USP proposes new 797 standards
June 19th 2006While most people haven't had time to digest the intricate details of the United States Pharmacopeia's proposed changes to General Chapter 797 (Pharmaceutical Compounding-Sterile Preparations), response to the protracted document has been almost universally positive.
Software helps hospitals deal with narcotics theft
May 22nd 2006Pandora Data Systems recently released a multi-user, HealthInsurance Portability & Accountability Act (HIPAA)-compliantversion of its medication usage analysis software. Designed in 1989in partnership with a local pharmacist to be used in conjunctionwith his Pyxis 1000 automated dispensing system (ADS), the currentversion of Pandora is compatible with the Pyxis 3000 and theMcKesson AcuDose and Omnicell dispensing systems as well.
This tool helps you standardize infusions
May 22nd 2006For many years, doses and rates of administration for continuousinfusions in pediatric patients have been based upon the "rule ofsix." This weight-based method relies on the following formula: sixtimes body weight is the amount of drug to be added to 100 ml ofcarrier fluid.
Cerner launches smarter med dispensing system
May 22nd 2006Cerner Corp.'s CareAware RxStation characterizes the nextgeneration of automated medication dispensing systems. Itintegrates electronic medical records with dispensing cabinets. "Itis a closed-loop system," said Dawn Iddings, director of resourceplanning for the company's device innovation group. "It's anend-to-end solution, fully integrating ordering, dispensing, andadministration at bedside, through a completely sealed device."
USP Drug Safety Review: Medication errors involving NMBAs
May 22nd 2006Medication errors involving neuromuscular blocking agents (NMBAs)are potentially serious and life-threatening because these agentsparalyze respiratory muscle and, if misused, can adversely affectrespiratory function. NMBAs should be administered only by staffwith experience in maintaining an adequate airway and respiratorysupport in facilities where intubation can readily be performed,oxygen can be administered, and respiratory support can beprovided.
Bedside bar-coding still lagging in hospitals
May 22nd 2006Despite a new Food & Drug Administration mandate, which wentinto effect April 26 requiring all drugs supplied to hospitals tobe bar-coded, less than 10% of U.S. hospitals have a bedsidebar-coding system in place. Many hospital pharmacy executives saythe main reason they are not on board yet is the high cost ofimplementing it.
Clinical twisters: Resolving HF 'revolving door'
May 22nd 2006A 68-year-old man is hospitalized with shortness of breath,fatigue, and 2+ edema-his third hospitalization in 12 months.He has heart failure (HF) (currently New York Heart Associationclass IV, ejection fraction 20%), LVH, and MI history. Heart rhythmis normal; lungs clear; lab tests within normal limits excepthemoglobin510.5 gm/dl, SrCr52.3 mg/dl; BP5160/90, pulse 85,respiratory rate522. Admitting medications: furosemide 80 mg,potassium (K), benazepril 20 mg, aspirin 81 mg, carvedilol (Coreg,GlaxoSmithKline) 6.25 mg twice daily. The resident continues allmedications, increasing furosemide to 80 mg twice daily. He askswhether adding digoxin might reduce future hospitalizations.
Personalized medicine is new watchword
May 22nd 2006The National Comprehensive Cancer Network (NCCN) recently sponsoreda roundtable discussion called Cancer Care in the 21stCentury-Reality and Promise. The panelists discussed a widerange of topics, including the most important advances in cancercare since the war on cancer was declared during the NixonAdministration in 1972 and how pharmacogenomics is revolutionizingcancer treatment. The roundtable meeting, at which the group ofoncology leaders assembled for the first time, took place duringthe NCCN 11th Annual Conference, held recently in Hollywood, Fla.
MTM takes center stage at AMCP meeting
May 22nd 2006Medication therapy management (MTM) was the recurring theme at thisyear's Academy of Managed Care Pharmacy (AMCP) meeting, heldrecently in Seattle. The American Pharmacists Association led aworking group of 11 pharmacy organizations to define MTM servicesin 2004. This year, a similar working group led by AMCP defined MTMprograms. The resulting consensus document was presented at theAMCP meeting.
Advances in treatment of MI reported at ACC show
April 17th 2006The low molecular weight heparin enoxaparin (Lovenox, Sanofi-Aventis) is superior to unfractionated heparin as an adjunct to thrombolytic therapy in patients with ST elevation myocardial infarction (MI), researchers reported at the 55th Annual Scientific Session of the American College of Cardiology (ACC). The meeting was held in Atlanta last month.
