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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...

How do you compound ear powder out of chloramphenicol, amphotericin B, and sulfamethoxazole? What studies are availab...
What does the literature say regarding heparin infusion dosing in obese patients related to time to therapeutic aPTT,...
What literature is there about the use of ceftriaxone as an IV push? Is there evidence of increased reactions with th...
benefits of GLP-1 inhibitors in patients with polycystic ovarian syndrome
Can Xacduro be safely used in a patient with an anaphylactic pencillin allergy?

What would you like to ask InpharmD™?

InpharmD's Answer GPT's Answer

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

Published evidence evaluating compounded otic powders containing chloramphenicol, amphotericin B, and sulfonamides is very limited. Available literature consists primarily of one published compounding formula, review articles, observational studies with limitations, and isolated case reports, with no randomized studies evaluating the specific combination of chloramphenicol, amphotericin B, and sulfamethoxazole (or sulfanilamide) as a compounded ear powder. The published compounding instructio...

A 2009 publication in the International Journal of Pharmaceutical Compounding (IJPC) elaborated on the formulation of a multi-component otic powder containing Amphotericin B, Chloramphenicol Palmitate, Hydrocortisone, and Sulfanilamide. The formulation yields 10 g of otic powder containing amphotericin B 470 mg, chloramphenicol palmitate 4.7 g, hydrocortisone 75 mg, sulfanilamide 4.7 g, and silica gel 55 mg. Silica gel is included as a desiccant and viscosity-enhancing excipient to help maintain a free-flowing powder. Compounding instructions consist of calculating the required quantities, accurately weighing each ingredient, triturating the powders together until a uniform mixture is obtained, and packaging the finished product in a tight, light-resistant container, with the authors noting that an accordion-style "puffer" device is suitable for administration. The instruction recommends a beyond-use date of up to 6 months, although storage conditions for the finished preparation ar...

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A search of the published medical literature revealed 7 studies investigating the researchable question:

How do you compound ear powder out of chloramphenicol, amphotericin B, and sulfamethoxazole? What studies are available on utilizing these treatments in the ear for ear infections as a powder form? Include drug combinations that have one or more of the active ingredients listed? I am interested in seeing data regarding product efficacy (include clinical data from other countries as well).

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

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[1] Allen LV Jr. Amphotericin B, chloramphenicol palmitate, hydrocortisone, and sulfanilamide otic powder. IJPC. 2009;13(1):65.
[2] Kesser BW. Assessment and management of chronic otitis externa. Curr Opin Otolaryngol Head Neck Surg. 2011;19(5):341-7.
[3] Goldenberg D, Golz A, Netzer A, Joachims HZ. The use of otic powder in the treatment of acute external otitis. Am J Otolaryngol. 2002;23(3):142-147. doi:10.1053/ajot.2002.123461
[4] Rosenfeld RM, Schwartz SR, Cannon CR, et al. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg. 2014;150(1 Suppl):S1-S24. doi:10.1177/0194599813517083
[5] Drew RH, Perfect JR. Conventional Antifungals for Invasive Infections Delivered by Unconventional Methods; Aerosols, Irrigants, Directed Injections and Impregnated Cement. J Fungi (Basel). 2022;8(2):212. Published 2022 Feb 21. doi:10.3390/jof8020212
[6] Hussain S, Philteos J, Kim H, Spiegel JL, Lin V. Management of Otomycosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Otol Neurotol. 2026;47(1):17-25. doi:10.1097/MAO.0000000000004684
InpharmD's Answer GPT's Answer

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

While major guidelines are often ambiguous on the optimal weight descriptor for heparin dosing in obesity, clinical data supports the use of adjusted body weight. Some studies demonstrate that using adjusted body weight leads to a faster time to achieving therapeutic anticoagulation levels and reduces the rate of supratherapeutic levels compared to using total body weight. Furthermore, this approach has been associated with a reduced risk of clinically significant bleeding in obese patients. ...

