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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.)


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This is how InpharmD™ transforms LITERATURE.

What's Being Asked...

What literature exists that looks at efficacy of infliximab for the treatment of acute severe ulcerative colitis and ...
Can KCentra be used in patients with HIT history?
IV azithromycin is on shortage. Is there any literature available to support alternative pre-op antibiotics (such as ...
What is the recommended dose of epinephrine IM for anaphylaxis, along with evidence to support this dosing?
Please send some peer-review (preferred) articles that demonstrate financial and clinical impacts of clinical pharmac...

What would you like to ask InpharmD™?

InpharmD's Answer GPT's Answer

Author:AJ Carvajal, PharmD, BCPS + InpharmD™ AI LEARN MORE 

The available literature consistently suggests that low serum albumin in acute severe ulcerative colitis and broader inflammatory bowel disease populations is identified as a predictor of increased infliximab clearance, reduced serum drug exposure, and higher risk of treatment failure, including colectomy. However, the evidence base is largely derived from retrospective cohorts, post hoc analyses, and pharmacokinetic modeling studies rather than prospective randomized trials specifically enro...

Available tertiary literature consistently supports hypoalbuminemia as a clinically relevant marker of increased infliximab clearance and reduced drug exposure in acute severe ulcerative colitis (ASUC). Hindryckx et al. describe enhanced infliximab clearance in ASUC driven by inflammatory burden, fecal drug loss, and impaired Fc receptor recycling, with low serum albumin functioning as a surrogate of protein-losing enteropathy and high-clearance states. Fiske et al. further emphasize that albumin < 35 g/L, particularly when accompanied by CRP > 50 mg/L, identifies patients at risk for underexposure, and that the 2019 British Society of Gastroenterology (BSG) guideline similarly recognizes CRP > 50 mg/L and albumin < 35 g/L as high-risk features in which accelerated induction (e.g., 5 mg/kg at weeks 0, 1, and 3 rather than 0, 2, and 6) may be considered. Gordon and Battat provide the most quantitative synthesis, reporting that low albumin is independently associated with increased in...

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

What literature exists that looks at efficacy of infliximab for the treatment of acute severe ulcerative colitis and Crohn's disease in patients with low albumin?

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

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[1] Hindryckx P, Novak G, Vande Casteele N, et al. Review article: dose optimization of infliximab for acute severe ulcerative colitis. Aliment Pharmacol Ther. 2017;45(5):617-630. doi:10.1111/apt.13913
[2] Gordon BL, Battat R. Therapeutic Drug Monitoring of Infliximab in Acute Severe Ulcerative Colitis. J Clin Med. 2023;12(10):3378. Published 2023 May 10. doi:10.3390/jcm12103378
[3] Fiske J, Conley T, Sebastian S, Subramanian S. Infliximab in acute severe colitis: getting the right dose. Frontline Gastroenterol. 2020;11(6):427-429. Published 2020 Apr 3. doi:10.1136/flgastro-2020-101407
[4] Lamb CA, Kennedy NA, Raine T, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut. 2019;68(Suppl 3):s1-s106. doi:10.1136/gutjnl-2019-318484

InpharmD's Answer GPT's Answer

Author:Leah Mueller, PharmD, BCPS + InpharmD™ AI LEARN MORE 

Four-factor prothrombin complex concentrate (4F-PCC) is generally not recommended in patients with a history of heparin-induced thrombocytopenia (HIT) because it contains heparin and is specifically contraindicated in individuals with known HIT. HIT is a prothrombotic immune-mediated reaction, and major guidelines emphasize strict avoidance of heparin exposure, particularly within the first three months after diagnosis when recurrence risk is highest. In addition, observational data with 4F-P...

The 2018 American Society of Hematology (ASH) guidelines by provide evidence-based recommendations for the diagnosis and management of heparin-induced thrombocytopenia (HIT), a prothrombotic immune-mediated adverse drug reaction caused by antibodies directed against platelet factor 4 (PF4)–heparin complexes. The guidelines outline management strategies across the five phases of HIT, including acute, subacute (A and B), and remote HIT. In patients with acute HIT, the panel recommends discontinuation of heparin and initiation of a non-heparin anticoagulant. For patients with remote HIT who require venous thromboembolism (VTE) treatment or prophylaxis, the panel recommends administration of a non-heparin anticoagulant rather than unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH). In procedural settings such as cardiovascular surgery, intraoperative heparin may be considered in patients with subacute HIT B or remote HIT, but exposure should be limited to the intraopera...

