Pharmacology, Toxicology and Environmental Health Commons^™

Use Of A Zebrafish Model To Identify Anticonvulsant Properties Of Cannabinoid And Terpenoid Extracts And Mixtures, Courtney Murr

LSU Master's Theses

Epilepsy is a complex group of neurological disorders affecting approximately 65 million people worldwide. Animal models reveal the activation of cannabinoid receptor 1 and cannabinoid receptor 2 reduces the severity of seizures associated with epilepsy. Trials of phytocannabinoids in mammals demonstrate their efficacy of reducing the severity of epileptic seizures. Numerous terpenoid compounds are present in Cannabis plants but most have yet to be clinically investigated. The goal of this research was to use zebrafish (Danio rerio) to identify the potential anticonvulsive properties of phytocannabinoid and terpenoid compounds. During acute cannabinoid exposures, 7-days-post-fertilization (7 dpf) zebrafish larvae were …

Characterization, Bio-Uptake And Toxicity Of Polymer-Coated Silver Nanoparticles And Their Interaction With Human Peripheral Blood Mononuclear Cells, Sahar Pourhoseini, Reilly T. Enos, Angela E. Murphy, Bo Cai Ph.D., Jamie Lead

Faculty Publications

Silver nanoparticles (AgNPs) are widely used in medical applications due to their antibacterial and antiviral properties. Despite the extensive study of AgNPs, their toxicity and their effect on human health is poorly understood, as a result of issues such as poor control of NP properties and lack of proper characterization. The aim of this study was to investigate the combined characterization, bio-uptake, and toxicity of well-characterized polyvinylpyrrolidone (PVP)-coated AgNPs in exposure media during exposure time using primary human cells (peripheral blood mononuclear cells (PBMCs)). AgNPs were synthesized in-house and characterized using a multimethod approach. Results indicated the transformation of NPs …

Investigating The Novel Role Of Dextromethorphan In Mitigating Oxidative Stress Induced Changes In Retinal Pigment Epithelial Cells (Rpe), Zeinab A. Mohamed

USF Tampa Graduate Theses and Dissertations

Oxidative stress contributes to the degeneration of retinal pigment epithelial (RPE) cells and photoreceptors that lead to the dry form of age-related macular degeneration. Activation of N-Methyl-D-aspartate (NMDA) receptors contributes to the increase of free radicals that induce oxidative stress-induced changes. Our study investigates if Dextromethorphan, an NMDA receptor antagonist, reverses oxidative stress-induced changes in RPE. We used Paraquat and H2O2 as oxidative stress-inducing agents to induce oxidative damage in human ARPE-19 cells. To illustrate the change in cell viability and measure the apoptosis of ARPE-19 cells from oxidative damage, we performed MTT assay and Annexin V-DAPI flow cytometry analysis. …

Drug Candidates Targeting Hsp90/Cdc37 For The Treatment Of Neurodegenerative Disease, Ryan Martin

USF Tampa Graduate Theses and Dissertations

Neurodegenerative disease refers to the death of specific populations of neurons that canresult in dementia, loss of voluntary muscle motility, and other abnormalities. Two major neurodegenerative diseases are Alzheimer’s disease (AD) and Parkinson’s disease (PD), which are linked to abnormalities in Tau and a-synuclein proteins, respectively. Currently, there is no cure for these diseases. Our group and others have shown that chaperone proteins play a critical role in the processing of Tau and a-synuclein. The inhibition of the Hsp90/Cdc37 chaperone complex is shown to affect the levels of these two proteins. Hence, we hypothesized that a drug molecule, conglobatin (Cb), …

Glutathione-S-Transferase Mu 1 (Gstm1) Gene Augmentation Attenuated Oxidative Stress Induced Changes In Retinal Pigment Epithelium Cells (Rpe), Riddhi Sandeep Vichare

USF Tampa Graduate Theses and Dissertations

Purpose: Loss of Retinal Pigment Epithelial (RPE) cells and photoreceptors leads to Age-related macular degeneration (AMD), one of the leading causes of blindness in the elderly worldwide. Oxidative stress-mediated damage is one of the factors that impair the survival of RPE and photoreceptors in dry-AMD. We sought to determine the role of human Glutathione S-Transferase Mu-1 (GSTM1) in protecting RPE cells from oxidative stress-induced changes.

