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36 results on '"Czosnowski, Quinn"'

2. Expansion of around the clock critical care and emergency medicine clinical pharmacy services at a large urban academic medical center

Author

Kruer, Rachel M., primary, Czosnowski, Quinn, additional, Miller, Emily M., additional, Anderson, Eve, additional, Peters, Haley, additional, Basting, Alyson T., additional, Hauser, Christian, additional, Negaard, Briana, additional, Stoldt, Joseph, additional, Vo, Dalena, additional, Wetmore, Lori, additional, Tai, Anis, additional, Bott, Julie, additional, and Trujillo, Tate, additional

Published
2023
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6. Use of Continuous Etomidate Infusion to Rapidly Correct Hypercortisolism in a Patient With Disseminated Nocardiosis

Author

Tasleem, Azka, Cavaghan, Melissa, Czosnowski, Quinn A, and Saeed, Zeb

Subjects
cavitary lung lesions, hypercortisolism, cushing's syndrome, Endocrinology/Diabetes/Metabolism, Internal Medicine, etomidate, General Engineering, Infectious Disease, disseminated nocardiosis
Abstract

Cushing’s syndrome (CS) is an immunocompromised state characterized by impaired cellular and adaptive immunity due to hypercortisolism. This imbalance in the immune system leads to a high risk of opportunistic infections which can potentially prove fatal. In such patients, mortality can be reduced with early diagnosis and effective management of the underlying hypercortisolism. In this case report, we describe how prompt reduction of cortisol levels using a low dose continuous etomidate infusion was pivotal in effective treatment of an opportunistic infection, disseminated nocardiosis, in a 29-year-old female with Cushing’s syndrome. We also discuss how treatment with antibiotics including empiric therapy with Imipenem and sulfamethoxazole/trimethoprim (SMX/TMP) and definite therapy as per susceptibility testing, with amikacin, SMX/TMP, and doxycycline helped to prevent adverse outcomes. Through this case, we aim to emphasize that infiltrates or cavitary lesions on the computed tomography (CT) scan of the chest in a patient with Cushing’s syndrome should raise concern for nocardiosis, and prompt management with antibiotics should be initiated. Similarly, disseminated nocardiosis should always raise concern for possible immune deficiency states like Cushing’s syndrome. Our case is unique in detailing the significance of using etomidate to acutely lower cortisol levels in a patient with endogenous CS and widespread invasive opportunistic infection. The pharmacology aspects of the Etomidate, in this case, have been published in the Journal of Pharmacy Practice and cited appropriately in this article.

Published
2021

19. Continuous Etomidate for the Management of Cushing's Syndrome Complicated by Pulmonary Nocardiosis.

Author

Hays, William Blake and Czosnowski, Quinn

Subjects
*ANTIBIOTICS, *KETOCONAZOLE, *INTENSIVE care units, *CUSHING'S syndrome, *NOCARDIOSIS, *PITUITARY tumors, *ETOMIDATE, *ADRENOCORTICOTROPIC hormone, *HYDROCORTISONE
Abstract

Severe Cushing's syndrome is associated with significant complications including opportunistic infections. In the setting of infection, urgent reduction of circulating cortisol is warranted and commonly used oral medications have a slow onset of effect. Here we describe a 29-years old female who presented to an outside hospital with symptoms of untreated Cushing's syndrome on ketoconazole. Following identification of a pulmonary Nocardia spp infection, she was transferred for a higher level of care. Her initial serum ACTH and cortisol levels after transfer were 106pg/mL and 53.7mCg/dL respectively. Given the severity of her nocardiosis and lack of response to ketoconazole, the patient was placed in the ICU and started on a continuous etomidate infusion. Her serum cortisol rapidly decreased to 5.7mCg/dL. She was transitioned to metyarapone and the etomidate infusion was weaned to off. The etomidate infusion was well tolerated without adverse effects or need for an advanced airway. Following discontinuation of etomidate, she was found to have a pituitary microadenoma that was resected. The patient was discharged from the hospital on antibiotics for the management of her Nocardia spp infection. In patients with severe Cushing's syndrome, continuous etomidate may be safe and effective for patients who are unresponsive to other therapies. [ABSTRACT FROM AUTHOR]

