Pharmacy and Pharmaceutical Sciences Commons^™

Compatibility Of Vancomycin And Oxacillin During Simulated Y-Site Delivery, Chad A. Knoderer, Hilary M. Teibel, Kristen R. Nichols

Scholarship and Professional Work – COPHS

Background: Vancomycin and oxacillin may be used together as empiric coverage in patients with proven or suspected Staphylococcus aureus infections. Though vancomycin hydrochloride 20 mg/mL and oxacillin sodium 160 mg/mL are reported to be compatible via Y-site delivery, Y-site compatibility of commonly used concentrations, vancomycin 10 mg/mL and oxacillin 20 mg/mL, has not yet been reported. Objective: To determine the Y-site compatibility of vancomycin 10 mg/mL and oxacillin 20 mg/mL. Methods: One vancomycin hydrochloride 1 g vial was reconstituted with 10 mL sterile water for injection (SWFI) and diluted with 90 mL 5% dextrose in water (D5W) …

Interactive Web-Based Learning Modules Prior To General Medicine Advanced Pharmacy Practice Experiences, Alex N. Isaacs, Alison M. Walton, Sarah A. Nisly

Scholarship and Professional Work – COPHS

Objective. To implement and evaluate interactive web-based learning modules prior to advanced pharmacy practice experiences (APPEs) on inpatient general medicine.

Design. Three clinical web-based learning modules were developed for use prior to APPEs in 4 health care systems. The aim of the interactive modules was to strengthen baseline clinical knowledge before the APPE to enable the application of learned material through the delivery of patient care.

Assessment. For the primary endpoint, postassessment scores increased overall and for each individual module compared to preassessment scores. Postassessment scores were similar among the health care systems. The survey demonstrated positive student perceptions of …

Acid-Suppressing Agents And Risk For Clostridium Difficile Infection In Pediatric Patients, Katelyn E. Brown, Chad A. Knoderer, Kristen R. Nichols, Ashley S. Crumby

Scholarship and Professional Work – COPHS

Background. Acid-suppressing agents have been associated with increased Clostridium difficile infection (CDI) in adults. The objective of this study was to evaluate the association of acid-suppressing therapy with the development of CDI in the pediatric population.

Methods. This was a retrospective case-control study. Children aged 1 through 17 years with a positive C difficile polymerase chain reaction (PCR) result obtained between June 1, 2008, and June 1, 2012, were randomly matched to a control population selected from patients with negative PCR.

Results. A total of 458 children were included. No difference was observed in acid-suppressive therapy prior …

Implementing Extended-Infusion Cefepime As Standard Of Care In A Children’S Hospital: A Prospective Descriptive Study, Kristen R. Nichols, Lauren C. Karmire, Elaine G. Cox, Michael B. Kays, Chad A. Knoderer

Scholarship and Professional Work – COPHS

Background: Extended-infusion cefepime (EIC) has been associated with decreased mortality in adults, but to our knowledge, there are no studies in children.

Objective: The objective of this study was to determine the feasibility of implementing EIC as the standard dosing strategy in a pediatric population.

Methods: This was a descriptive study of children aged 1 month to 17 years, including patients in the intensive care unit, who received cefepime after admission to a freestanding, tertiary care children’s hospital. Patients were excluded if they were admitted to the neonatal intensive care unit or received cefepime in the outpatient, …

Prescriptions For Bedtime Sedatives After The Introduction Of A General Admission Order Set At An Academic Health Center: The Potential And Pitfalls Of Order Sets, Areeba Kara, Alex N. Isaacs, Sarah A. Nisly

Scholarship and Professional Work – COPHS

Objective: This study describes the impact of modifications to a general admission order set on physician prescribing of 2 as-needed or pro re nata (PRN) bedtime sedatives.

