bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Chemotherapy-Induced Neutropenia: Opportunities for Pharmacist Involvement
Authors: Iacovelli Lew M. , Persson Brandy L. 
Published: May 2010

Purpose This article highlights the clinical impact of chemotherapy-induced neutropenia (CIN) and reviews the clinical evidence supporting the updated guideline recommendations from leading scientific organizations that focus on cancer care regarding the use of myeloid growth factors to reduce the incidence of febrile neutropenia (FN) from chemotherapy. The aim is to provide insight for practicing pharmacists regarding how they can be more proactive in developing best-practice strategies for the management of CIN as well as the prevention of FN. Summary CIN, the primary dose-limiting toxicity of chemotherapy, is common in many tumor types that are treated with myelosuppressive chemotherapy and occurs with the greatest frequency in the first cycle of treatment. Treatment with myeloid growth factors, or colony-stimulating factors (CSFs), has shown to be effective in reducing the risk, severity, and duration of FN from chemotherapy. Despite recent revisions to various clinical guidelines that have resulted in alignment on the recommendation for prophylactic CSF use in patients with a greater than or equal to 20% risk of developing FN, a gap remains between actual clinical usage and best practice. Pharmacists are key members of multidisciplinary health care teams and are uniquely positioned to evaluate current practice and develop strategies that ensure appropriate CSF use. This paper summarizes the recent changes to CSF guidelines, reviews clinical data that support those changes, and discusses strategies for pharmacist involvement in the management of CIN and FN prevention using real-world examples of improvement initiatives. Conclusion Neutropenia is a dose-limiting toxicity of chemotherapy that has significant implications for effective cancer treatment and patient health outcomes. Pharmacists are uniquely positioned to perform various interventions, which help ensure appropriate CSF use and improve the management of CIN.
Etravirine
Authors: Cada Dennis J. , Levien Terri , Baker Danial E. 
Published: May 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy & Therapeutics Committee. Subscribers also receive monthly 1-page summary monographs on the agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and are also 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 June 2008 monograph topics are on sumatriptan succinate and naproxen sodium, diclofenac epolamine topical patch, bendamustine hydrochloride, rotavirus vaccine, and live, oral, levoleucovorin for injection. The DUE is on sumatriptan succinate and naproxen sodium.
Preformatted, Tamper Evident Prescriptions to Minimize Omissions and Meet Regulatory Requirements
Authors: Knapp Judy Ann 
Published: May 2010

Patient safety is a complex issue that is constantly evolving. Communication via standardized drug ordering is recognized as one of the key elements to providing a safer hospital stay as well as a stronger patient outcome. This feature will publish bimonthly and will provide examples of standardized drug prescribing and a forum for discussion. If you have a template that you believe other hospital pharmacies can benefit from, please submit it along with answers to the questions (seen below in the text) to Joyce Generali, Director of Drug Information at Kansas University Medical Center, 3901 Rainbow Boulevard, Mail Stop 4040, Kansas City, KS 66160 or e-mail at jgeneral@kumc.edu .
Bortezomib (Intrapleural): Myelomatous Pleural Effusion
Authors: Generali Joyce , Cada Dennis J. 
Published: May 2010

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 that the reader can easily identify the scope of information available. A summary of these 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 regarding “Off-Label Drug Uses” to hospitalpharmacy@wolterskluwer.com .
Protection against the Extravasation of Anticancer Drugs by Standardization of the Management System
Authors: Watanabe Hiroyuki , Ikesue Hiroaki , Yoshida Minoru , Yamamoto Naoko , Sakamoto Setsuko , Koga Tomoichiro , Sueyasu Masanori , Egashira Nobuaki , Inoshima Ichiro , Nakanishi Yoichi , Oishi Ryozo 
Published: May 2010

The extravasation of anticancer drugs is a serious complication. On the basis of data regarding extravasation prevention and treatment obtained primarily by pharmacists, the management system for extravasation of anticancer drugs was standardized at an outpatient chemotherapy center. A kit was prepared so that physicians could promptly and safely perform venipuncture; the kit included a classification list of anticancer drugs. Prior to administration of vesicant or irritant drugs, pharmacists and nurses educated the patients. When anticancer drugs were administered via peripheral vein without using an implanted venous access device, extravasation occurred in 10 out of 7,059 courses (0.14%) during the 2-year study period postintroduction of the present management system. This incidence is remarkably low as compared with those previously reported. The extravasated drugs were epirubicin (n = 3), paclitaxel (n = 3), vinorelbine (n = 1), 5–fluorouracil (n = 1), carboplatin (n = 1), and cyclophosphamide (n = 1). Cold packs were applied around the injection site except in the cases involving vinorelbine, in which warm packs were used. In all cases of extravasation of vesicant drugs, glucocorticoid was injected locally. There were no cases involving continuous pain or skin ulcers. The standardization of the management system for extravasation of anticancer drugs was very effective in decreasing the occurrence, as well as decreasing skin damage if it occurred.
Improving Afghanistan Pharmacy Practices and Services
Authors: Blaine Philip J. 
Published: May 2010

