Expect
significant updates to the current web site layout. Our last major
update of the web site (page layout) was in 2007. Our
home page will be updated first and the rest of the site will use a
similar layout.
Date:
News Item
September 5th, 2011
Several new drugs were added to the renal dosing section.
Check it out....
We have also moved to a new server! The new
server has four times the capacity of our current traffic levels.
The new environment should improve page load times and errors seen with
some of our programs during extremely busy periods.
April 22, 2011
Several updates were just released (See the medical calculator section).
Also in the coming months, significant upgrades to the
Internal Medicine - Reference section
will be completed.
You will notice that all of the individual
Internal medicine disciplines were added to the left column navigation
section on the home page for easy access.
I will also be reviewing the potential for additional disease state
management calculators... Several beta versions are currently in the
development stage.
If you have any ideas for new calculators, let me know....
Several new calculators will be created in the coming months...
If time permits, a few new disease state management tools will also
be released.
Fiber Analysis
Preliminary research has been completed on a new
fiber analysis tool. Look
for this important release hopefully before the
end of the year. Analysis of
specific soluble fibers can impact
recommendations given to patients with elevated
cholesterol levels or as general nutritional
information. More to come.....
Current tools:
The missing link in
disease pathogenesis??
This topic is extremely important to not only
healthcare professionals, but also the general
public. Future articles will be added to
the nutrition section..... in the meantime,
please research the IMPORTANCE of the ratio
of the omega-6/omega-3 essential fatty acids.
"Several sources of information suggest that
human beings evolved on a diet with a ratio of
omega-6 to omega-3 essential fatty acids (EFA)
of approximately one whereas in Western
diets the ratio is 15/1-16.7/1."
"Excessive amounts of omega-6 polyunsaturated
fatty acids (PUFA) and a very high
omega-6/omega-3 ratio, as is found in today's
Western diets, promote the pathogenesis
of many diseases, including cardiovascular
disease, cancer, and inflammatory and autoimmune
diseases, whereas increased levels of
omega-3 PUFA (a low omega-6/omega-3 ratio) exert
suppressive effects. In the secondary
prevention of cardiovascular disease, a ratio of
4/1 was associated with a 70% decrease in total
mortality. A ratio of 2.5/1 reduced rectal cell
proliferation in patients with colorectal cancer,
whereas a ratio of 4/1 with the same amount of
omega-3 PUFA had no effect."
Source:
Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential
fatty acids. Biomed Pharmacother. 2002 Oct;56(8):365-79.
Tyan Thomas, PharmD
University of the Sciences in Philadelphia http://www.usp.edu/
The original version was based on the following equation:
Mean Plasma Blood Glucose = (HbA1c * 35.6) - 77.3
Updated equation:
eAG = (28.7 X A1C) – 46.7 [eAG
(estimated average glucose)]
Greater accuracy is expected with the updated equation... See quote
below:
"RESULTS— Approximately 2,700 glucose values were obtained by each
subject during 3 months. Linear regression analysis between the A1C and
AG values provided the tightest correlations (AGmg/dl = 28.7
x A1C - 46.7, R2 = 0.84, P < 0.0001), allowing calculation of
an estimated average glucose (eAG) for A1C values. The linear regression
equations did not differ significantly across subgroups based on age,
sex, diabetes type, race/ethnicity, or smoking status."
Source.
July 14th, 2010
Minor updates have been completed for the IV Dilution database section
including the addition of colistin and ketorolac.
Here is a preview of the new Oncology dilution section..... It
will probably take another sixty days or so to wrap this section up.
All of the initial navigation and launch pages have been completed.
Renal dosing section: Several new updates should
be available later this month. A comprehensive list has already
been developed (new listings). Over 100 new agents may be added.
Calculators:
Based on feedback from several visitors, we will be creating a
benzodiazepine equivalence calculator. Also, a levothyroxine
dosing calculator. Release date: ~August 2010.
Date:
News Item
March 9th, 2010
Vancomycin - single level analysis.
Based on important feedback from Dr. MacKichan, subtle improvements were
made to this recently released program [Jan 2010]. After further
analysis it was determined that the recommended dose was being
calculated using the 'regimen' interval and not the 'calculated'
interval. This unintentional mix up in programmatic variable names did
not affect the final dosage analysis. The newly calculated recommended
dosage and interval data should now be much closer to the final regimen
recommendations.
Contributor:
Janis J. MacKichan, Pharm.D., FAPhA
Vice Chair
Professor of Pharmacy Practice
Northeastern Ohio Universities
College of Pharmacy
Important update to the lean body weight equation. A pharmacist from
Nova Scotia had contacted one of the original authors of the LBW
article:
Demirovic JA, Pai AB, Pai MP. Estimation of creatinine clearance in
morbidly obese patients. Am J Health Syst Pharm. 2009 Apr 1;66(7):642-8
Mary Doig, BSc (Pharm)
South Shore Regional Hospital
Bridgewater, Nova Scotia
Substituting the lean body weight into the Cockcroft and Gault equation
(Female patient): Manjunath (Amit) Pai, PharmD, BCPS:
"Most important point is to not multiply by 0.85 for female as the LBW
compensates for the weight differential between males and females. The
0.85 assumption was made up as no females were studied by Cockcroft and Gault."
Started a new calculator section - Home Theater
/ Speaker systems / Widescreen LCD/Plasma screenwidth calculator......
August 4th
2009
Improved the handling of high-dose extended-interval dosing by providing
additional guidance. Original
Pharmacokinetics program updated.....
