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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.

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This is how InpharmD™ transforms LITERATURE.

What's Being Asked...

Is there any data or published reports to support use of Fetroja in pediatric patients?
What is the preparation for IV push administration of valproate sodium for off-label use in migraines?
What literature is available surrounding inebilizumab and satralizumab for neuromyelitis optica spectrum disorder (MM...
What evidence is available regarding impact of azithromycin (IV or PO) on gastric emptying?
What evidence is there for use of doses > 5 mg of tadalafil for treatment of BPH?

What would you like to ask InpharmD™?

InpharmD's Answer GPT's Answer

Author:Tai Huynh, PharmD, BCPS + InpharmD™ AI

INTRODUCTION BY INPHARMD™ RESEARCHER

Data supporting the use of Fetroja (cefiderocol) in pediatric patients are primarily limited to case reports, case series, and small trials. While two recent trials (one published, one ongoing) are evaluating cefiderocol in hospitalized pediatric patients, their primary endpoints focus on safety and pharmacokinetic measures rather than clinical efficacy. Nonetheless, available case series and reports have documented the successful use of cefiderocol for various multi-drug resistant (MDR) gram...

A recent 2025 review compiled panel recommendations for suggested dosing of beta-lactam antibiotics for treatment of antimicrobial-resistant gram negative infections in children. These pediatric dosing regimens are primarily based on a recent pharmacokinetic study conducted in children from birth to age < 18 years (Table 1). The dosing utilized in this study is predicted to achieve over 90% PTA for 75% fT > MIC for organisms with MICs of up to 4 µg/mL. Clinical data demonstrating the use of cefiderocol in children is limited to case reports and case series, which generally utilized a dose of 60 mg/kg Q8 hours (maximum dose 2 g). One case report used a 40 mg/kg dose Q8 hours in a 5-week-old infant. Ultimately, panel recommendations based on the limited data also reiterate the 60 mg/kg dose (maximum dose 2 g) given IV Q8 hours, with infusions over 3 hours in children ≥ 3 months to < 18 years of age. Cefiderocol is considered a reasonable option for treatment of gram-negative central n...

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A search of the published medical literature revealed 6 studies investigating the researchable question:

Is there any evidence to support the use of cefiderocol in pediatric patients?

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

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[1] Lockowitz CR, Hsu AJ, Chiotos K, et al. Suggested Dosing of Select Beta-lactam Agents for the Treatment of Antimicrobial-Resistant Gram-Negative Infections in Children. J Pediatric Infect Dis Soc. 2025;14(2):piaf004. doi:10.1093/jpids/piaf004
[2] Venuti F, Romani L, De Luca M, et al. Novel Beta Lactam Antibiotics for the Treatment of Multidrug-Resistant Gram-Negative Infections in Children: A Narrative Review. Microorganisms. 2023;11(7):1798. Published 2023 Jul 13. doi:10.3390/microorganisms11071798
[3] Olney KB, Thomas JK, Johnson WM. Review of novel β-lactams and β-lactam/β-lactamas...
InpharmD's Answer GPT's Answer

Author:Dena Homayounieh, PharmD, BCPS + InpharmD™ AI

INTRODUCTION BY INPHARMD™ RESEARCHER

The overall data on IV push administration of valproate sodium for acute migraine is limited. Reported regimens include 400 to 1,000 mg diluted in 50 to 150 mL of normal saline, administered over 2 to 20 minutes. Although IV push over 3-5 minutes has been used for lower doses, slower administration is generally preferred to reduce adverse effects.

According to the American Headache Society guideline on the management of adults with acute migraine in the emergency department (ED) and based on four randomized controlled trials (RCTs), intravenous (IV) valproic acid 500-1,000 mg may deem to be an effective dose with minimal adverse events. However, it is not to be used as first-line therapy as other treatments have been shown to be more effective. [1] A systematic review from the American Headache Society suggests that intravenous valproic acid has been shown to be effective as an acute treatment therapy for pediatric migraines. This recommendation is based on a retrospective review and a case series. The retrospective review included 31 children (mean age of 15 ± 2 years) who received 1,000 mg of IV valproic acid, with 6 (19%) requiring an extra 500 mg bolus of valproic acid. Pediatric patients who received one dose achieved a 40% reduction in pain, with a time to maximum relief of 63 ± 31 minutes. A limitation was that the ...

