Medicine and Health Sciences Commons^™

Optimizing Antibiotic Management Of Pediatric Acute Otitis Media In An Emergency Department, Alicia Daggett, Alaina N. Burns, Brian R. Lee, Nirav Shastri, Patricia Phillips, Rana E. El Feghaly

Posters

Problem

Children diagnosed with acute otitis media (AOM) at the Children's Mercy Hospital Kansas Emergency Department routinely get antibiotic prescriptions. There is rarely discussion with families about watchful waiting (defined as discussion of observation with parents and providing a safety-net antibiotic prescription that parents can ill if the patient is not improving or is worsening over the next 48 hours).

The aim of this quality improvement project is to increase watchful waiting for AOM at the CMK ED by 20% by March 2020, with an overall goal of decreasing antibiotic use for AOM.

Manufacturing Process Implications On Aerosolized Submicron To Nano-Sized Particles From Respiratory Drug Delivery Devices, Mohammed Ali

Faculty Posters

No abstract provided.

The Effect Of Antihypertensive Dose On Blood Pressure Control In Children With Chronic Kidney Disease, Benjamin A. Matta

Presentations

This presentation describes a study to determine the effect of antihypertensive dosing on blood pressure control in children with chronic kidney disease. The original version of this presentation is a prezi show at https://prezi.com/view/4qluDL1gMKFELOf1nLVA/

Predictive Performance Of Existing Population Pharmacokinetic Models Of Tacrolimus In Pediatric Kidney Transplant Recipients, Alenka Chapron, Susan M. Abdel-Rahman

Posters

With the goal of developing a clinician-driven tacrolimus (TAC) pharmacokinetic dosing tool, our initial objectives were 1) to examine whether published TAC population pharmacokinetic (popPK) models could serve as a foundation for the dosing tool, and 2) evaluate their performance predicting TAC concentrations in an independent cohort of Children's Mercy patients.

Pediatric Ppi Use And Fractures, Nathan R. Fleishman, Troy Richardson, Thomas M. Attard

Posters

This study compared the rate of fracture among pediatric patients exposed to proton pump inhibitors to the rate among patients without exposure, and also considered the fracture location among children exposed to proton pump inhibitors.

A Nsqip Analysis Of Post-Operative Antibiotic Utilization In Uncomplicated Appendicitis, Charlene Dekonenko, Robert M. Dorman, Janelle R. Noel-Macdonnell, Tolulope A. Oyetunji

Posters

APSA 2010 recommendations do not support antibiotic use post-operatively following appendectomy for uncomplicated appendicitis, but compliance varies by institution. This study determined the rate of post-operative antibiotic use in uncomplicated appendicitis and found that 10% of patients were discharged on antibiotics, using the NSQIP files.

Prospective Evaluation Of A Population Pharmacokinetic Model Of Pantoprazole For Obese Children, Alenka Chapron, Susan M. Abdel-Rahman, Valentina Shakhnovich

Posters

We previously developed a population pharmacokinetic (popPK) model of pantoprazole for obese children. Our objective was to evaluate the predictive performance of this model in an independent cohort of normal weight, overweight and obese children.

The Journey Of Implementing A Pediatric Essential Oil Program, Elizabeth Edmundson, Tiffany Kim

Nurse Presentations

Describes use of essential oil patches for specific indications with pediatric patients greater than 3 years old or greater than 20 kilograms. Lavender, peppermint, mandarin, or spearmint inhalation patches are used.

Evaluating The Effect Of Sodium Zirconium Cyclosilicate In Acute Hyperkalemia Management, Austin Brandes, Hannah Thompson, Paul Huiras

Pharmacy Posters

Introduction

• Sodium zirconium cyclosilicate (ZS-9) can acutely decrease serum potassium (K) levels after one dose and may have favorable side effects compared to sodium polystyrene sulfate (SPS).
• ZS-9 replaced oral SPS in the Hyperkalemia Order Set at St. Cloud Hospital in April 2019

Purpose

• To characterize the acute potassium-lowering effects of one 10-gram dose of sodium zirconium cyclosilicate in conjunction with other potassium-lowering medications

The Impact Of Medical Marijuana On The Opioid Crisis, Carl David Eastep

Physician Assistant Scholarly Project Posters

• The opioid crisis dictates the need for research into alternative treatments for acute and chronic pain.

