Medicine and Health Sciences Commons^™

Structure Elucidation Of A Pyrrolobenzodiazepine Alkaloid And A Biologically Active Polyketide Produced By Rhodococcus Sp. Mtm3w5.2 Via Two-Dimensional Nmr Spectroscopy, Garrett Johnson

Electronic Theses and Dissertations

As the battle against ever-increasing drug resistence bacteria rages on, novel and sometimes more complex natural products can be used to combat this. In this study, two-dimensional NMR techniques were utilized to collect a complete spectral data set for two natural products. The first structure, a synthesized Pyrrolobenzodiazepine alkaloid natural product was confirmed through these methods. The second, a strain of Rhodococcus, MTM3W5.2, produces a novel antibacterial molecule in broth cultures and the active compound was fractionated using a Sephedex LH-20 column. Chromatographic purification yielded a pure sample at 58.90 minutes, RT.58. HRMS data deduced an exact mass of …

Impact Of Serial Blood Glucose Monitoring And Treatment In Patients With Corticosteroid-Induced Hyperglycemia In The Inpatient Setting, Monica Tadros, Heidi Clarke, Radhan Gopalani, Stephanie Palma, Moe Shwin

All Publications

No abstract provided.

Cangrelor Use In Patients Undergoing Percutaneous Coronary Intervention Or Neurointervention With Stent Placement In A Community Hospital, Radhan Gopalani, Jessica Justiz, Monica Tadros, Stephanie Palma, Andrea Marr-Peralto

All Publications

No abstract provided.

Retrospective Chart Review Of Patients Treated With Ibutilide For Pharmacological Cardioversion, Joyce Lee, Radhan Gopalani, Faaria Quadri

All Publications

No abstract provided.

Evaluating Antipsychotic Prescribing In The Intensive Care Unit And Across The Continuum Of Care, Michael Pasqualicchio, Heidi Clarke

All Publications

Purpose/Background: The 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (PADIS) recommend against both typical and atypical antipsychotic use for delirium in critically ill patients. This recommendation is based on evidence showing that these medications are not associated with shorter durations of delirium, mechanical ventilation, intensive care unit (ICU) length of stay, or reduced mortality. There are many long term complications associated with the use of antipsychotics including QTc prolongation, extrapyramidal symptoms, metabolic abnormalities, and anticholinergic effects. Regardless, antipsychotics remain the most common medication used …

The Discovery And Development Of Thienopyrimidines As Inhibitors Of Helicobacter Pylori, Alex Kagabo Mugengana

Theses and Dissertations (ETD)

The rate of successful treatment for Helicobacter pylori infections, with the clarithromycin triple therapy, is only 75%. The triple therapy, which consists of a proton pump inhibitor and two broad-spectrum antibiotics such as clarithromycin and amoxicillin, is becoming less effective due to the rise of strains with resistance against these antibiotics. In the search for narrow spectrum drugs for the treatment of H. pylori infections, a high-throughput screen was performed to identify selective compounds against H. pylori. This screen revealed two selective and structurally related thienopyrimidines. Structure-activity relationship of the thienopyrimidines against H. pylori was examined through the synthesis of …

Drug Interactions With Antimalarial Medications In Older Travelers: A Clinical Guide, Jelena Lewis, Tania Gregorian, Ivan Portillo, Jeff Goad

Pharmacy Faculty Articles and Research

Increasingly older adults are traveling to international destinations with malaria as a present risk. Surveillance systems indicate that older adults are more likely to suffer severe complications from malaria. The role of health care providers in selecting an appropriate medication for chemoprophylaxis or treatment of malaria in adults becomes more difficult as older adults undergo physiologic changes that alter the pharmacokinetic and pharmacodynamic nature of medications potentially causing increased drug interactions, adverse events, and altered drug action. A comprehensive literature search from 1970 to present, with a focus on the last 10 years, was conducted on drug interactions, pharmacokinetic and …

