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Articles 1 - 25 of 25
Full-Text Articles in Pharmacy and Pharmaceutical Sciences
A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe
A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe
Posters
Introduction: Propionic Acidemia (PA) is a disorder related to abnormal protein and lipid metabolism resulting in progressive neurological injury and dilated cardiomyopathy (DCM). Interventions for PA and secondary disease manifestations can require multi-organ transplantation. Herein we report the case of a child with PA and end-stage DCM requiring left ventricular assist device (LVAD) support with eventual heart-liver transplant. Case Report: A 17 year old male diagnosed in childhood with PA developed chronically progressive DCM culminating in end stage heart failure with acute decompensations. In a recurrent admission, he progressed to require dual inotropic support and systemic anticoagulation for new LV …
Levetiracetam For Seizure Prophylaxis In Spontaneous Intracerebral Hemorrhage, Alanah Bratley, Krystal Commons, Allycia Natavio
Levetiracetam For Seizure Prophylaxis In Spontaneous Intracerebral Hemorrhage, Alanah Bratley, Krystal Commons, Allycia Natavio
Posters
Characterize the use of levetiracetam for early seizure prophylaxis in patients with sICH
Pharmacist-Provided Educational Intervention And Its Impact On Medical Resident Knowledge And Comfort Level With Continuous Glucose Monitors (Cgms), Chelsea Dezfuli, Sarah Muench, Colleen Lauster
Pharmacist-Provided Educational Intervention And Its Impact On Medical Resident Knowledge And Comfort Level With Continuous Glucose Monitors (Cgms), Chelsea Dezfuli, Sarah Muench, Colleen Lauster
Posters
Continuous glucose monitors (CGMs) have become an integral component of diabetes care
American Diabetes Association now recommends that CGMs be offered to all patients on insulin who can use the device safely
Integrating CGMs into clinical practice can be challenging for several reasons: – Data overload – Cost – Need for education on data interpretation
Safety Evaluation Of Intravenous Heparin Protocol Following Alteplase Treatment In Patients With Suspected Or Confirmed Pulmonary Embolism, Erika Waldsmith, Lisa Hall Zimmerman, Claudia Hanni
Safety Evaluation Of Intravenous Heparin Protocol Following Alteplase Treatment In Patients With Suspected Or Confirmed Pulmonary Embolism, Erika Waldsmith, Lisa Hall Zimmerman, Claudia Hanni
Posters
No abstract provided.
Evaluation Of Antimicrobial Prophylaxis In Spine Surgery Within An Enhanced Recovery Program At A Large Community Teaching Hospital, Sabrina Dipietro, Klea Noskey, Richard Zoltowski, Tania Saeed, Sapna Shah
Evaluation Of Antimicrobial Prophylaxis In Spine Surgery Within An Enhanced Recovery Program At A Large Community Teaching Hospital, Sabrina Dipietro, Klea Noskey, Richard Zoltowski, Tania Saeed, Sapna Shah
Posters
The risk of surgical site infections post spine surgery is 0% to 18%.1
• American Society of Health System Pharmacists (ASHP) and Enhanced Recovery After Surgery (ERAS) Society guidelines recommend using an agent with activity against the most common surgical site pathogens including Staphylococcus aureus. 2,3
• The preferred agent is cefazolin 2 grams intravenous (IV) (3 grams if patient weighs ≥120 kilograms [kg]) administered 30 minutes prior to skin incision and re-dosed every four hours intraoperatively.2,3
• In the case of a cephalosporin allergy, clindamycin 900 milligrams (mg) IV or vancomycin 15 mg/kg IV are recommended alternatives.2,3
• Due …
Evaluation Of Antibiotic Selection And Duration In Patients With Non-Severe Community Acquired Pneumonia, Emily Reich, Sandra Hartnagle, Jennifer Pilotto, Heidi Klotz, Ryan Herc
Evaluation Of Antibiotic Selection And Duration In Patients With Non-Severe Community Acquired Pneumonia, Emily Reich, Sandra Hartnagle, Jennifer Pilotto, Heidi Klotz, Ryan Herc
Posters
No abstract provided.