Method: We cloned human GSTM1 cDNA with P2A tag into a lenti-plasmid vector and later made a lentivector to express GSTM1. After that, we infected human retinal pigment epithelial cells (ARPE-19), screened stable ARPE-19 cells …

New Psychoactive Substances In Taiwan: The Current Situation And Initiative For Rational Scheduling, Wen-Jing Yu, Linda B. Cottler, Jih-Heng Li

Journal of Food and Drug Analysis

Use of New Psychoactive Substances (NPS) has posed a global threat to public health and the security of the population. As of December 2019, the NPS items identified in total have outnumbered by three to one the controlled substances listed in the 1961 and 1971 UN Drug Conventions. However, most of these NPS have not been scheduled by the United Nations because of their easy modification on the chemical structures to shun control. Currently, the scheduling and control of NPS is mostly at the national level and a rational scheduling of NPS by objective assessments is essential but often lacking. …

A Convenient And Sensitive Colorimetric Iodide Assay Based On Directly Inducing Morphological Transformation Of Gold Nanostars, Rongju Zhou, Xiaohui Huang, Qingxiao An, Weizhen Xu, Yi Liu, Dong Xu, Suyan Wang, Qinlu Lin, Jianglin Zhang

Journal of Food and Drug Analysis

We propose a convenient and easy colorimetric assay for highly sensitive detection of iodide by using gold nanostars (GNSs) as probes. The assay relies on that iodide directly changes the morphology of GNSs and alters their longitudinal localized surface plasmon resonance (LSPR) without surface modifications and the use of other reagents. Upon increasing iodide concentration, GNSs gradually transformed to sphere gold nanoparticles, the absorbance at longitudinal LSPR decreased, and solution color varied from greenish blue to red, as confirmed by the UV-Vis absorption spectroscopy and transmission electron microscopy. With this strategy, as low as 0.005 μM of iodide can be …

Quercetin Blocks The Aggressive Phenotype Of Triple Negative Breast Cancer By Inhibiting Igf1/Igf1r-Mediated Emt Program, Wei-Jen Chen, Jie-Heng Tsai, Li-Sung Hsu, Chih-Li Lin, Hui-Mei Hong, Min-Hsiung Pan

Journal of Food and Drug Analysis

The cancer-preventive activities of quercetin have been extensively studied in invasive breast cancer; however, the role of quercetin on triple-negative breast cancer (TNBC) with overexpression of insulin-like growth factor-1 receptor (IGF1R) has not been resolved. In this article, we demonstrated that quercetin inhibited the activation of IGF1R and its downstream kinases Akt and Erk1/2 in a dose-dependent manner in human MDA-MB-231 breast cancer cells (TNBC cell line). Related to this, quercetin markedly suppressed the metastatic phenotype and epithelial–mesenchymal transition (EMT) of MDA-MB-231 cells by inhibiting the expression of EMT transcription factors Snail and Slug. Quercetin also increased the secretion of …

N-Nitrosodimethylamine (Ndma) Contamination Of Ranitidine Products: A Review Of Recent Findings, Fahad S. Aldawsari, Yahya M. Alshehri, Thamer S. Alghamdi

Journal of Food and Drug Analysis

Ranitidine is a medication that has been used to alleviate heartburn and other disorders for over 40 years. Following reports of N-nitrosodimethylamine (NDMA) contamination in ranitidine products, there have been many recalls and registration suspensions. Here, we revise the literature information confirming ranitidine association with NDMA. Then, we highlight the documented mechanisms for NDMA release from ranitidine. In addition, the stability issue for this medicine is discussed. After that, we review and discuss the results of the United States Food and Drug Administration and the Australian Therapeutic Goods Administration laboratory testing of ranitidine products and the detected NDMA levels. Finally, …

The Bioactivities Of Resveratrol And Its Naturally Occurring Derivatives On Skin, Ming-Hsien Lin, Chi-Feng Hung, Hsin-Ching Sung, Shih-Chun Yang, Huang-Ping Yu, Jia-You Fang

Journal of Food and Drug Analysis

Resveratrol has been extensively reported as a potential compound to treat some skin disorders, including skin cancer, photoaging, allergy, dermatitis, melanogenesis, and microbial infection. There has been an increasing interest in the discovery of cosmetic application using resveratrol as the active ingredient because of its anti-aging and skin lightening activities. The naturally occurring derivatives of resveratrol also exert a beneficial effect on the skin. There are four groups of resveratrol derivatives, including hydroxylated compounds, methoxylated compounds, glycosides, and oligomers. The major mechanism of resveratrol and its derivatives for attenuating cutaneous neoplasia, photoaging and inflammation, are related with its antioxidative activity …