Using Community Pharmacy Immunization Screening Forms To Identify Potential Immunization Opportunities, Albert T. Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs …

Improving Medication Information Presentation Through Interactive Visualization In Mobile Apps: Human Factors Design, Don Roosan, Yan Li, Anandi Law, Huy Truong, Mazharul Karim, Jay Chok, Moom Roosan

Pharmacy Faculty Articles and Research

Background: Despite the detailed patient package inserts (PPIs) with prescription drugs that communicate crucial information about safety, there is a critical gap between patient understanding and the knowledge presented. As a result, patients may suffer from adverse events. We propose using human factors design methodologies such as hierarchical task analysis (HTA) and interactive visualization to bridge this gap. We hypothesize that an innovative mobile app employing human factors design with an interactive visualization can deliver PPI information aligned with patients’ information processing heuristics. Such an app may help patients gain an improved overall knowledge of medications.

Objective: The …

A Systematic Comparison Of Lipopolymers For Sirna Delivery To Multiple Breast Cancer Cell Lines: In Vitro Studies, Hamidreza Montazeri Aliabadi, Remant Bahadur Kc, Emira Bousoik, Ashley Barbarino, Bindu Thapa, Melissa Coyle, Parvin Mahdipoor, Hasan Uludağ

Pharmacy Faculty Articles and Research

Small interfering RNA (siRNA) therapy is a promising approach for treatment of a wide range of cancers, including breast cancers that display variable phenotypic features. To explore the general utility of siRNA therapy to control aberrant expression of genes in breast cancer, we conducted a detailed analysis of siRNA delivery and silencing response in vitro in 6 separate breast cancer cell models (MDA-MB-231, MDA-MB-231-KRas-CRM, MCF-7, AU565, MDA-MB-435 and MDA-MB-468 cells). Using lipopolymers for siRNA complexation and delivery, we found a large variation in siRNA delivery efficiency depending on the specific lipopolymer used for siRNA complexation and delivery. Some lipopolymers were …

Budesonide Enhances Agonist-Induced Bronchodilation In Human Small Airways By Increasing Camp Production In Airway Smooth Muscle, Cynthia J. Koziol-White, Timothy B. Johnstone, Maia L. Corpuz, Gaoyuan Cao, Sarah Orfanos, Vishal Parikh, Brian Deeney, Omar Tliba, Rennolds S. Ostrom, Ian Dainty, Reynold A. Panettieri Jr.

Pharmacy Faculty Articles and Research

The non-genomic mechanisms by which glucocorticoids modulate β₂ agonist-induced-bronchodilation remain elusive. Our studies aimed to elucidate mechanisms mediating the beneficial effects of glucocorticoids on agonist-induced bronchodilation. Utilizing human precision cut lung slices (hPCLS), we measured bronchodilation to formoterol, prostaglandin E₂ (PGE₂), cholera toxin (CTX) or forskolin in the presence and absence of budesonide. Using cultured human airway smooth muscle (HASM), intracellular cAMP was measured in live cells following exposure to formoterol, PGE₂, or forskolin in the presence or absence of budesonide. We showed that simultaneous budesonide administration amplified formoterol-induced bronchodilation and attenuated agonist-induced phosphorylation …

Trends In Prices Of Insulin Marketed In The Us, Hana Althobaiti

Pharmaceutical Sciences (MS) Theses

INTRODUCTION: Diabetes mellitus is one of the most prevalent and costly chronic diseases in the United States (US). The healthcare and drug cost of diabetes has risen steadily and the increase in patients’ out-of-pocket drug expenditures are associated with a reduction in treatment adherence. The objectives of this study were to assess trends in insulin products prices in the period January 1983-July 2019, and to compare the price, acquisition costs and reimbursement amount of insulins available in the US.

