bluuebunny/crossref_metadata_2025_split huggingface dataset:
For Every Problem a Solution; For Every Solution a Problem; Carpuject Syringe Mix-Ups; Carpuject Syringe Tampering; Tamiflu Gains Strength
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.
Human Growth Hormone (Recombinant): Lipodystrophy (HIV-Related)
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 .
Evaluation of Once Daily Aminoglycoside Use in the Elderly
Authors: Barlows Theodore G. , Luque Carla A. , Bernstein-Solomon Bridget J. , Menendez Lourdes B. 
Published: January 2018

Purpose This study evaluated the incidence of nephrotoxicity due to once daily aminoglycoside (ODA) use in elderly patients at two South Florida institutions. Methods A retrospective review of all patients who received 7 mg/kg/day of either gentamicin or tobramycin was conducted. Results Eighty-one (49%) males and 84 (51%) females with a mean age of 73 (range, 60 to 95) years were included. Nephrotoxicity was evident in 16 patients (9.7%). Of these, eight (4.8%) experienced nephrotoxicity possibly associated with aminoglycoside administration. A subgroup analysis of nonnephrotoxic patients compared with nephrotoxic patients revealed no significant differences in mean initial serum creatinine (1 mg/dL vs 0.95 mg/dL, P = 0.861) or dosing interval (31.4 vs 31.5 hours, P = 0.983). The mean duration of aminoglycoside treatment was less in the nonnephrotoxic group compared with the nephrotoxic group (5.2 vs 9.9 days, P < 0.05). Conclusion The results of this retrospective evaluation suggest that ODA dosing in the elderly is safe; however, patients should be monitored closely, especially when they require more than 5 days of aminoglycoside therapy, or are receiving concomitant nephrotoxic agents.
Treatment of Pulmonary Arterial Hypertension with Sildenafil
Authors: Fung Stacey M. , Ferrill Mary J. 
Published: January 2018

Purpose The study aimed to evaluate data on the treatment of sildenafil for pulmonary arterial hypertension (PAH). Selection Process Clinical literature from 1966 to May 2003 was accessed through MEDLINE, EMBASE, IPA, and the Cochrane System. Key search terms included sildenafil, Viagra, and pulmonary hypertension. Methods Current treatment of PAH includes anticoagulation, vasodilation, and transplantation. Available oral agents include calcium channel blockers and endothelin receptor antagonists. An evaluation of studies of sildenafil for PAH was conducted. Results Sildenafil for PAH was reported to be effective in 21 of 23 patients summarized in 14 case reports; 6 short-term (n = 83) and four long-term (n = 68) clinical trials described sildenafil administered with standard treatments for PAH. Conclusions Sildenafil may be a convenient option for PAH after traditional treatments have been attempted. It is administered orally and is longer-acting than other treatments for PAH. A dose of 50 to 100 mg three times daily was used in adults in four long-term studies, although doses from 25 to 500 mg/day in two to six divided doses have also been used in case reports. The only long-term study in children gave a median dose of 87.5 mg/day in children greater than 5 years of age weighing less than 30 kg. Side effects in the clinical trials were minimal, consisting primarily of mild headache, dizziness, flushing, and mild abdominal discomfort. Further studies to define the exact role and the dosing range of sildenafil in the management of PAH are needed.
Memantine
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. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. 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 2004 monograph topics are cinacalcet hydrochloride, sertaconazole nitrate, etoricoxib, abetimus sodium, and rasagiline mesylate. The DUE is on atypical antipsychotics.
Modafinil: Multiple Sclerosis-Related Fatigue
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 .
Alternative Strategies for Dispensing Exogenous Surfactant: Drug Cost Implications and in Vitro Feasibility Studies
Authors: Stevens Timothy P. , Sinkin Robert A. , Notter Robert H. , Wang Zhengdong , Delmonte Keith , Consenstein Larry , Maniscalco William M. 
Published: January 2018

Surfactant replacement therapy is highly effective in treating Respiratory Distress Syndrome, but remains expensive despite market competition. Objectives (1) to model potential surfactant drug cost savings under alternative dispensing strategies compared with the current, FDA-approved, single-patient, single-dose vial dispensing strategy; and (2) to determine whether alternative dispensing strategies potentially would maintain efficacy and safety by measuring surfactant surface activity and sterility under conditions designed to simulate alternative dispensing conditions. Design Potential drug cost savings were modeled by comparing the current, FDA-approved single-patient, single-dose vial dispensing guidelines with alternative dispensing strategies including single patient, multidose vials; multipatient, multidose vials; and reduced volume surfactant vials (ie, “half-sized”) to decrease drug wastage. To assess whether surface activity or sterility of exogenous surfactant could be reduced under these alternative dispensing conditions, serial surface tension measurements and bacterial and fungal cultures were conducted with aliquots of exogenous surfactant under conditions designed to simulate each strategy. Results Potential savings of $49,000 to $61,000/year (28.5%), depending on drug usage and cost, were identified in a model comparing a single-patient, multidose vial dispensing protocol with the current FDA-approved dispensing strategy. The greatest cost savings, $57,000 to $72,000/year (33.3%), were for multipatient, multidose drug dispensing. Simulating alternative dispensing conditions, three cycles of warming, entering, and cooling surfactant vials over 1 to 2 days or 1 to 2 weeks did not cause a measurable decrement in in vitro surface activity or compromise in drug sterility. Conclusion Substantial cost savings could be realized through use of multidose surfactant dispensing strategies.
Extreme Caution Needed with Flammable Products; Drug Information Errata; Protonix and Protamine; Prohibited Abbreviations
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.
Fatal Potassium Errors Linked to Pharmacy Processes Neumega, Neulasta and Neupogen
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. The reports described in this column were received through the USP–ISMP Medication Errors Reporting Program (MERP). Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) web sites or communicated directly to ISMP by calling 1-800-FAIL SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications. In 2004, ISMP is celebrating the 10th anniversary of its incorporation as a nonprofit organization. The Institute represents more than 20 years of experience in helping health care practitioners keep patients safe and continues to lead efforts to improve the medication use process.
Epoetin: Once-Weekly Administration (Cancer Patients)
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 .
FDA Committee Tackles Poor Labeling on Plastic Containers; Tracking Kayexalate; Orally Disintegrating Tablets Not Absorbed in the Mouth; Supply All Units with Oral Syringes
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. The reports described in this column were received through the USP-ISMP Medication Errors Reporting Program (MERP). Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) web sites or communicated directly to ISMP by calling 1-800-FAIL SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications. In 2004, ISMP is celebrating the 10th anniversary of its incorporation as a nonprofit organization. The Institute represents more than 20 years of experience in helping health care practitioners keep patients safe and continues to lead efforts to improve the medication use process.
The $181,000 Adverse Drug Reaction
Authors: Mcdonnell Patrick J. 
Published: January 2018

