Medicine and Health Sciences Commons^™

Evaluation Of A Pharmacist-Driven Electrolyte Replacement Protocol In A Community Health System, Corey Uetrecht Pharmd Candidate

Pharmacy Residency

This evaluation found a higher rate of pharmacist consults for electrolyte management, though these were not always indicated. Repletion via oral route was not optimized and there were opportunities for improvement in protocol alignment.

Presented at Great Lakes PRC

Implementation Of An Evidence Based Skin And Soft Tissue Infection Algorithm At A Large Community Health System, Jennifer Mccarthy Pharmd, Ms

Pharmacy Residency

This study found a continued need for an updated skin and soft tissue infection algorithm. Ongoing reliance on IV antibiotics suggests underutilization of oral options. Promoting oral antibiotic use may reduce inpatient admissions and length of stay.

Presented at OHIO PRC

Evaluating The Impact Of A Pharmacist-Led Wellness And Weight Management (Wwm) Service In The Primary Care Setting, Nicholas Buttermore Pharmd

Pharmacy Residency

This evaluation found superior weight loss from baseline with pharmacist management, along with comparable GLP-1 and non-GLP-1 use and considerable financial benefits.

Aluminum In Beverages And Foods: A Comprehensive Compilation Of Regulations; Concentrations In Raw, Prepared, And Stored Beverages And Foods; And Intake, Robert Yokel

Pharmaceutical Sciences Faculty Publications

The history and controversy concerning aluminum use in beverage and food preparation and storage are reviewed. This review on aluminum in drinking water, foods, and beverages updates and exceeds prior reviews. Country and international organization regulations that permit incorporation of aluminum containing food additives, their use limit, and purposes are presented. The aluminum concentration in beverages and foods consumed worldwide was gleaned from approximately 2100 sources available to the author. The approximately 17700 values are compiled in 175 tables by beverage or food category that include the analytical method used, sample source, and reference. The tables are posted on the …

A Cocaine Hydrolase Engineered From Human Butyrylcholinesterase As A Medical Countermeasure For Aldicarb Poisoning, Johnathan E. Lesaint, Nellore Bhanu Chandar, Annet Kyomuhangi, Huimei Wei, Fang Zheng, Chang-Guo Zhan

Pharmaceutical Sciences Faculty Publications

Aldicarb is known to be the most toxic carbamate pesticide and could be used easily by terrorists to cause a mass casualty incident. It is highly desired to discover a medical countermeasure for aldicarb poisoning. Based on structural insights from molecular modeling and in vitro experimental validation, CocH3-Fc(M3), a potent cocaine hydrolase engineered from human butyrylcholinesterase (BChE), has a ~4-fold improved binding affinity with aldicarb compared to wild-type human acetylcholinesterase (AChE) and BChE and a 9-28-fold improved bimolecular rate constant for the carbamylation with aldicarb compared to AChE. CocH3-Fc(M3) also has significant catalytic activity for aldicarb hydrolysis and, hence, is …

Development Of A Ghrelin Deacylase To Attenuate Drug Reward And Associated Effects Of Methamphetamine, Madeline J. Stewart, Huimei Wei, Nellore Bhanu Chandar, Fang Zheng, Chang-Guo Zhan

Pharmaceutical Sciences Faculty Publications

All addictive substances directly or indirectly interact with the dopamine reward system to alter the brain’s dopamine receptor activities. It is essential for a truly effective addiction medication to attenuate substance reward and normalize the brain’s physiological functions. Conventional pharmacological intervention approaches to the treatment of substance addiction usually aim to develop and deliver a potential therapeutic agent to the brain to directly block or decrease actions of the substance or its therapeutic target in the brain. However, it is a grand challenge to attenuate the substance reward without affecting the normal physiological functions of brain receptors or transporters. Here, …

Effects Of Biased Analogues Of The Kappa Opioid Receptor Agonist, U50,488, In Preclinical Models Of Pain And Side Effects, Ross Van De Wetering, Loan Y. Vu, Lindsay D. Kornberger, Dan Luo, Brittany Scouller, Sheein Hong, Kelly F. Paton, Thomas E. Prisinzano, Bronwyn M. Kivell

Pharmaceutical Sciences Faculty Publications

Kappa opioid receptor (KOR) agonists have well-established antinociceptive effects. However, many KOR agonists have negative side effects, which limit their therapeutic potential. Some researchers have suggested that the development of biased agonists that preferentially stimulate KOR G-protein pathways over β-arrestin pathways may yield drugs with fewer adverse side effects. This was investigated in the current study. We describe the synthesis and characterization of three U50,488 analogues, 1, 2, and 3. We evaluated the acute and chronic antinociceptive effects of these compounds in mice using the warm-water tail flick assay and in a paclitaxel-induced neuropathic pain model. Side …