DATA AND METHODS: Data of insulin products marketed in the US during the period January 1983-July 2019 was derived from the …

Summary Of The International Patient Safety Conference, June 28-29, 2019, Kathmandu, Nepal, Deepak C. Bajracharya, Kshitij Karki, Chhiring Yangjen Lama, Rajesh Dhoj Joshi, Shankar Man Rai, Sudhakar Jayaram, Amit Tomer, John Zervos, Mohammad Imran Khan, Arjun Sapkota, Madan Kumar Upadhyaya, Paul E. Kilgore

Department of Pharmacy Practice

Globally, medical errors are associated with an estimated $42 billion in costs to healthcare systems. A variety of errors in the delivery of healthcare have been identified by the World Health Organization and it is believed that about 50% of all errors are preventable. Initiatives to improve patient safety are now garnering increased attention across a range of countries in all regions of the world. From June 28--29, 2019, the first International Patient Safety Conference (IPSC) was held in Kathmandu, Nepal and attended by over 200 healthcare professionals as well as hospital, government, and non-governmental organization leaders. During the conference, …

Post-Implementation Analysis Of The Impact Of Intravenous Automation Systems On Health-System Pharmacy Operations, Craig Kimble, Ken Maxik, Chris Booth, Michael Rudolph, Kim Broedel-Zaugg

Faculty Research Day

We have all seen the reports on the news about issues related to IV rooms and IV room compounding. Many health-system pharmacies have implemented, or are considering some form of intravenous (IV) automation and/ or compounding system in their clean rooms to reduce pharmacy errors and improve accuracy, productivity, and workflow. Manufacturers tout that automated systems, used appropriately, aid in reducing errors from reaching patients. Additionally, IV admixture automation is one of the most recent areas where technology has been added to pharmacy workflow.

Machine Learning To Quantitate Neutrophil Netosis, L. Elsherif, N. Sciaky, C. A. Metts, M. Modasshir, I. Rekleitis, C. A. Burris, J. A. Walker, N. Ramadan, T. L. Leisner, S. P. Holly, M. Cowles, K. I. Ataga, J. N. Cooper, L. V. Parise

Pharmaceutical Sciences

No abstract provided.

Physical And Chemical Stability Of Dexamethasone Sodium Phosphate In Intravenous Admixtures Used To Prevent Chemotherapy-Induced Nausea And Vomiting, Ina Buga, Joy Uzoma, Kristin Reindel, Kateryna Rashid, Tuong Diep, Pamela Mccartan, Fang Zhao

Pharmacy Faculty/Staff Publications

Purpose: Dilute intravenous (IV) admixtures of dexamethasone sodium phosphate (DSP) are becoming increasingly used in antiemetic regimens to prevent chemotherapy-induced nausea and vomiting (CINV). Based on its chemical structure and previous studies, DSP is known to be susceptible to hydrolysis and oxidation under certain conditions. There are limited data to directly support the selection of IV diluents, storage conditions, and beyond-use dates for the dilute IV solutions of DSP used in the antiemetic regimens. This study was designed to investigate these parameters. Methods: A stability-indicating high-performance liquid chromatography (HPLC) method was first developed for the analysis of DSP. Commercially available …

November 2019, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Systemic Toxicity Reported For Cdk8/19 Inhibitors Cct251921 And Msc2530818 Is Not Due To Target Inhibition, Mengqian Chen, Jing Li, Jiaxin Liang, Zanshé S. Thompson, Katie Kathrein, Eugenia Broude, Igor Roninson

Faculty Publications

CDK8/19 kinases, which mediate transcriptional reprogramming, have become an active target for cancer drug discovery. Several small-molecule CDK8/19 inhibitors showed in vivo efficacy and two have entered clinical trials, with no significant toxicities reported. However, Clarke et al. (eLife 2016; 5; e20722) found severe systemic toxicity associated with two potent CDK8/19 inhibitors, Cmpd3 (CCT251921) and Cmpd4 (MSC2530818), and suggested that their toxicity was due to on-target effects. Here, we compared five CDK8/19 inhibitors: Cmpd3, Cmpd4, Senexin B, 16-didehydro-cortistatin A (dCA) and 15w, in different assays. Only Cmpd4 showed striking toxicity in developing zebrafish. In cell-based assays for CDK8 and CDK19 …

