Other Pharmacy and Pharmaceutical Sciences Commons^™

The Opioid Epidemic: How Genetics Play A Role In Addiction And Treatment, Kirsten Houston

Honors College Theses

The opioid epidemic is an issue within the pharmaceutical industry in the United States of America due to prescription and non-prescription substances being made available to the population. Opioids include chemical substances that affect the body and brain through opioid receptors, including the mu, kappa, and delta receptors. These substances are derived and synthesized from the poppy plant. Multiple causes have been linked to opioid abuse disorder, including but not limited to employment, income, housing, nutrition, mental health disorders, and genetics. By gathering information from previous literature, genetics may be the main cause of narcotic analgesic tolerance and abuse. Specific …

A New Method For Investigating Bioequivalence Of Inhaled Formulations: A Pilot Study On Salbutamol, Homa Razaei, Maryam Khoubnasabjafari, Vahid Jouyban-Gharamaleki, Hamed Hamishehkar, Mohammad Reza Afshar Mogaddam, Elaheh Rahimpour, Reza Mehvar, Abolghasem Jouyban

Pharmacy Faculty Articles and Research

Purpose: An efficient, cost-effective and non-invasive test is required to overcome the challenges faced in the process of bioequivalence (BE) studies of various orally inhaled drug formulations. Two different types of pressurized meter dose inhalers (MDI-1 and MDI-2) were used in this study to test the practical applicability of a previously proposed hypothesis on the BE of inhaled salbutamol formulations.

Methods: Salbutamol concentration profiles of the exhaled breath condensate (EBC) samples collected from volunteers receiving two inhaled formulations were compared employing BE criteria. In addition, the aerodynamic particle size distribution of the inhalers was determined by employing next generation impactor. …

An Economic And Regulatory Analysis Of Breast Cancer Drugs Approved By The Us Food And Drug Administration, Abdullah Althomali

Pharmaceutical Sciences (MS) Theses

Introduction

Breast cancer is the most common cancer among women and the leading cause of cancer death among women worldwide. The pharmacological options for breast cancer include chemotherapy, hormone therapy, targeted therapy, and immunotherapy, which are used for the prevention or treatment of breast cancer. This study assessed trends in FDA approvals and prices at the market entry of new drugs indicated for breast cancer in the period 1980-2022. The study also evaluated the factors associated with the price of the new breast cancer drugs at market entry.

Material and Methods

Regulatory data were collected from the FDA website, and …

Application Of Informatics Tools To Facilitate The Practice Of Precision Medicine With Genomic Testing And Clinical Data, Michael Sayer

Pharmaceutical Sciences (PhD) Dissertations

The practice of precision medicine considers a variety of sources of information to optimize patient care. Factors such as patient demographics, clinical history, and lab test values have well understood effects on treatment outcomes and influence decision making. However, effective inclusion of biomolecular data such as protein expression and DNA sequencing data within the practice of precision medicine needs continued study. Informatics tools offer solutions to allow these complex data sources to be effectively embraced. Utilization of informatics tools to visualize data pertaining to the gene selection practices of pharmacogenomic (PGx) tests effectively communicated large amounts of information into concise …

Genetic Mutations Of KCa2.3 And KCa3.1 Channels Affect Ca2+ Sensitivity, Razan Orfali

Pharmaceutical Sciences (PhD) Dissertations

The Ca²⁺-activated potassium channels K_Ca channels are a unique family of potassium channels activated by intracellular calcium. K_Ca channels are critical for maintaining K⁺ homeostasis and modulate several physiological processes, from the firing properties of neurons to the control of the transmitter release. The Ca²⁺ sensitivity of these channels allows intracellular Ca²⁺ to regulate the electrical activity of the cell membrane. Increased Ca²⁺ sensitivity of K_Ca channels caused by gain of function mutations (GOF) in the KCNN genes results in a broad spectrum of human channelopathies, including Zimmermann- Laband syndrome (ZLS), …

Beyond Use Date (Bud) Determination Of Ambroxol Hydrochloride Syrup By High-Performance Liquid Chromatography – Uv/Vis Detector, Catur Jatmika, Raditya Iswandana, Indah Dewi Lestari

