Effect of a Resident Physician Educational Program on Pediatric Emergency Department Pharmacy Interventions and Medication Errors.

Effect of a resident physician educational program on pediatric emergency department pharmacy interventions and medication errors.

J Pediatr Pharmacol Ther. 2013 Jan; 18(1): 53-62
Foster ME, Lighter DE, Godambe AV, Edgerson B, Bradley R, Godambe S

To determine the effects of a resident physician educational program in a pediatric emergency department (ED) on pharmacy interventions and medication errors, particularly dose adjustments, order clarifications, and adverse drug events (ADE).The ED pharmacist recorded all interventions and medication errors on weekdays from 3 to 11 pm during a 9-month period, consisting of a preobservational (Quarter 1), observational (Quarter 2), and interventional (Quarter 3) phases. Program implementation occurred in Quarter 3, with an initial 3-hour lecture during the ED orientation, followed by daily patient case discussions. Weekly interventions and errors were analyzed using statistical process control u-chart analyses. Chi-square analyses of independence were also performed. Resident and ED staff feedback on the program was obtained through anonymous internet-based surveys.A total of 3507 interventions were recorded during the 9-month period. Chi-square approximation and interval estimation of odds ratio showed a statistically significant decrease between Quarters 1 and 3 in the number of dose adjustments (95% confidence interval [CI], 0.324-0.689) and order clarifications (95% CI, 0.137 to 0.382) after initiation of the program. The decline in ADE, while not as substantial (95% CI, 0.003 to 1.078), still achieved a level of significance (90% CI, 0.006 to 0.674). Survey results were positive toward the program.The implementation of a resident physician educational program in our pediatric ED significantly decreased the number of medication errors, increased resident physician awareness of the potential for errors, and increased ED pharmacist utilization. HubMed – drug


Recent new drug approvals, part 2: drugs undergoing active clinical studies in children.

J Pediatr Pharmacol Ther. 2013 Jan; 18(1): 14-38
Chhim RF, Shelton CM, Christensen ML

The objective of this 2-part review is to provide information about drugs that have been recently approved by the US Food and Drug Administration. Part 1 reviewed recently approved drugs with pediatric indications. Part 2 reviews drugs recently approved only in adults and have published or ongoing studies in children. HubMed – drug


Ivacaftor: a novel gene-based therapeutic approach for cystic fibrosis.

J Pediatr Pharmacol Ther. 2013 Jan; 18(1): 8-13
Condren ME, Bradshaw MD

Ivacaftor is a new therapeutic agent that acts at the cystic fibrosis transmembrane conductance regulator (CFTR) channel to alter activity. It is approved for use in patients 6 years and older with cystic fibrosis who have at least 1 G551D mutation in the CFTR gene. It is unlike any other current pharmacologic agent for cystic fibrosis in that it specifically targets the gene defect associated with cystic fibrosis as opposed to treating resulting symptomology. Mucoactive agents, antibiotics, inhaled beta agonists, and other anti-inflammatory agents are currently the mainstay of cystic fibrosis treatment but can be associated with several side effects in addition to cumbersome frequency of administration. Ivacaftor’s oral dosing regimen offers a more convenient treatment option. However, it is associated with significant drug-drug interactions. HubMed – drug


Treating the mother, protecting the unborn: the motherisk approach.

J Pediatr Pharmacol Ther. 2013 Jan; 18(1): 4-7
Koren G

Pregnant women and their unborn babies are excluded from most pharmaceutical research. We have to convince regulatory agencies worldwide that, by not demanding research of drug safety and effectiveness in pregnancy from pharmaceutical agencies, we are orphaning pregnant women from progress in therapeutics and causing both themselves and their unborn babies tremendous unacceptable risks. HubMed – drug