The Top 10 iPad Apps for Pharmacists

Want to know the top 10 apps I use in pharmacy practice?

1. MedCalc Pro - is a medical calculator that gives you easy access to complicated medical formulas, scores, scales and classifications.MedCalc has been available on mobile platforms for more than a decade, so it leverages years of experience in bringing medical equations to physicians in an easy to use, yet very powerful format. The Pro version offers premium features such as native iPad support, a patient database to store results and many ways to export results (email, airprint, copy to clipboard). If you're on a tight budget, you can always check out the cheaper but still amazing MedCalc.

2. Sanford Guide - The Sanford Guide is the essential resource for healthcare professionals who care for patients with infectious diseases. The Sanford Guide to Antimicrobial Therapy 2011 application provides fast, convenient access to critical information on treatment of infectious diseases, for timely, effective decisions at the point of care. Always a pocket guide, still a pocket guide. Portability has been a hallmark of The Sanford Guide for over 40 years. The Sanford Guide to Antimicrobial Therapy 2011 application extends that portability to iOS4 devices: iPhone, iPod Touch and iPad. The most trusted infectious diseases treatment resource in print now presents the same comprehensive, treatment- focused coverage of infectious diseases and clinical conditions, anti-infective drug information, therapeutic adjuncts and comparative spectra of activity in a clean, uncluttered, device-optimized interface. Based on the Sanford Guide Web Edition, the application features expanded coverage of topics compared to the print edition.

3. Medscape - The #1 free medical app in iTunes containing drug reference, daily medical news, CME/CE, drug interaction checker, disease and condition reference, procedure and protocols, and other special features. A must!

4. MedPage - MedPage Today is the only service for physicians that provides a clinical perspective on the breaking medical news that their patients are reading. Co-developed by MedPage Today and The University of Pennsylvania School of Medicine, Office of Continuing Medical Education, each article alerts clinicians to breaking medical news, with summaries and actionable information enabling them to better understand the implications.

5. WebMD - WebMD helps you with your decision-making and health improvement efforts by providing mobile access 24/7 to mobile-optimized health information and decision-support tools including WebMD’s Symptom Checker, Drugs & Treatments, First Aid Information and Local Health Listings. WebMD also gives you access to first aid information without having to be connected wirelessly – critical if you don’t have Internet access in the time of need. Personalize your app by saving drugs, conditions and articles relevant to you — through secure access and easy sign-in.

6. Epocrates - Get quick access to reliable drug, disease, and diagnostic information at the point of care. Epocrates is the #1 mobile drug reference among U.S. physicians. Trusted for accurate content and innovative offerings, 50% of U.S. physicians rely on Epocrates to help improve patient safety and increase practice efficiency.

7. Lexicomp - Committed to improving medication safety with innovative products and technology designed for healthcare professionals, Lexicomp offers a variety of drug information and medical applications for iPhone, iPad and iPod touch. These applications are tailored to meet the point-of-care needs of pharmacists, physicians, nurses, nurse practitioners and dentists by storing content directly on the mobile device. Access to Lexicomp's up-to-date drug information and clinical content is a must for the busy healthcare professional who desires the necessary tools to make important medication and clinical decisions from the palm of their hand! Download your Lexicomp mobile drug information application on the app store.

8. Redi-Reader – the reader I use to read articles, studies, etc…

9. Pharmacy Times – Keeping up with pharmacy news. I choose this app.

10. PACID - Last, but certainly not least, ID Compendium, A Persiflager's Guide by Mark Crislip, MD and programming by Walter Crittenden, PharmD (shout out to the PharmD!). This app is sweet for infectious disease!

p.s. I saved the best for last ;)

Diprivan and the Death of Michael Jackson

Milk of amnesia, propofol, diprivan, whatever you want to label it, diprivan has always been a medication that I put in the category of a medication that definitely needs hospital or long-term care support when administrating. Now because of the latest error a physician made in the case of Michael Jackson, the drug is propelled into the spotlight. Just recently:

Propofol: Limited Recall Due to Elevated Endotoxin Levels − July 2009

Teva Pharmaceuticals USA has announced a voluntary recall of certain lots of propofol injectable emulsion 10 mg/mL 100 mL vials. The lots identified are being recalled due to elevated endotoxin levels in some of the vials. Teva has received reports of 41 propofol treated patients experiencing postoperative fever, chills, and other flu-like symptoms; most cases reported appeared to be self-limiting. Possible adverse effects associated with elevated endotoxin exposure include fever, chills, and rigors. High endotoxin level exposure may be associated with more serious adverse effects including disseminated intravascular coagulopathy, acute respiratory distress syndrome, and death.

But, that only included certain lots. Sounds scary, huh?

High alert medication: The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs which have a heightened risk of causing significant patient harm when used in error.

