美国卫生系统药学杂志 (AJHP) 是美国卫生系统药剂师协会 (ASHP) 的官方出版物。它发表了关于医院和卫生系统中当代药物治疗和药学实践创新的同行评审科学论文。 AJHP 的发行量超过 43,000 份，是世界上最广泛认可和最受尊敬的临床药学期刊。

The American Journal of Health-System Pharmacy (AJHP) is the official publication of the American Society of Health-System Pharmacists (ASHP). It publishes peer-reviewed scientific papers on contemporary drug therapy and innovations in pharmacy practice within hospitals and health systems. With a circulation of over 43,000 copies, AJHP is one of the most widely recognized and respected clinical pharmacy journals in the world.

《American Journal of Health-System Pharmacy》（AJHP）是美国卫生系统药剂师协会（ASHP）的官方出版物。该期刊发表关于医院和卫生系统中现代药物治疗及药学实践创新的同行评审科学论文。AJHP的发行量超过43,000份，是全球最受认可和尊敬的临床药学期刊之一。

American Journal of Health-System Pharmacy

Abstract Purpose Pain is a frequent finding in surgical and trauma patients, and effective pain control remains a common challenge in the hospital setting. Opioids have traditionally been the foundation of pain management; however, these agents are associated with various adverse effects and risks of dependence and diversion. Summary In response to the rising national opioid epidemic and the various risks associated with opioid use, multimodal pain management through use of nonopioid analgesics such as acetaminophen, nonsteroidal anti-inflammatory drugs, α 2 agonists, N-methyl-d-aspartate (NMDA) receptor antagonists, skeletal muscle relaxants, sodium channel blockers, and local anesthetics has gained popularity recently. Multimodal analgesia has synergistic therapeutic effects and can decrease adverse effects by enabling use of lower doses of each agent in the multimodal regimen. This review discusses properties of the various nonopioid analgesics and encourages pharmacists to play an active role in the selection, initiation, and dose-titration of multimodal analgesia. The choice of nonopioid agents should be based on patient comorbidities, hemodynamic stability, and the agents’ respective adverse effect profiles. A multidisciplinary plan for management of pain should be formulated during transitions of care and is an area of opportunity for pharmacists to improve patient care. Conclusion Multimodal analgesia effectively treats pain while decreasing adverse effects. There is mounting evidence to support use of this strategy to decrease opioid use. As medication experts, pharmacists can play a key role in the selection, initiation, and dose-titration of analgesic agents based on patient-specific factors.

Stephy George

Meagan Johns

Review of nonopioid multimodal analgesia for surgical and trauma patients

Abstract Purpose This review aims to provide an update on current pharmacological agents for the management of generalized myasthenia gravis (MG). Summary MG is an autoimmune disease characterized by impaired neuromuscular transmission and muscle weakness. Most patients have autoimmune antibodies to the nicotinic acetylcholine receptor, with treatments aimed at eliminating or decreasing levels of autoantibodies. Limitations of current treatments for generalized MG include limited efficacy and serious adverse effects, indicating a continued need for new treatments. Efgartigimod alfa, a biologic newly approved by the Food and Drug Administration, provides a novel treatment option for patients with chronic generalized MG. Conclusion While the landscape for treatment of generalized MG has expanded over recent years, there is still an unmet need for patients for whom multiple lines of treatment have failed. The introduction of neonatal Fc receptor antagonists such as efgartigimod alfa may have an immediate impact in patients for whom standard-of-care therapy has failed.

Tanya R Riley

Janine S Douglas

Christopher Wang

Kiarra M Bowser

An update of the pharmacological treatment options for generalized myasthenia gravis in adults with anti–acetylcholine receptor antibodies

The published literature on the use of dexmedetomidine as an adjunct to sedation and analgesia in the management of pediatric narcotic withdrawal was reviewed. Pediatric narcotic withdrawal syndromes are reported to be increasingly frequent in pediatric intensive care units. A number of tools specifically designed for assessment of withdrawal in newborns and infants are in current use, including the widely used Finnegan Scoring System. A limited number of studies and case reports suggest that dexmedetomidine, an α2-receptor agonist with a mechanism of action similar to that of clonidine but with greater α2-receptor specificity, might have a role in the treatment of pediatric withdrawal (by blunting withdrawal symptoms without causing respiratory depression and by permitting shorter narcotic tapering schedules) and also in the prevention of pediatric narcotic withdrawal (by reducing narcotic requirements). Potential adverse effects associated with dexmedetomidine use in pediatric patients are generally associated with use of bolus doses and mainly involve central nervous system effects (e.g., hypotension, bradycardia), with no hemodynamic manifestations. When bolus doses are used, strategies described in published reports entail a loading dose of 0.5–1.0 μg/kg administered over 5–10 minutes, followed by a continuous infusion at 0.1–1.4 μg/kg/hr for a period of 1–16 days. More research is needed to define the optimal use of dexmedetomidine in the management of pediatric narcotic withdrawal. A limited body of published evidence from retrospective studies and case reports suggests a potential role for dexmedetomidine as an adjunct therapy to provide sedation and analgesia to reduce narcotic withdrawal symptoms in pediatric patients.

