Medicine and Health Sciences Commons^™

Pharmacy Newsletter : December 2017, Pharmacy Department

Department of Pharmacy Archives

Content:

• Twice Daily Dose of Levetiracetam and Clinical Pharmacokinetics
• Management of Acute Hyperkalemia in Neonates
• Drug Induced Neuroleptic Malignant Syndrome (NMS)
• Influenza and Influenza Vaccine Myths and Reality.

Identifying Patterns In Health Care Disparities And Barriers To Health Care In Rural Tanzania, Karlee Platts, Christina Sanborn, Melinda E. Lull

Pharmacy Faculty/Staff Publications

Tanzania is a country in East Africa with a population of 55 million people. HIV/AIDs, malaria and nutritional deficiencies claim the lives of many each year across Tanzania. The World Health Organization (WHO) reported in 2013 that approximately 70 percent of the population of Tanzania live in more rural areas where access to healthcare, health education, and medications for these diseases may be limited. The objective of this study was to illuminate significant health disparities in rural Tanzania based on literature and direct observations to identify barriers to quality health care.

A comprehensive literature evaluation was completed on reports published …

Buspirone Maintenance Does Not Alter The Reinforcing, Subjective, And Cardiovascular Effects Of Intranasal Methamphetamine, Anna R. Reynolds, Justin Charles Strickland, William W. Stoops, Joshua A. Lile, Craig R. Rush

Pharmaceutical Sciences Faculty Publications

Background—Medications development efforts for methamphetamine-use disorder have targeted central monoamines because these systems are directly involved in the effects of methamphetamine. Buspirone is a dopamine autoreceptor and D3 receptor antagonist and partial agonist at serotonin 1A receptors, making it a logical candidate medication for methamphetamine-use disorder. Buspirone effects on abuse-related behaviors of methamphetamine have been mixed in clinical and preclinical studies. Experimental research using maintenance dosing, which models therapeutic use, is limited. This study evaluated the influence of buspirone maintenance on the reinforcing effects of methamphetamine using a self-administration procedure, which has predictive validity for clinical efficacy. The impact …

Synthesis Of 2,4,6-Substituted Pyrrolo[2,3-D]Pyrimidines As Potential Anticancer Agents, Si Yang

Electronic Theses and Dissertations

This thesis mainly focuses on the introduction of the background and work have been done in the areas of antifolates development, such as folate function, its three uptake mechanisms inside human cells, antifolates’ role in chemotherapy, et. al. In addition, the Structure-Activity-Relationship design rationale for the series of antifolates will also be discussed. Nevertheless, the details of synthesizing these pyrrolo[2,3-d]pyrimidines as potential antifolates have been described, including chemistry reviews on the pyrrolo[2,3-d]pyrimidine scaffold, and the challenges encountered and the solutions how to solve or improve in order to achieve better yield.

Effects Of Environmental Enrichment On Self-Administration Of The Short-Acting Opioid Remifentanil In Male Rats, Rebecca S. Hofford, Jonathan J. Chow, Joshua S. Beckmann, Michael T. Bardo

Psychology Faculty Publications

Background

Opioid abuse is a major problem around the world. Identifying environmental factors that contribute to opioid abuse and addiction is necessary for decreasing this epidemic. In rodents, environmental enrichment protects against the development of low dose stimulant self-administration, but studies examining the effect of enrichment and isolation (compared to standard housing) on the development of intravenous opioid self-administration have not been conducted. The present study investigated the role of environmental enrichment on self-administration of the short-acting μ-opioid remifentanil.

Methods

Rats were raised in an enriched condition (Enr), standard condition (Std), or isolated condition (Iso) beginning at 21 days of …

Role Of Human Arylamine N-Acetyltransferase 1 In Tumorigenesis And Cancer Biology., Marcus William Stepp

Electronic Theses and Dissertations

Human arylamine N-acetyltransferase 1 (NAT1) is a well-known phase II metabolic enzyme that has been associated with carcinogenesis. Its role in the biotransformation of aromatic and heterocyclic amine carcinogens has been investigated for many years, but more recent investigations focus on a possible endogenous role of human NAT1 in cancer initiation and progression. To further explore and understand possible endogenous roles for NAT1, we conducted in vitro enzymatic reactions, in vivo studies using homozygous high (rapid) or low (slow) NAT2 activity congenic F344.WKY rats, and genetically modified human breast cancer cell lines. Human NAT1 and rodent NAT2 hydrolyzed acetyl-coenzyme …