Methods: The hospitalists at our institution have used a general medical admission order set since 2005. Zolpidem was the only as-needed (PRN) bedtime sedative option on the order set until trazodone was added in December 2008. Trazodone is preferred over zolpidem in the geriatric population. We identified patients admitted by the hospitalists between January 2007 and August 2013 who were prescribed with either zolpidem or trazodone as a PRN sedative. Patient demographics, date …

Prescriptions For Bedtime Sedatives After The Introduction Of A General Admission Order Set At An Academic Health Center: The Potential And Pitfalls Of Order Sets., Areeba Kara, Alex N. Isaacs, Sarah A. Nisly

Scholarship and Professional Work – COPHS

OBJECTIVE:

This study describes the impact of modifications to a general admission order set on physician prescribing of 2 as-needed or pro re nata (PRN) bedtime sedatives.

METHODS:

The hospitalists at our institution have used a general medical admission order set since 2005. Zolpidem was the only as-needed (PRN) bedtime sedative option on the order set until trazodone was added in December 2008. Trazodone is preferred over zolpidem in the geriatric population. We identified patients admitted by the hospitalists between January 2007 and August 2013 who were prescribed with either zolpidem or trazodone as a PRN sedative. Patient demographics, date …

Success With Extended-Infusion Meropenem After Recurrence Of Baclofen Pump-Related Achromobacter Xylosoxidans Meningitis In An Adolescent, Kristen R. Nichols, Chad A. Knoderer, Nicholas G. Jackson, John J. Manaloor, John C. Christenson

Scholarship and Professional Work – COPHS

A 13-year-old female experienced a recurrence of baclofen pump-related central nervous system (CNS) infection caused by Achromobacter, despite absence of retained foreign material. Due to the failure of meropenem (120 mg/kg/d in divided doses every 8 hours and infused over 30 minutes) in the initial infection, the dose was infused over 4 hours during the recurrence. Meropenem is an antibiotic for which efficacy is time dependent, and 4-hour versus 30-minute infusions have been shown to prolong the time the concentration of the antibiotic exceeds the minimum inhibitory concentration (MIC) of the organism at the site of infection (T>MIC). …

Late-Occurring Vancomycin-Associated Acute Kidney Injury In Children Receiving Prolonged Therapy, Chad A. Knoderer, Allison L. Gritzman, Kristen R. Nichols, Amy C. Wilson

Scholarship and Professional Work – COPHS

Background: Acute kidney injury (AKI) in patients receiving vancomycin has been associated with trough concentrations ≥15 mg/L and longer therapy duration. The objective of this study was to determine the incidence and factors associated with late AKI in children receiving ≥8 days of vancomycin therapy. Methods: Children aged 30 days to 17 years who were admitted to our institution and received intravenous vancomycin for at least 8 days during January to December of 2007 and 2010 and had a suspected or proven gram-positive infection were included. Late AKI was categorized as AKI occurring after the first 7 days of therapy …

Analysis Of A Standardized Perioperative Pain Management Order Set In Highly Opioid-Tolerant Patients, Alex. N. Isaacs, Kellie L. Knight, Sarah A. Nisly

Scholarship and Professional Work – COPHS

Objective: The aim was to assess a standardized order set for perioperative pain management in highly opioid-tolerant patients undergoing elective orthopedic surgery.

Methods: This retrospective chart review evaluated a pain order set in highly opioid-tolerant patients undergoing elective total knee or total hip arthroplasty from January 2010 through August 2012. Based on the date of the surgery, patients were allocated into preimplementation or postimplementation order set groups. The primary outcome assessed whether an adjustment in daily opioid dosage was required within the first 48 hours postoperatively. Secondary outcomes included pain scores, length of hospitalization, and safety outcomes.

Results: Sixty patients …

Hypertension Management: Making Sense Of Guidelines And Therapy Options For The Elderly, Miranda Arthur, Lindsay Saum, Jessica E. Wilhoite

Scholarship and Professional Work – COPHS

Goal: The goal of this activity is to increase the awareness of the pharmacist on the complications surrounding hypertension management in the elderly individual, clarify the differences in current guideline recommendations, and aid in making the most appropriate drug therapy decisions regarding the management of hypertension.

