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Improving The Palatability Of Colonoscopy Preparations, Phuong Anh Hoang Nguyen, Darnell Leon Cuylear, Heather Elizabeth Canavan 2018 University of New Mexico

Improving The Palatability Of Colonoscopy Preparations, Phuong Anh Hoang Nguyen, Darnell Leon Cuylear, Heather Elizabeth Canavan

Shared Knowledge Conference

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. The most reliable screening method of CRC is a colonoscopy which requires a 4-Liter polymer with electrolytes preparation. Two in five patients are non-compliant to their colonoscopy schedules, with many patients who abstain reporting refusal due to significant discomfort associated with this preparation. Furthermore, there are distinct gender differences in the tolerance of colonoscopy preparations in male and female populations. We hypothesize the differences in clinic are a result of toxic effects of the drug associated with poor mixing by individual patients. PEG, the drug ...


Enhancing Immunization Rates At Aurora Family Medicine Clinics In Milwaukee, Wisconsin, Zeeshan A. Yacoob, Christopher Cook, Jessica J.F. Kram, Marianne Klumph, Dennis J. Baumgardner, Marisa Stanley, Paul Hunter, Fabiana Kotovicz 2018 University of Wisconsin School of Medicine and Public Health

Enhancing Immunization Rates At Aurora Family Medicine Clinics In Milwaukee, Wisconsin, Zeeshan A. Yacoob, Christopher Cook, Jessica J.F. Kram, Marianne Klumph, Dennis J. Baumgardner, Marisa Stanley, Paul Hunter, Fabiana Kotovicz

Journal of Patient-Centered Research and Reviews

Background: In the United States, only 72.2% of children (age 19–35 months) are up-to-date on all of their immunizations. This rate is even lower for children from impoverished households (68.7%). Lack of encouragement by providers, as well as parent perceptions of vaccine safety and efficacy, have been cited as some of the reasons for lower vaccination rates.

Purpose: Our study aimed to collect and compare patient demographic data to age appropriate and comorbidity-specific vaccination rates.

Methods: We conducted a quality improvement study at Family Practice Center (Aurora St. Luke’s Medical Center, Milwaukee, WI) and Family Care ...


Improving The Management Of Nationwide Drug And Iv Bag Shortages, Inpatient Pharmacy, Supply Chain, Stephen Tyzik, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks 2018 Maine Medical Center

Improving The Management Of Nationwide Drug And Iv Bag Shortages, Inpatient Pharmacy, Supply Chain, Stephen Tyzik, Mark Parker, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operational Excellence

IMPROVING THE MANAGEMENT OF NATIONWIDE DRUG AND IV SHORTAGE

In September of 2017, Hurricane Maria struck the island of Puerto Rico where over 50 pharmaceutical factories had previously operated. The impact of this was felt not only in the drastic reduction of products that are produced on the island, but it also exacerbated the supply chain issues for key drugs nationwide.

The pharmacy department and supply chain in an academic tertiary care medical center did not have a consistent and reliable process for communication, planning and real-time updates. This resulted in a tremendous amount of wasted staff time at their ...


Oxcarbazepine Overdose In A Polysubstance Related Suicide, Melissa Beals, Robert J. Krumsick, C. Clinton Frazee III, Lindsey J. Haldiman, Uttam Garg 2018 Children's Mercy Hospital

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 ...


Recombinant Human Proteoglycan-4 Reduces Phagocytosis Of Urate Crystals And Downstream Nuclear Factor Kappa B And Inflammasome Activation And Production Of Cytokines And Chemokines In Human And Murine Macrophages, Marwa Qadri, Gregory D. Jay, Ling X. Zhang, Wendy Wong, Anthony M. Reginato, Changqi Sun, Tannin A. Schmidt 2018 Chapman University