Published
2022
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26. Contributors

Author

Abouzgheib, Wissam, Al-Obaidi, Mohanad, Anderson, Mark B., Aqeel, Iram, Bagshaw, Sean M., Balk, Robert A., Barrese, James C., Barton, Richard G., Bartter, Thaddeus, Berkowitz, Robert, Bleck, Thomas P., Boujaoude, Ziad, Bowen, Frank, Brenner, Samantha K., Buchman, Timothy G., Bunnell, Eugene, Burns, Jeffrey P., Caironi, Pietro, Carlesso, Eleonora, Cecconi, Maurizio, Chaptini, Louis, Chang, Cherylee W.J., Chung, Kevin K., Cinel, Ismail, Clark, Damon H., Craig, T.R., Czosnowski, Quinn A., Dayoub, Hayan, De Backer, Daniel, Dellinger, R. Phillip, Domínguez-Cherit, Guillermo, Dries, David J., Elfant, Adam B., Ely, E. Wesley, Fraimow, Henry S., Frankel, Heidi L., Fraser, John F., Friedman, Bruce C., Gattinoni, Luciano, Geisen, Martin, Ginsberg, Fredric, Glotzer, Taya V., Gordon, Kevin C., Gregg, Sara R., Gurka, David P., Hernández-Cárdenas, Carmen M., Hollenberg, Steven M., Hyzy, Robert C., Jacobi, Judith, Jelnin, Vladimir, Jubran, Amal, Kapur, Navin K., Karam, George H., Karvellas, Constantine J., Kaufman, Steven T., Kavi, Tapan, Kim, Bernard, Kline, Jason A., Kobeissi, Zoulficar, Kruse, James A., Kumar, Anand, Lachant, Neil A., Laghi, Franco, Lapinsky, Stephen E., LaRosa, Jennifer, Lavery, G.G., Leeper, Kenneth V., Jr., Lu, Hsuan, Maddipati, Veeranna, Maki, Dennis G., Marini, John, Marra, Annachiara, Marshall, John C., Masur, Henry, Maybauer, Dirk M., Maybauer, Marc O., Mayo, Paul, McFadden, Christopher B., Mercado, Melissa, Mickey, Walter, Miller, Kristin, Mirsen, Thomas R., Morgan, Farah, Murphy, Nicholas, Nader, Kamyar, O’Neal, Hollis R., Ostrosky-Zeichner, Luis, Parrillo, Joseph E., Pasala, Tilak K.R., Paskar, Dave D., Pastores, Stephen M., Peikin, Steven, Peters, Priscilla, Pratter, Melvin R., Puri, Nitin, Reboli, Annette C., Reich, John Adam, Restrepo, Marcos I., Rewa, Oleksa G., Rhodes, Andrew, Rincon, Fred, Roberts, Brian W., Rocawich, Katie M., Rosengart, Axel, Ross, Jennifer, Ross, Steven E., Roy, Aviral, Ruiz, Carlos E., Sabir, Sajjad A., Sadaka, Farid, Sagana, Rommel, Salazer, Thomas L., Samad, Reza, Sanchez, Raul, Satya, Kumar, Schorr, Christa, Sessler, Curtis N., Shersher, David, Sigarroa, Eduardo Rivero, Simons, Grant R., Sterling, Michael, Thomas, Christopher B., Tobin, Martin J., Townsend, Sean R., Tremblay, Victor, Trohman, Richard G., Trottier, Steven J., Truog, Robert D., Trzeciak, Stephen, Tsigrelis, Constantine, Turi, Zoltan G., Turtz, Alan R., Vazquez-Grande, Gloria, Vincent, Jean-Louis, Weinstein, Robert A., Weisberg, Lawrence S., Werns, Steven, Wunderink, Richard G., Zahiruddin, Faisal, Zanotti-Cavazzoni, Sergio L., Zimmerman, Janice L., and Zimmerman, John M.