Alexandra Oschman

Tara McCabe

Robert J. Kuhn

Dexmedetomidine for opioid and benzodiazepine withdrawal in pediatric patients

儿童患者中使用右美托咪定治疗阿片类和苯二氮卓类药物戒断

Significant controversy and debate continue to surround the issue of mandatory immunization requirements with the human papillomavirus (HPV) vaccine in adolescent females. Much of the attention in the media has been directed to one extreme or the other and oftentimes used to support the agendas of liberals and conservatives. Unfortunately, this has led to a great deal of confusion and frustration for parents trying to make decisions for their own children. Many of the concerns and arguments against HPV immunization are not new, as similar arguments were made almost 20 years ago with the implementation of the hepatitis B immunization recommendations. Thus, we must look to the past to answer the questions of today and consider how the precedence set by decisions about HPV vaccination will affect future vaccination policies. The quadrivalent HPV vaccine is effective. HPV infection is the most common sexually transmitted disease in the United States, with over 6 million individuals infected annually.1 The health care cost allocated to the management of HPV infections is $4 billion and is second only to human immunodeficiency virus (HIV) in expenditures for sexually communicable diseases in the United States. Although not all HPV infections result in cervical cancer, cervical cancer is almost entirely (99%) caused by HPV infection.1 A vaccine that is effective in preventing 90% of precancerous cervical lesions and 100% of genital lesions caused by the four types of HPV that commonly cause infections seems almost ideal. If such a vaccine for HIV infection were available, few would likely question its potential effect and role as a universal vaccination. However, since HPV infection is less publicized, many people are not aware of its epidemiology and associated morbidity.

Sherry Luedtke

Human papillomavirus vaccine: Are the concerns unfounded?

人乳头瘤病毒疫苗：担忧是否毫无根据？

The process of identifying appropriate funding agencies for research projects is described, and grant application and review procedures are explained. Although the federal government is the largest single source of research funding, financial support is also offered by associations, foundations, and corporations. Research funding may be divided into two major types: grants, which are awarded in response to investigator-initiated projects, and contracts, under which the research topic is proposed by the funding agency. Competing successfully for grants and contracts requires a sound research plan whose objectives are consistent with those of the funder. Identification of an appropriate potential funding agency requires familiarity with its areas of interest, the size of grants offered, and other criteria. The development of the grant application has several steps, including determining specific aims and long-term project goals, reviewing the literature, obtaining letters of consent from collaborators and consultants, securing colleagues' assistance in reviewing the drafts, preparing a budget, and drafting and revising the proposal. Most grant applications have a number of common elements; each funder also may have unique requirements. Authors should familiarize themselves with the application criteria of the agency or institution from which they are seeking support and follow them scrupulously. Competition for grant funds is high, and many worthwhile proposals are rejected. After studying the reviewers' comments, the author may wish to revise the application for resubmission or submission to a different funding agency. Sound planning, selection of an appropriate funding agency, and preparation of a well-written proposal play key roles in successful grantsmanship.

Donald K. Woodward

G. Dennis Clifton

Development of a successful research grant application

成功科研基金申请的开发

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Anthony Vecchione

Philip Carpiniello

Corey A Fowler

Implementation of a pharmacist-driven ketogenic diet protocol at an academic, quaternary pediatric referral center

在一所学术性、四级儿科转诊中心实施药师主导的生酮饮食方案

Hinpetch Daungsupawong

Viroj Wiwanitkit

Drug information question responses by a drug information center and by ChatGPT: Correspondence

药物信息中心与ChatGPT对药物信息问题的回答：对比研究

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Antimicrobial stewardship programs have been widely implemented with positive results in the inpatient healthcare delivery model. However, data supporting these interventions is limited in other care settings. Summary Formulary restrictions and conducting prospective audit and feedback (PAF) are mainstays of antimicrobial stewardship. A PAF program targeted specifically at fluoroquinolone use was implemented in the Federal Bureau of Prisons (FBOP), in addition to exclusionary formulary restrictions on ciprofloxacin and levofloxacin. After implementation of these interventions, overall fluoroquinolone orders per 1,000 adults in custody (AICs) were reduced by 46.4% (P &amp;lt; 0.0001). The majority of PAF interventions addressed situations in which an antibiotic was unnecessary or a fluoroquinolone was not the recommended first-line agent. Over the same time period, nonformulary approval rates for ciprofloxacin and levofloxacin averaged 62%. Conclusion The interventions from this program provide data supporting the effectiveness of formulary changes and PAF for antimicrobial stewardship in a nontraditional care setting.

Alexander Brorby

Holly Herring

Evan Williams

Antimicrobial stewardship in the Federal Bureau of Prisons: Combining prospective audit and feedback with formulary changes to reduce inappropriate fluoroquinolone use

联邦监狱管理局的抗菌药物管理：结合前瞻性审核与反馈及处方集变更以减少不适当的氟喹诺酮类药物使用

Callahan Schlueter

Emilija Stojova

Elizabeth Rozycki

Gregory Eisinger

Jaelyn Westfield

Mary Beth Shirk

Effectiveness of rasburicase 4.5 mg in the treatment of tumor lysis syndrome–related hyperuricemia

拉布立酶4.5 mg治疗肿瘤溶解综合征相关高尿酸血症的有效性

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Megan Walters Fortenberry

Pediatric obesity and treatment controversies: Is the use of medications too good to be true?

儿童肥胖与治疗争议：药物使用是否过于美好以至于不真实？

Abbreviation	Am. J. Health. Syst. Pharm.
Journal Impact	1.90
Quartiles(Global)	PHARMACOLOGY & PHARMACY(Q3)

ISSN	1079-2082, 1535-2900
h-index	107

Publication Information	Publisher: American Society of Health-Systems Pharmacy，Publishing cycle: Semimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1995，Proportion of original research papers: 86.73%，Self Citation Rate:14.30%， Gold OA Rate: 10.97%
Average review cycle	网友分享经验：一般,3-8周
Average recruitment ratio	网友分享经验：容易

American Journal of Health-System Pharmacy

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