Suitability Of Sugar Alcohols As Antidiabetic Supplements: A Review, Nontokozo Z. Msomi, Ochuko L. Erukainure, Md. Shahidul Islam

Journal of Food and Drug Analysis

The major goals in the management of diabetes are to maintain normal control of glucose metabolism and glycemia. Dietary modification is one of the most recommended treatment modalities for diabetic patients. The use of foods sweetened with sugar alcohols (also known as polyols) such as xylitol, sorbitol, mannitol, maltitol, lactitol, isomalt and erythritol, has brought an escalating interest. Since some sugar alcohols do not raise plasma glucose, as they are partially digested and metabolised. Diet composition and adequacy may be altered by replacing carbohydrates with sugar alcohols. It has been established that these polyols are appropriate sugar substitutes for a …

Public Perception Of Air Quality Risks In Portland, Oregon, Dawn Nolan

Dissertations and Theses

The availability and demand for localized air quality information from communities are on the rise. However, not all information and not all communities are the same. Effective engagement and communication strategies will depend on a community's existing knowledge, opinion about air quality, individual experiences with inequities, and more. This study aims to understand how people living in Portland, Oregon understand and experience air pollution as an environmental risk and examine the extent to which those risk perceptions relate to confidence in science and technology. This gap is critical because of the complex interaction between air pollution and the risk perception …

Coastlines, Coastal Cities, And Climate Change: A Perspective On Urgent Research Needs In The United States, Paul A. Sandifer, Geoffrey I. Scott Ph.D.

Faculty Publications

This paper builds upon Friedman et al. (2020) and other reviews and statements but provides an explicit focus on research needed to improve the resilience and survivability of coastal communities as they face existential threats from climate change. It does not attempt a prescriptive analysis of potential research emphases, but instead recommends some key research areas that we believe will help provide a solid foundation for community adaptation. Our perspective is based on our experiences over a combined nearly 95 years of work in research, management, and policy, much of it related to coastal environments and their communities, rather than …

Microbiological Study In A Gneissic Cave From Sri Lanka, With Special Focus On Potential Antimicrobial Activities, Ethige Isuru P. Silva, Pathmakumara Jayasingha, Saman Senanayake, Anura Dandeniya, Dona Helani Munasinghe

International Journal of Speleology

The emergence of antibiotic resistance is a global health crisis, thus the search for novel antimicrobial compounds has become a continuous necessity. Underexplored and extreme environments, such as cave ecosystems, have been identified as a promising potential source for the discovery of novel microorganisms with novel antimicrobial compounds (AMC). This study presents the first cave microbiological investigation in Sri Lanka, with a special preference for bioprospecting of novel AMC. The cave sediment characterization demonstrated the presence of close to strong acidic conditions (pH 3.1 – 3.3) and thus indicates the possibility of isolating acidophilic microorganisms. Eight cave wall/ceiling fungal strains …

Mapping Km Methods And Tools Across The Pharmaceutical Product Lifecycle, Martin Lipa, Paige Kane

Level 3

Knowledge management is positioned as an enabler of ICH Q10, and the visibility and availability of product and process knowledge across the entire pharmaceutical product lifecycle is vital to the sustained success of an organization and to the effectiveness of an organization’s pharmaceutical quality system as defined by ICH Q10. This paper illustrates where knowledge management has a role to play within each product lifecycle phase. This paper goes on to further define phase-appropriate KM methods and tools to help address these needs and create end-to-end product and process knowledge visibility and availability.