Published
2019
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27. Metronidazole dosing in patients with hepatic dysfunction: how to minimize the risk of neurotoxicity

Author

Czosnowski, Quinn A., Czosnowski, Lauren M., Taylor, Jeremy, and Self, Timothy

Subjects
Metronidazole -- Dosage and administration -- Research, Liver diseases -- Risk factors -- Diagnosis -- Drug therapy -- Research, Cytochrome P-450 -- Physiological aspects -- Research, Health, Diagnosis, Drug therapy, Physiological aspects, Research, Risk factors, Dosage and administration
Abstract

Metronidazole, the prototype nitroimidazole, was originally released in 1959 for the treatment of Trichomonas vaginalis infections. It has since been used to treat a variety of infections caused by anaerobic [...]

Published
2008

30. 1023

Author

Siemianowski, Laura, primary, Whitman, Craig, additional, Czosnowski, Quinn, additional, and Zanotti-Cavazzoni, Sergio, additional

Published
2013
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31. 761: ANTIDEPRESSANT AND ANTIPSYCHOTIC PRESCRIBING FOLLOWING ICU ADMISSION DUE TO COVID-19.

Author

Czosnowski, Quinn, Elmore, Hannah, Kruer, Rachel, Miller, Emily, Khan, Babar, Sprunger, Amy, Richards, Samantha, and Khan, Sikandar

Subjects
*DRUG prescribing, *COVID-19, *ANTIDEPRESSANTS
Abstract

The primary endpoint was the rate of combined antidepressant and antipsychotic use before ICU admission compared to their last clinic visit. At the time of the last clinic visit none of the 16 patients were receiving an antipsychotic while all were receiving an antidepressant. The purpose of this study was to examine the rates of antidepressant and antipsychotic use in patients with PICS following critical illness due to COVID-19. [Extracted from the article]

Published
2023
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32. 1095

Author

Igneri, Lauren, primary, Whitman, Craig, additional, Czosnowski, Quinn, additional, Gajera, Mithil, additional, Milcarek, Barry, additional, Hunter, Krystal, additional, Schorr, Christa, additional, and Spevetz, Antoinette, additional

Published
2012
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34. Risk of Clostridium difficile infection in intensive care unit patients with sepsis exposed to metronidazole.

Author

Sabbah, Mohamad A., Schorr, Christa, Czosnowski, Quinn A., Hunter, Krystal, Torjman, Marc C., Fraimow, Henry S., Zanotti, Sergio, and Tsigrelis, Constantine

Subjects
CLOSTRIDIOIDES difficile, INTENSIVE care units, SEPSIS, SEPTICEMIA treatment, METRONIDAZOLE, VANCOMYCIN, CASE-control method, PATIENTS, DISEASE risk factors, THERAPEUTICS, ACADEMIC medical centers, ANTI-infective agents, CANDIDA, MULTIVARIATE analysis, STATISTICS, LOGISTIC regression analysis, STATISTICAL power analysis, DESCRIPTIVE statistics, ODDS ratio, MANN Whitney U Test
Abstract

Background: Antimicrobial agents used to treat Clostridium difficile infection (CDI), such as metronidazole and vancomycin, have been used during antibiotic treatment of other infections to try to prevent the development of CDI. We evaluated the hypothesis that intensive care unit (ICU) patients who receive metronidazole as part of an antibiotic treatment regimen for sepsis have a lower risk of subsequently developing CDI. Methods: This was a nested case-control study in a cohort of ICU patients who received antibiotic therapy for sepsis. Results: A total of 10 012 patients aged = 18 years were admitted to the Cooper University Hospital medical/surgical ICU from 1/1/2003 to 12/31/2008. After applying inclusion criteria including having received antibiotic therapy for sepsis and subsequently having developed CDI, 67 cases were identified. The cases were matched for age, gender, date of ICU admission, and hospital length of stay to 67 controls that also received antibiotic therapy for sepsis but did not subsequently develop CDI. In the multivariate analysis, there was no association between metronidazole exposure and the risk of CDI (odds ratio (OR) = 0.57; p = 0.23). The only significant associations on multivariate analysis were antifungal therapy (OR = 0.30; p = 0.02) and aminoglycoside and/or colistin therapy (OR = 0.17; p = 0.02). Conclusions: No association was found between metronidazole use and subsequent CDI in ICU patients who received antibiotic therapy for sepsis. [ABSTRACT FROM AUTHOR]

