Medicine and Health Sciences Commons^™

Safety Of Saccharomyces Boulardii (Florastor) In Solid Organ Transplant Patients, Nicole Marie Dores

Undergraduate Honors Thesis Collection

Probiotics have been promoted for use in many gastrointestinal ailments. Most studies find probiotics safe for human use, reporting no severe adverse effects. However, probiotics are live microorganisms and thus have the potential to cause infection. Transplant recipients are considered at high risk for infectious complications from probiotics due to the immunosuppressive medications used to prevent organ rejection. Nonetheless, clinicians are currently utilizing probiotics in the transplant population, due to their benefit in gastrointestinal disorders, particularly recurrent Clostridium difficile. Limited knowledge and paucity of prospective trials in this patient population demands the need for completion of studies to identify the …

Over-The-Counter Non-Steroidal Anti-Anflammatory Drugs In Adolescent Athletes, Anna Christine Parada

Undergraduate Honors Thesis Collection

Non-steroidal anti-inflammatory drugs (NSAIDs) are common medications used by the general population due their anti-inflammatory and analgesic properties. These are especially popular in athletes since they are not prohibited in many rules of athletic competition. Over-the-counter (OTC) NSAIDs comprise several drugs that may be purchased without a prescription. These are often over-utilized by the general population due to their accessibility and relatively low cost. The unsuspecting victims are the children, especially adolescent athletes, who deem OTC NSAIDs safe without realizing the potential adverse effects of inappropriate consumption of these medications. This article reviews the approved indications and side effects of …

Synthesis And Biological Evaluation Of Second Generation Anibamine Analogues As Novel Anti-Prostate Cancer Agents, Shilpa Singh

Theses and Dissertations

Prostate cancer is the most prevalent non-cutaneous cancer among men. Since the 19th century when Virchow first introduced the concept of inflammation in cancer, chemokines and their receptors have garnered a lot of interest. Chemokine receptor CCR5 has been especially implicated in many disease states and recently found to be over expressed in prostate cancer cell lines. Anibamine, a natural CCR5 antagonist discovered in 2004, has been found to have significant anti-prostate cancer activity at micromolar level. To optimize this compound and also discover a novel pharmacophore, exploration of the original structure was carried out. Significant modifications were made to …

Prescription Stimulant Use By Graduate Students, Matthew Donald Varga

Doctoral Dissertations

The purpose of this study was to measure graduate student prescription stimulant use by assessing the extent of use, reasons for use, and poly-substance use. Graduate students (n = 1,015) enrolled at a large Southeastern university completed the Student Life Survey. The data were analyzed using a variety of analytical techniques including descriptive statistics, frequencies, and a stepwise logistic regression in order to answer the research questions guiding this study:

1. What is the extent of prescription stimulant abuse among graduate students on college campuses?
2. What are the reasons for graduate students’ illicit use of prescription stimulants?
3. Are graduate students …

The Histone Deacetylase Inhibitor, Ms-275, Sensitizes Metastatic Osteosarcoma To Fasl-Induced Cell Death: A Role For C-Flip, Krithi R. Bindal

Dissertations & Theses (Open Access)

The purpose of this study was to determine the effects of the histone deacetylase inhibitor, MS-275, on the Fas signaling pathway and susceptibility of osteosarcoma (OS) to Fas ligand (FasL)-induced cell death. OS metastasizes almost exclusively to the lungs. We have shown that Fas expression in OS cells is inversely correlated with their metastatic potential. Fas⁺ cells are rapidly eliminated when they enter the lungs via interaction with FasL, which is constitutively expressed in the lungs. Fas^- OS cells escape this FasL-induced apoptosis and survive in the lung microenvironment. Moreover, upregulation of Fas in established OS lung metastases …

Off-Label Prescribing: Pediatrician Beliefs And Experience, Elizabeth G. Evola

Seton Hall University Dissertations and Theses (ETDs)

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Investigations Of Pharmacokinetic Challenges In Premature Infants, Yi Zhang

