advances and Controversies in Adult ICU Sedation, Part 2: Objective Patient Assessment Tools and Review of Outcome Studies
Authors: Fraser Gilles L. , Riker Richard
Published: January 2018

This feature examines the impact of pharmacologic interventions on the treatment of the critically ill patient—an area of health care that has become increasingly complex. It will review recent advances (including evolving and controversial data) in drug therapy for adult ICU patients and assess these new modalities in terms of clinical, humanistic, and economic outcomes.
Operating Room Process and Nursing Issues: Medication/IV Charting
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting computerized prescriber order entry (CPOE) at the Ohio State University Medical Center. (By “prescribers,” we refer to health care professionals authorized to prescribe medications by their states.) Practical information on what worked and what failed will be provided, along with current updates on the status of CPOE at the Medical Center.
Contraception Physician-Assisted Suicide Gout, Pseudogout, and Hyperuricemia
Authors: Generali Joyce A.
Published: January 2018

To help readers monitor the most important developments in specialized areas of pharmacy practice in organized health systems, Hospital Pharmacy commissions Basic Bibliographies by guest editors, who have expertise in their respective fields. These guest editors survey the relevant literature and rank approximately 15 to 20 references that represent the most significant research and practice contributions in their areas. The more fundamental are listed first so that persons with limited time can select reading appropriate to their needs. A cumulative index to Basic Bibliography topics will be published semi-annually in June and December.
Oral Dosage Forms that should not be Crushed or Chewed
Authors: Mitchell John
Published: January 2018

The 2002 update of the Hospital Pharmacy feature “Oral Dosage Forms that Should Not Be Crushed or Chewed” is included with this issue as a wall chart.
Etoposide, Methylprednisolone, Cytarabine, and Cisplatin (ESHAP) Regimen for Refractory or Relapsed Lymphomas
Authors: Edwards Evelyne Tuong , Solimando Dominic A. , Waddell J. Aubrey
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column reviews various issues related to the preparation, dispensing, and administration of cancer chemotherapy, both commercially available and investigational.
• Caution Advised When Preservative-Free Forms of Midazolam are Used • New FDA Panel • Don't Overlook Preanalytical Variables When Assessing Lab Results • Errors in Clinical References • Another Fatality Due to Unsafe Pharmacy Practice
Authors: Cohen Michael R.
Published: January 2018

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program, which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.
• Renal Tubular Acidosis and Dyspnea in Patients Taking ACE Inhibitors • Aplastic Anemia Associated with Ketoconazole • Leflunomide-Induced Fever, Thrombocytosis, and Leukocytosis • Radiographic Contrast Material Causes Dystonia • Zolpidem and Delirium • Hepatotoxicity with Short-Term Trazodone Therapy
Authors: Shuster Joel
Published: January 2018

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program (1-800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
Questions and Answers from the F.I.X. • Insulin Drips • Warfarin Protocol • Glucosamine Chondroitin Adverse Reaction • Proton-Pump Inhibitor Review
Authors: Cada Dennis J.
Published: January 2018

The Formulary Information Exchange (The F.I.X.) is an online drug information service available to subscribers to The Formulary Monograph Service at http://theformulary.com , or you may log on through drugfacts.com . In this column, we present samples of recent dialog on The F.I.X. If you would like more information on The Formulary Monograph Service or The F.I.X., please call 800-322-4349.
Improving a Medication Error Monitoring Program at an Acute-Care Hospital
Authors: Massaro Frank J.
Published: January 2018

This report describes the development and implementation of a medication error monitoring program (MEMP) at an acute-care hospital in a multisite health care system. Data from every reported potential error (mistakes in prescribing, transcribing, dispensing, or planned administration that are detected and corrected before actual administration) and actual error (mistakes identified after drug is administered or failure to administer a scheduled drug) were entered in an electronic database. Medication errors with more than one potential cause were counted more than once. A designated pharmacist, in consultation with other health care professionals, assigned a severity level (levels I–IV; from no apparent injury to permanent functional impairment or death based on published definitions1) to the clinical outcome of every error. A summary of the data and performance improvement activities were reported to the hospital's Pharmacy and Therapeutics Committees, Quality Improvement Committees, and Board of Trustees.
Herbal Supplement Use among Patients in a Rural Health System
Authors: Gore Alvin , Mills Orlando , Gonzalez Luis , Volokhonsky Helen
Published: January 2018

Background

The use of herbal supplements is common but has not been adequately documented in a rural health system.