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A search of the published medical literature revealed 2 studies investigating the researchable question:

Can KCentra be used in patients with HIT history?

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

READ MORE→

[1] Cuker A, Arepally GM, Chong BH, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia. Blood Adv. 2018;2(22):3360-3392. doi:10.1182/bloodadvances.2018024489
[2] Linkins LA, Dans AL, Moores LK, et al. Treatment and prevention of heparin-induced thrombocytopenia: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e495S-e530S. doi:10.1378/chest.11-2303
[3] Warkentin TE, Greinacher A, Koster A, Lincoff AM. Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(6 Suppl):340S-380S. doi:10.1378/chest.08-0677
[4] Tanaka KA, Shettar S, Vandyck K, Shea SM, Abuelkasem E. Roles of Four-Factor Prothrombin Complex Concentrate in the Management of Critical Bleeding. Transfus Med Rev. 2021;35(4):96-103. doi:10.1016/j.tmrv.2021.06.007
[5] Sin JH, Berger K, Lesch CA. Four-factor prothrombin complex concentrate for life-threatening bleeds or emergent surgery: A retrospective evaluation. J Crit Care. 2016;36:166-172. doi:10.1016/j.jcrc.2016.06.024

InpharmD's Answer GPT's Answer

Author:zophia@inpharmd.com, PharmD, BCPS + InpharmD™ AI LEARN MORE 

There is limited literature describing alternative preoperative antibiotics to IV azithromycin for women undergoing cesarean delivery. The American College of Obstetricians and Gynecologists (ACOG) recommends a single dose of IV azithromycin for unplanned cesarean delivery but does not provide alternatives in cases of allergy, intolerance, or drug shortage. While ACOG and the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommend erythromycin in other obstetric contexts, such ...

The 2018 American College of Obstetricians and Gynecologists (ACOG) guidance on the use of prophylactic antibiotics in labor and delivery recommend that antibiotic prophylaxis is appropriate for all cesarean deliveries, unless the patient is already receiving an antibiotic regimen with equivalent broad-spectrum coverage, such as for chorioamnionitis. Prophylaxis should be administered within 60 minutes before the start of the cesarean delivery, or as soon as possible if emergent circumstances prevent preincision administration. First-line therapy is a single intravenous dose of cefazolin, with 1 g recommended for women weighing ≤80 kg and 2 g for women >80 kg. Single-dose therapy is generally as effective as multidose therapy, while reducing cost, toxicity, and the risk of colonization with resistant organisms. For patients with severe penicillin or cephalosporin allergies (anaphylaxis, angioedema, respiratory distress, or urticaria), a single-dose combination of clindamycin with an...

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A search of the published medical literature revealed 2 studies investigating the researchable question:

IV azithromycin is on shortage. Is there any literature available to support alternative pre-op antibiotics (such as erythromycin) for laboring women undergoing C-sections? Is there a role for PO azithromycin instead of IV azithromycin?

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

READ MORE→

[1] Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 199: Use of Prophylactic Antibiotics in Labor and Delivery. Obstet Gynecol. 2018;132(3):e103-e119. doi:10.1097/AOG.0000000000002833
[2] van Schalkwyk J, Van Eyk N. No. 247-Antibiotic Prophylaxis in Obstetric Procedures. J Obstet Gynaecol Can. 2017;39(9):e293-e299. doi:10.1016/j.jogc.2017.06.007
[3] Sanchez-Ramos L, Preis R, Romero R. Prophylactic antibiotics to prevent postcesarean infection: which antimicrobial, when, how, and why?. Am J Obstet Gynecol. 2026;233(6S):S483-S503. doi:10.1016/j.ajog.2025.09.044
[4] Antonucci R, Cuzzolin L, Locci C, Dessole F, Capobianco G. Use of Azithromycin in Pregnancy: More Doubts than Certainties. Clin Drug Investig. 2022;42(11):921-935. doi:10.1007/s40261-022-01203-0
[5] Tita ATN, Carlo WA, McClure EM, et al. Azithromycin to Prevent Sepsis or Death in Women Planning a Vaginal Birth. N Engl J Med. 2023;388(13):1161-1170. doi:10.1056/NEJMoa2212111
InpharmD's Answer GPT's Answer

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

Intramuscular epinephrine is the first line treatment for anaphylaxis, with guidelines consistently recommending a dose of 0.01 mg/kg using the 1 mg/mL (1:1000) concentration, administered into the mid anterolateral thigh. Maximum single doses are 0.3 mg in prepubertal children and 0.5 mg in adolescents and adults, with repeat dosing every 5 to 15 minutes for persistent or recurrent symptoms. This dosing strategy is supported by multiple international guidelines, including those from the Amer...

