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 10,000+ clinical 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.)


More than 30 of the world's best health systems hire an InpharmD™ virtual DI pharmacist, yielding:


144,346

Clinical Pharmacist Hours Saved

4x +

ROI

100%

Customer Satisfaction Rate

This is how InpharmD™ transforms LITERATURE.

What's Being Asked...

Please summarize guidance and clinical trials surrounding when to get an EKG when using dofetilide therapy.
What are the recommended number of clinical pharmacist specialists to bed size of various clinical care areas (ED, Me...
What evidence showing that terlipressin is superior to norepinephrine in HRS-AKI reversal?
What is the enoxaparin VTE prophylaxis renal dosing recommended for morbidly obese patients with BMI >= 40 and CrCl <...
What recommendations exist for holding trental prior to surgery?

What would you like to ask InpharmD™?

InpharmD's Answer GPT's Answer

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

Dofetilide prescribing information and professional guidance recommend baseline QTc/QT assessment before the first dose, initiation or re-initiation with continuous ECG monitoring for at least 3 days, and QTc/QT reassessment 2 to 3 hours after each inpatient dose through doses 2 to 5. The 2023 ACC/AHA/ACCP/HRS atrial fibrillation guideline similarly recommends inpatient monitoring with baseline ECG, continuous ECG monitoring, renal function assessment, and electrolyte monitoring, followed by ...

The 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation states that dofetilide initiation or reloading is generally performed with admission for at least 3 days to a health care facility capable of creatinine clearance calculation, continuous electrocardiographic monitoring, and cardiac resuscitation; recommended monitoring includes a baseline 12-lead electrocardiograph (ECG) to assess rhythm and calculate QTc, continuous ECG monitoring during the 3-day hospitalization for initiation, and serum potassium, magnesium, and creatinine assessment for CrCl estimation. After discharge on a stable dose, the guideline recommends repeat 12-lead ECG, serum potassium and magnesium concentrations, and serum creatinine for CrCl estimation at 3 to 6 months and every 3 to 6 months thereafter, with more frequent monitoring for patients receiving concomitant QT interval-prolonging drugs or with changing kidney function. The guideline’s supporting evidence notes tha...

READ MORE→

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

Please summarize guidance and clinical trials surrounding when to get an EKG when using dofetilide therapy.

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

READ MORE→

[1] Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193
[2] Sandau KE, Funk M, Auerbach A, et al. Update to practice standards for electrocardiographic monitoring in hospital settings: a scientific statement from the American Heart Association. Circulation. 2017;136(19):e273-e344. doi:10.1161/CIR.0000000000000527
InpharmD's Answer GPT's Answer

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

While there is no universal pharmacist-to-patient ratio applicable across all practice settings, much of the literature investigating optimal pharmacist-to-patient ratios has focused on the intensive care unit (ICU) patient population. In the neonatal intensive care unit (NICU) setting, guidelines require that at least 1 pharmacist with experience in neonatal and/or pediatric pharmacology be readily available on-site or via telehealth 24/7. In the broader ICU setting (encompassing both adult ...

The 2023 Standards for Levels of Neonatal Care II, II, and IV consensus document from the American Academy of Pediatrics outlines a comprehensive framework for stratified neonatal care and resources/staffing recommendations for Level II through IV neonatal intensive care units (NICUs). The document meticulously delineates the required components and standards for each care level, ranging from Special Care Nursery (SCN, Level II) to complex subspecialty services including surgery (Level IV). All three levels require at least 1 registered pharmacist with experience in neonatal and/or pediatric pharmacology who is available for consultation on-site or by telehealth/telephone 24 hours a day and 7 days per week, has completed continuing education specific to pediatric and neonatal pharmacology, and participates in multidisciplinary care. Level II SCN status permits participation "as needed," while Levels III and IV NICUs require active participation in patient care rounds. All levels mus...

READ MORE→

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

What are the recommended number of clinical pharmacist specialists to bed size of various clinical care areas (ED, Medical ICU, Trauma ICU, NICU, AMS, internal medicine, etc)? What are the recommended number of staff pharmacists per facility bed size?

