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This is how InpharmD™ transforms LITERATURE.

What's Being Asked...

is there a data for using carboplatin desensitization protocol?
Can you summarize any available studies or data on if GLP-1RAs can impact the absorption of other medications besides...
Is there literature supporting administration of metronidazole 2000 mg IV once for the treatment of Trichomoniasis?
What herbal/supplements can help treat Parkinson’s disease? Can these interact with sinemet?
What are recommended dosing strategies for ceftazidime, avycaz, and zerbaxa for VV ECMO assuming normal renal function

What would you like to ask InpharmD™?

InpharmD's Answer GPT's Answer

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

There exists a substantial and consistently reported body of evidence supporting the use of carboplatin desensitization protocols in patients with prior hypersensitivity reactions. The available literature is composed predominantly of retrospective cohort studies, single- and multi-institutional case series, and a limited number of observational experiences. These data are most robust in the settings of recurrent platinum-sensitive ovarian cancer, where continued exposure to carboplatin is of...

The 2022 American Academy of Allergy, Asthma & Immunology (AAAAI) and American College of Allergy, Asthma & Immunology (ACAAI) joint practice parameter update indicates that for patients with a history of immediate hypersensitivity reactions (HSRs) to platinum-based chemotherapeutic agents, the severity of the initial reaction and skin testing results can help guide risk stratification and management, though the overall certainty of evidence is low. Skin testing with platinum agents can help confirm allergy and identify patients who may not require desensitization, but false-negative results have been reported in up to 8-8.5% of cases, and reactions can still occur despite a negative test, particularly if the time since the initial HSR is short (less than six weeks) or long (greater than six months). Risk-stratification protocols using serial skin tests have been shown to safely differentiate allergic from nonallergic patients and reduce unnecessary desensitizations, although they i...

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A search of the published medical literature revealed 5 studies investigating the researchable question:

Is there any evidence supporting use of a carboplatin desensitization protocol?

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

READ MORE→

[1] Khan DA, Banerji A, Blumenthal KG, et al. Drug allergy: a 2022 practice parameter update. J Allergy Clin Immunol. 2022;S0091-6749(22)01186-1. doi:10.1016/j.jaci.2022.08.028
[2] Boulanger J, Boursiquot JN, Cournoyer G, et al. Management of hypersensitivity to platinum- and taxane-based chemotherapy: cepo review and clinical recommendations. Curr Oncol. 2014;21(4):e630-e641. doi:10.3747/co.21.1966
[3] Makrilia N, Syrigou E, Kaklamanos I, Manolopoulos L, Saif MW. Hypersensitivity reactions associated with platinum antineoplastic agents: a systematic review. Met Based Drugs. 2010;2010:207084. doi:10.1155/2010/207084
[4] Gonzalez RV, Guadarrama-Rendón E, Cruz CDLC de L, et al. Hypersensitivity reactions to platinums: systematic review of efficacy and safety of desensitization. Annals of Allergy, Asthma & Immunology. 2024;133(6):S10. doi:10.1016/j.anai.2024.08.057
[5] Li K, Yin R. Platinum desensitization therapy and its impact on the prognosis of ovary high-grade serous adenocarcinoma: a real world-data. Front Immunol. 2024;15:1346464. Published 2024 Jan 19. doi:10.3389/fimmu.2024.1346464
InpharmD's Answer GPT's Answer

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

Available evidence indicates that GLP-1 receptor agonists (GLP-1RAs) consistently delay gastric emptying, which can alter the absorption kinetics of several orally administered medications. Available studies report that this delay generally reduces or delays peak plasma concentrations (Cmax) and prolongs time to maximum concentration (Tmax) for drugs including digoxin, warfarin, acetaminophen, statins (atorvastatin, lovastatin, rosuvastatin), ACE inhibitors (lisinopril), ARBs (valsartan), met...

