Showing posts with label levels. Show all posts
Showing posts with label levels. Show all posts

Correlation of weight-based i.v. immune globulin doses with changes in serum immunoglobulin G levels Society Logo Skip to main page content

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Correlation of weight-based i.v. immune globulin doses with changes in serum immunoglobulin G levels Collin R. Anderson? and Jared A. Olson
Collin R. Anderson, Pharm.D., Ph.D., BCPS, is Clinical Pharmacist; and Jared A. Olson, Pharm. D., BCPS, is Infectious Disease Stewardship Pharmacist, Department of Pharmacy, Primary Children’s Hospital, Salt Lake City, UT. Address correspondence to Dr. Anderson (collin.anderson{at}imail.org). Abstract Purpose Correlations between the i.v. immune globulin (IVIG) dose and the change in serum immunoglobulin G (IgG) concentration with three methods of weight-based dosing were investigated.

Methods A retrospective medical records review was conducted to identify patients in a multicenter healthcare system who received IVIG over a 10-year period and had serum IgG measurements within two days before and two days after the date of IVIG administration. For each of the 11 adults and 7 adolescents identified, the relationship between the weight-based dose of IVIG (determined using actual body weight [BW], adjusted BW, or ideal BW [IBW]) and the resulting change in serum IgG was evaluated. Correlation coefficients and corresponding p values for the three dosing methods were calculated and compared.

Results Among adult patients, the correlation of IVIG dose and postdose change in serum IgG was strongest with dosing by IBW (correlation coefficient [r], 0.83 [p < 0.05] versus r values of 0.73 and 0.70 for dosing by adjusted BW or actual BW, respectively [p = 0.05 for both]); the corresponding r values in adolescent patients were 0.99, 0.99, and 0.95, respectively (p < 0.005 for all). There were no statistically significant differences between the r values calculated for the three weight-based dosing methods in either adults or adolescents.

Conclusion In adult patients, the correlation between the dose of IVIG and the change in IgG level was strongest when doses were calculated using IBW; comparable degrees of correlation were observed with the three evaluated methods of weight-based dosing in the adolescent population.

Copyright ? 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved. Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp140171 American Journal of Health-System Pharmacy February 15, 2015 vol. 72 no. 4 285-289 ? Abstract Full Text Full Text (PDF) Classifications Print Content Clinical Report Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Anderson, C. R. Articles by Olson, J. A. PubMed PubMed citation Articles by Anderson, C. R. Articles by Olson, J. A. Related Content Load related web page information Social Bookmarking Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

Current Issue February 15, 2015, 72 (4) Current Issue Alert me to new issues of American Journal of Health-System Pharmacy From the Cover RhOD immune globulin products for prevention of alloimmunization during pregnancy Sublingual tacrolimus as an alternative to oral administration for solid organ transplant recipients Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective Comparative analytics of infusion pump data across multiple hospital systems ABOUT AJHP SUBSCRIPTIONS FOR AUTHORS/REVIEWERS PERMISSION REQUESTS ADVERTISING EMAIL ALERTS (FREE) Email Alerts (Free) RSS FEEDS (FREE) RSS Feeds (Free) HELP CONTACT US/FEEDBACK American Society of Health System Pharmacists Learning Center (CE) Store Meetings & Conferences ASHP Foundation MOST READ ARTICLES (Last 30 Days) Clinical practice guidelines for antimicrobial prophylaxis in surgery Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists How to write a patient case report Treatment of poisoning caused by {beta}-adrenergic and calcium-channel blockers ? View all Most Read articles Advertisement ? 2015 by the American Society of Health-System Pharmacists. Terms of Use | Copyright Online ISSN: 1535-2900 Print ISSN: 1079-2082

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Reduction of clinical support warnings through recategorization of severity levels Society Logo Skip to main page content