Evaluating A Commercially Available In-Duct Bipolar Ionization Device For Pollutant Removal And Potential Byproduct Formation, Yicheng Zeng, Prashik Manwatkar, Aurelie Laguerre, Marina Beke, Insung Kang, Akram S. Ali, Delphine K. Farmer, Elliott T. Gall, Mohammad Heidarinejad, Brent Stephens

Mechanical and Materials Engineering Faculty Publications and Presentations

We conducted a series of experiments to evaluate the gas and particle removal effectiveness and potential for byproduct formation resulting from the operation of a commercially available in-duct bipolar ionization device. Laboratory tests were conducted with the ionizer installed in a small air handler serving a large semi-furnished chamber. Chamber experiments were conducted under (i) normal operating conditions to characterize the impact of the ionizer on concentrations of particles (0.01–10 μm), ozone (O3), nitrogen dioxide (NO2), volatile organic compounds (VOCs), and aldehydes, and (ii) particle injection and decay conditions to characterize the impact of the ionizer operation on particle loss …

Whole-Body Acute Contact Toxicity Of Formulated Insecticide Mixtures To Blue Orchard Bees (Osmia Lignaria), Joseph Belsky, David J. Biddinger, Neelendra K. Joshi

Entomology and Plant Pathology Faculty Publications and Presentations

Blue orchard bees, [Osmia lignaria (Say) (Hymenoptera: Megachilidae)], have been developed as an important pollinator for orchard crops in North America over the last 40 years. The toxicity of several pesticides to O. lignaria and other Osmia species has been previously reported. However, the field-realistic toxicity of formulated premix insecticides comprised of multiple active ingredients (each with a different mode of action) to O. lignaria has not been assessed. Here, we use a customized spray tower in a laboratory setting to assess adult male and female whole-body direct contact exposure to four formulated pesticide mixtures: thiamethoxam + lambda-cyhalothrin (TLC), …

Effect Of Crohn's Disease On Villous Length And Cyp3a4 Expression In The Pediatric Small Intestine., Carrie A. Vyhlidal, Brian D. Chapron, Atif Ahmed, Vivekanand Singh, Rebecca Casini, Valentina Shakhnovich

Manuscripts, Articles, Book Chapters and Other Papers

Changes in absorptive capacity and first-pass metabolism in the small intestine affect oral drug bioavailability. Characterization of such changes as a consequence of inflammation is important for developing physiologically-based pharmacokinetic (PBPK) models for inflammatory bowel disease. We sought to elucidate the impact of small intestinal Crohn's disease (CD) on villous length and CYP3A4 expression in children. Freshly frozen duodenal and terminal ileum (TI) biopsies from 107 children (1-19 years) with and without CD were evaluated for active inflammation. Villous length and CYP3A4 mRNA/protein expression were compared among regions of active and inactive inflammation in CD and controls. A twofold reduction …

Review Of Machine Learning Techniques For Mosquito Control In Urban Environments, Ananya Joshi, Clayton Miller

Research Collection College of Integrative Studies

Machine learning (ML) techniques excel at forecasting, clustering, and classification tasks, making them valuable for various aspects of mosquito control. In this literature review, we selected 120 papers relevant to the current state of ML for mosquito control in urban settings. The reviewed work covers several different methodologies, objectives, and evaluation criteria from various environmental contexts. We first divided the existing papers into geospatial, visual, or audio categories. For each category, we analyzed the machine learning pipeline, from dataset creation to model performance. We conclude with a discussion of the challenges and opportunities for further research. While the reviewed ML …

Impact Of Sampling Depth On Pathogen Detection In Pit Latrines., Drew Capone, Petros Chigwechokha, Francis L. De Los Reyes, Rochelle H. Holm, Benjamin B. Risk, Elizabeth Tilley, Joe Brown

Faculty and Staff Scholarship

Wastewater based epidemiology (WBE) is increasingly used to provide decision makers with actionable data about community health. WBE efforts to date have primarily focused on sewer-transported wastewater in high-income countries, but at least 1.8 billion people in low-and middle-income countries (LMIC) use onsite sanitation systems such as pit latrines and septic tanks. Like wastewater, fecal sludges from such systems offer similar advantages in community pathogen monitoring and other epidemiological applications. To evaluate the distribution of enteric pathogens inside pit latrines–which could inform sampling methods for WBE in LMIC settings unserved by sewers–we collected fecal sludges from the surface, mid-point, and …

Conservation Risks And Benefits Of Establishing Monarch Butterfly (Danaus Plexippus) Breeding Habitats Close To Maize And Soybean Fields In The North Central United States: A Landscape-Scale Analysis Of The Impact Of Foliar Insecticide On Nonmigratory Monarch Butterfly Populations, Tyler J. Grant, Niranjana Krishnan, Steven P. Bradbury

