June 2025, Swosu Rural Health Center

RURAL ROCKS

• PBM Reform Takes Off in 2025
• Tirzepatide as Compared with Semaglutide for the Treatment of Obesity | New England Journal of Medicine
• Know the ABCs of Diabetic Skin Care
• Updated Recommendations for Pneumococcal Vaccination

Spravato® Fda-Approved As Monotherapy For Adults With Treatment-Resistant Depression, Rileigh Rahrig, Kennedy Kosikowski, Haylee Whyde, Kiley Devoll, Allie Honigford, Macy Davis, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza

Pharmacy and Wellness Review

Treatment-resistant depression (TRD) is a challenging and possibly life-threatening condition that affects millions of people worldwide. Patients with major depressive disorder (MDD) are diagnosed with TRD once they have tried and failed to respond to two antidepressant treatments at the maximum dose for a full trial of six to eight weeks. Most traditional antidepressant therapies work by increasing the levels of monoamine neurotransmitters such as dopamine, serotonin, and norepinephrine in the brain. These medications have a delayed onset of action, ranging from two to eight weeks, and often fail to relieve depressive symptoms in a patient with TRD. Therefore, targeting …

Reducing The Percentage Of Intubation Time On Continuous Infusion Midazolam, Arsemen Brown, Emily Highsmith, Michelle Horng

Advances in Cancer Education and Quality Improvement

This quality improvement study was conducted at a comprehensive cancer care center with the aim to decrease the percentage of on continuous infusion (CI) midazolam by 30% by May 5, 2023. The pre-intervention and post-intervention data collection phases occurred from January 1, 2022, to October 31, 2022, and March 7, 2023, to May 5, 2023, respectively. Sedation was assessed utilizing the Richmond Agitation and Sedation Scale (RASS), and delirium was assessed utilizing the Intensive Care Delirium Screening Checklist (ICDSC). A sedation pathway and associated educational materials were developed by a multidisciplinary team and frontline staff. Interventions in the sedation pathway …

Dexmedetomidine As An Adjunct To Local Anesthetics In Neuraxial Anesthesia: A Scoping Review, Meaghan Elrod, Jacob Flake, Sarah Eggers, Kieraney Coston, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Neuraxial anesthesia is key for pain management and comfort during surgery. While local anesthetics and opioids have notable side effects, Dexmedetomidine (DEX) offers a promising alternative. Early studies suggest DEX improves pain control, prolongs anesthesia duration, and reduces opioid-related side effects. This review explores the benefits of incorporating DEX into neuraxial anesthesia for better patient safety and comfort

Methods

This scoping literature review took place from August 2023 to April 2024, utilizing PubMed, CINAHL, Cochrane Library, and Google Scholar for sources. After reviewing over 2,000 abstracts, 25 articles met the inclusion criteria, with nine selected as most relevant. Four …

Cobenfy(Xanomeline/Trospium) Vs. Clozapine For Treatment-Resistant Schizophrenia, Harmann Singh, Akash M. Patel, Abdullah Noory, Kush C. Patel, Simran Gandhi

Rowan-Virtua Research Day

Background: Treatment-resistant schizophrenia (TRS) poses significant therapeutic challenges. Although clozapine remains the gold-standard pharmacologic treatment for TRS, its clinical utility is hampered by severe side effects and intensive monitoring requirements. KarXT (Cobenfy), a combination of xanomeline and trospium chloride, represents a novel antipsychotic approach by targeting muscarinic M1/M4 receptors instead of dopamine D2 pathways.

Hypothesis: KarXT offers comparable efficacy to clozapine with a more favorable safety and tolerability profile, making it a viable alternative for patients with TRS.

Methods: A systematic review was conducted to identify studies from 2015–2025 evaluating KarXT in schizophrenia. Sources included PubMed, ClinicalTrials.gov, FDA databases, ICER …

Transient Small Bowel Intussusception In An Adult Patient: A Rare Complication Of Glp-1 Receptor Agonist Therapy, Shmilah Choudhary, Alisha Vincent, Majid Michael, Sagar Acharya, Christopher Bader

Rowan-Virtua Research Day

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are widely used to treat type 2 diabetes (T2DM) and obesity due to their benefits in glycemic control, weight loss, and cardioprotection. However, their effects on gastrointestinal (GI) motility raise concerns about potential complications, including bowel obstruction and, in rare cases, intussusception. We present a case of a 34-year-old male on semaglutide for weight loss who developed transient small bowel intussusception. The patient has no prior gastrointestinal surgeries or structural abnormalities, but he had a history of baseline slow bowel motility and was also diagnosed with influenza A during his hospitalization. His condition improved …

