Medicine and Health Sciences Commons^™

Teaching Residents To Teach: Preparing Faculty And Clinical Educators, Sarah Nisly, Tracy Sprunger, Alison Walton, Tracy Costello, Jane M. Gervasio, Mary H. Andritz

Scholarship and Professional Work – COPHS

Abstract from the 114th Annual Meeting of the American Association of Colleges of Pharmacy, Chicago, IL, July 13-17, 2013.

Medication Utilization Evaluation Of Dabigatran And Rivaroxaban Within A Large, Multicenter Health System., Sarah A. Nisly, Alex N. Issacs, Meagan Doolin, Courtney Morse, Erin Shiltz

Scholarship and Professional Work – COPHS

Objective. The objective of this medication utilization evaluation (MUE) was to determine the appropriateness of dabigatran and rivaroxaban while also reviewing outcomes for safety and effectiveness within a large, multi-center health system.

Methods. A retrospective chart review was performed using the system’s electronic medical record. A data inquiry was requested and generated for dabigatran usage from July 28, 2011 through July 28, 2012 and for rivaroxaban from March 1, 2012 to July 31, 2012 at eight health system hospitals. All patients receiving at least one dose were eligible for inclusion in the MUE.

Results. For dabigatran, 78 of 390 unique …

Lipid Goals: Update On Their Status, Katie Axford, Eliza Dy, Sarah A. Nisly

Scholarship and Professional Work – COPHS

Goal: The goal of this lesson is to discuss current medical management of dyslipidemias, including available agents and goals of therapy, as well as potential future treatment strategies based on recently published literature.

Simvastatin: A Risk Factor For Angioedema?, Sarah A. Nisly, Areeba Kara, Tamara B. Knight

Scholarship and Professional Work – COPHS

Objective. To report a case of simvastatin-induced angioedema in a patient with near nightly episodes of orofacial angioedema.

Case Summary. A 75-year-old African American female presented to the emergency department with recurrent face, lip, and tongue swelling. The patient described frequent episodes of orofacial edema, with 4 emergency department visits over the previous 6 months. Her home medications were reviewed and simvastatin was identified as a possible contributing medication. Simvastatin was discontinued with resolution of the symptoms during hospitalization and a significant reduction in episodes.

Discussion. Drug-induced angioedema has been documented with several agents, most commonly angiotensin-converting enzyme inhibitors. …

Use Of A Subcutaneous Insulin Computerized Glucostabilizer™ Program On Glycemic Control In The Intensive Care Setting: A Retrospective Data Analysis., Sarah A. Nisly, Serena Harris, Laura Aykroyd, Joni Carrol, Brian Ulmer, Michael Waddell, Samuel Flanders, Rattan Juneja

Scholarship and Professional Work – COPHS

Background: Despite guidelines that recommend strongly against Sliding Scale Insulin (SSI) it continues to be the most commonly insulin regimen used in hospitals to treat hyperglycemia. In addition to being reactionary to a glucose that has already increased, SSI offers practical challenges in the randomness of the doses of insulin prescribed and often a disconnect with glucose testing that should be occurring in congruence to the insulin dosing. While many clinical trials have shown improved glycemic control in critical care patients receiving intravenous insulin; few studies have demonstrated the efficacy of subcutaneous (SQ) insulin in this setting. In this study, …

Canagliflozin, A New Sodium-Glucose Co-Transporter 2 Inhibitor, In The Treatment Of Diabetes, Sarah A. Nisly, Denise M. Kolanczyk, Alison M. Walton

Scholarship and Professional Work – COPHS

Purpose. The published evidence on the pharmacology, pharmacodynamics, pharmacokinetics, safety, and efficacy of a promising investigational agent for managing type 2 diabetes is evaluated.

Summary. Canagliflozin belongs to a class of agents—the sodium–glucose cotransporter 2 (SGLT2) inhibitors—whose novel mechanism of action offers potential advantages over other antihyperglycemic agents, including a relatively low hypoglycemia risk and weight loss-promoting effects. Canagliflozin has dose-dependent pharmacokinetics, and research in laboratory animals demonstrated high oral bioavailability (85%) and rapid effects in lowering glycosylated hemoglobin (HbA1c) values. In four early-stage clinical trials involving a total of over 500 patients, the use of canagliflozin for varying periods …

A Randomized, Controlled Trial Of Catheter-Related Infectious Event Rates Using Antibiotic-Impregnated Catheters Versus Conventional Catheters In Pediatric Cardiovascular Surgery Patients, Elaine G. Cox, Chad A. Knoderer, Aimee Jennings, John W. Brown, Mark D. Rodefeld, Scott G. Walker, Mark W. Turrentine

Scholarship and Professional Work – COPHS

We conducted a randomized, controlled clinical trial to determine whether a difference in catheter-associated blood stream infection (CABSI) incidence existed between children who underwent cardiac surgery and had a central venous catheter impregnated with minocycline and rifampin versus those who had a conventional, nonimpregnated catheter after cardiac surgery. Due to a lower number of infections than expected, the study was terminated early. Among 288 evaluable patients, the rates of CABSI and line-related complications were similar between the 2 groups.

