InpharmD™





One touch literature search.

So you can spend more time with patients

Ask any clinical question, receive a curated response.

Get Started Free

Trusted by 20,000+ physicians, nurse practitioners, physician assistants, and pharmacists.

                     

Play Circle

Learn about InpharmD™ in under 90 seconds

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.)


82,046

Clinical Pharmacist Hours Saved

4x +

ROI

100%

Clinical Pharmacist Satisfaction Rate

This is how InpharmD™ transforms LITERATURE.

What's Being Asked...

Is there any evidence in using Humira for treating CRMO in pediatric population?
Are there any specific oral fluid hydration protocols for hospitalized patients and surgical patients?
What is the data for maximum fluid rates for papaverine containing fluids in pediatrics patients?
Is there any evidence to support the use of a green tea supplement (not in tea/brewed form, but as capsule or tablet)...
What are shortage alternatives for Clinisol 15%?

What would you like to ask InpharmD™?

InpharmD™'s Answer GPT's Answer

Author: Brenda Nguyen, PharmD, BCPS + InpharmD™ AI

INTRODUCTION BY INPHARMD™ RESEARCHER

Several retrospective studies and case reports suggest that the anti-TNF biologic therapy adalimumab can be an effective treatment option for CRMO, particularly in cases refractory to conventional treatments such as NSAIDs, corticosteroids, and bisphosphonates. These reports describe successful management of refractory CNO/CRMO cases with adalimumab after failure of other medications, with improvement in symptoms, normalization of inflammatory markers, and radiographic resolution of bone lesi...

Many retrospective studies in recent years have included patients with chronic nonbacterial osteomyelitis/chronic recurrent multifocal osteomyelitis (CRMO) treated with adalimumab. A 2021 retrospective study investigated the dual diagnosis of inflammatory bowel disease (IBD) and CRMO in patients at a children's hospital over 10 years. Most patients were diagnosed with IBD first before later being diagnosed with CRMO. At the time of CRMO diagnosis, some patients' IBD treatment included sulfasalazine, infliximab, or adalimumab. One patient started on subcutaneous methotrexate for CRMO was also started on adalimumab due to ongoing IBD symptoms, with both diseases well controlled on weekly methotrexate and adalimumab. Another patient was started on adalimumab for treatment of both CRMO and IBD, with both conditions well controlled since. The authors conclude that biologics like adalimumab can be used for effective treatment of both conditions while reducing the medication burden of the ...

READ MORE→

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

Is there any evidence for use of Humira (adalimumab) to treat chronic recurrent multifocal osteomyelitis (CRMO)?

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

READ MORE→

[1] Dushnicky MJ, Beattie KA, Cellucci T, et al. Pediatric Patients with a Dual Diagnosis of Inflammatory Bowel Disease and Chronic Recurrent Multifocal Osteomyelitis. J Pediatr Gastroenterol Nutr. 2021;73(5):626-629. doi:10.1097/MPG.0000000000003225
[2] Girschick H, Finetti M, Orlando F, et al. The multifaceted presentation of chronic recurrent multifocal osteomyelitis: a series of 486 cases from the Eurofever international registry. Rheumatology (Oxford). 2018;57(7):1203-1211. doi:10.1093/rheumatology/key058

InpharmD™'s Answer GPT's Answer

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

INTRODUCTION BY INPHARMD™ RESEARCHER

Published guidance regarding oral fluid hydration in non-surgical patients recommend oral hydration when patients are presenting with mild dehydration and able to tolerate oral intake (see Table 4). Guidance on oral hydration for surgery patients are tailored to the pre- and postoperative period, with a general consensus on intake of clear fluids up to 2 h prior to procedure, and immediate return to oral fluids when tolerated post-surgery (see Tables 1-3 for fluid recommendations).