Recombinant Human Proteoglycan-4 Reduces Phagocytosis Of Urate Crystals And Downstream Nuclear Factor Kappa B And Inflammasome Activation And Production Of Cytokines And Chemokines In Human And Murine Macrophages, Marwa Qadri, Gregory D. Jay, Ling X. Zhang, Wendy Wong, Anthony M. Reginato, Changqi Sun, Tannin A. Schmidt

Pharmacy Faculty Articles and Research

Microbial biofilms are organized communities of cells that are associated with a wide spectrum of resistant and chronic infections that lead to the treatment failure. Accordingly, there is an urgent demand to create novel effective therapeutic drugs that can inhibit biofilm formation with new mechanisms of action to surmount the current escalating resistance. In this study, in silico hybrid model was utilized to develop three novel short linear peptides (4, 5, and 6) with potential biofilm inhibiting activities (scores > 1.0). The peptides were composed of cationic and hydrophobic residues. They were synthesized using solid-phase strategy. Synthesized peptides were purified ...


A V-To-F Substitution In Sk2 Channels Causes Ca2+ Hypersensitivity And Improves Locomotion In A C. Elegans Als Model, Young-Woo Nam, Sabia N. Baskoylu, Dimitris Gazgalis, Razan Orfali, Meng Cui, Anne C. Hart, Miao Zhang 2018 Chapman University

A V-To-F Substitution In Sk2 Channels Causes Ca2+ Hypersensitivity And Improves Locomotion In A C. Elegans Als Model, Young-Woo Nam, Sabia N. Baskoylu, Dimitris Gazgalis, Razan Orfali, Meng Cui, Anne C. Hart, Miao Zhang

Pharmacy Faculty Articles and Research

Small-conductance Ca2+-activated K+ (SK) channels mediate medium afterhyperpolarization in the neurons and play a key role in the regulation of neuronal excitability. SK channels are potential drug targets for ataxia and Amyotrophic Lateral Sclerosis (ALS). SK channels are activated exclusively by the Ca2+-bound calmodulin. Previously, we identified an intrinsically disordered fragment that is essential for the mechanical coupling between Ca2+/calmodulin binding and channel opening. Here, we report that substitution of a valine to phenylalanine (V407F) in the intrinsically disordered fragment caused a ~6 fold increase in the Ca2+ sensitivity of SK2-a channels. This substitution resulted in a ...


Design, Synthesis, And Evaluation Of Homochiral Peptides Containing Arginine And Histidine As Molecular Transporters, Naglaa Salem El-Sayed, Taryn Miyake, Amir Nasrolahi Shirazi, Shang Eun Park, Jimmy Clark, Stephani Buchholz, Keykavous Parang, Rakesh Tiwari 2018 Chapman University

Design, Synthesis, And Evaluation Of Homochiral Peptides Containing Arginine And Histidine As Molecular Transporters, Naglaa Salem El-Sayed, Taryn Miyake, Amir Nasrolahi Shirazi, Shang Eun Park, Jimmy Clark, Stephani Buchholz, Keykavous Parang, Rakesh Tiwari

Pharmacy Faculty Articles and Research

Linear (HR)n and cyclic [HR]n peptides (n = 4,5) containing alternate arginine and histidine residues were synthesized. The peptides showed 0–15% cytotoxicity at 5–100 μM in human ovarian adenocarcinoma (SK-OV-3) cells while they exhibited 0–12% toxicity in human leukemia cancer cell line (CCRF-CEM). Among all peptides, cyclic [HR]4 peptide was able to improve the delivery of a cell impermeable fluorescence-labeled phosphopeptide by two-fold. Fatty acids of different alkyl chain length were attached at the N-terminal of the linear peptide (HR)4 to improve the molecular transporter property. Addition of fatty acyl chains was expected ...


