bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Adverse Effects of Simvastatin plus Gemfibrozil and Atorvastatin plus Gemfibrozil
Authors: Werremeyer Amy B. , Koo Ji M. , Welch Justin M. 
Published: June 2010

Background The manufacturer of simvastatin recommends a dose limitation of 10 mg daily when used in combination with gemfibrozil, due to increased risk of myopathy and rhabdomyolysis. Little information is available regarding the risk of adverse effects of atorvastatin when used in combination with gemfibrozil. Purpose To compare the rate of discontinuation or dose reduction due to adverse effects with simvastatin and gemfibrozil versus atorvastatin and gemfibrozil. Methods Retrospective review of patients taking gemfibrozil in combination with simvastatin 10 mg, simvastatin 80 mg, or atorvastatin 40 mg for at least 6 months. Results A total of 166 patients were included; 59 were taking simvastatin 10 mg (S10), 47 were taking simvastatin 80 mg (S80), and 60 were taking atorvastatin 40 mg (A40). There was no significant difference in the rate of discontinuation or dose reduction due to adverse effects among the groups (10.2% for S10, 21.2% for S80, and 10% for A40, P = 0.159). A paired comparison of discontinuation or dose reduction due to adverse effects between the simvastatin 80 mg and atorvastatin 40 mg groups approached a trend toward a difference ( P = 0.104). Severe adverse effects occurred in the simvastatin 80 mg and atorvastatin 40 mg groups. Conclusion Our results did not show a significant difference in discontinuation or dose reduction due to adverse effects between patient groups taking gemfibrozil in combination with simvastatin 10 mg, simvastatin 80 mg, or atorvastatin 40 mg. However, the rate of this outcome in the S80 group was approximately double that for the S10 and A40 groups. Further studies are needed to compare the safety of these statin-gemfibrozil combinations.
Paliperidone
Authors: Cada Dennis J. , Baker Danial E. , Levien Terri 
Published: June 2010

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 July 2007 monograph topics are rotigotine transdermal system, maraviroc, armodafinil, fluticasone furoate, motexafin gadolinium. The DUE is on rotigotine transdermal system.
ARV Medication Errors: Experience of a Community-Based HIV Specialty Clinic and Review of the Literature
Authors: Cocohoba Jennifer , Dong Betty J. 
Published: June 2010

Objective To describe antiretroviral (ARV) medication errors reported within a community Human Immunodeficiency Virus (HIV) clinic, identify potential strategies to prevent errors, and review the literature pertaining to ARV medication errors. Design Review of voluntarily reported ARV errors. Errors were classified using the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) Index. The clinic's medication distribution process was also analyzed. Setting Community-based clinic with HIV-experienced clinicians in an urban setting. Results Thirty-seven errors were reported over 3 years; 81.1% of these were classified as NCC-MERP category C. Most errors resulted from lapses in clinic and pharmacy systems of care (n = 21). Pharmacy and clinic prescribing errors were less (n = 11). Conclusion ARV medication errors were notable. Changes in drug distribution and prescribing processes may reduce future ARV medication errors.
Impact of Educational Interventions to Prevent Drug Interactions between Oral Fluoroquinolone or Tetracycline Antibiotics with Polyvalent-Cation Supplements
Authors: Depestel Daryl D. , Depestel Jill M. , Walker Paul C. 
Published: June 2010

Purpose Fluoroquinolone and tetracycline antibiotics are routinely used for the treatment of a variety of bacterial infections. A disadvantage with their oral administration is the potential for a drug interaction leading to decreased absorption when coadministered with oral supplements containing polyvalent cations. The objective of this study was to evaluate the impact of several inservices aimed at educating nursing staff on reducing this drug interaction. Methods To assess the impact of the educational interventions, a retrospective chart review was conducted in two phases to determine the incidence of the drug interaction. Phase 1 was conducted before implementation of the educational inservices. Following the educational inservices, phase 2 was conducted to determine their impact on reducing coadministration. Results This interaction occurs frequently in hospitals; we found that these antibiotics were given within 2 hours of polyvalent-cation containing supplements in 72.5% of patients before inservices. An inservice involving multiple approaches significantly reduced the frequency of the drug interaction to 10%; P < 0.001. Conclusion Educational inservices directed toward nursing staff were successful in significantly reducing the incidence of this drug interaction.
Ongoing Incidents Involving Fentanyl Patches are Alarming!; Insulin CONCENTRATE U-500; WHO: Dilute Vincristine in a Minibag
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: June 2010

