Includes bibliographical references.

CBD: Considerations for Use Within the Health System -- Early Acute Ischemic Stroke Management for Pharmacists -- Impact of the Sequence of Norepinephrine and Vasopressin Discontinuation in Patients Recovering From Septic Shock -- Evaluation of a Long-Acting Opioid Restriction Policy: Does Restriction Reduce the Need for Naloxone Reversal? -- Off-label Medications Use in the Eastern Province of Saudi Arabia: The Views of General Practitioners, Pediatricians, and Other Specialists -- Piperacillin-Tazobactam Versus Carbapenems for the Treatment of Nonbacteremic Urinary Tract Infections due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae -- Factors Associated With Increased Hospital Length of Stay in Peritoneal Dialysis Patients With Peritonitis: A Need for Antimicrobial Stewardship? -- The Clinical and Financial Impact of a Pharmacist-Driven Penicillin Skin Testing Program on Antimicrobial Stewardship Practices -- Prolonged Versus Short Infusion Rates of IV Magnesium in Hospitalized General Medicine Patients with Hypomagnesemia -- Ischemic Stroke Symptoms After Warfarin Reversal With 4-Factor Prothrombin Complex Concentrate Case Report.

[Article Title: CBD: Considerations for Use Within the Health System /Jennifer L. Dill and Austin Kurkowski, p. 9-11]

Abstract: The landscape for use of cannabidiol (CBD) is rapidly evolving across the United States. Laws regulating the sale, distribution, and possession of CBD are being enacted on a state-by-state basis, creating ambiguity in navigating the medical, legal, and ethical issues surrounding the use of these products. As public opinion propels toward the acceptable use of CBD, patients are increasingly seeking advice and information regarding safe and effective use of these products. Pharmacists are the likely go-to experts to assist the health care team in addressing patient questions and concerns related to CBD and it is imperative that they be well informed on medical literature and legal considerations to effectively navigate these issues within the health system environment.

https://doi.org/10.1177/0018578719873870

[Article Title: Sodium Zirconium Cyclosilicate / Terri L. Levien and Danial E. Baker, p. 12-19]

Abstract: Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column.

https://doi.org/10.1177/0018578718817470

[Article Title: Early Acute Ischemic Stroke Management for Pharmacists / Michael Armahizer and three others, p. 12-25]

Abstract: The management of patients with acute ischemic stroke (AIS) continues to evolve, with the recent publication of several trials evaluating fibrinolytic, interventional, and medical management of critically ill patients presenting with occlusions of the cerebral vasculature. Recently published American Heart Association and American Stroke Association (AHA/ASA) guidelines on the early management of these patients have provided updated recommendations for a variety of pharmacotherapeutic interventions for the treatment of AIS.2 The primary focus of this article will be the early pharmacologic management of patients presenting with AIS. Pharmacists should be aware of medical and surgical interventions available to patients presenting with AIS to effectively manage and monitor therapy.

https://doi.org/10.1177/0018578718791504

[Article Title: Impact of the Sequence of Norepinephrine and Vasopressin Discontinuation in Patients Recovering From Septic Shock / Benjamin E. Bredhold and five others, p. 26-31]

Abstract: Septic shock is a serious medical condition affecting millions of people each year and guidelines direct vasopressor use in these patients. However, there is little information as to which vasopressor should be discontinued first.

https://doi.org/10.1177/0018578718817469

[Article Title:Evaluation of a Long-Acting Opioid Restriction Policy: Does Restriction Reduce the Need for Naloxone Reversal? / Jenna L. Fancher, and four others, p. 32-36]

Abstract: After a sentinel event related to long-acting (LA) opioid administration at our institution and subsequent root cause analysis, an inpatient LA opioid restriction policy was implemented to improve patient safety. The objectives of this study were to evaluate the effect of an inpatient LA opioid restriction policy on inpatient therapy utilization and to compare rates of naloxone reversal events among patients administered LA opioids before and after policy implementation.

https://doi.org/10.1177/0018578718817471

[Article Title: Off-label Medications Use in the Eastern Province of Saudi Arabia: The Views of General Practitioners, Pediatricians, and Other Specialists / Zainab AbuAlsaud and four others, p. 37-43]

Abstract: Off-label drug prescribing remains a major pediatric health concern worldwide. The lack of studies in this vulnerable population causes many practitioners to prescribe drugs outside their license. This study aims to investigate and compare the current knowledge and views of general practitioners, pediatricians, and other specialists toward off-label pediatric prescribing.

https://doi.org/10.1177/0018578718817861

[Article Title: Piperacillin-Tazobactam Versus Carbapenems for the Treatment of Nonbacteremic Urinary Tract Infections due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae / Jordan Brooke Tullos, Laura Leigh Stoudenmire and Jonathon David Pouliot, p. 44-49]

Abstract: Carbapenems are the drug of choice for treatment of infections due to extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Current evidence regarding piperacillin-tazobactam (PTZ) as an effective treatment alternative remains controversial. The purpose of this study was to determine the efficacy of PTZ versus carbapenems for treatment of nonbacteremic urinary tract infections (UTIs) due to ESBL-producing Enterobacteriaceae.

https://doi.org/10.1177/0018578718817933

[Article Title: Factors Associated With Increased Hospital Length of Stay in Peritoneal Dialysis Patients With Peritonitis: A Need for Antimicrobial Stewardship? / Taylor Morrisette and three others, p. 50-57]

Abstract: Peritonitis remains a complication of peritoneal dialysis (PD) and contributes to morbidity. Adherence to evidence-based recommendations should resolve peritonitis within 5 days; however, hospital length of stay (LOS) for patients with PD-associated peritonitis (PDAP) varies. Factors contributing to increased LOS and vigilance with antimicrobial stewardship (ASP) in this population are not well described.

https://doi.org/10.1177/0018578718817944

[Article Title: The Clinical and Financial Impact of a Pharmacist-Driven Penicillin Skin Testing Program on Antimicrobial Stewardship Practices / Stacy Harmon and five others, p. 58-63]

Abstract: Pharmacist-led penicillin skin testing (PST) was incorporated into antimicrobial stewardship at a community hospital to increase use of optimal antimicrobial therapy, reduce use of broad-spectrum agents, and reduce antimicrobial therapy–related costs.

https://doi.org/10.1177/0018578718817917

[Article Title: Prolonged Versus Short Infusion Rates of IV Magnesium in Hospitalized General Medicine Patients with Hypomagnesemia / Shaily Doshi, Jennifer Waller, and Amber Clemmons p. 64-68]

Due to the renal handling mechanism of magnesium, prolonging the time for infusion of intravenous (IV) magnesium has been postulated to decrease magnesium requirements; however, a paucity of clinical evidence exists to support prolonging infusion rates.

https://doi.org/10.1177/0018578718817941

[Article Title: Ischemic Stroke Symptoms After Warfarin Reversal With 4-Factor Prothrombin Complex Concentrate Case Report / Laura Carson and John E. Price, II p. 69-71]

An 83-year-old woman with atrial fibrillation on chronic warfarin therapy was given 4-factor prothrombin complex concentrate to reverse her warfarin for surgery. She had fallen off a step stool at home and fractured her left wrist which initially the surgeon was going to repair surgically. Method: The day after she received 4-factor prothrombin complex concentrate, she developed stroke-like symptoms, National Institutes of Health Stroke Scale (NIHSS) was 14, and met criteria for tissue plasminogen activator (tPA) administration. Tissue plasminogen activator was administered and she was transferred to the intensive care unit (ICU), per hospital protocol.

https://doi.org/10.1177/0018578718823739