bluuebunny/crossref_metadata_2025 huggingface dataset:
This CE is published through an unrestricted educational grant from Bristol-Myers Squibb
Authors: Beckwith M. Christina , Mullin Shantei
Published: January 2018

Credit

This lesson is good for 0.2 CE units, with a passing grade of 70%.

Goal

The goal of this program is to inform the participant of costeffective ways to prevent, identify, and manage nausea and vomiting induced by antineoplastic agents.

Objectives

At the completion of this program the participant will be able to: 1. List antineoplastic agents associated with a high incidence of nausea and vomiting. 2. Identify patient-specific risk factors for developing chemotherapyinduced nausea and vomiting (CINV) and how these factors may influence treatment of this syndrome. 3. Compare the three major types of CINV, including the pathophysiologic mechanism, time of onset, and symptom duration of each type. 4. Explain the mechanism of action and appropriate place in therapy for each type of antiemetic agent. 5. Differentiate between pharmacologic regimens for the prevention and treatment of CINV in adults. 6. Identify drug-specific factors that must be considered in developing a formulary management strategy for the antiemetic agents. 7. Describe specific information that the pharmacist can share with patients to help them understand and manage CINV.
Gemtuzumab Triptorelin
Authors: Lai Cecilia , 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.
• Death Caused by Unregulated “Internet Drug”/ • More Problems with Herbals and OTCs/ • Fluoxetine ADRs: Postmarketing Reporting/ • Recurrent Supraventricular Tachycardia in a Pediatric Patient Receiving Albuterol/ • Fatal Arrhythmias in Hyperkalemic Patients Given Lidocaine
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./ • Adenosine Stress Test/ • Rimantadine (Flumadine) for Parkonsonism/ • Canadian-Purchased Medications for Use in the US /• Vancomycin Peak and Trough Levels/ • Levaquin Dosing in Renal Impairment
Authors: Cada Dennis J.
Published: January 2018

The Formulary Information Exchange (The F.I.X.) is an online drug information service available to subscribers of The Formulary Monograph Service 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.
Intranasal Lidocaine: Migraine Headaches
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. Finally, references direct the reader to the full literature for more comprehensive information prior to patient care decisions.
Sodium Phosphate Monobasic Monohydrate, USP and Sodium Phosphate Anhydrous, USP
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary® Monograph Service receive five to six researched 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 called The Formulary Information Exchange (The F.I.X). All topics pertinent to clinical 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 March 2001 Formulary monographs are nateglinide, bivalirudin, caspofun-gin, tositumomab, and omalizumab. The DUE is on meperidine.
Pharmacy Issues: Intravenous Drug Ordering
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting prescriber computer order entry (PCOE) 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 PCOE at the Medical Center.
Issues in Implementation and Enforcement of Hospital Pharmacy Policies and Procedures
Authors: Van Dusen Virgil , Pray W. Steven
Published: January 2018

Policies (a type of long-range plan) and procedures (a type of short-range plan) are corporate statements that reflect the organization's objectives. Whereas policies are guidelines for guiding a work effort, procedures represent an acceptable set of steps for carrying out the specific policy. As such, it is vital to orient new employees as to the content of policies and procedures. Flexibility in enforcement of policies and procedures helps encourage employee creativity and innovation, although any departure from established policies and procedures may be viewed as a breach of the hospital pharmacy's standards of practice. Furthermore, in a civil lawsuit, a lawyer may argue that various hospital documents, such as memoranda or notes related to policies or procedures, are part of policies and procedures. Policies and procedures are vital segments of institutional life that should be communicated to all employees. Failure to follow them may create liability risk.
Hospice and Palliative Care in Managed Care Organizations
Authors: Vogenberg F. Randy
Published: January 2018

Managed health care has changed the way health services are provided and paid for. It is still evolving. Many pharmacists have already felt the impact of these changes. This continuing feature illuminates the many facets of managed care with special emphasis placed on how these changes may affect pharmacists working in health systems. The expertise provided by pharmacists will be needed to fulfill the potential of affordable, comprehensive, and quality health care as promised by managed care. Pharmacists must understand what is happening, why it is happening, and what is likely to happen in the future. To be an active and effective player, you must understand what is happening on the field.
• Unrecognized Neuroleptic Malignant Syndrome Caused by Risperidone;• Cerebral Hemorrhage Due to Ginkgo Biloba?;• Abnormal Movements Due to Donepezil?;• Febrile Pancytopenia Associated with Clopidogrel;• Colon Perforation Due to Clozapine;• Steroid Psychosis after Intra-Articular Administration
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.
Caspofungin
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: January 2018