• Comprehensive literature review was conducted to determine if medical marijuana might play a role in the treatment of acute and chronic pain.

• The addiction profiles of medical marijuana and prescription opiates were compared along with the adverse effects and quality of life.

• No use for medical marijuana for the treatment of acute pain.

• Likely some benefits from medical marijuana for chronic pain.

• Addictive profile

• Marijuana – marijuana withdrawal syndrome.
• Prescription Opiates – highly addictive

• Adverse …

Use Of Beta-Antagonists Or Hmg-Coa Reductase Inhibitors For Cardioprotection During Chemotherapy In Oncology Patients, Nicole Streich

Physician Assistant Scholarly Project Posters

Over the years, oncologists are better able to fight cancer and have increased cancer survival, but we are also finding that these lifesaving therapies can affect the heart and other parts of the body in a negative way. Chemotherapy is excellent at destroying cancer cells, but it also causes collateral damage to other healthy cells. There are certain chemotherapeutic agents that are known to cause cardiotoxicity. Currently we are monitoring the heart function of the patients who are receiving these cardiotoxic drugs prior to starting the chemotherapy as well as during and after treatment. However, there are currently no recommendations …

Oxcarbazepine Overdose In A Polysubstance Related Suicide, Melissa Beals, Robert J. Krumsick, C. Clinton Frazee Iii, Lindsey J. Haldiman, Uttam Garg

Posters

Introduction
Oxcarbazepine is a derivative of carbamazepine that is used primarily in the treatment of epilepsy, and experimentally as a mood-stabilizer in adjunctive therapy for the treatment of bipolar disorder. Oxcarbazepine is converted through oxidation to its pharmacologically active metabolite 10-OH-Carbazepine, which is thought to be responsible for most of the anticonvulsant action of the drug. Adverse effects of oxcarbazepine are generally dose-dependent and may include fatigue, somnolence, dizziness, diplopia, nystagmus, and ataxia. Additive sedative effects have been noted when oxcarbazepine is used in combination with other CNS depressionproducing medications. Furthermore, oxcarbazepine and 10-OH-Carbazepine are powerful CYP2C19 inhibitors, potentially increasing …

The Evaluation Of Mefloquine Drug Repurposing On Acute Myeloid Leukemia, Jessica L. Phan, Bhavuk Garg, Hrishikesh Mehta, Seth Corey

Undergraduate Research Posters

The aim of this study is to observe cell proliferation, cell viability, apoptosis, and autophagy on acute myeloid leukemia (AML) cell lines, NB4 and U937, with the drug repurposing of mefloquine (MQ). Methods such as the 3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay and trypan blue staining have shown a decrease in live cells with high concentrations of mefloquine. Using their average perspective IC50 values of MQ concentration, Western blotting was applied by means of apoptosis and autophagy markers to determine if the induction of apoptosis and inhibition of autophagy was present in MQ-treated AML cells. The experiment will be continued with more …

The Forensic Characterization Of Bacterial And Fungal Organisms In Traditional Chinese Medicine, Julia Grzymkowski, Christopher J. Ehrhardt, Justin L. Poklis, Michelle R. Peace

Undergraduate Research Posters

There has been an increase in use of Traditional Chinese Medicine (TCM) in the United States because they are less expensive and believed to be more effective with less adverse effects in comparison to traditional pharmaceutics. Therefore, sales have increased in the US, despite articles and case studies demonstrating the dangers, such as injury and death, related to TCM, stemming from improper labelling, toxic contaminants, and, in some cases, the presence of pathogenic bacteria. The aim of this study was to perform a survival experiment to demonstrate the importance of proper herbal brewing technique and to conduct a molecular and …

Pharmacy Driven Best Possible Admission Medication History At A Pediatric Institution, Damon Pabst, Charity Thompson, Brandon French, Brian O'Neal, Garret Matthews, Zeb Benner, Joshua Meade

Posters

No abstract provided.