Using An "Escape Room" Toolbox Approach To Enhance Pharmacology Education, Melinda Hermanns, Belinda Deal, Ann M. C, Shawn Hillhouse, J. Brian Opella, Casey Faigle, Robert H. Campbell Iv

Nursing Faculty Publications and Presentations

Background: Faculty are encouraged to use a variety of teaching/learning strategies to engage nursing students. While simulation and games are now common, there were no reports in the nursing literature using an “escape room” concept. Escape rooms use an entertainment approach as teams engage in critical thinking to solve puzzles and find clues to escape a room. In the classroom setting, this concept is modified to solve a mystery by finding various objects through a series of puzzles to locate clues. Some of these games involve finding numerical clues to open locks on a box, such as a toolbox. The …

Harmonizing Lipidomics: Nist Interlaboratory Comparison Exercise For Lipidomics Using Srm 1950-Metabolites In Frozen Human Plasma, J Bowden, C Ulmer, C Jones, J Koelmel, L Abdullah, Houli Jiang, Michal Schwartzman, Amaury Cazenave-Gassiot, Antonio Checa, Michelle Cinel, Romain Colas, Serge Cremers, Edward Dennis, James Evans, Alexander Fauland, Jun Han, Houli Jiang, Michal Schwartzman

NYMC Faculty Publications

As the lipidomics field continues to advance, self-evaluation within the community is critical. Here, we performed an interlaboratory comparison exercise for lipidomics using Standard Reference Material (SRM) 1950-Metabolites in Frozen Human Plasma, a commercially available reference material. The interlaboratory study comprised 31 diverse laboratories, with each laboratory using a different lipidomics workflow. A total of 1,527 unique lipids were measured across all laboratories and consensus location estimates and associated uncertainties were determined for 339 of these lipids measured at the sum composition level by five or more participating laboratories. These evaluated lipids detected in SRM 1950 serve as community-wide benchmarks …

Ixekizumab Efficacy And Safety With And Without Concomitant Conventional Disease-Modifying Antirheumatic Drugs (Cdmards) In Biologic Dmard (Bdmard)-Naive Patients With Active Psoriatic Arthritis (Psa): Results From Spirit-P1, Laura Coates, M Kishimoto, Alice Gottlieb, C Shuler, C Lin, C Lee, P Mease

NYMC Faculty Publications

Objective: To evaluate the efficacy and safety of ixekizumab alone or with concomitant conventional disease-modifying antirheumatic drugs (cDMARDs) versus placebo in patients with active psoriatic arthritis (PsA) as part of a SPIRIT-P1 subgroup analysis (NCT01695239). Methods: Patients were stratified by cDMARD use (concomitant cDMARDs use (including methotrexate) or none (past or naive use)) and randomly assigned to treatment groups (ixekizumab 80 mg every 4 weeks (IXEQ4W) or every 2 weeks (IXEQ2W) or placebo). Efficacy was evaluated versus placebo at week 24 by the American College of Rheumatology criteria (ACR20/50/70), modified total Sharp score and Health Assessment Questionnaire-Disability Index (HAQ-DI). Safety …

How We Close The Gaps: Our Interprofessional Team Approach To Meeting Quality Measures, Peter Blockhurst, William Buselmeier, Mckenzie Calhoun, Paige Gilbert-Green, Jesse Gilbreath, Erin Harris, Amy Lawrence

ETSU Faculty Works

• Define the role/function of an interprofessional team in the management of complex outpatients.
• Identify the types of patients that would benefit most from a team-based approach.
• Implement elements of our team-based patient care model into individual practices.

A Phenomenological Investigation Of Pharmacists' Experiences, Motivation, And Preferences In The Context Of Continuing Pharmacy Education, Laura Beth Ladymon

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to describe select Tennessee pharmacists’ experiences, motivation, and preferences in the context of continuing pharmacy education (CPE). The pharmacists’ experiences, motivation, and preferences related to CPE were generally defined as participating in CPE programming in a manner that meets the needs of the pharmacist. Also, select pharmacists were defined as pharmacists with at least six hours of continuing pharmacy education credit within the last year. This study explored how 12 pharmacist participants in Tennessee experienced CPE as well as what motivated them to attend CPE activities. Additionally, the study investigated pharmacists’ preferences in …

Neomycin, Polymyxin B, And Dexamethasone Allergic Reactions Following Periocular Surgery., Nicholas A Moore, Craig N Czyz, Tracy D Carter, Jill A Foster, Kenneth V Cahill

Pharmacy Articles

BACKGROUND: The aim of this study was to evaluate the rate of periocular allergic skin reactions to topical neomycin, polymyxin B, and dexamethasone (NPD) ophthalmic ointment.