Each month, subscribers to The Formulary® Monograph Service receive five to six researched 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 called The Formulary Information Exchange (The F.I.X). All topics pertinent to clinical 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 2001 Formulary monographs are on formoterol fumarate, esomepra-zole, galantamine, valganciclovir, and travoprost. The DUE is on formoterol fumarate.
Vaccines for Workers: Immune Aspects of Occupational Health
Authors: Grabenstein John D.
Published: January 2018

With the rapid pace of immunologic research, it is more important than ever for readers to understand rational immunodiagnosis, immunoprophylaxis, and immunotherapy. This column is intended to help you carry out proper immuno-logic drug use in your practice.
•Fetal Abnormalities Due to Anticonvulsants; •Are Manufacturers' Recommended Doses Too High?; •Mood Disorders Associated with Interferon Therapy; •Prochlorperazine and Extrapyramidal Reactions; •Gynecomastia and AIDS Drugs;•Toxicity of Lithium Combined with Angiotensin II Receptor Blockers
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.
Pheochromocytoma: A Brief Review
Authors: Tolstoi Linda G.
Published: January 2018

Pheochromocytoma, a rare tumor, can cause one of the most dramatic, life-threatening crises in the medical field of endocrinology. This catecholamine-producing tumor can occur from infancy to old age and may be associated with pregnancy. The tumor is difficult to diagnose and treat because of its location in the body and its association with a variety of symptoms, which often mislead and confuse physicians. Pheochromocytoma must be suspected in patients, especially young individuals, who experience resistant or episodic hypertension associated with sweating and headaches. Surgical treatment of pheochromocytoma is the treatment of choice. However, it is important to medically treat the patient prior to surgery to reverse the adverse effects (eg, hypertension, cardiovascular disease) associated with the excess circulating catecholamines. Pharmacists must be aware that pheochromocytoma is potentially curable if successfully treated. Thus, the urgency of diagnosis and treatment cannot be overemphasized.
New Drugs Approved by the FDA New Dosage Forms and Indications Agents Pending FDA Approval
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 .
Unique IV Drug Ordering: Patient-Controlled Analgesia, Sliding-Scale Insulin, and Sliding-Scale Heparin
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting prescriber computer order entry (PCOE) 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 PCOE at the Medical Center.
Cancer Chemotherapy Update: Paclitaxel and Cisplatin (TC) Regimen for Advanced Ovarian Cancer
Authors: Wagner Keith A. , 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.
Total Parenteral Nutrition Preparation for a Known Latex-Allergic Patient
Authors: Bianchi Carolyn M. , Seaver David E. , Fanikos John , Churchill William
Published: January 2018

This article describes how a hospital pharmacy department provided total parenteral nutrition (TPN) fora known latex-allergic patient to safely meet the patient's nutritional needs and maintain proper aseptic technique during the compounding process. After numerous attempts to feed the patient enterally failed, total parenteral nutrition was recommended. It was decided that preparation and administration of parenteral nutrition for this patient should follow the recently initiated Pharmacy policy for the preparation of sterile products for latex-allergic patients as closely as possible. After reviewing the compounding process, it was determined that a base solution of protein and dextrose could be safely prepared by making sure that the products we used did not contain latex and that the process did not involve puncturing of latex-containing ports or stoppers. All other ingredients would be added manually. Prior to discharge, enteral feeding was reintroduced and the TPN solution was discontinued.
Process Improvements to Decrease Pharmacy Turnaround Time
Authors: Kilsdonk Gary F. , Henke Lori W. , Perley Diana L.
Published: January 2018

This case study will describe the steps taken to improve pharmacy turnaround times at a 450-bed community hospital. Working through a pharmacy/nursing committee, the pharmacy implemented changes to streamline the order entry process and reorganize workflow. An upgrade of unit-based dispensing cabinets improved floorstock levels and pharmacy control over this stock. Gains were made by faxing medication orders to pharmacy and by decentralizing pharmacy staff during peak hours. Turnaround times ranged between 80 to 147 minutes before the changes and 26 minutes to 33 minutes following the changes. Pharmacist turnover decreased and staff morale improved.
Famotidine: Prevention of Paclitaxel Hypersensitivity Reactions
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 .
Illegible Prescription Handwriting; Blanket Medication Orders; “Range” Medication Orders; Automatic Stop Orders
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.
Pharmacy Issues: Weight-Based Dosing
Authors: Miller Alicia S.
Published: January 2018

This continuing feature will inform readers about the process of implementing, maintaining, and supporting prescriber computer order entry (PCOE) 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 PCOE at the Medical Center.
Using Acetylcysteine to Prevent Radiographic-Contrast-Media-Induced Nephropathy in a Patient with Chronic Renal Failure
Authors: Burns Kevin E.
Published: January 2018

