Journal of pharmacy practice
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Antibiotic-associated diarrhea (AAD) describes any unexplained diarrhea associated with the use of an antibiotic. AAD also includes infection caused by Clostridium difficile, however this organism only accounts for a small percentage of diarrhea caused by antibiotics. AAD can be caused by multiple other organisms including C perfringens, S aureus, and Candida. ⋯ There are several meta-analyses that report a relative risk reduction of AAD with the use of probiotics during antibiotic administration. Interpretation of these studies has been challenging due to the heterogeneity and size of the patient populations, unclear probiotic regimen, and unclear safety profile. Since AAD can be a reason for a patient to become non-compliant or receive incomplete treatment, clinicians should monitor for this potential adverse effect caused by antibiotics.
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Up to one-third of intensive care unit (ICU) patients require mechanical ventilation. Mechanical ventilation is associated with numerous complications including ventilator-induced lung injury and gastrointestinal bleeding due to ulcerations.(1) Sedation protocols are used in order to optimize treatment and decrease days spent on mechanical ventilation. ⋯ The use of sedation protocols can decrease the days spent on mechanical ventilation. The results also illustrate the enormous impact pharmacists have on policy and protocol development.
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To describe the role that an emergency medicine (EM) clinical pharmacist has on the management of patients presenting to the emergency department (ED) with sepsis, severe sepsis, or septic shock. ⋯ A clinical EM pharmacist has multiple roles in the early management of patients presenting with sepsis, severe sepsis, or septic shock in the ED. Most commonly, they have a role in optimizing empiric antibiotic selection and dosing; thereby ensuring adequate antimicrobial coverage in this complex patient population.
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Comparative Study
Computerized prescriber order entry and opportunities for medication errors: comparison to tradition paper-based order entry.
Predefined error opportunity categories were used as a surrogate for medication errors to assess the impact of computerized prescriber order entry (CPOE) on the potential for error in the prescribing and order entry phases of the medication-use process. ⋯ The implementation of CPOE was associated with a reduction in OEs in the prescribing phase or order entry phase of the medication-use process.
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Letter
Clinical toxicology and management of intoxications with synthetic cathinones ("bath salts").
Synthetic cathinones are synthetic derivatives of the natural cathinone, one of the psychoactive compounds present in Catha edulis (khat). There are at least 12 different types of synthetic cathinones, with mephedrone and 3,4-methylendioxypyrovalerone (MDPV) being the most commonly used by the purchasers. The legal control of these substances is especially difficult because when a specific compound is banned, a new slightly modified chemical variant is introduced into the market. ⋯ Furthermore, some cases of deaths related to their consumption have also been reported. Nowadays, there is no established treatment protocol for the clinical management of these intoxications. Because of this, we have developed some recommendations that may be useful to determine the treatment of these patients.