Medicine and Health Sciences Commons^™

Implementation Of An Iv Workflow System To Reduce Iv Preparation Errors, Craig Senholzi, Rph, Mba, Jeremy Lawton, Pharmd, Gary Bea, Bs, Brian G. Swift, Pharm.D., Mba

Pharmacy Presentations, Posters, and Grand Rounds

The goals of our IV workflow implementation project were to:

• Promote safety by reducing the number of preparation errors involving IV products that could subsequently lead to patient harm.
• Promote efficiency and standardization in our IV workflow process.
• Minimize waste of compounded IV products.
• Assist in our journey toward high reliability.

Employing Pharmacy Students To Improve The Medication Use Process For Underserved Patients With A History Of Mental Health Or Substance Use Disorders, Ashley Maister, Pharmd Candidate, Toni Campanella, Pharmd Candidate, Roshni S. Patel, Pharmd, Bcps

College of Pharmacy Posters

Project HOME is a non-profit organization in Philadelphia that provides housing, employment opportunities, medical care, and education for chronically homeless individuals with serious mental health conditions.

One nurse oversees the medication use process at three of Project HOME’s residences; however, non-clinical staff are responsible for carrying out the medication use process.

The purpose of this project was to identify how the Jefferson College of Pharmacy’s APhA-ASP chapter could assist Project HOME with their medication-related needs and improve the medication use process.

The Effect Of Undergraduate Exposure And Experience On Choosing To Pursue A Pharmacy Degree, Erica M. Mcgovern, Ms, Andrew Stacy, Bs, Elena Schmidt, Phd, Ma, Elena Umland, Pharmd

College of Pharmacy Posters

BACKGROUND

• Shortage of pharmacists identified by Department of Health and Human Services in 20001
• Despite investment of significant recruitment resources to achieve optimum enrollment, fewer applications are being submitted for consideration to pharmacy school, and the number of students pursuing pharmacy school continues to decline2
• American Association of Colleges of Pharmacy (AACP) Recruitment Admissions Task Force speculates that qualified candidates may be pursuing other healthcare professions due to lack of awareness of and limited exposure to the expanding role of the pharmacist2
• Limited studies have been conducted to evaluate the primary factors motivating students to pursue a career in pharmacy …

Ethanol Pharmacokinetics In Neonates Secondary To Medication Administration, Elizabeth Marek, Pharmd, Susan C. Adeniyi-Jones, Md, Lindsey Roke, Pharmd, Tara E. Decerbo, Pharmd, Rebecca L. Cordell, Pharmd, Paul S. Monks, Pharmd, Walter K. Kraft, Md

Department of Pharmacology and Experimental Therapeutics Posters

Purpose:

Ethanol serves as a solvent and microbial preservative in oral liquid medications and is the second most commonly used solvent in liquid medications following water. Despite widespread use of ethanol in liquid medications for neonates, the pharmacokinetics and toxicity of ethanol in young children are not well described. The aim of the current study is to quantify blood ethanol levels in neonates secondary to oral ethanol containing medications.

Methods:

Neonates who received either oral phenobarbital (15% ethanol) and/or oral dexamethasone (30% ethanol) per standard of care were eligible for enrollment. A maximum of 6 blood samples per patient (4.5 …

Pharmacist Consult Service In Geriatric Trauma Patients, Vanessa M. Gleason, Pharm D., Rohit A. Moghe, Pharm D., Msph, Cde, Doris Warner, Msn, Rn, Cen, Michael S. Weinstein, Md, Facs

Pharmacy Presentations, Posters, and Grand Rounds

Introduction

• Geriatric patients (> 65 years of age) have a 3-5% incremental increase in annual occurrence of trauma making it a top five leading cause of death in this population.

• The mortality rate ranges from 15-30%, which is 4-5 times higher than younger patients.

• In 2011, data from the Pennsylvania Trauma Systems Foundation (PTSF) demonstrated nearly 32% of injured patients statewide and nearly 50% of the trauma patients at Thomas Jefferson University Hospital (TJUH) were > 65 years.

• Most geriatric patients have comorbidities that are treated with many medications, which may predispose them for falls.

• Although …

Neonatal Abstinence Syndrome In Methadone Exposed Infants: Role Of Genetic Variability, Andrea L. Fielder, J. K. Coller, M. R. Hutchinson, Ross R. Haslam, Nona Lu, Susan C. Adeniyi-Jones, Michelle Ehrlich, Walter K. Kraft

Department of Pharmacology and Experimental Therapeutics Posters

Poster presented at: CPDD Scientific Meeting, San Juan, PR.

Aims: NAS incidence & severity in infants exposed to methadone during gestation is independent of maternal methadone dose. The incidence & severity of NAS could be in part due to genetic variability of key genetic loci related to opioid response; the interleukin-1beta (IL-1B) & mu opioid receptor (OPRM1) genes. This study aimed to investigate the impact of genetic variability in IL-1B -31 or OPRM1 A118G on NAS incidence (treatment required) & severity (dose of morphine).