Evaluation Of Safety Outcomes Of Two Hydrocortisone Dosing Regimens In Patients In Septic Shock, Alexandra Rola, Joshua Wirtz, Daniel Kalaj, Vasil Rrushi, Megan Cadiz
Evaluation Of Safety Outcomes Of Two Hydrocortisone Dosing Regimens In Patients In Septic Shock, Alexandra Rola, Joshua Wirtz, Daniel Kalaj, Vasil Rrushi, Megan Cadiz
Posters
• Steroids are used in shock to minimize the impact of shock-induced dysregulation of inflammatory response – Hydrocortisone is preferred for its activity as a glucocorticoid and a mineralocorticoid • Available data on the use of hydrocortisone shows mixed benefit – Data to guide dosing is limited, use of 100 mg IV every 8 hours may have benefit over 50 mg IV every 6 hours • Use of steroids has been associated with potential risks, including gastrointestinal bleeding, hyperglycemia, hypernatremia, superinfection, etc.
Impact Of Continuous Infusion Ketamine As Sedation On Concomitant Opioid And Sedative Requirements In Mechanically Ventilated Covid-19 Patients, Gabrielle R. Bradley, Megan Cadiz, Allycia Natavio
Impact Of Continuous Infusion Ketamine As Sedation On Concomitant Opioid And Sedative Requirements In Mechanically Ventilated Covid-19 Patients, Gabrielle R. Bradley, Megan Cadiz, Allycia Natavio
Posters
Characterize the impact of continuous infusion ketamine (CIK) on concomitant opioid and sedative requirements in mechanically ventilated COVID-19 patients
Impact Of Soy-Based Versus Composite Lipid Emulsion (Soybean, Medium Chain Triglycerides, Olive And Fish Oil) In Critically Ill Patients, Sandra Kless, Lisa Hall Zimmerman, Olaf Kroneman
Impact Of Soy-Based Versus Composite Lipid Emulsion (Soybean, Medium Chain Triglycerides, Olive And Fish Oil) In Critically Ill Patients, Sandra Kless, Lisa Hall Zimmerman, Olaf Kroneman
Posters
No abstract provided.
Vancomycin Auc Monitoring In Individuals With Cystic Fibrosis At A Pediatric Institution, Christopher M. Oermann, Stephanie Duehlmeyer, Ellen Meier, Claire Elson
Vancomycin Auc Monitoring In Individuals With Cystic Fibrosis At A Pediatric Institution, Christopher M. Oermann, Stephanie Duehlmeyer, Ellen Meier, Claire Elson
Posters
Vancomycin AUC monitoring in individuals with cystic fibrosis at a pediatric institution S. Duehlmeyer1, C. Oermann1, E. Meier1, E. Elson1. 1Pulmonology, Children’s Mercy Kansas City, Kansas City, USA Background: Antibiotic therapy is essential for the treatment of cystic fibrosis (CF) lung infections. Methicillin-resistant Staphylococcus aureus (MRSA) infects 20% to 25% of people with CF (PwCF) and is associated with increased morbidity. Treatment of pulmonary exacerbations (PEs) often requires hospitalization including respiratory treatments and intravenous (IV) antimicrobials. IV vancomycin, which is commonly used for MRSA infections, requires serum concentration monitoring to ensure efficacy and minimize toxicity. Previous guidelines recommended trough concentrations …
Covid-19 Vaccination In Individuals With Cystic Fibrosis At A Pediatric Cystic Fibrosis Center, Christopher M. Oermann, Claire Elson, Ellen Meier, Paula Capel, Jessica Haynes, Michelle Fischer, Stephanie Duehlmeyer
Covid-19 Vaccination In Individuals With Cystic Fibrosis At A Pediatric Cystic Fibrosis Center, Christopher M. Oermann, Claire Elson, Ellen Meier, Paula Capel, Jessica Haynes, Michelle Fischer, Stephanie Duehlmeyer
Posters
Background: Observational data suggest that most people with cystic fibrosis (PwCF) who contract COVID-19 have outcomes similar to those of the general population, although PwCF who are older or have CF-related diabetes, poor lung function, or a history of lung transplantation may be at greater risk for more severe disease. Therefore, the CF Foundation advocates for PwCF to discuss vaccination with care teams. At present, the FDA has authorized emergency use of 3 COVID-19 vaccines. ACIP/CDC guidance allows each state to determine vaccine distribution based on an individual’s exposure and risk for severe disease. This study describes the attitudes of …
Improving Skin And Soft Tissue Antibiotic Duration Concordance With National Guidelines In Pediatric Urgent Care Clinics, Megan Hamner, Amanda Nedved, Holly Austin, Donna Wyly, Alaina N. Burns, Diana King, Brian Lee, Rana El Feghaly
