Benefits of a concentrated teaching rotation: Perspectives of pharmacy residents and faculty.

The postgraduate pharmacy residency experience requires residents to develop the proper skillset to not only provide optimal therapeutic management to patients, but to effectively deliver their knowledge to trainees and other health care providers. Without specific recommendations for how to achieve these skills, residents may hone their communication, organizational, and teaching skills through a number of different venues currently offered by residency programs nationwide. Residency programs commonly offer a longitudinal experience in order for residents to obtain didactic teaching skills; less often do programs offer a concentrated rotation dedicated to academia. Residents can acquire a number of skills from a focused academic rotation including curriculum development, career growth, and preceptorship by following a schedule that more closely mimics that of a clinical faculty member. These skills are typically more difficult to develop with a longitudinal experience due to time constraints and other resident and faculty member commitments. Prior to implementing this experience, the impact on both the resident and faculty member should be taken into consideration.

Effects of Total Dose Infusion of Iron Intravenously in Patients With Acute Heart Failure and Anemia (Hemoglobin < 13 g/dl).

Iron deficiency is common in heart failure (HF), and intravenous (IV) iron therapy has been associated with improved clinical status in ambulatory patients with HF. There are limited data to support the safety and efficacy of IV iron administration in patients with acute HF. This was a retrospective cohort study of patients admitted to the University of Michigan Health System for HF with low iron studies during admission. Patients were grouped based on the receipt of IV iron therapy. Study outcomes included change in hemoglobin, 30-day readmission, and adverse events. Forty-four patients who received IV iron and 128 control patients were identified. The mean dose of IV iron received was 1,057 (±336) mg. IV iron resulted in a significantly greater increase in hemoglobin over time (p = 0.0001). The mean change in hemoglobin in the iron and control groups was 0.74 g/dl and 0.01 g/dl at day 7 and 2.61 g/dl and 0.23 g/dl at day 28, respectively. Thirty-day readmission rates were 30% and 22% for patients in the iron and control groups, respectively (p = 0.2787). In conclusion, total dose infusion IV iron is well tolerated and associated with significant improvement in hemoglobin in acute HF.

Alternate Routes of Administration of Antidepressant and Antipsychotic Medications.

OBJECTIVE: To review the administration of antidepressant and antipsychotic medications via inhaled, intranasal, buccal, sublingual, transdermal, and rectal routes. DATA SOURCES: A PubMed search was conducted for all data through March 31, 2015 to identify pertinent literature. Search terms included the generic name of each antidepressant and antipsychotic medication in combination with the following terms: alternate routes of administration, inhaled, intranasal, buccal, sublingual, transdermal, and rectal. STUDY SELECTION AND DATA EXTRACTION: English-language case reports, studies, and reviews describing medication administration in human subjects were included. DATA SYNTHESIS: Commercially available products that use an alternative route of administration include loxapine for inhalation, asenapine for sublingual administration, and selegiline for transdermal administration. Case reports and studies describe intranasal, sublingual, and transdermal routes of administration of antipsychotic medications as well as buccal, sublingual, transdermal, and rectal administration of antidepressant medications. The concordance between the physicochemical properties possessed by some antipsychotic and antidepressant agents and the physicochemical properties required for nontraditional routes of administration suggest that administration via alternative routes may be feasible for some of these drugs. Further exploration of drug absorption via alternative routes in addition to consideration of patient and formulation factors may yield improvements in medication therapy for patients with psychiatric illnesses. CONCLUSIONS: For patients unable to tolerate oral or injectable therapy, administration of psychotropic medications via nontraditional routes may be feasible. The development of alternative routes of drug delivery could prevent discontinuation of needed medication therapy.