InpharmD™





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What is InpharmD™?

Literature searching is tedious. InpharmD™ is here to help.

Clinical pharmacists can ask any question, anytime, from anywhere, and we’ll perform a custom literature search.

(And a 32% chance it’s already been asked.)


More than 30 of the world's best health systems hire an InpharmD™ virtual DI pharmacist, yielding:


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ROI

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This is how InpharmD™ transforms LITERATURE.

What's Being Asked...

What happens if you administer pregablin with a patient with low creatinine clearance?
What is the stability and sterility data for regular insulin stored in polypropylene syringes under refrigeration?
Therapeutic alternatives for Tacrolimus 30mg?
Antiviral management of seasonal and pandemic influenza?
What are the therapeutic alternatives for amoxicillin?

What would you like to ask InpharmD™?

InpharmD's Answer GPT's Answer

Author:gabrielle pak, PharmD, BCPS + InpharmD™ AI LEARN MORE 

Studies show gabapentinoids given to patients with renal impairment can result in altered mental status and falls if administered without dose adjustment.

Gabapentin and pregabalin exhibit unique pharmacokinetic properties that pose challenges in achieving therapeutic concentrations, especially in patients with renal impairment. Neither drug undergoes hepatic metabolism; instead, they are primarily excreted unchanged through the urine, minimizing the risk of hepatic cytochrome P450-related drug-drug and drug-food interactions. Gabapentin's clearance is linearly correlated with creatinine clearance (CrCl) and may involve active tubular secretion via organic cation transporter-1 (OCT-1), though this is not fully clinically significant due to its primary filtration excretion. Pregabalin undergoes some tubular reabsorption, with a clearance rate lower than that of gabapentin. Both drugs require dose adjustments based on the degree of renal impairment. For instance, pregabalin maximum recommended dosages are altered based on CrCl values: 100 mg TID or 150 mg BID for CrCl 30-59 mL/min, 50 mg TID or 75 mg BID for CrCl 15-29 mL/min, 75 mg onc...

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A search of the published medical literature revealed 1 study investigating the researchable question:

What happens if you administer pregablin with a patient with low creatinine clearance?

Level of evidence
C - Multiple studies with limitations or conflicting results  

READ MORE→

[1] Raouf M, Atkinson TJ, Crumb MW, Fudin J. Rational dosing of gabapentin and pregabalin in chronic kidney disease. J Pain Res. 2017;10:275-278. Published 2017 Jan 27. doi:10.2147/JPR.S130942
[2] Ishida JH, McCulloch CE, Steinman MA, Grimes BA, Johansen KL. Gabapentin and Pregabalin Use and Association with Adverse Outcomes among Hemodialysis Patients. J Am Soc Nephrol. 2018;29(7):1970-1978. doi:10.1681/ASN.2018010096
InpharmD's Answer GPT's Answer

Author:Vignesh Gorakala, PharmD, BCPS + InpharmD™ AI LEARN MORE 

Overall, stability data for regular insulin stored in syringes is sparse. Two studies have observed stability in polypropylene syringes for up to 28 days (Tables 1 and 2). Additional studies investigate stability of insulin mixed with 0.9% NaCl solution in polyvinyl chloride and polypropylene bags, demonstrating stability for 24 hours to 14 days.

A 2022 study investigated the physicochemical stability of ready-to-administer human insulin 1 IU/mL injection solution from two different brands (Huminsulin® and Actrapid Penfill®) when stored in disposable 50 mL plastic syringes. The products were diluted with 0.9% NaCl, prepared in polypropylene syringes (PVC and latex-free), and stored for 90 days at 2-8°C dark room or 20-25°C diffused light room. The results found that the concentration was stable (> 90%) after 90 days in the 2-8°C group, but was stable for at least 14 days in the 20-25°C group. [1]

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A search of the published medical literature revealed 1 study investigating the researchable question:

What is the stability and sterility data for regular insulin stored in polypropylene syringes under refrigeration?

