Papers by Joseph Larochelle
The Journal of Pediatric Pharmacology and Therapeutics, 2021
OBJECTIVE The purpose was to characterize antimicrobial and anticoagulation therapies used in hea... more OBJECTIVE The purpose was to characterize antimicrobial and anticoagulation therapies used in health systems with children receiving extracorporeal membrane oxygenation (ECMO). METHODS An anonymous electronic survey assessing health system demographics and antimicrobial and anticoagulation therapies during ECMO was distributed to the American College of Clinical Pharmacy Pediatric Practice and Research Network and the Pediatric Pharmacy Association Critical Care Special Interest Group. The primary objective was to identify the number of respondents using antimicrobial prophylaxis for ECMO cannulation and ECMO runs. Secondary objectives included the first- and second-line anticoagulants and anticoagulation laboratory parameters. Additionally, the antimicrobial regimens and the dosing and administration of antithrombin III (AT III) with systemic anticoagulation were collected. Descriptive statistics were employed. RESULTS The questionnaire was completed by 38 respondents from 33 healt...
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Currents in Pharmacy Teaching and Learning, 2016
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Objective: The objectives of this study were 1) to describe and characterize interventions perfor... more Objective: The objectives of this study were 1) to describe and characterize interventions performed by a clinical pharmacist and 2) provide a comparative analysis of length of stay, mortality, and drug charges in control and intervention groups. Design: This was a retrospective analysis of clinical pharmacy interventions performed in a Pediatric Intensive Care Unit (PICU) over two years. The clinical pharmacy faculty member was a dual-residency trained specialist in pediatric critical care, and was on-site in the PICU for approximately 0.5 full time equivalents. Setting and patients: The interventions occurred in an 18-bed medical-surgical PICU in a tertiary care children's hospital. All patients admitted to the PICU during the study period were included. Interventions: The intervention group was comprised of patients admitted to the PICU during the study period for which the clinical pharmacist suggested changes in medication therapy. All other PICU patients were included in t...
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Objective: To describe the administration of vincristine and daunorubicin to a 14-year-old girl r... more Objective: To describe the administration of vincristine and daunorubicin to a 14-year-old girl requiring ECMO support due to a non-Hodgkin’s lymphoma mediastinal mass.
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The Journal of Pediatric Pharmacology and Therapeutics
Single tablet regimens (STRs) have simplified antiretroviral therapy (ART) over the years in the ... more Single tablet regimens (STRs) have simplified antiretroviral therapy (ART) over the years in the adult human immunodeficiency virus (HIV) population. However, there is still a prevalent need to simplify regimens in children and adolescents living with HIV. Finding the optimal regimen requires a multi-factorial approach due to their complex pharmacokinetic profiles throughout childhood and the challenges and limitations of medication non-adherence in the pediatric population. These challenges include pill size, available formulations, palatability, and caregiver health literacy, which can all affect the proper administration of medications. The complexity of this population implies the importance of customizing everyone's antiretroviral regimen so that the patient and family can successfully adhere to the therapy. The current recommendations for ART in the adult and pediatric populations are similar, yet the use of STRs are limited. The goal of this review was to assess current d...
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American Journal of Pharmaceutical Education
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Journal of Medical Toxicology
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Journal of the American College of Clinical Pharmacy
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Dermatopathology
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Journal of the American College of Clinical Pharmacy
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The Journal of Pediatric Pharmacology and Therapeutics
We describe a 16-year-old, 65-kg male deployed on extracorporeal membrane oxygenation (ECMO) for ... more We describe a 16-year-old, 65-kg male deployed on extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure secondary to ingestion of multiple substances. During his ECMO course, standard sedative and analgesic strategies failed and alternative medications were used. The patient received various dosages of fentanyl, morphine, hydromorphone, clonidine patches, dexmedetomidine, lorazepam, methadone, pentobarbital, olanzapine, and propofol. Despite administration of multiple agents, on day 29 of ECMO the patient experienced elevated blood pressures due to agitation, and continuous infusion etomidate was started. At the time of etomidate initiation, the osmolar gap was 8 mOsm/kg. During etomidate therapy, the blood pressure remained normal, sedative agents were slowly weaned, and the patient required few PRN medications. On day 6 of etomidate, the osmolar gap increased to 127 mOsm/kg and etomidate was discontinued. Continuous-infusion ketamine was started, but the bl...
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American Journal of Pharmaceutical Education, 2016
To examine racial differences in communication apprehension and interprofessional socialization i... more To examine racial differences in communication apprehension and interprofessional socialization in fourth-year PharmD students and to investigate the relationship between the two constructs. Two measures with reliability and validity psychometric evidence were administered to fourth-year pharmacy students at a single historically black university with a large racial minority population. The Personal Report of Communication Apprehension (PRCA-24) measures level of fear or anxiety associated with communication. The Interprofessional Socialization and Valuing Scale (ISVS) measures beliefs, attitudes, and behaviors towards interprofessional collaborative practice. One hundred fourteen students completed the survey. This produced a 77.4% response rate and 45.6% of the participants were African American. There were significant differences between races (ie, White, African-American, and Asian) on both measures. The PCRA-24 and ISVS were significantly correlated in each racial group. As pharmacy education moves to more interprofessional collaborations, the racial differences need to be considered and further explored. Pharmacy curricula can be structured to promote students' comfort when communicating interprofessionally across racial groups. Understanding of culture and early education in cultural competence may need to be emphasized to navigate racial or cultural differences.
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Hospital Pharmacy, 2011
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The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2009
The 2008 Surviving Sepsis Campaign guidelines state that intravenous antibiotic therapy should be... more The 2008 Surviving Sepsis Campaign guidelines state that intravenous antibiotic therapy should be started within the first hour of recognition of septic shock. Currently, there are no published studies looking at antibiotic timing in pediatric sepsis patients. The purpose of this study is to determine if sepsis patients admitted to a Pediatric Intensive Care Unit (PICU) are administered antibiotics in the appropriate time frame according to the Surviving Sepsis Guidelines. A retrospective chart review was conducted during a six-month time frame. For the purpose of this pilot study the onset of severe sepsis was defined as the time of a physician order for a vasopressor. Antibiotic appropriateness was based on culture results, drug dosing, and route. Length of PICU stay, overall hospital days, and mortality data were collected. Descriptive statistics on patient demographics, and the prescribing and time of administration of both antibiotics and vasopressors are included. Fifty-four p...
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Hospital Pharmacy, 2011
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Hospital Pharmacy, 2012
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Currents in Pharmacy Teaching and Learning, 2011
... The North Atlantic Pharmacist Licensure Examination (NAPLEX) Review session in the last profe... more ... The North Atlantic Pharmacist Licensure Examination (NAPLEX) Review session in the last professional year was a review of the major pediatric concepts and used an audience response system to answer case-based questions. ...
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American Journal of Health-System Pharmacy, 2011
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Medical Education Online
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Hospital Pharmacy, Feb 1, 2017
Pediatric medication nonadherence is a major problem in the United States health care system. Age... more Pediatric medication nonadherence is a major problem in the United States health care system. Age of the child, lack of understanding about the disease or treatment, culture, socioeconomic status, family structure, schedule of medications, and taste can all contribute to this problem. Strategies that target interventions to the individual patient and family can be most effective. Pharmacists are at the forefront of patient care and can help children become more adherent to their medications through counseling and building a trusting relationship with the family. This article highlights some common problems to adherence and some solutions to increase adherence.
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Papers by Joseph Larochelle