A 2019 review evaluated the latest evidence on perioperative fluid therapy for major surgery, focusing on the optimal type and volume of fluids administered. Preoperative fluid management aims to prevent hypovolemia or dehydration before surgery. Guidelines from the American Society of Anesthesiologists recommend unrestricted intake of clear fluids up to 2 hours prior to elective procedures. This is supported by a meta-analysis showing reduced aspiration risk with clear liquid intake compared to overnight fasting. Natural saliva and gastric secretions contribute 500 to 1,250 mL of fluid after an 8-hour fast, and allowing clear fluids dilute gastric acidity, enhancing comfort and safety without increasing gastric volume. Some guidelines have shifted from “allow” to “encourage” clear fluids, though this needs further validation. Clear liquids include water, fruit juice (without pulp), carbonated drinks, and black coffee. Enhanced Recovery After Surgery (ERAS) protocols often include c...

READ MORE→

A search of the published medical literature revealed 4 studies investigating the researchable question:

Are there any specific oral fluid hydration protocols for hospitalized patients and surgical patients?

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

READ MORE→

[1] Miller TE, Myles PS. Perioperative Fluid Therapy for Major Surgery. Anesthesiology. 2019;130(5):825-832. doi:10.1097/ALN.0000000000002603
[2] Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017;126(3):376-393. doi:10.1097/ALN.0000000000001452
[3] Thiele R...

InpharmD™'s Answer GPT's Answer

Author: Hoda Abbasi, PharmD, BCPS + InpharmD™ AI

INTRODUCTION BY INPHARMD™ RESEARCHER

There is a paucity of data evaluating maximum papaverine-containing fluid infusion rates in the pediatric population. Two identified studies evaluated the use of papaverine for peripheral arterial catheter patency in pediatric patients, with no defined infusion rates (see Tables 1 and 2). Expert opinion recommends an infusion rate of ≤1 mL/hour for papaverine-containing solutions, however, clinical evidence to support this recommendation could not be identified.

Papaverine, an opium alkaloid, is a potent vasodilator and antispasmodic commonly used for the management of vascular spasms or cardiac extrasystole either as an intravenous (IV) bolus or intramuscular injection in adult patients. Although clinical evidence for papaverine use is limited in pediatric populations, a 2008 review of papaverine discussed the pharmacology, dosing, and evidence for use in peripheral arterial lines for neonatal treatment. Papaverine continuous IV infusions have been utilized to manage peripheral arterial catheter (PAC) patency, reducing catheter failure risk and increasing the duration of catheter function; catheter failure is associated with vasospasm events, resulting in an inability to draw blood or drip from PAC. Despite the overall clinical benefit for catheter retention, papaverine use in premature infants within the first few days following birth should be administered with caution as these patients are at a heightened risk for intraventricular hemor...

READ MORE→

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

What is the data for maximum fluid rates for papaverine containing fluids in pediatrics patients?

Level of evidence
D - Case reports or unreliable data  

READ MORE→

[1] Bell SG. Use of a papaverine solution in peripheral arterial lines. Neonatal Netw. 2008;27(1):65-66. doi:10.1891/0730-0832.27.1.65
[2] Panigrahy N, Kumar PP, Chirla DK, Vennapusa SR. Papaverine for Ischemia Following Peripheral Arterial Catheterization in Neonates. Indian Pediatr. 2016;53(2):169.

InpharmD™'s Answer GPT's Answer

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

INTRODUCTION BY INPHARMD™ RESEARCHER

The majority of data exploring the impact of green tea on breast cancer is limited to its consumption as a drink and literature specific to green tea supplements given in capsule/tablet form is lacking. One randomized trial utilized green tea extract, administered as four daily decaffeinated capsules, to assess potential chemoprotective effects via ​​mammographic density after 12 months, finding no significant effects. Thus, no conclusive evidence could be identified to support the use of gre...

Green tea has attracted significant research interest over the past few decades for its potential health benefits, particularly its anti-cancer properties. A 2014 review article discusses various epidemiological studies that examine the relationship between green tea consumption and breast cancer prevention. Initial findings from a 1997 study indicated that increased green tea intake may reduce breast cancer risk, especially among women consuming over ten cups daily. Subsequent meta-analyses have also explored this association. A 2010 meta-analysis assessed two studies on breast cancer recurrence and seven on breast cancer incidence and suggested that heavy green tea drinkers (>3 cups daily) had a non-significant 27% reduction in recurrence rate and a statistically significant 19% reduction in breast cancer incidence. However, cohort studies did not demonstrate a significant association with breast cancer incidence. Additional evidence suggests that green tea may have enhanced prote...