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A search of the published medical literature revealed 8 studies investigating the researchable question:

What is the optimal dosing regimen and supporting evidence for using valproate sodium intravenously for the treatment of acute migraines?

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

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[1] Orr SL, Friedman BW, Christie S, et al. Management of adults with acute migraine in the emergency department: The American Headache Society evidence assessment of parenteral pharmacotherapies. Headache. 2016;56(6):911-940.
[2] Patniyot IR, Gelfand AA. Acute treatment therapies for pediatric migraine: A qualitative systematic review. Headache. 2016;56(1):49-70.
[3] Frazee LA, Foraker KC. Use of intravenous valproic acid for acute migraine. Ann Pharmacother. 2008;42(3):403-407.
[4] Wang F, Zhang H, Wang L, Cao Y, He Q. Intravenous sodium valproate for acute migraine in the emergency de...
InpharmD's Answer GPT's Answer

Author:Naveed Aijaz, PharmD, BCPS + InpharmD™ AI

INTRODUCTION BY INPHARMD™ RESEARCHER

Neuromyelitis optica spectrum disorder (NMOSD) is a distinct inflammatory and demyelinating condition affecting the central nervous system, predominantly targeting the optic nerves and spinal cord and potentially leading to severe relapses. Inebilizumab-cdon (UPLIZNA®), a CD19-directed cytolytic antibody, and satralizumab-mwge (ENSPRYNG®), an interleukin-6 receptor antagonist, are approved for the treatment of NMOSD in patients who are anti-aquaporin-4 (AQP4) antibody positive and have been s...

A 2024 review article analyzed the pathophysiological mechanisms underlying neuromyelitis optica spectrum disorder (NMOSD), focusing on the association between NMOSD and the presence of autoantibodies against aquaporin-4 (AQP4), examining the resulting astrocyte dysfunction and demyelination processes. NMOSD is a distinct inflammatory and demyelinating condition affecting the central nervous system, predominantly targeting the optic nerves and spinal cord, potentially leading to severe relapses with only partial recovery, distinguishing it from conditions like multiple sclerosis. AQP4 and its isoforms play a critical role in this pathophysiology, aggregating in orthogonal arrays of particles essential for maintaining water homeostasis and neuronal function. These isoforms act as binding targets for AQP4 autoantibodies, instigating complement-mediated inflammatory responses that culminate in water influx, necrosis, and axonal damage. AQP4 autoantibodies contribute to disease pathogen...

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A search of the published medical literature revealed 3 studies investigating the researchable question:

What literature is available surrounding inebilizumab and satralizumab for neuromyelitis optica spectrum disorder (MMOSD)?

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

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[1] Mireles-Ramírez MA, Pacheco-Moises FP, González-Usigli HA, et al. Neuromyelitis optica spectrum disorder: pathophysiological approach. Int J Neurosci. 2024;134(8):826-838. doi:10.1080/00207454.2022.2153046
[2] Frampton JE. Inebilizumab: First Approval. Drugs. 2020;80(12):1259-1264. doi:10.1007/s40265-020-01370-4
[3] ClinicalTrials.gov. Myasthenia Gravis Inebilizumab Trial (MINT). Available https://clinicaltrials.gov/ct2/show/NCT04524273. Accessed June 13, 2025.
[4] ClinicalTrials.gov. A Study of Inebilizumab Efficacy and Safety in IgG4-Related Disease. Available https://clinicaltrial...
InpharmD's Answer GPT's Answer

Author:Muna Said, PharmD, BCPS + InpharmD™ AI

INTRODUCTION BY INPHARMD™ RESEARCHER

Evidence regarding the clinical utility of azithromycin for the treatment of gastric emptying is sparse. While no high-quality comparative trials were identified, available data show that azithromycin demonstrates comparable efficacy to erythromycin for the treatment of gastric emptying, with a lower risk of cardiac arrhythmia development and QTc prolongation, in addition to a longer half-life and greater antral contractility in both pharmacokinetic and retrospective trials. The long-term saf...