Standardized Competencies For Parenteral Nutrition Prescribing: The American Society For Parenteral And Enteral Nutrition Model, Peggi Guenter, Joseph I. Boullata, Phil Ayers, Jane Gervasio, Ainsley Malone, Erica Raymond, Beverly Holcombe, Michael Kraft, Gordon Sacks, David Seres, Parenteral Nutrition Safety Task Force, American Society For Parenteral And Enteral Nutrition (A.S.P.E.N.)

Scholarship and Professional Work – COPHS

Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized model for PN prescribing competency is proposed based on a competency framework, the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)–published interdisciplinary core competencies, safe practice recommendations, and clinical guidelines. This framework will guide institutions and agencies in developing and maintaining …

Total Nutrient Admixtures (3-In-1): Pros Vs Cons For Adults, Jane Gervasio

Scholarship and Professional Work – COPHS

Total nutrient admixture (TNA) is a complete parenteral nutrition (PN) formulation composed of all macronutrients, including dextrose, amino acids, and intravenous fat emulsions (IVFE), in one bag. The TNA may be safely administered to the patient, with all components aseptically compounded and minimal administration manipulation required, lending itself to decreases in risks of catheter contamination and patient infections. The TNA is compatible and stable at recommended concentrations, and since the IVFE is in the TNA, it is infused at slower rates, allowing for better fat clearance. The TNA offers convenience of administration and a potential cost savings to the healthcare …

Tolerability Of Induction Chemotherapy Dosing Practices In Acute Myeloid Leukemia Patients, Kaylene M. Peric, David J. Reeves

Scholarship and Professional Work – COPHS

For patients with high body surface areas (BSA), differing chemotherapy dosing strategies have been utilized in attempts to reduce toxicity. In a retrospective evaluation, we compared the effects of chemotherapy dosing in acute myeloid leukemia patients with high BSA (>2 m²) who received capped doses (n = 12) to those who received uncapped doses (n = 24), and to patients with BSA ≤ 2 m² (n = 42). There were no statistically significant differences among groups (BSA ≤ 2 m², BSA > 2 m² capped, and BSA > 2 m² uncapped) …

The Cost Of Treating Cancer Patients With Antineoplastic Medications During Inpatient Hospital Admission, Alexandra Foster, David J. Reeves

Scholarship and Professional Work – COPHS

Abstract from 2015 American College of Clinical Pharmacy Global Conference, San Francisco, CA

Evaluation Of A Vancomycin Dosing Protocol And Pharmacokinetic Parameters In Burn Patients, T. A. Walroth, K. A. Lavery, S. Erdman, N. R. Buening, D. R. Foster, Kendra M. Damer, R. Sood

Scholarship and Professional Work – COPHS

Published abstract from the 47th American Burn Association Annual Meeting. Chicago, IL April 2015.

Self-Assembling Modified Β -Cyclodextrin Conjugated Sirna Nanoparticles And Liposomal Sirna Efficiently Knock Down The Mutant Huntingtin Gene In A Modified Pc-12 Cell Line, Rukmini Ladi, Sudip Das, Nandita Das

Scholarship and Professional Work – COPHS

Purpose: To formulate and characterize liposomal siRNA (LP-siRNA) and cationic β-cyclodextrin siRNA (CD-siRNA) nanoparticle complexes and evaluate their efficacy in knockdown of mutant Huntingtin protein (mHtt) in a modified PC-12 cell line.

Curcuminoid In Nanoemulsion Formulations Cause Enhanced Cell Death In The Hela Cancer Cell Culture Model, Nikita Kheradia, Nandita Das, Sudip Das

Scholarship and Professional Work – COPHS

Purpose: To formulate and characterize curcuminoid (insoluble chemoprevention agent) loaded nanoemulsions and evaluate their cytotoxicity in HeLa cells.

Context And Contribution: Going Beyond The Research Paper In The Health Sciences, Laura Menard

Scholarship and Professional Work

Conference poster presented at the Midwest Medical Library Association Chapter Meeting, October 2-6, 2015 in Louisville, KY.