METHODS: A consecutive patient prospective study was performed. A total of 522 patients who had a procedure involving incision of the periocular skin with subsequent postoperative application of NPD ophthalmic ointment were included. Patients were evaluated for signs of allergy at 1 week postoperatively or prior if the patient had complaints. A periocular allergic reaction was defined as any periocular skin pruritus, erythema, edematous papules, vesicles, or plaques at the site of ointment application …

Green Chemistry Oxidative Modification Of Peptoids Utilizing Bleach And Tempo, Jesse Leland Roberts

Graduate Theses and Dissertations

Biotherapeutic drugs, derived from biological molecules such as proteins and DNA, are becoming an integral and exceptionally critical aspect of modern medicine. Compared to common pharmaceutical drugs, biotherapeutics are much larger in size and have greater target specificity, allowing them to treat many chronic diseases ranging from cancer to rheumatoid arthritis. The major issue with protein based therapeutics is that they readily undergo proteolysis, or enzymatic degradation, when administered through subcutaneous injections. Traditionally, biotherapeutic modification procedures have centered on the use of PEG derivatives. This process, called PEGylation, is unfavorable due to the increases in molecular weights of the proteins …

Binge Alcohol Exposure Transiently Changes The Endocannabinoid System: A Potential Target To Prevent Alcohol-Induced Neurodegeneration, Daniel J. Liput, James R. Pauly, Audra L. Stinchcomb, Kimberly Nixon

Pharmaceutical Sciences Faculty Publications

Excessive alcohol consumption leads to neurodegeneration, which contributes to cognitive decline that is associated with alcohol use disorders (AUDs). The endocannabinoid system has been implicated in the development of AUDs, but little is known about how the neurotoxic effects of alcohol impact the endocannabinoid system. Therefore, the current study investigated the effects of neurotoxic, binge-like alcohol exposure on components of the endocannabinoid system and related N-acylethanolamines (NAEs), and then evaluated the efficacy of fatty acid amide hydrolase (FAAH) inhibition on attenuating alcohol-induced neurodegeneration. Male rats were administered alcohol according to a binge model, which resulted in a transient decrease in …

Challenges In Characterizing The Environmental Fate And Effects Of Carbon Nanotubes And Inorganic Nanomaterials In Aquatic Systems, Peter Laux, Christian Riebeling, Andy M. Booth, Joseph D. Brain, Josephine Brunner, Cristina Cerrillo, Otto Creutzenberg, Irina Estrela-Lopis, Thomas Gebel, Gunnar Johanson, Harald Jungnickel, Heiko Kock, Jutta Tentschert, Ahmed Tlili, Andreas Schäffer, Adriënne J. A. M. Sips, Robert A. Yokel, Andreas Luch

Pharmaceutical Sciences Faculty Publications

The current lack of commonly used protocols for dispersion, characterization, and aquatic toxicity testing of nanomaterials (NMs) has resulted in inconsistent results, which make meaningful comparisons difficult. The need for standardized sample preparation procedures that allow the reproducible generation of relevant test conditions remains a key challenge for studies of the environmental fate and aquatic toxicity of NMs. Together with the further development of optimized and cost-effective analytical techniques for physicochemical characterization that depend on reproducible sample preparation, such methods have the potential to overcome the current uncertainties with regard to NM dispersion properties, effective dose, and particle dissolution. In …

Modulation Of Cytochrome P450, P-Glycoprotein And Pregnane X-Receptor By Selected Antimalarial Herbs: Implication For Herb-Drug Interaction, P. S. Fasinu, V. K. Manda, O. R. Dale, N. O. Egiebor, L. A. Walker, S. I. Khan

Pharmaceutical Sciences

No abstract provided.

Compounds And Method Of Use As Anti-Infection Compounds And Therapeutic Agents To Regulate Cholesterol Metabolism, Joseph Chappell, Tom D. Niehaus, Kristin Brooke Linscott

Molecular and Cellular Biochemistry Faculty Patents

A compound is provided which comprises at least a portion of an amino acid linker-domain from squalene synthase. In alternative forms, the compound can include the amino-acid linker-domain from various fungus, including S. cerevisiae or the compound can be the functional equivalent and/or mimics an amino acid linker-domain from squalene synthase. A pharmaceutical composition includes the compound and may further include a pharmaceutical carrier. A method is provided for treating or controlling cholesterol metabolism and ergosterol metabolism in non-fungal organisms. One method includes a therapeutic treatment in humans by administering a therapeutically effective amount of the compound or pharmaceutical composition, …

