Medicine and Health Sciences Commons^™

A Cost-Effectiveness Study Comparing Ready-Toadminister And Traditional Vial-And-Syringe Method For Opioids, Prachi Arora, Maria Muehrcke, John Hertig

Scholarship and Professional Work – COPHS

No abstract provided.

Stem Cell Architecture Drives Myelodysplastic Syndrome Progression And Predicts Response To Venetoclax-Based Therapy, Irene Ganan-Gomez, Hui Yang, Feiyang Ma, Guillermo Montalban-Bravo, Natthakan Thongon, Valentina Marchica, Guillaume Richard-Carpentier, Kelly Chien, Ganiraju Manyam, Feng Wang, Ana Alfonso, Shuaitong Chen, Caleb Class, Rashmi Kanagal-Shamanna, Justin P. Ingram, Yamini Ogoti, Ashley Rose, Sanam Loghavi, Pamela Lockyer, Benedetta Cambo, Muharrem Muftuoglu, Sarah Schneider, Vera Adema, Michael Mclellan, John Garza, Matteo Marchesini, Nicola Giuliani, Matteo Pellegrini, Jing Wang, Jason Walker, Ziyi Li, Koichi Takahashi, Joel D. Leverson, Carlos Bueso-Ramos, Michael Andreeff, Karen Clise-Dwyer, Guillermo =Garcia-Manero, Simona Colla

Scholarship and Professional Work – COPHS

Myelodysplastic syndromes (MDS) are heterogeneous neoplastic disorders of hematopoietic stem cells (HSCs). The current standard of care for patients with MDS is hypomethylating agent (HMA)-based therapy; however, almost 50% of MDS patients fail HMA therapy and progress to acute myeloid leukemia, facing a dismal prognosis due to lack of approved second-line treatment options. As cancer stem cells are the seeds of disease progression, we investigated the biological properties of the MDS HSCs that drive disease evolution, seeking to uncover vulnerabilities that could be therapeutically exploited. Through integrative molecular profiling of HSCs and progenitor cells in large patient cohorts, we found …

Oxidative Phosphorylation Is A Metabolic Vulnerability In Chemotherapy-Resistant Triple-Negative Breast Cance, Kurt W. Evans, Erkan Yuca, Stephen S. Scott, Ming Zhao, Natalia Paez Arango, Christian X. Cruz Pico, Turcin Saridogan, Maryam Shariati, Caleb Class, Christopher A. Bristow, Christopher P. Vellano, Xiaofeng Zheng, Ana Maria Gonzalez-Angulo, Xiaoping Su, Coya Tapia, Ken Chen, Argun Akcakanat, Bora Lim, Debu Tripathy, Timothy A. Yap, Maria Emilia Di Francesco, Giulio F. Draetta, Philip Jones, Heffernan P. Heffernan, Joseph R. Marszalek, Funda Meric-Bernstam

Scholarship and Professional Work – COPHS

Oxidative phosphorylation (OXPHOS) is an active metabolic pathway in many cancers. RNA from pretreatment biopsies from patients with triple-negative breast cancer (TNBC) who received neoadjuvant chemotherapy demonstrated that the top canonical pathway associated with worse outcome was higher expression of OXPHOS signature. IACS-10759, a novel inhibitor of OXPHOS, stabilized growth in multiple TNBC patient-derived xenografts (PDX). On gene expression profiling, all of the sensitive models displayed a basal-like 1 TNBC subtype. Expression of mitochondrial genes was significantly higher in sensitive PDXs. An in vivo functional genomics screen to identify synthetic lethal targets in tumors treated with IACS-10759 found several potential …