A 2016 expert clinical guidance on the practical management of heparin anticoagulants for venous thromboembolism (VTE) provides recommendations on dosing, monitoring, dose adjustment, and management in special populations, including those with extreme body weights. For obese and morbidly obese patients, the guidance recommends calculating heparin doses using either total or adjusted body weight, with close monitoring of early laboratory values to ensure timely achievement of therapeutic anticoagulation. The guidance also cautions that empiric dose caps may lead to under-anticoagulation and advises individualized dosing when caps are applied. Heparin infusion rates achieving therapeutic anticoagulation in this population have been reported to range from approximately 5 to 12.8 units/kg/hour. Notably, the guidance did not define a maximum heparin infusion rate in obese patients, emphasizing instead the importance of ensuring the therapeutic threshold is reached promptly. Due to limite...

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A search of the published medical literature revealed 13 studies investigating the researchable question:

What does the literature say regarding heparin infusion dosing in obese patients related to time to therapeutic aPTT, BMI threshold for using adjusted body weight, and safety?

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

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[1] Smythe MA, Priziola J, Dobesh PP, Wirth D, Cuker A, Wittkowsky AK. Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism. J Thromb Thrombolysis. 2016;41(1):165-186. doi:10.1007/s11239-015-1315-2
[2] Holbrook A, Schulman S, Witt DM, et al. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e152S-e184S. doi:10.1378/chest.11-2295
[3] O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61(4):e78-e140. doi:10.1016/j.jacc.2012.11.019
[4] Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [published correction appears in J Am Coll Cardiol. 2014 Dec 23;64(24):2713-4. Dosage error in article text]. J Am Coll Cardiol. 2014;64(24):e139-e228. doi:10.1016/j.jacc.2014.09.017
[5] Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines [published correction appears in Chest. 2012 May;141(5):1369. Dosage error in article text] [published correction appears in Chest. 2013 Aug;144(2):721. Dosage error in article text]. Chest. 2012;141(2 Suppl):e24S-e43S. doi:10.1378/chest.11-2291
[6] Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e195S-e226S. doi:10.1378/chest.11-2296
[7] Smythe MA, Priziola J, Dobesh PP, Wirth D, Cuker A, Wittkowsky AK. Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism. J Thromb Thrombolysis. 2016;41(1):165-186. doi:10.1007/s11239-015-1315-2
[8] Vandiver JW, Ritz LI, Lalama JT. Chemical prophylaxis to prevent venous thromboembolism in morbid obesity: literature review and dosing recommendations. J Thromb Thrombolysis. 2016;41(3):475-481. doi:10.1007/s11239-015-1231-5
[9] Sebaaly J, Covert K. Enoxaparin Dosing at Extremes of Weight: Literature Review and Dosing Recommendations. Ann Pharmacother. 2018;52(9):898-909. doi:10.1177/1060028018768449
InpharmD's Answer GPT's Answer

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

Available literature evaluating ceftriaxone intravenous (IV) push includes primarily retrospective studies and one small randomized trial of beta-lactam antibiotics in which ceftriaxone was the most common agent. Overall, ceftriaxone IV push was commonly administered over approximately 1 to 5 minutes and was associated with faster administration, operational/cost advantages, and generally low or comparable reported adverse-event rates versus IV piggyback/intermittent infusion in the emergency...

A 2018 comprehensive review evaluated the literature and clinical considerations regarding intravenous (IV) push administration of antibiotics in adults, including cephalosporins such as cefazolin and ceftriaxone. Cefazolin is FDA-approved for IV push administration, and available literature supports its feasibility when reconstituted with sterile water for injection (e.g., 1–2 g diluted in approximately 10 mL) and administered over short time frames, typically 1–5 minutes depending on the source. Ceftriaxone, while not FDA-approved for IV push administration, has been evaluated in several clinical settings—including emergency departments, outpatient parenteral antimicrobial therapy (OPAT), and hospitalized patients—with studies generally reporting similar rates of phlebitis and other complications compared with short infusions. Evidence describing IV push ceftriaxone administration is somewhat limited by inconsistent reporting of preparation and administration details, though avail...

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A search of the published medical literature revealed 9 studies investigating the researchable question:

What literature is there about the use of ceftriaxone as an IV push? Is there evidence of increased reactions with the use of ceftriaxone given IV push versus intermittent infusion? Or is there specific evidence of the safe administration of ceftriaxone as IV push?