Case Report: A Case Of Transient Dress Syndrome (Drug Rash With Eosinophilia And Systemic Symptoms), Dip Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 41-year-old female with a history of hypertension who presented with fever and a diffuse erythematous rash after taking trimethoprim-sulfamethoxazole (TMP-SMX) for an ear infection. Due to her symptoms, mild eosinophilia, and elevated liver function tests, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) was suspected. Although the patient’s rash had resolved by the time of initial evaluation, it recurred overnight, reinforcing suspicion for DRESS syndrome. TMP-SMX was discontinued, and acetylcysteine was administered due to the patient’s high-dose use of acetaminophen in the days prior to her hospital presentation. Infectious and autoimmune workups were negative. …

Exploring Anticoagulant Prescription Disparities: A Focus On Hispanic Patient Care, Michael Acevedo, Vanessa Veltre

Rowan-Virtua Research Day

Anticoagulants play a critical role in preventing thromboembolic events, yet disparities persist in their prescription among minority populations. This presentation explores inequities in anticoagulant prescribing patterns, with a specific focus on Hispanic patient care. Using retrospective electronic health record data, we analyzed the prescription rates of warfarin versus direct oral anticoagulants (DOACs) among adults with clinical indications for anticoagulation. Our findings reveal that Hispanic patients are significantly less likely to receive DOACs compared to non-Hispanic White patients, even after adjusting for demographics, comorbidities, and insurance status. Contributing factors include language barriers, lack of insurance, and potential implicit bias in provider …

Radiofrequency Ablation Versus Naproxen For The Management Of Ankylosing Spondylitis: A Comparative Analysis, Akash Manish Patel, Alec Birnbaum, Yashas Sattur

Rowan-Virtua Research Day

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation primarily affecting the spinal vertebrae and sacroiliac joints, leading to pain, stiffness, and progressive loss of spinal mobility.

Management typically focuses on alleviating symptoms and controlling inflammation to improve patient quality of life. In this study, we compared the efficacy of two common treatment modalities: radiofrequency ablation (RFA) and naproxen. RFA is a minimally invasive procedure that targets specific nerve endings to interrupt pain signals, whereas naproxen is a non-steroidal anti-inflammatory drug (NSAID) used to reduce inflammation and provide symptomatic relief. Our systematic review involved a cohort of AS …

Polypharmacy As A Treatment Barrier In Autism Spectrum Disorder, Ahmed Aly

Rowan-Virtua Research Day

The purpose of the study is to assess the prevalence of polypharmacy in current literature in the Autism Spectrum Disorder (ASD) population. It is hypothesized to find patients with ASD over prescribed compared to the neurotypical counterparts.

Side Effect Profiles In Immunotherapy Vs Chemotherapy In The Treatment Of Pediatric Acute Lymphoblastic Leukemia, Chloe Triolo, Mariana Sales, Amy Nguyen, Jaclyn Schultz, Melissa Crisci

Rowan-Virtua Research Day

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer in children and also one of the most curable, with current cure rates surpassing 90%. Immunotherapy using biologics is an emerging cancer treatment approach that shows significant promise and is generally less toxic than traditional chemotherapy. Due to its lower toxicity compared to chemotherapy, standalone immunotherapy may represent a promising treatment option for pediatric ALL patients.

Hypothesis: This review aims to compare acute side effect profiles and chronic complications in chemotherapy versus immunotherapy treatment modalities for pediatric patients with ALL. Immunotherapy is hypothesized to have a more tolerable side effect …

A Systematic Review On Cinacalcet’S Effect In Reducing Pth Serum Levels In Peritoneal Dialysis Patients, Akhil Gumidyala, Youssef Daoud, Mark Hanna, Han Jie Liu, Rikita Doshi

Rowan-Virtua Research Day

Background: Patients with Chronic Kidney Disease (CKD) have low calcium levels. Low blood calcium triggers the parathyroid gland to constantly secrete parathyroid hormone (PTH) in an attempt to raise blood calcium levels back to normal. One way PTH tries to do this is by removing calcium from bone. Chronically high PTH levels leads to increased bone resorption and increases the risk for bone fractures and mortality risk. This phenomenon is called secondary hyperparathyroidism (SHPT). Calcimimetics, like cinacalcet (sensipar), act similarly to calcium by binding allosterically to Calcium-Sensing Receptors (CaSR) on the parathyroid gland, thereby reducing PTH levels. The effect of …

Assessing The Efficacy Of Prolonged Doxycycline Pep Use In High-Risk Populations For Sti Prevention, Lam Doan, Pearl Joslyn, Lizann Sung, Timothy Breiner, Sarah Marotta, Shikhar Rastogi

