bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caution when Seeking Information about Palladone; Patients Need Education about Proper Use of Inhalers; Shaken, Not Stirred; Pharmacy Intervention Trigger; Hot Flashes from Hot Patches
Authors: Cohen Michael R. 
Published: December 2017

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 (MERP), 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. 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 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.
Evaluation of the First International Normalized Ratio after Acute Care Discharge to the Primary Care Environment
Authors: Spray Jeffery W. , Brackbill Marcia L. 
Published: December 2017

Purpose To determine the percentage of patients who maintain a therapeutic INR (international normalized ratio) when presenting for their first INR follow-up in the primary care setting after hospital discharge. Methods Prospective observational trial enrolling patients newly initiated on warfarin. Results Data for 35 patients were collected. Fifty-one percent of patients were therapeutic at their first follow-up lab visit with 23% subtherapeutic and 26% supratherapeutic. Conclusion A low percentage of patients were therapeutic and more intervention is necessary in the immediate post-discharge time.
Symlin Insulin Adjunct Presents Safety Issues; Changed Ophthalmic Color-Code; Name Pair Confusion
Authors: Cohen Michael R. 
Published: December 2017

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 (MERP), 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. 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 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.
Two Steps Forward and One Step Back for Patient Safety? Two Groups Focus on Improved Outcomes, Another on Rx “Vending” Machines Organ Storage Solution
Authors: Cohen Michael R. 
Published: December 2017

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 (MERP), 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. 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 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.
Decreasing Costs and Optimizing Therapy of Erythropoietic Medications in a Hospital-Based Outpatient Cancer Treatment Center
Authors: Clark Deidre B. , Byrd Debbie C. , Andrus Miranda R. , Rogers Tom , Martin Timothy A. 
Published: December 2017

The objectives of this study were to decrease the costs associated with erythropoietic medications and to optimize the use of these medications for patients with chemotherapy-induced anemia. Methods A cost-analysis was completed by performing cost calculations which determined that darbepoetin is the most cost-effective erythropoietic medication for one Cancer Treatment Center (CTC). Darbepoetin protocol and order forms were then developed for chemotherapy-induced anemia. The total costs of all erythropoietic medications at the CTC before and after protocol implementation were evaluated via purchasing data. Pre- and post-protocol retrospective chart reviews were completed to determine if protocol implementation resulted in therapy optimization. Results Forty-two patients were included in the pre-protocol review, and 21 patients were included in the post-protocol review. After darbepoetin protocol implementation, the average cost per month of erythropoietic medications decreased by approximately $30,500. The percent of patients receiving an appropriate initial dose doubled post-protocol (pre: 38% vs post: 76%). Appropriate monitoring of hemoglobin at baseline, monthly, and before dose adjustments increased to 100% post-protocol implementation; and there was a 50% increase in the percent of patients who had their hemoglobin monitored appropriately until stable. Conclusions A savings of approximately $335,000 was expected for the year of 2004 with the protocol use and darbepoetin as the erythropoietic agent of choice. The optimization of therapy should continue to improve via continued use of the darbepoetin protocol.
Adalimumab: Crohn Disease
Authors: Generali Joyce , Cada Dennis J. 
Published: December 2017

Off-Label Drug Uses This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Wolters Kluwer Health. 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 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 hospital pharmacy@drugfacts.com .
Impact of a Pharmacy-Initiated HIV Admission Note on Medication Errors within an Academic Hospital
Authors: Sterling Emily S. , Romanelli Frank , Martin Craig A. , Hoven Ardis D. , Smith Kelly M. 
Published: December 2017

Purpose Medication errors occur frequently in the medical management of patients infected with human immunodeficiency virus (HIV). Recent studies propose the use of a pharmacy admission note to help identify and prevent such errors during hospitalization. However, a clear reduction in the number of antiretroviral medication errors utilizing an admission note within a large, academic hospital has yet to be confirmed. Methods A retrospective, chart-review of hospitalized HIV-seropositive patients 1 year prior to and after implementation of an admission note policy was performed with the expedited Institutional Review Board (IRB) approval. Antiretroviral medication errors were identified and compared to documented pharmacy interventions at the time of admission. Results Twenty-seven antiretroviral medication errors existed in the pre-policy period (n = 32 admissions), with no identification or correction by pharmacy services at the time of admission. Forty-six antiretroviral medication errors were detected in the post-policy period (n = 59 admissions), of which three errors were identified in pharmacy admission notes. Common antiretroviral medication errors in the pre-policy period included incorrect dosing frequency (33.3%) and incorrect drug strength (33.3%). This contrasts with the post-policy period, during which the most frequent antiretroviral medication errors included missing antiretroviral components of known regimens (19.6%) and lack of renal or hepatic dosage adjustment (15.2%). Overall, no improvement in detection and reconciliation of medication errors occurred with admission note implementation. Conclusions Potential obstacles in the effective use of an admission note to reduce errors do exist. Strategies for improved outcomes in our academic hospital will focus on improved training of general pharmacy staff in HIV management, providing accessible online resources, and emphasizing reconciliation between outpatient and inpatient medication regimens.
Preventing Errors with Neuromuscular Blocking Agents: Fluoxetine–Fluvoxamine Mix-Up: Sandoz Ceftriaxone Labeling
Authors: Cohen Michael R. 
Published: December 2017