Effect Of Energy Metabolism On Nf-Kb Activity In Ovarian Cancer, Simren K. Bagri

Undergraduate Research Posters

NF-kB is a transcription factor involved in cancer cell growth and survival. The activation of NF-kB can be assessed by monitoring phosphorylation of RelA p65 at Ser-536, which is a surrogate of the NF-kB transcription factor activation. The objective of this study was to determine if the loss of ATP leads to NF-kB deficiency and thus, apoptotic cell death of “bad” cells in ovarian cancer cells. The independent variables were metformin (Met), an anti-diabetic medicine, another compound MinB functionally similar to Met and a glucose transporter inhibitor BAY-876. The dependent variables were the resulting effect of Met and MinB on …

Sustainability And Outcomes Of A Standardized Aminoglycoside Induced Ototoxicity Monitoring Algorithm, Claire Elson, Christopher M. Oermann, Michelle Weltman, Ellen Meier

Posters

No abstract provided.

A Ninja Initiative At Children's Mercy, Richard Ogden, Bradley A. Warady, Vimal Chadha, Wendy Hoebing

Posters

No abstract provided.

Cannabinoid Therapy In Chronic Pain Management, Breanna Joy Privratsky

Physician Assistant Scholarly Project Posters

In 1996, the state of California was the first in the union to allow for the use of medical marijuana. Since then, 28 more states have enacted similar laws (National Conference of State Legislatures, [NCSL], 2017). With the ever-growing opiate problem that has now been classified as an epidemic by the Centers for Disease Control and Prevention, medical marijuana could be a viable alternative to this problem.

As of 2014, the CDC reported opioid deaths were up 369%, which is more than 91 deaths per day from overdose (Centers for Disease Control, [CDC], 2017). The purpose of this study is …

Medication Education In The Pediatric Rheumatology Clinic, Ashley M. Cooper, Julia G. Harris

Posters

No abstract provided.

Medication Timeliness In Emergency Department In Pediatric Sickle Cell Disease Population Presenting With Vaso-Occlusive Episode, Derrick Goubeaux, Kaitlyn Hoch, Gerald Woods, Julie Routhieaux, Maureen Guignon, Valerie Mcdougall Kestner

Posters

No abstract provided.

The Association Of Hormonal Contraception With Depression, Pamela Derickson

Family Medicine Clerkship Student Projects

Hormonal contraceptives are widely used by women during their reproductive years. Currently, over 100 million women worldwide use the pill, and 82% of sexually active women in the USA will use oral contraceptive pills at some time during their reproductive years (Carrol, 2017). Oral contraceptive use, especially among adolescents, is associated with subsequent use of antidepressants and a first diagnosis of depression, suggesting depression may be a potential adverse effect of hormonal contraceptive use (Skovlund, 2016). This project focused on educating health care providers at the Community Health Center of Burlington, VT (CHCB) about the association of depression and oral …

The Safety And Efficacy Of Creatine Supplementation In The General Public, Cody Baxter

Physician Assistant Scholarly Project Posters

The purpose of this study was to determine whether supplementation with creatine monohydrate is efficacious beyond the realm of its most popular use, which is in athletics. This study investigated the safety of creatine supplementation in the general population. References were collected through a review of PubMed and Scopus databases. Initial keywords searched were creatine supplementation and creatine safety. Where possible, trials with human subjects were utilized. Studies focused on creatine’s effects in athletes or weightlifting parameters were eliminated. Topics were further narrowed down by conditions with the most amount of research and medical concerns recognized as common to primary …

Out-Of-Pocket Cost For Individuals Being Treated For Opioid Dependence In Rutland County, Vermont, Christopher T. Veal

Family Medicine Clerkship Student Projects

Each day more than 140 Americans die from drug overdoses, 91 specifically due to opioids. In Vermont, more than 50 people die each year from opioid poisoning. With insurance coverage being a critical component of Opioid Dependence Recovery, many people seeking treatment are unaware of the financial barriers to recovery- namely the out-of-pocket costs associated with treatment. This study sought to provide insight on the financial impact of Opioid Dependence Treatment on the patient, and provide financial assistance information to the Rutland County community.