Short-Term Treatment With Multi-Drug Regimens Combining Braf/Mek-Targeted Therapy And Immunotherapy Results In Durable Responses In Braf-Mutated Melanoma, Michael G. White, Robert Szczepaniak Sloane, Russell G. Witt, Alexandre Reuben, Pierre Olivier Gaudreau, Miles C. Andrews, Ningping Feng, Sarah Johnson, Caleb Class, Christopher Bristow, Khalida Wani, Courtney Hudgens, Luigi Nezi, Teresa Manzo, Mariana Pettaccia De Macedo, Jianhua Hu, Richard Davis, Hong Jiang, Peter Prieto, Elizabeth Burton, Patrick Hwu, Hussein Tawbi, Jeffrey Gershenwald, Alexander J. Lazar, Michael T. Tetzlaff, Willem Overwijk, Scott E. Woodman, Zachary A. Cooper, Joseph R. Marszalek, Michael A. Davies, Timothy P. Heffernan, Jennifer A. Wargo

Scholarship and Professional Work – COPHS

Targeted and immunotherapy regimens have revolutionized the treatment of advanced melanoma patients. Despite this, only a subset of patients respond durably. Recently, combination strategies of BRAF/MEK inhibitors with immune checkpoint inhibitor monotherapy (α-CTLA-4 or α-PD-1) have increased the rate of durable responses. Based on evidence from our group and others, these therapies appear synergistic, but at the cost of significant toxicity. We know from other treatment paradigms (e.g. hematologic malignancies) that combination strategies with multi-drug regimens (>4 drugs) are associated with more durable disease control. To better understand the mechanism of these improved outcomes, and to identify and prioritize …

Activation Of Gene Expression By Detergent-Like Protein Domains, Bradley K. Broyles, Andrew T. Gutierrez, Theodore P. Maris, Daniel A. Coil, Thomas M. Wagner, Xiao Wang, Daisuke Kihara, Caleb Class, Alexandre M. Erkine

Scholarship and Professional Work – COPHS

The mechanisms by which transcriptional activation domains (tADs) initiate eukaryotic gene expression have been an enigma for decades because most tADs lack specificity in sequence, structure, and interactions with targets. Machine learning analysis of data sets of tAD sequences generated in vivo elucidated several functionality rules: the functional tAD sequences should (i) be devoid of or depleted with basic amino acid residues, (ii) be enriched with aromatic and acidic residues, (iii) be with aromatic residues localized mostly near the terminus of the sequence, and acidic residues localized more internally within a span of 20–30 amino acids, (iv) be with both …

Prmt1-Dependent Regulation Of Rna Metabolism And Dna Damage Response Sustains Pancreatic Ductal Adenocarcinoma, Virginia Giuliani, Meredith A. Miller, Chiu-Yi Liu, Stella R. Hartono, Caleb Class, Christopher A. Bristow, Erika Suzuki, Lionel A. Sanz, Guang Gao, Jason P. Gay, Ningping Feng, Johnathon L. Rose, Hideo Tomihara, Joseph R. Daniele, Michael D. Peoples, Jennifer P. Bardenhagen, Mary K. Geck Do, Qing E. Chang, Bhavatarini Vangamudi, Christopher Vellano, Haoqiang Ying, Angela K. Deem, Kim-Anh Do, Giannicola Genovese, Timothy P. Heffernan, Jeffrey J. Kovacs, Michael Kim, Jason B. Fleming, Ernesto Guccione, Andrea Viale, Anirban Maitra, M. Emilia Di Francesco, Timothy A. Yap, Philip Jones, Giulio Draetta, Alessandro Carugo, Frederic Chedin, Timothy P. Heffernan

Scholarship and Professional Work – COPHS

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer that has remained clinically challenging to manage. Here we employ an RNAi-based in vivo functional genomics platform to determine epigenetic vulnerabilities across a panel of patient-derived PDAC models. Through this, we identify protein arginine methyltransferase 1 (PRMT1) as a critical dependency required for PDAC maintenance. Genetic and pharmacological studies validate the role of PRMT1 in maintaining PDAC growth. Mechanistically, using proteomic and transcriptomic analyses, we demonstrate that global inhibition of asymmetric arginine methylation impairs RNA metabolism, which includes RNA splicing, alternative polyadenylation, and transcription termination. This triggers a robust downregulation of multiple …