Theses and Dissertations (ETD)

Premature infants (gestational age less than 37 weeks) are considered a vulnerable patient population due to their immaturity at birth. Currently, off-label prescribing is common in younger pediatric populations, especially in premature neonates and infants, which is a primary group receiving intensive care. Unique pharmacokinetic (PK) challenges—such as limited blood volume and frequency of blood sample collections, rapid growth and continuous developmental changes, complexity of pediatric studies as well as scientific, practical, and ethical concerns— lead to the current lack of PK information and empirical dosing in premature neonates and infants. In this research, several approaches were investigated to overcome …

Approaches In The Treatment Of Parkinson's Disease : A Focus On Stem Cell-Based Therapies., Tareq Al-Maqtari 1979-

Electronic Theses and Dissertations

Parkinson's disease (PD) is a hypokinetic movement disorder resulting from the progressive neurodegeneration of the dopaminergic nigrostriatal system in the brain and the resulting imbalance between dopamine and acetylcholine in the basal ganglia motor circuitry. Although drug-based therapy approaches have shown dramatic symptomatic improvement in patients, they do not halt the progressive nature of the disease and their long-term use is associated with distressing adverse side effects. Consequently, several studies have aimed at discovering effective non-pharmacological strategies to reduce or to eliminate the need for drugs and possibly to halt or to reverse the neurodegenerative process in PD. Surgical deep …

Development Of Co-Processed Plasticized Cellulose Acetate For Sustained Release Matrix Tablets, Yinqi Zhou

Theses and Dissertations (ETD)

Cellulose Acetate (CA) is a polymer extensively used in pharmaceutical applications. Because of the hydrophobic nature and good film properties of CA, it is a good polymer candidate for sustained release matrix tablets. Sustained release matrix tablets of cellulose acetate can be prepared by direct compression or wet granulation methods. However, previous studies showed that a large amount of CA was required to achieve the desired sustained release profile for a sparingly soluble drug and it was difficult to formulate a highly water soluble drug by using CA as the retarding agent. Some studies concluded that CA is very sensitive …

Preclinical Study Of Potential Antiglioma Novel Tetrahydroisoquinoline Analogs: Pharmacokinetics And Mechanism Of Action, Fei Ma

Theses and Dissertations (ETD)

Gliomas, the tumors of glial cells, account for 80% of primary malignant brain tumors. In 2011, there were about 18,300 new cases of maligant gliomas in the United States alone. Patients with glioblastoma multiforme or anaplastic astrocytoma, the two major types of malignant gliomas, have a median survival of 14 months or 2 to 3 years, respectively. Therefore novel treatments for malignant glioma are urgently needed.

A novel series of tetrahydroisoquinoline derivatives with antiglioma activity has been undergoing drug metabolism/pharmacokinetics (DMPK)-guided lead optimization. EDL-291 was result from structure modification of last generation compound EDL-155. Its preclinical pharmacokinetics were characterized in …

Therapeutic Drug Monitoring Of Factor Viii Prophylaxis Using Its Plasma Coagulant Activity And Global Hemostasis Biomarkers: A Pharmacokinetic/Pharmacodynamic Pilot Study, Hawaj Maitham Al