Identification Of “Kratom” (Mitragyna Speciosa) Alkaloids In Commercially Available Products, Julia Grzymkowski, Michelle R. Peace, Justin Poklis

Undergraduate Research Posters

“Kratom” is the common name for the botanical mitragyna speciosa. It is a tree native to Southeast Asia in which leaves contain the psychoactive alkaloids mitragynine and 7-hydroxymitragynine. Kratom is often ingested as teas, chewed, or smoked. It acts as a stimulant in small doses and as an opioid in large doses. Overdoses can result in vomiting, seizures, and death. Recently the Drug Enforcement Agency (DEA) placed Kratom on Schedule 1, but, due to public outcry, it was almost immediately removed.

Eleven kratom based products were obtained from various tobacco shops, “headshops” and via the internet including: Choice brand …

Can A Layer Of Antimicrobial Agents Be Placed Around Breast Implants To Prevent Staph Infections From Occurring?, Valerie L. Tran

Undergraduate Research Posters

The most common infection that occurs after breast augmentation is a staph infection. Currently, there are only three ways to treat this type of infection, all of which treat the breast implant after the infection has developed. The first option is to treat the infection with an oral antibiotic. If this doesn’t completely rid the infection, then intravenous antibiotics are used. If this too doesn’t remove the infection, then surgery will be performed to remove the breast implant and a new implant will be inserted. Although, these options have a low mortality rate, the success rate of completely getting rid …

Pharmacogenetic Testing In The Treatment Of Major Depressive Disorder, Brianna Strube

Physician Assistant Scholarly Project Posters

• Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders in the United States and is a large cause of disability. Antidepressants take weeks/months to become effective which can lead to noncompliance. Treatment has a high failure rate which increases medical costs and leads to decreased patient outcomes.

• Pharmacogenetic testing is the practice of analyzing genetic differences to predict a patient’s response to medications to improve efficacy and decrease adverse side effects. The purpose of this study was to investigate if pharmacogenetic-guided treatment, specifically in the use of antidepressants in MDD, has resulted in improved patient …

Metformin And Vitamin B12 Deficiency: Consequences And Patient Monitoring, Kathryn Dietz

Physician Assistant Scholarly Project Posters

• The incidence of type 2 diabetes has been increasing at a rapid rate in the United States.

• Metformin is recommended as the first line treatment to be started at the time of diagnosis in all patients without contraindications and has been associated with vitamin B12 deficiency.

• There are currently no clinical guidelines for the routine monitoring of B12 levels in this population.

• The purpose of this scholarly project is to determine if there are consequences of this deficiency and to make recommendations for screening patients.

• It includes current research that focuses on the pathophysiology of …

The Association Between Antipsychotic Medication And Weight Gain, Brian Steen

Physician Assistant Scholarly Project Posters

• Antipsychotic medications are utilized for patients with many mental health problems including schizophrenia, attention deficit hyperactivity disorder, autism, bipolar mania, and psychotic depression. The antipsychotic medications treat the symptoms associated with these mental health disorders.

• Antipsychotic medications, while being efficacious to these symptoms, can have unwanted side effects, including weight gain. The purpose of this study was to determine if there is a strong relationship with antipsychotic medication use and weight gain.

• The review of literature was conducted with an online search of Cochrane, PubMed, and PsycInfo for journal articles, research studies, and other scholarly reviews. Articles …

Association Between Proton Pump Inhibitor Use & Dementia: A Two-Fold Approach, Lisa Steers

Physician Assistant Scholarly Project Posters

An observational study of data derived from the German Study on Aging, Cognition and Dementia indicated that proton pump inhibitor use was associated with dementia risk (Benmassaoud, McDonald, & Lee, 2016). The purpose of this study is to explore a two-fold approach between proton pump inhibitor use and dementia. This two-fold approach will first investigate the association between dementia and proton pump inhibitor use and secondly, the proposed pathophysiology behind it. This approach to proton pump inhibitor use and dementia will allow for providers to utilize the association and make decisions to avoid chronic proton pump inhibitor use in effort …