Medication Safety

Soon, Hooi Cheng; Geppetti, Pierangelo; Lupi, Chiara; Kho, Boon Phiaw

doi:10.1007/978-3-030-59403-9_31

Cited by 3 publications

(5 citation statements)

References 70 publications

(94 reference statements)

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“…Management of complex drug therapy is safer and more sustainable whenever it can be streamlined for application in the real-world environment. 5 Successful carboplatin desensitization must be followed by use of the desensitization schema with each subsequent chemotherapy cycle containing carboplatin contingent on demonstrated patient tolerance to this method of drug administration and the premise that immunologic resensitization may occur during the interval between cyclic carboplatin administrations. 2,4,9 Effective desensitization is accomplished by controlled and uninterrupted carboplatin administration that delivers an increasing intensity of drug exposure to ultimately administer the regimen-based dose.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Interdisciplinary planning, order input, and implementation of every desensitization schema step must be done in a meticulous manner for delivery of safe and appropriate patient care. 2,5 Desensitization schemas are complex and add significantly to the workload of interdisciplinary staff. System adoption of a standard approach to chemotherapy desensitization is helpful for providing safe and seamless patient care, but widespread implementation is limited by the complexity of these protocols.…”

Section: Introductionmentioning

confidence: 99%

“…2–4 Interdisciplinary planning, order input, and implementation of every desensitization schema step must be done in a meticulous manner for delivery of safe and appropriate patient care. 2,5…”

Section: Introductionmentioning

confidence: 99%

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Carboplatin desensitization – simplified 4-step 2-bag method

Kintzel,

Gressel,

Van Rossum

et al. 2024

J Oncol Pharm Pract

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Introduction Our cancer program adopted a method for carboplatin desensitization (4-step 2-bag method) that administers the same intensity of drug exposure with a simplified approach to product management in comparison to a published protocol (4-step 4-bag method). Methods The intensity of carboplatin administration for 1:1,000, 1:100, 1:10, and 1:1 dilutions and concomitant fluid administration were compared for the 4-step 2-bag (bags A, B) and 4-step 4-bag (bags 1, 2, 3, 4) methods. Pharmacy preparation of bags A and B is described. A succinct overview of the desensitization procedure is provided. Important considerations germane to pharmacy practice are presented. Chart review of patients who underwent carboplatin desensitization with the 4-step 2-bag method between 7/13/2021 and 11/22/2023 was performed to demonstrate institutional use. Results The 4-step 2-bag method delivers similar rates of drug intensity from start of desensitization to completion of the planned dose as the previously published 4-step 4-bag method. Accuracy of regimen-based dose administration is assured by infusion of bag B contents irrespective of infusion interruptions or rate changes necessitated by patient tolerance. Bag A provides the 1:1000 dilution in a pharmaceutically elegant manner using administration rates and volumes compatible with clinical practice. Conclusion The 4-step 2-bag method for carboplatin desensitization administers controlled drug titration corresponding to 1:1000, 1:100, 1:10, and 1:1 dilutions for dose administration using two compounded admixture bags. Inaugural clinical use of the 4-step 2-bag method for carboplatin desensitization at our healthcare facility has proceeded with expected patient tolerance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Carboplatin desensitization – simplified 4-step 2-bag method

Kintzel,

Gressel,

Van Rossum

et al. 2024

J Oncol Pharm Pract

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“…Therefore, nurses must understand how polypharmacy and pill burden occur and affect patients' health outcomes. In geriatric patients, the liver size decreases with age, and its ability to metabolize drugs also declines, which increases the risk of toxicity (7).…”

Section: Introductionmentioning

confidence: 99%

Knowledge And Practices Used By Old Age Patients To Control Polypharmacy

Aboudonya¹,

Elden

Hassan

et al. 2022

NILES journal for Geriatric and Gerontology

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Background: Older people now constitute more than 60% of the world's population. The elderly population suffers from chronic diseases and multimorbidity and is treated with an increasing number of drugs that result in Polypharmacy. Polypharmacy was defined as per a systematic review conducted in 2017 as the concurrent use of five or more different prescription medications. Aim: This study aimed to assess the level of knowledge regarding Polypharmacy among older patients and assess the alternative practices used by old-age patients to control Polypharmacy. Design: A descriptive cross-sectional study design was used. Subjects & Setting:The sample size was 114 elderly patients selected from outpatient clinics monthly. Tools: (1) Questionnaire to assess geriatric patient's Polypharmacy's knowledge, (2) Checklist to assess poly pharmacy's alternative practices. Results: two-thirds of the study sample (66.7%) took medication based on their previous experience. More than half of the study sample (57%) depended on the pharmacist's prescription, and about half of the sample referred to friends 'advice.In comparison, nearly half of the study sample (44.7%) took medication based on the experience of a family member (32.5 %) were aware of the meaning of Polypharmacy. In comparison (23.7%) were aware of the Polypharmacy contributing factors. Conclusion: The study concluded that; the prevalence of Polypharmacy and its consequences among the elderly are significantly related to the level of education. Recommendations: designing an educational program for the elderly, aiming to increase their awareness and knowledge and maintain a healthy lifestyle; Activating the role of health educators during inpatient discharge and within outpatient services to promote the use of non-drug methods.

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“…Simplifying the delivery of patient care improves medication safety and regimen adherence. 6 The purpose of this commentary is to evaluate an empirical rationale for dexamethasone administration according to a standard schedule with elotuzumab-containing myeloma regimens.…”

mentioning

confidence: 99%

Elotuzumab: Empiric analysis of dexamethasone administration schedule

Kintzel

2023

J Oncol Pharm Pract

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Elotuzumab in combination with dexamethasone and immunomodulating agents (IMiDs) lenalidomide or pomalidomide is 2nd to 4th line therapy for multiple myeloma. The labelled dosage of dexamethasone for use in conjunction with elotuzumab and IMiDs splits the dexamethasone dose into two administrations, one oral and one intravenous, on the days of each elotuzumab infusion. Administration of split dose dexamethasone on days of elotuzumab administration is based on the registration trials submitted for drug approval and was intended to ensure standard well-timed immunotherapy premedication using pharmacologically equivalent dexamethasone doses for both study arms. Administration of dexamethasone in the manner delineated by the elotuzumab product label adds complexity to the delivery of care. This commentary provides an empirical assessment of established medication safety and effectiveness which supports administration of dexamethasone standard intermittent dose instead of the split dose approach delineated on elotuzumab package insert. Simplification of regimen administration improves medication adherence, reduces the risk of inadvertent omission or duplication of medication therapy, and improves the workflow required for delivery of care.

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Medication Safety

Cited by 3 publications

References 70 publications

Carboplatin desensitization – simplified 4-step 2-bag method

Carboplatin desensitization – simplified 4-step 2-bag method

Knowledge And Practices Used By Old Age Patients To Control Polypharmacy

Elotuzumab: Empiric analysis of dexamethasone administration schedule

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