American Pharmacists Association

About: American Pharmacists Association is a other organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Pharmacist & Pharmacy. The organization has 2413 authors who have published 1969 publications receiving 30470 citations. The organization is also known as: APhA & American Pharmaceutical Association.

Levofloxacin for Drug-Resistant Mycobacterium Tuberculosis

Abstract: moxifen. Vitamin B12 and folate concentrations were measured to rule out nutritional deficiencies as a cause of peripheral neuropathy. Vitamin B12 concentration of 374 pg/mL (normal range 200–1100) and folate of 8.2 ng/mL (2–20) were within normal limits at this visit, with no history of megaloblastic anemia, diabetes mellitus, toxic exposures, or clinical evidence of malabsorption. Based on her symptoms and abnormalities in the physical examination, including decreased sensation in a stocking-glove distribution bilaterally causing her to drop objects from her hands, decreased sensation to touch and pin prick, intact reflexes (2+ bilaterally in all extremities), and no weakness, the patient was diagnosed with peripheral neuropathy suspected to be secondary to metronidazole therapy. It was believed that the patient was dropping objects due to poor touch sensation, not to carpal tunnel syndrome. The patient’s metronidazole therapy was discontinued and no further treatment for peripheral neuropathy was instituted. The patient reported improvement 4 months after metronidazole discontinuation; the peripheral neuropathy was completely resolved as evaluated by physical examination of sense to touch and pin prick at her follow-up 5 months after discontinuation. Discussion. This case is unique because of the presence of peripheral neuropathy in a patient receiving metronidazole 2 g/d for 5 days every other month. Reported cases of metronidazole-induced peripheral neuropathy occurred among patients receiving 1.5 g or more daily for more than 30 days.3 Three cases of peripheral neuropathy associated with amitriptyline have been reported in the literature,6-8 and paresthesias have been reported rarely with both lisinopril and omeprazole. However, it is unlikely these agents contributed to our patient’s peripheral neuropathy as amitriptyline, lisinopril, and omeprazole were continued after metronidazole discontinuation and the patient experienced resolution of the peripheral neuropathy. This case presents new concerns about the predictability of metronidazole-induced peripheral neuropathy. With the increasing use of metronidazole for the treatment of Helicobacter pylori–associated peptic ulcer disease, practitioners should be cognizant of the potential for peripheral neuropathy with repeated short courses of metronidazole.

Simultaneous TLC–densitometric determination of tamoxifen citrate and medroxyprogesterone acetate and UV‐degradation kinetic study of medroxyprogesterone acetate

Abstract: Coadministration of tamoxifen citrate (TMC) and medroxyprogesterone acetate (MPA) is preferred to increase the response rate and the percentage recovery in patients with endometrial carcinoma. Administration of TMC and MPA and their combination affects estrogen and progestin receptor concentrations in advanced endometrium carcinoma by affecting 17β-hydroxyl steroid dehydrogenase activity and serum hormone concentrations. A sensitive, accurate and robust thin-layer chromatography method has been established for simultaneous analysis of TMC and MPA. Method development was carried out on silica gel F254 using butanol-acetic acid-water (6:0.5:0.5, v/v/v) as mobile phase. Densitometric scanning was carried out at 241 nm for simultaneous detection of TMC and MPA. Retardation factor (Rf ) values for TMC and MPA were 0.21 and 0.85, respectively. The method was validated according to ICH guidelines. Regression plots revealed linear relationships in the concentration range of 50-500 and 25-250 ng/band for TMC and MPA, successively. Accuracy was ≥99.60 and 98.72% for TMC and MPA, respectively. Forced degradation studies using UV photodegradation was applied on MPA after exposure to UV light for different times and applying a kinetic study for calculating the degradation rate constant (k) and half-life time (t1/2 ).

Patient aberrant drug taking behaviors in a large family medicine residency program: A retrospective chart review of screening practices, incidence, and predictors

Abstract: Introduction: Potentially aberrant drug-taking behaviors (pADTB) are described as any departure from strict adherence to prescribed use of medications for their intended indication. There are several validated instruments, processes, and databases available to assist the clinician in screening and stratifying risk for patients in which controlled substances are being prescribed or considered. Actual utilization of these tools in nonspecialist healthcare settings is largely unknown. The primary objective of this retrospective chart review was to describe utilization patterns of these common tools within a 56 physician family medicine training program. Secondary objectives included identification of site-specific predictors of pADTB and correlation of prescribing patterns with documented aberrant behaviors. Methods: A total of 202 chronic pain patients were identified for inclusion based on prior 12-month prescription and refill records within the electronic health record (EHR) from March 2008 through March 2009. Each patient included had at least one opioid for 30 days within the study period and had chronic pain symptoms for at least 90 days. Each chart was reviewed for predefined pADTB, controlled substance refill request, prescription drug monitoring profile, and post hoc investigator completion of the Opioid Risk Tool Clinician Form. Descriptive statistics and regression analysis was used to report results. Results: Clinician documentation of risk-screening tool use of any type was limited to one patient of the 202 records reviewed. Within this sample, 203 unique pADTB were documented in the EHR records of 89 (44.1 percent) patients. Patients prescribed morphine or tramadol appeared to exhibit less use of multiple prescribers and multiple pharmacies while an association between this behavior and two or more concurrent opioid prescriptions became apparent. Those taking fentanyl or morphine exhibited unsanctioned dose escalations more frequently. Conclusions: These results suggest that routine evaluation of risk for abuse or misuse of opioid analgesics occurs infrequently in a large family medicine training program. pADTB exhibited by patients using opioids for chronic pain syndromes in this sample were consistent with those reported in other similar settings. Policies and procedures in primary care settings for improved risk evaluation and ongoing monitoring of chronic opioid therapy is needed.

Safety of Peripheral Administration of 3% Hypertonic Saline in Critically Ill Patients: A Literature Review.

Abstract: Background Hyponatremia and neurocritical injury are life-threatening conditions requiring immediate management with consideration of the safety concerns related to peripheral intravenous administration of hypertonic solutions. Although a central intravenous catheter is the preferred route of administration, central intravenous catheters have many complications and can potentially delay medication administration in urgent situations. Objective To evaluate the safety and efficacy of continuous infusion of 3% hypertonic saline via peripheral intravenous administration in critically ill adult patients. Methods Data were collected from PubMed and Web of Science from database inception to April 7, 2019. Included studies involved adult patients with hyponatremia and/or neurocritical situations and compared administration of 3% hypertonic saline via peripheral administration with standard supportive care (administration through a central intravenous catheter). Results Of 502 articles identified, 7 were included in the review. Three articles were retrospective studies, 2 were prospective studies, 1 was a case series, and 1 was a case report. Infusion-related adverse events and electrolyte abnormalities due to 3% hypertonic saline administration through a peripheral intravenous catheter were minimal and were limited to phlebitis, erythema, edema, hyperchloremia, and hypokalemia with administration at a high infusion rate (83.3 mL/h) and for a prolonged duration (≥ 6 hours). Infusion rate, duration, catheter gauge, and catheter placement may have a role in infusion-related adverse events. Conclusions Current recommendations to administer continuous infusions of 3% hypertonic saline through a central intravenous catheter should be reassessed. Peripheral intravenous administration can be used safely and effectively in patients in critical situations.

Hospital Pharmacy Practice and the Way Forward for Pharmacy Education in Thailand

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