Effects Of Fentanyl-Adulterated Methamphetamine On Circulating Ghrelin In Rats, Huimei Wei, Elise C. Maul, Shawn Park, Kaniz Fatema, Daniel J. Peter, Chang-Guo Zhan, Fang Zheng

Pharmaceutical Sciences Faculty Publications

The appetite hormone ghrelin influences biological processes that are responsible for substance use disorder, which is related to alcohol and most abused drugs including cocaine, methamphetamine, nicotine, etc. In general, upregulation of the ghrelin system enhances drug cravings and substance use. Studies reported in the literature consistently demonstrated that the ghrelin system is associated with stimulants. However, research on opioids in combination with methamphetamine has not been reported. In this study, we examined the relationship of circulating ghrelin with the polydrug use of fentanyl and methamphetamine in male Sprague-Dawley rats, demonstrating for the first time that concurrent use of fentanyl …

Effects Of Fentanyl-Laced Cocaine On Circulating Ghrelin, Insulin, And Glucose Levels In Rats, Huimei Wei, Elise C. Maul, Annet Kyomuhangi, Shawn Park, Maddilynn L. Mutchler, Chang-Guo Zhan, Fang Zheng

Pharmaceutical Sciences Faculty Publications

Opioid mixed with cocaine has been increasingly implicated in overdose deaths, including both intentional co-use of opioid and cocaine and fentanyl-adulterated drug supply. As ghrelin plays an important role in drug reward and can also influence insulin, this study aimed to assess responses of the circulating ghrelin, insulin, and glucose levels to the combined use of fentanyl and cocaine (a polydrug) in rats by performing combined animal behavioral experiments and biochemical analysis. The experimental data consistently revealed that the fentanyl and cocaine co-use can significantly elevate both the acyl-ghrelin and desacyl-ghrelin levels and significantly decrease the insulin level without significant …

Fluorescence-Guided Resection Of Gl261 Red-Fluc And Trp-Mcherry-Fluc Mouse Glioblastoma Tumors, Louis T. Rodgers, Bryan J. Maloney, Anika M. S. Hartz, Björn Bauer

Pharmaceutical Sciences Faculty Publications

Background: Most preclinical studies on glioblastoma (GBM) fail to provide translational utility in the clinic. Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) improves tumor resection, disease prognosis, and, thus, patient outcomes. Given the critical role of surgery in managing recurrent GBM, it is essential to incorporate surgical elements into preclinical models to accurately reflect clinical scenarios and enhance translational success. However, existing protocols for 5-ALA-guided resection in preclinical models are limited and often lack clinical relevance.

Methods: To address this gap, we developed a novel protocol for the 5-ALA-guided resection in two mouse GBM models: TRP-mCherry-FLuc and GL261 Red-FLuc.

Results: The …

Development Of Zafirlukast Analogues For Improved Antithrombotic Activity Through Thiol Isomerase Inhibition, Justine A. Keovilay, Kaitlind C. Howard, Kirk A. Taylor, Sabeeya Khan, Sienna E. Wurl, Melanie K. Szahaj, Tanya Sage, Nishad Thamban Chandrika, Caixia Hou, Oleg V. Tsodikov, Jonathan M. Gibbins, Sylvie Garneau-Tsodikova, Daniel R. Kennedy

Pharmaceutical Sciences Faculty Publications

Background:   Thiol isomerases play essential and nonredundant roles in platelet activation, aggregation, and thrombus formation. Thiol isomerase inhibitors have the potential to overcome the 2 major drawbacks of current antithrombotic therapies, as they target both arterial and venous thrombosis without enhancing bleeding risks. Recently, a Food and Drug Administration–approved drug, zafirlukast (ZAF), was shown to be a promising pan-thiol isomerase inhibitor. The objective of this study is to develop analogues of ZAF with optimized thiol isomerase inhibition and antithrombotic activity.   Methods:   Thirty-five ZAF analogues were tested in an insulin turbidometric assay for thiol isomerase inhibition. Analogues were tested for platelet …

Functional And Structural Studies On The Esperamicin Thioesterase And Progress Toward Understanding Enediyne Core Biosynthesis, Erome D. Hankore, Mitchell D. Miller, Abigael J. Kosgei, Weijun Xu, Kemin Tan, Michael Endres, Minakshi Bhardwaj, Grazyna Joachimiak, Andrzej Joachimiak, George N. Phillips Jr., Jon S. Thorson, Steven G. Van Lanen

