Pharmacy and Pharmaceutical Sciences Commons^™

Population Pharmacokinetic And Pharmacodynamic Analysis Of Buprenorphine For The Treatment Of Neonatal Abstinence Syndrome, Jason N. Moore, Pharmd, Marc Gastonguay, Susan C. Adeniyi-Jones, Md, David E. Moody, Walter K. Kraft, Md, Facp

Department of Pharmacology and Experimental Therapeutics Posters

Neonatal abstinence syndrome (NAS) is a condition affecting newborns exposed to an opioid in utero. Symptoms of NAS include excessive crying, poor feeding, and disordered autonomic control. Up to 2/3 of infants will require pharmacologic therapies to reach symptom control. Opioids including morphine and methadone are the current first-line treatments. Buprenorphine is being investigated as a treatment of NAS. The purpose of this analysis was to evaluate the pharmacokinetics (PK) and pharmacodynamics (PD) of BUP in infants with NAS.

Poster presented at American Society for Clinical Pharmacology and Therapeutics (ASCPT) 2017 Annual Meeting, March 15-18, 2017 in Washington DC.

Catatonia Secondary To Sudden Clozapine Withdrawal: A Case With Three Repeated Episodes And A Literature Review, John Bilbily, Betsy Mccollum, Jose De Leon

Psychiatry Faculty Publications

A literature search identified 9 previously published cases that were considered as possible cases of catatonia secondary to sudden clozapine withdrawal. Two of these 9 cases did not provide enough information to make a diagnosis of catatonia according to the Diagnostic and Statistical Manual, 5th Edition (DSM-5). The Liverpool Adverse Drug Reaction (ADR) Causality Scale was modified to assess ADRs secondary to drug withdrawal. From the 7 published cases which met DSM-5 catatonia criteria, using the modified scale, we established that 3 were definitive and 4 were probable cases of catatonia secondary to clozapine withdrawal. A new definitive case is …

Reliability And Credibility Of Progress Test Criteria, Developed By Alumni, Faculty, And Mixed Alumni-Faculty Judge Panels, H. Glenn Anderson Pharmd, Arthur A. Nelson Phd

H. Glenn Anderson

Objective. To compare the reliability and credibility of Angoff-based, absolute criteria derived by faculty, alumni, and a combination of alumni and faculty judge panels. Methods. Independently, faculty, alumni, and mixed faculty-alumni judge panels developed pass/fail criteria for an 86-item test. Generalizability and decision studies were performed. Root mean square errors (RMSE) and 95% confidence intervals were calculated for reliability and credibility assessment. School graduate performance upon the North American Licensure Examination (NAPLEX) was the comparator for credibility assessment. Results. RMSEs were 1.06%, 1.42%, and 2.32% for the alumni, faculty, and mixed judge panels respectively. The school's NAPLEX pass rate was …

A Standardized Patient Counseling Rubric For A Pharmaceutical Care And Communications Course, Niambi Horton Pharmd, Kenna D. Payne Pharmd, Michelle Jernigan Pharmd, Jill Frost Pharmd, Stephen Wise Pharmd, Mary Klein Pharmd, Joel Epps Mba, H. Glenn Anderson Pharmd

H. Glenn Anderson

Objective. To restructure a required pharmaceutical care and communications course to place greater emphasis on communication skills and include a high-stakes assessment. Design. A standardized counseling rubric was developed for use throughout the pharmacy curriculum and the counseling laboratory practicals were changed to high-stakes assessments. Assessment. An annual mid-semester and end-of-semester high-stakes patient-counseling objective structured clinical examination (OSCE) conducted prior to and after revision of the course and counseling rubric documented improvements in students’ scores. Performance on the post-course annual assessment patient counseling OSCE improved compared to that on the pre-course (p,0.001). Conclusion. The 2010 course revision improved students’ medication …

Cost Variability Of Suggested Generic Treatment Alternatives Under The Medicare Part D Benefit, Rajul A. Patel, Mark P. Walberg, Emily Tong, Florence Tan, Ashley E. Rummel, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal

Joseph Woelfel

BACKGROUND: The substitution of generic treatment alternatives for brand-name drugs is a strategy that can help lower Medicare beneficiary out-of-pocket costs. Beginning in 2011, Medicare beneficiaries reaching the coverage gap received a 50% discount on the full drug cost of brand-name medications and a 7% discount on generic medications filled during the gap. This discount will increase until 2020, when beneficiaries will be responsible for 25% of total drug costs during the coverage gap. OBJECTIVE: To examine the cost variability of brand and generic drugs within 4 therapeutic classes before and during the coverage gap for each 2011 California stand-alone …

