Showing posts with label serum. Show all posts
Showing posts with label serum. 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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Comparison of free fraction serum valproic acid concentrations between inpatients and outpatients Society Logo Skip to main page content

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Comparison of free fraction serum valproic acid concentrations between inpatients and outpatients Haley G. Gibbs?, David E. Zimmerman, Kenneth M. Shermock, William Clarke, Marek A. Mirski and John J. Lewin III
Haley G. Gibbs, Pharm. D., is Clinical Pharmacy Specialist, Department of Pharmacy, Johns Hopkins Hospital (JHH), Baltimore, MD. David E. Zimmerman, Pharm.D., is Assistant Professor of Pharmacy, Department of Clinical, Social, and Administrative Sciences, Mylan School of Pharmacy, Duquesne University, Pittsburgh, PA. Kenneth M. Shermock, Pharm.D., Ph. D., is Director of the Center for Medication Quality and Outcomes, Department of Pharmacy; William Clarke, Ph.D., is Associate Professor, Director of Clinical Toxicology, Department of Clinical Toxicology; Marek A. Mirski, M.D., Ph.D., is Vice-Chair and Director, Neuroscience Critical Care Unit, Department of Anesthesiology and Critical Care Medicine; and John J. Lewin III, Pharm.D., M.B.A., is Division Director, Critical Care and Surgery Pharmacy, Department of Pharmacy, and Adjunct Assistant Professor, Department of Anesthesiology and Critical Care Medicine, JHH. Address correspondence to Dr. Gibbs (hgoodwi3{at}jhmi.edu). Abstract Purpose The differences in free fraction serum valproic acid concentrations between inpatients and outpatients were compared, and factors associated with therapeutic discordance were evaluated.

Methods This retrospective, single-center, cross-sectional study included patients with both a free and a total valproic acid concentration drawn within 30 minutes of each other between January 7, 2003, and June 1, 2011. Serum valproic acid concentrations were stratified by admission status (inpatient versus outpatient). In the primary analysis, for patients who had multiple paired concentrations drawn, one free valproic acid level and one total valproic acid level (i.e., one pair) were chosen at random for each inpatient. Information regarding patient demographics, laboratory data, and concomitant medication therapy was collected. Single and multivariable logistic regressions were performed to determine the odds of therapeutic discordance.

Results During the study period, inpatient concentrations were measured in 220 patients, and outpatient concentrations were measured in 41 patients. The median total valproic acid concentration in the inpatient group was significantly lower than that in the outpatient group (54 ?g/mL versus 83 ?g/mL, p < 0.001). The median free fraction of inpatient levels was nearly twice as high as that of outpatient levels (28.8% versus 15.5%, p < 0.001). Levels drawn in inpatients were therapeutically discordant 63% of the time compared to only 19% in outpatients (p < 0.001). Multivariable logistic regression identified low albumin as an independent risk factor for therapeutic discordance.

Conclusion The median free fraction of valproic acid was significantly higher in inpatients than in outpatients. Low albumin concentration was a predictor of discordance between free and total valproic acid concentrations.

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/ajhp140191 American Journal of Health-System Pharmacy January 15, 2015 vol. 72 no. 2 121-126 ? 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 Gibbs, H. G. Articles by Lewin, J. J. PubMed PubMed citation Articles by Gibbs, H. G. Articles by Lewin, J. J. 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