Improving Skin And Soft Tissue Antibiotic Duration Concordance With National Guidelines In Pediatric Urgent Care Clinics, Megan Hamner, Amanda Nedved, Holly Austin, Donna Wyly, Alaina N. Burns, Diana King, Brian Lee, Rana El Feghaly
Posters
Introduction: Skin and soft tissue infections (SSTIs) are the second most common diagnosis leading to pediatric antibiotic prescriptions in the outpatient setting after respiratory diagnoses. Children with SSTIs often receive >7 days of antibiotics, although current guidelines recommend 5-7 days for most diagnoses. At CMH urgent care clinics (UCCs), only 58% patients received the recommended 5-7 days of antibiotics. We aimed to increase the percentage of patients receiving 5-7 days of oral antibiotics for SSTIs from 58% to 75% by December 31st, 2021. Methods: We formed a multidisciplinary team in April 2020. A provider survey assessed factors influencing prescribing habits. …
Response To Dexamethasone Predicts Diagnosis Of Severe (Type 2) Bronchopulmonary Dysplasia Or Death, Christopher R. Nitkin, Keith Feldman, Alain Cuna, Alexandra Oschman, William E. Truog, Michael Norberg, Jane Taylor, Tamorah Lewis
Response To Dexamethasone Predicts Diagnosis Of Severe (Type 2) Bronchopulmonary Dysplasia Or Death, Christopher R. Nitkin, Keith Feldman, Alain Cuna, Alexandra Oschman, William E. Truog, Michael Norberg, Jane Taylor, Tamorah Lewis
Posters
Background: Bronchopulmonary dysplasia (BPD) is the most common respiratory morbidity after preterm birth but requires diagnosis at 36 weeks postmenstrual age (PMA). Dexamethasone is often used to treat infants at high-risk of BPD. The ability for earlier prediction of BPD, based on steroid response, could be useful as a surrogate marker for new therapies.
Objective: To construct a model that predicts severe BPD or death at 36 weeks PMA based on clinical response to dexamethasone.
Design/Methods: Retrospective chart review of preterm infants treated with dexamethasone between 2010-2020 at a Level IV NICU with data collected on demographics, age of steroid …
Multimodal Pain Control In Common Neonatal Surgeries: Post-Operative Pain Protocol Reduces Opiate Exposure And Side Effects, Jamesia Donato, Nefertari Terrill-Jones, Ashley K. Sherman, Warren Teachout, Stephanie Prince, Alexandra Oschman, Daphne Reavey, Darian Younger, Tamorah R. Lewis
Multimodal Pain Control In Common Neonatal Surgeries: Post-Operative Pain Protocol Reduces Opiate Exposure And Side Effects, Jamesia Donato, Nefertari Terrill-Jones, Ashley K. Sherman, Warren Teachout, Stephanie Prince, Alexandra Oschman, Daphne Reavey, Darian Younger, Tamorah R. Lewis
Posters
Background: Opioids are the primary post-operative (post-op) analgesic in neonates. Side effects include hypotension, apnea and ileus. Previous studies show IV acetaminophen decreases opiate need in specific populations including cleft palate repair, cardiac surgery. The effect of IV acetaminophen as part of a post-op pain algorithm is not known in common neonatal surgical procedures.
Objective: To determine if (a) a post-op pain algorithm including IV acetaminophen and (b) IV acetaminophen exposure reduces cumulative opioid requirements in neonates undergoing common surgeries in the NICU.
Design/Methods: This is a retrospective cohort study comparing cumulative post-operative opiate exposure between infants with common surgeries …
Antibiotic Durations For Skin And Soft Tissue Infections In Pediatric Urgent Care Clinics, Megan Hamner, Amanda Nedved, Holly Austin, Donna Wyly, Alaina N. Burns, Diana King, Brian R. Lee, Rana El Feghaly
Antibiotic Durations For Skin And Soft Tissue Infections In Pediatric Urgent Care Clinics, Megan Hamner, Amanda Nedved, Holly Austin, Donna Wyly, Alaina N. Burns, Diana King, Brian R. Lee, Rana El Feghaly
Posters
Background: Skin and soft tissue infections (SSTIs) are the second most common diagnosis leading to pediatric antibiotic prescriptions in the outpatient setting after respiratory diagnoses. However, most antibiotic stewardship programs have mainly focused on the latter. Children seen in the ambulatory setting for SSTIs often receive >7 days of antibiotics, although current society guidelines recommend 5-7 days for most diagnoses.