Pharmaceutical Sciences Faculty Publications

Enediynes are among the most potent antitumor and antibacterial natural products. Studies on their biosynthetic pathways have identified a shared, linear polyene precursor generated from an iterative type I polyketide synthase (PKSE) as the source of the enediyne warhead. A key step is the release of this polyene from the PKSE by a discrete thioesterase (TE). Here, we used X-ray crystallography, site-directed mutagenesis, and heterologous coexpression of PKSEs and TEs to elucidate how enediyne TEs mediate the production of the polyene. We solved the structure of wild-type EspE7 from esperamicin producer Actinomodura verrucosospora. The substrate binding pocket was also …

Hypertensive Hijinks: Implementation Of An Emergency Department Hypertensive Emergency Order Panel, Caleb Hoppe Pharmd Candidate

Pharmacy Residency

This evaluation found that the order panel was effective in promoting rapid blood pressure attainment and appropriate antihypertensive dosing.

This was presented at the OHIO PRC.

Daratumumab Monotherapy: Reconsidering Relapsed And Refractory Multiple Myeloma Maintenance Therapy, Gabrielle O. Carreon Pharmd, Ms

Pharmacy Residency

Results from this study support the continued use of daratumumab monotherapy in carefully selected patients who may not be candidates for more intensive combination therapies due to age, comorbidities, or prior toxicities. However, further research is needed to confirm these early observations.

Presented at Great Lakes PRC

Silent Pressure: Outcomes Of As-Needed Antihypertensives In Hospitalized Adults*, Corey Uetrecht Pharmd Candidate

Pharmacy Residency

Presented at ACCP

This study found that PRN antihypertensives are frequently used for AEBP in hospitalized patients, despite limited benefit and potential risk of hypotension-related adverse events.

Development And Implementation Of An Analgesia, Sedation, And Paralysis Order Panel For Mechanically Ventilated Pediatric Patients At A Large Community Health System, Kristin Lytal Pharmd, Mspgx

Pharmacy Residency

This project describes best practices and steps taken in development of a protocol for analgesia, sedation, and paralysis in pediatric patients.

This was presented at OHIO PRC.

The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri

Indiana Journal of Law and Social Equality

This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …

Medical-Grade Honey And Standard Dressings In Burn Wound Care: Evaluating Effectiveness, Cost, And Patient Outcomes, Chloe Shin, Andrew Golonka

Nursing | Student Research Posters

Background: Burn injuries burden the healthcare system globally as silver sulfadiazine (SSD) is the standard treatment even though it delays healing and is highly costly. Medical-grade honey (MGH) demonstrates superior antimicrobial and anti-inflammatory properties, however, there are still evidence gaps when comparing effectiveness, cost efficiency, and patient centered outcomes. Purpose: This study aims to compare MGH and SSD amongst these gaps to inform evidence based burn care. Methods: A randomized controlled trial will enroll 100 people between 25-50 years of age with first and second degree burns, < 20% total body surface area within two hospital burn units. Participants will be assigned to either MGH or SSD treatment. The study will be a single blind design where dermatologists evaluating the wound photographs will not know the treatment given. Primary outcomes include wound healing time, infection rates, and patient reported pain scores. Secondary outcomes will focus on cost effectiveness analyses and patient quality of life. Standardized protocols will be implemented for data collection, wound assessment, and safety monitoring. Results: We anticipate that MGH will have lower infection rates, promote faster wound healing, improved outcomes from patient reports, and better cost effectiveness through shorter hospital stays and reduced medical treatments compared to SSD. Conclusion: This study will provide evidence comparing MGH and SSD across economic, clinical, and patient centered outcomes. If our hypothesis aligns with the results, MGH could be a new evidence based standard in burn care as it offers many advantages over SSD in patient comfort, healing efficiency, and medical costs. The findings will provide areas for future research, especially long term outcome and a bigger patient population.