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 Parenteral Nutrition Management in a Hospital without a Formal Nutrition Support Team
Authors: Williams Nancy Toedter 
Published: June 2010

Purpose A preliminary review of several adult inpatients receiving parenteral nutrition (PN) revealed opportunities for improvement. In response, a drug usage evaluation (DUE) was conducted to: 1) determine specific areas of adult PN management needing improvement; 2) evaluate the current PN order forms; 3) identify reasons for PN wastage; 4) establish pharmacist involvement in prescribing/monitoring of PN in a community hospital without a formal nutrition support team. Methods A prospective DUE was performed on various adults receiving PN from January through February 2005. The following data were collected and evaluated: 1) PN indication; 2) whether ordered PN formula met patients' estimated needs; 3) adequate adjustments of electrolyte or glucose imbalances; 4) appropriate ramping/tapering of PN; 5) appropriate laboratory data ordered. Additionally, a record was kept of PN solutions wasted from January through April 2005. Results Twenty-two adult patients receiving PN were prospectively reviewed. Protein and caloric needs were met in only 59% of patients (n = 13), and electrolytes were abnormal in 73% of patients (n = 16), with most physicians making minimal or no electrolyte adjustments. PN was not routinely ramped up upon initiation. Phosphorus, triglycerides, and prealbumin were not routinely monitored. An average of 14.5 PN bags was wasted per month. In response to these findings, the PN order forms were redesigned to facilitate appropriate monitoring and to facilitate physician-initiated consults for pharmacists to manage PN. One year after implementation, a 40% reduction in PN wastage was noted. Conclusions Pharmacists play an integral role in PN management, resulting in improved patient monitoring and a reduction in expensive PN wastage.
Etoposide, Doxorubicin, Vincristine, Cyclophosphamide, Prednisone (EPOCH) for Treatment of Lymphomas
Authors: Leu Lily , Solimando Dominic A. , Waddell J. Aubrey 
Published: June 2010

The increasing complexity of cancer chemotherapy now requires that pharmacists be familiar with these highly toxic agents. This column will review various issues related to preparation, dispensing, and administration of cancer chemotherapy, and review various agents, both commercially available and investigational, used to treat malignant diseases. The views expressed in this article are those of the author(s) and do not reflect the official policy of the Department of Army, Department of Defense, or US Government.
Intravenous Patient-Controlled Analgesia Pump and Reservoir Logistics: Results from a Multicenter Questionnaire
Authors: Hutchison Rob W. , Anastassopoulos Kathryn , Vallow Sue , Mordin Margaret , Olson William , Hewitt David , Sikirica Vanja 
Published: June 2010