Therapeutic Benefit Of Apremilast On Enthesitis And Dactylitis In Patients With Psoriatic Arthritis: A Pooled Analysis Of The Palace 1-3 Studies, Dafna D. Gladman, Arthur Kavanaugh, Juan J. Gomez-Reino, Jurgen Wollenhaupt, Maurizio Cutolo, Georg Schett, Eric Lespessailles, Benoit Guerette, Nikolay Delev, Lichen Teng, Christopher J. Edwards, Charles Birbara, Philip J. Mease 2018 Toronto Western Hospital

Therapeutic Benefit Of Apremilast On Enthesitis And Dactylitis In Patients With Psoriatic Arthritis: A Pooled Analysis Of The Palace 1-3 Studies, Dafna D. Gladman, Arthur Kavanaugh, Juan J. Gomez-Reino, Jurgen Wollenhaupt, Maurizio Cutolo, Georg Schett, Eric Lespessailles, Benoit Guerette, Nikolay Delev, Lichen Teng, Christopher J. Edwards, Charles Birbara, Philip J. Mease

Open Access Articles

Objective: The Psoriatic Arthritis Long-term Assessment of Clinical Efficacy (PALACE) clinical trial programme findings demonstrated that apremilast, an oral phosphodiesterase 4 inhibitor, is effective for treating psoriatic arthritis (PsA). Enthesitis and dactylitis are difficult-to-treat features of PsA leading to disability and affecting quality of life. PALACE 1, 2 and 3 data were pooled to assess the efficacy of apremilast on enthesitis and dactylitis outcomes in patients with these conditions at baseline.

Methods: Patients with enthesitis (n=945) or dactylitis (n=633) at baseline were analysed after receiving double-blind treatment with placebo, apremilast 30 mg two times per day or apremilast ...


Efficient Intracellular Delivery Of Cell-Impermeable Cargo Molecules By Peptides Containing Tryptophan And Histidine, Amir Nasrolahi Shirazi, Saghar Mozaffari, Rinzhin Tshering Sherpa, Rakesh Tiwari, Keykavous Parang 2018 Chapman University

Efficient Intracellular Delivery Of Cell-Impermeable Cargo Molecules By Peptides Containing Tryptophan And Histidine, Amir Nasrolahi Shirazi, Saghar Mozaffari, Rinzhin Tshering Sherpa, Rakesh Tiwari, Keykavous Parang

Pharmacy Faculty Articles and Research

We have previously evaluated and reported numerous classes of linear and cyclic peptides containing hydrophobic and hydrophilic segments for intracellular delivery of multiple molecular cargos. Herein, a combination of histidine and tryptophan amino acids were designed and evaluated for their efficiency in intracellular delivery of cell-impermeable phosphopeptides and the anti-HIV drug, emtricitabine. Two new decapeptides, with linear and cyclic natures, both containing alternate tryptophan and histidine residues, were synthesized using Fmoc/tBu solid-phase chemistry. The peptides were characterized and purified by using matrix-assisted laser desorption/ionization (MALDI) spectroscopy and high-performance liquid chromatography (HPLC), respectively. These peptides did not show significant ...


Preparation Of Supramolecular Amphiphilic Cyclodextrin Bilayer Vesicles For Pharmaceutical Applications, Kate E. Frischkorn 2018 California Polytechnic State University, San Luis Obispo

Preparation Of Supramolecular Amphiphilic Cyclodextrin Bilayer Vesicles For Pharmaceutical Applications, Kate E. Frischkorn

Master's Theses and Project Reports

Recent pharmaceutical developments have investigated using supramolecular nanoparticles in order to increase the bioavailability and solubility of drugs delivered in various methods. Modification of the carbohydrate cyclodextrin increases the ability to encapsulate hydrophobic pharmaceutical molecules by forming a carrier with a hydrophobic core and hydrophilic exterior. Guest molecules are commonly added to these inclusion complexes in order to add stability and further increase targeting abilities of the carriers. One such guest molecule is adamantine combined with a poly(ethylene glycol) chain. Vesicles are formed by hydrating a thin film of amphiphilic cyclodextrin and guest molecules in buffer solution that mimics ...