This update was based on important feedback from: Thomas M. Gray, PharmD - Manager Clinical Pharmacy
Services- Genesys Regional Medical Center
Date:
News Item
July 23rd
2009
Recent updates are now added to twitter (new account) to improve delivery of update notices.
July 22
2009
The website forum will be removed soon...... Over 8000 spam posts were
removed recently. If I locate a better platform, a new web forum
will be added in the future.
July 15th
2009
Several improvements were made to our popular
blood alcohol calc... used by
several universities ...
July 14th
2009
A large medical terminology section was added
based on input from our visitors.
July 3rd
2009
Added an additional option (LBW) for obese patients to our
Multi-CRCL calc...
July 2nd
2009
Added ng/kg/min option to our drip rate calc
based on a suggestion from Jennifer Pawelek - Bronson Methodist Hospital.
MASSIVE update to the financial
calculator section .... There are now more than 40
calculators. Everything from asset allocation, retirement,
investing, mortgages, etc.
Date:
News Item
April 8th
2009
In the next couple of weeks, I will be adding several new financial
calculators including new investment tools, retirement calculators, as
well as a few other calculators.
Date:
News Item
March 24th
2009
Minor changes were made to our phenytoin
calculator based on comments from a VA (Veterans Administration)
pharmacist: Kelly Maxwell, Pharm.D.
The updated version now has a specific option for patient's with
profound renal insufficiency (CrCL<10 ml/min). The previous version
provided guidelines but did not actually calculate corrected phenytoin
levels for this type of patient. Additional dosing information can
be found here.....
Date:
News Item
February 19th
2009
Quick Access:
Easy access to all major section menus -
New Page. This page
can also be accessed by clicking the main header (top) image on the
homepage.
Laboratory values (tables): Added navigation buttons to the top of
each separate lab page. Also added a quick drop down menu to the Lab home page.
Date:
News Item
December 17th
2008
New custom sodium calculator released...
This new tool was created based on important feedback from
Dr. Shaw. Minor changes to the original
calc were completed as well.
Robert F. Shaw, PharmD, MPH, BCPS, BCNSP
ICU Clinical Pharmacy Specialist
".....The hypertonic saline calculator still did not meet what I was
looking for, but I understand one calculator cannot fit every
need and the inherent risks and liability with administration of
3% saline.
If I had the "perfect" calculator... I would want fields for:
starting Na
desired ending Na
gender
weight
choice of saline concentration 0.9% or 3%
This would provide how many ml of either 3% or 0.9% saline
required to change the sodium to the desired value. This could
further be defined if a meq/hr choice was provided of 0.5 meq/hr
or 1 to give a infusion rate...."
Date:
News Item
November 18th
2008
The Internal Medicine section has been completed:
Internal Med...... Also, the following additional updates have been completed:
Jessica Morehouse, Pharm.D.
"............ I needed to make a 12.5 % dextrose and 1/4 % NS 250
ml infusion out of a dextrose 70% bag and a bottle of concentrated NaCl
23.4%...." .."I think it would be extremely helpful if you
put in another calculator to calculate out a solution with one
base and 2 additives. I know I have run into this before, and it
would be great to have a verification of our math.."
(2) An option for the new serum creatinine IDMS method was added to
the CRCL Multi-calc.
Background info.
This update was based on a request from:
Patricia Vetter, Pharm.D. - Central
Washington Hospital. "I want to know what
reference standard for SCr value you are using in the
multi-calculator. I am assuming you are using the more
traditional serum creatinine range and not the IDMS based range
for your calculator......" ".... I suggest you add
another option to the serum creatinine box, so one can enter
either SCr (traditional range) or SCr (IDMS)...."
Future updates in the coming months:
Expanded pediatric section and a complete review and update to the
infectious disease empiric dosing section.
Date:
News Item
October 8th
2008
In the next couple of weeks, a completely new
section will be added to help navigate the entire GlobalRPh website.
In many cases, typical users are not aware of or are unable to quickly
locate several valuable tables, calculators, or articles that be needed.
This new section will divide the website into the primary Internal Medicine
disciplines in order to improve the navigation of the site. Here
is an early glimpse.... click the thumbnail below for a larger view.....
Also, new programs are being created for the infectious disease section. Here is an early look at the
cephalosporin's dosing program, which is based primarily on package insert data.
It covers all of the IV cephalosporin's [ Microbiology, Indications, and
Dosing]. All antibiotics will eventually be covered.
September 9th
2008
Significant changes/updates to the current
Intravenous Dilution Guidelines have been completed. I was
especially interested in reviewing the latest stability data from the
various manufacturers. Occasionally new formulations or even new
studies have led to changes in the recommended storage requirements for
some agents.
Currently, GlobalRPh is the 8th largest medical reference site on the
internet (MDConsult leads this group). One of the reasons this
site has grown so large is due to the tremendous support this site
receives from its visitors. I frequently receive emails from our
visitors with helpful insight and ideas for improving this site....
Examples include: 1) Simple message informing us of a missing
dilution standard for a new medication. 2) Summary of a recently
published study that may impact one of our current drug monographs. 3)
Ideas for new medical calculators. 4) Many others...
THANK YOU!!!!
Future revisions:
Several other sections of this website will be undergoing substantial
revisions. The infectious disease section in particular should be
completed by the end of this year.
New tools for the palm and pocket pc:
Actually, some of our latest work can be found on the
Epocrate's website.
Check out the
Medtools section... GlobalRPh has been a long time contributor to
this section along with other outside developers. You will find some of
our popular tools as well as a few new ones. Looking for a medical
software suite?? Take a look at the
software solution page at Epocrates...