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

READ MORE→

[1] Stark AR, Pursley DM, Papile L-A, et al. Standards for levels of neonatal care: II, III, and IV. Pediatrics. 2023;151(6):e2023061957. doi:10.1542/peds.2023-061957
[2] Sikora A, Murray B, Henry K, et al. Consensus recommendations for the integration of critical care pharmacists on intensive care unit teams: Endorsed by the American Association of Critical-Care Nurses, American College of Clinical Pharmacy, American Society of Health-System Pharmacists, Institute for Safe Medication Practices, and Society of Critical Care Medicine. J Am Coll Clin Pharm. 2025 Sep;8(9):914-930. doi: 10.1002/jac5.70084
InpharmD's Answer GPT's Answer

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

Across comparative randomized data, terlipressin and norepinephrine generally demonstrate similar efficacy for HRS-AKI reversal when used with albumin, with most analyses showing no statistically significant differences in renal recovery or short-term survival. However, pooled trial data and select comparative analyses suggest a consistent numerical trend favoring terlipressin, with slightly higher rates of HRS reversal and, in some analyses, improved survival outcomes, although these finding...

According to the 2024 American Gastroenterological Association (AGA) Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in Cirrhosis, terlipressin is considered the vasoactive drug of choice for hepatorenal syndrome (HRS)-acute kidney injury (AKI) based on the available evidence, primarily from placebo-controlled randomized trials demonstrating improved renal function and reduced need for renal replacement therapy, although without a mortality benefit. Evidence directly comparing terlipressin with norepinephrine is limited; however, the largest randomized trial (n=120) reported higher rates of HRS-AKI reversal and improved survival with terlipressin administered as a continuous infusion compared with norepinephrine (Table 1). A network meta-analysis also suggested a possible slight advantage of terlipressin, although with low certainty. [1] Per 2021 updated American Association for the Study of Liver Diseases (AASLD) guidelines, vasoconstrictor drugs ...

READ MORE→

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

What evidence showing that terlipressin is superior to norepinephrine in HRS-AKI reversal?

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

READ MORE→

[1] Garcia-Tsao G, Abraldes JG, Rich NE, Wong VW. AGA Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in Cirrhosis: Expert Review. Gastroenterology. 2024;166(1):202-210. doi:10.1053/j.gastro.2023.10.016
[2] Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74(2):1014-1048. doi:10.1002/hep.31884
[3] Olson JC, Subramanian RM. Comparative efficacy of terlipressin and norepinephrine for treatment of hepatorenal syndrome-acute kidney injury: A systematic review and meta-analysis. PLoS One. 2024;19(1):e0296690. Published 2024 Jan 29. doi:10.1371/journal.pone.0296690
[4] Malik A, Malik MI, Qureshi S, Nadir A. Efficacy and safety of terlipressin and albumin vs. noradrenaline and albumin in adult patients with hepatorenal syndrome: A systematic review and meta-analysis. Ann Hepatol. 2024;29(4):101495. doi:10.1016/j.aohep.2024.101495
[5] Pitre T, Kiflen M, Helmeczi W, et al. The Comparative Effectiveness of Vasoactive Treatments for Hepatorenal Syndrome: A Systematic Review and Network Meta-Analysis. Crit Care Med. 2022;50(10):1419-1429. doi:10.1097/CCM.0000000000005595
[6] Best LMJ, Freeman SC, Sutton AJ, Cooper NJ, Tng EL, Csenar M, Hawkins N, Pavlov CS, Davidson BR, Thorburn D, Cowlin M, Milne EJ, Tsochatzis E, Gurusamy KS. Treatment for hepatorenal syndrome in people with decompensated liver cirrhosis: a network meta‐analysis. Cochrane Database of Systematic Reviews 2019,doi: 10.1002/14651858.CD013103.pub2
[7] Wang H, Liu A, Bo W, Feng X, Hu Y. Terlipressin in the treatment of hepatorenal syndrome: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97(16):e0431. doi:10.1097/MD.0000000000010431
[8] Israelsen M, Krag A, Allegretti AS, Jovani M, Goldin AH, Winter RW, Gluud LL. Terlipressin versus other vasoactive drugs for hepatorenal syndrome. Cochrane Database Syst Rev. 2017 Sep 27;9(9):CD011532. doi: 10.1002/14651858.CD011532.pub2. PMID: 28953318; PMCID: PMC6483765.
[9] Facciorusso A, Chandar AK, Murad MH, et al. Comparative efficacy of pharmacological strategies for management of type 1 hepatorenal syndrome: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2017;2(2):94-102. doi:10.1016/S2468-1253(16)30157-1
InpharmD's Answer GPT's Answer

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

There is a general lack of available literature which provides a validated enoxaparin prophylaxis dosing strategy in patients with morbid obesity and renal dysfunction. Evidence is primarily derived from studies examining either renal dysfunction or obesity in isolation, with minimal data evaluating both conditions concurrently. In morbid obesity (BMI ≥40 kg/m²) with normal renal function, enoxaparin prophylaxis is commonly increased to 40 mg twice daily or 0.5 mg/kg twice daily. However, one...