Methods

A questionnaire measuring the use of herbal supplements, disclosure to a physician, and discussion with a physician was distributed to 400 adult patients in three rural offices. A separate survey was distributed to 24 physicians in these three practices.

Results

Two hundred ninety-three of 400 patient questionnaires (74%) and 18 of 22 physician questionnaires (75%) were returned and analyzed. Twenty percent of patients used herbal supplements and 59% of these disclosed this use to their physicians. Only half of the doctors returning the survey regularly asked their patients about herbal use and most admitted a lack of knowledge about herbals.

Conclusion

The use of herbal products may be less common in a rural health system than in other practice settings. Patients would disclose the use of herbal supplements to physicians more often if they were asked about such consumption and physician knowledge about the products were improved.
Fenoldopam: Prevention of Contrast Media Nephrotoxicity
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses — This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data—including, background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
New Drugs Approved by the FDA; New Dosage Forms and Indications; Agents Pending FDA Approval; Labeling Changes Related to Safety
Authors: Baker Danial E.
Published: January 2018

This monthly feature will help readers keep current on new drugs, new indications and dosage forms, and safety-related changes in labeling or use. Each month, new information will be added to the table (shown in bold type) and older information will be removed. Efforts have been made to ensure the accuracy of the information; however, if there are any questions, let us know at hospitalpharmacy@drugfacts.com .
Nursing Issues
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting computerized prescriber order entry (CPOE) at the Ohio State University Medical Center. (By “prescribers,” we refer to health care professionals authorized to prescribe medications by their states.) Practical information on what worked and what failed will be provided, along with current updates on the status of CPOE at the Medical Center.
Beware: Antibiotic-Induced Hepatotoxicity is Rare but Deadly
Authors: Simmons Carol
Published: January 2018

Hospital Pharmacy welcomes contributions to this column, in which articles originally published in pharmacy department newsletters are reprinted. Material is selected because of its educational value or because it typifies the type of information that is interesting to pharmacy newsletter readers. If you would like us to consider your newspaper material for publication, mail a copy and a computer disk containing the document to: Hospital Pharmacy, Facts and Comparisons, 111 Westport Plaza, Suite 300, St. Louis, MO 63146.
• Automation: Acute Care • Personal Digital Assistants (PDAs) • Urinary Tract Infections
Authors: Generali Joyce A.
Published: January 2018

To help readers monitor the most important developments in specialized areas of pharmacy practice in organized health systems, Hospital Pharmacy commissions Basic Bibliographies by guest editors, who have expertise in their respective fields. These guest editors survey the relevant literature and rank approximately 15 to 20 references that represent the most significant research and practice contributions in their areas. The more fundamental are listed first so that persons with limited time can select reading appropriate to their needs. A cumulative index to Basic Bibliography topics will be published semi-annually in June and December.
Clinicians Often Unaware of Colchicine Dose Limits; What is a “Bolus?”; Drug Information Leaflets can Help Prevent Errors
Authors: Cohen Michael R.
Published: January 2018

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program, which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.
Delayed-Onset Heparin-Induced Thrombocytopenia; Paradoxical Reactions to Commonly Used Medications; Leukocytoclastic Vasculitis Caused by Efavirenz; Reactivation of Histoplasmosis after Treatment with Infliximab; Two More Reports of Dystonias: Bupropion and Metoclopramide Are the Culprits
Authors: Shuster Joel
Published: January 2018