Theses and Dissertations

Background: The current clinical practice of factor VIII (FVIII) prophylaxis revolves around converting patients with severe hemophilia A, hereafter simply referred to as hemophilia, phenotype (defined as plasma factor VIII coagulant activity [FVIII:C] <1 IU dL-1) to moderate hemophilia phenotype (defined as plasma FVIII:C from 1–5 IU dL-1). However, a wide inter-individual variation in bleeding tendency is observed despite changes in plasma FVIII:C (pharmacokinetic [PK] changes). Therefore, monitoring FVIII prophylaxis by global hemostasis biomarkers (pharmacodynamic [PD] response) can potentially be beneficial. Objective: To conduct appropriate PK/PD modeling using plasma FVIII:C and global hemostasis (platelet function and blood viscoelastic) biomarkers in severe hemophilia. Methods: Nine non-bleeding severe hemophiliacs (plasma FVIII:C <1 IU dL-1) with variant bleeding tendency (5 frequent bleeders and 4 infrequent bleeders) were infused with a recombinant factor FVIII (rFVIII) prophylactic dose (mean = 32.1 international units per kilogram [IU kg-1]). Blood was collected at baseline and 0.5-, 1-, 2-, 4-, 8-, 12-, 24- and 48-hours (h) post-dose for plasma FVIII:C, platelet function (platelet contractile force [PCF], clot elastic modulus [CEM] and force onset time [FOT]) and blood viscoelastic (reaction-time [R], kinetics-time [K] and maximum amplitude [MA]) biomarkers and activated partial thromboplastin time (aPTT). Non-compartmental analysis (NCA) was performed using standard methods. Compartmental analysis (CA) and PK/PD modeling were performed by non-linear regression. Correlation and analysis of variance (ANOVA) were used to explore the role of clinically relevant modifiers of bleeding tendency, as appropriate. ANOVA was used to assess inter-group differences in pertinent PK and PD parameters. P value <0.05 significance level was pre-specified for all statistical tests. Results: Mean (±SD) volume of distribution at steady state (Vss), total clearance (CLtot) and terminal half-life (t1/2) from NCA were 40.5 (±11.2) milliliter per kilogram (mL kg-1), 2.9 (±1.2) milliliter per hour per kilogram (mL h-1 kg-1) and 11.6 (±6.2) h, respectively. Mean (±SD) Vss and CLtot from the one-compartment body model (CA) were 39.6 (±8.9) mL kg-1 and 3.1 (±1.3) mL h-1 kg-1, respectively. The mean (±SD) baseline effect (E0) and slope from the PK/PD linear modeling were: for aPTT, 48.9 (±4.4) seconds (sec) and -0.025 (±0.009) second deciliter per international unit (sec dL IU-1), respectively; for PCF, 0.3 (±0.3) kilodynes (kdynes) and 0.008 (±0.004) kilodynes deciliter per international unit (kdynes dL IU-1), respectively; and for CEM, 0.0 (±0.0) kilodynes per square centimeter (kdynes cm-2) and 0.032 (±0.016) kilodynes deciliter per international unit per square centimeter (kdynes dL IU-1 cm-2), respectively. The mean (±SD) maximum effect (Emax) and half the maximum effective concentration (EC50) from the PK/PD sigmoidal Emax model were: for FOT, 70.1 (±16.9) % reduction and 87.8 (±31.4) IU dL-1 for FOT, respectively; for R, 74.9 (±26.0) % reduction and 68.5 (±28.4) IU dL-1, respectively; and for K, 73.2 (±36.4) % reduction and 67.2 (±29.0) IU dL-1, respectively. MA was not PK/PD modeled due to its low sensitivity. Conclusions: Plasma FVIII:C remained ≥1 IU dL-1 over the prophylactic interval. FOT and R were the most sensitive biomarkers at lower plasma FVIII:C. PCF and CEM were more sensitive than K and aPTT at lower plasma FVIII:C. MA was the least sensitive biomarker. Correlation and inter-group differences did not reach statistical significance (small sample size). These results may be used to assess risk of bleeding and dose-optimize FVIII prophylaxis in severe hemophilia.