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

READ MORE→

[1] Spencer S, Ipema H, Hartke P, et al. Intravenous Push Administration of Antibiotics: Literature and Considerations. Hosp Pharm. 2018;53(3):157-169. doi:10.1177/0018578718760257
[2] Brady RE, Giordullo EL, Harvey CA, Krabacher ND, Penick AM. Intravenous push antibiotics in the emergency department: Education and implementation. Am J Health Syst Pharm. 2024;81(12):531-538. doi:10.1093/ajhp/zxae039
[3] Baize P, Smith T, Faust A. 1831: intermittent iv infusion versus slow iv push beta-lactam administration. Critical Care Medicine. 2019;47:889. doi:10.1097/01.ccm.0000552569.08640.4b
[4] Lee R, Tran T, Tan S, Chun P. 602. Intravenous push versus intravenous piggyback administration of cephalosporin antibiotics: impact on safety, workflow, and cost. Open Forum Infectious Diseases. 2021;8(Supplement_1):S403-S404. doi:10.1093/ofid/ofab466.800
[5] Branan T, Bland C, Smith S. 486: intravenous push versus iv piggyback ceftriaxone in critically ill obese patients with sepsis. Critical Care Medicine. 2024;52(1):S217-S217. doi:10.1097/01.ccm.0001000124.28023.b0
[6] Agunbiade A, Routsolias JC, Rizvanolli L, Bleifuss W, Sundaresan S, Moskoff J. The effects of ceftriaxone by intravenous push on adverse drug reactions in the emergency department. Am J Emerg Med. 2021;43:245-248. doi:10.1016/j.ajem.2020.03.022
InpharmD's Answer GPT's Answer

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

A moderate body of evidence suggests that glucagon-like peptide-1 (GLP-1) receptor agonists may benefit women with polycystic ovary syndrome (PCOS), particularly those who are overweight or have obesity. Current international PCOS guideline recommendations support their use as an adjunct to lifestyle intervention for management of higher weight while acknowledging the lack of long-term safety data. Consistent with these recommendations, multiple meta-analyses have demonstrated reductions in b...

According to the 2023 international evidence-based guideline for polycystic ovary syndrome (PCOS), anti-obesity medications, including the glucagon-like peptide-1 (GLP-1) receptor agonists liraglutide and semaglutide, could be considered in addition to active lifestyle intervention for management of higher weight in adults with PCOS, consistent with general population obesity guidelines. Effective contraception is recommended when pregnancy is possible, as pregnancy safety data are lacking, and gradual dose escalation is advised to reduce gastrointestinal adverse effects. Shared decision-making should include discussion of potential side effects, the possible need for long-term therapy for weight management, the risk of weight regain after discontinuation, and the lack of long-term safety data. Anti-obesity agents are recommended for reproductive outcomes only in research settings until efficacy and safety are established. These recommendations were informed by a meta-analysis of 11...

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

What are the benefits of GLP-1 inhibitors in patients with polycystic ovarian syndrome?