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program (1-800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
Oxcarbazepine: Bipolar Disorders
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses — This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data—including, background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Outcome Analysis of Antimicrobial Prophylaxis in Cardiothoracic Surgery Patients Receiving Cefazolin Alone or a Ceftazidime—Vancomycin Combination
Authors: Brooks Joseph C. , Hatton Randy C. , Winner Larry
Published: January 2018

Although cefazolin is recommended as the drug of choice for most cardiothoracic surgeries, some surgeons prefer a broad-spectrum prophylactic regimen. The purpose of this observational study was to compare the infection rates in a cohort of male patients undergoing heart, lung, and thoracic aneursym surgeries from 1995 to 1998 at a single institution who received cefazolin, ceftazidime plus vancomycin (broad-spectrum), or other antibiotics for antimicrobial prophylaxis. Data were collected for 648 patients over more than 2 years. Infection rates were not different (p = 0.5) between the cefazolin (14%) and the broad-spectrum antibiotic groups (11%). The incidences of mediastinitis were also not different between the cefazolin and broad-spectrum groups. There was a statistically shorter length-of-stay in the ICU (p = 0.0109) in the cefazolin group (median 2.0 days) compared with the broad-spectrum group (median 3.0 days) when phases I and II were combined. Multiple logistic regression suggests that antibiotics were changed more often in the patients who received cefazolin instead of ceftazidime plus vancomycin. Other variables associated with the need to change antibiotics include surgeon, open-heart surgery, diabetes, and hospital stay greater than 1 day. These data convinced the cardiac surgeons at this institution to use cefazolin as the drug of choice for cardiothoracic surgery antibiotic prophylaxis.
The Effect of the Bispectral Index on Medication Utilization in the Operating Room and Time to Discharge from the Postanesthesia Care Unit
Authors: Windisch Paul A. , Worsham G. Michael
Published: January 2018

Goal

To assess the effectiveness of the Bispectral Index (BIS) monitor in reducing hypnotic medication utilization, associated costs, and length of patient stay in the postanesthesia care unit (PACU).

Methods

The utilization and cost of inhaled anesthetics, induction agents, and time to discharge from the PACU before the introduction of BIS technology were evaluated retrospectively. The same data was then collected from patients whose level of consciousness was assessed using the BIS monitor.

Results

The mean total medication cost per patient case was $53.40 in the baseline group compared with $33.10 in the BIS group; when normalized to a 60-minute case, total costs per case were comparable. The mean cost of inhaled anesthetic per case in the baseline group was $19.47 compared with $8.14 in the BIS group; the normalized cost of inhaled anesthetic per case in the baseline group was $13.43 compared with $9.36 in the BIS group. The mean time to discharge from the recovery room was 68 minutes in the baseline group and 54 minutes in the BIS group. Cases were also categorized by length of procedure, and costs and times to discharge were tabulated for each category.

Conclusion

The BIS monitor appears to decrease the utilization and costs of hypnotic/induction agents. However, the cost of the BIS monitor is substantial and could ultimately offset the medication cost savings.
Frovatriptan Succinate
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary® Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-ser-vices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. The monographs are published in printed form and on diskettes that allow customization. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The April 2002 Formulary monograph topics are pegfilgrastim, fondaparinux sodium, dutasteride, aripiprazole, and ezetimibe. The DUE is on drotrecogin alfa.
Implementing the Rules Engine
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting computerized prescriber order entry (CPOE) at the Ohio State University Medical Center. (By “prescribers,” we refer to health care professionals authorized to prescribe medications by their states.) Practical information on what worked and what failed will be provided, along with current updates on the status of CPOE at the Medical Center.
The Case for the Personal Digital Assistant (PDA)
Authors: Felkey Bill G. , Fox Brent I.
Published: January 2018