Optimizing Endogenous Glp-1 Holistically: A Nursing Led Approach To Sustainable Weight Loss Without Glp-1 Agonist Use, Taylee A. Carscadden

Nursing | Senior Theses

The increase in off-label Glucagon-like peptide-1 (GLP-1) receptor agonist drugs, such as semaglutide (Ozempic), for weight loss has sparked concern in regards to the not fully understood drug outcomes and safety. GLP-1 agonists were originally developed to manage Type 2 Diabetes Mellitus, but have been widely prescribed for obesity management despite minimal research on prolonged use in non-diabetic patients. This study explores how off-label use of GLP-1 agonist drugs exacerbate various adverse health outcomes, highlighting gastrointestinal complications, and the very possible dependency on drugs for weight management. It will also examine the efficacy of nursing-led education on the implementation of …

Medical-Grade Honey And Standard Dressings In Burn Wound Care: Evaluating Effectiveness, Cost, And Patient Outcomes, Andrew Golonka, Chloe Shin

Nursing | Senior Theses

Background: Burn injuries burden the healthcare system globally as silver sulfadiazine (SSD) is the standard treatment even though it delays healing and is highly costly. Medical-grade honey (MGH) demonstrates superior antimicrobial and anti-inflammatory properties, however, there are still evidence gaps when comparing effectiveness, cost efficiency, and patient centered outcomes. Purpose: This study aims to compare MGH and SSD amongst these gaps to inform evidence based burn care. Methods:A randomized controlled trial will enroll 100 people between 25-50 years of age with first and second degree burns, < 20% total body surface area within two hospital burn units. Participants will be assigned to either MGH or SSD treatment. The study will be a single blind design where dermatologists evaluating the wound photographs will not know the treatment given. Primary outcomes include wound healing time, infection rates, and patient reported pain scores. Secondary outcomes will focus on cost effectiveness analyses and patient quality of life. Standardized protocols will be implemented for data collection, wound assessment, and safety monitoring. Results: We anticipate that MGH will have lower infection rates, promote faster wound …

Investigating The Extent To Which Diet-Induced Obesity Alters Gene Expression In Hematopoietic Stem And Progenitor Cells Following Influenza Immunization In Mice, Chaitanya Lahari Chowdary Pathipati

Theses, Dissertations and Capstones

Vaccines are a vital tool in preventing diseases, but their effectiveness varies depending on factors like diet and body weight. Obese individuals often experience reduced vaccine protection, as seen with influenza vaccines, where they have twice the risk of getting the flu compared to healthy-weight individuals after vaccination. This study aims to understand why obesity weakens vaccine effectiveness, focusing on the role of blood-forming stem cells in the bone marrow, known as hematopoietic stem and progenitor cells (HSPCs). These cells are crucial for producing immune cells that defend the body against infections. Previous research has shown that diet-induced obesity alters …

Magnetic And Ph-Sensitive Dual Actuation Of Biohybrid Microswimmer Of Targeted Drug Release Suitable For Cancer Cell Microenvironment, Richa Chaturvedi, Yumin Kang, Yunji Eom, Sri Ramulu Torati, Cheolgi Kim

Center for Bioelectronics Publications

The chemotherapeutic agents most frequently used in cancer treatment often have limited effectiveness because of their low specificity for tumors and poor therapeutic performance. In addition to the aforementioned therapeutic challenges the drug delivery carriers conjugated with the drug encounter early detection and elimination from the immune system before arriving at the affected area continues to be a significant research focus among researchers. To address this prevalent issue, an effective approach has been developed that leverages the physiological differences between normal and tumor tissue to enhance the efficacy of anticancer drugs. This drug delivery system is designed based on pH-sensitive …

A Diagnostic Challenge—Tinu Syndrome, Sophia Lee, Md, Claire Kassakian, Md

Books, Presentations, Posters, Etc.

Introduction: •TINU Syndrome: Tubulointerstitial Nephritis and Uveitis  rare multi-system syndrome  has renal manifestations typical of acute interstitial nephritis (AIN), in addition to bilateral anterior uveitis  not well-understood •Thought to be an immune-mediated process, although mechanisms for disease remain unclear  Likely secondary to a combination of genetic predisposition and certain environmental exposures •Genetic predisposition:  specific HLA phenotypes  possibly an auto-antigen to modified C-reactive protein (mCRP) •Potential triggers:  Infections: tuberculosis, EBV, varicella zoster, chlamydia, toxoplasma  Medications: antibiotics (β-lactams, meropenem, azithromycin, levofloxacin), NSAIDs, goreisan (Chinese herb)  Endocrine diseases: hypoparathyroidism, hyperparathyroidism, rheumatoid arthritis, IgG4-related autoimmune …

January 2025, Swosu Rural Health Center

RURAL ROCKS

This is the January 2025 issue of Rural Rocks from the SWOSU College of Pharmacy.

