Despite a paucity of data, the role of intravenous lidocaine (IVLI) as adjunctive analgesia in the intensive care unit (ICU) seems promising due to a low potential to contribute to respiratory depression. A retrospective chart review was conducted to evaluate the safety and effectiveness of IVLI for the treatment of pain in ICU patient with varying degrees of organ dysfunction from March 2014 to March 2016. The primary outcomes included the time to a ≥ 20 % reduction in pain scores after the initiation of IVLI and the difference in opioid requirements as well as pain scores prior to and during IVLI therapy. Other variables included the presence of IVLI-related adverse events and the dosage and duration of IVLI. A total of 21 ICU patients were included from two different hospitals. The mean time to a ≥ 20 % reduction in pain scores from the start of IVLI was 3.3 hours (SD = 2.2). The median morphine dose equivalents required during 6, 12, and 24 hours pre-IVLI were significantly higher compared to the same time periods after IVLI (18.3 vs. 10 mg, p=0.002; 41.8 vs. 18.3 mg, p=0.002; 93.5 vs. 30.5 mg, p=0.037). Neurological adverse effects of lidocaine were noted in 3 patients, but the effects were reversed upon IVLI discontinuation. This report suggested that IVLI as an adjunctive agent in the treatment of acute pain may be a potential option in ICU patients who are refractory to opioids or those in whom opioid-induced respiratory depression is a concern.

Use of chemoprophylaxis and increasing amounts of blood products following orthotopic liver transplant was associated with increased mortality. A significant positive association was observed between blood product administration and VTE, while chemoprophylaxis use was not significantly associated with VTE. Larger prospective studies are necessary to further examine the significance of this finding.

The term “pharmacovigilance” defines the activities related to the collection, detection, assessment, monitoring, and prevention of adverse reactions occurring with medications. Recently, the spectrum of “-vigilance” has broadened to include safety of herbal products and cosmetic products as well. “Cosmetovigilance” was introduced as a new term used for defining surveillance carried out by industry to address the safety of cosmetic products. It was first used in literature by Vigan (1997) to refer to the monitoring of cosmetic product safety. Today, it is recognized globally as a concept of public health. For this systematic review, a PubMed search was conducted in July 2018 for the term “cosmetovigilance.”

Empirical dose adjustments may be prudent in critically ill patients with renal dysfunction; however, the optimal fondaparinux dosage in this population remains unknown. Peak anti-Xa concentrations may help guide therapy.

Utilizing elemental nutrition compared to PES plus nonelemental enteral nutrition in patients with pancreatitis was not associated with a significant reduction in percentage of diarrhea-free days, time-to-goal enteral nutrition, and nutrition status. A multicenter, prospective, randomized, controlled trial is warranted to further evaluate the efficacy of elemental nutrition in patients with pancreatitis.

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first manifested in Wuhan, China in December 2019 as multiple cases of pneumonia with unknown etiology. This was the herald of an infectious catastrophe that would eventually affect millions of people across the world, claim countless lives, and uproot the very foundations of modern-day healthcare practice. Hospital pharmacists, alongside with physicians, nurses, and numerous other disciplines, are an integral part of the healthcare team that responded to this pandemic. The purpose of this article is to highlight the teamwork, determination, and innovativeness demonstrated by clinical pharmacists at a 510-bed community hospital in response to the coronavirus disease of 2019 . Pharmacists rose to the occasion to ensure that patients continue to receive the best therapy possible during this pandemic, and they supported other disciplines to ensure a collaborative response. Despite the unprecedented challenges posed to hospital pharmacy practice in the setting of COVID-19, our pharmacy team's response has resoundingly proven the resiliency of the human spirit, and shows that nothing is insurmountable in the face of collaboration, creativity, and an overwhelming desire to care for our community.

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