How urban hospitals can help rural pharmacies
April 17th 2006Virtually none of the more than 1,000 rural critical access hospitals (CAHs) in rural America can afford a round-the-clock R.Ph. on staff. And this lack of coverage can adversely affect quality by slowing the prescription review process, said Tim Stratton, R.Ph., Ph.D., an associate professor at the University of Minnesota College of Pharmacy in Duluth.
Preparing for the worst: Hospitals...
April 17th 2006In the aftermath of the Sept. 11 attacks, disaster preparedness became a priority for the nation's hospitals. Then interest in the topic trailed off somewhat. But in the late summer of 2005, Hurricanes Katrina and Rita slammed the Gulf Coast, and disaster preparedness was suddenly back with a vengeance.
Clinical Twisters: Surgery when INR=2.8
April 17th 2006An ambulatory 70-year-old man, F.H., has been admitted to yourhospital with a hip fracture that will require surgery. AlthoughF.H. has a history of atrial fibrillation (AF) episodes andtransient ischemic attacks (TIA), his heart is currently in normalsinus rhythm. Medications on admission included verapamil 120 mgand warfarin 5 mg daily; fracture pain is being treated withmorphine intramuscular (IM) injections at present. F.H.'s INR(International Normalized Ratio) on admission is 2.8; bloodpressure is 135/75; lab tests were within normal limits. F.H.'sphysician requests an anticoagulation consult to aid him indetermining the timing of surgery and venothromboembolism (VTE)prophylaxis. What do you suggest?
FDA asks: Should we go with RFID tags now?
March 20th 2006The Food & Drug Administration has been counting on radio frequency identification (RFID) technology to be ready for widespread adoption next year, allowing drug product packages to be tagged with tiny chips containing an electronic product code or unique electronic serial number. Now the agency thinks that may not happen and is in a bit of a quandary.
PAD treatment should cover pharmaceutical care
March 20th 2006People with lower-extremity peripheral arterial disease (PAD) should get treatment, including pharmaceutical treatment, comparable to that for people with established coronary artery disease. That's according to new, comprehensive guidelines on PAD from the American Heart Association (AHA) and other medical groups.
Clinical twisters: Updating antipsychotic choice
March 20th 2006A 58-year-old man, G.C., is hospitalized with an acute myocardialinfarction (MI). His physician has prescribed metoprolol, ramipril,warfarin, and atorvastatin (Lipitor, Pfizer), but is debatingwhether to continue G.C.'s bedtime chlorpromazine 400 mg, whichhe's taken for 20 years for schizophrenia, or switch to a newermedication. G.C. is showing signs of tardive dyskinesia (TD). Hisrecent records show normal fasting blood glucose levels. His BMI is22. He is a smoker. His physician asks your opinion aboutantipsychotic therapy. What do you recommend?
Imatinib-like agents on way to treat CML
March 20th 2006Small signs of resistance to imatinib (Gleevec, Novartis) emerged soon after the drug's approval in 2001 as the first oral tyrosine kinase inhibitor for chronic myeloid leukemia (CML). But second-generation drugs with similar mechanisms of action were already in the pipeline, according to studies presented at the recent 2005 ASH annual meeting, held in Atlanta. Generally about 20% of CML chronic-phase patients relapse after three years of imatinib therapy, researchers pointed out.
ROI model confirms value of pharmacy services
March 20th 2006Pharmacists can and should prove that their treatments provide a significant return on investment (ROI), said Fred Pane, R.Ph., senior director of pharmacy affairs at Premier Inc., the San Diego group purchasing organization. "Pharmacists can move from a compartmentalized budget and expense analysis model to an overall cost-of-care model," he said. "The data exist to establish that the work they do generates the best patient outcomes, with a positive effect on overall costs and reimbursements."
Eliminating insulin errors: R.Ph.s share tricks
March 20th 2006Not only do 11% of serious medication errors involve insulin misadministration, but the same errors seen today have been documented at least as far back as 1975. These were but two of the points Matthew Grissinger, R.Ph., used to emphasize the importance of health-system insulin safety during February's ISMP teleconference, "Preventing Errors with Insulin: A Multidisciplinary Approach."
Medicare cuts threaten access to oncology care
March 20th 2006Oncology care faces two cliffs, said Lee Schwartzberg, M.D., board member of the Community Oncology Alliance (COA): a planned $400 million to $500 million in Medicare cuts and severe payment cuts announced by private insurers. An access-to-treatment crisis was averted primarily by the addition of $400 million in funding through the implementation of a Centers for Medicare & Medicaid Services oncology demonstration project at the end of 2004. Schwartzberg, also a medical oncologist in private practice at The West Clinic in Memphis, addressed a plenary session on the Medicare Modernization Act (MMA) at the First Annual Oncology World Congress, held recently in New York City.