Minimizing Part D Costs For Medicare Beneficiaries: Not Just A Drop In The Bucket, Rajul A. Patel, Kate M. O'Dell, Kim-Anh Vo, Tiffany Chu, Kenneth Wang, Shu Lu, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal, Berit Gundersen

Joseph Woelfel

Background: Although Medicare Part D has been largely successful in providing prescription drug coverage for Medicare beneficiaries, many continue to be burdened with unnecessary out-of-pocket (OOP) costs. Objective: This study sought to identify the frequency and impact of cost-lowering strategies used to assist Medicare beneficiaries with their Part D drug costs. Methods: Twelve outreach events were conducted in 6 different cities throughout Northern/Central California during the 2013 Medicare open enrollment period. During each event, trained student pharmacists under the supervision of licensed pharmacists assisted beneficiaries to minimize their OOP costs. Individualized assistance included: optimization of the beneficiary's Part D plan, …

Medicare Part D Prescription Drug Costs And Plan Satisfaction As A Function Of Student Pharmacists' Assistance, Rajul A. Patel, Kate M. O'Dell, Kenneth Wang, Shu Lu, Tiffany Chu, Kim-Anh Vo, Sian M. Carr-Lopez, Joseph A. Woelfel, Suzanne M. Galal, Berit Gundersen

Joseph Woelfel

Background: Beneficiaries can become overwhelmed by the myriad of Medicare Part D (MPD) plans that offer prescription drug coverage. Poor choice and increased out-of-pocket (OOP) costs can be reduced through annual plan reevaluation. Objective: To examine beneficiaries' plan satisfaction and MPD drug costs as a function of prior assistance from trained student pharmacists. Methods: Twelve outreach events, nine at the same location as the previous year, were held throughout Northern/Central California during October-November 2012. Trained student pharmacists, at each event, identified the MPD plan best meeting a beneficiary's needs based on their current medications and personal preferences (e.g., preferred pharmacy). …

Medicare Part D Roulette: Potential Implications Of Random Assignment And Plan Restrictions, Rajul A. Patel, Mark P. Walberg, Joseph A. Woelfel, Michelle M. Amaral, Paresh Varu

Joseph Woelfel

Background: Dual-eligible (Medicare/Medicaid) beneficiaries are randomly assigned to a benchmark plan, which provides prescription drug coverage under the Part D benefit without consideration of their prescription drug profile. To date, the potential for beneficiary assignment to a plan with poor formulary coverage has been minimally studied and the resultant financial impact to beneficiaries unknown. Objective: We sought to determine cost variability and drug use restrictions under each available 2010 California benchmark plan. Methods: Dual-eligible beneficiaries were provided Part D plan assistance during the 2010 annual election period. The Medicare Web site was used to determine benchmark plan costs and prescription …

Medication Adherence Behaviors Of Medicare Beneficiaries, Sian M. Carr-Lopez, Allen Shek, Janine Lastimosa, Rajul A. Patel, Joseph A. Woelfel, Suzanne M. Galal, Berit Gundersen

Joseph Woelfel

Background: Medication adherence is crucial for positive outcomes in the management of chronic conditions. Comprehensive medication consultation can improve medication adherence by addressing intentional and unintentional nonadherence. The Medicare Part D prescription drug benefit has eliminated some cost barriers. We sought to examine variables that impact self-reported medication adherence behaviors in an ambulatory Medicare-beneficiary population and to identify the factors that influence what information is provided during a pharmacist consultation.Methods: Medicare beneficiaries who attended health fairs in northern California were offered medication therapy management (MTM) services during which demographic, social, and health information, and responses to survey questions regarding adherence …

Medicare Part D Plan Optimization: The Need For An Annual Check-Up, Rajul A. Patel, Mark P. Walberg, Nataliya Mcelroy, Anil Mallya, Aesun Kim, Yvonne Mai, Justin Seo, Joseph A. Woelfel, Sian M. Carr-Lopez, Suzanne M. Galal

Joseph Woelfel

Background: Since its inception, Medicare Part D requires beneficiaries to choose from a myriad of insurance plans in order to receive prescription drug coverage. Moreover, each year beneficiaries are confronted with plan cancellations, new plan offerings, changes in existing plan formularies and cost-sharing structure. Objective: This study prospectively examined the relationship between stand-alone prescription drug plan (PDP) costs, subsidy status, and the number of plans offered in California from 2009-2012. Methods: Forty-one community outreach events were held throughout Central/Northern California during the Medicare Part D annual election periods from 2008-2011. In total, 1,578 beneficiaries were assisted, 983 (62.2%) of whom …