A 2018 review article examined the dosing and monitoring of enoxaparin for venous thromboembolism (VTE) prophylaxis and treatment in patients at extremes of body weight, specifically those with low and high body weights. This review synthesized data from a variety of studies covering literature from 1995 to January 2018. The key studies included in the review investigated the impacts of body weight and body mass index (BMI) on VTE outcomes, bleeding risks, enoxaparin dosing efficacy, and anti-Xa levels, excluding pediatric, and pregnant populations and those with renal dysfunction. The review highlighted that traditional enoxaparin dosing regimens might not be suitable for patients at the extremes of body weight, proposing tailored dosing recommendations based on observed trends despite the lack of definitive clinical trial data. The results emphasized potential dosing adjustments for distinctive patient groups. For patients with low body weight, evidence suggested consideration of...

READ MORE→

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

What is the enoxaparin VTE prophylaxis renal dosing recommended for morbidly obese patients with BMI >= 40 and CrCl < 30?

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

READ MORE→

[1] Sebaaly J, Covert K. Enoxaparin Dosing at Extremes of Weight: Literature Review and Dosing Recommendations. Ann Pharmacother. 2018 Sep;52(9):898-909. doi: 10.1177/1060028018768449.
[2] Nutescu EA, Spinler SA, Wittkowsky A, Dager WE. Low-molecular-weight heparins in renal impairment and obesity: available evidence and clinical practice recommendations across medical and surgical settings. Ann Pharmacother. 2009 Jun;43(6):1064-83. doi: 10.1345/aph.1L194.
[3] Sikes L, Charles K, Antigua A, Patel R, Imboywa S, Cherian P. Anti-Factor Xa Level Monitoring for Enoxaparin Prophylaxis and Treatment in High-Risk Patient Groups. HCA Healthc J Med. 2023 Apr 28;4(2):105-109. doi: 10.36518/2689-0216.1464.
InpharmD's Answer GPT's Answer

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

Available guidance regarding perioperative management of pentoxifylline (Trental) is inconsistent across sources. A 2022 perioperative medication guideline from the University of Wisconsin Health does not provide specific recommendations on continuation, discontinuation, or timing prior to surgery, but emphasizes individualized risk-benefit assessment and interdisciplinary coordination. In contrast, a 2024 UK Clinical Pharmacy Association review recommends continuing pentoxifylline through su...

A 2022 perioperative medication management clinical practice guideline from the University of Wisconsin Health, developed to standardize perioperative medication practices and reduce complications in patients undergoing procedures requiring anesthesia, recommends that perioperative management of pentoxifylline be coordinated with the surgeon and prescribing provider (strong recommendation, low quality of evidence). The guideline defines “hold” as a temporary interruption of therapy and emphasizes that perioperative medication decisions should involve assessment of risks and benefits and collaboration among the anesthesiologist, surgeon, and prescribing clinician. Within this framework, no specific recommendation is provided regarding continuation, discontinuation, or timing of pentoxifylline prior to surgery. [1] A 2024 UK Clinical Pharmacy Association Handbook of Perioperative Medicines review states that pentoxifylline (Trental) should be continued during both elective and emer...

READ MORE→

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

What recommendations exist for holding trental prior to surgery?

Level of evidence
D - Case reports or unreliable data  

READ MORE→

[1] University of Wisconsin Hospitals and Clinics Authority. Perioperative Medication Management – Adult/Pediatric – Inpatient/Ambulatory Clinical Practice Guideline. Published August 10, 2022. Accessed May 4, 2026.
[2] UK Clinical Pharmacy Association. Pentoxifylline. In: Handbook of Perioperative Medicines. UKCPA; April 2024. Accessed May 4, 2026.
[3] Waukee Surgery Center. Medications to Stop Prior to Surgery for Surgical Patients. The Iowa Clinic website. Accessed May 4, 2026.
[4] Virginia Interventional Pain & Spine Center. Pre-Procedure Medication Policies. Virginia Interventional Pain & Spine Center; n.d. Accessed May 4, 2026.
[5] Oklahoma Spine Hospital. Preoperative Guidelines For Medications Prior To Surgery. Accessed May 4, 2026.
[6] https://www.neurosurg.org/pdf/preop-guidelines.pdf

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.


What would you like to ask InpharmD™?

Sign up for a free trial & start right away.

Get Started Free