Objective: To determine the baseline percentage of patients receiving antibiotic prescriptions for >7 days for SSTIs in urgent care clinics (UCC)s of a pediatric health system and to evaluate factors that influence providers towards longer durations.
Design/Methods: We built a …
Development And Interim Analysis Of A Cystic Fibrosis-Specific Antibiogram, Claire Elson, Ellen Meier, Douglas Swanson, Rangaraj Selvarangan, Megan Gripka, Christopher M. Oermann
Development And Interim Analysis Of A Cystic Fibrosis-Specific Antibiogram, Claire Elson, Ellen Meier, Douglas Swanson, Rangaraj Selvarangan, Megan Gripka, Christopher M. Oermann
Posters
Antimicrobial therapy is essential to treat cystic fibrosis (CF) lung infections. Empiric antimicrobial selection is generally based on previous culture information and, if available, an institution-specific antibiogram (ABGM). Most institutions antibiograms exclude cultures from individuals with cystic fibrosis, imposing challenges with empiric antimicrobial selection and monitoring susceptibility patterns over time. A cystic fibrosis-specific antibiogram may help drive population-specific antimicrobial selection and improve antimicrobial stewardship.
Standardizing Aminoglycoside Induced Ototoxicity Monitoring, Claire Elson, Christopher M. Oermann, Stephanie Duehlmeyer, Ellen Meier
Standardizing Aminoglycoside Induced Ototoxicity Monitoring, Claire Elson, Christopher M. Oermann, Stephanie Duehlmeyer, Ellen Meier
Posters
Aminoglycoside (AG) antibiotics are essential for the treatment of cystic fibrosis (CF) lung infections. Pseudomonas aeruginosa. Nontuberculous mycobacteria. Monitoring is critical secondary to potential nephrotoxicity and ototoxicity. Children’s Mercy Kansas City (CMKC), standardized nephrotoxicity monitoring in 2016. Observed variable ototoxicity monitoring practices. Prevalence of ototoxicity, 2016 CFF Patient Registry, 1.1% in pediatric patients (less than or equal to 18 years). 2.2% in pediatric and adult population. National Institute of Deafness and Other Communication Disorders, 13% in US population equal to or less than 12 years old. A standardized AG induced ototoxicity monitoring algorithm (AIOA) was developed and implemented at CMKC …
Pediatric Surgery Opioid Prescription Follow-Up, Gadison Quick, Nathaniel Aviles, Gabriel Melgarejo, Hunjung Choi, Elizabeth Edmundson
Pediatric Surgery Opioid Prescription Follow-Up, Gadison Quick, Nathaniel Aviles, Gabriel Melgarejo, Hunjung Choi, Elizabeth Edmundson
Posters
This quality improvement project is assisting general and orthopedic surgeons in gaining greater clarity when prescribing opioids for specific surgical procedures. Additional surgical services are being added to the project fall of 2019. Opioid prescribing patterns are, and will continue to be, key to all prescribing providers within our organization.
Collaboration Between Rheumatology Clinic And Specialty Pharmacy To Positively Impact Patient Experience And Hospital Stewardship, Alaina Linafelter, Julia G. Harris, Robert Herr, Stephanie Quinn, Ashley M. Cooper
Collaboration Between Rheumatology Clinic And Specialty Pharmacy To Positively Impact Patient Experience And Hospital Stewardship, Alaina Linafelter, Julia G. Harris, Robert Herr, Stephanie Quinn, Ashley M. Cooper
Posters
Biologic medications are commonly utilized to treat pediatric rheumatic diseases. Being high-cost, most third-party payers require dispensing through a specialty pharmacy. Children's Mercy Hospital Specialty Pharmacy (CMH SP) started acceting patients in March 2015.
The number of patients benefited by the superior service of CMH SP has risen steadily, leading to high patient satisfaction and financial benefits for the hospital.
Development And Implementation Of An Evidence-Based Process For Scarce Resource Allocation, Richard K. Ogden Jr., Daniel L. Millspaugh, Brian O'Neal
Development And Implementation Of An Evidence-Based Process For Scarce Resource Allocation, Richard K. Ogden Jr., Daniel L. Millspaugh, Brian O'Neal
Posters
Background: Intravenous immune globulin (IVIG) is a plasma-derived product from pooled donors. It has six FDA approved indications. It is also considered standard of care for a few other conditions in specific populations. Additionally, there is growing non-evidence-based use. Due to a global shortage, IVIG has become increasing difficult to obtain.