Natural Bioactive Compounds: Alternative Approach To The Treatment Of Glioblastoma Multiforme, Vilas Desai, Alok Bhushan

College of Pharmacy Faculty Papers

Glioblastoma multiforme (GBM) is the most frequent, primary malignant brain tumor prevalent in humans. GBM characteristically exhibits aggressive cell proliferation and rapid invasion of normal brain tissue resulting in poor patient prognosis. The current standard of care of surgical resection followed by radiotherapy and chemotherapy with temozolomide is not very effective. The inefficacy of the chemotherapeutic agents may be attributed to the challenges in drug delivery to the tumor. Several epidemiological studies have demonstrated the chemopreventive role of natural, dietary compounds in the development and progression of cancer. Many of these studies have reported the potential of using natural compounds …

Pneumonia Vaccines: Current Recommendations And Advocacy Opportunities, Laressa Bethishou

Pharmacy Faculty Articles and Research

"Despite the demonstrated efficacy of these vaccines, only 66.9% of adults over age 65 years have ever received a pneumonia vaccine. Given the consequences of acquiring pneumonia, there is both a need and an opportunity to improve vaccination rates. The pharmacist can play a valuable role in identifying high-risk patients, providing education on benefits and risks, and advocating for pneumonia vaccination when indicated."

November 2017, Randy Curry, Cindy Brooks

RURAL ROCKS

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

Test Of A Workforce Development Intervention To Expand Opioid Use Disorder Treatment Pharmacotherapy Prescribers: Protocol For A Cluster Randomized Trial, Todd Molfenter, Hannah K. Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Mark Van Etten, Jee-Seon Kim, Eric Haram, Elizabeth Collier, Sanford Starr, Alexander Toy, Lynn Madden

Behavioral Science Faculty Publications

Background: Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations’ efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications. Historically, the addiction treatment field has not attracted physicians, and many barriers to implementing OUD pharmacotherapy exist, ranging from lack of confidence in treating OUD patients to …

Medication Safety: Lessons From Practice, Jessica L. Hinson, Brittany L. Long

Pharmacy Faculty Scholarship

No abstract provided.

Clinical Potential Of An Enzyme-Based Novel Therapy For Cocaine Overdose, Ting Zhang, Xirong Zheng, Ziyuan Zhou, Xiabin Chen, Zhenyu Jin, Jing Deng, Chang-Guo Zhan, Fang Zheng

Molecular Modeling and Biopharmaceutical Center Faculty Publications

It is a grand challenge to develop a truly effective medication for treatment of cocaine overdose. The current available, practical emergence treatment for cocaine overdose includes administration of a benzodiazepine anticonvulsant agent (e.g. diazepam) and/or physical cooling with an aim to relieve the symptoms. The inherent difficulties of antagonizing physiological effects of drugs in the central nervous system have led to exploring protein-based pharmacokinetic approaches using biologics like vaccines, monoclonal antibodies, and enzymes. However, none of the pharmacokinetic agents has demonstrated convincing preclinical evidence of clinical potential for drug overdose treatment without a question mark on the timing …

Student Pharmacists’ Personal Finance Perceptions, Projected Indebtedness Upon Graduation, And Career Decision-Making, Nicholas E. Hagemeier, Chad K. Gentry, Debbie C. Byrd, Leonard B. Cross, Daniel Rose, Nasar Ansari, Pooja Subedi, Tandy Branham

ETSU Faculty Works

Objectives: To evaluate the extent to which students’ personal finance perceptions, projected student loan indebtedness, and demographic characteristics predict post-PharmD career intentions.

Methods: Students at three pharmacy colleges completed a 31-item survey instrument that assessed personal finance perceptions, self-efficacy beliefs, anticipated student loan debt upon graduation, postgraduate intentions, anticipated practice setting upon graduation, and demographic characteristics. Logistic regression models were used to examine the extent to which personal finance perceptions, student loan indebtedness, and demographic characteristics predicted postgraduate intentions and anticipated practice setting.