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Reduction of clinical support warnings through recategorization of severity levels Crystal Parke?, Elizabeth Santiago, Brent Zussy and Dusko Klipa
Crystal Parke, Pharm.D., is Assistant Professor, School of Pharmacy and Pharmaceutical Sciences, Florida A&M University, Tallahassee; at the time of writing, she was Postgraduate Year 1 Pharmacy Resident, St. Vincent’s Medical Center–Riverside, Jacksonville, FL. Elizabeth Santiago, Pharm.D., M.B.A., is Pharmacy Manager, St. Vincent’s Medical Center–Clay County, Middleburg, FL. Brent Zussy, Pharm.D., is Pharmacy Informaticist, Ascension Health Information Services, Jacksonville, FL. Dusko Klipa, Pharm. D., BCPS, is Pharmacy Operations Manager, St. Vincent’s Medical Center–Riverside. Address correspondence to Dr. Parke (crystal.parke{at}famu.edu). Abstract Purpose Study results indicating that non–clinically significant alerts generated by clinical support systems can be reduced by recategorizing alert severity levels, thereby decreasing alert fatigue, are presented.

Methods In a single-site retrospective pre–post study, all drug–drug interaction alerts displayed by a medical center’s clinical support system over a three-month baseline period were evaluated by a multidisciplinary expert panel. Based on a review of pharmaceutical package inserts and other evidence, the panel reduced the severity ranking of 99 of the 201 most frequently triggered alerts with the aim of reducing nonactionable alerts (i.e., alerts viewed but not resulting in a clinical intervention such as the discontinuation of a medication, a dose reduction, or the ordering of a laboratory test). Alert frequencies and types during the baseline period and a one-month period after adjustment of the alert severity rankings were compared to characterize the distribution of alert override responses.

Results Comparison of drug–drug interaction alerts before (n = 8023) and after (n = 7270) alert recategorization indicated significant differences in pharmacists’ documentation of override responses in four evaluated categories (p < 0.001 for all comparisons); notably, alerts overrides in the “not clinically significant” category declined 22%. No significant difference was detected in the numbers of reported medication errors related to clinically significant drug–drug interaction alerts before and after alert recategorization.

Conclusion Reducing the number of nonactionable drug–drug interaction alerts by recategorizing alert severity levels decreased alert overrides by 6%.

Copyright ? 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved. Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

? Previous | Next Article ? Table of Contents This Article doi: 10.2146/ajhp140095 American Journal of Health-System Pharmacy January 15, 2015 vol. 72 no. 2 144-148 ? Abstract Full Text Full Text (PDF) Classifications Print Content Notes Services Email this article to a colleague Alert me when this article is cited Alert me if a correction is posted Alert me when eLetters are published Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Download to citation manager eLetters Submit an eLetter No eLetters published Citing Articles Load citing article information Google Scholar Articles by Parke, C. Articles by Klipa, D. PubMed PubMed citation Articles by Parke, C. Articles by Klipa, D. Related Content Load related web page information Social Bookmarking Add to CiteULikeCiteULike Add to DeliciousDelicious Add to DiggDigg Add to FacebookFacebook Add to Google+Google+ Add to RedditReddit Add to TwitterTwitter What's this?

Current Issue February 15, 2015, 72 (4) Current Issue Alert me to new issues of American Journal of Health-System Pharmacy From the Cover RhOD immune globulin products for prevention of alloimmunization during pregnancy Sublingual tacrolimus as an alternative to oral administration for solid organ transplant recipients Economic burden of recurrent venous thromboembolism: Analysis from a U.S. hospital perspective Comparative analytics of infusion pump data across multiple hospital systems ABOUT AJHP SUBSCRIPTIONS FOR AUTHORS/REVIEWERS PERMISSION REQUESTS ADVERTISING EMAIL ALERTS (FREE) Email Alerts (Free) RSS FEEDS (FREE) RSS Feeds (Free) HELP CONTACT US/FEEDBACK American Society of Health System Pharmacists Learning Center (CE) Store Meetings & Conferences ASHP Foundation MOST READ ARTICLES (Last 30 Days) Clinical practice guidelines for antimicrobial prophylaxis in surgery Therapeutic monitoring of vancomycin in adult patients: A consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists How to write a patient case report Treatment of poisoning caused by {beta}-adrenergic and calcium-channel blockers ? View all Most Read articles Advertisement ? 2015 by the American Society of Health-System Pharmacists. Terms of Use | Copyright Online ISSN: 1535-2900 Print ISSN: 1079-2082

View the original article here