Customary Corruption, Ani B. Satz, Liza Vertinsky

Faculty Articles

For over a hundred years, it has been well-accepted among tort scholars that physicians—as one of the legally recognized professions— determine their own customary practices. Within tort law, and medical malpractice more specifically, customary practice establishes whether physicians breach or uphold the required standard of care toward their patients. The results of our hand-coded examination of decided cases and statutes show a more complex picture. While some states have endeavored to shift the standard away from professional custom, it continues to play a critical, and in many cases a determinative, role in establishing physician liability in most states.

Using illustrative …

Defederalizing Opioid Addiction Care, Matthew B. Lawrence

Faculty Articles

Lack of access to evidence-based care for drug addiction is an urgent problem amid a decades-long overdose crisis that kills tens of thousands of Americans a year. Opioid addiction is the primary driver of overdoses today, and medicines exist to treat such addiction that can dramatically improve quality of life while reducing the risk of deadly overdose by more than half. Yet fewer than one in four of the nine million Americans who need such evidence-based medical care for their addiction receive it. Chief among barriers to access are restrictive and burdensome federal requirements limiting the use of narcotic medications …

Cytotoxic Constituents From Cylindrolobus Mucronatus Against Glioblastoma Cells, Shune Lae Yee Soe

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study reported the phytochemical investigation of Cylindrolobus mucronatus Lindl., a member of the Orchidaceae family, focusing on its chemical constituents and cytotoxic potential against glioblastoma cells. Eleven compounds were successfully isolated and structurally characterized, including new phenanthrene derivatives, cymucronins A-D, along with seven known compounds comprising confusarin , nudol, erianthridin, coelonin, bleformin I, (2,3-trans)-2-(4-hydroxy-3-methoxyphenyl)-3-hydroxymethyl-10-methoxy-2,3,4,5-tetrahydrophenanthro [2,1-b] furan-7-ol, and blestriarene C. Structural elucidation was accomplished using NMR, MS, IR and UV-Vis spectroscopic techniques, supported by comparison with literature data. Eight compounds were evaluated for their cytotoxic activity against U-87 human glioblastoma cells and three non-cancerous human cell lines: HEK293 (embryonic kidney), …

Barriers Of Access Of Infertility Treatment: A Literature Review, Karlee Carney, Danielle N. Craven, Aine O'Connor

SPARK Symposium Presentations

Background: Infertility is experienced by 17.5 % of the world’s adult population, and research indicates that it will only worsen. Objective: This literature review aims to highlight a few of the barriers that interfere with an individual’s ability to receive care. Methods: A search was conducted across PubMed and Embase since August 2024. Search terms such as socioeconomic status, infertility, fertility education, fertility treatment, affordability, IVF, poverty, IUI, and sterility were used. Data was extracted via an Excel Spreadsheet, highlighting the type of study, fertility treatment assessed, social determinants of health assessed, and study limitations. Results: Our research yielded 15 …

Protocol For Screening Of Small Molecules In A Cln3 Disease Patient-Specific Ipsc-Derived Neuronal Progenitor Cell Model, Ramu Venkatesan, Paul C. Trippier

Journal Articles: Pharmaceutical Sciences

Although rare, CLN3 disease is the most common neurodegenerative disorder of childhood. Here, we present a protocol for screening small molecules in a CLN3 disease patient-specific induced pluripotent stem cell (iPSC)-derived neuronal progenitor cell (NPC) model. We describe steps for converting human iPSCs (hiPSCs) to neural stem cells (NSCs) and developing NPCs using feeder-free medium and cytokine-based differentiation. We then detail procedures for achieving access to mature neurons. For complete details on the use and execution of this protocol, please refer to Simeon et al.

Laser-Induced Graphene Sensor For The Electrochemical Detection Of Acetaminophen, Abdellatif Ait Lahcen, Mazhar Sher, Sikander Ameer, Gymama Slaughter

Center for Bioelectronics Publications

Here we present a simple and efficient method for fabricating laser-induced graphene (LIG) electrodes for the electrochemical detection of acetaminophen (AAP), a crucial analgesic and antipyretic that can become toxic at elevated concentrations. Unlike conventional sensors that require intricate chemical modifications, the fabricated LIG-based sensor eliminates the need for functionalization, offering a streamlined sensing solution. The LIG electrodes were characterized using scanning electron microscopy, energy-dispersive spectroscopy, and Raman spectroscopy, which confirmed the formation of a highly porous graphene network with excellent purity and conductivity. Cyclic voltammetry analysis with a ferricyanide redox probe revealed a large electroactive surface area of 1.21 …