Results: A total of 763 usable responses were obtained (response rate=90.3%). Students reported an anticipated personal student …

Tobacco's Minor Alkaloids: Effects On Place Conditioning And Nucleus Accumbens Dopamine Release In Adult And Adolescent Rats, Julie A. Marusich, Mahesh Darna, A. George Wilson, Emily D. Denehy, Amanda Ebben, Agripina G. Deaciuc, Linda P. Dwoskin, Michael T. Bardo, Timothy W. Lefever, Jenny L. Wiley, Chad J. Reissig, Kia J Jackson

Pharmaceutical Sciences Faculty Publications

Tobacco products are some of the most commonly used psychoactive drugs worldwide. Besides nicotine, alkaloids in tobacco include cotinine, myosmine, and anatabine. Scientific investigation of these constituents and their contribution to tobacco dependence is less well developed than for nicotine. The present study evaluated the nucleus accumbens dopamine-releasing properties and rewarding and/or aversive properties of nicotine (0.2-0.8 mg/kg), cotinine (0.5-5.0 mg/kg), anatabine (0.5-5.0 mg/kg), and myosmine (5.0-20.0 mg/kg) through in vivo microdialysis and place conditioning, respectively, in adult and adolescent male rats. Nicotine increased dopamine release at both ages, and anatabine and myosmine increased dopamine release in adults, but not …

Computational Study Targeting Anti-Fungal Tavaborole Analogs And Anti-Cancer Braco19, Babitha Machireddy

Theses and Dissertations

This thesis comprises of three computer aided drug design studies utilizing molecular docking and molecular dynamic simulations: (i) a lead optimization study virtually screening an initial library of ~120000 lead compounds targeting fungal leucyl tRNA synthetase, (ii) an exploratory study to understand the binding pathway of BRACO19 to a parallel telomeric DNA G-quadruplex by MD simulations and compare with experimentally solved X-ray crystal structure (iii) a comparative study to understand the lack of selectivity of BRACO19 to various topologies of human telomeric DNA G-quadruplex over DNA duplex.

The first chapter provides the background information required to understand the molecular docking …

Ensemble-Based Modeling And Rigidity Decomposition Of Allosteric Interaction Networks And Communication Pathways In Cyclin-Dependent Kinases: Differentiating Kinase Clients Of The Hsp90-Cdc37 Chaperone, Gabrielle Stetz, Amanda Tse, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

The overarching goal of delineating molecular principles underlying differentiation of protein kinase clients and chaperone-based modulation of kinase activity is fundamental to understanding activity of many oncogenic kinases that require chaperoning of Hsp70 and Hsp90 systems to attain a functionally competent active form. Despite structural similarities and common activation mechanisms shared by cyclin-dependent kinase (CDK) proteins, members of this family can exhibit vastly different chaperone preferences. The molecular determinants underlying chaperone dependencies of protein kinases are not fully understood as structurally similar kinases may often elicit distinct regulatory responses to the chaperone. The regulatory divergences observed for members of CDK …

Disruption Of Hippocampal Multisynaptic Networks By General Anesthetics., Min-Ching Kuo, L Stan Leung

Physiology and Pharmacology Publications

BACKGROUND: Previous studies showed that synaptic transmission is affected by general anesthetics, but an anesthetic dose response in freely moving animals has not been done. The hippocampus provides a neural network for the evaluation of isoflurane and pentobarbital on multisynaptic transmission that is relevant to memory function.

METHODS: Male Long-Evans rats were implanted with multichannel and single electrodes in the hippocampus. Spontaneous local field potentials and evoked field potentials were recorded in freely behaving rats before (baseline) and after various doses of isoflurane (0.25 to 1.5%) and sodium pentobarbital (10 mg/kg intraperitoneal).

RESULTS: Monosynaptic population excitatory postsynaptic potentials at the …

Paving The Road To Personalized Medicine: Recommendations On Regulatory, Intellectual Property And Reimbursement Challenges, Lori Knowles, Westerly Luth, Tania M. Bubela

Office of the Provost

Personalized medicine (PM) aims to harness a wave of 'omics' discoveries to facilitate research and discovery of targeted diagnostics and therapies and increase the efficiency of healthcare systems by predicting and treating individual predispositions to diseases or conditions. Despite significant investment, limited progress has been made bringing PM to market. We describe the major perceived regulatory, intellectual property, and reimbursement challenges to the development, translation, adoption, and implementation of PM products into clinical care. We conducted a scoping review to identify (i) primary challenges for the development and implementation of PM identified in the academic literature; (ii) solutions proposed in …

Evaluating Patient Preferences For Different Incentive Programs To Optimize Pharmacist-Provided Patient Care Program Enrollment, Daniel M. Tomaszewski, Tim Cernohaus, Rajiv Vaidyanathan

Pharmacy Faculty Articles and Research

BACKGROUND: Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM).

OBJECTIVES: To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference.

METHODS: This study was composed of a paper-based survey administered to participants after focus group sessions. Participants included MTMeligible beneficiaries from 2 employer groups and included …