Aerosolized In Vivo 3d Localization Of Nose-To-Brain Nanocarrier Delivery Using Multimodality Neuroimaging In A Rat Model—Protocol Development, Michael C. Veronesi, Brian D. Graner, Shih-Hsun Cheng, Marta Zamora, Hamideh Zarrinmayeh, Chin-Tu Chen, Sudip K. Das, Michael W. . Vannier

Scholarship and Professional Work – COPHS

The fate of intranasal aerosolized radiolabeled polymeric micellar nanoparticles (LPNPs) was tracked with positron emission tomography/computer tomography (PET/CT) imaging in a rat model to measure nose-to-brain delivery. A quantitative temporal and spatial testing protocol for new radio-nanotheranostic agents was sought in vivo. LPNPs labeled with a zirconium 89 (89Zr) PET tracer were administered via intranasal or intravenous delivery, followed by serial PET/CT imaging. After 2 h of continuous imaging, the animals were sacrificed, and the brain substructures (olfactory bulb, forebrain, and brainstem) were isolated. The activity in each brain region was measured for comparison with the corresponding PET/CT region of …

Evaluation Of Student Pharmacists’ Attitudes And Perceptions Of Hormonal Contraception Prescribing In Indiana, J. Henry Papineau, Jenny L. Newlon, Ryan S. Ades, Veronica Vernon, Tracey A. Wilkinson, Lynn M. Thoma, Ashley H. Meredith

Scholarship and Professional Work – COPHS

Community pharmacists’ scope of practice is expanding to include hormonal contraceptive prescribing. Prior to introducing statewide legislation, it is important to assess the perceptions of future pharmacists. A cross-sectional survey was distributed to 651 third- and fourth-year professional students enrolled at three colleges of pharmacy in Indiana. Data were collected between September and October 2019 to assess students’ attitudes about prescribing hormonal contraceptives, readiness to prescribe, perceived barriers, and desire for additional training. In total, 20.9% (n = 136) students responded. Most (89%, n = 121) believe that pharmacist-prescribed hormonal contraceptives would be beneficial to women in Indiana, and 91% …

The Relationship Between Fake News And Fake Medicines: How Misinformation Has Fuelled The Sale Of Covid-19 Substandard And Falsified Medical Products, Oksana Pyzik, John Hertig, Hoda Kanso, Anika Chamba, Sofia Khan

Scholarship and Professional Work – COPHS

As waves of COVID-19 continue to threaten public health, an increasing volume of disease related information is widely accessible, and not all of it is accurate or reliable. The World Health Organisation (WHO) described this overabundance of information, misinformation, and disinformation as an "infodemic", making it difficult for many to distinguish fact from fiction. These definitions are complex and transitional; however, misinformation is defined as the "inadvertent sharing of false information", whereas disinformation is more sinister in origin and constitutes "the deliberate creation and sharing of information known to be false." The infodemic encapsulates both intentional and unintentional erroneous sources. …

Pharmacists’ Perceptions And Attitudes Toward Drug Importation Into The State Of Florida, John Hertig, Jade M. Jochem, Allissa M. Long

Scholarship and Professional Work – COPHS

Background: The Department of Health and Human Services and the Food and Drug Administration released the Safe Importation Action Plan in July 2020 detailing methods to import medicines from Canada to combat increasing drug costs. In November 2020, Florida became the first state in the United States to create and propose an importation plan from Canada. This study examines the proposal submitted by Florida, Florida pharmacists’ perceptions of the program on patient safety, and Florida pharmacists’ thoughts on the pharmacy operational impact.

Methods: This was a cross-sectional study utilizing an electronic questionnaire sent to pharmacist members of the Florida Pharmacy …

Feasibility And Acceptability Of A Proposed Pharmacy-Based Harm Reduction Intervention To Reduce Opioid Overdose, Hiv And Hepatitis C, Beth E. Meyerson, Jon D. Agley, Wasantha Parakrama Jayawardene, Lori Ann Eldridge, Prachi Arora, Carriann Smith, Nina Vadiei, Amy K. Kennedy, Taylor J. Moehling

Scholarship and Professional Work – COPHS

Background: Evidence-based harm reduction intervention components which might benefit pharmacy patients have not been integrated and studied.