Efficacy And Safety Of Direct Oral Anticoagulants Approved For Cardiovascular Indications: Systematic Review And Meta-Analysis, Raghavendra Charan Makam, David C. Hoaglin, David D. McManus, Victoria Wang, Joel M. Gore, Frederick A. Spencer, Richeek Pradhan, Hoang Tran, Hong Yu, Robert J. Goldberg 2018 University of Massachusetts Medical School

Efficacy And Safety Of Direct Oral Anticoagulants Approved For Cardiovascular Indications: Systematic Review And Meta-Analysis, Raghavendra Charan Makam, David C. Hoaglin, David D. Mcmanus, Victoria Wang, Joel M. Gore, Frederick A. Spencer, Richeek Pradhan, Hoang Tran, Hong Yu, Robert J. Goldberg

Quantitative Health Sciences Publications and Presentations

BACKGROUND: Direct oral anticoagulants (DOACs) have emerged as promising alternatives to vitamin K antagonists (VKAs) for patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE). Few meta-analyses have included all DOACs that have received FDA approval for these cardiovascular indications, and their overall comparisons against VKAs have shortcomings in data and methods. We provide an updated overall assessment of the efficacy and safety of those DOACs at dosages currently approved for NVAF or VTE, in comparison with VKAs.

METHODS: We used data from Phase 3 randomized trials that compared an FDA-approved DOAC with VKA for primary prevention of stroke ...


Dexmedetomidine (Precedex) Induced Fever, Patrick DeAlmeida DO, Michael Matrale DO 2018 Rowan University SOM

Dexmedetomidine (Precedex) Induced Fever, Patrick Dealmeida Do, Michael Matrale Do

Stratford Campus Research Day

Precedex is an intravenous, α-2 receptor agonist broadly used for analgesia, maintenance of sedation, and alcohol withdrawal treatment in the intensive care unit (ICU).

The most commonly reported adverse effects associated with precedex are hypotension and bradycardia1.

Fever has been reported with a 5-7% incidence rate. Our case shows a very impressive pyrexia in a 49 year old patient most likely associated to Precedex. When compared to the previously three reported cases his fever reached the largest value (T= 107ºF).

As its use becomes more and more common in the ICU, clinicians should be aware of this adverse effect especially ...


A Comparison Of The Costs Associated With The Administration Of Select High-Cost Infused Medications In Three Sites Of Care For A State Medicaid Population, Sage Bagwell, Pavel Lavitas, Thomas C. Pomfret, Bonnie C. Greenwood, Nicole M. Trask, Stephanie Tran, Nancy L. Schiff, Tasmina Hydery, Patricia Leto, Mylissa K. Price, Caroline J. Alper, Kimberly J. Lenz, Paul L. Jeffrey 2018 University of Massachusetts Medical School

A Comparison Of The Costs Associated With The Administration Of Select High-Cost Infused Medications In Three Sites Of Care For A State Medicaid Population, Sage Bagwell, Pavel Lavitas, Thomas C. Pomfret, Bonnie C. Greenwood, Nicole M. Trask, Stephanie Tran, Nancy L. Schiff, Tasmina Hydery, Patricia Leto, Mylissa K. Price, Caroline J. Alper, Kimberly J. Lenz, Paul L. Jeffrey

Commonwealth Medicine Publications

This poster evaluates the financial impact of high-cost infused medications across three site of care programs. Site of care programs help payers save money on specialty drug spend by shifting utilization on high costs infused medications to less costly sites of administration. The objective of this project was to evaluate the costs associated with the administration of select high-cost infused medications in site of care programs in Massachusetts Medicaid populations. Research was done through retrospective analysis that included pharmacy and medical claims data for select high cost infused medications between April 1, 2017 - September 20, 2017.

This presentation was given ...