PurposeTo understand and quantify the logistics (ie, acquisition, utilization, storage, distribution, maintenance, repair) of intravenous patient-controlled analgesia (IV PCA) pumps and analgesics in the acute postoperative pain setting.MethodsAs part of a larger multicentered, observational study, 29 hospitals in the United States were surveyed to examine IV PCA logistics. Data were collected via interviews with hospital staff using a standardized hospital questionnaire. Descriptive statistics were calculated on all site characteristics and IV PCA logistics data.Results: Average beds per hospital and inpatient surgery volume per year were 455.5 beds and 6,483.2 patients. The majority of sites (75.9%) owned their pumps and, on average, reported 1.3 pump types and 2.3 different storage locations. Most hospitals utilized 3 of 4 different opioid agents (ie, morphine, fentanyl, hydromorphone, meperidine). Morphine is the most common prefilled reservoir (75.9%), while hydromorphone is the most common pharmacy staff-filled reservoir used (72.4%). A fentanyl staff-filled reservoir is available in 62.5% of the hospitals.Conclusions: The process of providing IV PCA from initial order to set-up is complex and variable. The process to IV PCA initiation involves the understanding of various types of pumps and analgesics, coordination of hospital staff, and substantial time to implement. Future postoperative care should explore improved technologies (or means of delivery) to reduce the complexity and steps involved with IV PCA while continuing to deliver on-demand pain relief.
Failure to Cap IV Tubing and Disinfect IV Ports Places Patients at Risk for Infections; Unintended Consequences of CPOE; Numerous Problematic Name Pairs Relegated to History
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: June 2010

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). Reports published by ISMP are 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.
Eculizumab and Temsirolimus
Authors: Worley Katherine B. , Whitmore M. Brooke , Waddell J. Aubrey , Solimando Dominic A. 
Published: June 2010

The increasing complexity of cancer chemotherapy now requires that pharmacists be familiar with these highly toxic agents. This column will review various issues related to preparation, dispensing, and administration of cancer chemotherapy, and review various agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr., President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110545, Arlington, VA 22203, e-mail: OncRxSvc@aol.com ; or J. Aubrey Waddell, Associate Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net . The views expressed in this article are those of the author(s) and do not reflect the official policy of the Department of Army, Department of Defense, or US Government.
A Prospective Observational Study of Risk Factors for Candida glabrata in an SICU: Role of Fluconazole
Authors: Gentry Chris A. , Callen Erin D. , Flournoy Dayl J. , Winner Jamie S. , Slater Leonard N. 
Published: June 2010

Background Candida glabrata has emerged as a serious nosocomial pathogen, particularly in surgical intensive care units (SICU). Purpose To determine potential risk factors for the emergence of C. glabrata colonization or infection (C/I) in the SICU. Methods A prospective observational study was conducted collecting and analyzing variables associated with the development of C/I with C. glabrata versus non- glabrata Candida species in our SICU. Results Fourteen patients developed C/I with C. glabrata (cases), while 21 patients developed C/I with non- glabrata Candida species (controls). Univariate analyses identified the following continuous variables as being statistically significant for the development of C/I with C. glabrata: number of days prior to antifungal or penicillin class therapy. The following categorical variables were significant by univariate analyses: any prior use of piperacillin/tazobactam, penicillin class, or fluconazole, or at least 5 days of use of fluconazole. Any prior use of levofloxacin was found to be statistically significant for controls. Multivariate-logistic regression analysis identified more than 5 days of fluconazole use and no prior use of levofloxacin as independent risk factors for the development of C. glabrata C/I in the SICU. Conclusions Prior fluconazole use was identified as an independent risk factor for development of C. glabrata C/I.
Intern Pharmacists as Change Agents to Improve the Practice of Nonprescription Medication Supply: Provision of Salbutamol to Patients with Asthma
Authors: Schneider Carl R , Everett Alan W , Geelhoed Elizabeth , Padgett Cale , Ripley Scott , Murray Kevin , Kendall Peter A , Clifford Rhonda M 
Published: June 2010

Background: Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. Objective: To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. Methods: Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma contral and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. Results: A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p < 0.001) was noted. Conclusions: A doubling in the rate of medical referral showed a clear improvement in professional practice during the provision of nonprescription salbutamol. The improved patient outcome in the intervention group was due to increased assessment of reliever use frequency. Identification of poor inhaler technique remained near zero in both groups, which suggests that intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.
Piscicides and Invertebrates: After 70 Years, Does Anyone Really Know?
Authors: Vinson Mark R. , Dinger Eric C. , Vinson Deanna K. 
Published: June 2010

