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.

Inhaled Tobramycin in Non—Cystic Fibrosis Patients with Bronchiectasis and Chronic Bronchial Infection with Pseudomonas Aeruginosa

Abstract: BACKGROUND:Non—cystic fibrosis (CF) patients with bronchiectasis usually develop chronic bronchial infection with Pseudomonas aeruginosa (PA) that is related to worsening lung function and increased morbidity and mortality.OBJECTIVE:To determine whether direct aerosol delivery of tobramycin to the lower airways may control infection and produce only low systemic toxicity.METHODS:A double-blind, placebo-controlled crossover trial involving 30 patients was conducted to determine the clinical effectiveness and safety of 6-month tobramycin inhalation therapy. Patients received 300 mg of aerosolized tobramycin or placebo twice daily in 2 cycles, each for 6 months, with a one-month washout period. The number of exacerbations, number of hospital admissions, number of hospital admission days, antibiotic use, pulmonary function, quality of life, tobramycin toxicity, density of PA in sputum, emergence of bacterial resistance, and emergence of other opportunistic bacteria were recorded.RESULTS:The number of admissio...

Sleep disruption in critically ill patients: pharmacological considerations

Abstract: Sleep disturbances are common in critically ill patients and contribute to morbidity. Environmental factors, patient care activities and acute illness are all potential causes of disrupted sleep. Additionally, it is important to consider drug therapy as a contributing factor to this adverse experience, which patients perceive as particularly stressful. Sedative and analgesic combinations used to facilitate mechanical ventilation are among the most sleep disruptive drugs. Cardiovascular, gastric protection, anti-asthma, anti-infective, antidepressant and anticonvulsant drugs have also been reported to cause a variety of sleep disorders. Withdrawal reactions to prescribed and occasionally recreational drugs should also be considered as possible triggers for sleep disruption. Tricyclic antidepressants and benzodiazepines are commonly prescribed in the treatment of sleep disorders, but have problems with decreasing slow wave and rapid eye movement sleep phases. Newer non-benzodiazepine hypnotics offer little practical advantage. Melatonin and atypical antipsychotics require further investigation before their routine use can be recommended.

Inhaled Nitric Oxide Reverses the Increase in Pulmonary Vascular Resistance Induced by Permissive Hypercapnia in Patients with Acute Respiratory Distress Syndrome

Abstract: BackgroundThe aim of this prospective study was to determine if inhaled nitric oxide (NO) would reverse the increase in pulmonary arterial pressures and in pulmonary vascular resistance induced by acute permissive hypercapnia in patients with acute respiratory distress syndrome.MethodsIn 11 critical

An innovative approach to integrated medicines management

Abstract: Rationale, aims and objectives To determine whether an increased input by clinical pharmacists at each stage of the patient’s hospital journey, from admission through discharge, resulted in an enhanced level of patient care as measured by a number of clinical and economic outcomes. Methods This project was designed to address medicines management issues in patients deemed at risk of drug-related problems. During the project, these latter patients at the time of admission were randomly assigned to an integrated medicines management (IMM) service group (n = 371) or regular hospital care group (n = 391). The IMM service involved comprehensive pharmaceutical care provided by a pharmacy team throughout each of three stages: patient admission, inpatient monitoring and counselling, and patient discharge. Results Patients who received the IMM service benefited from a reduced length of hospital stay [by 2 days (P = 0.003; independent samples t-test loge)]. IMM patients also had a decreased rate of readmission over a 12-month follow-up period (40.8% vs. 49.3%; p = 0.027; Fisher’s exact test) and an increased time to readmission [20 days longer (P = 0.0356; log rank test)]. A numbers-needed-to-treat calculation indicated that for approximately every 12 patients receiving the IMM service, one readmission to hospital, within 12 months of discharge, would be prevented. The new service was welcomed by cognate health care professionals. Conclusion The IMM service proved very effective and can be used as a template to support the implementation of comprehensive pharmaceutical care as a routine service across Northern Ireland and beyond.

Patient counseling provided in community pharmacies: effects of state regulation, pharmacist age, and busyness.

Abstract: Objective To describe the nature and extent of patient counseling in community pharmacies and determine whether current counseling practices are influenced by pharmacist and pharmacy characteristics and variations in state regulation of patient counseling. Design Observational, cross-sectional study. Setting 306 community pharmacies in eight states. Participants Trained shoppers (acting as patients). Interventions Three new prescriptions were presented in each pharmacy, and regression techniques were used to analyze the effects of pharmacist age, pharmacy type, and busyness; whether written information was provided; and "intensity" of a state's patient counseling regulation as measured by its scope, stringency, and duration. Main Outcome Measures Whether any or all of these events occurred: pharmacist talked with shopper, oral drug information was given, oral risk information was given, and/or questions were asked to assess shopper understanding; number of informational items mentioned (range 0–7) was also recorded. Results About 63% of the shoppers were given oral drug information (mean = 2.3 items). Shoppers with a younger responsible pharmacist were more likely than other shoppers to receive risk information, a higher number of informational items, and assessment of understanding. While pharmacy type was unrelated to counseling, busyness reduced the odds of any pharmacist talk, oral information-giving, and assessment of understanding. Counseling practices varied significantly according to the intensity of a state's counseling regulation, with frequency of any information provision climbing from 40% to 94% as states' counseling regulations increased in intensity. More intensive regulations also increased the likelihood of any pharmacist talk, any provision of risk information, any assessment of shopper understanding, and amount of oral information given. Conclusion Counseling varied significantly according to intensity of state regulation, pharmacy busyness, and age of responsible pharmacist. These results present important challenges to state boards of pharmacy, pharmacy associations, managers, and individual practitioners who are in a position to improve this important element of patient care.