Clinical Pearls

Each of these special features conveys an idea, concept, or fact that may be useful in your pharmaceutical practice, but may not be widely known, published, or taught. An 84-year-old male with a history of chronic renal failure secondary to nephrectomy and chronic hypertension was admitted for elective coronary angiography following complaints of midsternal chest pain and an abnormal thallium stress test. The patient was found to have other risk factors for radiographic-contrast-media-induced nephropathy, including hyponatremia and hypoalbuminemia. Mild volume expansion was initiated and acetylcysteine 600 mg was administered orally every 12 hours on the day before the procedure. The patient's baseline serum creatinine was found to be 2 mg/dL. A total of 125 mL of nonionic, low-osmolality contrast media was infused during the procedure. An additional two doses of acetylcysteine 600 mg were administered on the day of the procedure. The patient's recovery was uneventful and he was discharged. The postprocedure serum creatinine was stable at 2 mg/dL 48 hours after the procedure. It appears that orally administered acetylcysteine can prevent radiographic-contrast-media-induced nephropathy.
Transforming Health Care through Regulatory Action (Not a Managed Care Story)
Authors: Vogenberg F. Randy
Published: January 2018

Managed health care has changed the way health services are provided and paid for. It is still evolving. Many pharmacists have already felt the impact of these changes. This continuing feature illuminates the many facets of managed care with special emphasis placed on how these changes may affect pharmacists working in health systems. The expertise provided by pharmacists will be needed to fulfill the potential of affordable, comprehensive, and quality health care as promised by managed care. Pharmacists must understand what is happening, why it is happening, and what is likely to happen in the future. To be an active and effective player, you must understand what is happening on the field.
Pharmacy Issues: Nonpharmacy Medications, Investigational Drugs, and Replacement Drug Ordering
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.
Update on Anabolic Agents
Authors: Dickerson Roland N.
Published: January 2018

Nutrition Support Consultant features issues pertinent to the clinical aspects of pharmacy nutritional support practice.
Lovastatin: Extended-Interval (Alternate-Day) Dosing
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 .
Mechlorethamine, Vincristine, Procarbazine, and Prednisone (MOPP) Regimen for Advanced Hodgkin's Disease
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.
Ambiguous Argatroban Labeling on Cartons and Vials Could Lead to Errors/Tracking “Missing” Medications to Learn Why a Dose was Omitted/Look-alike Containers of Nimbex (Cisatracurium Besylate) Injection
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 1-800-233-7767 (1-800-23-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.
Questions and Answers from the F.I.X./More on UFH after LMWH/Carboprost (Hemabate) in Hemorrhagic Cystitis/Stability of Ferrlecit (Sodium Ferric Gluconate Complex)/Pamidronate (Aredia) IV Weekly/Pantoprazole (Protonix) Continuous Infusion/Heparin Dosing in Cardiology Patients
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.
Utilization of Glycoprotein IIB/IIIA Receptor Antagonists in the Management of Acute Coronary Syndrome: Focus on Patient Characteristics and Formulary Decisions
Authors: Cheng Judy W.M. , Greenberg Karin A. , Mehl Bernard
Published: January 2018

This study described the utilization of glycoprotein IIB/IIIA inhibitors (GP IIB/IIIAs) in a tertiary-care center. Medical records of 316 patients receiving GP IIB/IIIA were reviewed. Patient demographics, medical history, coronary intervention, and outcomes were recorded and compared among groups based on specific GP IIB/IIIA used. The majority of GP IIB/IIIA was used for coronary interventions. Two patients died during hospitalization (1 tirofiban, 1 combination abciximab and tirofiban). Ten patients developed thrombocytopenia (5 tirofiban, 2 epti-fibatide). For coronary interventions, eptifibatide was the more economical therapy. For unstable angina and non-Q-wave myocardial infarction, tirofiban became the most economical therapy. Based on this data, a marginal cost saving of $676 per 316 patients would be achieved if abciximab and eptifibatide were used only. The selection of agents of choice in individual institutions should be based on data from clinical trials and pharmacoeconomic studies, as well as the institution-specific patient population and practice.
Meningococcal Vaccines: Expanding Protection from Infants to College
Authors: Grabenstein John D.
Published: January 2018