The 2022 American Gastroenterological Association (AGA) guideline on pharmacological interventions for obesity notes that glucagon-like peptide 1 (GLP-1) receptor agonists, including semaglutide and liraglutide, delay gastric emptying, and explicitly states that this effect may impact the absorption of some oral medications that require rapid onset of action. However, the guideline does not provide drug-specific pharmacokinetic data or identify particular medications affected. [1] A 2024 systematic review assessed drug-drug interactions between GLP-1 receptor agonists (GLP-1RAs) and oral medications and included 22 reports and 6 prescribing sheets, finding that GLP-1RAs slow gastric emptying and result in reduced or unchanged Cmax and delayed Tmax across multiple drug classes including warfarin, contraceptive pills, acetaminophen, statins, (angiotensin converting enzyme) ACE inhibitors, and digoxin; however, overall exposure (AUC) was generally unchanged and no clinically signifi...

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A search of the published medical literature revealed 0 studies investigating the researchable question:

Can you summarize any available studies or data on if GLP-1RAs can impact the absorption of other medications besides oral contraceptives?

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

READ MORE→

[1] Grunvald E, Shah R, Hernaez R, et al. AGA Clinical Practice Guideline on Pharmacological Interventions for Adults With Obesity. Gastroenterology. 2022;163(5):1198-1225. doi:10.1053/j.gastro.2022.08.045
[2] Calvarysky B, Dotan I, Shepshelovich D, Leader A, Cohen TD. Drug-Drug Interactions Between Glucagon-Like Peptide 1 Receptor Agonists and Oral Medications: A Systematic Review. Drug Saf. 2024;47(5):439-451. doi:10.1007/s40264-023-01392-3
[3] Min JS, Jo SJ, Lee S, et al. A Comprehensive Review on the Pharmacokinetics and Drug-Drug Interactions of Approved GLP-1 Receptor Agonists and a Dual GLP-1/GIP Receptor Agonist. Drug Des Devel Ther. 2025;19:3509-3537. Published 2025 Apr 30. doi:10.2147/DDDT.S506957
[4] Maideen NMP. Pharmacologically relevant drug interactions of glucagon-like peptide-1 receptor agonists. J Anal Pharm Res. 2019;8(2):51-53. doi:10.15406/japlr.2019.08.00311
[5] Hurren KM, Pinelli NR. Drug-drug interactions with glucagon-like peptide-1 receptor agonists. Ann Pharmacother. 2012;46(5):710-717. doi:10.1345/aph.1Q583
[6] Hooper L, Liu S, Pai MP. GLP-1RA-induced delays in gastrointestinal motility: Predicted effects on coadministered drug absorption by PBPK analysis. Pharmacotherapy. 2025;45(4):211-219. doi:10.1002/phar.70007
[7] de la Peña A, Cui X, Geiser J, Loghin C. No Dose Adjustment is Recommended for Digoxin, Warfarin, Atorvastatin or a Combination Oral Contraceptive When Coadministered with Dulaglutide. Clin Pharmacokinet. 2017;56(11):1415-1427. doi:10.1007/s40262-017-0531-7
[8] Malm-Erjefält M, Ekblom M, Vouis J, Zdravkovic M, Lennernäs H. Effect on the Gastrointestinal Absorption of Drugs from Different Classes in the Biopharmaceutics Classification System, When Treating with Liraglutide. Mol Pharm. 2015;12(11):4166-4173. doi:10.1021/acs.molpharmaceut.5b00278
InpharmD's Answer GPT's Answer

Author:Younghee Kwon, PharmD, BCPS + InpharmD™ AI LEARN MORE 

No clinical literature was identified supporting administration of metronidazole 2000 mg intravenous (IV) once for the treatment of trichomoniasis. Available evidence consistently describes the 2 g dose in the context of oral single-dose therapy, while IV use is derived from older descriptive literature or utilized in multidose salvage regimens or desensitization protocols rather than as a single-dose strategy.