Pharmaceutical Sciences and Research

Ambroxol HCl is a mucolytic agent often used to treat respiratory disorders associated with excess mucus secretion. This study aims to determine the beyond-use date (BUD) of ambroxol HCl syrup on the market based on analysis of the decrease in drug content using High-Performance Liquid Chromatography (HPLC) – UV/Vis detector. The HPLC conditions were reversed-phase with a C18 column, mobile phase containing acetonitrile - phosphate buffer 0.05 M pH 4.5 (60:40) at a flow rate of 1.0 ml/min using UV detection at 248 nm. To determine BUD, five syrup preparations (brands) obtained from the Jakarta area were analyzed in triplicate. …

Utilization Of Spent Arabica Coffee Grounds As Raw Material For Activated Charcoal In Liquid Bath Soap Formulation, Hilda Maysarah, Lydia Septa Desiyana, Siti Nurzuhra, Didi Nurhadi Illian

Pharmaceutical Sciences and Research

Arabica coffee (Coffea arabica) is one of the most popular coffees among Acehnese, an ethnic group from Aceh, Indonesia. The amount of coffee consumed is directly proportional to the amount of coffee waste produced. Spent coffee grounds are the residue obtained during the brewing process. Spent coffee grounds can be utilized by converting them into active charcoal adsorbents. This study aimed to produce activated charcoal from spent arabica coffee grounds (SACG), to utilize it as an active ingredient in the liquid bath soap formulations, and to determine the best formula. The characterization of activated charcoal was conducted and …

Solid Dispersion Technology For Improving The Solubility Of Antiviral Drugs, Maria Elvina Tresia Butar-Butar, Nasrul Wathoni, Hestiary Ratih, Yoga Windhu Wardhana

Pharmaceutical Sciences and Research

Most drugs, including antiviral drugs, show low solubility in water, which affects dissolution, bioavailability, and therapeutic effectiveness. Therefore, many antiviral drugs are given in very large doses. One of the efforts to overcome these problems is the application of solid dispersions in which polymers and surfactants can trap drug molecules that are in the amorphous phase. Drugs in a hydrophilic carrier will increase wettability, water absorption capacity, and porosity of particles, so that the drug is released better. This review article will discuss the development of technology in solid-state, how solid dispersion overcomes the lack of solubility and the rate …

Death Due To Drug Reaction With Eosinophilia And Systemic Symptoms (Dress) Syndrome: A Case Report, Samantha P. Sternad, Jane Pangburn, Chad Johnston, David Rowe

HCA Healthcare Journal of Medicine

Background

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening, multi-organ adverse drug reaction with an incidence of 1 in 1000 to 1 in 10 000 highrisk drug exposures.

Case Presentation

An elderly female presented to the hospital with progressive weakness and a diffuse erythematous macular rash covering most of her body that started 3 days prior. Over the next 3 days, the patient quickly deteriorated, developing disorientation with acute onset left-sided weakness, leukocytosis, thrombocytopenia, eosinophilia, liver and kidney failure, and hypoxia. Clinical and histological changes supported the diagnosis of DRESS syndrome caused by intravenous (IV) ampicillin …

Impact Of Inhaled Epoprostenol In Patients On Covid-19 Acute Respiratory Distress Syndrome (Ards), Stacey Nguyen, Stephen Chromi, Mark Decerbo, Surajit Dey, Joseph Mccoy, Jeffrey Murawsky

HCA Healthcare Journal of Medicine

Background

Coronavirus disease 2019 (COVID-19), a novel respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can progress to critical illness and the development of acute respiratory distress syndrome (ARDS). Variability in clinical presentation has led to 2 distinct theoretical classifications of COVID-19 ARDS based on different phenotypical presentations. The first of which follows closely to traditional ARDS presenting as severe hypoxemia with markedly reduced lung compliance, whereas the second presents as severe hypoxemia with preserved to high lung compliance. With uncertainty surrounding the specific pathological and mechanistic nature of COVID-19, we designed this study to elucidate the …

Operationalizing A Medication Safety Gap Assessment For A Large Health System, Carley Warren, Joan Kramer, L Hayley Burgess

HCA Healthcare Journal of Medicine

Background

Medication errors continue to be a leading cause of medical errors. In the United States alone, 7000 to 9000 people die annually due to a medication error, and many more are harmed. Since 2014, the Institute for Safe Medication Practices (ISMP) has advocated for several best practices in acute care facilities derived from reports of patient harm.