Analysis Of Anti-Xa Concentrations In Patients On Treatment Dose Enoxaparin: A Retrospective Chart Review, Lauren Levine, Nicole Pallme, Erik Angelotti, Dane L. Shiltz

Scholarship and Professional Work – COPHS

The purpose of this retrospective chart review was to determine the correlation between full weight-based enoxaparin use and the frequency of anti-Xa concentrations within the defined therapeutic range; to ascertain if anti-Xa monitoring is being appropriately ordered in relation to the timing of enoxaparin dose (after 3 consistent therapeutic doses and 3-5 hours post-dose); to establish if the evidence-based recommended dose adjustment protocol that was studied in the pediatric population was utilized; and if this yielded anti-Xa concentrations within the target range (0.6 – 1.1 IU/mL) for an adult population. The data may suggest a lack of correlation between BMI …

Linezolid-Associated Thrombocytopenia In Children With Renal Impairment, Chad A. Knoderer, Kristen R. Nichols, Heather L. Deyoung, Sara J. Jones, Elaine G. Cox

Scholarship and Professional Work – COPHS

Poster presented at ID Week, October 2013, San Francisco, California.

Outcomes Of Extended-Infusion Piperacillin/Tazobactam In Pediatric Patients., Kristen R. Nichols, Katie Andricopulos, Ashley S. Crumby, Elaine G. Cox, Chad A. Knoderer

Scholarship and Professional Work – COPHS

Poster presented at: ID Week 2013, October 2013, San Francisco, California.

Vancomycin And Gentamicin Pharmacokinetic Alterations In An Adolescent Amputee, Kristen R. Nichols, Kari M. Edison, Michelle D. Rosenbaum, Chad A. Knoderer

Scholarship and Professional Work – COPHS

A 14-year-old male with bilateral above-the-knee amputations presented to our hospital for treatment of a skin and soft-tissue infection. We report the experience of vancomycin and gentamicin therapy in this patient. Because these medications require weight-based dosages and pharmacokinetic monitoring of serum levels, it was necessary to obtain peak and trough levels of the two drugs in order to determine the pharmacokinetic differences in this patient compared to those in an adolescent male without amputations. To our knowledge, this is the first report describing pharmacokinetic differences in an adolescent amputee.

We Can Do More Than Just Sell The Test: Pharmacist Perspectives About Over-The-Counter Rapid Hiv Tests, Beth Meyerson, Priscilla T. Ryder, Christiana Van Hippel, Kelsey Coy

Scholarship and Professional Work – COPHS

Pharmacist attitudes about the over-the-counter (OTC) sale of HIV rapid tests in pharmacies were explored through interviews conducted among 17 licensed community pharmacists in a Midwestern, moderate HIV incidence state between May and September 2012. Participants recognized that OTC rapid HIV tests would increase the number of people aware of their HIV status. Concerns included linkage to care and results consultation for those who test HIV-positive. Point of sale was identified as an opportunity for consultation about the test and to establish a relationship for future discussion about results and linkage to care. Pharmacists could provide initial test consultation or …

Survey Of Pharmacist-Managed Primary Care Clinics Using Healthcare Failure Mode And Effect Analysis (Hfmea), Ashley H. Vincent, Jasmine D. Gonzolvo, Darin C. Ramsey, Alison M. Walton, Zachary A. Weber, Jessica E. Wilhoite

Scholarship and Professional Work – COPHS

Objectives: The primary objective was to expand upon results of a previously piloted patient perception survey with Healthcare Failure Mode and Effect Analysis (HFMEA), to identify areas within pharmacist-managed clinics needing improvement.

Methods: The survey was adapted for use in pharmacist-managed clinics. Patients completed the survey following regularly scheduled pharmacist appointments. Data were analyzed with a method adapted from HFMEA. Product scores could range from five to 25. A product of five indicates that pharmacists are doing a good job on the items that patients place the most value on, while a product score of 25 indicates that pharmacists are …

Geriatric Medication Therapy: Weighing The Evidence Versus Best Practice, Lindsay M. Saum, Cathy Ramey

Scholarship and Professional Work – COPHS

Goals: The goal of this article is to provide a review of available evidence for safe prescribing in older adults and recommend medication therapies based on anticipated pharmacokinetic/physiologic changes in this population.

Assessing The Accuracy And Quality Of Medication History Collection: Effect Of Implementation Of Electronic Health Record, Kena Lanham, Lindsay Saum, David J. Reeves, Colleen Scherer, Beth Johnson, Anthony Antonopoulos, Suellyn Sorenson

Scholarship and Professional Work – COPHS

Abstract from 2013 ACCP Annual Meeting, Alburquerque, New Mexico.