Evaluating Controlled Substance Documentation In An Electronic Medical Record, Delora Brooks

Dissertations

The Centers for Disease Control and Prevention (CDC) directives issued in 2016 gave guidelines for safely prescribing opiates; however, primary source discussions about methods used for documenting opioid and controlled substance monitoring within an electronic medical record (EMR) are limited (Hussain, Nelson, Polston & Zheng, 2019). This leaves individual providers to determine the appropriate way to document. Inconsistent documentation may not protect providers or organizations from regulatory, civil or criminal liability. As stated by Raveesh, Nayak & Kumbar (2016), “The best way to handle medico-legal issues is by preventing them”. Even with the advent and widespread use of EMRs, documentation …

Prevalence, Determinants, And Characteristics Of Extemporaneous Compounding In Jordanian Pharmacies, Hatim S. Alkhatib, Sara Jalouqa, Nour Maraqa, Anna Ratka, Eman Elayeh, Suha Al Muhaissen

Pharmacy Faculty/Staff Publications

Background:

Pharmaceutical compounding is an essential component in pharmacy practice allowing pharmacists to provide dosage forms or strengths that are commercially unavailable. Medications compounded for patient-specific needs contribute to personalized medicine. Extemporaneous compounding provided by pharmacies overcomes the market shortage of these therapeutic products. The aim of this study is to investigate and characterize the prevalence, characteristics, and determinants of extemporaneous compounding in Jordanian pharmacies.

Methods:

This study was based on a cross-sectional questionnaire and included 431 randomly selected pharmacies in the twelve governorates of the country. Data were collected via face to face interviews of pharmacists who voluntarily and …

Physicochemical Properties Of Blend Poly (Vinyl Alcohol) And Sodium Alginate Membranes For Potential Application In Wound Dressings, Martha Pieper

Mechanical Engineering Theses

Poly (vinyl alcohol) (PVA) and sodium alginate (SA) are water-soluble polymers with excellent biocompatibility suitable for biomedical applications in wound dressings. In this study, pure PVA, pure SA, and blends of PVA/SA membranes were solvent cast into films followed by crosslinking in CaCl₂, boric acid, and a mixture of CaCl₂/boric acid solutions for 5, 10, and 30 minutes. Initial feasibility studies showed a strong correlation of film thickness to the observed mechanical properties. Further studies in solvent casting of blend PVA/SA films, using various polymer concentrations, yielded better film appearance with minimal physical changes after crosslinking. …

A Simple And Flexible Model To Calculate Annual Merit Raises For Health Sciences Faculty, Reza Mehvar

Pharmacy Faculty Articles and Research

Purpose

The objective of this study was to develop and implement a simple and flexible mathematical model to generate merit-based salary increases as a percentage of the faculty base salaries, with the flexibility to choose the range of merit raises.

Methods

Annual faculty performance scores, faculty base salaries, and available salary increase pool were used in a relatively simple linear model to determine the individual faculty merit raises as a percentage of their base salary. The core model allows the selection of a slope value that determines how steeply the merit raise changes with a change in the performance score. …

The Fallacy Of Enzymatic Hydrolysis For The Determination Of Bioactive Curcumin In Plasma Samples As An Indication Of Bioavailability: A Comparative Study, Sidney J. Stohs, C. Y. O. Chen, Harry G. Preuss, Sidhartha D. Ray, Luke R. Bucci, Jin Ji, Kevin J. Ruff

