Pharmacy and Pharmaceutical Sciences Commons^™

Pro: The Use Of Sugammadex Does Not Preclude The Need For Objective Neuromuscular Monitoring., J Ross Renew, Dustin D. Linn

Parkview Pharmacy Department

Based on strong evidence, optimal management of neuromuscular block should incorporate objective (or quantitative) neuromuscular monitoring with appropriately dosed antagonists such as sugammadex. Sugammadex has the unique ability to antagonize aminosteroidal-induced neuromuscular block at any level; however, neostigmine is a reasonable alternative at minimal levels. Blind or excessive administration of sugammadex does not eliminate the risk of patients having postoperative residual neuromuscular block. Significant variability exists in how patients respond both to neuromuscular blocking agents and their antagonists.

Incorporating Pediatrics In Clinical Education: A Call To Action In Inpatient Pharmacy Practice., Caroline M Sierra, Amanda C Capino, Cober M Petrea, Lea S Eiland, Norm Fenn Bcps, Bcpps, Nicholas M Fusco, Lucas E Orth

Parkview Pharmacy Department

Background

The recently revised 2025 Accreditation Council for Pharmacy Education (ACPE) Standards state the expectations of Advanced Pharmacy Practice Experiences (APPEs) are to “emphasize continuity of care and incorporate acute, chronic, and wellness-promoting patient-care services…[and] expose students to diverse patient populations as related to age, sex race/ethnicity, socioeconomic factors…and disease states.”1 These expectations describe the conditions under which student pharmacists are expected to develop and demonstrate competence in the entrustable professional activities (EPAs), which were revised in 2022 to more accurately reflect current pharmacy practice.2 However, the definition of required APPE (Standard 3.2.d.) states that the inpatient patient …

Forecasting The Impact Of Artificial Intelligence On Clinical Pharmacy Practice, Adrian Wong Pharmd, Mph, Fccp, Trenton Flanagan Pharmd, Elizabeth W. Covington Pharmd, Elaine Nguyen Pharmd, Mph, Mba, Dustin D Linn Pharmd, Mba, Gretchen Brummel Pharmd, Brian Hoffmaster Pharmd, Mba, Diana Issacs Pharmd, Fccp, Sandra L. Kane-Gill {Harmd, Msc, Fccp

Parkview Pharmacy Department

There is a need to understand contemporary scientific advances as clinical pharmacy evolves. One rapidly expanding area is artificial intelligence (AI), which has grown significantly over the past year because of the public availability of large language models. This commentary reviews published literature describing and evaluating applications of AI to each aspect of the medication use process and forecasts potential future roles for AI in pharmacy practice. Potential challenges in implementation are also described.

Use Of Finerenone For Chronic Kidney Disease In Type 2 Diabetes: A Cross-Sectional Study At A Large Health System, Robert D. Beckett

Parkview Pharmacy Department

Presented at the Midyear Clinical Meeting.

While most patients met individual KDIGO finerenone initiation criteria, fewer than one-third met all guideline recommended parameters. Guideline directed K+ monitoring following initiation was underperformed, highlighting a need for improved follow up Procedures.

Evaluation And Reduction Of Pediatric Precaution Alert Volume Across A Large Community Health System, Sarah Ferrell Pharmd

Parkview Pharmacy Department

Presented at the Midyear Clinical Meeting.

This evaluation found the potential to remove 15,174 alerts per year. Based off a physician spending a median of 8 seconds processing an alert, a reduction of 15,174 alerts per year saves about 34 hours of physician work-time per year.

Levetiracetam-Induced Acute Kidney Injury In A Pediatric Patient, Makaila A. Geese Pharmd Candidate, Norm Fenn Bcps, Bcpps

Parkview Pharmacy Department

Presented at PPA Meeting.

Objective: To describe a case of acute kidney injury following levetiracetam administration in an adolescent patient.

Key takeaways:

Acute kidney injury (AKI) following levetiracetam is rare, especially in pediatric patients

Kidney injury was not correlated with supratherapeutic levetiracetam concentrations

Morganella Morganii Meningitis In A Neonate: A Case Report, Madelin Vessels Pharmd Candiadate, Cassie Rough Pharmd Candidate, Robyn Schmucker Md, Mph, Norm Fenn Bcps, Bcpps

Parkview Pharmacy Department

Presented at Midyear Clinical Meeting

Objective: To summarize the interventions that took place to add to the limited data that exists in the world surrounding the treatment and outcomes of M. morganii infections.