Quantitative Analysis Of Multiple Charged Large Molecules In Human Or Rat Plasma Using Liquid Chromatography Tandem Mass Spectrometry, Matthew Halquist

Theses and Dissertations

Immunoassays have traditionally been employed for the determination of plasma concentration-time profiles for pharmacokinetic studies of therapeutic proteins and peptides. These ligand binding assays have high sensitivity but require significant time for antibody generation (1 to 2 years) for assay development. Despite high sensitivity, these assays suffer from cross-reactivity that can lead to inaccurate results. As an alternative to immunoassays, this dissertation was focused on the development and validation of assays that can be used for quantitative analysis of peptides or proteins in plasma using liquid chromatography tandem mass spectrometry (LC-MS/MS). Two approaches were considered for measurement of proteins and …

In Vitro Methods To Predict Aerosol Drug Deposition In Normal Adults, Renishkumar Delvadia

Theses and Dissertations

This research was aimed at the development and validation of new in vitro methods capable of predicting in vivo drug deposition from dry powder inhalers, DPIs, in lung-normal human adults. Three physical models of the mouth, throat and upper airways, MT-TB, were designed and validated using the anatomical literature. Small, medium and large versions were constructed to cover approximately 95% of the variation seen in normal adult humans of both genders. The models were housed in an artificial thorax and used for in vitro testing of drug deposition from Budelin Novolizer DPIs using a breath simulator to mimic inhalation profiles …

Encapsulation And Controlled Release Of Rhu-Erythropoietin From Chitosan Biopolymer Nanoparticles, Cody Bulmer

Electronic Thesis and Dissertation Repository

The objective of this research project was to develop a drug delivery system for recombinant human erythropoietin (rHu-EPO), a glycoprotein hormone used in the treatment of renal anaemia and chemotherapy induced anaemia, using the biopolymer chitosan as the base component. Two types of chitosan nanoparticles were produced through ionotropic gelation using flush mixing with either tripolyphosphate (TPP) or carrageenan polymer. Chitosan-TPP and chitosan-carrageenan nanoparticles were generated under a variety of conditions to evaluate the effects of chitosan concentration, chitosan to anion mass ratio and solution pH on the nanoparticle characteristics of particle diameter, surface charge and particle size distribution. A …

A Cellular Automata Model Of Enantiomer Interactions With Beta-Cyclodextrin, Desoi Darren

Theses and Dissertations

The binding mechanisms of molecules to cyclodextrins continues to be studied to better explain the interactions occurring. The majority of published models focus on one-to-one molecular binding thermodynamics to explain experimental results. They rely on physical concepts of energies and forces to guide the actions of molecules expressed mathematically in terms of differential and non-linear equations. These models are limited in scope due to their complexity and are not easily expanded to study many diverse analytes. Conversely, cellular automata uses simple mathematical idealizations of systems governed by deterministic and probabilistic rules that are easily adaptable to many types of molecular …

Preparation Of Different Polyamide Nanofiltration Membranes By Interfacial Polymerization And The Effect Of Post-Polymerization Treatment On Separation Performance, Yu Qin

Theses

Interfacial polymerization (IP) is a powerful technique for fabrication of thin film composite (TFC) membranes. In this study, polyamide nanofiltration (NF) composite membranes ware prepared by interfacial polymerization of polyethylenimine (PEI) or m-phenylene diamine (MPD) with isophthaloyl dichloride (IPD) on the surface of a porous polyethersulfone (PES) support. Concentrations of monomer reactants for this reaction were decided by equivalent weight ratio. A standard IP procedure was applied to successfully coat PES flat films. After preparation, three different post-polymerization treatments were employed and one optimal treatment was proven after membrane testing.

The TFC flat film membranes were characterized by nanofiltration of …

Chronic Opioid Use In Fibromyalgia Syndrome: Characteristics And Outcomes, Jacob T. Painter

Theses and Dissertations--Pharmacy

Fibromyalgia syndrome (FMS) is a chronic pain condition with significant societal and personal burdens of illness. Chronic opioid therapy in the treatment of chronic nonmalignant pain has increased drastically over the past decade. This is a worrisome trend in general, but specifically, given the pathophysiologic characteristics seen in fibromyalgia syndrome patients, the use of this class of medication deserves special scrutiny. Although the theoretical case against this therapy choice is strong, little empirical evidence exists. In order to supplement this literature, retrospective analysis methods are utilized to examine the association of state-, provider-, and patient level characteristics with the prevalence …