Objective: To investigate the feasibility and acceptability of a proposed pharmacy-based harm reduction intervention to reduce opioid overdose, HIV and hepatitis C called PharmNet.

Methods: Indiana managing pharmacists were surveyed in 2018 to assess the feasibility and acceptability of an intervention for opioid misuse screening, brief intervention, syringe and naloxone dispensing, and referrals provision. The Consolidated Framework for Implementation Research informed the survey development and analysis.

Result: The sample included 303 (30.8%) pharmacists; 215 (70.9%) provided detailed written comments. Intervention Characteristics: 83.3% believed …

Transcriptomic Analysis Implicates Necroptosis In Disease Progression And Prognosis In Myelodysplastic Syndromes, Guillermo Montalban-Bravo, Caleb Class, Irene Ganan-Gomez, Rashmi Kanagal-Shamanna, Koji Sasaki, Guillaume Richard-Carpentier, Kiran Naqvi, Yue Wei, Hui Yang, Kelly A. Soltysiak, Kelly Chien, Carlos Bueso-Ramos, Kim-Anh Do, Hagop Kantarjian, Guillermo Garcia-Manero

Scholarship and Professional Work – COPHS

Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis and cytopenias due to uncontrolled programmed cell death. The presence of pro-inflammatory cytokines and constitutive activation of innate immunity signals in MDS cells suggest inflammatory cell death, such as necroptosis, may be responsible for disease phenotype. We evaluated 64 bone marrow samples from 55 patients with MDS or chronic myelomonocytic leukemia (CMML) obtained prior to (n=46) or after (n=18) therapy with hypomethylating agents (HMAs). RNA from sorted bone marrow CD34+ cells was isolated and subject to amplification and RNA-Seq. Compared to healthy controls, expression levels of MLKL (CMML: 2.09 log2FC, p=0.0013; MDS: …

Genomic Context And Tp53 Allele Frequency Define Clinical Outcomes In Tp53-Mutated Myelodysplastic Syndromes, Guillermo Montalban-Bravo, Rashmi Kanagal-Shamanna, Christopher B. Benton, Caleb A. Class, Kelly S. Chien, Koji Sasaki ,, Kiran Naqvi, Yesid Alvarado, Tapan M. Kadia, Farhad Ravandi, Naval Daver, Koichi Takahashi, Elias Jabbour, Gautham Borthakur, Naveen Pemmaraju, Marina Konopleva, Kelly A. Soltysiak, Sherry R. Pierce, Carlos E. Bueso-Ramos, Keyur P. Patel, Hagop Kantarjian, Guillermo Garcia-Manero

Scholarship and Professional Work – COPHS

TP53 mutations are associated with adverse outcomes and shorter response to hypomethylating agents (HMAs) in myelodysplastic syndrome (MDS). Limited data have evaluated the impact of the type, number, and patterns of TP53 mutations in response outcomes and prognosis of MDS. We evaluated the clinicopathologic characteristics, outcomes, and response to therapy of 261 patients with MDS and TP53 mutations. Median age was 68 years (range, 18-80 years). A total of 217 patients (83%) had a complex karyotype. TP53 mutations were detected at a median variant allele frequency (VAF) of 0.39 (range, 0.01-0.94). TP53 deletion was associated with lower overall response rate …

Understanding The Healthcare Experiences And Needs Of African Immigrants In The United States: A Scoping Review, Ogbonnaya I. Omenk, Dennis P. Watson, Hugh C. Hendrie

Scholarship and Professional Work – COPHS

Background: Africans immigrants in the United States are the least-studied immigrant group, despite the research and policy efforts to address health disparities within immigrant communities. Although their healthcare experiences and needs are unique, they are often included in the “black” category, along with other phenotypically-similar groups. This process makes utilizing research data to make critical healthcare decisions specifically targeting African immigrants, difficult. The purpose of this Scoping Review was to examine extant information about African immigrant health in the U.S., in order to develop lines of inquiry using the identified knowledge-gaps.