Key takeaways: 

• M. morganii meningitis is highly rare in neonates
• There are no defined treatment guidelines or outcomes available to date
• Cefepime sufficiently treated M. morganii meningitis, bacteremia, and concurrent E. coli urinary tract infection

Comparison Of Isoflurane To Sevoflurane In A Pediatric Patient With Refractory Status Asthmaticus: A Case Report, Janella Rianna N. Benitez Mba, Pharmd, Norm Fenn Bcps, Bcpps, Fashp

Parkview Pharmacy Department

Presented at Midyear Clinical Meeting.

Objective: To describe the use of inhaled anesthetics in a pediatric patient with severe, refractory status asthmaticus unresponsive to conventional therapies.

Implementation Of An Updated Intravenous Iron Order Panel In The Acute Care Setting: A Pre/Post Study, Robert D. Beckett

Parkview Pharmacy Department

Presented at Midyear Clinical Meeting

Implementation of the revised order panel led to reduced utilization including a reduction in the proportion of patients receiving IV iron, number of total doses, proportion of patients receiving more than one dose, and proportion of patients receiving more than 200 mg.

One Bolus, Many Benefits: Implementing Tenecteplase For Acute Ischemic Stroke, Robert D. Beckett Pharmd

Parkview Pharmacy Department

Presented at the Midyear Clinical Meeting.

Overall, no statistically significant differences in door-to-needle time or secondary outcomes between alteplase and tenecteplase groups was identified. This could relate to time in imaging and patient evaluation. Patients treated with tenecteplase showed greater bleeding risk versus alteplase, though these results were not statistically significant when accounting for baseline age in an exploratory regression. Patients who received tenecteplase were slightly older, on average.

Evaluation Of Terlipressin Use At A Community Health System, Robert D. Beckett Pharmd

Parkview Pharmacy Department

Presented at the Midyear Clinical Meeting.

Findings of this evaluation suggest opportunities to improve terlipressin utilization by sharing results back to Nephrology and GI and

reviewing P&T-approved criteria for use, implementing EMR alerts to reinforce dosing

protocols every 24-48 hours for dose adjustments

or discontinuation based on Scr trends (day 4 and

beyond), and supporting daily monitoring of fluid

and respiratory status.

Findings of this evaluation suggest opportunities to improve terlipressin utilization by sharing results back to Nephrology and GI and

reviewing P&T-approved criteria for use, implementing EMR alerts to reinforce dosing

protocols every 24-48 hours for dose adjustments

or …

Using A Modified Delphi Panel To Develop Best Practices In Course Evaluations Of Teaching., Ma. Emmanuelle (Ella) Domingo Vogt Pharmd, Robert D. Beckett Pharmd, Monica Miller Pharmd, Ms, Alex N. Issacs Pharmd, Ms

Parkview Pharmacy Department

Presented at AACP Annual Meeting. Boston, MA: July 2024.

This study generated best practices colleges of pharmacy should employ when conducting student evaluations of teaching and courses.

Best Practices For Pgy1 Letters Of Intent: Recommendations From A Modified Delphi Process., Robert A. Bechtol, Aleda M.H. Chen, Diana M. Sobieraj, Bupendra Shah, Robert D. Beckett Pharmd, Jill Augustine

Parkview Pharmacy Department

Presented at ACCP Virtual Poster Symposium. Lenexa, KS: May 2024.

This study generated best practices student pharmacists pursuing residency training should employ when preparing a letter of intent.

Adherence To The Prisma 2020 Guideline: An Evaluation Of Meta-Analyses And Systematic Reviews Published In Pharmacy Journals., Kendall Littlefield, Samantha Alspaugh, Andrew Forte Pharmd, Robert D. Beckett Pharmd, Bcps

Parkview Pharmacy Department

Presented at ACCP Virtual Poster Sessions. Lenexa, KS: May 2024

This cross-sectional evaluation study found that, on average, published meta-analyses in pharmacy journals are adherent to PRISMA best practices, though several areas, related to background and rationale of the study, discussion items, and search strategy, were identified for improvement.

