Functions performed by paid pharmacy interns in hospitals in New York.

PURPOSE: The types of clinical and nonclinical activities performed by paid pharmacy interns in the hospitals in New York state were studied. METHODS: In November 2008, a list of hospitals in New York was obtained from the website of the New York State Department of Health. A survey was sent to each hospital's pharmacy director requesting information on hospital characteristics and whether the pharmacy department employed nongraduate pharmacy interns. For those hospitals that employed pharmacy interns, questions were asked about the number of nongraduate pharmacy interns employed, the shifts worked by interns, whether there was a minimum work-hour requirement for interns, the functions routinely performed by interns, and the percentage of interns who remained employed at the hospital upon licensure. RESULTS: Of the 184 surveys distributed, 96 responses (52.2%) were received. The majority of hospitals had 400 beds or fewer and were teaching institutions, and 45 employed pharmacy interns. The five functions reported most frequently were answering telephone calls (91%), preparing and distributing medications (82%), compounding nonparenteral medications (69%), compounding parenteral medications (62%), and responding to drug information queries (51%). The mean ± S.D. number of clinical activities performed by interns was 2.1 ± 2.1. The most frequently reported clinical activities were responding to drug information queries (51.1%), performing clinical interventions (33.3%), and completing adverse-drug-reaction reports (31.1%). CONCLUSION: Hospital pharmacy departments in New York utilized paid pharmacy interns to perform a variety of functions, including clinical activities. While there appears to be recognition that interns can perform clinical activities, the mean number of such activities was relatively low.

Update on the status of 89 drug information centers in the United States.

PURPOSE: Previously identified U.S. drug information centers (DICs) were surveyed to determine whether they were still in existence and whether changes had occurred in the DICs since 2003. METHODS: Eighty-nine DICs identified in a 2003 survey were surveyed in April 2008. For DICs still in existence, questions were designed to determine whether there were changes in the mission, time spent on activities, staffing, and drug information questions (number, complexity, and time required to answer) compared with five years earlier. Respondents' projected need for their DIC over the next five years was also surveyed. RESULTS: Seventy-five (84%) of the 89 DICs were still active. The most notable changes in activities were increases in time spent on educating health-professions students (53%), supporting the institution's medication safety program (44%), and providing information-systems support (36%). The majority of respondents (73%) reported no change in the number of employed drug information personnel. The percentages of DICs reporting an increase, decrease, and no change in the number of drug information requests received were 29%, 42%, and 29%, respectively. Seventy percent reported an increase in the number of complex questions, while 53% reported an increase in the time required to answer each question. Ninety-seven percent of respondents projected no change or an increase in the need for their DIC over the next five years. CONCLUSION: Eighty-four percent of the previously identified DICs were still in existence. The most notable changes in these DICs were increases in the number of DICs focusing on educating health-professions students, the complexity of drug information questions, and the amount of time required to answer each request.

Silodosin: a selective alpha1A-adrenergic receptor antagonist for the treatment of benign prostatic hyperplasia.

BACKGROUND: Silodosin is a new alpha(1)-adrenergic receptor antagonist that is selective for the alpha(1A)-adrenergic receptor. It was approved by the US Food and Drug Administration (FDA) in 2008 for the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). OBJECTIVE: This article reviews the pharmacology, pharmacokinetics, clinical efficacy, adverse effects, drug interactions, and dosage and administration of silodosin in adult male patients with BPH. METHODS: A search of MEDLINE (1950-October 8, 2009), International Pharmaceutical Abstracts (1970-October 8, 2009), and the Iowa Drug Information Service database (1966-October 8, 2009) was conducted using the terms silodosin, KMD-3213, benign prostatic hyperplasia, and alpha(1)-adrenergic receptor antagonist. Reports of research and review articles published in English were identified and evaluated, and the bibliographies of these articles were reviewed for additional relevant publications. A search of the FDA Web site was performed, and abstracts and posters presented at scientific meetings of the American Urological Association were reviewed. RESULTS: By antagonizing alpha(1A)-adrenergic receptors in the prostate and urethra, silodosin causes smooth muscle relaxation in the LUT. Silodosin has greater affinity for the alpha(1A)-adrenergic receptor than for the alpha(1B)-adrenergic receptor (by a factor of 583), minimizing the propensity for blood pressure-related adverse effects mediated by alpha(1B) blockade. In 3 controlled clinical studies in patients with BPH-related LUTS (1 published; 2 presented in the prescribing information and published in a pooled analysis), patients receiving silodosin at a total daily dose of 8 mg had significant improvements in the International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Q(max)) compared with those receiving placebo (both, P < 0.05). The most commonly reported adverse effect was abnormal or retrograde ejaculation (>22%), and the incidence of orthostatic hypotension was low (<3%). CONCLUSIONS: In the small number of clinical trials reviewed, silodosin was associated with significant reductions in IPSS and Q(max) compared with placebo. To determine whether silodosin's selectivity for the alpha(1A)-adrenergic receptor translates into a clinical advantage relative to other available agents, long-term studies evaluating the comparative efficacy and tolerability of silodosin and other alpha(1)-blockers (specifically tamsulosin) are necessary.