Metronidazole and tinidazole are the primary agents used for treatment of trichomoniasis, with standard regimens consisting of either a single 2 g dose or multidose therapy administered orally. Intravenous (IV) administration is noted as a potential alternative route when oral therapy is not feasible; however, specific IV dosing strategies or the clinical circumstances under which IV use should be employed are not described. [1,2] A 2004 narrative review on the microbiology, pharmacology, and treatment of Trichomonas vaginalis infection describes metronidazole as the primary systemic therapy, typically administered as oral single-dose or multidose regimens. Within this discussion, IV administration is noted, including doses of 500 mg to 2 g infused over approximately 20 minutes, with reported cure rates of 85% to 95% for both oral and IV regimens; however, these IV dosing details are derived from older referenced literature rather than contemporary treatment data. [3,4] Studie...

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

Is there literature supporting the administration of metronidazole 2000 mg IV once for the treatment of Trichomoniasis?

Level of evidence
X - No data  

READ MORE→

[1] Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015 [published correction appears in MMWR Recomm Rep. 2015 Aug 28;64(33):924]. MMWR Recomm Rep. 2015;64(RR-03):1-137.
[2] Meites E, Gaydos CA, Hobbs MM, et al. A Review of Evidence-Based Care of Symptomatic Trichomoniasis and Asymptomatic Trichomonas vaginalis Infections. Clin Infect Dis. 2015;61 Suppl 8(Suppl 8):S837-S848. doi:10.1093/cid/civ738
[3] Cudmore SL, Delgaty KL, Hayward-McClelland SF, Petrin DP, Garber GE. Treatment of infections caused by metronidazole-resistant Trichomonas vaginalis. Clin Microbiol Rev. 2004;17(4):783-793. doi:10.1128/CMR.17.4.783-793.2004
[4] Lossick JG. Treatment of sexually transmitted vaginosis/vaginitis. Rev Infect Dis. 1990;12 Suppl 6:S665-S681. doi:10.1093/clinids/12.supplement_6.s665
[5] Van Gerwen OT, Camino AF, Bourla LN, Legendre D, Muzny CA. Management of Trichomoniasis in the Setting of 5-Nitroimidazole Hypersensitivity. Sex Transm Dis. 2021;48(8):e111-e115. doi:10.1097/OLQ.0000000000001326
[6] Helms DJ, Mosure DJ, Secor WE, Workowski KA. Management of trichomonas vaginalis in women with suspected metronidazole hypersensitivity. Am J Obstet Gynecol. 2008;198(4):370.e1-370.e3707. doi:10.1016/j.ajog.2007.10.795
[7] Kissinger P, Muzny CA, Mena LA, et al. Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. Lancet Infect Dis. 2018;18(11):1251-1259. doi:10.1016/S1473-3099(18)30423-7
[8] Howe K, Kissinger PJ. Single-Dose Compared With Multidose Metronidazole for the Treatment of Trichomoniasis in Women: A Meta-Analysis. Sex Transm Dis. 2017;44(1):29-34. doi:10.1097/OLQ.0000000000000537
[9] Cudmore SL, Delgaty KL, Hayward-McClelland SF, Petrin DP, Garber GE. Treatment of infections caused by metronidazole-resistant Trichomonas vaginalis. Clin Microbiol Rev. 2004;17(4):783-793. doi:10.1128/CMR.17.4.783-793.2004
InpharmD's Answer GPT's Answer

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

Current evidence indicates that commonly studied supplements in Parkinson’s disease, including Mucuna pruriens, vitamin D, and coenzyme Q10, demonstrate heterogeneous and largely non–reproducible clinical effects. Mucuna pruriens may provide faster onset and prolonged ON time due to its intrinsic levodopa content, but substantial variability in commercial preparations introduces unpredictable dopaminergic exposure; vitamin D supplementation reliably increases serum 25(OH)D levels without cons...