Biological Sciences Faculty Research & Creative Works

Establishing habitat in agricultural landscapes of the north central United States is critical to reversing the decline of North America's eastern monarch butterfly (Danaus plexippus) population. Insecticide use could create population sinks and threaten recovery. Discouraging habitat establishment within a 38-m zone around crop fields is a suggested risk mitigation measure. In Story County, Iowa, United States, this mitigation would discourage habitat establishment in 84% of roadsides and 38% of noncrop land. It is unclear if the conservation benefits from establishing habitat close to crop fields outweigh suppression of population growth owing to insecticide exposure. Consequently, monarch conservation …

Ambient Air Quality And The Risk For Chronic Obstructive Pulmonary Disease Among Metro Manila Development Authority Traffic Enforcers In Metro Manila: An Exploratory Study, Xerxes Seposo, Audrey Lynn A. Arcilla, Jose Guillermo N. De Guzman Iii, Enrico Miguel S. Dizon, Andrea Nova R. Figuracion, Christina Micaela M. Morales, Pauleenaa Katriona A. Tugonon, Geminn Louis C. Apostol

Ateneo School of Medicine and Public Health Publications

Background

Air pollution and poor ambient air quality are significantly related to multiple health risks. One associated disease is chronic obstructive pulmonary disease (COPD), a preventable disease with several contributing factors and one of the leading causes of morbidity/mortality locally and globally. A potentially high-risk population are traffic enforcers who are constantly exposed to air pollution. In the Philippines, the MMDA has the widest coverage in traffic management. The study determined the risk of COPD among Metro Manila Development Authority (MMDA) traffic enforcers in relation to ambient air quality level, as well as identified other factors that increase the risk …

How A Low-Cost Method For Cumulative Water-Sampling Shows Need For Improvement Of Legal Public-Contact Standards In The United States, Samuel C. Kessler

Grawemeyer Colloquium Papers

Across the world, it is estimated that 4.5 billion people live near water sources “impaired” for use or contact. Standards for human-interaction are established by international organizations such as the WHO, and legislative bodies from national to local levels with jurisdiction over the quality of our waterways to ensure public & environmental health. Standards are often assessed from “grab-samples” taken from a waterbody at a certain time, with a minimum number analyzed. Water-quality standards in the United States are enforced under the Clean Water Act (CWA) via the Environmental Protection Agency (EPA), applying to “waters of the United States” (WOTUS). …

Impact D’Un Stress Thermique Représentatif Des Milieux De Travail Sur L’Absorption Pulmonaire Et La Toxicocinétique De Trois Solvants Organiques, Axelle Marchand, Pierre Brochu, Jessie Ménard, Sami Haddad

Rapports de recherche scientifique

Plusieurs des changements physiologiques associés à la thermorégulation peuvent influencer la cinétique des substances chimiques dans le corps humain, comme la ventilation alvéolaire et la redistribution du débit sanguin aux organes. Si certaines mesures préventives peuvent permettre de protéger les travailleurs contre les effets directs de la chaleur, elles ne permettent toutefois pas d’empêcher les processus de thermorégulation de prendre place. Une exposition concomitante à la chaleur et aux substances chimiques volatiles peut donc entraîner des variations dans l’absorption par inhalation et dans la cinétique de ces substances, biaisant ainsi l’évaluation des données de biosurveillance.

Dans cette étude, l’influence de …

Protecting Intestinal Microenvironment Alleviates Acute Graft-Versus-Host Disease, Zhengcan Zhou, Ting Shang, Xiurong Li, Hongyan Zhu, Yu-Bo Qi, Xin Zhao, Xi Chen, Zhe-Xin Shi, Guixiang Pan, Yue-Fei Wang, Guanwei Fan, Xiumei Gao, Yan Zhu, Benjamin Feng

Peer Reviewed Articles

Acute gut graft-versus-host disease (aGVHD) is a leading threat to the survival of allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Abnormal gut microbiota is correlated with poor prognosis in allo-HSCT recipients. A disrupted intestinal microenvironment exacerbates dysbiosis in GVHD patients. We hypothesized that maintaining the integrity of the intestinal barrier may protect gut microbiota and attenuate aGVHD. This hypothesis was tested in a murine aGVHD model and an in vitro intestinal epithelial culture. Millipore cytokine array was utilized to determine the expression of proinflammatory cytokines in the serum. The 16S rRNA sequencing was used to determine the abundance and diversity …

