Applying principles of formulary management to blood banking.

The pharmacy and therapeutics (P&T) committee or its equivalent has been a long-standing committee of the medical staff in almost every institution. The P&T committee is typically defined as the body that recommends policy to the medical staff and the administration of the organization on matters related to the safe and therapeutic use of medications as well as other matters relating to medication use. The Food and Drug Administration definition of a drug includes blood and blood components, and the American Society of Health-System Pharmacists guidelines suggest including blood derivatives in their definition of a drug. Clinicians and other health care providers have needed to become more familiar with blood and blood component therapy as more prescription blood products have become available. As such, the P&T committee could work collaboratively with blood bank personnel, who are experts in this area, to help ensure that blood derivative products undergo the same evidence-based formulary review process as other medications.

Educational technology use among US colleges and schools of pharmacy.

OBJECTIVE: To develop a searchable database of educational technologies used at schools and colleges of pharmacy. METHODS: A cross-sectional survey design was used to determine what educational technologies were being used and to identify an individual at each institution who could serve as an information resource for peer-to-peer questions. RESULTS: Eighty-nine survey instruments were returned for a response rate of 75.4%. The resulting data illustrated the almost ubiquitous presence of educational technology. The most frequently used technology was course management systems and the least frequently used technology was microblogging. CONCLUSIONS: Educational technology use is trending toward fee-based products for enterprise-level applications and free, open-source products for collaboration and presentation. Educational technology is allowing educators to restructure classroom time for something other than simple transmission of factual information and to adopt an evidence-based approach to instructional innovation and reform.

Elevated International Normalized Ratio associated with concurrent use of ophthalmic erythromycin and warfarin.

PURPOSE: The case of a patient whose International Normalized Ratio (INR) increased with concurrent use of ophthalmic erythromycin and warfarin is reported. SUMMARY: A 77-year-old Caucasian woman began therapy with warfarin for thromboembolism prophylaxis secondary to atrial fibrillation (target INR, 2-3). Warfarin was prescribed by her cardiologist, and care was established with clinical pharmacists in an anticoagulation clinic. She was receiving a weekly maintenance dosage of 14 mg. She had a history of atrial fibrillation, hyperlipidemia, osteoarthritis, hypothyroidism, coronary artery disease, myocardial infarction, congestive heart failure, and breast cancer. In addition to warfarin, the patient had been receiving alprazolam, carvedilol, furosemide, levothyroxine sodium, lisinopril, nitroglycerin, potassium chloride, propoxyphene hydrochloride-acetaminophen, simvastatin, and trazodone. After receiving warfarin at the same weekly dosage for over four months, the patient's ophthalmologist prescribed erythromycin ophthalmic ointment for chronic bacterial conjunctivitis. Three weeks later, her INR was found to be 8.5. A total of four warfarin doses were withheld, and her weekly maintenance dosage of warfarin was subsequently decreased to 12 mg. Five weeks later, her INR was 1.5, and it was determined that the erythromycin ophthalmic ointment had been discontinued five days prior. Her weekly maintenance dosage of warfarin was increased to 16 mg. Rechallenge with erythromycin five days before her next INR measurement resulted in an INR of 4.2. A new weekly maintenance dosage of 13 mg was established, and her subsequent INRs were within normal range. CONCLUSION: An increase in INR values was reported after initiation of ophthalmic erythromycin in a patient receiving warfarin and recurred upon rechallenge with ophthalmic erythromycin.

Educational mentor program in a Web-based doctor of pharmacy degree pathway.

OBJECTIVE: To establish a successful educational mentor program for the Web-based doctor of pharmacy pathway at Creighton University, School of Pharmacy and Health Professions. DESIGN: A recruitment process was established and the educational mentor's responsibilities were identified. The roles of faculty instructors, the Office of Information Technology and Learning Resources, the Office of Faculty Development and Assessment, and Web-based Pharmacy Pathway Office as it pertains to the training of educational mentors were clearly delineated. An evaluation process for all key aspects of the program was also put in place. ASSESSMENT: Student, instructor, and mentor evaluations showed overall satisfaction with the program. Persistent areas of concern include the difficulty in motivating students to participate and/or engage in learning with the mentors. Many students remain unclear about mentors' roles and responsibilities. Lastly, in regards to mentors, there is a limited utilization of provided online resources. CONCLUSION: The educational mentor program has become an invaluable component of the Web pathway and has enhanced the interactions of students with the content and mentor.