Natural products and herbal supplements have been explored as potential adjunctive therapies in Parkinson’s disease, although the evidence base remains predominantly preclinical and heterogeneous. Broad reviews describe multiple classes of compounds, including polyphenols, flavonoids, alkaloids, terpenoids, and amino acid–derived products, which demonstrate antioxidant, anti-inflammatory, anti-apoptotic, anti–α-synuclein aggregation, and mitochondrial-protective effects in experimental models, supporting biologic plausibility for neuroprotection. Selected agents with some degree of clinical investigation include Mucuna pruriens (a natural levodopa source), caffeine, green tea, and traditional formulations such as Jiawei-Liujunzi Tang, which have been associated with potential improvements in motor or nonmotor symptoms in small or limited studies; however, findings are inconsistent and not supported by robust, reproducible randomized data. Importantly, plant-derived compounds are gen...

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

What herbal/supplements can help treat Parkinson’s disease? Can these interact with sinemet?

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

READ MORE→

[1] Bhusal CK, Uti DE, Mukherjee D, et al. Unveiling Nature's potential: Promising natural compounds in Parkinson's disease management. Parkinsonism Relat Disord. 2023;115:105799. doi:10.1016/j.parkreldis.2023.105799
[2] Aktaş E, Hanağası HA, Özgentürk NÖ. Levodopa and Plant-Derived Bioactive Compounds in Parkinson's Disease: Mechanisms, Efficacy, and Future Perspectives. CNS Neurosci Ther. 2025;31(8):e70540. doi:10.1111/cns.70540
[3] Roni MAH, Jami MdABS, Hoque S, et al. Clinically proven natural products in aid of treating Parkinson’s disease: a comprehensive review. Curr Med. 2024;3(1):6. doi:10.1007/s44194-024-00033-w
[4] Nazish Quasmi M, Pooja P, Kumar S. Various herbal remedies for the management of Parkinson’s disease: A Review. RJPT. Published online February 20, 2024:963-970. doi:10.52711/0974-360X.2024.00149
[5] Lim SY, Tan AH, Ahmad-Annuar A, et al. Parkinson's disease in the Western Pacific Region. Lancet Neurol. 2019;18(9):865-879. doi:10.1016/S1474-4422(19)30195-4
[6] Cilia R, Laguna J, Cassani E, et al. Mucuna pruriens in Parkinson disease: A double-blind, randomized, controlled, crossover study. Neurology. 2017;89(5):432-438. doi:10.1212/WNL.0000000000004175
[7] Soumyanath A, Denne T, Hiller A, Ramachandran S, Shinto L. Analysis of Levodopa Content in Commercial Mucuna pruriens Products Using High-Performance Liquid Chromatography with Fluorescence Detection. J Altern Complement Med. 2018;24(2):182-186. doi:10.1089/acm.2017.0054
[8] Zhou Z, Zhou R, Zhang Z, Li K. The Association Between Vitamin D Status, Vitamin D Supplementation, Sunlight Exposure, and Parkinson's Disease: A Systematic Review and Meta-Analysis. Med Sci Monit. 2019;25:666-674. Published 2019 Jan 23. doi:10.12659/MSM.912840
[9] Al-Kuraishy HM, Al-Gareeb AI, Selim HM, et al. Does vitamin D protect or treat Parkinson's disease? A narrative review. Naunyn Schmiedebergs Arch Pharmacol. 2024;397(1):33-40. doi:10.1007/s00210-023-02656-6
[10] Zhu ZG, Sun MX, Zhang WL, Wang WW, Jin YM, Xie CL. The efficacy and safety of coenzyme Q10 in Parkinson's disease: a meta-analysis of randomized controlled trials. Neurol Sci. 2017;38(2):215-224. doi:10.1007/s10072-016-2757-9
[11] Agnieszka W, Paweł P, Małgorzata K. How to Optimize the Effectiveness and Safety of Parkinson's Disease Therapy? - A Systematic Review of Drugs Interactions with Food and Dietary Supplements. Curr Neuropharmacol. 2022;20(7):1427-1447. doi:10.2174/1570159X19666211116142806
InpharmD's Answer GPT's Answer