Methods: This pilot study collected cheek cells from 71 methadone exposed infants; 46 …

Clevidipine For Acute Blood Pressure Management In The Neurological Intensive Care Unit, Dorota K. Szarlej, Pharmd, Jessica L. Mckeon, Pharmd, Akta S. Patel, Pharmd, Bcps, Amber King

College of Pharmacy Faculty Papers

Clevidipine is a third generation intravenous dihydropyridine calcium channel antagonist approved for treatment of acute hypertension when oral therapy is not feasible or desirable. It is an arterial vasodilator that is metabolized by plasma esterases; therefore, it is eliminated independently of the liver and kidney.1 Clevidipine has been studied for the control of perioperative hypertension2-5 as well as for the management of hyper-tensive crises6 when immediate blood pressure control is clinically necessary. Benefits include its tolerability, rapid onset and offset, and easy titration with predictable response. Other continuously infused intravenous antihypertensives used in the neurocritical care patient population include nicardipine, …

The Impact Of Community Use Of Novel Oral Anticoagulants On An Academic Medical Center, Luis Eraso, Md, Taki Galanis, Md, Kristina Kipp, Pharm.D., Walter K. Kraft, Md, Michael Palladino, Pharm.D., Cacp, Alejandro Perez, Md, Kimberle Ferebee-Spruill, Crnp, Geno Merli, Md, Brian G. Swift, Pharm.D., Mba, Lynda Thomson, Brittany Vining

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Warfarin has been a mainstay of therapy for treatment and prevention of venous thromboembolic disease (VTED) and prevention of stroke and systemic embolism for over 50 years. Recent FDA approval of several novel oral anticoagulants has offered more extensive treatment options for management of these disease states.

The availability of the novel anticoagulants offers an attractive alternative to warfarin therapy for patients due to their convenience of use. In comparison to warfarin, dabigatran, rivaroxaban and apixaban offer: - a fixed dosage regimen

- a relatively small potential drug interaction profile

- minimal laboratory monitoring

- little to no dietary restrictions. …

Heart Failure Transition Of Care Program: The Pharmacist’S Role In Reducing Readmissions, Joseph Favatella, Pharmd Candidate 2013, Joanne Heil, Pharmd, Bcps

College of Pharmacy Faculty Papers

Presented at: ASHP Mid-Year Clinical Meeting in Las Vegas.

Introduction & Background

Current Trends¹

•Approximately 19.6% of Medicare patients are readmitted to the hospital within 30 days

•These readmissions accounted for $15 billion of Medicare spending in 2009

Changes Coming

•As part of the Affordable Care Act, Medicare will not be reimbursing hospitals for patients readmitted within 30 days of discharge

•Hospitals have already begun improving discharge protocols to provide a greater continuity of care and minimize the financial loss of future readmissions

A Model²

•Boston University Medical Center's Re-Engineered Discharge (RED) was the first program to improve …

The Use Of Glucarpidase In An Open-Label Treatment Protocol As Adjunctive Treatment For A Patient With Delayed Methotrexate Elimination, Cheryl A. Abbas, Pharmd, Anne Marie Valorie-Oberle, Bs, Pharmd, Bcop

College of Pharmacy Faculty Papers

Presented at: ASHP Clinical MidYear Meeting in Las Vegas.

Background

Methotrexate (MTX)

• Cytotoxic agent that competitively inhibits dihydrofolate reductase (DHFR), the intracellular enzyme responsible for converting folic acid to reduced folate inhibitors, necessary for DNA synthesis
• Used since 1948 in the treatment of various malignancies and as a disease-modifying agent in rheumatoid arthritis and psoriasis
• High-dose mexthotrexate (HDMTX) began in 1960s solely or in combination with other chemotherapeutic agents

Methotrexate Toxicity

• Almost exclusively cleared through the kidneys
  • Precipitation of drug occurs in the renal tubules
  • Prolonged elevations of systemic MTX concentrations results in potential serious toxicity
• Increased use of HDMTX …

Dysregulation Of Mir-31 And Mir-21 Induced By Zinc Deficiency Promotes Esophageal Cancer, Hansjuerg Alder, Cristian Taccioli, Hongping Chen, Yubao Jiang, Karl Smalley, Paolo Fadda, Hatice G. Ozer, Kay Huebner, John Farber, Carlo M. Croce, Louise Fong

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Presented at: Hallmarks and Cancer Conference, October 29-31 in San Francisco.

And AICR Annual Meeting, November 1-2, 2012.

Dietary zinc (Zn) deficiency (ZD) in rats induces an inflammatory gene signature that fuels esophageal squamous cell cancer (ESCC). Using nanoStringTM technology, we show that the inflammation is accompanied by altered expression of specific microRNAs in esophagus, as well as skin, lung, pancreas, liver, prostate, and PBMC, predictive of disease development. Particularly, the ZD esophagus has a microRNA signature resembling human ESCC/tongue SCC miRNAomes with overexpression of miR-31 and miR-21 and downregulation of their respective tumor suppressor targets PPP2R2A and …

Interprofessional Education In Didactic And Experiential Settings At The Jefferson School Of Pharmacy, Elena M. Umland, Cynthia A. Sanoski, Emily R. Hajjar, Bhavik Shah

College of Pharmacy Faculty Papers

Presented at: 2012 Annual Meeting of the American Association of Colleges of Pharmacy in Kissimmee, Florida.

Objective:

To evaluate the various IPE offerings at a new school of pharmacy at a large academic medical center.

Prediction Of Sublingual Bioavailability Of Buprenorphine In Newborns With Neonatal Abstinence Syndrome—A Case Study On Physiological And Developmental Changes Using Nonmem And Simcyp, Di Wu, Walter K. Kraft, Michelle E. Ehrlick, Jeffrey S. Barnett

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Poster presented at 2009 American College of Clinical Pharmacology conference in Orlando. April 24-28.

Background: About 55 to 94% of infants born to opioid dependent mothershave neonatal abstinence syndrome (NAS). Buprenorphine (BUP) is usedclinically as an analgesic and a detoxification agent and a maintenancetreatment for opioid dependence. No data, however, has been reported about the use of sublingual administration of BUP below the age of 4 year, especially for term infants with NAS.

Objectives: Characterize pharmacokinetics (PK) of BUP in newborn patients;Evaluate the developmental changes in newborns in order to assist dosingoptimization in ongoing clinical studies.

Methods: In silico prediction …