This continuing series will be a valuable resource for both experienced and novice users of handheld computer technology. Topics will include how to evaluate hardware and software, clinical and business applications, and the development of a “digital peripheral brain.” The authors will also discuss PDA organization skills that can maximize professional and personal efficiency.
Questions and Answers from the F.I.X.; Insulin Aspart vs Insulin Lispro; Phenothiazines and Contrast Media; Meperidine Removal from Formulary; Furosemide and Albumin as an Admixture
Authors: Cada Dennis J.
Published: January 2018

The Formulary Information Exchange (The F.I.X.) is an online drug information service available to subscribers to The Formulary Monograph Service at http://theformulary.com , or you may log on through drugfacts.com. In this column, we present samples of recent dialog on The F.I.X. If you would like more information on The Formulary Monograph Service or The F.I.X., please call 800-322-4349. If you would like to comment on any of the following questions or answers, please e-mail them to Dennis J. Cada at dcada@drugfacts.com .
Depression: Postpartum; Gastrointestinal Disorders; Pharmacoeconomics of Cancer Therapy
Authors: Generali Joyce A.
Published: January 2018

To help readers monitor the most important developments in specialized areas of pharmacy practice in organized health systems, Hospital Pharmacy commissions Basic Bibliographies by guest editors, who have expertise in their respective fields. These guest editors survey the relevant literature and rank approximately 15 to 20 references that represent the most significant research and practice contributions in their areas. The more fundamental are listed first so that persons with limited time can select reading appropriate to their needs. A cumulative index to Basic Bibliography topics will be published semi-annually in June and December.
FDA Advise-ERR: Deaths Associated with IV Colchicine; PCA Means Patient-Controlled Analgesia
Authors: Cohen Michael R.
Published: January 2018

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program, which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.
Coital Headaches Caused by Amiodarone; Breast Enlargement Due to Penicillamine; Dystonia Due to Carbamazepine Toxicity; Gemcitabine-Induced Pulmonary Toxicity; Thrombocytopenia with Linezolid; Omeprazole and Leucocytoclastic Vasculitis
Authors: Shuster Joel
Published: January 2018

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program (1-800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
Important Changes in the ACLS 2000 Guidelines for the Management of Cardiac Arrest
Authors: Fraser Gilles L. , Bagwell Sandra P.
Published: January 2018

This feature examines the impact of pharmacologic interventions on the treatment of the critically ill patient—an area of health care that has become increasingly complex. It will review recent advances (including evolving and controversial data) in drug therapy for adult ICU patients and assess these new modalities in terms of clinical, humanistic, and economic outcomes.
The Evolving Role of Angiotensin Receptor Blockers in Heart Failure
Authors: Howard Patricia A.
Published: January 2018

This continuing feature will update readers on recent developments in cardiovascular pharmacotherapy. Cardiovascular disease remains the number one killer in the US, and more clinical outcome trials have been conducted in cardiology than in any other field of medicine. Given this rapidly expanding knowledge base, pharmacists can have a significant impact on the prevention and treatment of cardiovascular disease—if they keep current with developments in drug therapy.
Selecting Appropriate Pharmacotherapy for Patients with Osteoporosis: Holistic Risk—Benefit Analysis
Authors: Hansten Philip D.
Published: January 2018

In the US, the major pharmacotherapeutic approaches for the prevention or treatment of osteoporosis in women are estrogen-based hormone replacement therapy, selective estrogen receptor modulators, salmon calcitonin, bisphosphonates, calcium, and vitamin D. All of these treatments are beneficial in increasing bone mineral density and reducing fractures in patients with osteoporosis. However, each of the therapies possesses a unique mechanism of action and other potential benefits and side effects. Estrogen replacement therapy may lower the risk of cardiovascular disease, but it increases the risk of venous thromboembolism (VTE) and may increase the risk of breast cancer. Unopposed estrogen therapy is associated with increased risk for endometrial cancer, but the addition of progestins virtually eliminates this adverse event. The selective estrogen receptor modulator raloxifene is associated with positive cardiovascular effects and demonstrates a protective effect against some types of breast cancer. Like estrogen, raloxifene increases the risk of VTE. Salmon calcitonin has a strong analgesic effect and is not associated with any serious long-term adverse events, but some individuals may not be able to tolerate the nasal formulation. Bisphosphonates are associated with serious upper GI effects. The concomitant administration of calcium and vitamin D in all patients being treated for osteoporosis is generally recommended.