Touro Scholarly Works

Background

Numerous health benefits have been demonstrated for curcumin which is extracted from turmeric (Curcuma longa L). However, due to its poor absorption in the free form in the gastrointestinal tract and rapid biotransformation, various formulations have been developed to enhance its bioavailability. Previous studies indicate that the free form of curcumin is more bioactive than its conjugated counterparts in target tissues. Most curcumin pharmacokinetics studies in humans designed to assess its absorption and bioavailability have measured and reported total (free plus conjugated) curcumin, but not free, bioactive curcumin in the plasma because enzymatic hydrolysis was employed prior to …

Connecting Health Plan Care Managers With A Network Of Enhanced Services Community Pharmacies: A Pennsylvania Case Study, Nicholas Leon, Pharmd, Stephanie Mcgrath, Pharmd, Kim Coley, Pharmd, David Pope, Pharmd, Elizabeth Grassmyer, Melissa A. Mcgivney, Pharmd, Patricia Epple

College of Pharmacy Posters

PPCN pharmacies have been able to successfully collaborate, bi-directionally, with health plan care managers to improve patient health and enable appropriate utilization of healthcare resources

To build off of our early success, additional systems and tracking capabilities are being explored related to the following:

• Bi-directional tracking of referrals
• Care managers to pharmacists
• Pharmacists to care managers
• Delivery drivers as community health workers
• Drug class specific interventions (ex. a focus on opioids)
• Disease state specific interventions (ex. a focus on asthma or type 2 diabetes)
• Formal interventions focused on dialing patients back into the services/resources offered by health plans

PPCN is …

Graft Versus Host Disease-Associated Dry Eye: Role Of Ocular Surface Mucins And The Effect Of Rebamipide, A Mucin Secretagogue, Kiumars Shamloo, Ashley Barbarino, Saleh Alfuraih, Ajay Sharma

Pharmacy Faculty Articles and Research

PURPOSE. The present study was designed to investigate the role of ocular surface glycocalyx and mucins in graft versus host disease (GVHD)-associated dry eye. The ameliorative effect of topical rebamipide, a mucin secretagogue, on GVHD-associated dry eye was also tested.

METHODS. A mouse model of allogeneic transplantation was used to induce ocular GVHD with C57BL/6 as donors and B6D2F1 as recipient mice. Phenol red thread method and fluorescein staining was used to quantify tear secretion and corneal keratopathy. At 8 weeks after the allogeneic transplantation, corneas were harvested to perform glycocalyx staining and confocal microscopy. Goblet cell staining was performed …

Simulated Biological Fluid Exposure Changes Nanoceria’S Surface Properties But Not Its Biological Response, Robert A. Yokel, Matthew L. Hancock, Benjamin Cherian, Alexandra J. Brooks, Marsha L. Ensor, Hemendra J. Vekaria, Patrick G. Sullivan, Eric A. Grulke

Pharmaceutical Sciences Faculty Publications

Nanoscale cerium dioxide (nanoceria) has industrial applications, capitalizing on its catalytic, abrasive, and energy storage properties. It auto-catalytically cycles between Ce³⁺ and Ce⁴⁺, giving it pro-and anti-oxidative properties. The latter mediates beneficial effects in models of diseases that have oxidative stress/inflammation components. Engineered nanoparticles become coated after body fluid exposure, creating a corona, which can greatly influence their fate and effects. Very little has been reported about nanoceria surface changes and biological effects after pulmonary or gastrointestinal fluid exposure. The study objective was to address the hypothesis that simulated biological fluid (SBF) exposure changes nanoceria’s surface properties …

A Baker's Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2018, Elias B. Chahine, Spencer H. Durham, Krutika N. Mediwala, Daniel B. Chastain, Timothy P. Gauthier, Brandon K. Hill, Bruce M. Jones, Jamie J. Kisgen, Ashley H. Marx, Kayla R. Stover, Marylee V. Worley, Christopher M. Bland, P Brandon Bookstaver

Faculty Publications

With an increasing number of antimicrobial stewardship-related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an actionable intervention for 2018. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training as well as to identify potential intervention opportunities within one's institution.