Level of evidence
C - Multiple studies with limitations or conflicting results  

READ MORE→

[1] Erdnüß F, Mohr A, Krämer I. Longterm physicochemical stability of ready-to-administer human insulin injection solutions 1 I.U./mL in 50 mL plastic syringes. Pharmaceutical Technology in Hospital Pharmacy. 2022;7(1). doi: 10.1515/pthp-2021-0014
InpharmD's Answer GPT's Answer

Author:Neil Patel, PharmD, BCPS + InpharmD™ AI LEARN MORE 

The International Association for the Study of Pain defines chronic pain as any pain lasting longer than three months. There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach.

The International Association for the Study of Pain defines chronic pain as any pain lasting longer than three months. There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. Significant changes in blood flow or in the integrity of cerebral vessels are believed to cause cerebrovascular disease (CVD) and to contribute to dementias including Alzheimer’s disease [1]. Stroke, the most serious form of CVD, is one of the lead...

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A search of the published medical literature revealed 1 study investigating the researchable question:

Therapeutic alternatives for Tacrolimus 30mg?

Level of evidence
D - Case reports or unreliable data  

READ MORE→

[1] Imtiaz S, Shield KD, Fischer B, Elton-Marshall T, Sornpaisarn B, Probst C, Rehm J. Recent changes in trends of opioid overdose deaths in North America. Subst Abuse Treat Prev Policy. 2020 Aug 31;15(1):66.
[2] Wang LJ, Xiong J, Liu ST, Pan LL, Yang GX, Hu JF. J Nat Prod. 2015 Jul 24;78(7):1635-46. doi: 10.1021/acs.jnatprod.5b00195. Epub 2015 Jul 1.
[3] Wang LJ, Xiong J, Liu ST, Liu XH, Hu JF. Chem Biodivers. 2014 Jun;11(6):919-28. doi: 10.1002/cbdv.201300283.
[4] Zhang M, Wang JS, Oyama M, Luo J, Guo C, Ito T, Iinuma M, Kong LY. J Asian Nat Prod Res. 2012;14(7):708-12. doi: 10.1080/10...
InpharmD's Answer GPT's Answer

Author:Neil Patel, PharmD, BCPS + InpharmD™ AI LEARN MORE 

The goals of antiviral treatment for influenza are to decrease symptoms and functional disability and, more important, to decrease associated complications, hospitalizations, and mortality. Four drugs have been approved for treatment of and prophylaxis against influenza in the United States, but they are underutilized. The M2 ion channel inhibitors amantadine and rimantadine are effective for prophylaxis, and they decrease the duration of symptoms if they are used for early treatment of influ...

Oseltamivir has been shown to decrease antibiotic use, the number of hospitalizations, and, probably, the risk of death after influenza. NA inhibitors might provide substantial benefits in the treatment of pandemic influenza, with reductions in the numbers of hospitalizations and deaths occurring if such treatment (1) is made available in sufficient time, through rapid distribution, and (2) is available in sufficient quantities as a result of stockpiling. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. Significant changes in blood flow or in the integrity of cereb...

READ MORE→

A search of the published medical literature revealed 1 study investigating the researchable question:

Antiviral management of seasonal and pandemic influenza?

Level of evidence
B - One high-quality study or multiple studies with limitations  

READ MORE→

[1] Imtiaz S, Shield KD, Fischer B, Elton-Marshall T, Sornpaisarn B, Probst C, Rehm J. Recent changes in trends of opioid overdose deaths in North America. Subst Abuse Treat Prev Policy. 2020 Aug 31;15(1):66.
[2] Wang LJ, Xiong J, Liu ST, Pan LL, Yang GX, Hu JF. J Nat Prod. 2015 Jul 24;78(7):1635-46. doi: 10.1021/acs.jnatprod.5b00195. Epub 2015 Jul 1.
[3] Wang LJ, Xiong J, Liu ST, Liu XH, Hu JF. Chem Biodivers. 2014 Jun;11(6):919-28. doi: 10.1002/cbdv.201300283.
[4] Zhang M, Wang JS, Oyama M, Luo J, Guo C, Ito T, Iinuma M, Kong LY. J Asian Nat Prod Res. 2012;14(7):708-12. doi: 10.1080/10...
InpharmD's Answer GPT's Answer

Author:Neil Patel, PharmD, BCPS + InpharmD™ AI LEARN MORE 

Amoxicillin is the most common antibiotic prescribed in children with increasing use over time. While up to 10% of children are labelled as amoxicillin allergic, most children can tolerate amoxicillin after allergy evaluation. It is well documented that the label of amoxicillin allergy in children is associated with adverse health outcomes such as antibiotic-resistant infections. However, it remains controversial how best to assess children for amoxicillin allergy. While in general it is reco...

