UHSP Collections (University of Health Sciences and Pharmacy)
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Evaluation of Appropriate Sodium Polystyrene Sulfonate Use With a Hyperkalemia Order Set: A Pilot Study
No full textBackground: No consensus guidelines exist to assist practitioners in the management of hyperkalemia. Sodium polystyrene sulfonate (SPS) is a common treatment option for hyperkalemia. To aid health-care professionals, a hyperkalemia order set was created at a 979-bed community teaching hospital. Objective: The objective of this study was to determine whether use of a hyperkalemia order set is associated with appropriate use of SPS. Methods: Orders for SPS were evaluated for appropriateness in this retrospective cohort of adult patients. Data were collected from December 1, 2015, to December 31, 2016. All orders for SPS not from an order set were randomly matched to those from the order set in a 2:1 fashion. Appropriate use was defined as potassium level \u3e5.5 mEq/L and no contraindications to use. The primary outcome was the absolute difference in the proportion of patients with appropriate SPS use in the order set group compared to the nonorder set group. Results: A total of 120 patients were analyzed, 40 in the order set group and 80 in the nonorder set group. Baseline characteristics were similar between the groups. Appropriate use occurred in 97.5% of order set patients compared to 60% in the nonorder set group (P \u3c.001). Use of the order set was associated with a greater reduction in serum potassium, quicker follow-up potassium level, and lower incidence of gastrointestinal adverse effects. Conclusions: The use of a hyperkalemia order set is associated with appropriate use of SPS. Requiring the use of the hyperkalemia order set for administration of SPS may enhance patient care and safety
Perioperative Bridging With Glycoprotein IIb/IIIa Inhibitors Versus Cangrelor: Balancing Efficacy and Safety
No full textObjective: To review the efficacy and safety of perioperative administration of intravenous (IV) antiplatelet agents as a substitute for oral P2Y12 inhibitors and to provide clinicians guidance on optimal and cost-effective use of these medications. Data Sources: A MEDLINE literature search (1950 to November 2018) was performed using the key search terms abciximab, bridging, cangrelor, cardiac surgery, coronary artery bypass surgery, eptifibatide, intravenous antiplatelet agent, and tirofiban. Additional references were identified from a review of literature citations. Study Selection and Data Extraction: In all, 18 original research reports and case reports/series were included in the review. Data Synthesis: Prevention of postoperative bleeding is critical to decrease morbidity and mortality after cardiac surgery. IV antiplatelet medications have short half-lives and are frequently used to substitute for oral P2Y12 inhibitors to allow platelet function recovery before procedures. Functional recovery of platelets is delayed after abciximab discontinuation and increases postoperative bleeding risk. Eptifibatide and tirofiban have similar pharmacokinetic/pharmacodynamic properties and comparable efficacy and safety in the setting of perioperative bridging. Cangrelor may be considered in patients with renal insufficiency as decreased clearance of eptifibatide or tirofiban may increase the risk of postoperative bleeding. Relevance to Patient Care and Clinical Practice: Comparative studies of IV antiplatelet medications have not been published. Appropriate use of IV antiplatelet medications can prevent perioperative ischemic events and bleeding. Conclusions: Eptifibatide, tirofiban, and cangrelor are preferred over abciximab as a perioperative bridge. The choice of agent should be tailored to clinical characteristics of the patient and institutional acquisition costs
Development of a tool to assess and advance the effectiveness of preceptors: The Habits of Preceptors Rubric
No full textPresent the research performed to identify and describe habits of effective pharmacy preceptors and provide a framework for targeted preceptor assessment and development. Methods: A 5-round Delphi consensus-building process was used to refine the initial Habits of Preceptors Rubric (HOP-R) developed by the research team. Twenty experts in pharmacy experiential education participated. During the Delphi process, feedback and agreement on all parts of the HOP-R were sought, including the premise, introductory content, framework, preceptor domains, habits, habit level descriptions, and continuous professional development (CPD) plan. After each Delphi round, the research team grouped responses into themes and modified the draft rubric accordingly. These themes were used to frame the response document sent to the expert panel for the following Delphi round; this document explained modifications made to the HOP-R. Consensus was defined as a mean score of ≥3.25 on a 4-point scale (4 = strongly agree, 1 = strongly disagree) for posed statements or ≥70% agreement for ranked items. Results: In the final Delphi round (response rate, 95%), consensus was achieved for all HOP-R individual structural and content elements except the habit level descriptors, for which a secondary rank order analysis was performed. The final HOP-R has 3 domains encompassing 11 preceptor habits that can be displayed across 4 habit levels progressing from developing to master. Conclusion: The HOP-R was developed to assess, quantify, and demonstrate growth across a wide variety of pharmacy preceptor habits. Potential utility includes use as a framework to articulate the knowledge, skills, and behaviors of effective preceptors, facilitate the creation of individualized CPD plans, and assess the impact of participation in teaching and learning curricula
A rare case of a gabapentin-induced cardiomyopathy
No full textWhat is known and objective: Gabapentin, a γ-aminobutyric acid derivative, is used for the treatment of partial onset seizures, postherpetic neuralgia, diabetic neuropathy and a host of other neurological disorders. Case description: A 44-year-old woman with spinal stenosis was prescribed gabapentin for pain. Two months after initiating therapy, she was diagnosed with a new-onset non-ischaemic cardiomyopathy with an ejection fraction of 36% measured on a transthoracic echocardiogram. What is new and Conclusion: A patient with suspected gabapentin-induced cardiomyopathy is reported. However, to date, gabapentin therapy has not been associated with risk of the developing a cardiomyopathy
Chemical Hygiene Plan Policy
No full textThe primary purpose of this policy is to direct the University of Health Sciences & Pharmacy Chemical Hygiene Plan for laboratories using chemicals which must maintain a work-area specific Chemical Hygiene Plan to conform to the requirements of the OSHA Occupational Exposure to Hazardous Chemicals in Laboratories standard (29 CFR 1910.1450). University of Health Sciences & Pharmacy laboratories may use the University of Health Sciences & Pharmacy Chemical Hygiene Plan as a starting point for creating their work area- specific Chemical Hygiene Plan.