Selecting optimal treatment relies on an individualized risk–benefit analysis that takes into account the patient's medical history, concomitant diseases, current medications, general physical and mental well being, and personal feelings about the various therapies. Careful consideration of the various treatment options may lead to improved compliance and more effective management of osteoporosis.
Strategies for Providing Culturally Appropriate Pharmaceutical Care to the Hispanic Patient
Authors: Davidhizar Ruth , Shearer Ruth
Published: January 2018

As the American Hispanic population grows, the need for health care services for individuals who do not speak English is becoming increasingly apparent. Spanish-speaking persons encounter difficulties accessing health care. This article focusses on the special needs of the Spanish-speaking individual in the health care system and presents strategies for providing culturally appropriate care.
Drotrecogin Alfa
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary® Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-ser-vices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. The monographs are published in printed form and on diskettes that allow customization. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The May 2002 Formulary monograph topics are 90Y ibritumomab tiuxetan, inerferon beta-1a, tiotropium, rifaximin, and eplerenone. The DUE is on pegfilgrastim.
Quality and Operations Improvement: Medication Error Reduction
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting computerized prescriber order entry (CPOE) at the Ohio State University Medical Center. (By “prescribers,” we refer to health care professionals authorized to prescribe medications by their states.) Practical information on what worked and what failed will be provided, along with current updates on the status of CPOE at the Medical Center.
Using outside Compounding Firms during Drug Shortages; CMS Interpretation of Medication Security; Refrigerator Temperature Checks; More on Pharmacist Review of Orders; Nurse Dispensing; Storing IV Admixtures in Other Departments
Authors: Rich Darryl S.
Published: January 2018

This column addresses questions from readers about any issue, process, standard, or future direction of the Joint Commission, whether it relates to home care, the hospital, or other practice environment. The objective is to give you a better insight into the Joint Commission accreditation process in your own practice site. Any question is fair game.
Palm OS or Pocket PC?
Authors: Felkey Bill G. , Fox Brent I.
Published: January 2018

This continuing series will be a valuable resource for both experienced and novice users of handheld computer technology. Topics will include how to evaluate hardware and software, clinical and business applications, and the development of a “digital peripheral brain.” The authors will also discuss PDA organization skills that can maximize professional and personal efficiency.
Mitoxantrone and Prednisone for Hormone-Resistant Prostate Cancer
Authors: Church Jessica , Solimando Dominic A. , Waddell J. Aubrey
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column reviews various issues related to the preparation, dispensing, and administration of cancer chemotherapy, both commercially available and investigational.
Quality and Operations Improvement: Medication Turnaround Time
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting computerized prescriber order entry (CPOE) at the Ohio State University Medical Center. (By “prescribers,” we refer to health care professionals authorized to prescribe medications by their states.) Practical information on what worked and what failed will be provided, along with current updates on the status of CPOE at the Medical Center.
Questions and Answers from the F.I.X. Perphenazine for Nausea and Vomiting; Atypical Antipyschotics; IV Contrast and Renal Dysfunction; Albumin in TPN
Authors: Cada Dennis J.
Published: January 2018

The Formulary Information Exchange (The F.I.X.) is an online drug information service available to subscribers to The Formulary Monograph Service at http://theformulary.com , or you may log on through drugfacts.com. In this column, we present samples of recent dialog on The F.I.X. If you would like more information on The Formulary Monograph Service or The F.I.X., please call 800-322-4349.
Anakinra
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary® Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. The monographs are published in printed form and on diskettes that allow customization. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The May 2002 Formulary monograph topics are 90Y ibritumomab tiuxetan, inerferon beta-1a, tiotropium, rifaximin, and eplerenone. The DUE is on pegfilgrastim.
Beware of Erroneous Daily Oral Methotrexate Dosing; Sound-Alike Names: Diprivan and Ditropan how Many Viokase? Indicate mEq of Potassium or Sodium when Phosphorous Supplements are Prescribed
Authors: Cohen Michael R.
Published: January 2018