Published
2015
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35. Contributors

Author

Abouzgheib, Wissam, Anthony, David, Attaya, Shariff, Balk, Robert A., Barton, Richard G., Bartter, Thaddeus, Bashour, C. Allen, Bekes, Carolyn, Bellavance, Emily, Berger, Karen, Bion, Julian, Bleck, Thomas P., Bowen, Frank, Braithwaite, Susan S., Carioni, Pietro, Carlesso, Eleonora, Cartin-Ceba, Rodrigo, Cecconi, Maurizio, Chaptini, Louis, Chawla, Lakhmir S., Cinel, Ismail, Craig, T.R., Curti, Brendan D., Czosnowski, Quinn A., Danis, Marion, Dellinger, R. Phillip, DePalma, Fedele J., Diaz-Gomez, Jose, Dokainish, Hisham, Domínguez-Cherit, Guillermo, Dries, David J., Durairaj, Lakshmi, Elfant, Adam B., Ely, E. Wesley, Fraimow, Henry S., Fraser, John F., Friedman, Yaakov, Fuller, Brian M., Gajic, Ognjen, Gattinoni, Luciano, Gautam, Nandan, Geisen, Martin, Ginsberg, Fredric, Goldman, H. Warren, Grandhi, Bala K., Groeneveld, A.B.J., Gurka, David P., Haupt, Marilyn T., Hipp, Dustin M., Hockstein, Michael J., Hollenberg, Steven M., Hyzy, Robert C., Jneid, Hani, Johnson, Laura S., Johnson, Robert, Jubran, Amal, Karam, George, Kaufman, Steven T., Kline, Jason A., Kobeissi, Zoulficar, Kumar, Anand, Lachant, Neil A., Laghi, Franco, Lakshmanan, Rekha, Lapinsky, Stephen E., Laufgraben, Marc, Lavery, G.G., Leeper, Kenneth V., Jr., Longo, Dan L., Lotano, Ramya, Lotano, Vincent E., Maki, MD, Dennis G., Maree, Andrew O., Marik, Paul E., Marini, John, Marshall, John C., Masur, Henry, Maybauer, Dirk M., Maybauer, Marc O., McFadden, Christopher B., Miano, Todd A., Mirsen, Thomas R., Mittal, Manoj K., Moreno, Rui, Murphy, Nick, Muzevich, Katie M., Nair, Girish B., Neiderman, Michael S., O'Neal, Hollis, Ortman, Matthew, Ostrosky-Zeichner, Luis, Ougorets, Igor, Palacios, Igor F., Palevsky, Paul M., Parikh, Amay, Park, Sea Mi, Parrillo, Joseph E., Peikin, Steven, Peters, Priscilla, Posadas-Calleja, Juan Gabriel, Pratter, Melvin R., Rajaram, S. Sujanthy, Reboli, Annette C., Rex, John H., Rhodes, Andrew, Rincon, Fred, Rosengart, Axel, Russo, Andrea M., Ryszkiewicz, Rebecca L., Sabir, Sajjad A., Saffle, Jeffrey R., Sagana, Rommel, Sanchez, Raul, Schmidt, Gregory A., Schorr, Christa, Sessler, Curtis N., Shen, Michael C., Silverman, Henry, Sobek, Sabine, Sterling, Michael, Taylor, Robert W., Thomas, Christopher B., Tobin, Martin J., Topalian, Simon K., Townsend, Sean, Trohman, Richard, Trzeciak, Stephen, Tsapenko, Mykola V., Tsigrelis, Constantine, Turi, Zoltan G., Turtz, Alan R., Unligil, Ulug, Vincent, Jean-Louis, Weisberg, Lawrence S., Werns, Steven, Wijdicks, Eelco F.M., Zanotti-Cavazzoni, Sergio L., and Zimmerman, Janice L.

Published
2014
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