Medicine and Health Sciences Commons^™

Evaluation Of The Appropriate Weaning Of Neonatal Morphine Solution (Nms) In The Treatment Of Neonatal Abstinence Syndrome (Nas) And Its Effect On Length Of Stay (Los), Nicole Hollinger, Pharmd Candidate, Christopher Hvisdas, Pharmd Candidate, Maria Samohod, Md Candidate, Tara E. Decerbo, Pharmd, Janet Larson, Md, Kristin Mckenna, Md, Lindsey Roke, Pharmd

Pharmacy Presentations, Posters, and Grand Rounds

Purpose: Neonates suffering from NAS receive NMS to treat withdrawal symptoms associated with this disease. Frequent NMS dosing and close monitoring are required to ensure adequate symptom control and prevent adverse events. Maximum dose achieved, titration, severity of disease, and variance in in-utero exposure to addictive drugs all contribute to length of stay. The primary objective of this drug utilization evaluation is to assess adherence to current institutional guidelines for titrating neonates and infants off NMS and to identify opportunities for improvement to potentially decrease length of stay in this population.

Methods: A retrospective chart review of neonates …

An Institution Wide Interdisciplinary Protocol For Improving The Recognition And Treatment Of Sepsis In Patients Presenting To The Emergency Department, Glenn Oettinger, Pharmd, Bcps

Pharmacy Presentations, Posters, and Grand Rounds

Objectives of this presentation were to describe our severe sepsis protocol, tools for sepsis identification, management, and staff education, as well as results of our research demonstrating the impact of this initiative on mortality.

Presented at: UHC Annual Conference 2013 in Atlanta, GA

36 PowerPoint slides.

Rituximab Treatment For Antibody-Mediated Rejection (Amr) Following Heart And Kidney Transplant, Laura Falconieri, Ba, Pharmd, Cheryl A. Abbas, Pharmd

Pharmacy Presentations, Posters, and Grand Rounds

Background

Antibody Mediated Rejection (AMR)1,2

• Rejection that occurs due to antibodies against donor-specific antigen (DSA)

– Antibodies activate complement system

– Leads to cell death and tissue necrosis

• Risk Factors

– Pregnancy

– Blood transfusions

– Prior transplantation

• Types of AMR

– Hyperacute

• Occurs within minutes of graft transplantation causing death of the graft

• Due to pre-formed antibodies present in high titers

• Rarely occurs now due to universal cross-matching

– Acute

• Occurs within a few days of transplantation causing graft dysfunction

• Due to pre-formed antibodies or antibodies that develop de novo after …

What’S Your Line? Defining Pharmacists' Role In Jejunostomy Tube Medication Administration, Jamie M. Gomes, Pharmd, Gloria M. Espinosa, Pharmd, Brian P. Roslund, Pharmd, Bcps, Joanne Heil, Pharmd, Bcps

Pharmacy Presentations, Posters, and Grand Rounds

Enteral nutrition is preferred over parenteral nutrition in patients with inadequate oral intake for an extended period of time. Enteral feeding helps preserve the functioning of the gastrointestinal (GI) tract. 1 Feeding tubes provide access to the GI tract allowing administration of medication while unable to swallow. Drug therapy is complicated by drug formulation, absorption site, first-pass elimination, as well as the size and placement of the tube.1-3 Medication errors revolving around administration via enteral feeding tubes represent a need for education and implementation of hospital guidelines.

Implementation Of Three Times Daily Small Volume Parenteral (Svp) Processing Using Lean Methodology, Phuoc Lynsey Le, Pharmd, Dominick Bulone, Pharmd, Akta S. Patel, Pharmd, Bcps, Glenn Oettinger, Pharmd, Bcps, Dennis Delisle, Mhsa, Pmp

Pharmacy Presentations, Posters, and Grand Rounds

Clinical Importance

• Small volume parenteral (SVP) medications are batch-processed once daily at a 900+ bed academic medical center
• Labels are printed 36 hours before medications are due and prepared and delivered for a 24-hour period
• Therapy changes, discontinuations or patient transfers lead to increased rework, missing doses, and ultimately waste
• Lean methodology was originally developed as a production philosophy and quality
• system with an emphasis on problem solving, partnership, and process improvement1-3
• The Lean philosophy emphasizes the continual identification and elimination of waste in order to maximize value1
• Lean has been used in healthcare with great success4-5

Use Of Apheresis And Insulin For Hypertriglyceridemia-Induced Pancreatitis And Diabetic Ketoacidosis, Drew Kirk, Pharmd, Cara Mcdaniel, Pharmd, Bcps, Rohit A. Moghe, Pharmd, Msph, Cde

Pharmacy Presentations, Posters, and Grand Rounds

CLINICAL RELEVANCE

• Acute pancreatitis (AP) is a common gastrointestinal disease that may result in multiple organ failure and death¹

– Gallstones & alcohol are the most common causes of AP¹

– Hypertriglyceridemia (HTG) causes 1-4% of cases, and should be suspected if triglycerides (TG) are > 1,000 mg/dL in the absence of gallstones or history of significant alcohol use¹

– Clinical management of hypertriglyceridemia-induced pancreatitis (HTGP) is based primarily on anecdotal evidence and case reports

• Concurrent diabetic ketoacidosis (DKA) and AP have been described in the literature

– DKA may be a risk factor for AP, but it …