Abstract
The piscicides rotenone and antimycin have been used for more than 70 years to manage fish populations by eliminating undesirable fish species. The effects of piscicides on aquatic invertebrate assemblages are considered negligible by some and significant by others. This difference of opinion has created contentious situations and delayed native fish restoration projects. We review the scientific evidence and report that short-term (&lt; 3 months) impacts of piscicides to invertebrate assemblages varied from minor to substantial and long-term (&gt; 1 year) impacts are largely unknown. Recovery of invertebrate assemblages following treatments ranged from a few months for abundances of common taxa to several years for rarer taxa. Variation in reported effects was primarily due to natural variation among species and habitats and a lack of adequate pre- and post-treatment sampling which prevents determining the true impacts to invertebrate assemblages. The factors most likely to influence impacts and recovery of aquatic invertebrate assemblages following piscicide treatments are: (1) concentration, duration, and breadth of the piscicide treatment; (2) invertebrate morphology and life history characteristics, including surface area to volume ratios, type of respiration organs, generation time, and propensity to disperse; (3) refugia presence; and (4) distance from colonization sources.
Resumen
Los piscicidas rotenona y antimicina han sido utilizados por más de 70 años para manejar poblaciones de peces, eliminando especies indeseables. Para algunos autores los efectos de los piscicidas en las asociaciones de invertebrados acuáticos son considerados como insignificantes sin embargo, para otros, son importantes. La diferencia entre las opiniones ha creado una situación tirante, retrasando así los proyectos de restauración de peces nativos. Revisando la evidencia científica, se encontró que en el corto plazo (&lt;3 meses) los impactos de los piscicidas en las asociaciones de invertebrados varió de menor a sustancial, y en el largo plazo (&gt;1 año) los impactos son básicamente desconocidos. Tras recibir los tratamientos, la recuperación de dichas asociaciones fue de pocos meses para los taxa más abundante hasta varios añs para los taxa más raros. La variación en los efectos reportados se debió principalmente a la variación natural entre especies y hábitats y a la falta de un adecuado muestreo pre y post-tratamiento. Los factores que más probablemente determinen el impacto y recuperación de las asociaciones de invertebrados después del tratamiento con piscicidas son: (1) concentración, duración y espectro del tratamiento de piscicida; (2) la morfología de los invertebrados así como las características de su historia de vida, incluyendo la razón superficievolumen, tipo de órganos respiratorios, tiempo generacional y propensión a la dispersión; (3) presencia de refugios; y (4) distancia hacia las áreas de colonización.
Mucosal Melanomas: A Case-Based Review of the Literature
Authors: Seetharamu Nagashree , Ott Patrick A. , Pavlick Anna C. 
Published: June 2010

AbstractLearning ObjectivesAfter completing this course, the reader will be able to: Differentiate mucosal melanoma from cutaneous melanoma and describe its etiology, molecular features, and treatment approaches in surgical, radiation, and medical oncology.Evaluate mucosal melanoma patients with non-metastatic disease for adjuvant radiation to optimize treatment of the primary tumor.Refer appropriate patients for testing for c-KIT mutations and gene aberrations in order to avoid subjecting them to chemotherapy with minimal benefit.CME This article is available for continuing medical education credit at CME.TheOncologist.com.Mucosal melanoma is a rare cancer that is clearly distinct from its cutaneous counterpart in biology, clinical course, and prognosis. Recent studies have shown important differences in the frequencies of various genetic alterations in different subtypes of melanoma. Activating mutations in the c-KIT gene are detected in a significant number of patients with mucosal melanoma. This observation has resulted in the initiation of several clinical trials aimed at exploring the role of receptor tyrosine kinases that inhibit c-KIT in this patient population. We herein present a comprehensive literature review of mucosal melanoma along with case vignettes of a number of pertinent cases. We further discuss melanomas of the head and neck, the female genital tract, and the anorectum, which are the three most common sites of mucosal melanoma, with a particular focus on the diagnostic, prognostic, and therapeutic data available in the literature.