The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, the Department of Defense, nor the US Government. I am a military service member. This work was prepared as part of my official duties. Title 17, USC, 105 provides that “copyright protection under this title is not available for any work of the United States Government.” Title 17, USC, 101 defines a US Government as part of that person's official duties.
Implementing Consultant Recommendations in Percutaneous Coronary Interventions: Look before you Leap
Authors: Girardeau Caroline Johnson , Montague Deborah 
Published: May 2010

Purpose To determine if hospital consultant recommendations were clinically applicable to the cardiac catheterization laboratory and to compare medication usage in percutaneous coronary intervention (PCI) to those goals. Methods The medical records of 96 adults on whom PCI had been performed over a 6-month period were reviewed retrospectively. Only PCIs that included intracoronary stent placement were considered. The primary end point was to determine if abciximab usage was 15% or less in all PCI cases. Secondary end points evaluated the use of abciximab, eptifibatide, and bivalirudin based on the acuity of the clinical syndrome. Results Abciximab, eptifibatide, and bivalirudin monotherapy were used in 16.7%, 40.6%, and 42.7% of all cases, respectively. The total consumption of abciximab exceeded the primary end point by 1.7%. Eptifibatide usage was 71% of all glycoprotein (GP) IIb/IIIa inhibitors, less than the 85% target proposed by the hospital consultants. Bivalirudin monotherapy surpassed eptifibatide as the antithrombotic of choice across all PCI cases. The use of provisional GP IIb/IIIa inhibitors in conjunction with bivalirudin was 8.3%, more than the 5% target specified by the consultants. Emergent PCIs comprised 41% of all cases sampled. Conclusion This 6-month retrospective survey demonstrated that the use of abciximab exceeded the percentage recommended by consultants. However, given the large percentage of emergent PCIs during the time period and the literature supporting the use of abciximab in emergent PCIs, a change in GP IIb/IIIa inhibitor usage patterns was not considered necessary.
Impact of a Pharmacist on Medication Reconciliation on Patient Admission to a Veterans Affairs Medical Center
Authors: Strunk Lisa B. , Matson Adrienne W. , Steinke Douglas 
Published: May 2010

Purpose Medication errors are a leading cause of injury to hospitalized patients, and studies reveal that these errors occur most often at transitions of care. The objective of this study was to evaluate a pharmacist's impact on medication errors at the Veterans Affairs Medical Center (VAMC) through involvement in medication reconciliation on patient admission. Methods A retrospective, observational, single-center study was conducted to evaluate pharmacist-initiated medication reconciliation. Preprogram and postprogram data were compared. In both phases medical records were evaluated for discrepancies by comparing outpatient medications with inpatient medication orders. Inclusion criteria comprised patients with outpatient medications who were admitted to the VAMC for at least 72 hours. The primary outcome measure was the percentage of unreconciled medications. Secondary outcomes included cost savings to the VAMC and avoidance of potential adverse events. Results A total of 206 patients were included in the study. Patients in the postprogram group had a significantly lower percentage of unreconciled medications ( P < 0.001). The most common type of discrepancy was omission of medications at admission, and the most common drug class for discrepancies was psychiatric medications. In the postprogram group, 21 medications were discontinued as a result of a pharmacist intervention, with a median cost savings of $36.58 (range, $1.10 to $2,311). An increase in the number of medications per patient was associated with an increase in unreconciled medications (coefficient of linear regression [ R 2 ] = 0.31; P < 0.001). No adverse drug events (ADEs) were noted. Conclusion Pharmacists' involvement in medication reconciliation significantly reduces the number of unreconciled medications. In addition, this involvement may greatly improve patient safety and reduce the costs of medication errors and the occurrence of ADEs.
Identify Home Medications Restricted Character Space and Truncated Drug Listings are a Set-Up for Medication Errors “can't Tell a Book by its Cover” Rings True for Medications Child Dies from Misuse of Fentanyl Patch
Authors: Cohen Michael R. 
Published: May 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 United States Pharmacopeia (USP) Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). 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.
Driving Standardized Pharmacy Practice through Central Training
Authors: Madsen Janet Jean , Phelps Pamela , Beacher Robert , Stevens Vicki L. 
Published: May 2010