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

There is severely limited data specifically assessing VV ECMO. In general, Ex vivo studies demonstrate that ceftazidime shows no significant interaction with ECMO circuits, and case reports indicate that standard doses of ceftolozane/tazobactam (3 g Q8H) are sufficient to achieve therapeutic targets. While data for ceftazidime/avibactam on VV ECMO is more limited, its dosing is typically guided by renal function rather than ECMO presence, with augmented renal clearance being the primary conce...

A 2022 comprehensive review was conducted which included an analysis to determine dosage considerations for various beta-lactam/beta-lactamase inhibitors in patients receiving extracorporeal membrane oxygenation (ECMO). However, the authors note that the overall data is limited, and what data was available focuses on venoarterial ECMO (VA-ECMO) rather than venovenous ECMO (VV-ECMO). It is possible that VA-ECMO has different physiological effects.There was no data for ceftazidime/avibactam in the author’s search for ECMO, with most findings focused on other forms of renal replacement therapy. For ceftolozane/tazobactam, two case reports/series were found in patients receiving ECMO. The first case used the standard 3 g Q8H dose which was sufficient for achieving aggressive target levels, although lower Cmax and Cmin were seen on the last 2 days of therapy. In the other case report used as part of prophylaxis in cystic fibrosis for a ECMO post-lung transplant, regular manufacturer dosi...

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

What are recommended dosing strategies for ceftazidime, avycaz, and zerbaxa for VV ECMO assuming normal renal function

Level of evidence
D - Case reports or unreliable data  

READ MORE→

[1] Bakdach D, Elajez R, Bakdach AR, Awaisu A, De Pascale G, Ait Hssain A. Pharmacokinetics, Pharmacodynamics, and Dosing Considerations of Novel β-Lactams and β-Lactam/β-Lactamase Inhibitors in Critically Ill Adult Patients: Focus on Obesity, Augmented Renal Clearance, Renal Replacement Therapies, and Extracorporeal Membrane Oxygenation. J Clin Med. 2022;11(23):6898. Published 2022 Nov 22. doi:10.3390/jcm11236898
[2] Arena F, Marchetti L, Henrici De Angelis L, et al. Ceftolozane-Tazobactam Pharmacokinetics during Extracorporeal Membrane Oxygenation in a Lung Transplant Recipient. Antimicrob Agents Chemother. 2019;63(3):e02131-18. Published 2019 Feb 26. doi:10.1128/AAC.02131-18
[3] Argudo E, Riera J, Luque S, et al. Effects of the extracorporeal membrane oxygenation circuit on plasma levels of ceftolozane. Perfusion. 2020;35(3):267-270. doi:10.1177/0267659119864813
[4] Hunt JP, McKnite AM, Green DJ, Whelan AJ, Imburgia CE, Watt KM. Interaction of ceftazidime and clindamycin with extracorporeal life support. J Infect Chemother. 2023;29(12):1119-1125. doi:10.1016/j.jiac.2023.08.007
[5] Leven C, Fillâtre P, Petitcollin A, et al. Ex Vivo Model to Decipher the Impact of Extracorporeal Membrane Oxygenation on Beta-lactam Degradation Kinetics. Ther Drug Monit. 2017;39(2):180-184. doi:10.1097/FTD.0000000000000369
[6] Mané C, Delmas C, Porterie J, et al. Influence of extracorporeal membrane oxygenation on the pharmacokinetics of ceftolozane/tazobactam: an ex vivo and in vivo study. J Transl Med. 2020;18(1):213. Published 2020 May 27. doi:10.1186/s12967-020-02381-1

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.


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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.)


     

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