These medication errors have occurred in health care facilities at least once. They will happen again–perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program, which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.
Methemoglobinemia as a Result of Excessive Topical Anesthesia; Severe MAOI Hypertensive Reaction Unrecognized by ED Personnel; Pulmonary Toxicity Secondary to Procarbazine; Acute Pancreatitis Associated with Propofol; Delirium Caused by Donepezil; Fatal Aspergillus Infection following Short-Term Corticosteroid Therapy
Authors: Shuster Joel
Published: January 2018

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program (1-800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
Fluoxetine: Raynaud's Phenomenon
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses

This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data–including, background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations–precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
PDAs: Focus on Hardware
Authors: Fox Brent I. , Felkey Bill G.
Published: January 2018

This third article in a series of 12 on the personal digital assistant (PDA) focuses on evaluating and selecting a PDA hardware platform. An upcoming article will feature readers' experiences and anecdotes related to PDAs in the health care setting.
Evaluation of Reteplase for the Management of Acute Myocardial Infarction: Door-to-Drug Time and Safety
Authors: Barlows Theodore G. , Machado Caridad , Salado Chanel , Trimino Estela
Published: January 2018

A drug use evaluation was conducted to determine if reteplase was administered expeditiously, appropriately, and safely to patients arriving in the emergency department (ED) with acute myocardial infaction (AMI). A retrospective review of the medical records of 28 patients receiving reteplase in the ED during a 6-month period was conducted. The median door-to-drug time for administration of reteplase was 33 minutes. Major and minor bleeding events occurred in 3.6% and 42.8% of patients, respectively. In general, reteplase was administered correctly and in a timely manner to appropriately screened patients.
Amiodarone-Induced Skin Pigmentation and Pulmonary Fibrosis
Authors: González Pilar , Otero María-José , Barrueco Miguel , Domínguez-Gil Alfonso
Published: January 2018

Amiodarone is a valuable drug for the treatment of supraventricular and ventricular arrhythmias. However, toxicity involving a variety of organs and tissues that limits the agent's clinical use is not uncommon. This article presents the case of a patient who developed amiodarone-induced pulmonary fibrosis and blue-gray facial pigmentation. The authors emphasize awareness of amiodarone's toxicity profile and the importance of appropriate treatment and followup care. Patients should be educated to take an active role in this process by monitoring themselves for symptoms of amiodarone-induced pulmonary toxicity, to aid in early diagnosis and help prevent fatal outcomes.
West Nile Virus
Authors: Gelone Steven P.
Published: January 2018

Several infectious agents have emerged over the past two decades as a result of population migration and enhanced world travel. The introduction of arthropodborne infections to formerly unaffected geographic areas has occurred in the western hemisphere at an alarming rate. In 1999, the West Nile virus (WNV) first appeared in North America in Queens, New York and spread rapidly to infect bird and mosquito populations along the Atlantic and Gulf coasts. Significant human morbidity and mortality has been associated with the virus, with several patients deaths from encephalitis. Specific antiviral therapy is currently unavailable, but recommendations for a national plan to control and prevent the spread of this vector-borne disease have been made by the Centers for Disease Control and Prevention. Educating the public about how WNV is transmitted, how to best protect one's self, and what signs and symptoms are consistent with this infection are extremely important. Pharmacists, who have more patient interactions per unit time than any other health care provider group, are in an excellent position to play a pivotal role in this educational effort.
Estramustine and Vinblastine (EV) Regimen for Advanced Hormone-Refractory Prostate Cancer
Authors: Waddell J. Aubrey , Solimando Dominic A.
Published: January 2018