Impact Of Lumacaftor/Ivacaftor On Pulmonary Exacerbation Rates In Members With Cystic Fibrosis In A Medicaid Population, Mark A. Tesell, Karen Stevens, Bonnie C. Greenwood, Caroline J. Alper, Kimberly J. Lenz, Paul L. Jeffrey 2018 University of Massachusetts Medical School

Impact Of Lumacaftor/Ivacaftor On Pulmonary Exacerbation Rates In Members With Cystic Fibrosis In A Medicaid Population, Mark A. Tesell, Karen Stevens, Bonnie C. Greenwood, Caroline J. Alper, Kimberly J. Lenz, Paul L. Jeffrey

Commonwealth Medicine Publications

This poster gives an overview of pulmonary exacerbation rates pre- and post-initiation of Lumacaftor/Ivacaftor (LUM/IVA) in Massachusetts' Medicaid program. Pulmonary disease is one of the leading causes of morbidity and mortality among patients with cystic fibrosis. LUM/IVA has been effective in improving pulmonary outcomes in two observational studies, but before this study, there had been no published data evaluating real-world outcomes for Medicaid patients receiving this therapy.

This poster on the impact of a drug for patients with cystic fibrosis was shared during the 2018 Academy of Managed Care Pharmacy Managed Care & Specialty Pharmacy Annual Meeting and ...


Comparing The Side Effects Of Prescription Opioids And Medicinal Marijuana In The Treatment Of Chronic Pain, Callie Glenn, Ryan Bopp 2018 Carroll College - Helena

Comparing The Side Effects Of Prescription Opioids And Medicinal Marijuana In The Treatment Of Chronic Pain, Callie Glenn, Ryan Bopp

Carroll College Student Undergraduate Research Festival

Opioids are medications that interact with receptors in the central nervous system to provide pain relief, and have been a standard foundation for treatment of chronic pain since their discovery. But advancements in medical technology have led to the discovery of several alternatives to narcotics, one being medical marijuana. Cannabis has become increasingly pertinent in the medical field due to the medicinal and recreational legalization of the substance in several states. The purpose of this Evidence Based Practice Brief is to determine how the side effects of medical marijuana compared to those of opioid treatment affect quality of life for ...


Anxiety, Depression, And Adverse Clinical Outcomes In Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network Wave Study, Christine Baumgartner, Dongjie Fan, Margaret C. Fang, Daniel E. Singer, Daniel M. Witt, John R. Schmelzer, Marc S. Williams, Jerry H. Gurwitz, Sue Hee Sung, Alan S. Go 2018 University of California, San Francisco

Anxiety, Depression, And Adverse Clinical Outcomes In Patients With Atrial Fibrillation Starting Warfarin: Cardiovascular Research Network Wave Study, Christine Baumgartner, Dongjie Fan, Margaret C. Fang, Daniel E. Singer, Daniel M. Witt, John R. Schmelzer, Marc S. Williams, Jerry H. Gurwitz, Sue Hee Sung, Alan S. Go

Open Access Articles

BACKGROUND: Anxiety and depression are associated with worse outcomes in several cardiovascular conditions, but it is unclear whether they affect outcomes in atrial fibrillation (AF). In a large diverse population of adults with AF, we evaluated the association of diagnosed anxiety and/or depression with stroke and bleeding outcomes.

METHODS AND RESULTS: The Cardiovascular Research Network WAVE (Community-Based Control and Persistence of Warfarin Therapy and Associated Rates and Predictors of Adverse Clinical Events in Atrial Fibrillation and Venous Thromboembolism) Study included adults with AF newly starting warfarin between 2004 and 2007 within 5 health delivery systems in the United States ...


Refrigerated Stability Of Diluted Cisatracurium, Rocuronium, And Vecuronium For Skin Testing After Perioperative Anaphylaxis, Kristen Dinsmore, Bethany Campbell, Timothy Archibald, Greg Mosier, Stacy Brown PhD, Alexei Gonzalez-Estrada MD 2018 East Tennessee State University

Refrigerated Stability Of Diluted Cisatracurium, Rocuronium, And Vecuronium For Skin Testing After Perioperative Anaphylaxis, Kristen Dinsmore, Bethany Campbell, Timothy Archibald, Greg Mosier, Stacy Brown Phd, Alexei Gonzalez-Estrada Md

Appalachian Student Research Forum

Rationale: The purpose of this study is to investigate the stored stability of dilutions of neuromuscular blocking agents (NMBAs), namely cisatracurium, rocuronium, and vecuronium, for skin prick/intradermal testing.

