ABSTRACT
Many children require medications in oral liquid dosage forms when their dose does not conform to a manufactured tablet or capsule size. Liquid medications are also needed for children who are unable to swallow solid dosage forms. This statement from the PPAG is in support of standardizing the concentrations of extemporaneous formulations of liquid medications for the benefits of safety, accuracy, and overall communication between providers.
ABSTRACT
OBJECTIVE: This study was conducted to evaluate the impact of education on optimizing medication histories in a single-center pediatric emergency department. METHODS: This was a prospective, 2-phase study of 200 patients ages 21 years and younger who presented to the pediatric emergency department in January and February 2017. In phase I of the study, 100 patients were interviewed by both a nurse and a pharmacist. Between phases I and II, the pharmacist educated each nurse and disseminated standardized education materials. In phase II, 100 additional patients were interviewed by both a nurse and a pharmacist. Discrepancies were quantified in both phases of the study. The primary outcome was the distribution of total discrepancies in medications identified. Total discrepancies were defined as a composite of medication name, dose, route, frequency, and time of last dose. RESULTS: A total of 200 medication histories were collected over phases I and II. In phase I (n = 79), the pharmacist identified 185 medications, 88 of which were also identified by the nurse. In phase II (n = 82), the pharmacist identified 180 medications, 95 of which were also identified by the nurse. The distribution of discrepancies per patient and per medication was significantly reduced in regard to dose, route, and frequency documentation. CONCLUSION: Although improvement was observed, barriers beyond a knowledge deficit exist to limit accuracy of medication histories collected by nurses.
ABSTRACT
OBJECTIVES: The standard of care for treatment of an asthma exacerbation includes oxygen, inhaled short-acting bronchodilators, and systemic corticosteroids; adjunctive therapies, such as intravenous magnesium sulfate, can be used for patients who are having life-threatening exacerbations. The purpose of this study was to analyze the prescribing patterns as well as the safety of intravenous magnesium sulfate for the treatment of acute asthma exacerbations in pediatric patients across multiple hospitals in New Jersey. METHODS: This retrospective chart review was conducted at 4 medical centers in New Jersey on patients who presented to the emergency department between January 1, 2010, and December 31, 2010. RESULTS: Fifty-three patients were included in the study. In the emergency department, 98% of patients received inhaled albuterol plus ipratropium and 85% received systemic corticosteroids before intravenous magnesium sulfate administration. The median dose of magnesium sulfate was 40 mg/kg with a median time of administration of 20 minutes. One patient experienced hypotension that was thought to be related to magnesium sulfate administration. CONCLUSIONS: This study demonstrates that weight-based dosage, as well as time of administration of magnesium sulfate for pediatric patients with an acute asthma exacerbation, varies across different institutions in New Jersey. Magnesium sulfate use was safe in this patient population.
ABSTRACT
OBJECTIVE: To evaluate the difference in time until medical clearance when comparing tincture of opium (TO) to oral morphine (OM) in the treatment of neonatal abstinence syndrome (NAS). DESIGN: Retrospective chart review conducted from May 2007 to July 2011. SETTING: Level III Neonatal Intensive Care unit at Morristown Medical Center in Morristown, New Jersey. PATIENTS, PARTICIPANTS: Clinical Drug Utilization reports identified 26 neonates who were treated with TO and 25 neonates who were treated with OM for NAS. No patients were excluded. INTERVENTIONS: Patients were treated with either TO or OM for the indication of NAS. MAIN OUTCOME MEASURE(S): The primary outcome is to compare the time it takes for a baby being treated with TO versus OM for NAS to be medically cleared for discharge. RESULTS: The median time until medical clearance for those treated with TO was 29.5 days compared to 37 days for those treated with OM (p = 0.14). CONCLUSION: There was no statistically significant difference in the time it takes for a baby being treated with TO versus OM for NAS to be medically cleared for discharge. There are a number of safety benefits in using OM compared to TO. Until further data are collected, it is appropriate to continue treatment of neonates with NAS with OM.