. . . .
Conclusions: Development, implementation, and promotion of adherence to an evidence-based criterion allowed our scarce IVIG supply to be sustained. Further refinement of the criteria for use is ongoing, as is an evaluation of IVIG utilization by indication, pre- and post-implementation. This process can be applied …
Facilitating The Everyday Steward: Impact Of Mandatory Antimicrobial Indication/Duration And A 48 Hour Time Out, Ann L. Wirtz, Alaina N. Burns, Brian R. Lee, Tammy Frank, Laura Fitzmaurice, Richard Ogden, Brian O'Neal, Jennifer Goldman
Facilitating The Everyday Steward: Impact Of Mandatory Antimicrobial Indication/Duration And A 48 Hour Time Out, Ann L. Wirtz, Alaina N. Burns, Brian R. Lee, Tammy Frank, Laura Fitzmaurice, Richard Ogden, Brian O'Neal, Jennifer Goldman
Posters
Introduction: Required indication, duration, and a 48-hour antimicrobial timeout are an integral part of antimicrobial stewardship standards; however, limited data are available to demonstrate an effect on antimicrobial utilization and antimicrobial stewardship practice. Therefore, we evaluated the impact of mandatory declared indication/duration along with a pharmacy-driven 48-hour timeout on antimicrobial utilization and antimicrobial stewardship interventions.
Methods: We performed a retrospective evaluation of ASP interventions and antimicrobial use following implementation of mandatory antimicrobial indication/duration at the point of computerized physician order entry (CPOE). A pharmacist-driven 48-hour antimicrobial timeout was introduced on the same date. This study was conducted at Children’s Mercy …
Implementation Of A Guideline-Based Nontuberculous Mycobacteria Management Algorithm, Claire Elson, Ellen Meier, Douglas Swanson, Christopher M. Oermann
Implementation Of A Guideline-Based Nontuberculous Mycobacteria Management Algorithm, Claire Elson, Ellen Meier, Douglas Swanson, Christopher M. Oermann
Posters
Nontuberculous mycobacterial (NTM) disease is a challenge to manage in patients with cystic fibrosis (CF). Diagnosis of NTM pulmonary disease is complex. Effective treatment requires long term, multi-drug therapy delivered by several routes. Consensus recommendations published in 2016 were developed to guide CF providers in NTM screening, diagnosis and management. Primary Outcomes. Children’s Mercy-Kansas City (CMKC) developed an NTM working group to facilitate implementation of standardized NTM management. Methods. NTM working group: Pulmonologist (CF Center Director), Infectious Diseases specialist, nurse practitioner (CF Center Coordinator), and pharmacist. Sought expertise from the Director of Microbiology Laboratory regarding susceptibility testing. Developed NTM Management …
Pharmacy Driven Best Possible Admission Medication History At A Pediatric Institution, Damon Pabst, Charity Thompson, Brandon French, Brian O'Neal, Garret Matthews, Zeb Benner, Joshua Meade
Pharmacy Driven Best Possible Admission Medication History At A Pediatric Institution, Damon Pabst, Charity Thompson, Brandon French, Brian O'Neal, Garret Matthews, Zeb Benner, Joshua Meade
Posters
No abstract provided.
A Ninja Initiative At Children's Mercy, Richard Ogden, Bradley A. Warady, Vimal Chadha, Wendy Hoebing
A Ninja Initiative At Children's Mercy, Richard Ogden, Bradley A. Warady, Vimal Chadha, Wendy Hoebing
Posters
No abstract provided.
Knowledge Gap In Adolescent Heart Transplant Recipients, Pamela Finn, Brian Birnbaum, Audrey R. Kennedy, Jennifer A. Marshall, Mark Gelatt
Knowledge Gap In Adolescent Heart Transplant Recipients, Pamela Finn, Brian Birnbaum, Audrey R. Kennedy, Jennifer A. Marshall, Mark Gelatt
Posters
Background:
Studies have reported a knowledge gap Studies have reported a knowledge gap among adolescent and young adult heart heart transplant patients upon transitioning to adult cardiology practices.
This population is vulnerable to life-threatening complications as they progress to adult care.
Framework/Methods:
We assess the current knowledge deficit of our adolescent and young adult patients and their caregivers in order to inform pediatric providers of their unique needs as they prepare to transition.
Heart transplant patients >10 yrs and their caregivers completed a written questionnaire prior to a clinic visit. 17 questions were asked including the need for …