Development Of Novel Thermosensitive Polymers For Bioresponsive Drug Delivery, Vivek Kumar Garripelli

Electronic Theses and Dissertations

Stimuli-responsive polymers have already shotremendous promise in controlled and self-regulated drug delivery. Successful construction of responsive polymers requires amalgamation of chemical, physical and biological principles. For careful therapy, a great deal of advantages offered by stimuli-responsive polymers is essential. A small or modest change in the environmental condition (e.g. temperature, pH, light) brings a sharp change in the properties of the responsive polymers. 'Smart' drug delivery systems utilize these principles to mimic the biological response behavior to a certain extent. Synthetic polymers incorporated with stimuli-responsive behavior would be amenable to overcome some of the systemic and intracellular delivery barriers. Development …

The Effect Of Exercise On Mechanical Pressure Pain Threshold In The Presence And Absence Of Delayed-Onset Muscle Soreness, Brandon Tynes

Electronic Theses and Dissertations

Research has shown decreased pain sensitivity (hypoalgesia) during and following maximal and sub-maximal isometric exercise (Koltyn, 2002). Research on fibromyalgia patients however has shown the same exercises increase pain sensitivity (hyperalgesia) (Staud, Robinson, & Price, 2005; Kosek, Ekholm, & Hansson, 1996). The purpose of the present study was to examine the effects of exercise on pressure pain thresholds (PPT) in the presence and absence of delayed-onset muscle soreness (DOMS) within the ipsilateral (contracting) and contralateral quadriceps muscle and plurisegmental finger. Data were collected using twenty-five male participants (aged 18-29) over five testing days: two days of familiarization, one day of …

Anticancer And Antibiotic Leads From Marine Organis, Bin Wang

Electronic Theses and Dissertations

During the past three decades, the development of marine natural products as drug leads has become a promising avenue for research. As our efforts towards the discovery of anticancer and antibiotic drug leads from marine organisms, modifications of anticancer drug candidate kahalalide F, isolations of new peptides from the mollusk, Elysia rufescens and anticancer drug leads from the NCI repository, as well as chemical regulation of antibiotic production from marine Pseudomonas aeruginosa were investigated. Kahalalide F (KF) is a potent anticancer lead isolated from the herbivorous marine mollusk E. rufescens and its algal diet Bryopsis pennata. Our semisynthesis approach was …

Geographic And Host-Microbe Symbiotic Influence On Secondary Metabolism, Samuel Hamed Abbas

Electronic Theses and Dissertations

This thesis is composed of studies that regard the advancement to the Arctic region and the importance of host-microbe interactions in natural product discovery. Bioactive metabolites have been reported from a myriad of marine and terrestrial organisms around the world including plants, insects, sponges, tunicates, bacteria, and fungi among others. Many macroorganisms, of which the metabolites are found, depend on the symbiotic relationship of microorganisms for metabolite production. The scope of this work is to investigate secondary metabolism of both marine and terrestrial organisms from different areas of the world as well as search for the importance of host-microbe symbiosis …

Design And Development Of Drug Delivery Systems For Immediate And Sustained Release Utilizing Hot Melt Extrusion, Abhilasha Singh

Electronic Theses and Dissertations

Polymers have indispensable role in pharmaceutical formulation development. Polymer choice is a critical factor to obtain the desired drug-release profile during formulation development for HME (Hot melt extrusion). Many commercially available, pharmaceutical-grade polymers can be used in HME formulations. The suitable polymer choice facilitates processing in the extruder. When choosing a polymer to use in a formulation, processing conditions and processing attributes of the active pharmaceutical ingredients (APIs) should be considered. The physicochemical and the mechanisms of drug release from drug delivery systems prepared by utilizing HME with various polymeric carriers were investigated. Amorphous forms of API can have as …

Pharmaceutical Formulation Development Utilizing Hot Melt Extrusion And Other Techniques For Development Of Immediate And Controlled Release Dosage Forms, Noorullah Naqvi Mohammed