The Chemical Hygiene Plan Policy applies to all laboratories that use, store, or handle hazardous chemicals and all students, faculty, staff, contractors, and visitors who work in those facilities
Context-based interactive health information searching
No full textIntroduction. This paper deals with the impact of contextual features, such as sex, age, mother tongue, health status, health literacy, Internet use experience, and frequency of health information seeking on health information searching. Method. An interactive information retrieval approach was used to study users\u27 searching behaviour. An online survey and experiment using simulated situation technique were used as data collection methods. The online survey gathered data about user features, such as sex, age, mother tongue, health status, health literacy, Internet use experience, and health information seeking. An experiment was then carried out using four simulated tasks to collect information about health information searching. Analysis. The multiple linear regression analysis method was used to identify contextual factors affecting query length and number of queries. In addition, binary logistic regression analysis method was used to identify contextual factors affecting result clicking. Results. Frequent health information seeking leads to more queries and long query length, and English as a mother tongue and being healthy contribute to long query length. Queries with spelling errors and those formulated outside task descriptions are found to be ineffective. Conclusion. Contextual features such as frequency of health information seeking, mother tongue, and health status influence query formulation. In addition, spelling errors and source of query affect the effectiveness of queries. The findings could be useful for health information retrieval systems to learn and predict users’ information needs to aid effective retrieval
Reflections and interdisciplinary perceptions of pharmacy learners on an international medical brigade
No full textBackground and purpose: The Mountain Area Health Education Center, Inc. and Shoulder to Shoulder have partnered on medical brigades in rural Honduras since 2005, with pharmacy learner participation beginning in 2007. This study assesses the value of this experience to pharmacy learners and their contribution to a brigade\u27s success. Educational activity and setting: Pharmacy learners and faculty, family medicine residents and faculty physicians, student volunteers, and other health care professionals participate in two-week medical brigades each February and August. Since 2011, brigades have been based out of Camasca, a small town in rural, southwest Honduras. February brigade teams conduct home visits, while August brigades consist primarily of mobile clinics. In both situations, the pharmacy team prepares, dispenses, and counsels on medications. Participants from three trips were surveyed. Findings: All pharmacy learners agreed the brigade contributed to improvements in their skills and competence as pharmacists. Brigade members agreed that pharmacy learners made valuable contributions, particularly in counseling patients, maintaining an organized workflow, and assisting in activities outside of pharmacy services. All respondents agreed that pharmacy learners were necessary to a trip\u27s success. These international medical brigades were impactful educational experiences for pharmacy learners. Brigade participants viewed pharmacy learners as essential team members
Minute ventilation during hypoxia is augmented with capsaicin supplementation in aged mice
No full textCapsaicin is an agonist for transient receptor potential vanilloid 1 (TRPV1), and acute injection results in an increased frequency and tidal volume in young rats. It is unknown how capsaicin influences breathing in aged mice. We tested the hypothesis that capsaicin supplementation would elicit an augmented pattern of breathing in old mice compared to controls. Male 22-month old C57BL/6 J mice consumed a diet containing capsaicin (50 ppm) or lecithin control for one month. Breathing patterns were obtained prior to/following the dietary supplementation period using unrestrained barometric plethysmography. Frequency, tidal volume (VT), minute ventilation (VE), VE to expelled carbon dioxide ratio (VE/VCO 2 ) and VT divided by inspiratory time (VT/T i ) were analyzed at baseline and during a 15-minute hypoxic exposure (10% O 2 ). Capsaicin supplemented mice showed greater VE, VE/VCO 2 and TV/T i during hypoxic exposure compared to controls, with no change at baseline. Overall, these findings suggest an acute augmented response to hypoxia following capsaicin administration in older mice
Healthcare professionals\u27, students\u27, patients\u27 and donors\u27 perceptions of stem cell research and therapy: a systematic review protocol
No full textIntroduction Stem cell research (SCR) and the biomedical potential of developing therapies are crucial topics in biomedicine. Like other biotechnologies, stem cells are context specific entities understood through local conceptualisations of culture, politics, nationhood, as well as their perceived therapeutic efficacy. There is a need to recognise how these developments are understood within the healthcare community and by those who may use them. This protocol describes a systematic literature review that aims to explore healthcare professionals\u27, healthcare students\u27, patients\u27, and donors\u27 perceptions of SCR and therapy (SCR/T) and the factors that influence their perceptions. Methods and analysis Following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines a systematic review will be undertaken. Web of Science, Scopus, Medline+Journals @Ovid and Ariti Library will be systematically searched for studies on healthcare professionals\u27, healthcare students\u27, patients\u27 and donors\u27 perceptions of SCR and developing therapies. All articles will be screened by a researcher for inclusion and evaluation based on 12 criteria for evaluating qualitative research. At least 20% of articles will also be reviewed by a second researcher and any disagreement will be solved via consensus. Data extracted from the articles will be analysed using thematic synthesis enabling the identification of concepts across studies and the development of new theory. Ethics and dissemination As part of a larger research project, ethical approval has been provided by the Institutional Research Board (IRB) at Chang Gung Memorial Hospital. This review will be able to determine the impact that certain perceptions of SCR/T will have on the development of future medical knowledge and practice. The results of the study will be published in a peer-reviewed journal and disseminated at relevant conferences. PROSPERO registration number CRD42018103627