With the rapid pace of immunologic research, it is more important than ever for readers to understand rational immunodiagnosis, immunopro-phylaxis, and immunotherapy. This column is intended to help you ensure proper immunologic drug use in your practice.
Severe Diarrhea Associated with Biaxin COX-2 Inhibitors Cause Renal Damage Fluconazole and Torsade de Pointes Hepatic Adenoma Due to Oral Contraceptives Acute Cardiotoxicity with Anthracyclines
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. Your report will be published anonymously unless otherwise requested. This feature is provided by the Institute for Safe Medication Practices in cooperation with the FDA's medWatch Program and Temple University School of Pharmacy. ISMP is an FDA medWatch partner.
Performance Measurement of a Pharmacist-Directed Anticoagulation Management Service
Authors: Schommer Jon C. , Mott David A. , Schneider Philip J. , Knoell Karen R.
Published: January 2018

The purpose of this study was to use a performance-driven organizational change framework to measure both the clinical performance and time performance of a pharmacist-directed anticoagulation management service. A sample of 286 consecutive encounters between patients and anticoagulation management service staff was selected over a 2-month period at the anticoagulation management service of a midwestern university medical center. Data were analyzed using descriptive statistics, logistic regression, and linear regression analysis. Regression-based estimates documented that patients with at least one regimen adherence problem were approximately 10 times more likely to be outside their clinical INR range (clinical performance issue) and required an average of 4 minutes more per encounter (time performance issue) compared with patients who exhibited no adherence problems. Performance metrics such as clinical and time performance can be useful for organizational adaptation and organizational growth decisions related to an anticoagulation management service.
Impact of the Family and Medical Leave Act on Hospital Pharmacy Practice Management
Authors: Monk-Tutor M. R. , Webster A. A. , Denaburg S. G. , Woolley T. W. , Whelan K. W. , Dohoney J. M.
Published: January 2018

The implementation of the Family and Medical Leave Act of 1993 (FMLA), how employees use such leave, and its effect on pharmacy service provision were examined in a national survey of 494 hospital pharmacy directors (16.2% useable response rate). Although there is some discrepancy regarding how to calculate the 12 weeks of leave time, at least 18.7% of respondents were found to allow less time than allowed by law. In general, respondents indicated that men used FMLA benefits only about 20% less than women. About 20% of respondents indicated that they were unable to expand departmental services with current staffing levels due to the impact of the FMLA and another 50% reported that they were only able to continue usual pharmacy services by hiring additional staff or requesting that employees work overtime. Strategies that respondents used to deal with perceived problems caused by staff usage of FMLA benefits are presented. Employers appear to interpret and enforce the FMLA inconsistently. Pharmacists and pharmacy managers need to obtain a better understanding of their rights and responsibilities under this Act.
Oxcarbazepine in Mood Disorders
Authors: Norton John
Published: January 2018

Patients with bipolar illness or schizoaffective disorder–manic type can present with a variety of symptoms and have mixed responses to treatment. This is especially true for patients who have rapid cycling or mixed bipolar illness. The following cases describe the use of oxcarbazepine in patients with either bipolar illness or schizoaffective disorder. This agent, an analogue of carbamazepine, has fewer drug–drug interactions and side effects and thus may prove to be a better tolerated agent in the treatment of these very serious illnesses. A discussion of the properties of oxcarbazepine is also included.
Pharmacy Issues: Clinical Screenings and Discharge Prescriptions
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.
Cyclophosphamide, Hydroxydaunomycin (Doxorubicin), Oncovin (Vincristine), and Prednisone (CHOP) Regimen for Advanced Non-Hodgkin's Lymphomas
Authors: Rutledge Matthew R. , 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.
Questions and Answers from the F.I.X. Ketorolac IV (Toradol IV) for Fever IV Promethazine and Tissue Ulceration Quetiapine (Seroquel) PRN FDA Bioterrorism News
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
Confusion between Adult and Pediatric Hepatitis B Vaccines Rifater and Rifadin Mix-Up PEG-Intron Package Label Change in the Works
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 1-800-233-7767 (1-800-23-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.
The Elderly, ADRs, and Polypharmacy Liver Failure with Rosiglitazone Lactulose-Induced Pneumatosis Intestinalis Lung Injury from Marijuana Use Extensive Skin Necrosis Caused by Warfarin-Like Anticoagulant Anticholinergic Agent-Induced Ileus
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. Ketorolac Continuous Infusion Pregnancy and Newer NSAIDs Article Review: Medication Errors and Adverse Drug Events in Pediatric Inpatients
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://theformu-lary.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
Nifedipine Dosing Error Caused by Poor Handwriting, Abbreviated Terms, and Incomplete Verification
Authors: Dunn Eddie B. , Wolfe Jonathan J.
Published: January 2018