Purpose Fairview Pharmacy Services needed to “systemize” clinical service provision, drug policy, and drug use in its hospitals. Lack of standardized and quality training contributed to dissatisfaction and disengagement early in the employee experience. A shortage in available pharmacists necessitated attracting and retaining new staff. A standardized training system also promised financial and safety incentives. Because financial improvement, medication safety, and employee engagement were all strategic initiatives within the health system, an innovative, uniform training process that would address deficiencies in technology and clinical training was made a key part of the tactical plan to gain and retain new staff. Summary The central pharmacist training program includes introduction to computer resources, the e-mail system, the intranet, system-wide policies and procedures, the Health Insurance Portability and Accountability Act (HIPAA), and medication safety. Order entry is a primary focus of training because the hospitals share a common pharmacy computer system. Creating consistent training without consistent practice was an initial obstacle, and the program continues to undergo enhancement, which includes more systemization of policy and practice. Trainers involved in the program see opportunities for systemizing that individuals dealing with only their hospitals may overlook. Verbal and written survey feedback regarding the program has been positive; and financial benefit, improved training, enhanced employee engagement, and improved patient safety have resulted. Conclusion Taking the pharmacists away from their work locations for initial training has been beneficial. Without the day-to-day interruptions that are typical in a pharmacy, the trainees are able to engage in a more intensive training experience. Patient cases used in order entry have been developed to ensure maximum exposure of the trainees to problems and situations that employ the guidelines and policies they are learning. The implementation of a central hospital pharmacist training program has lowered overall costs of training, enhanced employee satisfaction, and served as a catapult to standardization of policies and practice.
Alvimopan
Authors: Cada Dennis J. , Levien Terri L. , Baker Danial E. 
Published: May 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and are also 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 FIX., call The Formulary at 800-322-4349. The October 2008 monograph topics are on clevidipine butyrate injectable emulsion, tetrabenazine, tenofovir disoproxil fumarate tablets, ferumoxytol, and saxagliptin. The DUE is on clevidipine butyrate injectable emulsion.
Controlled Drug Symbol C-IV Mistaken as IV; Fatal Medication Errors in the Home; Ambulatory E-Prescribing Requires Patient's Check; EPINEPHrine-ePHEDrine Mix-Ups
Authors: Smetzer Judy L. , Cohen Michael R. 
Published: May 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 at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the United States Pharmacopeia (USP) Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). 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.
Ifosfamide, Carboplatin, and Etoposide (ICE) for Metastatic Soft Tissue Sarcoma
Authors: Moussavian Parvaneh A. , Solimando Dominic A. , Waddell J. Aubrey 
Published: May 2010

The complexity of cancer chemotherapy requires that pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy and the 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 the Army, the Department of Defense, or the United States Government.
Misprogramming Patient-Controlled Analgesia Concentration Leads to Dosing Errors; Communicate Alteplase Dose and Indication; Do Not Use Empty Prelabeled Syringes/Bowls
Authors: Cohen Michael R. 
Published: May 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 at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the United States Pharmacopeia (USP) Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). 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.
Product Selection and Pharmaceutical Comparison of Two Anti-D Immune Globulins
Authors: Siegel Jerry , Hildebrand April , Richards Jessica 
Published: May 2010

Purpose Two anti-D immunoglobulin (anti-D) products, Rhophylac and WinRho, have been approved by the US Food and Drug Administration for the treatment of chronic immune thrombocytopenic purpura. There is a significant difference in acquisition cost—and perhaps in preparation cost—of the products. This time-and-motion study was designed to evaluate the difference in time and relevant costs required for preparation of a single dose of anti-D immunoglobulin using these 2 products. Methods To evaluate the difference in time required for preparation of a single dose (3,600 mcg) of the 2 anti-D immunoglobulins for a patient weighing 72 kg, each product was prepared 9 times and the time for each preparation was recorded. The cost analysis was limited to comparison of the acquisition costs of both anti-D products and the incremental labor costs associated with their preparation. Results The results showed that the average total time for 9 preparations of WinRho was 1 minute 30.1 seconds, with the assembly time comprising 46.7 seconds. The average total time for the 9 preparations with Rhophylac was 5 minutes 7.1 seconds, with an average assembly time of 2 minutes 59.2 seconds. The difference in total average time between the 2 products was 3.62 minutes. Conclusion The cost comparison showed that the acquisition cost for as single dose of WinRho for a patient weighing 72 kg was $2,647 and that the cost for the same dose of Rhophylac was $946. Even with a personnel cost of $20 per hour, the increased labor cost is only $1.20 per preparation of Rhophylac. This is a minor cost compared to the $1,850 savings in product acquisition per average dose of Rhophylac.