Methods

The medication safety best practices chosen for this assessment were based on the 2020 ISMP Targeted Medication Safety Best Practices (TMSBP) and health system-identified opportunities. Each month, for 9 months, select best practices were covered with associated tools to assess the …

Implementing Auc Monitoring In A Pharmacist-Managed Vancomycin Dosing Protocol: A Retrospective Cohort Study, Brandon L S Robinson, Blake Bennie, Mahmoud Nasiri, Kieu Nguyen, Reba Forbess, Mallory Gessner-Wharton, Cassie Robertson

HCA Healthcare Journal of Medicine

Background

Consensus guidelines on the therapeutic drug monitoring of vancomycin published in 2020 recognize that using the calculated area-under-the-curve (AUC) to guide dosing maximizes clinical efficacy and minimizes risk when compared to traditional trough-based dosing. The purpose of this study was to determine whether AUC monitoring results in reduced acute kidney injury (AKI) rates in adult patients receiving vancomycin for all indications.

Methods

In this study, patients 18 years or older who received pharmacist-managed vancomycin therapy were selected using pharmacy surveillance software from 2 timeframes. Patients were excluded if they received less than 48 hours of therapy or had unstable …

Scheduled Opioid Administration In Hospice Patients Before And After Targeted Caregiver Education, Katherine G. Hood, Eve B. Woodum, Rebeccah J. Collins

HCA Healthcare Journal of Medicine

Background

Hospice and palliative care have been shown to increase patient satisfaction and improve symptom control at the end of life. Opioid analgesics are typically given around the clock at the end of life to maintain symptom control and prevent the need for larger doses later. Many hospice patients have some degree of cognitive impairment, putting them at risk of being undertreated for pain.

Methods

This was a retrospective, quasi-experimental study at a 766-bed community hospital with hospice and palliative care services. Adult patients admitted to inpatient hospice care with active orders for scheduled opioids for at least 12 hours …

A Retrospective Comparison Of The Effectiveness Of Buprenorphine Versus Baclofen For Acute Opioid Withdrawal, Matthew Hermenau, Benton Stamper, Kitty Leung, Raymond Pomm, Christina Guerrier, Joseph Cammilleri, Brittany Johnson

HCA Healthcare Journal of Medicine

Background

A significant impediment to opioid cessation or dose reduction is mitigating withdrawal severity that has been shown to affect the course of opioid dependence. Current guidelines recommend the use of buprenorphine and methadone over alpha-2 adrenergic agonists. Baclofen, a GABA-B agonist, has promising results as an adjunct agent for opioid withdrawal but has not been compared to buprenorphine. This study compared the ability of buprenorphine and baclofen to mitigate acute opioid withdrawal.

Methods

This was a single-center, retrospective chart review of 63 patients with diagnosed opioid use disorder that received scheduled buprenorphine or baclofen for 3 days, in addition …

Diversity, Equity, And Inclusion In The Profession Of Pharmacy: The Perspective Of Three Pharmacy Leaders, Aigner George, Keith Teelucksingh, Kara Fortune

HCA Healthcare Journal of Medicine

Diversity, equity, and inclusion (DEI) is a growing force within all industries, with healthcare being no exception. The 2020 sociopolitical landscape made DEI a priority for the majority of organizations. The structural element of DEI education in pharmacy is comprised of academia, professional organizations, and healthcare systems and companies. To address inequities that stand before students, professional pharmacy organizations must have a voice that sets an inclusive tone. This article provides background into DEI in the pharmacy profession and provides the unique perspectives of 3 pharmacy leaders.

