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The Pharmacist’s News Source Hematology/Oncology Pharmacy Edition
pharmacypracticenews.com
Volume 39 • Number 4 • April 2012
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ISMP Launches New Oncology Med Safety Self-Assessment Tool
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ospitals and clinics providing care to patients with cancer have a new tool to help them improve oncology medication safety. In March, the Institute for Safe Medication Practices (ISMP) with ISMP Canada launched the International Medication Safety Self Assessment for Oncology. Ann Shastay, RN, MSN, AOCN, managing editor at the ISMP, showcased the tool at a webinar in February. Ms. Shastay noted that managing chemotherapy agents is particularly challenging, and Sylvia Bartel, RPh, MHP, vice president of pharmacy services at the Dana-Farber Cancer Institute, in Boston, agreed. “These regimens are very complicated. The same drugs can be used differently, in different doses and schedules depending on the disease and stage,” said Ms. Bartel, who also
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see ASSESSMENT TOOL, page 29
Anti-Seizure Drugs, HIV Medications Don’t Always Yield Safe Mix
in this issue Policy
Compliance A primer on drug waste management.
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Reimbursement Matters Coding tips, other strategies for getting the most out of payers.
Communicating hope and vision—a primary focus for the servant leader.
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Clinical
Medication Safety Two overlooked treatments for reversing cardiac drug toxicity.
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Safety Pearls Avoiding intrathecal methotrexate mishaps, boosting IV oxytocin safety, handling investigational drugs, and more.
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Technology
Opinion
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Educational Review
see HIV MIX, page 33
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Leadership in Action
Why the time is now to comment on stage 2 ‘meaningful use’ IT provision—and its impact on bar coding.
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Critical care pharmacists play major role in update
Operations & Mgmt
International panel finds loss of efficacy, serum concentrations with several drug combinations ertain anti-seizure drugs and HIV medications may interact in such a way as to alter the efficacy or serum concentrations of these agents, according to an international panel of investigators. But some of the panel’s suggested strategies for mitigating the interactions have been criticized by specialists who treat HIVinfected patients. The panel, convened by the American Academy of Neurology and the International League Against Epilepsy, analyzed 42 papers that provided data about the concomitant use of antiseizure and HIV drugs. The analysis showed that several combinations may warrant dose adjustments to prevent potentially serious adverse reactions (Neurology 2012;78:139-145).
Pain, Agitation and Delirium Guidelines To Be Unveiled
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Medication Errors: The Year in Review See insert after page 30
Medication Safety Systems In the ICU See page 35
Houston–Pharmacists, nurses and physicians will soon have an updated set of guidelines to help them manage pain, agitation and delirium (PAD) in the intensive care unit (ICU). At the recent annual meeting of the Society of Critical Care Medicine (SCCM), clinicians who helped develop the guidelines provided a snapshot preview for attendees. “We’ve been working hard for the last six years, and it is now time to give birth to this product,” said Gil Fraser, PharmD, FCCM, clinical pharmacist in critical care at Maine Medical Center, in Portland, and professor of medicine at Tufts University School of Medicine, in Boston. According to Juliana Barr, MD, chair of the PAD Guideline Taskforce, the methodology used to develop the 2012 guidelines is more rigorous than that used for the 2002 guidelines. “The recommendations in these guidelines are more patientcentered, integrated and interdisciplinary in their approach, with less emphasis on
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see DELIRIUM, page 22
Antimicrobial Stewardship Program Cuts Drug Costs—and CDI Rates New Orleans—Not only can antimicrobial stewardship programs (ASPs) reduce inappropriate antibiotic use and lower pharmacy costs, they also can lower Clostridium difficile infection (CDI) rates, according to a recent study. Lead researcher Kevin Tapia, PharmD, clinical pharmacist at Mercy San Juan Medical Center, noticed that
CDI rates were at an all-time high in 2009 at the 370-bed acute care hospital in Carmichael, Calif. He initiated an ASP in the hope of improving patient outcomes and minimizing the negative consequences of misuse of antimicrobial treatment. The 18-month study showed that the antibiotic cost per patient-day
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Late-Breaker ASHP blasts Utah bill allowing office-based physicians to dispense oral cancer drugs. See page 12.
see STEWARDSHIP, page 7
New Product CutisPharma, Inc. announces FIRST® Mouthwash BLM 4oz and 6oz compounding kits. See page 32.
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