Combatting The Opioid Epidemic In Texas By Holding Big Pharma Manufacturers Liable, Katherine Spiser

St. Mary's Law Journal

Abstract forthcoming

Standardizing Aminoglycoside Induced Ototoxicity Monitoring, Claire Elson, Christopher M. Oermann, Stephanie Duehlmeyer, Ellen Meier

Posters

Aminoglycoside (AG) antibiotics are essential for the treatment of cystic fibrosis (CF) lung infections. Pseudomonas aeruginosa. Nontuberculous mycobacteria. Monitoring is critical secondary to potential nephrotoxicity and ototoxicity. Children’s Mercy Kansas City (CMKC), standardized nephrotoxicity monitoring in 2016. Observed variable ototoxicity monitoring practices. Prevalence of ototoxicity, 2016 CFF Patient Registry, 1.1% in pediatric patients (less than or equal to 18 years). 2.2% in pediatric and adult population. National Institute of Deafness and Other Communication Disorders, 13% in US population equal to or less than 12 years old. A standardized AG induced ototoxicity monitoring algorithm (AIOA) was developed and implemented at CMKC …

An Update On Pharmaceutical Strategies For Oral Delivery Of Therapeutic Peptides And Proteins, Nirnoy Dan

Theses and Dissertations (ETD)

Peptides and proteins are imperative for the human body and play crucial roles in governing various bio-chemical processes. Recent advances in molecular biology and biochemistry helped in understanding the role of these endogenous macromolecules in different pathological and disease conditions. Currently, small molecule drugs (< 900dalton) in comparison to the therapeutic peptides and proteins-based drugs (TPP) dominate pharmaceutical market. However, the game is changing with the recent advances of biotechnological tools like recombinant DNA technology, solid phase protein synthesis etc., which enabled large-scale production of therapeutic peptides and proteins. The Success of Human Insulin, the first FDA approved commercial recombinant protein based therapeutic in 1982, revolutionized the field of TPPs. The number of FDA approved TPPs reached about to ~239 in 2017 compared to where it was only ~130 in 2008. Rapid progress in this sector can be attributed to several advantages of proteins and peptides over small molecule drugs both financially and clinically. From a clinical perspective, proteins and peptides are inherently more specific to the target site than the small molecules drugs, which lead to less interferences with normal biological system of the patient and caused minimal off-target side effects. A handful of proteins which are used for different clinical complications are less immunogenic because they are produced in the body naturally. Furthermore, proteins and peptides also take part in several complex and complicated biological processes, which is difficult to be to be mimicked by the small molecule drugs. From a financial standpoint, median total pre-market development times were shorter for biologics (10.6 years) than the small molecules drugs (12.6 years) estimated using Merck Index. In 2009, US Congress passed the Biologics Price Competition and Innovation Act (BPCIA) which gave new biologics 12 years of guaranteed exclusivity. The most commonly utilized routes for administering TPPs are I.V, I.P or I.M injections, which largely suffer from patient compliances. There are ~350 TPPs under clinical development and among them only 2 are given orally which is Interferon-α and Human growth hormone. Currently, most efforts in both industry and academia are centered around enhancing bioavailability of orally administered TPPs which typically are less than 1%. Oral administration is the non-invasive, most preferred route of drug administration for the patients. Furthermore, oral dosage forms are cheaper to manufacture as well as to administer, because they do not need to be produced under sterile conditions or administered in clinics. However, unfavorable physicochemical characteristics of TPPs like high molecular weight, hydrophilicity, poor stability in the physiological conditions, short biological half-life, low permeability through the epithelial barrier in the small intestine put up a massive barrier in the development of orally available dosage forms of TPPs. In this review, we will discuss the challenges associated with oral delivery of TPPs and the ongoing efforts to solve them.