Interprofessional Education: Models That Promote Shared Clinical Decision-Making, James D. Nash

HCA Healthcare Journal of Medicine

Interprofessional education continues to be emphasized as an area that needs to continue to grow by agencies that accredit higher education professional degree programs. Teams of healthcare professionals need to learn more about each other, collaborate, and understand what matters most to the patient when care is needed in an acute or ambulatory care setting. Settings that promote clinical shared decision-making and collaboration with pharmacists among the team and increase communication between members and the patient will decrease medical errors, increase patient safety, and improve the quality of life for the patient.

Elevating Exposure Of Pharmacy Services And Medication Management, L. Hayley Burgess, Joan Kramer, Jocasta G. Olp

HCA Healthcare Journal of Medicine

Medications are the mainstay of treatment for many disorders and diseases. Our guest editorial board is proud to highlight the complexity of medication management and the talented pharmacists dedicated to safety and effectiveness. This special issue of the HCA Healthcare Journal of Medicine is dedicated specifically to pharmacy services across the healthcare spectrum, featuring pharmacist medication management research and education aimed at enhancing the safety of patients and colleagues.

Eruptive Lentigines Confined To Resolving Psoriatic Plaques Following Treatment With Guselkumab, Jacob R. Kilgore Md, James C. Curry, Shane E. Cook Md

Marshall Journal of Medicine

Eruptive lentigines in the area of resolving psoriatic plaques has been well documented in the literature following successful treatment with multiple therapies. This is historically associated with light treatment but has been expanded to include other therapies such as anti-tumor necrosis factor therapies and, more recently, some biologics⁵. Guselkumab (Tremfya) is an IgG1λ monoclonal antibody used in the treatment of plaque psoriasis with only one case of eruptive lentigines confined to resolving psoriatic plaques (ELRP) noted as a side effect. We present the second such case of ELRP associated with successful treatment of plaque psoriasis with Guselkumab, as …

Low-Dose Psilocybin Enhances Novel Object Recognition But Not Inhibitory Avoidance In Adult Rats, Claire E. Miller, Colin R. Del Valle, Margaret M. Naylor, Heather R. Sparkman, Connor M. Cruea, Rachel E. Rice, Brooke E. Bramlage, Lillianna P. Puppel, Madison L. Brown, Aleece K. Al-Olimat, Elizabeth S. Dietz, Phillip R. Zoladz

ONU Student Research Colloquium

Given the recently renewed interest in using psychedelics to aid in the treatment of psychological disorders, we aimed to examine the impact of psilocybin, a 5-HT_2A agonist, on learning and memory in rodents. Previous work has demonstrated that psilocybin and other 5-HT_2A agonists can enhance fear conditioning, fear extinction, and novel object recognition (NOR). Thus, we predicted that low doses of psilocybin would enhance inhibitory avoidance (IA) and NOR memory. In the first experiment, adult male and female Sprague-Dawley rats underwent step-through IA training (involving 0.45, 0.65, or 1 mA scrambled footshock) and were injected intraperitoneally (i.p.) with …

Psilocybin Prevents Symptoms Of Hyperarousal And Enhances Novel Object Recognition In Rats Exposed To The Single Prolonged Stress Paradigm, Colin R. Del Valle, Heather R. Sparkman, Margaret M. Naylor, Connor M. Cruea, Rachel E. Rice, Claire E. Miller, Brooke E. Bramlage, Lillianna P. Puppel, Madison L. Brown, Aleece K. Al-Olimat, Elizabeth S. Dietz, Phillip R. Zoladz

ONU Student Research Colloquium

Pharmacotherapy for stress-related psychological disorders remains inadequate. Patients who are treated with conventional pharmacological agents frequently report negligeable symptom reduction, and, in most cases, less than 50% experience full remission. Clearly, there is a need for additional pharmaceutical research into both established and novel approaches to alleviate these conditions. Over the past several years, there has been a renewed interest in the use of psychedelics to aid in the treatment of psychological disorders. Several studies have reported promising results in patients with major depression, anxiety disorders, and post-traumatic stress disorder (PTSD) following treatment with psychedelic agents such as lysergic acid …