Methods: Literature published in the English language between 1980 …

Novel Targeting Approaches Of Nanoparticles For Anticancers Drug Delivery: A Focused Review, Yatri S. Patel, Nandita Das, Sudip Das

Scholarship and Professional Work – COPHS

Nanoparticles have presented a new paradigm in anticancer drug delivery to reduce adverse effects and improve therapeutic outcomes. Nanoparticle surface properties and morphology significantly affect the drug delivery to tumors while passive targeting. Conjugations with hyaluronic acid, transferrin and aptamers have shown to be effective in active targeting of anticancer drugs to tumor tissues. This review presents an overview of some credible techniques of passive and active drug delivery to tumors.

Resident Physicians’ Perceptions Of Ambulatory Care Pharmacy, Ashley Meredith, Darin Ramsey, Andrew Schmelz, Rachel Berglund

Scholarship and Professional Work – COPHS

Background: Physicians' acceptance of clinical pharmacy services is dependent on exposure to those services, with use increasing as resident physicians progress through their training. Resident physicians train within environments that have a multidisciplinary teaching and clinical care approach, working closely with other healthcare professionals. Ambulatory care pharmacists are increasingly working with resident physicians in clinic settings as part of the multidisciplinary team, and identification of resident physicians’ perceptions may influence future collaboration.

Objective: The objective of this research is to evaluate the perception of ambulatory care clinical pharmacy services from the perspective of resident physicians.

Methods: A statewide network of …

Characteristics Of Patients Experiencing Extrapyramidal Symptoms Or Other Movement Disorders Related To Dopamine Receptor Blocking Agent Therapy, Shaina Musco, Laura Ruekert, Jaclyn Myers, Dennis Anderson, Michael Welling, Elizabeth Ann Cunningham

Scholarship and Professional Work – COPHS

Purpose/background: Dopamine receptor blocking agents (DRBAs), also known as antipsychotics, are medications widely used to treat a growing number of mental health diagnoses. However, their utility is limited by the potential to cause serious adverse movement reactions. Akathisia, dystonia, parkinsonism, and tardive dyskinesia (collectively known as extrapyramidal symptoms or EPSs) are associated with reduced social and occupational functioning, negative patient attitudes toward treatment, and nonadherence to pharmacotherapy. Neuroleptic malignant syndrome is a life-threatening reaction that can result from DRBA use and cause musculoskeletal dysfunction. The aim of this study is to profile patients who have developed DRBA-related movement adverse effects …

Evaluation Of An Unfractioned Heparin Pharmacy Dosing Protocol For The Treatment Of Venous Thromboembolism In Nonobese, Obese, And Severely Obese Patients, Chad A. Knoderer, Lindsey M. Hosch, Emily Y. Breedlove, Lauren E. Scono

Scholarship and Professional Work – COPHS

Background: Despite large interpatient variability in dose response, heparin is utilized for treatment of venous thromboembolism (VTE). Current data on the optimal heparin dosing in obese patients are conflicting. Objective: The objective was to evaluate the time and dose required to achieve a therapeutic activated partial thromboplastin time (aPTT) in nonobese, obese, and severely obese patients using a pharmacist-directed heparin dosing protocol. Methods: This was a retrospective cohort study in a single-center community hospital inpatient setting. Adult patients receiving heparin for VTE treatment from July 1, 2013, to July 31, 2015, were evaluated. Patients were categorized into 3 groups: nonobese …

Occurrence Of Potential Adverse Drug Events From Prescribing Errors In A Pediatric Intensive And High Dependency Unit In Hong Kong: An Observational Study, Chad A. Knoderer, Celeste L. Ewig, Hon Ming Cheung, Kwok Ho Kam, Hiu Lam Wong

Scholarship and Professional Work – COPHS

No abstract provided.

The Pharmacy (Organization) Divide: A Focus On The Impact In Pediatric Pharmacy, Chad A. Knoderer, Lisa Lubsch, Kristin C. Klein

Scholarship and Professional Work – COPHS

No abstract provided.