Erythromycin has motilin receptor agonist activity, which improves gastric-emptying rates by stimulating enteric contractility. It causes pyloric relaxation and is a potent gastric-emptying stimulant. However, its use is limited by many drug interactions and adverse effects, including QT-interval prolongation. As a result, azithromycin has been studied as a potential alternative to erythromycin for treating gastroparesis because it has fewer adverse effects and drug interactions than erythromycin. [1] Azithromycin is assumed to have prokinetic characteristics similar to those of erythromycin. In one study, small-bowel manometric data of 30 patients with chronic digestive problems or documented refractory gastroparesis revealed that azithromycin and erythromycin has a similar effect on antral activity when the same dosage of 250 mg is administered intravenously (IV). Another study using gastric-emptying scintigraphy showed that azithromycin’s effect on accelerating gastric emptyin...

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A search of the published medical literature revealed 3 studies investigating the researchable question:

What evidence is available regarding impact of azithromycin (IV or PO) on gastric emptying?

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

READ MORE→

[1] Nguyen N. Controversies in Using IV Azithromycin to Treat Gastroparesis. US Pharm. 2014;39(12):HS13-HS17.
[2] Lacy BE, Tack J, Gyawali CP. AGA Clinical Practice Update on Management of Medically Refractory Gastroparesis: Expert Review. Clin Gastroenterol Hepatol. 2022;20(3):491-500. doi:10.1016/j.cgh.2021.10.038
[3] Camilleri M, Kuo B, Nguyen L, et al. ACG Clinical Guideline: Gastroparesis. Am J Gastroenterol. 2022;117(8):1197-1220. doi:10.14309/ajg.0000000000001874
[4] Liu N, Abell T. Gastroparesis Updates on Pathogenesis and Management. Gut Liver. 2017;11(5):579-589.
[5] Shakir AK...
InpharmD's Answer GPT's Answer

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

INTRODUCTION BY INPHARMD™ RESEARCHER

The available evidence does not strongly support the use of tadalafil doses >5 mg for treating BPH, due to the lack of data directly comparing between doses. While one urodynamic study suggested higher doses (e.g., 20 mg) were not associated with adverse effects, most meta-analyses found significant benefits only with the 5 mg dose, particularly for Qmax. Primarily literature observed a trend towards greater effects with higher doses, but robust efficacy and safety comparisons to confirm a be...

A 2015 systematic review and meta-analysis evaluated the clinical efficacy of phosphodiesterase type 5 inhibitors (PDE5-Is), including tadalafil, in the management of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), both with and without concurrent erectile dysfunction (ED). The analysis incorporated data from 16 randomized, double-blind, placebo-controlled trials to assess the various primary outcomes. Tadalafil 2.5 mg, 5 mg, 10 mg, and 20 mg were only assessed together for the outcome of maximum urinary flow rate (Qmax) in LUTS/BPH, which was found to not be statistically significant (effect estimate 0.22; mean difference -0.04 to 0.49; p= 0.10). There did not appear to be any further assessments for tadalafil doses > 5 mg. In contrast, the 5 mg dose of tadalafil alone significantly improved the Qmax (mean difference 0.33; p= 0.03). [1] Additionally, a 2013 meta-analysis synthesized data from eight randomized, double-blind, placebo-controll...

READ MORE→

A search of the published medical literature revealed 3 studies investigating the researchable question:

What evidence is there for use of doses over 5 mg of tadalafil for treatment of BPH?

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

READ MORE→

[1] Zhang LT, Park JK. Are phosphodiesterase type 5 inhibitors effective for the management of lower urinary symptoms suggestive of benign prostatic hyperplasia?. World J Nephrol. 2015;4(1):138-147. doi:10.5527/wjn.v4.i1.138
[2] Dong Y, Hao L, Shi Z, Wang G, Zhang Z, Han C. Efficacy and safety of tadalafil monotherapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia: a meta-analysis. Urol Int. 2013;91(1):10-18. doi:10.1159/000351405

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.


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


     

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


     

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