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.

Drug Utilization Evaluation of Imipenem in Patients Undergoing Bone Marrow Transplantation

Abstract: Introduction: Drug Utilization Evaluation (DUE) studies are designed to assess drug usage appropriateness. DUEs have traditionally focused on drugs with high price tags, complicated dosage schedules, narrow therapeutic indices and regular side effects. The primary goal of the present study is to evaluate imipenem usage in Bone Marrow Transplantation (BMT) wards. Methods: The study was a prospective DUE study, carried out in three BMT wards in Dr. Shariati hospital, Hematology- Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences. The study was performed from April 2008 to October 2008. NCCN Clinical Practice Guidelines in Oncology and AHFS recommended protocols were used for evaluation. For a statistical analysis, SPSS (version 16.0) was used. Results: A total of 64 patients were evaluated during the study. In all patients, imipenem was started empirically. In thirty five (54.7%) patients, the antibiotic seemed to be effective. Twenty- two (35.9%) patients needed dosage adjustments due to low weight or renal failure, but no action in this regard was taken. In 51.6% of patients, the antibiotic therapy duration was not appropriate. Thirty seven (57.8%) patients experienced nausea. Conclusion: Imipenem in febrile neutropenic patients is administered empirically. Imipenem induced nausea was observed in 57.8% of patients. This result may be due to rapid infusion of imipenem in the wards. The result of this study indicates the need for further education on dosage adjustment based on renal function and patients’ weight. Improper duration of the treatment could result in resistance and thus should be noted.

Aerosol Pentamidine for Pneumocystis Carinii Pneumonia

Abstract: anion gap (Na[CI+ HCO,)) was20 mEq/L (normal 8-16 mEq/L). The measured serum osmolarity on admission was 423 mOsmol/kg. The calculated serum osmolarity (2Na+ BUN/28 + glucose/I 8) was 306mOsmol/kg (normal 280-295 mOsmol/kg) for an osmolar gap of 117 mOsmol/kg. Urinalysis showedthe urine to beclearand yellow; witha specificgravityof 1.020;pH 6.0; no ketones, blood, albumin, crystals, or casts; and a WBC count of one per high-powered field. Toxicological analysis revealed an initial ethanol blood level of 297 mg/dL and an ethylene glycol blood level of 2100 mg/L (210 mg/dL). Ethyleneglycollevelswerereportedas milligrams per literbythe laboratory throughout this case. The treatment courseof this patient includedan ethanol infusionand hemodialysis.Figure I summarizesthe useof ethanol and the timingof hemodialysis procedures. The presence of a high ethanol concentration on admission is believed to have aided in preventingthis patient from developing a potentially severemetabolicacidosisby inhibiting the metabolismof ethyleneglycol.The initial infusionrate of ethanolchosen(7.5g/h) waslowfor thisyoungalcoholic patient with normal liverfunction. Compensationfor ethanol removedduring hemodialysis was also inadequate, as shown in Figure I. The ethanol infusion wascontinued without change on days 3 and 4; ethanol serum concentrations on these days were again subtherapeutic. Figure I also summarizesall blood concentrationsof ethanol and ethyleneglycolobtained and their relationshipto ongoingtherapy. BEN M. LOMAESTRO, B.S.Pharm. Clinical Specialist Intensive Care Albany Medical Center Albany, New York 12208

Treatment of Ampicillin-Resistant Enterococcus faecium Urinary Tract Infections.

Abstract: There was no statistically significant difference between amoxicillin and nitrofurantoin for the treatment of ampicillin-resistant Enterococcus faecium urinary tract infections.

Warfarin and Ropinirole Interaction

Abstract: OBJECTIVE:To report a case of increased international normalized ratio (INR) in a geriatric patient receiving warfarin and ropinirole.CASE SUMMARY:A 63-year-old African-American man with a history of Parkinson disease, Alzheimer disease, and status postcardio-vascular accident was evaluated for symptoms of progressing stiffness and rigidity. Ropinirole was added to his current therapy for Parkinson disease, with a corresponding decrease in the dose of levodopa/carbidopa to allow levodopa sparing. On laboratory evaluation, he was noted to have an increased INR nine days after these adjustments; the INR had previously been stable. No other significant medication, social, or diet changes were noted. Warfarin was withheld for four days and restarted at approximately 75% of the previous weekly dose. The patient had no obvious signs of bleeding. Furthermore, the warfarin dose was again increased after discontinuation of ropinirole due to common gastrointestinal adverse effects.DISCUSSION:Warfarin is an oral ant...

InforMatrix as an alternative tool in rational and transparent drug-decision making.

Abstract: InforMatrix is a decision matrix technique by means of which a group of experts on a subject (health condition) determine, on the basis of agreed criteria, an order of merit for the various available treatment options for that condition. The goal of the InforMatrix program is to make a rational selection of first-choice medications or drugs following the evaluation of the clinical value of available therapeutic agents. This paper describes the InforMatrix methodology, and also provides an explanation of the various selection criteria that are used by the InforMatrix technique of drug selection.