Erstad, B. L. (2003). Osmolality and osmolarity: Narrowing the terminology gap. Pharmacotherapy, 23(9 I), 1085-1086.
Jacques, K. A., & Erstad, B. L. (2010). Availability of information for dosing injectable medications in underweight or obese patients. American Journal of Health-System Pharmacy, 67(22), 1948-1950.
PMID: 21048212;Abstract:
Purpose. Product information and pivotal studies on newly marketed injectable medications were reviewed to determine whether a weight descriptor was included and if information was provided for dosing patients with extremes of body weight. Methods. Products with new drug applications approved by the Food and Drug Administration between January 1, 2004, and January 30, 2009, were evaluated. Any information related to weight descriptors or dosing of patients with extremes of weight (body mass index of 18.5 or >40 kg/m2) relative to age and height was extracted from the product labeling or pivotal studies. Pharmaceutical companies were contacted if pivotal studies had not been published. The information was evaluated with a dosing usefulness score of 0-3; a score of 2 or greater was considered minimally adequate for dosing patients with extremes of weight. Results. Of the 84 medications evaluated, some reference to weight descriptors was found for 23 (27%). None had a calculated usefulness score of 2 or above based on information from product information or pivotal trials. Conclusion. Information from product labeling and pivotal studies involving newly marketed injectable medications is inadequate for dosing patients with extremes of weight.
O'Connell, H., & Erstad, B. L. (1995). Comparison of predicted and measured energy expenditure in mechanically ventilated obese patients. Journal of Pharmacy Technology, 11(2), 47-49.
Abstract:
Objective: To test the appropriateness of using actual body weight (ABW), ideal body weight (IBW), or an adjusted weight for predicting caloric requirements in moderately obese, mechanically ventilated patients receiving parenteral or enteral nutrition. Design: Prospective, nonrandomized pilot study involving seven patients. Setting: University medical center. Main Outcome Measures: Predicted caloric requirements based on ABW, IBW, or an adjusted weight were compared with measured requirements by indirect calorimetry after parenteral nutrition or tube feedings were at goal rate for 24-72 hours. Results: Mean differences between predicted and measured energy requirements for ABW, IBW, and adjusted weight were 821 ± 556 (p 0.05), - 256 ± 493, and 182 ± 501 kcal/d, respectively. Conclusions: Until additional studies are available, IBW or adjusted weight should be used for calculating caloric requirements in the moderately obese patient being mechanically ventilated when actual measurements are not available.
Balling, L. M., Erstad, B. L., & Weibel, K. J. (2015). Impact of a Transition-of-Care Pharmacist During Hospital Discharge. J Am Pharm Assoc, 55, 443-448.
Barletta, J. F., Erstad, B. L., Loew, M., & Keim, S. M. (2000). A prospective study of pain control in the emergency department. American Journal of Therapeutics, 7(4), 251-255.
PMID: 11486159;Abstract:
The most common complaint in the emergency department is pain. The management of acute pain, however, has not been well studied. This prospective study was designed to assess pain intensity and relief along with satisfaction in the emergency department. Adult patients with a primary complaint of acute pain were asked to complete a two-part questionnaire administered by a research assistant. The first part was completed on arrival and the second part on discharge from the emergency department. The respondents were not permitted to see the first part of the questionnaire while completing the second. The questionnaire used an unmarked, horizontal 10-cm visual analog scale along with short answer questions to measure pain, relief, and satisfaction. Choice of drug therapy was decided by the physician according to usual treatment methods. Fifty-seven people presented with the chief complaint of pain. Of those, 30 (53%) were treated with medications. The mean level of pain on admission for treated patients was 6.64 compared with a mean level of pain on discharge of 4.02 (P = .0001). Untreated patients had a mean admission visual analog scale score of 4.19. Compared with treated patients, this difference was statistically significant (P = .001). A mean visual analog scale score of 5.43, representing the mean amount of pain relief, was reported among treated patients. Treated patients also reported a visual analog scale score of 6.46 in overall satisfaction with pain management. The results of this study indicate that there is a significant and clinical difference in levels of pain and satisfaction between admission and discharge in these patients in the emergency department. © 2000 Lippincott Williams & Wilkins, Inc.