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

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[1] Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447-2469. doi:10.1210/clinem/dgad463
[2] Goldberg A, Graca S, Liu J, et al. Anti-obesity pharmacological agents for polycystic ovary syndrome: A systematic review and meta-analysis to inform the 2023 international evidence-based guideline. Obes Rev. 2024;25(5):e13704. doi:10.1111/obr.13704
[3] Forslund M, Wändell P, Forsberg L, et al. GLP-1 receptor agonist treatment in women with polycystic ovary syndrome-a systematic review and meta-analysis. Eur J Endocrinol. 2026;194(3):25-39. doi:10.1093/ejendo/lvag033
[4] Austregésilo de Athayde De Hollanda Morais B, Martins Prizão V, de Moura de Souza M, et al. The efficacy and safety of GLP-1 agonists in PCOS women living with obesity in promoting weight loss and hormonal regulation: A meta-analysis of randomized controlled trials. J Diabetes Complications. 2024;38(10):108834. doi:10.1016/j.jdiacomp.2024.108834
[5] Siamashvili M, Davis SN. Update on the effects of GLP-1 receptor agonists for the treatment of polycystic ovary syndrome. Expert Rev Clin Pharmacol. 2021;14(9):1081-1089. doi:10.1080/17512433.2021.1933433
[6] Szczesnowicz A, Szeliga A, Niwczyk O, Bala G, Meczekalski B. Do GLP-1 Analogs Have a Place in the Treatment of PCOS? New Insights and Promising Therapies. J Clin Med. 2023;12(18):5915. Published 2023 Sep 12. doi:10.3390/jcm12185915
[7] Han Y, Li Y, He B. GLP-1 receptor agonists versus metformin in PCOS: a systematic review and meta-analysis. Reprod Biomed Online. 2019;39(2):332-342. doi:10.1016/j.rbmo.2019.04.017
[8] Lin S, Deng Y, Huang J, et al. Efficacy and safety of GLP-1 receptor agonists on weight management and metabolic parameters in PCOS women: a meta-analysis of randomized controlled trials. Sci Rep. 2025;15(1):16512. Published 2025 May 13. doi:10.1038/s41598-025-99622-4
[9] Zhao Y, Jiang L, Li N, Cao J, Pi J. Comparison of GLP-1 Receptor Agonists Combined with Metformin Versus Metformin Alone in the Management of PCOS: A Comprehensive Meta-Analysis. Reprod Sci. 2025;32(5):1661-1675. doi:10.1007/s43032-025-01788-9
[10] Tong X, Song X, Zhang Y, Zhao Q. Efficacy and safety of glucagon-like peptide-1 receptor agonists in the treatment of polycystic ovary syndrome-A systematic review and meta-analysis. Arch Physiol Biochem. 2024;130(6):1005-1011. doi:10.1080/13813455.2024.2380422
[11] Hoteit BH, Kotaich J, Ftouni H, et al. The dual impact of GLP-1 receptor agonists on metabolic and reproductive health in polycystic ovary syndrome: insights from human and animal trials. Ther Adv Endocrinol Metab. 2025;16:20420188251383064. Published 2025 Oct 7. doi:10.1177/20420188251383064
InpharmD's Answer GPT's Answer

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

There is currently insufficient evidence to determine whether Xacduro (sulbactam/durlobactam) can be safely administered to patients with a history of penicillin-induced anaphylaxis. Sulbactam is a β-lactam antimicrobial that also functions as a penicillanic acid sulfone β-lactamase inhibitor, whereas durlobactam is structurally distinct as a novel diazabicyclooctane (DBO) β-lactamase inhibitor. In Xacduro clinical trials, patients with a history of hypersensitivity to any β-lactam were exclu...

Sulbactam, developed by Pfizer in the late 1970s, is a penicillanic acid sulfone β-lactamase inhibitor originally designed to restore the activity of ampicillin by inhibiting selected class A β-lactamases (e.g., SHV and CTX-M), thereby reducing ampicillin minimum inhibitory concentrations against susceptible gram-positive and gram-negative organisms. In contrast, durlobactam is a novel diazabicyclooctane (DBO) β-lactamase inhibitor designed to retain potent inhibition of class A and C β-lactamases while expanding activity against class D β-lactamases (e.g., OXA-23, OXA-24, and OXA-58) commonly produced by Acinetobacter species, addressing a key limitation of earlier β-lactamase inhibitors. [1] A 2019 review identified 12 published reports of hypersensitivity reactions following administration of ampicillin–sulbactam or cefoperazone–sulbactam. Only one case definitively implicated sulbactam, involving a healthcare worker with contact urticaria confirmed by allergy testing (Table 1...

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

Can Xacduro be safely used in a patient with an anaphylactic pencillin allergy?

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

READ MORE→

[1] Papp-Wallace KM, McLeod SM, Miller AA. Durlobactam, a Broad-Spectrum Serine β-lactamase Inhibitor, Restores Sulbactam Activity Against Acinetobacter Species. Clin Infect Dis. 2023;76(Suppl 2):S194-S201. doi:10.1093/cid/ciad095
[2] Stover KR, Barber KE, Wagner JL. Allergic Reactions and Cross-Reactivity Potential with Beta-Lactamase Inhibitors. Pharmacy (Basel). 2019;7(3):77. Published 2019 Jun 28. doi:10.3390/pharmacy7030077

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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