BackgroundDextrose is commonly administered with insulin during the management of hyperkalaemia to avoid hypoglycaemia. Previous research has evaluated the incidence of hypoglycaemia; however, none have reported the extent of blood glucose reduction after this regimen. The aim of this study was to better characterise the changes in blood glucose and to identify patients who may have an increased response to insulin.MethodsThis was a multicentre retrospective study evaluating adult patients who received a regimen of 10 units of intravenous regular insulin plus 25 g of intravenous dextrose to manage hyperkalaemia between January 2014 and September 2016. The primary outcome was to evaluate the extent of blood glucose reduction (milligram per decilitre) up to 6 hours following the above regimen. Secondary outcomes included incidence of hypoglycaemia (blood glucose <70 mg/dL) and severe hypoglycaemia (blood glucose <40 mg/dL), and predictors of the extent of blood glucose reduction.ResultsA total of 90 patients were included. The median blood glucose change over 6 hours was −24 mg/dL (IQR −53 to 6 mg/dL). Hypoglycaemia developed in 20 patients (22.2%, 95% CI 14.1% to 32.2%) and five patients (5.6%, 95% CI 1.8% to 12.5%) had severe hypoglycaemia. Patients who developed hypoglycaemia had a median baseline blood glucose of 110 mg/dL (IQR 80 to 127 mg/dL), which decreased to a median value of 52 mg/dL (IQR 40 to 60 mg/dL). Higher baseline blood glucose was significantly associated with greater blood glucose reduction (coefficient −0.36, 95% CI −0.55 to −0.18, p<0.001).ConclusionsThe extent of blood glucose reduction is variable and hypoglycaemia is common. The high incidence of hypoglycaemia highlights the importance of frequent blood glucose monitoring.

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Background The number of students enrolled in the colleges of pharmacy in Saudi Arabia is high, and the number of pharmacy graduates expected to join the workforce in the coming years is expected to grow. There are limited number of studies that assess factors influencing pharmacy students’ career choices in Saudi Arabia in the literature. The aim of this study was to assess the factors that influence career goals and to investigate students’ perceptions about their career goals. Methods This study was a prospective cross-sectional survey targeting PharmD students in their last year (i.e. interns) in the academic year of 2018 – 2019. A questionnaire containing four parts and total questions of 32 was completed by interns. Data collected and analyzed using Qualtrics. This study was reviewed and approved by the Unit of Biomedical Ethics Research Committee at King Abdulaziz University. Results 93 were reachable via email and all of them attended the interview and completed the survey (100% response rate). The most important job considerations were: work environment (67.7%), advancement opportunities (55.9%), salary (52.7%), benefits (40.9%), flexible work schedule (34%), and finally geographic region (29%). The top ranked career goal upon graduation were in industry and drug company (35.5%), clinical pharmacy (26.9%), (14%) academics/research and hospital pharmacy setting (inpatient/outpatient) (14%) each, and regulatory and community pharmacy (3.2% and 4.3%, respectively) Conclusion This study showed that work environment, advancement opportunities, and salary were the most important job consideration for pharmacy interns. The top ranked career goals were industry and drug company followed by clinical pharmacy. Further studies across Saudi Arabia are needed to confirm our results.

Background: The aging process makes geriatric populations more prone to various chronic diseases. Such diseases require older patients to be on more medications than any other age group and make them more susceptible to adverse drug events related to potentially inappropriate medications (PIMs). Aim: To identify the prevalence of potentially inappropriate medications among older people and explore the most commonly prescribed PIMs in hospitalized patients. Design and Setting: A retrospective study conducted in a large tertiary hospital among patients hospitalized in a 4 year period from January 2015 to December 2018. Methods: The 2019 Beers Criteria were used to assess PIMs in all inpatient prescribed medications focusing on the first class (i.e., drug/drug class to be avoided in older adults). Results: The mean age was 75.17 ± 7.66 years. A total of 684 (80.6%) patients were prescribed at least one medication listed in the first-class category of the 2019 Beers Criteria. Top five drugs were proton pump inhibitors (40.3%), nonsteroidal anti-inflammatory drugs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin (5.4%). Conclusions: The prevalence of PIMs is high among older patients admitted to the hospital. More efforts are needed to investigate the potential reasons and develop action plans to improve concordance to Beers Criteria among healthcare providers.