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 (MERP), 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. 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 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.
Exenatide Injection
Authors: Cada Dennis J. , Levien Terri , Baker Danial E. 
Published: December 2017

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 3 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 November 2005 monograph topics are pregabalin, nepafenac ophthalmic suspension, mecasermin (rDNA origin) injection, abatacept, and rimonabant. The DUE is on pregabalin.
Safety and pharmacodynamics of venetoclax (ABT-199) in a randomized single and multiple ascending dose study in women with systemic lupus erythematosus
Authors: Lu P , Fleischmann R , Curtis C , Ignatenko S , Clarke S H , Desai M , Wong S L , Grebe K M , Black K , Zeng J , Stolzenbach J , Medema J K 
Published: December 2017

Objective The anti-apoptotic protein B-cell lymphoma 2 (Bcl-2) may contribute to the pathogenesis of systemic lupus erythematosus. The safety, tolerability, and pharmacodynamics of the selective Bcl-2 inhibitor venetoclax (ABT-199) were assessed in women with systemic lupus erythematosus. Methods A phase 1, double-blind, randomized, placebo controlled study evaluated single ascending doses (10, 30, 90, 180, 300, and 500 mg) and multiple ascending doses (2 cycles; 30, 60, 120, 240, 400, and 600 mg for 1 week, and then 3 weeks off per cycle) of orally administered venetoclax. Eligible participants were aged 18–65 years with a diagnosis of systemic lupus erythematosus for 6 months or more receiving stable therapy for systemic lupus erythematosus (which could have included corticosteroids and/or stable antimalarials). Results All patients (48/48) completed the single ascending dose, 25 continued into the multiple ascending dose, and 44/50 completed the multiple ascending dose; two of the withdrawals (venetoclax 60 mg and 600 mg cohorts) were due to adverse events. Adverse event incidences were slightly higher in the venetoclax groups compared with the placebo groups, with no dose dependence. There were no serious adverse events with venetoclax. The most common adverse events were headache, nausea, and fatigue. Venetoclax 600 mg multiple ascending dose treatment depleted total lymphocytes and B cells by approximately 50% and 80%, respectively. Naive, switched memory, and memory B-cell subsets enriched in autoreactive B cells exhibited dose-dependent reduction of up to approximately 80%. There were no consistent or marked changes in neutrophils, natural killer cells, hemoglobin, or platelets. Conclusions Venetoclax was generally well tolerated in women with systemic lupus erythematosus and reduced total lymphocytes and disease-relevant subsets of antigen-experienced B cells. Registration ClinicalTrials.gov: NCT01686555.
Radiographic Change of the Distal Tibiofibular Joint Following Removal of Transfixing Screw Fixation
Authors: Baek Jong Hun , Kim Tae Yong , Kwon Yoo Beom , Jeong Bi O 
Published: December 2017

Background: Syndesmosis disruptions in the ankle joint are typically treated with anatomic reduction followed by transfixing screw and/or suture button fixation. The purpose of our study was to analyze the effects of the removal of transfixing screws on syndesmosis integrity using plain radiographs and computed tomography (CT) scans. Methods: Twenty-nine cases (29 patients) who had been treated with transfixing screw fixation for syndesmosis disruptions were studied prospectively. Plain radiographs and CT scans were obtained 1 day before and 3 months after the removal of transfixing screws. The tibiofibular clear space (TCS) and tibiofibular overlap (TFO) were measured on plain radiographs, and the anterior and posterior measurement ratio (A/P ratio) of the syndesmosis was measured on axial CT scans to radiographically analyze the effect of the removal of screws on syndesmosis integrity. Results: On plain radiographs, syndesmosis diastasis was not observed before or after the removal of transfixing screws. No statistically significant difference was found in the TCS and the TFO between measurements at prescrew removal and at postscrew removal ( P = .761 and .628, respectively). However, the syndesmosis was found malreduced on CT scans in 7 cases (24.1%) before screw removal. All 7 cases showed anterior malreduction of the syndesmosis, 5 (71.4%) of which spontaneously reduced after screw removal. The A/P ratio of the 7 cases decreased from a mean of 1.37 (range, 1.26-1.61) at prescrew removal to a mean of 1.12 (range, 0.96-1.25) at postscrew removal ( P = .016). Conclusion: Syndesmosis malreduction not observed on plain radiographs after performing transfixing screw fixation was identified with CT scans. Of the cases with a malreduced syndesmosis, 71.4% showed spontaneous reduction after screw removal. Therefore, we believe the removal of transfixing screws is recommended after confirming malreduction on CT scans, although plain radiographs demonstrate anatomic reduction. Level of Evidence: Level II, prospective prognostic study.
Artikel
Authors: Hakkarainen Pekka , Tigerstedt Christoffer 
Published: December 2017