Um, no brainer. It's a medication that is an intravenous infusion and has several pharmacological purposes includng induction of anesthesia in patients ≥3 years of age; maintenance of anesthesia in patients >2 months of age; in adults, for monitored anesthesia care sedation during procedures; sedation in intubated, mechanically-ventilated ICU patients.

And straight from the books:

Concerns related to adverse effects:

• Anaphylaxis/hypersensitivity reactions: May rarely cause hypersensitivity, anaphylaxis, anaphylactoid reactions, angioedema, bronchospasm, and erythema; medications for the treatment of hypersensitivity reactions should be available for immediate use.

• Hypertriglyceridemia: Because propofol is formulated within a 10% fat emulsion, hypertriglyceridemia is an expected side effect. Patients who develop hypertriglyceridemia (eg, >500 mg/dL) are at risk of developing pancreatitis. Serum triglyceride levels should be obtained prior to initiation of therapy and every 3-7 days thereafter. Monitoring of serum triglycerides should especially be considered with therapy >48 hours with doses exceeding 50 mcg/kg/minute (Devlin, 2005). An alternative sedative agent should be employed if significant hypertriglyceridemia occurs. Use with caution in patients with preexisting hyperlipidemia as evidenced by increased serum triglyceride levels or serum turbidity.

• Hypotension: The major cardiovascular effect of propofol is hypotension especially if patient is hypovolemic or if bolus dosing is used. Hypotension may be substantial with a reduction in mean arterial pressure occasionally exceeding 30%. Use with caution in patients who are hemodynamically unstable, hypovolemic, or have abnormally low vascular tone (eg, sepsis).

• Injection-site reaction: Transient local pain may occur during I.V. injection; lidocaine 1% solution may be administered prior to administration or may be added to propofol immediately prior to administration to reduce pain associated with injection (see Administration).

• Myoclonus: Perioperative myoclonus (eg, convulsions and opisthotonos) has occurred with administration.

• Propofol-related infusion syndrome (PRIS): PRIS is a serious side effect with a high mortality rate characterized by dysrhythmia (eg, bradycardia or tachycardia), heart failure, hyperkalemia, lipemia, metabolic acidosis, and/or rhabdomyolysis or myoglobinuria with subsequent renal failure. Risk factors include poor oxygen delivery, sepsis, serious cerebral injury, and the administration of high doses of propofol (usually doses >83 mcg/kg/minute or >5 mg/kg/hour for >48 hours), but has also been reported following large dose, short-term infusions during surgical anesthesia. The onset of the syndrome is rapid, occurring within 4 days of initiation. The mechanism of the syndrome has yet to be determined. Alternate sedative therapy should be considered for patients with escalating doses of vasopressors or inotropes, when cardiac failure occurs during high-dose propofol infusion, when metabolic acidosis is observed, or in whom lengthy and/or high-dose sedation is needed (Jacobi, 2002; Corbett, 2008).

Sound familiar???

I Am Back

I'm back after my brief hiatus into some time off. Boy, was it ever nice! Now I cannot wait for retirement! LOL Anyway, right now my biggest issue is the pharmaceutical companies and their TV ads, baseball ads, etc... The worst ad? Viva Viagra!

[youtube=http://youtube.com/watch?v=umhEoIdKYm8]

Even worse:

[youtube=http://youtube.com/watch?v=KVNXxQyK1MU&feature=related]

Live Claritin Clear

And have silicosis. The reason I write this is that there is a commercial on TV right now featuring the wonderdrug Claritin. This commercial features a sculptor of some sort banging on a statue and makes the comment that if "he were to sneeze, he might take the statue's nose off."  (It's important not to sneeze) The funny thing is that the man is wearing no form of ventilation protection and silica is flying around everywhere.  He's inhaling it.  It's dusty in the air.

I think he should worry about bigger things -- like Silicosis:

From Wikipedia, the free encyclopedia

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ICD-10	J62.
ICD-9	502

Silicosis (also known as Grinder's disease and Potter's rot) is a form of occupational lung disease caused by inhalation of crystalline silica dust, and is marked by inflammation and scarring in forms of nodular lesions in the upper lobes of the lungs.

Silicosis (especially the acute form) is characterized by shortness of breath, fever, and cyanosis (bluish skin). It may often be misdiagnosed as pulmonary edema (fluid in the lungs), pneumonia, or tuberculosis.

This respiratory disease was first recognized in 1705 by Ramazzini who noticed sand-like substances in the lungs of stonecutters. The name silicosis (from the Latin silex or flint) was attributed to Visconti in 1870.

The full name for this disease when caused by the specific exposure to fine silica dust found in volcanoes is pneumonoultramicroscopicsilicovolcanoconiosis, and at 45 letters it is the longest word in any of the major English dictionaries. (The name has been described as a "trophy word"—its only job is to serve as the longest word.^[1])

Once again proving that Schering Corporation didn't think about this or ask ANYONE before airing this incredibly stupid commercial.

Can someone PLEASE let them know?