Training and recruiting future pharmacists through a hospital-based student internship program.

PURPOSE: A hospital-based pharmacy internship program is described. SUMMARY: The University of Pittsburgh Medical Center (UPMC) is a 19-hospital partnership affiliated with the University of Pittsburgh Schools of the Health Sciences, serving over 4 million patients per year through its community and teaching hospitals, community care programs, and managed care insurance product. UPMC created a structured pharmacy internship program that provides students with the skills to prepare them for future employment in a hospital or institutional pharmacy setting and creates a hiring and benefits infrastructure focused on student retention after graduation. During the first year of the internship, the training for the student pharmacist focuses on hands-on learning in hospital pharmacy operations. Subsequent years provide the opportunity to learn from pharmacists in a variety of practice sites, training side by side and working on a project with a pharmacist in a specialty area of the student's choice. A pathway of sequential job classifications with increasing salary and the advantage of accruing years of service with UPMC was established through administrative approval. Additional financial incentives offer encouragement for students to accept pharmacist positions at UPMC after graduation. Since the internship's inception in 2004, eight interns have completed the program. Of these, four are employed by UPMC as hospital pharmacists, and another is completing a postgraduate year 1 residency at UPMC. CONCLUSION: A four-year, structured pharmacy internship program at UPMC provided students with early experience in hospital pharmacy practice and resulted in successful training and retention of the interns as pharmacists at UPMC.

Use of probiotics in the management of chemotherapy-induced diarrhea: a case study.

Gastrointestinal disturbances (particularly diarrhea) are often induced in response to cancer treatments such as chemotherapy or radiation. Oral chemotherapeutic agents can induce diarrhea by damaging the intestinal lining. Two common oral drugs used in cancer treatment that are known to have gastrointestinal side effects are capecitabine and lapatinib. In this brief communication, the authors discuss a case study of a stage IV breast cancer patient whose chemotherapy-induced diarrhea was treated successfully with a multispecies combination of probiotics. This is a unique study in which grade 3 chemotherapy-induced diarrhea (characterized by 7-9 stools per day and associated with incontinence and abdominal cramping) was treated with only a multispecies combination of probiotics. Probiotics have been used to treat diarrhea in patients with irritable bowel syndrome, ulcerative colitis, pouchitis, and Crohn's disease. More recently, probiotics have been used to treat chemotherapy-induced diarrhea in colon cancer patients. This case study demonstrates that the probiotics can also be used to treat severe cases of chemotherapy-induced diarrhea in breast cancer patients. The use of different probiotics in gastrointestinal diseases is an increasingly important area of study, and more research into this area is needed. This study demonstrates that probiotics should be considered for advanced breast cancer patients with chemotherapy-induced diarrhea.

Nationwide survey of hospital practices when compounding parenteral nutrition solutions in latex-allergic patients.

We surveyed 100 institutions in 50 states, varying in size from 50 to 1,000 beds. The purpose of this survey was to examine the policies and techniques hospitals used in confirming latex allergy (LA) in patients and preparing parenteral nutrition (PN) for LA patients. Our survey indicated that within the institutions in our study, many inpatient pharmacists do not use any defined method for confirming LA other than what is documented in the patient profile upon admission. Most inpatient pharmacies are not aware of any institutional policy concerning parenteral medications in LA patients, and some do not identify the importance of LA in preparing PN. It is apparent from the results of this survey that uniform guidelines or practice standards for this important issue should be developed. Although the publications on LA are numerous, they mostly deal with the exposure to latex gloves or latex devices. Knowledge of preparing parenteral medications for LA patients in the literature is minimal. It is also clear that awareness and knowledge of pharmacy personnel should be enhanced. Finally, we are hoping that this survey will send a clear message to pharmacy organizations to develop guidelines or pharmacy practice standards for this issue, and for health institutions to develop policies and make them available to their personnel.