Student-Generated E-Learning For Clinical Education, Sarah Nisly, Alex N. Isaacs, Alison M. Walton

Scholarship and Professional Work – COPHS

Background

Within clinical education, e-learning facilitates a standardised learning experience to augment the clinical experience while enabling learner and teacher flexibility. With the shift of students from consumers to creators, student-generated content is expanding within higher education; however, there is sparse literature evaluating the impact of student-developed e-learning within clinical education. The aim of this study was to implement and evaluate a student-developed e-learning clinical module series within ambulatory care clinical pharmacy experiences.

Methods

Three clinical e-learning modules were developed by students for use prior to clinical experiences. E-learning modules were created by fourth-year professional pharmacy students and reviewed by …

Optimizing Guideline-Recommended Antibiotic Doses For Pediatric Infective Endocarditis, Chad A. Knoderer, Kristen R. Nichols, Emily N. Israel, Christopher A. Thomas

Scholarship and Professional Work – COPHS

The American Heart Association recently published an updated scientific statement on the management of infective endocarditis in childhood. The recommendations included for vancomycin, aminoglycoside, and β-lactam dosing and monitoring are based primarily on expert opinion and do not consider available evidence for dose optimization based on pharmacokinetic and pharmacodynamic principles in pediatric patients. This is concerning because even when clinically necessary, some practitioners may be hesitant to deviate from guideline-recommended doses. In this perspective, we highlight potential areas for improvement in the statement-recommended doses and summarize evidence supporting antibiotic dosing optimization. The addition of a pediatric clinical pharmacist with expertise …

Venous Thromboembolism Prophylaxis Compliance Before And After Electronic Health Record Implementation, Lindsay Saum, David Reeves

Scholarship and Professional Work – COPHS

Background: Adherence to American College of Chest Physicians (CHEST) and National Comprehensive Cancer Network (NCCN) guidelines for venous thromboembolism (VTE) prophylaxis helps avoid thromboembolic complications during hospitalization. Electronic health records (EHR) have the potential to make an impact on guideline adherence, but data are lacking.

Objectives: To determine compliance with VTE prophylaxis guidelines in internal medicine and oncology populations and to determine whether EHR implementation had any effect on the rate and appropriateness of prophylaxis practices.

Methods: A retrospective chart review was conducted on medical and oncology patients admitted to the hospital for a 2-month period pre-EHR and post-EHR implementation. …

Design Of Drug-Induced Diseases Elective Utilizing Active Learning, Alison M. Walton, Alex N. Isaacs, Annette T. Mcfarland, Lauren M. Czosnowski, Sarah A. Nisly

Scholarship and Professional Work – COPHS

Objectives

To describe active learning utilized in a drug-induced diseases (DID) elective and determine inter-rater reliability of the assessment rubric for oral case-based presentations.

Methods

The design of this DID elective focuses on problem-based learning to enhance students’ critical thinking and problem-solving skills pertaining to the treatment of inducible diseases and general medicine. Each class incorporates active learning, utilization of drug information resources, and group work. The primary course assessment is student developed oral case-based presentations evaluated with a standard rubric.

Results

The intra-class correlation coefficient (ICC) was calculated amongst evaluators to assess the inter-rater reliability of the DID rubric …

Strategies For The Management Of Postoperative Anemia In Elective Orthopedic Surgery, Taylor D. Steuber, Meredith L. Howard, Sarah A. Nisly

Scholarship and Professional Work – COPHS

Objective: To assess the use of oral iron, intravenous (IV) iron, and erythropoiesis-stimulating agents (ESAs) for the prevention and management of perioperative anemia in elective orthopedic surgery patients, and to provide a clinical algorithm for use. Data Sources: A PubMed and MEDLINE search was conducted from 1964 through March 2016 using the following search terms alone or in combination: orthopedic, surgery, elective, anemia, blood transfusion, iron, erythropoiesisstimulating agents, and erythropoietin. Study Selection and Data Extraction: All English-language prospective and retrospective human studies and meta-analyses evaluating oral iron, IV iron, or ESA alone or in combination in elective orthopedic surgery …

Glp-1 Agonists In Type 1 Diabetes Mellitus: A Review Of The Literature, Kristin M. Janzen, Taylor D. Steuber, Sarah A. Nisly