Healthcare Provider Utilization And Patient Outcomes: The Call For Enhanced Coordinated Care For Medicare Beneficiaries, Yvonne Mai, Rajul A. Patel, Suzanne M. Galal, Sian M. Carr-Lopez, Joseph A. Woelfel

Joseph Woelfel

Background: The use of complementary and alternative medicine (CAM) and other non-physician health care providers (dentists, optometrists, etc.) has steadily increased in the United States; however, the associated outcomes reported in the Medicare population is limited. Objective: To evaluate the utilization of different healthcare providers by Medicare beneficiaries and assess resultant patient outcomes. Methods: Fourteen outreach events targeting Medicare beneficiaries were conducted throughout Northern/Central California during the 2014 open enrollment period. Trained student pharmacists (working under licensed pharmacist supervision) provided beneficiaries with comprehensive medication therapy management (MTM) services. During each intervention, demographic, quality-of-life, health behavior, and health provider/service utilization data …

Utilizing Three Years Of Epidemiological Data From Medical Missions In Cambodia To Shape The Mobile Medical Clinic Formulary, Jeany Kim Jun, Junia S. Koo, Amy Y. Kang, Deborah B. Chien, Albert Shim, Dale Knutson, Eda M. Kim

Pharmacy Faculty Articles and Research

Objective: The purpose of this project was to gather epidemiological data on common diseases and medications dispensed during medical mission teams to Cambodia to shape the mobile medical clinic formulary.

Methods: Data for patients seen during week-long, mobile, medical clinics was collected in Cambodia during Septembers 2012 to 2014. Patient’s gender, age, weight, blood pressure, glucose, pertinent laboratory values, diagnoses, and medications dispensed were collected. Blood pressure and glucose were measured in patients 18 years and above. Data collected onto paper intake forms were transferred onto spreadsheets without patient identifying information and analyzed for aggregate means, common diseases, and most …

Empirical Assessment Of The Impact Of Low-Cost Generic Programs On Adherence-Based Quality Measures, Nathan J. Pauly, Jeffery C. Talbert, Joshua D. Brown

Pharmacy Practice and Science Faculty Publications

In the United States, federally-funded health plans are mandated to measure the quality of care. Adherence-based medication quality metrics depend on completeness of administrative claims data for accurate measurement. Low-cost generic programs (LCGPs) cause medications fills to be missing from claims data as medications are not adjudicated through a patient’s insurance. This study sought to assess the magnitude of the impact of LCGPs on these quality measures. Data from the 2012–2013 Medical Expenditure Panel Survey (MEPS) were used. Medication fills for select medication classes were classified as LCGP fills and individuals were classified as never, sometimes, and always users of …

Polymer Micelle Formulation For The Proteasome Inhibitor Drug Carfilzomib: Anticancer Efficacy And Pharmacokinetic Studies In Mice, Ji Eun Park, Se-Eun Chun, Derek Alexander Reichel, Jee Sun Min, Su-Chan Lee, Songhee Han, Gongmi Ryoo, Yunseok Oh, Shin-Hyung Park, Heon-Min Ryu, Kyung Bo Kim, Ho-Young Lee, Soo Kyung Bae, Younsoo Bae, Wooin Lee

Pharmaceutical Sciences Faculty Publications

Carfilzomib (CFZ) is a peptide epoxyketone proteasome inhibitor approved for the treatment of multiple myeloma (MM). Despite the remarkable efficacy of CFZ against MM, the clinical trials in patients with solid cancers yielded rather disappointing results with minimal clinical benefits. Rapid degradation of CFZ in vivo and its poor penetration to tumor sites are considered to be major factors limiting its efficacy against solid cancers. We previously reported that polymer micelles (PMs) composed of biodegradable block copolymers poly(ethylene glycol) (PEG) and poly(caprolactone) (PCL) can improve the metabolic stability of CFZ in vitro. Here, we prepared the CFZ-loaded PM, PEG-PCL-deoxycholic …

The Pharmacological And Cognitive Effects Of Propranolol On Cd-1 Mice, Jennifer Hindieh

Post & Beyond

The Pharmacological and Cognitive Effects of Propranolol on CD-1 Mice Jennifer Hindieh, William Hoefer, Grace Rossi, Christopher McAllister Long Island University Post Campus, Psychology Department, College of Liberal Arts & Sciences Currently, 31 million people in the United States have chronic kidney disease; with high blood pressure being the 2nd leading cause of kidney disease, and about 70 million people in the United States have high blood pressure. The importance of studying the conditions becomes more prevalent as the average individual, of recent times, has a diet consisting of preservatives, artificial ingredients, which in turn leads to a more consistent …