A 2020 Chinese guideline on the emergency management of anaphylactic reactions aimed to provide evidence-based recommendations for the emergency management of anaphylaxis. The recommended dose of intramuscular (IM) epinephrine is 0.01 mg/kg, with a maximum dose of 0.5 mg for patients aged 14 years and older, and a maximum of 0.3 mg for patients under 14 years. The concentration used should be 1 mg/mL (1:1000), consistent with commercial preparations. If there is no response, repeat dosing is suggested every 5 to 15 minutes, as strongly recommended by clinical guidelines. A systematic review did not find any randomized controlled trials (RCTs) evaluating different doses of epinephrine, but four clinical guidelines support the recommended dosage and concentration. Additionally, six guidelines advise on the 5 to 15-minute intervals for repeated doses. This dosing protocol has been longstanding, supported by safety data, with the Tmax for IM epinephrine reported as 8 ± 2 minutes, which ...

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

What is the recommended dose of epinephrine IM for anaphylaxis, along with evidence to support this dosing?

Level of evidence
A - Multiple high-quality studies with consistent results  

READ MORE→

[1] Li X, Ma Q, Yin J, et al. A Clinical Practice Guideline for the Emergency Management of Anaphylaxis (2020). Front Pharmacol. 2022;13:845689. Published 2022 Mar 28. doi:10.3389/fphar.2022.845689
[2] Panchal AR, Bartos JA, Cabañas JG, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020;142(16_suppl_2):S366-S468. doi:10.1161/CIR.0000000000000916
[3] Gaudio FG, Johnson DE, DiLorenzo K, et al. Wilderness Medical Society Clinical Practice Guidelines on Anaphylaxis. Wilderness Environ Med. 2022;33(1):75-91. doi:10.1016/j.wem.2021.11.009
[4] Golden DBK, Wang J, Waserman S, et al. Anaphylaxis: A 2023 practice parameter update. Ann Allergy Asthma Immunol. 2024;132(2):124-176. doi:10.1016/j.anai.2023.09.015
[5] Sicherer SH, Simons FER. Epinephrine for First-aid Management of Anaphylaxis. Pediatrics. 2017;139(3):e20164006. doi:10.1542/peds.2016-4006
[6] Casale TB, Burks AW. Clinical practice. Hymenoptera-sting hypersensitivity. N Engl J Med. 2014;370(15):1432-1439. doi:10.1056/NEJMcp1302681
[7] Morriello F, Chapman M. Epinephrine in anaphylaxis. CMAJ. 2023;195(19):E683. doi:10.1503/cmaj.221319
InpharmD's Answer GPT's Answer

Author:Kevin Shin, PharmD, BCPS + InpharmD™ AI LEARN MORE 

There is an extensive body of ambulatory care literature evaluating the impact of clinical pharmacists providing comprehensive medication management (CMM) or medication therapy management (MTM), although reported economic and utilization outcomes are heterogeneous. Pharmacist-led medication review in ambulatory clinics is consistently associated with improved identification and resolution of drug-related problems, reductions in potentially inappropriate medications, and modest decreases in to...

A 2019 review evaluates health economics evidence based on 11 randomized controlled trials of pharmacist-led medication review in pharmacotherapy managed cardiovascular disease risk factors, specifically hypertension, type-2 diabetes mellitus, and dyslipidemia, in ambulatory settings. Among 5 US-based studies conducted from 2001 to 2016, pharmacist-led interventions primarily consisted of a medication review with adherence counseling and a face-to-face interview with patients during follow-ups. Economic evaluations included cost-effectiveness, third payer, societal, and cost-utility. All studies conducted in the US reported favorable outcomes in blood pressure improvements, life years gained, quality-adjusted life year (QALY), or refill adherence, with life year incremental costs from individual studies ranging from $49.73 per patient to $432.1 per patient. The corresponding incremental cost-effectiveness ratio was determined to be ​​$59.76 per QALY (one study), $1.66 per mmHg to $4...