Electronic Theses and Dissertations

Hot melt extrusion (HME) was evaluated as a processing technology for the manufacture of immediate as well as controlled release formulations for oral delivery of two model compounds. For immediate release applications lower molecular weight grades of Hydroxypropyl cellulose polymers, EF and ELF, were utilized as carrier matrices to form solid solutions of a poorly soluble compound, Ketoprofen (KPR). Thermal characterization techniques were used to confirm thermal stability, miscibility and setting up processing conditions for extrusion. Extruded matrices were pelletized to be filled into pellets or further milled and compressed into tablets. Pellets exhibited a carrier dependent release with ELF …

Design Synthesis And Biological Evaluation Of Non-Peptide Neuropeptide Ff Ligands, Jessica Valentinas Mankus

Electronic Theses and Dissertations

Neuropeptide FF is an endogenous RF-amide with two receptor subtypes originally described as having anti-opioid characteristics. While peptide work helped to elucidate key features for targeting the subtypes of the neuropeptide FF receptor, non-peptide small molecules offer a more refined tool to discover features that affect selectivity and affinity. Improvements in small molecule ligands for neuropeptide FF support lead development and offer a clearer understanding of the binding pocket of each receptor subtype. Previous work on the lead 4–anilindopiperidine structure clarified a key feature between agonist and antagonist behavior. Early modifications of substituents of the piperidine nitrogen were tolerated and …

Discovery Of Small-Molecule Natural Products That Target Cellular Bioenergetics, Sandipan Datta

Electronic Theses and Dissertations

Molecular-targeted antitumor therapy has found favor in antitumor drug discovery programs. Hypoxia (< 5% oxygen) is a comfeature of solid tumors and hypoxia-inducible factor-1 (HIF-1) represents an important antitumor target. Bioenergetic homeostasis is typically altered in tumor cells and HIF-1 plays an important role to produce a glycolytic phenotype. Glycolysis inhibitors are an emerging class of potential tumor-selective adjuvant therapeutic agents. Natural product aerobic glycolysis inhibitors may enhance the effectiveness of current therapies. Mitochondrial oxidative phosphorylation inhibitors in botanical dietary supplements (BDS) possess a potential health hazard which should be identified and appropriately regulated. Chapter one briefly reviews the molecular-targeted natural product antitumor drug discovery process. Descriptions of tumor hypoxia, HIF-1, HIF-1 regulatory pathways and the effect of HIF-1 on tumor cell bioenergetics are presented. Cellular bioenergetic pathways and natural products that inhibit HIF-1 by interfering with cellular bioenergetics are discussed. Mitochondriotoxic small-molecule natural products reported previously are further reviewed. Chapter two discusses the effect of chromatographic media on molecular-targeted antitumor drug discovery. A panel of crude extracts was eluted through columns of various chromatographic media using a step gradient method. Total recoveries from the various columns and various elution protocols were compared and statistically analyzed. The crude extracts and column eluates were evaluated for HIF-1 inhibitory activity. Chapter three discusses the development of a bioenergetics-based screening method to screen crude extracts for glycolysis inhibitors. Crude extracts (10,648) were screened and seven hits (hit rate 0.72%) were identified. Bioassay-guided isolation of Moronobea coccinea crude extract resulted in isolation of a protonophoric compound moronone (1) (false positive). The structure of 1 was determined by a combination of spectroscopic and spectrometric means. The protonophoric compounds must be rapidly dereplicated for successful discovery of glycolysis inhibitors. Chapter four discusses the screening of BDS products and pure compounds for mitochondrial uncouplers or electron transport chain inhibitors. The blue cohosh (Caulophyllum thalictroides) extract and three saponins cauloside A (3), saponin PE (4) and cauloside C (5) permeabilize the mitochondrial membrane. Sesamin (6) and guggulsterol III (7) and guggul (Commiphora wightii) extract inhibit mitochondrial complex I. These extracts and compounds are cytotoxic in nature.