The increasing complexity of cancer chemotherapy makes it mandatory that pharmacists be familiar with these highly toxic agents. This column reviews various issues related to the preparation, dispensing, and administration of cancer chemotherapy, both commercially available and investigational.
Quality and Operations Improvement: Order Set Development and Maintenance
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting computerized prescriber order entry (CPOE) at the Ohio State University Medical Center. (By “prescribers,” we refer to health care professionals authorized to prescribe medications by their states.) Practical information on what worked and what failed will be provided, along with current updates on the status of CPOE at the Medical Center.
Fondaparinux Sodium
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary®Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late Phase III trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. The monographs are published in printed form and on diskettes that allow customization. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The July 2002 Formulary monograph topics are olmesartan medoximil, fulvestrant, adalimumab, secretin, and duloxetine. The DUE is on olmesartan medoximil.
USP-Proposed Changes in Neuromuscular Blocker Package Labeling Will Help Prevent Errors; Important Check: Why Are “Missing Doses” Missing?; Information Technology Department Has Important Role in Preventing Medication Errors; Caution about Name Similarity: Avinza and Invanz
Authors: Cohen Michael R.
Published: January 2018

These medication errors have occurred in health care facilities at least once. They will happen again–perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program, which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.
Thrombocytopenia Caused by a Protein Pump Inhibitor; Hepatic Failure Associated with the Benzodiazepine Triazolam; Three Cases of Transient Encephalopathy with Paclitaxel; Thalidomide Problems: Hypothyroidism and Venous Thrombosis; Hypertensive Crisis with St. John's Wort
Authors: Shuster Joel
Published: January 2018

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medWatch program (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
Refeeding Syndrome in the Intensive Care Unit
Authors: Dickerson Roland
Published: January 2018

Nutrition Support Consultant features issues pertinent to the clinical aspects of pharmacy nutrition support practice.
Lamotrigine: Rectal Administration
Authors: Generali Joyce , Cada Dennis J.
Published: January 2018

Off-Label Drug Uses — This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Facts and Comparisons. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form so that the reader can easily identify the scope of information available. A summary of the data–including, background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations–precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments on “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Implementing and Tracking Clinical Quality Improvement in a Hospital Pharmacy
Authors: Weinhold Frank E. , Hill Marshall , Lonborg Randy , Jenkins Kristine , Golden Thomas , Duong Dao
Published: January 2018

This study describes a hospital pharmacy's initiative in tracking the progress of its clinical quality-improvement programs. Using first a manual system and then an online program for tracking pharmacy consultations, information on pharmacy performance quality was collected for a two-year period. Pharmacy consultations increased from 43 in February 1999 to 266 in December 1999, peaking at 402 in August 2000. Consultations increased during each month of the year 2000 compared with the corresponding month of 1999. The majority (33%) of consultations were order clarifications, followed by drug information consults (23%), patient care encounters (13%), pharmacokinetic consults (8%), therapeutic consults (7%), renally excreted drug monitoring (4%), and consultations involving duplicate unnecessary therapy, formulary conversion, and interactions/compatability (all at 3%). Antibiotic regimen change (2%) and allergy/disease state contraindication (1%) were the least frequent types of consultations. The online tracking system provided more detail than the manual tracking system. This detail can be used to target goals and demonstrate pharmacy progress to hospital committees and accreditation agencies.
CNS and Psychiatric Drugs
Authors: Generali Joyce A.
Published: January 2018

“Black-box” warnings report valuable postmarketing safety data about prescription drugs, keeping practitioners informed about potential adverse events, drug interactions, key dosing information, monitoring and administration requirements, and at-risk patient populations. They are especially crucial for newly approved agents. A list of agents with black-box warnings does not currently exist; however Hospital Pharmacy will be publishing comprehensive lists by drug category in this column until November 2002. At that time, a complete list in wall chart form will be released. Hospital Pharmacy will update the data as salient information becomes available.