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A search of the published medical literature revealed 23 studies investigating the researchable question:

Please send some peer-review (preferred) articles that demonstrate financial and clinical impacts of clinical pharmacists providing Comprehensive Medication Management (CMM) or medication therapy management (MTM) in ambulatory clinics.

Level of evidence
A - Multiple high-quality studies with consistent results  

READ MORE→

[1] Ahumada-Canale A, Quirland C, Martinez-Mardones FJ, Plaza-Plaza JC, Benrimoj S, Garcia-Cardenas V. Economic evaluations of pharmacist-led medication review in outpatients with hypertension, type 2 diabetes mellitus, and dyslipidaemia: a systematic review. Eur J Health Econ. 2019;20(7):1103-1116. doi:10.1007/s10198-019-01080-z
[2] Viswanathan M, Kahwati LC, Golin CE, et al. Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis. JAMA Intern Med. 2015;175(1):76-87. doi:10.1001/jamainternmed.2014.5841
[3] Bou Malham C, El Khatib S, Cestac P, Andrieu S, Rouch L, Salameh P. Impact of pharmacist-led interventions on patient care in ambulatory care settings: A systematic review. Int J Clin Pract. 2021;75(11):e14864. doi:10.1111/ijcp.14864
[4] Kassis A, Moles R, Carter S. Stakeholders' perspectives and experiences of the pharmacist's role in deprescribing in ambulatory care: A qualitative meta-synthesis. Res Social Adm Pharm. 2024;20(8):697-712. doi:10.1016/j.sapharm.2024.04.014
[5] Hawes EM, Misita C, Burkhart JI, et al. Prescribing pharmacists in the ambulatory care setting: Experience at the University of North Carolina Medical Center. Am J Health Syst Pharm. 2016;73(18):1425-1433. doi:10.2146/ajhp150771
[6] Shaya FT, Chirikov VV, Rochester C, Zaghab RW, Kucharski KC. Impact of a comprehensive pharmacist medication-therapy management service. Journal of Medical Economics. 2015;18(10):828-837. doi:10.3111/13696998.2015.1052463
[7] Heaton PC, Frede S, Kordahi A, et al. Improving care transitions through medication therapy management: A community partnership to reduce readmissions in multiple health-systems. J Am Pharm Assoc (2003). 2019;59(3):319-328. doi:10.1016/j.japh.2019.01.005
[8] Budlong H, Brummel A, Rhodes A, Nici H. Impact of Comprehensive Medication Management on Hospital Readmission Rates. Popul Health Manag. 2018;21(5):395-400. doi:10.1089/pop.2017.0167
[9] Wright EA, Graham JH, Maeng D, et al. Reductions in 30-day readmission, mortality, and costs with inpatient-to-community pharmacist follow-up. J Am Pharm Assoc (2003). 2019;59(2):178-186. doi:10.1016/j.japh.2018.11.005
[10] Gernant SA, Snyder ME, Jaynes H, Sutherland JM, Zillich AJ. The Effectiveness of Pharmacist-Provided Telephonic Medication Therapy Management on Emergency Department Utilization in Home Health Patients. J Pharm Technol. 2016;32(5):179-184. doi:10.1177/8755122516660376
[11] Hui RL, Yamada BD, Spence MM, Jeong EW, Chan J. Impact of a Medicare MTM program: evaluating clinical and economic outcomes. Am J Manag Care. 2014;20(2):e43-e51. Published 2014 Feb 1.
[12] El-Deyarbi M, Ahmed L, King J, et al. The effects of multifactorial pharmacist-led intervention protocol on medication optimisation and adherence among patients with type 2 diabetes: A randomised control trial. F1000Res. 2024;13:493. Published 2024 Sep 16. doi:10.12688/f1000research.146517.2
[13] Jay JS, Ijioma SC, Holdford DA, Dixon DL, Sisson EM, Patterson JA. The cost-effectiveness of pharmacist-physician collaborative care models vs usual care on time in target systolic blood pressure range in patients with hypertension: a payer perspective. J Manag Care Spec Pharm. 2021;27(12):1680-1690. doi:10.18553/jmcp.2021.27.12.1680

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.


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