The androgens and androgen receptor (AR) play key roles in the prostate cancer (PCa) development and progression via epithelium-stroma cross talk. Prostate cancer-associated fibroblasts (CAFs) are dominant components in PCa stroma and are essential in the malignant progression by supporting tumorigenesis and metastasis. However, the AR roles in CAFs are still obscure. We isolated and immortalized the CAFs from human PCa tissues and found the CAFs are AR positive. We then knocked down their AR with siRNA and co-cultured the resultant CAFs with PCa cell line PC3. The MTT, invasion, and colony formation assays were performed to study the PC3 biological behavior. The results showed that the PCa epithelial growth, invasion, and colony formation abilities decreased when knocking down the CAFs AR. By using the real-time quantitative polymerase chain reaction, we found the IGF1, FGF7, FGF10, SDF1, HGF, and TGFb2 expression levels decreased in the AR knocked down CAFs. [1] The CAFs and NPF...

READ MORE→

A search of the published medical literature revealed 1 study investigating the researchable question:

What are the therapeutic alternatives for amoxicillin?

Level of evidence
C - Multiple studies with limitations or conflicting results  

READ MORE→

1. Chinni SR, Li Y, Upadhyay S, Koppolu PK, Sarkar FH. Oncogene. 2001 May 24;20(23):2927-36. doi: 10.1038/sj.onc.1204365.
2. Benitez DA, Pozo-Guisado E, Alvarez-Barrientos A, Fernandez-Salguero PM, Castellón EA. J Androl. 2007 Mar-Apr;28(2):282-93. doi: 10.2164/jandrol.106.000968. Epub 2006 Oct 18.

Why choose InpharmD™?

Find answers, not documents.

Before InpharmD™


BeforeTime
Your team spends hours per week cobbling together literature from different studies, many behind paywalls, leaving little time for action.
BeforeTime
TI opportunities are discovered (or presented by third parties) months after the fact, resulting in costly missed savings.
BeforeTime
Decisions may be made without a complete picture, or pushed out while gathering consensus.

After InpharmD™


BeforeTime
InpharmD™ delivers customized, actionable drug information in real time, so you can focus on execution.
BeforeTime
Your team stays informed immediately when new data emerges or prices change, and you’ll always be the first to know when any changes impact your formulary.
BeforeTime
With InpharmD™, your team can make faster, more informed decisions and move forward with confidence.

What Clinical Pharmacists Are Saying...


     

Assists in our research and is a great way or us to get an answer to a medical question without spending an average of 2 hours researching UptoDate or PubMed ourselves.


—   Jordan C., PharmD, New Jersey

     

Huge time saver with thorough responses.


—   Jane D., PharmD, Georgia

     

I’d never heard of a DI pharmacist before, now I have one. In. My. Pocket. Amazing!


     

Holy Shhh. Cow! Holy Cow! These summaries are beautiful.


—   Jane D., PharmD, Georgia

     

I just want to say: This is such a brilliant idea! You people are genius.


     

OH MY GOD WHERE HAVE YOU BEEN ALL MY LIFE!


     

I can’t tell you how much time I spend literature searching. And how I CANNOT STAND PAYWALLS. THIS IS UNBELIEVABLE!! (covers face for sec) thank you, thank you, thank you!


     

So they’re basically connecting academic researchers with front line providers and then automating everything. It’s simply brilliant.


     

The clinical pharmacist was our secret weapon anyway. (Smiles wryly) This pharmacist AI seems superhuman. I’m just blown away, honestly. (Looks at camera somberly.)


     

It’s an ENTIRE DI DEPARTMENT, that lives in Epic. Give me a second. I’m just having a hard time wrapping my head around that.


     

Sorry just give me a second, my mind is blown.


     

Stop reading and just download the app already! I’ve tried all of them. This is by far the most advanced, best-in-class.


   

Good


—   Chinna Rao Sana

     

Good


—   Vignesh Gorakala

What would you like to ask InpharmD™?

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