Environmentally Marginalized Populations: The "Perfect Storm" For Infectious Disease Pandemics, Including Covid-19, Gabriella Y. Meltzer, Oyemwenosa Avenbuan, Christina Awada, Oluwakemi B. Oyetade, Tricia Blackman, Simona Kwon Drph, Mph, Esther Erdei Phd, Judith T. Zelikoff Phd

Journal of Health Disparities Research and Practice

COVID-19 has exacted a severe toll on the United States population’s physical and mental health and its effects have been felt most severely among people of color and low socioeconomic status. Using illustrative case studies, this commentary argues that in addition to COVID-19 health disparities created by psychosocial stressors such as the inability to socially distance and access quality healthcare, environmental justice communities have the additional burden of disproportionate exposure to toxic contaminants that contribute to their higher risk of COVID-19. Environmental contaminants including heavy metals and persistent organic pollutants found contaminating their nearby environments can alter the immune response, …

The Feasibility Of Renewable Natural Gas In New Jersey, Anneliese Dyer, Amelia Christine Miller, Brianna Chandra, Juan Galindo Maza, Carley Tran, Justin Bates, Vicky Olivier, Amy Tuininga

PSEG Institute for Sustainability Studies Publications

With traditional natural gas being one of the top options for heating in the United States and the present threat of climate change, there is a demand for an alternative clean fuel source. A Renewable Natural Gas Implementation Decision-Making Conceptual Model was created to provide a framework for considering the feasibility of renewable natural gas (RNG) projects and applied to New Jersey, specifically investigating landfills and wastewater treatment plants (WWTPs). Data from the US EPA’s Landfill Methane Outreach Program and New Jersey’s Department of Environmental Protection Sewage Sludge databases were used to identify seven landfills and 22 WWTPs as possible …

Comparative Effects Of Chemical And Physical Sunscreen On Fertilization Of Purple Sea Urchins (Strongylocentrotus Purpuratus), Marilla Lippert, Maurice Codespoti Goodman, Nikki Adams

Biological Sciences

Organic compound-based “chemical” sunscreens dominate the commercial sunscreen market, but recent research has revealed the ingredients of these products are detrimental to the health of marine organisms. This revelation has led to increased popularity of mineral-based “physical” sunscreens, primarily containing zinc-oxide (ZnO), as environmentally safe alternatives. While they are marketed as environmentally safe, these claims are largely untested, and it is important to consider potential effects of ZnO-based sunscreens on the development of marine organisms. Though Zn is a necessary micronutrient in the ocean, excess Zn is released into marine environments from anthropogenic sources has negative effects on marine life. …

Inhibition Of Biofilm Formation By The Synergistic Action Of Egcg-S And Antibiotics, Shrameeta Shinde, Lee Lee, Tinchun Chu

Department of Biology Faculty Scholarship and Creative Works

Biofilm, a stress-induced physiological state, is an established means of antimicrobial tolerance. A perpetual increase in multidrug resistant (MDR) infections associated with high mortality and morbidity have been observed in healthcare settings. Multiple studies have indicated that the use of natural products can prevent bacterial growth. Recent studies in the field have identified that epigallocatechin gallate (EGCG), a green tea polyphenol, could disrupt bacterial biofilms. A modified lipid-soluble EGCG, epigallocatechin-3-gallate-stearate (EGCG-S), has enhanced the beneficial properties of green tea. This study focuses on utilizing EGCG-S as a novel synergistic agent with antibiotics to prevent or control biofilm. Different formulations of …

Utilization Of The Naranjo Scale To Evaluate Adverse Drug Reactions At A Free-Standing Children's Hospital., Madhavi Murali, Sarah Suppes, Keith Feldman, Jennifer Goldman

Manuscripts, Articles, Book Chapters and Other Papers

The relationship between the Naranjo scaling system and pediatric adverse drug reactions (ADR) is poorly understood. We performed a retrospective review of 1,676 pediatric ADRs documented at our hospital from 2014-2018. We evaluated patient demographics, implicated medication, ADR severity, calculated Naranjo score, associated symptoms, and location within the hospital in which the ADR was documented. ADR severity was poorly correlated with Naranjo interpretation. Out of the 10 Naranjo scale questions, 4 had a response of "unknown" greater than 85% of the time. Cardiovascular and oncological/immunologic agents were more likely to have a probable or definite Naranjo interpretation compared to antimicrobials. …