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❃ pharmacypracticenews.com
Volume 36 • Number 11 • November 2009 ❃
The Pharmacist’s News Source
Printer-friendly versions available online
Q&A: Judi Jacobi, PharmD
First Pharmacist To Lead SCCM Says Team Approach Is Crucial T
he run-up to the Society of Critical Care Medicine’s annual meeting in January 2010 is gathering steam, and Judi Jacobi, PharmD, is feeling the heat. During a morning in which she was putting the final touches on new guidelines for insulin infusion management in the ICU, juggling phone calls as a critical care pharmacy specialist at Methodist Hospital/Clarian Health and eyeing her growing list of duties as the first pharmacist/president-elect of SCCM, Dr. Jacobi spoke with Pharmacy Practice News editor David Bronstein about her accomplishments and the current and future direction of the specialty.
McMahon Publishing
in this issue Change in Heparin Potency Up Front Events
Catches Profession by Surprise
Using TV spots, other outreach efforts to sing praises of the profession.
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Operations & Mgmt
Assistance Programs Making medications more affordable for low-income patients.
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Clinical
Critical Care Documenting the value of ED pharmacy services: part 2 in a series.
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Policy
Drug Pricing
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: Critical care pharmacy has come a long way since 1989, when you helped form the Clinical Pharmacy and Pharmacology [CPP] section of SCCM. Have the ensuing 20 years given pharmacists a strong enough presence on the ICU team? A: The fact that SCCM has gone so far as to recognize me as a key member of the critical care team and supports me as its next president speaks volumes.
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The basics of federal 340B discount program.
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People in Pharmacy
Addiction Medicine A pharmacist’s tale of substance abuse and recovery.
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Technology
see FIRST PHARMACIST, page 56
Guest Editorial
New Study Shines Light On Vancomycin Toxicity More vigilance on trough levels by specialty urged
Health IT funding and BPOC: Are we there yet?
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see VANCOMYCIN, page 34
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s of early last month, all heparin products shipped in the United States were about 10% less potent than earlier formulations, the result of efforts by the FDA and the U.S. Pharmacopeia (USP) to harmonize dosage measurement units with international standards established by the World Health Organization (WHO). Although the change, which took effect Oct. 8, had been in the works for months, the official announcement by the FDA on Oct. 1 caught many clinicians and patient safety experts off guard. They worry that hospitals and other facilities that administer the widely used anticlotting drug may not be prepared to adjust dosing protocols, manage inventory procedures and monitor patients for anticoagulation efficacy. “One week is a pretty short time for most institutions to think through all the logistical and therapeutic issues that this seemingly small change might require,” said Stuart T. Haines, PharmD, professor and pharmacotherapy specialist at the University of Maryland School of Pharmacy in Baltimore. “For those institutions that decide to change their heparin dosing protocols, educating the physicians, nurses and pharmacists about the change will require considerably more time to plan and implement,” he told Pharmacy Practice News.
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Educational Review Contemporary Management of Hyponatremia See page
Anaheim, Calif.—Vancomycin trough levels greater than 15 mg/L may cause nephrotoxicity and should be closely monitored, especially in patients at risk for renal problems, according to new research from the University of California, Davis. Pharmacists at UC Davis Medical Center casually observed over the years that patients treated with higher trough levels seemed to develop more nephrotoxicity than patients treated with lower levels. In a retrospective study, they reviewed the charts of 105 patients admitted to the center between December 2005 and January 2006. They separated patients into
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Improving the Safety of IV Drug Delivery Clinical Use of Desirudin, a New Subcutaneously Administered Direct Thrombin Inhibitor
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see HEPARIN POTENCY, page 48
Pharmacists Help Minimize Delays to Proper Sepsis Care Anaheim, Calif.—Failure to recognize severe sepsis or septic shock and delays in antibiotic administration after pharmacy processing present significant obstacles to treating patients promptly, according to new research from Mayo Clinic. An internal review of Mayo Clinic patients found that in some cases, it took more than three hours for patients to be treated for sepsis, including more than two hours to
New Product EPS, Inc. releases two new SHRINKSAFE ID Bands for chemotherapy and other “highalert” drugs. See page
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properly diagnose sepsis, and close to one hour to administer antibiotics. These results, presented at the American College of Clinical Pharmacy’s annual meeting, have led to a number of changes in the evaluation and treatment of sepsis patients at Mayo Clinic that are improving outcomes. The review was part of a quality improvement program to boost compliance with the medical center’s
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see SEPSIS DELAYS, page 32
Research Awards Rural pharmacy, medication safety among topics garnering gold stars. See page
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