Pharmacological Basis For The Medicinal Use Of Polyherbal Formulation And Its Ingredients In Cardiovascular Disorders Using Rodents, A Malik, Malik Hassan Mehmood, H Channa, Ms Akhtar, Ah Gilani

Department of Biological & Biomedical Sciences

A compound herbal formulation (POL4) has been used in the indigenous system of medicine to treat cardiometabolic disorders like diabetes and associated hypertension. POL4 and most of its constituents have not been studied widely for its therapeutic use in hypertension. This study is aimed to determine the efficacy and possible insight into mechanism(s) for the medicinal use of POL4 and its ingredients in hypertension.

Selective Immunoproteasome Inhibitors With Non-Peptide Scaffolds, Chang-Guo Zhan, Kyung Bo Kim, Vinod Kasam, Na-Re Lee

Pharmaceutical Sciences Faculty Patents

Compounds useful for inhibiting the immunoproteasome have the formula of [image on patent].

Methods and compounds for inhibiting the immunoproteasome, particularly, immunoproteasome inhibitors with non-peptide scaffolds, are described.

Mccrearamycins A-D, Geldanamycin-Derived Cyclopentenone Macrolactams From An Eastern Kentucky Abandoned Coal Mine Microbe, Xiachang Wang, Yinan Zhang, Larissa V. Ponomareva, Qingchao Qiu, Ryan M. Woodcock, Sherif I. Elshahawi, Xiabin Chen, Ziyuan Zhou, Bruce E. Hatcher, James C. Hower, Chang-Guo Zhan, Sean Parkin, Madan K. Kharel, S. Randal Voss, Khaled A. Shaaban, Jon S. Thorson

Center for Pharmaceutical Research and Innovation Faculty Publications

Four cyclopentenone‐containing ansamycin polyketides (mccrearamycins A–D), and six new geldanamycins (Gdms B–G, including new linear and mycothiol conjugates), were characterized as metabolites of Streptomyces sp. AD‐23‐14 isolated from the Rock Creek underground coal mine acid drainage site. Biomimetic chemical conversion studies using both simple synthetic models and Gdm D confirmed that the mccrearamycin cyclopentenone derives from benzilic acid rearrangement of 19‐hydroxy Gdm, and thereby provides a new synthetic derivatization strategy and implicates a potential unique biocatalyst in mccrearamycin cyclopentenone formation. In addition to standard Hsp90α binding and cell line cytotoxicity assays, this study also highlights the first assessment of Hsp90α …

Reduction Of Cocaine-Induced Locomotor Effects By Enriched Environment Is Associated With Cell-Specific Accumulation Of Δfosb In Striatal And Cortical Subregions, Audrey Lafragette, Michael T. Bardo, Virginie Lardeux, Marcello Solinas, Nathalie Thiriet

Psychology Faculty Publications

Background: Early exposure to enriched environments has been shown to decrease the locomotor effects induced by repeated injections of cocaine and modify basal and cocaine-induced total protein levels of the transcription factor ΔFosB in the whole striatum of mice. In this study, we aimed at characterizing whether the profile of ΔFosB accumulation induced by enriched environments and cocaine would be similar or different in terms of brain areas and cell type.

Methods: We used mice expressing the eGFP protein in D1 receptor positive (D1R(+)) neurons to determine whether ΔFosB induced by enriched environment or cocaine injections (5×15 mg/kg) would occur …

Adverse Events And Treatment Discontinuations Of Antimuscarinics For The Treatment Of Overactive Bladder In Older Adults: A Systematic Review And Meta-Analysis, Scott Martin Vouri, Clark D. Kebodeaux, Paul M. Stranges, Besu F. Teshome

Pharmacy Practice and Science Faculty Publications

Introduction

Antimuscarinics should be used with caution in older adults with overactive bladder (OAB) due to anticholinergic adverse events (AEs). Systematic reviews and meta-analyses (SRMAs) have analyzed safety-related outcomes but have not specified risk in the elderly, the population at highest risk for AEs. The aim of this review is to explore and evaluate AEs and treatment discontinuations in adults 65 or older taking antimuscarinics for OAB.

Methods

Keywords were searched in MEDLINE, EMBASE, SCOPUS, and Cochrane Central Register for Controlled Trials. Randomized controlled trials (RCTs) along with sub-analyses and pooled analyses that compared antimuscarinics to placebo or another antimuscarinic …