Evaluation Of Intravenous Immunoglobulin Utilization In Pediatric And Neonate Population Within A Community Health System., Hannah Davis Pharm D Candidate, Robert D. Beckett Pharmd, Bcps, Heather Nichols Pharm D, Bcpps, Norm Fenn Bcps, Bcpps

Parkview Pharmacy Department

This project evaluated appropriateness of intravenous immunoglobulin (IVIG) use in pediatric and neonatal patients within a community health system based on current evidence. Presented at 2023 ASHP Midyear Clinical Meeting

Evaluation Of Intravenous Iron In The Inpatient Setting At A Large Health System., Abby Miller Pharmd Candidate, Robert D. Beckett Pharmd, Bcps, Cole Luty Pharmd, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated the appropriateness of interleukin (IL)-17 and IL-23 inhibitor usage within Parkview Health, in both inpatient and outpatient settings. This project set out to determine whether the inpatient use of intravenous (IV) iron replacement was justified and followed evidence-based guidelines.

Medication Use Evaluation Of Il-17 And Il-23 Inhibitors At A Large Health System., Corey Uetrecht Pharmd Candidate, Robert D. Beckett , Pharmd, Bcps, Kevin Baumgartner Pharmd, Jennifer Sposito Pharmd

Parkview Pharmacy Department

Presented at the ASHP Midyear Clinical Meeting. December 2023.

This project evaluated the appropriateness of interleukin (IL)-17 and IL-23 inhibitor usage within Parkview Health, in both inpatient and outpatient settings.

Tertiary Drug Information Sources For Treatment And Prevention Of Covid-19., Robert D. Beckett, Yashawna Brattain, Judy Truong, Genevieve Engle

Parkview Pharmacy Department

OBJECTIVE: To evaluate tertiary drug information databases in terms of scope, consistency of content, and completeness of COVID-19 drug information.

METHODS: Five electronic drug information databases: Clinical Pharmacology, Lexi-Drugs, AHFS DI (American Hospital Formulary Service Drug Information), eFacts and Comparisons, and Micromedex In-Depth Answers, were evaluated in this cross-sectional evaluation study, with data gathered from October 2021 through February 2022. Two study investigators independently extracted data (parallel extraction) from each resource. Descriptive statistics were primarily used to evaluate scope (i.e., whether the resource addresses use of the medication for treatment or prevention of COVID-19) and completeness of content (i.e., whether …

Evaluation Of Piperacillin/Tazobactam Utilization In Suspected Urinary Tract Infections At A Community Hospital, Adam P. Yagodinski, Jamie Gaul Pharmd, Bcps, Dana Lorber Pharmd, Bcps, Alissa Keillor Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: Evaluate and characterize the utilization of piperacillin/tazobactam in patients with a suspected urinary tract infection (UTI) at a community hospital in Fort Wayne, Indiana.

Characterization Of Vancomycin Use At A Community Hospital, Caleb Hoppe Pharmd Candidate, Jamie Gaul Pharmd, Bcps, Christina Ford Pharm, Bcpsd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To characterize the use of vancomycin medication therapy at a non-profit community hospital (Parkview Regional Medical Center) in preparation for a potential change to AUC:MIC dosing and monitoring.

Comparison Of Clinical Pharmacist Versus Nurse Led Medicare Annual Wellness Visits In The Primary Care Clinic Setting, Payton Waltz Pharmd, Erin Copi Pharmd, Bcacp, Rachel Steele Pharmd, Bcacp

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To characterize the impact of a primary care pharmacist completing Medicare Annual Wellness Visits by determining:

• Primary: The rate of overall care gap closure by pharmacist-led versus nurse-led visits.

• Secondary: The percentage of recommended care gap opportunities during pharmacist-led versus nurse-led visits and the number of pharmacist made medication interventions during AWVs.

