Charles Turck | Massachusetts College of Pharmacy and Health Sciences (original) (raw)

Papers by Charles Turck

Annals of Emergency Medicine, Aug 1, 2017

The intranasal route for medication administration is increasingly popular in the emergency depar... more The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain. The intranasal route appears to be an effective alternative for naloxone in opioid overdose. The literature is less clear on roles for intranasal ketamine and dexmedetomidine. [

Annals of Emergency Medicine, 2017

The intranasal route for medication administration is increasingly popular in the emergency depar... more The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain. The intranasal route appears to be an effective alternative for naloxone in opioid overdose. The literature is less clear on roles for intranasal ketamine and dexmedetomidine. [

Critical care nursing clinics of North America, 2010

Hepatic encephalopathy (HE) is caused by liver impairment and has a multitude of symptoms in affe... more Hepatic encephalopathy (HE) is caused by liver impairment and has a multitude of symptoms in affected patients, including change in level of consciousness, intellectual function, and neuromuscular function. Pharmacologic therapy includes use of nonabsorbable disaccharides (lactulose and lactitol), and antibiotics such as neomycin, paromycin, metronidazole, and rifaximin. Probiotics, acarbose, and drugs such as L-carnitine and flumazenil, may also be helpful in treating HE.

Journal of Continuing Education in the Health Professions, 2014

Treatment with pulmonary surfactant sig-nificantly reduces the morbidity and mortality OBJECTIVE ... more Treatment with pulmonary surfactant sig-nificantly reduces the morbidity and mortality OBJECTIVE To compare calfactant (CA) and poractant alfa (PA) administration traits, short-term clinical responses, and resource use in the neonatal respiratory distress syndrome (RDS) setting.

The Journal of Pediatric Pharmacology and Therapeutics, 2006

Treatment with pulmonary surfactant significantly reduces the morbidity and mortality OBJECTIVE T... more Treatment with pulmonary surfactant significantly reduces the morbidity and mortality OBJECTIVE To compare calfactant (CA) and poractant alfa (PA) administration traits, short-term clinical responses, and resource use in the neonatal respiratory distress syndrome (RDS) setting. METHODS An open label series of 277 (213 PA and 64 CA) infants was evaluated for 445 administrations. Registered respiratory therapists collected patient, surfactant administration, and postadministration clinical data. Economic analysis involved labor costs of surfactant administration and usage, wastage, and product average wholesale price. Analysis utilized the Mann-Whitney rank sum test for differences in administration time and either the chi-square or Fisher's exact test for categorical variables. RESULTS PA had a statistically lower bedside administration time than CA (3.8 minutes vs. 5.3 minutes; P = .006) and a higher percentage of doses administered in less than five minutes (58.9% vs. 4.3%; P < .001). Doses administered per patient were similar (1.67 vs. 1.72). PA and CA were similar in time to recovery (81.4% vs. 74.3%), percent desaturation (24.8% vs. 26.7%), and bradycardia (3.8% vs. 8.5%). Reflux was significantly higher (13.2% vs. 3.5%; P < .001) with CA. Economic analyses found total administration costs per dose were 2.21forPAand2.21 for PA and 2.21forPAand3.08 for CA. Mean wastage costs were 141.21forPAand141.21 for PA and 141.21forPAand337.34 for CA (P < .001). CONCLUSIONS PA appeared to utilize fewer neonatal intensive care unit resources than CA due to reduced administration time and less wastage of drug product. Future studies should more closely evaluate time, resource, wastage, and post-administrative clinical effects to fully assess the impact of surfactant products in this setting.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2004

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2015

Ten recently published articles with important implications for critical care pharmacotherapy are... more Ten recently published articles with important implications for critical care pharmacotherapy are summarized. The Critical Care Pharmacotherapy Literature Update (CCPLU) group is a national assembly of experienced intensive care unit (ICU) pharmacists across the United States. Group members monitor 25 peer-reviewed journals on an ongoing basis to identify literature relevant to pharmacy practice in the critical care setting. After evaluation by CCPLU group members, selected articles are chosen for summarization and distribution to group members nationwide based on (1) applicability to critical care practice, (2) relevance to pharmacy practitioners, and (3) quality of evidence or research methodology. Hundreds of relevant articles were evaluated by the group during the period January-December 2013, of which 98 were summarized and disseminated nationally to CCPLU group members. Among those 98 publications, 10 deemed to be of particularly high utility to critical care practitioners wer...