Methods: Concentrations of NMBAs were monitored by liquid chromatography-mass spectrometry (LC-MS/MS) for a period of 14 days. Dilutions of NMBAs were prepared in saline by factors of 10x, 100x, 1,000x, 10,000x, and 100,000x as sensitivity of the assay allowed. Diluted drug products were stored in a laboratory refrigerator until sampling. On sampling days, aliquots of each dilution were removed and compared to a freshly prepared set of ...


Cost-Effectiveness Of Alternative Anticoagulation Strategies For Postoperative Management Of Total Knee Arthroplasty Patients, Savannah R. Smith, Jeffrey Katz, Elena Losina 2018 George Washington University

Cost-Effectiveness Of Alternative Anticoagulation Strategies For Postoperative Management Of Total Knee Arthroplasty Patients, Savannah R. Smith, Jeffrey Katz, Elena Losina

GW Research Days 2016 - Present

Background: Anticoagulation is essential for deep vein thrombosis (DVT) and pulmonary embolism (PE) prevention following total knee arthroplasty (TKA). Some research has suggested that longer duration anticoagulation can substantially reduce the risks of DVT and PE; however, in the absence of definitive recommendations, physicians are left weighing the risks of DVT and PE against those of anticoagulation, including gastrointestinal (GI) and central nervous system (CNS) hemorrhage and increased likelihood of prosthetic joint infection (PJI). We conducted a cost-effectiveness analysis to evaluate the benefits and risks of 14- and 35-day therapy with the most commonly prescribed anticoagulants post-TKA.

Background: Anticoagulation is ...


Acute Hepatic Failure And Oral Amiodarone, Hani Alhamoud, Sivateja Mandava, Talal Alzahrani 2018 George Washington University

Acute Hepatic Failure And Oral Amiodarone, Hani Alhamoud, Sivateja Mandava, Talal Alzahrani

GW Research Days 2016 - Present

Introduction:

Amiodarone is associated with serious complications such as lung toxicity, thyroid dysfunction, and QT-prolongation. Further, hepatic failure from the intravenous (IV) formulation of amiodarone is described in numerous case reports and case series. Although there are reports of elevated liver enzymes from the oral formulation of amiodarone, to our knowledge, none have definitively identified a case of acute hepatic failure from the oral formulation alone. In this case, we report an instance of acute hepatic failure after increasing the oral amiodarone dosage as well as rapid recovery following cessation of the medication.

Case report:

A 61-year-old male with a ...


Effect Of Study Design On Sample Size In Studies Intended To Evaluate Bioequivalence Of Inhaled Short-Acting Β-Agonist Formulations, Yaohui Zeng, Sachinkumar Singh, Kai Wang, Richard C. Ahrens 2018 University of Iowa

Effect Of Study Design On Sample Size In Studies Intended To Evaluate Bioequivalence Of Inhaled Short-Acting Β-Agonist Formulations, Yaohui Zeng, Sachinkumar Singh, Kai Wang, Richard C. Ahrens

Stead Family Department of Pediatrics Publications

Pharmacodynamic studies that use methacholine challenge to assess bioequivalence of generic and innovator albuterol formulations are generally designed per published Food and Drug Administration guidance, with 3 reference doses and 1 test dose (3-by-1 design). These studies are challenging and expensive to conduct, typically requiring large sample sizes. We proposed 14 modified study designs as alternatives to the Food and Drug Administration-recommended 3-by-1 design, hypothesizing that adding reference and/or test doses would reduce sample size and cost. We used Monte Carlo simulation to estimate sample size. Simulation inputs were selected based on published studies and our own experience with ...


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