Safety Of 10,000 Unit Unfractionated Heparin Boluses For Acute Myocardial Infarction In The Emergency Department, Emma Pastula Pharmd, Sarah Meeks Pharmd, Amber Ooley Pharmd, Bcps, Bcccp, Sarah Ferrell Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

The purpose of this retrospective chart-review study is to evaluate the safety and efficacy of a 10,000 unit unfractionated heparin bolus in the emergency department prior to PCI. • The primary objective was percentage of ACT values within goal range of 250-300 seconds. • Secondary objectives included major bleeding rate, weight-based UFH bolus dose in comparison to guideline recommended bolus dose, percentage of initial ACT values within goal range, protamine use, and need for additional UFH boluses.

Evaluation Of Therapies For Treatment Of Hyponatremia, Laura Fischer Pharmd Candidate, Jennifer Sposito Pharmd, Blake Burton Pharmd, Bcps, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: Characterize the use and assess the efficacy of tolvaptan and urea in the treatment of patients who were admitted to the hospital with chronic hyponatremia.

Impact Of Specialty Pharmacy Services On Pneumococcal Vaccination Rates In A Large Inflammatory Bowel Disease Population, Jessica Offerle Pharmd, Tara Jellison Pharmd, Mba,Fashp, Michele Walters Pharmd, Bcps, Bcidp, Toni Zahorian Pharmd, Bcacp

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: The purpose of this study is to assess the impact of clinical specialty pharmacy services and education on compliance with vaccine recommendations in subjects with IBD.

Continued Use Of Proton Pump Inhibitors And Risk For Recurrence Of Clostridium Difficile Infection-A Retrospective Study, Cecilia Schowe Pharmd Candidate, Breia Leavell Pharmd Candidate, Cole Luty Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To determine if the continued use of proton pump inhibitors leads to an increased risk of recurrent Clostridium difficile infections.

Evaluation Of Rituximab Use At Parkview Health, Sarah Stopczynski Pharmd Candidate, Jesse Christman Pharmd, Bcop, Kristen Christman Pharmd, Bcps, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Poster Presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: Characterize the use of rituximab at Parkview Health by differentiating between inpatient and outpatient use as well as evaluate indications for use, incidence of documented infusion reactions, and biosimilar use.

Characterizing Appropriate Use Of Octreotide Continuous Infusions For Gastroesophageal Bleeding, Austin Harris Pharmd, Curtis Stump Pharmd, Luke Keller Pharmd, Bcps, Bcccp

Parkview Pharmacy Department

Poster Presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To characterize the appropriate use of octreotide infusions for gastroesophageal bleeding at a community hospital system to pursue guideline-driven standardization of care.

Evaluation Of Intravenous Loop Diuretic Use In Acute Decompensated Heart Failure In A Community Hospital, Catherine Eichler Pharmd, Cole Luty Pharmd, Kris Howard Pharmd, Aacc

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition

Objective: To characterize the use of intravenous loop diuretics in patients hospitalized with fluid overload secondary to acute decompensated heart failure (ADHF) within the heart failure service of a community hospital

Medication Use Evaluation Of Angiotensin Ii, Kevin Baumgartner Pharmd, Dustin D Linn Pharmd, Bcccp, Michael Todt Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition

Background: Angiotensin II is a vasopressor agent used for septic shock and has been found to effectively raise the blood pressure in patients who did not respond to other conventional high dose vasopressors. Angiotensin II’s wholesale acquisition cost (WAC) of $1800 per vial creates a significant financial burden for health care institutions. A limited warranty manufacturer program replaces angiotensin II vials in patients not achieving an increase in mean arterial pressure (MAP) of at least 10 mmHg or to >65mmHg within the first 3 hours of initiation.

Objective: Evaluate compliance …

Impact Of Pharmacist-Led Direct Oral Anticoagulant Monitoring On Appropriate Medication Use, Bhavika Patel Pharmd, Kenneth Wiley Pharmd, Bcacp, Alicia Sawmiller Pharmd, Bcacp

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Background: Direct oral anticoagulants (DOACs) are the preferred treatment for patients with venous thromboembolism and atrial fibrillation and are an attractive alternative to vitamin K antagonists in multiple indications for long-term anticoagulation. Although DOACs require less frequent clinical monitoring than vitamin K antagonists and their standardized dosing is often more convenient for patients, these medications still require monitoring. Medication adherence, monitoring renal function, hepatic function and drug interactions are important safety concerns for managing patients on DOAC therapy. Previous studies have shown pharmacist can impact monitoring, dosing and adherence to …