Scholarship and Professional Work – COPHS

Objective: To review the use of GLP-1 agonists in patients with type 1 diabetes mellitus (T1DM). Data Sources: A search using the MEDLINE database, EMBASE, and Cochrane Database was performed through March 2016 using the search terms glucagon-like peptide 1 (GLP-1) agonists, incretin, liraglutide, exenatide, albiglutide, dulaglutide, type 1 diabetes mellitus. Study Selection and Data Extraction: All English-language trials that examined glycemic end points using GLP- 1 agonists in humans with T1DM were included. Data Synthesis: A total of 9 clinical trials examining the use of GLP-1 agonists in T1DM were identified. On average, hemoglobin A1C (A1C) was lower than …

Ascorbic Acid For The Treatment Of Rasburicase Induced Methemoglobinemia In The Setting Of Acute Renal Failure, David J. Reeves, Lindsay Saum, Ruemu Birhiray

Scholarship and Professional Work – COPHS

Purpose A case of apparent rasburicase-induced methemoglobinemia and acute kidney injury treated with i.v. ascorbic acid because of suspected glucose-6-phosphate dehydrogenase (G6PD) deficiency is reported.

Summary A 46-year-old African-American man with a recent diagnosis of multiple myeloma and renal insufficiency was admitted to the hospital with a cough, hemoptysis, and fatigue. His medical history included hypertrophic cardiomyopathy, ventricular tachycardia, attention deficit/hyperactivity disorder, and pleural effusion. No treatments for multiple myeloma were started before hospital admission. Levofloxacin 750 mg orally daily for possible pneumonia, lenalidomide 10 mg orally daily, and dexamethasone 20 mg orally weekly were administered. Plasmapheresis was also initiated. …

Development And Implementation Of A Pharmacist-Managed Outpatient Parenteral Antimicrobial Therapy Program, Eun Kyoung Chung, Cole B. Beeler, Eva W. Muloma, Danielle Osterholzer, Kendra M. Damer, Sharon M. Erdman

Scholarship and Professional Work – COPHS

Purpose The development and implementation of a pharmacist-managed outpatient parenteral antimicrobial therapy (OPAT) program in a county teaching hospital are described.

Summary A pharmacist-managed OPAT program was developed and implemented at a county teaching hospital to provide consistent evaluation, approval, and monitoring of patients requiring OPAT for the treatment of infection. The developmental and implementation stages of the OPAT program included (1) a needs assessment, (2) the identification of resources necessary for program operation, (3) delineation of general OPAT program operations and activities of individual OPAT clinicians, (4) the development of patient selection criteria, including a plan of care algorithm, …

What Is Causing This Man's Rectal Pain And Urinary Retention?, Mikaela L. Mckenney-Drake, Kali E. Veness, Christopher T. Roman

Scholarship and Professional Work – COPHS

Case: A 23-year-old man presented to an urgent care office with a 2-week history of rectal pain and scant rectal bleeding. In the few days leading up to his presentation, he also had a fever of 101° F (38.3° C), inguinal lymphadenopathy, and urinary retention.

Retrospective Analysis Of Methotrexate Elimination When Coadministered With Levetiracetam, David Reeves, Sarah Didominick, Suzanne Finn, Hyeon Jin Kim, Amanda Shake

Scholarship and Professional Work – COPHS

Background: Delayed elimination of methotrexate was previously reported in 2 patients receiving concomitant levetiracetam. Objective: To explore the potential interaction between methotrexate and levetiracetam in patients receiving high-dose methotrexate. Methods: This retrospective study reviewed the records of 81 adults receiving 280 cycles of methotrexate to determine the effects of levetiracetam on methotrexate elimination. Institutional review board approval was obtained. Results: Levetiracetam was administered in 33 (12%) cycles of methotrexate. Patients receiving levetiracetam had significantly lower 24-hour methotrexate concentrations compared with those not receiving levetiracetam (2.91 vs 7.37 µmol/L, P = 0.005). Despite this difference, concentrations at 48 and 72 hours …