Poverty Shelf, New Zealand From The Holocene To Present: Stratigraphic Development And Event Layer Preservation In Response To Sediment Supply, Tectonics And Climate, Lila Eve Rose Pierce

Dissertations, Theses, and Masters Projects

The small, high sediment yield Waipaoa River is located on the tectonically active, mountainous Poverty Margin on the east coast of the North Island, New Zealand. In contrast to sedimentary sequences on passive margin shelves, active margins, such as the Poverty Margin, can preserve continuous records of changing geological and environmental conditions at the land-sea interface during rapid sea-level rise. Two subsiding mid-shelf basins on the Poverty Shelf contain thick transgressive sequences which provide a record of evolving river, climate, landscape, and oceanographic conditions since the Last Glacial Maximum (LGM). This dissertation investigates the stratigraphic development of Poverty Shelf, including …

Metabolism And Pharmacokinetics In The Development Of New Therapeutics For Cocaine And Opioid Abuse, Pradeep Kumar Vuppala

Electronic Theses and Dissertations

Cocaine and opioid abuse are a major public health concern and the cause of significant morbidity and mortality worldwide. The development of effective medication for cocaine and opioid abuse is necessary to reduce the impact of this issue upon the individual and society. The pharmacologic treatment for drug abuse has been based on one of the following strategies: agonist substitution, antagonist treatment, or symptomatic treatment. This dissertation is focused on the role of metabolism and pharmacokinetics in the development of new pharmacotherapies, CM304 (sigma-1 receptor antagonist), mitragynine and 7-hydroxymitragynine (μ-opioid receptor agonists), for the treatment of drug abuse. The affinity …

The Potential For Screening For Interpersonal Violence In Community Pharmacies: An Exploratory Study, Marie Barnard

Electronic Theses and Dissertations

Intimate partner violence (IPV) is a public health problem of epidemic proportion; the only known effective health care intervention is routine screening for IPV exposure. Despite professional guidelines for routine screening, this intervention has been poorly adopted. Expansion of screening efforts to the community pharmacy setting provides an opportunity to have a substantial impact on the health, well-being of pharmacy patients. This investigation is the first to examine IPV screening related to the pharmacy environment. An existing measure of physicians' readiness to manage IPV (PREMIS) was adapted for the community pharmacy environment and validated in a national random sample of …

Development And Comparative Predictive Validity Of An Outpatient Medication Exposure Measure For Risk Adjustment Using Retrospective Claims Data, Kyle Dennis Null

Electronic Theses and Dissertations

The purpose of this study was to develop and test a measure of outpatient prescription utilization (medication exposure measure, or MEM) that may be coupled with the CMS-HCC and CMS-RxHCC methodologies to improve risk-adjusted payments to Medicare Part C and Part D plans. Studies have identified prescription measures that predict future expenditures; however, many are easily manipulable by health plans or practitioners, thus limiting their utility as risk-adjusters. The addition of a non-manipulable prescription utilization measure to existing risk-adjustment models may improve prediction, reducing adverse risk selection incentives by health plans. A secondary objective of this study was to evaluate …

Discovery Of Gz-793a, A Novel Vmat2 Inhibitor And Potential Pharmacotherapy For Methamphetamine Abuse, David B. Horton

Theses and Dissertations--Pharmacy

Methamphetamine abuse is a serious public health concern affecting millions of people worldwide, and there are currently no viable pharmacotherapies to treat methamphetamine abuse. Methamphetamine increases extracellular dopamine (DA) concentrations through an interaction with the DA transporter (DAT) and the vesicular monoamine transporter-2 (VMAT2), leading to reward and abuse. While numerous studies have focused on DAT as a target for the discovery of pharmacotherapies to treat psychostimulant abuse, these efforts have been met with limited success. Taking into account the fact that methamphetamine interacts with VMAT2 to increase DA extracellular concentrations; the focus of the current work was to develop …