■ Aims Official records indicate that in 1996 no more than five drug addicts in Finland received medically assisted treatment. By 2004 that figure had grown to 600–700 persons. This article retraces the path to this crucial change. ■ Design Several factors of this change are scrutinised. In the latter part of the 1990s, Finland saw a significant increase in drug-related harms, resulting in a gradual revision of drug policies. Medically assisted treatment was brought under the spotlight through serious public controversies, centred on two private doctors prescribing buprenorphine for their heroin-using patients. Claims-makers, representing a variety of agencies, stood up for substitution treatment. International trends in substitution treatment, as well as scientific research, facilitated the advocacy of such treatment. ■ Results The drug user has been redefined in terms of private and public health, and civil rights, engendering a more liberal attitude towards substitution treatment. National drug policy is characterised by a joint move: social and health policy initiatives, on the one hand, and criminal policy, on the other, are running on separate tracks, making it possible to increase control powers and to expand treatment services. ■ Conclusions Several questions are still unresolved. For example, there has been very little debate on the widely known problem of buprenorphine abuse.
Artikel
Authors: Nordlund Sturla 
Published: December 2017

■ Aims The aim is to describe the development of the availability, attitudes to, and personal use of illegal drugs among the adult population in Norway, based on survey data from 1968 until today. Compared with data on young people, the data on drugs for the adult population have been collected more rarely, and results have not been widely reported. ■ Data and Method Surveys directed to the adult population with questions about drugs were performed in 1968, 1985, 1991, 1994, 1999 and 2004. The samples are selected in a three stage stratified quota procedure, and are representative for the whole adult population age 15 years and over. The data were collected with a face-to-face interview, mainly about alcohol. The drug questions were answered in writing, and in such a way that the interviewer did not see the answers. The availability of all kinds of drugs was measured by asking if the respondents think they could get hold of it in 2–3 days. ■ Results The availability of drugs has increased. In 2004, some 35 per cent said they could get hold of cannabis, while some 20 per cent could get other drugs. The attitudes towards own use were measured by asking if the respondents would try the drugs if it was not illegal. In 2004 about 8 per cent were positive about trying cannabis, with less than 2 per cent for all the other drugs. The attitudes have not varied much for any of the drugs between 1994 and 2004 and for cannabis have been rather stable since 1968. Lifetime prevalence of cannabis use has increased continuously since 1968, and was about 13.5 per cent in 2004. Last year prevalence increased until 1994, but has stabilised at about 3.7 per cent since then. For other drugs the lifetime prevalence has been stable at less than 2 per cent, with around 3 per cent for amphetamines. Last year, the prevalence of these drugs was less than 1 per cent, possibly with a slightly decreasing tendency. For cannabis the highest prevalence (both lifetime, previous year, and previous 30 days) is in the age group 20–24 years. ■ Conclusion The results are somewhat contrary to reports about increased problematic drug use in Norway during the 1990s. Survey methods are however not the best method to estimate problem drug use. The stability and even tendency to decrease of the prevalence of present drug use shown here might, however, indicate a decrease in the recruitment of problem drug users. Other signs point in the same direction: The sharp increase in drug-related deaths in Norway during the 1990s has given way to a decrease in the latest years. The prevalence of present drug use in youth surveys shows a decreasing trend.
Artikel
Authors: Törrönen Jukka , Maunu Antti 
Published: December 2017

This article explores the distinctive characteristics of present-day drinking habits in Finland. The data are young adults' narratives of their nights out obtained in interviews that asked about ideal, typical, and disastrous nights out. The dataset comprises 117 interviews (60 women and 57 men). The interviewees were recruited from the rapidly growing sectors of information and service work in business and administration: from the meanings assigned by this generation to alcohol we are able to infer which aspects of Finnish drinking habits are still culturally valid and which susceptible to change. Questions covered in this article include: What motivates young adults to drink? What kind of self-regulation do they exhibit in their drinking? Is getting drunk a value in itself, or does it have a secondary meaning to other activities? Are there any gender differences in drinking habits? We look specifically at the roles of alcohol in young people's nights out and how these roles vary during the course of the evening. Furthermore, the analysis looks at how the narratives are structured on the dimensions of goal-oriented linear time and ritualised repetitive cyclical time. The analysis applies the tools of semiotic sociology. Our analysis shows that the drinking habits of young adults reflect a movement away from the goal-oriented time of the everyday towards the cyclical time of one's own circle of friends. These breakaways are essentially an exercise in creating and strengthening a general will within the groups. They do not resemble total inversions or transgressions of the prevailing reality, nor are they about defiance, loutish behaviour, getting legless or locked up. Rather, these breakaways find mainly culturally regulated and ordered expressions. Getting drunk is not an end in itself. The inebriation of young women and young men is not one of defiance or a mythical search for new experiences; they just want to be sociable. Indeed one can infer that sociable drinking habits have gained a stronger footing among young adults in Finland today.