Effect of infusion time of intravenous acetaminophen on blood pressure in the intensive care unit.

OBJECTIVE: To understand the effect of prolonged intravenous acetaminophen infusion on blood pressure. MATERIALS AND METHODS: We retrospectively studied a cohort of intensive care patients receiving initial intravenous acetaminophen. We used propensity score matching to adjust for differences between patients who were classified into two groups: control (acetaminophen infusion for 15 minutes) and prolonged administration (acetaminophen infusion for > 15 minutes). RESULTS: After acetaminophen administration, diastolic blood pressure was unchanged in the control group, and was significantly lower at 30 and 60 minutes in the prolonged administration group. CONCLUSION: Prolonged duration of acetaminophen infusion did not prevent acetaminophen-induced blood pressure reduction.

[Evaluation of Usefulness of the Tools for Collaboration between Hospital and Community Pharmacists in the Provision of Outpatient Cancer Chemotherapy].

Outpatient cancer chemotherapy is becoming increasingly widely adopted. It is, therefore, essential to strengthen the collaboration between hospital and community pharmacists. Although there have been several reports on the collaboration between these two health care providers in the provision of outpatient cancer chemotherapy, there have been no reports on the usefulness of the tools provided by hospital pharmacists to their community counterparts. Hence, this study examined the usefulness of the Adverse Drug Reaction Information Form, which was provided to insurance pharmacies. The response rate of community pharmacists to the information provided was 80%. The most common content of the information provided was related to supportive care(55.9%). Telephone consultations between community pharmacists and patients were conducted in 20 cases(34.8%)to confirm the symptoms of adverse drug reactions. The telephone follow-up rate for each grade of adverse drug reaction was 34.8% for grade 1 and 45.5% for Grade 2, with the number of Grade 2 adverse drug reaction cases being the highest. These findings demonstrate that collaboration between hospital and community pharmacists using the Adverse Drug Reaction Information Form can help provide high-quality outpatient cancer care.

Antimicrobial Time-Out for Vancomycin by Infectious Disease Physicians Versus Clinical Pharmacists: A Before-After Crossover Trial.

BACKGROUND: The present study assessed the impact of time-out on vancomycin use and compared the strategy's efficacy when led by pharmacists versus infectious disease (ID) physicians at a tertiary care center. METHODS: Time-out, consisting of a telephone call to inpatient providers and documentation of vancomycin use >72 hours, was performed by ID physicians and clinical pharmacists in the Departments of Medicine and Surgery/Critical Care. Patients in the Department of Medicine were assigned to the clinical pharmacist-led arm, and patients in the Department of Surgery/Critical Care were assigned to the ID physician-led arm in the initial, 6-month phase and were switched in the second, 6-month phase. The primary outcome was the change in weekly days of therapy (DOT) per 1000 patient-days (PD), and vancomycin use was compared using interrupted time-series analysis. RESULTS: Of 587 patients receiving vancomycin, 132 participated, with 79 and 53 enrolled in the first and second phases, respectively. Overall, vancomycin use decreased, although the difference was statistically nonsignificant (change in slope, -0.25 weekly DOT per 1000 PD; 95% confidence interval [CI], -0.68 to 0.18; P = .24). The weekly vancomycin DOT per 1000 PD remained unchanged during phase 1 but decreased significantly in phase 2 (change in slope, -0.49; 95% CI, -0.84 to -0.14; P = .007). Antimicrobial use decreased significantly in the surgery/critical care patients in the pharmacist-led arm (change in slope, -0.77; 95% CI, -1.33 to -0.22; P = .007). CONCLUSIONS: Vancomycin time-out was moderately effective, and clinical pharmacist-led time-out with surgery/critical care patients substantially reduced vancomycin use.