READ MORE→

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

Is there any evidence to support use of green tea capsule or tablet supplement or extracts for reduction in breast cancer recurrence rates?

Level of evidence
X - No data  

READ MORE→

[1] Li MJ, Yin YC, Wang J, Jiang YF. Green tea compounds in breast cancer prevention and treatment. World J Clin Oncol. 2014;5(3):520-528. doi:10.5306/wjco.v5.i3.520
[2] Ogunleye AA, Xue F, Michels KB. Green tea consumption and breast cancer risk or recurrence: a meta-analysis. Breast Cancer Res Treat. 2010;119(2):477-484. doi:10.1007/s10549-009-0415-0
[3] Gianfredi V, Nucci D, Abalsamo A, et al. Green Tea Consumption and Risk of Breast Cancer and Recurrence-A Systematic Review and Meta-Analysis of Observational Studies. Nutrients. 2018;10(12):1886. Published 2018 Dec 3. doi:10.3390/nu101...

InpharmD™'s Answer GPT's Answer

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

INTRODUCTION BY INPHARMD™ RESEARCHER

A comprehensive literature search did not identify any comparative studies on therapeutic alternatives for Clinisol 15% sulfate-free parenteral nutrition solution. According to the American Society of Health-system Pharmacists (ASHP), several products are listed as available options, including Aminosyn II 10%, Plenamine 15%, and Travasol 10%, but there is no evidence to suggest they are interchangeable with Clinisol 15%. One source lists certain amino acid solutions as therapeutically equival...

Per the American Society of Health-System Pharmacists (ASHP) current drug shortage database, Baxter has the Clinisol 15% injection (sulfite-free) on shortage due to manufacturing delays. The panel has listed the following products as available options, but did not make any comments regarding their interchangeability with Clinisol 15%: Aminosyn II (sulfite-free) injection 10%, Aminosyn II (sulfite-free) injection 15%, Plenamine injection 15%, Premasol (sulfite-free) injection 10%, Prosol (sulfite-free) injection 20%, Travasol injection 10%, and TrophAmine injection 10%. It was stated that Baxter has 15% Clinisol 500 mL containers available in limited supply. While the American Society for Parenteral and Enteral Nutrition (ASPEN) guidelines provide general recommendations for managing shortages of parenteral nutrition products, no specific substitutions for any product were suggested. [1,2] A 2018 paper presented at the National Home Infusion Association annual conference provides s...

READ MORE→

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

What are shortage alternatives for Clinisol 15%?

Level of evidence
X - No data  

READ MORE→

[1] American Society of Health-System Pharmacists (ASHP). Current Drug Shortages. Amino acid products. Updated September 6, 2024. Accessed October 2, 2024. https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=564&loginreturnUrl=SSOCheckOnly
[2] American Society for Parenteral and Enteral Nutrition (ASPEN). Parenteral Nutrition Amino Acids Product Shortage Considerations. Updated April 20, 2016. Accessed October 2, 2024. https://www.nutritioncare.org/News/General_News/Parenteral_Nutrition_Amino_Acids_Product_Shortage_Considerations/
[3] Rollins CJ. Surviving s...

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., APP, 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., APP, 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 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.


     

Wow. . Just wow.


     

Answers are evidence based and help me make clinical decisions. Quick turn around time for some urgent questions.


     

Was bragging about you and your outstanding business the other day while on vacation. I recently used your service and was blown away at how fast and thorough I got your response


     

It would be helpful to provide a discussion of the questions frequently submitted to InpharmD. Other than that it is excellent, please keep it up!


     

A must have resource for evidence based medicine!


     

All information provided is up to date.


     

Provides a good summary of information with citations.


     

Answers clinically relevant questions with quick responses.


     

The review of evidence provided is excellent.


     

I find the vaccination guideline information the most useful.


     

The tables provided from the studies used to formulate the responses are very helpful for review.


     

It is helpful that InpharmD provides indications to treat adverse effects of various drugs in similar classes.


What would you like to ask InpharmD™?

Sign up for a free trial & start right away.

Get Started Free