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2007

Management of neonatal patent ductus arteriosus (PDA) often is resource-intensive and costly. The... more Management of neonatal patent ductus arteriosus (PDA) often is resource-intensive and costly. Therefore, it is in hospitals' best interests to ensure the most cost-efficient use of associated resources. Clinical status, comorbidities, and response to prior therapy are considered in selecting the most appropriate intervention for PDA management. Currently, supportive measures (e.g., fluid restriction), surgical ligation, and pharmacologically based medical therapy are the primary treatment modalities for correcting PDA. Medical therapy, which comprises a small percentage (2.0%-5.0%)1 of overall PDA treatment expenses in the United States, consists of either of the 2 intravenous (IV) cyclooxygenase (COX) inhibitors: IV indomethacin and the newly available IV ibuprofen lysine. Although IV COX inhibitors represent a small portion of medical expenses, their benefits appear to be considerable. Pharmacoeconomic studies have evaluated indomethacin's beneficial impact on cost-effecti...

American Journal of Health-System Pharmacy, 2014

Advances in Therapy, 2007

To assess the efficacy and safety of 2 different strengths of a manufactured albuterol solution f... more To assess the efficacy and safety of 2 different strengths of a manufactured albuterol solution for nebulization (AccuNeb ® ; DEY, L.P., Napa, Calif), 349 children with moderate to severe asthma were enrolled in this prospective, multicenter, double-blind, placebo-controlled study. For 4 wk, children 6 to 12 y old were randomly assigned to 1.25 mg (A1) or 0.62 mg (A2) albuterol or placebo (P), nebulized 3 times daily for 4 weeks. Pulmonary function and safety were evaluated at weeks 0, 2, and 4 (visits 2-4). Nonparametric tests (Kruskal-Wallis and Wilcoxon's rank-sum) were used to compare treatments. Primary endpoint (week 4, %∆ area under the curve [AUC] forced expiratory volume in 1 sec [FEV 1 ]) results for A1, A2, and P were 90.3%•h * , 73.6%•h * , and 34.2%•h. Secondary assessments for A1, A2, and P were as follows: (1) week 2, %∆AUC FEV 1 (99.5%•h * , 104.5%•h * , and 43.6%•h); (2) maximum FEV 1 (28.6% * , 26.3% * , and 13.4%); and (3) duration of effect (116.8 min * , 115.9 min * , and 39.2 min). A2 was more effective in 463 Advances in Therapy ® Transmission and reproduction of this material in whole or part without prior written approval are prohibited. 1126 * P<.001 vs placebo.

Journal of Continuing Education in the Health Professions, 2014

Annals of Emergency Medicine, Aug 1, 2017

The intranasal route for medication administration is increasingly popular in the emergency depar... more The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain. The intranasal route appears to be an effective alternative for naloxone in opioid overdose. The literature is less clear on roles for intranasal ketamine and dexmedetomidine. [

Annals of Emergency Medicine, 2017

The intranasal route for medication administration is increasingly popular in the emergency depar... more The intranasal route for medication administration is increasingly popular in the emergency department and out-of-hospital setting because such administration is simple and fast, and can be used for patients without intravenous access and in situations in which obtaining an intravenous line is difficult or time intensive (eg, for patients who are seizing or combative). Several small studies (mostly pediatric) have shown midazolam to be effective for procedural sedation, anxiolysis, and seizures. Intranasal fentanyl demonstrates both safety and efficacy for the management of acute pain. The intranasal route appears to be an effective alternative for naloxone in opioid overdose. The literature is less clear on roles for intranasal ketamine and dexmedetomidine. [

Critical care nursing clinics of North America, 2010

Hepatic encephalopathy (HE) is caused by liver impairment and has a multitude of symptoms in affe... more Hepatic encephalopathy (HE) is caused by liver impairment and has a multitude of symptoms in affected patients, including change in level of consciousness, intellectual function, and neuromuscular function. Pharmacologic therapy includes use of nonabsorbable disaccharides (lactulose and lactitol), and antibiotics such as neomycin, paromycin, metronidazole, and rifaximin. Probiotics, acarbose, and drugs such as L-carnitine and flumazenil, may also be helpful in treating HE.

Journal of Continuing Education in the Health Professions, 2014

Treatment with pulmonary surfactant sig-nificantly reduces the morbidity and mortality OBJECTIVE ... more Treatment with pulmonary surfactant sig-nificantly reduces the morbidity and mortality OBJECTIVE To compare calfactant (CA) and poractant alfa (PA) administration traits, short-term clinical responses, and resource use in the neonatal respiratory distress syndrome (RDS) setting.