This article reports the case of a 52-year-old male, status post-heart transplant, who was admitted to the hospital with profound pancytopenia. The cause was an adverse drug reaction, specifically the well-established drug interaction between allopurinol and azathioprine. This reaction was severe and costly, with total charges of $181,000 incurred during the patient's 31-day hospital stay. The annual cost of drug-related morbidity and mortality exceeds $136 billion. Adverse drug events can be classified variously; two common categories are adverse drug reactions and medication errors. If an adverse drug reaction is determined to be preventable, it can be classified as a medication error. Factors that determine preventability include whether a known drug-drug interaction was involved in the event and whether health care providers made efforts to avoid this interaction through increased monitoring or dose adjustments. Pharmacist intervention and increased vigilance can decrease the occurrence of such events. Furthermore, pharmacists who are aware of preventability factors involved in adverse drug events can become proactive leaders in the area of medication safety.
Cinacalcet Hydrochloride
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. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. 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 2004 monograph topics are insulin glulisine; azacitidine; morphine sulfate extended-release liposome injection; rifaximin; and lidocaine hydrochloride/epiniphrine inontophoretic patch. The DUE is on insulin glulisine.
Sodium Polystyrene Sulfonate Dosing Guidelines for the Treatment of Adult Hyperkalemia
Authors: Mikrut Michael , Brockmiller-Sell Heather 
Published: January 2018

Standard treatment of hyperkalemia has consisted of the administration of a number of medications including sodium polystyrene sulfonate (SPS) suspension orally or as an enema. Dosage ranges of 15 to 60 g are described in the literature, but specific dosing recommendations based on a patient's serum potassium are lacking. The purpose of this study was to develop a dosing guideline for the oral administration of SPS in the treatment of adult hyperkalemia at our institution. A retrospective review was conducted for adult patients receiving only SPS to treat hyperkalemia during a 3-month period. Serum levels of potassium were recorded prior to and following SPS administration. The retrospective review demonstrated that a 30 g SPS dose resulted in an average decrease in serum potassium of 0.99 mEq/L with a standard deviation (SD) of 0.64. Based on these results, an SPS dose of 30 g was recommended for a serum potassium level greater than 5 mEq/L but less than 6.0 mEq/L in the guidelines. A SPS dose of 60 g was recommended for a serum potassium level of 6 mEq/L or greater. After an internal review in the pharmacy and physician approval, the guidelines were instituted. Clinical outcomes were monitored for 1 month following implementation of the guideline. The prospective analysis resulted in an average decrease of 1.01 mEq/L (SD = 0.67) in serum potassium with a 30 g SPS dose, supporting the guideline.
Use of Acid Suppression Agents following Acute, Nonvariceal, Upper Gastrointestinal Bleeding
Authors: Nguyen Cindy M. , Barletta Jeffrey F. , Devlin John W. 
Published: January 2018

Purpose This study evaluated the utilization of acid suppression agents following upper gastrointestinal (GI) bleeding in the state of Michigan. Methods A focus group was used to develop a one-page survey that consisted of questions pertaining to acid suppression agents following acute, upper GI bleeding. Survey consistency and validity were established through review by several experienced pharmacists practicing in either critical care or drug information. Surveys were mailed twice (at 30-day intervals) to the director of pharmacy at all hospitals (n = 267) in the state of Michigan. Results Completed surveys were received from 76/267 (28.5%) institutions. Sixty-five percent of institutions stated that they had one preferred intravenous (IV) acid suppressive agent for acute GI bleeding, with 59% using a histamine-2 receptor antagonist (H2RA) and 41% using a proton pump inhibitor (PPI). When an IV PPI was prescribed, only 36% used a continuous infusion dosing regimen. For IV to oral step-down therapy, PPIs were chosen more often than H2RAs (81% vs 19%). Oral PPI therapy was usually initiated using a capsule/tablet (82%) as opposed to a PPI suspension (18%). Institutional guidelines for acid suppression were in place at only 23% of institutions, although 67% had restrictions for IV PPI use. Conclusion Wide variation exists in the use of acid suppressive agents following upper GI bleeding in the state of Michigan.
Tinidazole
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. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. 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 October 2004 monograph topics are duloxetine, acamprosate calcium, methyl aminolevulinate cream, poly-l-lactic acid, and pentetate calcium trisodium. The DUE is on duloxetine.