A medication order containing a hazardously written Latin abbreviation is described. The order resulted in a medication error reaching a hospitalized patient. Guidelines on how this error could have been prevented are discussed.
Alteplase
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 February 2002 Formulary monograph topics are drotrecogin alfa, ertapenem, anakinra, bosentan, and valdecoxib. The DUE is on ertapenem.
Selective Serotonin Reuptake Inhibitors: Nocturnal Enuresis
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 .
Efficacy of Beta Blockers in Severe 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.
Cefditoren Pivoxil
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 March 2002 Formulary monograph topics are rosuvastatin calcium, pimecrolimus cream, omapatrilat, desloratadine, and norelgestromin/ethinyl estradiol transdermal system. The DUE is on valdecoxib.
• More on Medication Security • Patient Education • Packaging Half-Tablets • Pharmacist Review of Medication Protocols • Pharmacist Review in Ambulatory Clinics • Commentary on Automated Dispensing Devices • New Medication Use Standards for 2003
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.
Advances and Controversies in Adult ICU Sedation, Part 3: Evolving Pharmacological Treatment Issues
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.
Dexamethasone, Cytarabine, and Cisplatin (DHAP) Regimen for Refractory or Relapsed 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.
Luteinizing-Hormone-Releasing Hormone Agonist plus Antiandrogen Regimens in the Treatment of Advanced Prostate Cancer
Authors: Waddell J. Aubrey , Garman Patrick M. , 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.
Etanercept: Crohn's Disease
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 offlabel 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 .
Questions and Answers from the F.I.X. Diabetic Blood Glucose Monitors; Thyroid Replacement after Surgery; IV Nitroglycerin Dosing; Calcium Channel Blockers in CHF
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://theformu-lary.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.
Pediatric Emergency Carts; Signature Sheets; Childproofing of Medication Samples; Placing Paralyzing Agents with Nonparalyzing Agents in a Kit; Self-Administration of Medications; Solution for Blanket Orders; Distributing Investigational Drug Information; Surveyability of Warfarin Protocols; Range Orders in Pain Management; Acceptable Use of Meperidine; Certification for Disease-Specific Care; Surveying Sentinel Event Alert Recommendations; Concentrated Potassium Chloride
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.
Institutional Pharmacoeconomics: Who Benefits?
Authors: Vogenberg F. Randy
Published: January 2018

Managed health care has changed the way health services are provided and paid for. Many pharmacists have already felt the impact of these changes. This continuing feature illuminates the many facets of managed care, with a special emphasis on how these changes are affecting pharmacists working in health systems. Managed health care systems are still evolving, and the expertise of pharmacists will be needed for these systems to attain their primary goal: the delivery of affordable, comprehensive, high-quality health care.
Acid-Base Disorders; Drug Information in the Pharmaceutical Industry (Part 1); Endometriosis
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.
Questions and Answers from the F.I.X. Epinephrine Interaction with Beta-Blocker; C. Difficle Prevention and Treatment; Levalbuterol Frequency; Protonix IV to PO
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.
How to Get the Best Deal Online or Anywhere
Authors: Felkey Bill G. , Fox Brent I.
Published: January 2018

You've been following our series and have now settled on a PDA operating system and a particular hardware product. We will now help you get the best deal nationwide on your new PDA. An upcoming issue will feature readers' own experiences with PDAs in the health care setting.
Profound Hypoglycemia in a Mail-Order Pharmacy Customer as a Result of a Dispensing Error
Authors: Hanley James F. , Willardsen Darin D. , Biberdorf Robert
Published: January 2018

Accidental hypoglycemia is most commonly associated with the inadvertent ingestion of oral hypoglycemic drugs, and profound hypoglycemia can result in significant morbidity and mortality. Dispensing errors involving sulfonylureas are usually cited as the cause, and these errors have historically been related to sound-alike compounds or proximity errors. We present the case of a patient who received sulfonylureas meant for a different patient through the mail and simply complied with the instructions on the medication bottle, with the result of severe hypoglycemia. This case demonstrates the need for clinicians to properly assess all patients with profound hypoglycemia, evaluating them for inadvertent ingestion of hypoglycemic agents. Furthermore, pharmacies that provide mail-order prescription services must ensure patient safety through quality-control mechanisms.
Alternative Medicines; External Analgesic Agents; Public Health Pharmacy
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.
Acute Dystonic Reactions to “Misbranded” Street Drugs; Steroid-Induced Psychosis in SLE Patients; Colchicine-Induced Rhabdomyolysis; Capecitabine-Induced Cardiac Problem; Fulminant Hepatic Failure Associated with Rifampin and Pyrazinamide Therapy; Piperacillin-Induced Magnesium and Potassium Loss in ICU Patients
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.