Presentation Outline ICHP Annual Meeting September 13-15

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IV Acetaminophen –Average Length of Stay and Charges May 2012, ICD‐9 Code 715.36 (When IV APAP was used) May 2011, ICD‐9 Code 715.36(When IV APAP was NOT used) May 2012, ICD‐9 Code 715.35(When IV APAP was used) May 2011, ICD‐9 Code 715.35(When IV APAP was NOT used) May 2012, ICD‐9 Code 654.21 (When IV APAP was used) May 2011, ICD‐9 Code 654.21 (When IV APAP was NOT used) Average Length of Stay Average Charges 2.68 days $36,100 2.88 days $35,600 2.56 days $42,600 3 days $42,500 2.56 days $7,700 2.4 days $7,600 Review • What positives do you see from IV Acetaminophen use? • What negatives do you see from IV Acetaminophen use? • What additional research data would you like to see about IV Acetaminophen use? Assessment Question Which of the following statements is/are true regarding the infusion of intravenous acetaminophen? A. Infusion time is 30 minutes B. Cmax occurs at 30 minutes C. Overall AUC is similar to oral administration D. After penetration of the seal the product should be used within 12 hour E. All of the above IV Acetaminophen – Multiple Dosing • 15 patients who received multiple doses of IV APAP (average of 3.23 doses) were randomly selected and compared to 15 patients who received a single dose of IV APAP. Total oral morphine equivalent dose Multiple doses of IV APAP Single dose of IV APAP Calculated p-value 27.93mg 26.47mg 0.8946 Symptoms of 6 patients, 5 patients, 1.0 (Fisher’s nausea/vomiti receiving g total receiving g total exact test) ) ng 0-24 hours of 10 doses of of 8 doses of after surgery ondansetron ondansetron 4mg 4mg Average lowest oxygen saturation 0- 24 hours after surgery Average lowest respiratory rate 0-24 hours after surgery Conclusion 94.2% 94.83% 16.2 16.08 • Place in therapy is undetermined – Results of our DUE failed to demonstrate that clinical advantages outweigh the economic burden • Additional research needed – Larger sample size – Time to first physical therapy – Frequency of nausea and vomiting • Needs to be proven fiscally responsible – Anticipated benefits must be observed Questions 8/29/2012 3
References • Schechter, Leslie N., BS,PharmD. "Multimodal Approach to Pain Management Focus on Ofirmev (acetaminophen) Injection." U.S. Pharmacist (2012): 1‐12. Apr. 2012. Web. • Yeh, Yu‐Chen, M.S., and Prabashni Reddy, Pharm.D.,M.Med.Sc. "Clinical and Economic Evidence for Intravenous Acetaminophen." Pharmacotherapy 32.6 (2012): 559‐79. Web. • KKodali, d li Bhavani‐Shankar, Bh i Sh k MD, MD and d Jasmeet J tOb Oberoi, i MD. MD "REFERENCES "REFERENCES." " Management of Postoperative Pain. UpToDate, 10 Oct. 2011. Web. 12 Aug. 2012. . • Zacharoff, Kevin, MD. "The Role of Rational Polypharmacy in Pain Management." PainEDU.org { Articles }. N.p., 11 Mar. 2008. Web. 12 Aug. 2012. . 8/29/2012 4
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ACTIVITY DESCRIPTION Target Audienc
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Current Challenges • Expansion of
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Examples of Medication Consideratio
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Etiology (Dana Point, 2008) 1’. P
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PAH Therapy Targets Schulze-Neick I
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Chronic Adjuvant Therapies in PAH D
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Cummulative suurvival Survival in I
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ACCF/AHA Consensus PAH Treatment Al
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Study Name Drug SUPER-1 Oral silden
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IV Epoprostenol in PAH Due to Scler
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70 60 50 40 30 20 10 Inhaled Ilopro
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Conclusions • PAH therapy improve
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ESC/ERS Guidelines Galie N, et al.
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FUTURE DIRECTIONS WHICH MAY IMPACT
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Rationale for “Front-Loaded” Ap
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Addressing gthe Challenges g in PAH
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Considerations • Central vs. peri
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Pulmonary Hypertension • Approxim
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Example Cassette Calculations • V
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Assessment Question 1 Which of the
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Illinois Council of Health‐System
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Patient Activity ‐ 1 Patients in
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Hospitalists National Trends • Ja
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Pharmacy Landscape • PGY‐2: So
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Primary Care Physicians by Field, F
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Health Systems Pharmacy and TATAI
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Readings The 21 Irrefutable Laws of
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What is a “Practice Model”? •
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Completing the Self Assessment •
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Residency trained (B23p) Illinois N
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Solving the PPMI Puzzle ‐ Here Ar
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Overview of Value Based Purchasing
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Implementation of Medication‐ rel
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Question #1 Within which programs a
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Solving the PPMI Puzzle‐ Here are
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Discharge Education/Med Rec • New
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Media‐Worthy Trials? Making Sense
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Prevention of Recurrent VTE • Unp
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VTE recurrence during study period
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Which patient might be a candidate
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Azithromycin and CV Death • Endpo
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Azithromycin and CV Death Azithromy
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Hormonal Contraception and VTE •
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• Age • Calendar year • Educa
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ARR=2.20, 2.28 for stroke, MI when
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Which of the following combinations
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3 Months of Treatment for Latent TB
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3 Months of Treatment for Latent TB
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T/F: Rifapentine in combination wit
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2. Which of the following statement
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Fitting the Counseling Piece into M
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Current Evidence: Implementing Bund
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Teach Back Process • Step 1 Expla
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Questions for Consideration and Dis
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Why do we care about ADE? • Adver
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True or False • Medication errors
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Check Point Which of the following
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Proactive Screening Process Patient
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MTI Pilot at NAH PharmD Students tr
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ASHP PPMI Case Study Adding Value:
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Interdisciplinary Teamwork: How Phy
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Highly Effective Healthcare • Wha
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Inter‐Professional Teams ‐ Chan
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Meeting the PPMI Goals for Technolo
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Drug‐Bug Mismatch Example Con’t
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Drug‐Bug Mismatch Build Rules •
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Patient Scanning Compliance Sample
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Global Immunizations 3 • Jan 2012
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Mobile Devices: Beyond Angry Birds
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Google Play • Google Play - Inter
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Other Useful Productivity Apps •
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Mobile Devices: Beyond Angry Birds
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Net Activations by Industry Source:
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News Readers/Aggregators Features S
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Contact Information • E‐mail: -
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Early‐Onset Sepsis • Sign and s
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• BR is on day 2 of cefotaxime wi
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Immunizations: The Superheroes to P
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Current ACIP Recommendations Influe
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Herpes Zoster Vaccine Recommendatio
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Assessment Questions 1. What are th
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HIV Linkage and Retention in Care T
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DHHS Guidelines, March 2012: When t
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Protease Inhibitors • Require “
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Mean Change (mg/ /dL) STARTMRK: Lip
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RAL Drug Interactions • Does not
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Instructions for Credit In order to
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Staging Stage Criteria (Durie‐Sal
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Page 211 and 212: Unraveling Unraveling The The Puzzl
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Page 255 and 256: Special thanks to: • Carol Heunis
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Page 269 and 270: Questions? Residency Project Pearls
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Piecing together the new CHEST guid
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Initiating therapy CHEST 2012 2.1.8
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What is “Consistently Stable?”
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Puzzle # 2A: patient has just compl
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What would you do for JJ? • A. Ho
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Considerations for SB • Bleeding
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Presentation Outline ICHP Annual Meeting September 13-15

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