The Journal of Pediatric Pharmacology and Therapeutics, 2006

Treatment with pulmonary surfactant significantly reduces the morbidity and mortality OBJECTIVE T... more Treatment with pulmonary surfactant significantly reduces the morbidity and mortality OBJECTIVE To compare calfactant (CA) and poractant alfa (PA) administration traits, short-term clinical responses, and resource use in the neonatal respiratory distress syndrome (RDS) setting. METHODS An open label series of 277 (213 PA and 64 CA) infants was evaluated for 445 administrations. Registered respiratory therapists collected patient, surfactant administration, and postadministration clinical data. Economic analysis involved labor costs of surfactant administration and usage, wastage, and product average wholesale price. Analysis utilized the Mann-Whitney rank sum test for differences in administration time and either the chi-square or Fisher's exact test for categorical variables. RESULTS PA had a statistically lower bedside administration time than CA (3.8 minutes vs. 5.3 minutes; P = .006) and a higher percentage of doses administered in less than five minutes (58.9% vs. 4.3%; P < .001). Doses administered per patient were similar (1.67 vs. 1.72). PA and CA were similar in time to recovery (81.4% vs. 74.3%), percent desaturation (24.8% vs. 26.7%), and bradycardia (3.8% vs. 8.5%). Reflux was significantly higher (13.2% vs. 3.5%; P < .001) with CA. Economic analyses found total administration costs per dose were 2.21forPAand2.21 for PA and 2.21forPAand3.08 for CA. Mean wastage costs were 141.21forPAand141.21 for PA and 141.21forPAand337.34 for CA (P < .001). CONCLUSIONS PA appeared to utilize fewer neonatal intensive care unit resources than CA due to reduced administration time and less wastage of drug product. Future studies should more closely evaluate time, resource, wastage, and post-administrative clinical effects to fully assess the impact of surfactant products in this setting.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2004

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2015

Ten recently published articles with important implications for critical care pharmacotherapy are... more Ten recently published articles with important implications for critical care pharmacotherapy are summarized. The Critical Care Pharmacotherapy Literature Update (CCPLU) group is a national assembly of experienced intensive care unit (ICU) pharmacists across the United States. Group members monitor 25 peer-reviewed journals on an ongoing basis to identify literature relevant to pharmacy practice in the critical care setting. After evaluation by CCPLU group members, selected articles are chosen for summarization and distribution to group members nationwide based on (1) applicability to critical care practice, (2) relevance to pharmacy practitioners, and (3) quality of evidence or research methodology. Hundreds of relevant articles were evaluated by the group during the period January-December 2013, of which 98 were summarized and disseminated nationally to CCPLU group members. Among those 98 publications, 10 deemed to be of particularly high utility to critical care practitioners wer...

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2007

Management of neonatal patent ductus arteriosus (PDA) often is resource-intensive and costly. The... more Management of neonatal patent ductus arteriosus (PDA) often is resource-intensive and costly. Therefore, it is in hospitals' best interests to ensure the most cost-efficient use of associated resources. Clinical status, comorbidities, and response to prior therapy are considered in selecting the most appropriate intervention for PDA management. Currently, supportive measures (e.g., fluid restriction), surgical ligation, and pharmacologically based medical therapy are the primary treatment modalities for correcting PDA. Medical therapy, which comprises a small percentage (2.0%-5.0%)1 of overall PDA treatment expenses in the United States, consists of either of the 2 intravenous (IV) cyclooxygenase (COX) inhibitors: IV indomethacin and the newly available IV ibuprofen lysine. Although IV COX inhibitors represent a small portion of medical expenses, their benefits appear to be considerable. Pharmacoeconomic studies have evaluated indomethacin's beneficial impact on cost-effecti...

American Journal of Health-System Pharmacy, 2014

Advances in Therapy, 2007

To assess the efficacy and safety of 2 different strengths of a manufactured albuterol solution f... more To assess the efficacy and safety of 2 different strengths of a manufactured albuterol solution for nebulization (AccuNeb ® ; DEY, L.P., Napa, Calif), 349 children with moderate to severe asthma were enrolled in this prospective, multicenter, double-blind, placebo-controlled study. For 4 wk, children 6 to 12 y old were randomly assigned to 1.25 mg (A1) or 0.62 mg (A2) albuterol or placebo (P), nebulized 3 times daily for 4 weeks. Pulmonary function and safety were evaluated at weeks 0, 2, and 4 (visits 2-4). Nonparametric tests (Kruskal-Wallis and Wilcoxon's rank-sum) were used to compare treatments. Primary endpoint (week 4, %∆ area under the curve [AUC] forced expiratory volume in 1 sec [FEV 1 ]) results for A1, A2, and P were 90.3%•h * , 73.6%•h * , and 34.2%•h. Secondary assessments for A1, A2, and P were as follows: (1) week 2, %∆AUC FEV 1 (99.5%•h * , 104.5%•h * , and 43.6%•h); (2) maximum FEV 1 (28.6% * , 26.3% * , and 13.4%); and (3) duration of effect (116.8 min * , 115.9 min * , and 39.2 min). A2 was more effective in 463 Advances in Therapy ® Transmission and reproduction of this material in whole or part without prior written approval are prohibited. 1126 * P<.001 vs placebo.

Journal of Continuing Education in the Health Professions, 2014