Rowan-Virtua Research Day

First recommended in October 2022, doxycycline post-exposure prophylaxis (DoxyPEP) has been increasingly used as a treatment for multiple sexually transmitted infections (STIs). To evaluate the efficacy of prolonged DoxyPEP use in high risk populations - men who have sex with men (MSM) and transgender women - for STIs, different sources addressing various aspects of DoxyPEP, its efficacy in STI prevention, and the potential consequences of its widespread use in terms of antimicrobial resistance were examined. Across 9 studies, DoxyPEP was found to decrease the incidence of bacterial STIs, specifically, syphilis, chlamydia, and gonorrhea with varying efficacy, especially for gonorrhea. Furthermore, …

Assessing The Efficacy Of Remimazolam Vs. Midazolam In Short-Duration Gastrointestinal Endoscopy Procedures And How They Affect Patient Recovery Time: A Scoping Review, Kelsey Gray, Bsn, Rn, Ccrn, Shannon Guthrie, Bsn, Rn, Ana Grace Holder, Bsn, Rn, Will Howard, Bsn, Rn, Dwayne Accardo Dnp, Crna, Faana, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose

The purpose of this scoping review is to evaluate and compare the efficacy of Remimazolam and Midazolam as sedatives in short-duration gastrointestinal endoscopy procedures.

May 2025, Swosu Rural Health Center

RURAL ROCKS

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

Cardiovascular Effects Of Glp-1 Receptor Agonists In Non-Diabetic Adults With Obesity: A Systematic Literature Review, Mariam Abdeen

Rowan-Virtua Research Day

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in individuals with obesity. GLP-1 receptor agonists, initially developed for glycemic control in diabetes, are now approved for weight loss in non-diabetic populations. Recent clinical trials suggest these agents may also offer direct cardiovascular benefits.

Objective: This literature review aims to evaluate the cardiovascular effects of GLP-1 receptor agonists, specifically semaglutide, liraglutide, and tirzepatide, in non-diabetic adults with overweight or obesity.

Methods: A systematic search was conducted in January 2025 using PubMed as the primary database, supplemented by Google Scholar and Embase. Clinical trials were selected based on …

Patient Education And Health Literacy Effects On Statin Use And Adherence, Ian M. Smith, Richard G. Olarsch, Alison M. Mancuso

Rowan-Virtua Research Day

Background: While the use of statins (HMG-CoA reductase inhibitors) plays a significant role in the prevention of cardiovascular disease, it is estimated approximately 60% of patients who would benefit from a statin are receiving these medications. Current research suggests that a preference for life-style intervention over medical management, concern over medical adverse reactions, and a lower perceived risk of cardiovascular events is associated with statin non-adherence.

Methods: An IRB-approved paper survey was administered to patients aged 18 to 89 at an ambulatory primary care clinic for non-acute visits. Qualtrics was utilized to collect, store, and process data. Information elicited from …

Case Report: Lamotrigine-Induced Rash In An Adult Patient, Dhruvin Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Lamotrigine (Lamictal®) is a commonly prescribed anticonvulsant and mood-stabilizing medication. One of the rare but serious adverse effects of lamotrigine is the development of a drug-induced rash, which can be potentially life-threatening. This case report highlights the occurrence of a drug-induced rash in a 33-year-old female patient who was prescribed lamotrigine for the management of bipolar disorder. The patient presented with a characteristic rash, and following timely intervention, the rash resolved without complications. This case emphasizes the importance of monitoring for early signs of rash in patients receiving lamotrigine and outlines management strategies.

To Heal A Mind: A Comparison Of Functional And Conventional Treatments In Major Depressive Disorder, Gillian Chambers

Senior Honors Theses

Incidence of major depressive disorder is increasing year over year, with little able to be done to halt the spread of the condition. However, there are many treatment possibilities considered unconventional by the healthcare system. This thesis examines the respective benefits and risks, in comparison to one another, between conventional pharmacological treatment and functional, holistic treatment of depression. This was done via integrative review of available clinical literature, synthesizing evidence on both conventional and functional treatments for depression, as dictated by Whittemore and Knafl (2005). Exploratory search methods revealed 758 records fulfilling inclusion criteria, which were screened and narrowed down …

Mechanistic Investigation Of Ring-Opening Polymerization Of Polycaprolactone Using Tin(Ii) Catalysts: Ligand Effects And Biomedical Applications, Eva-Larue M. Barber

Honors Scholar Theses

This research explores the mechanistic aspects of ring-opening polymerization (ROP) of ε-caprolactone (CL) to produce polycaprolactone (PCL), a biodegradable polymer widely used in biomedical applications. The study investigates how light exposure and catalyst concentration influence polymerization efficiency, using tin(II) 2-ethylhexanoate [Sn(Oct)₂] as the catalyst in a non-polar toluene solvent at 90 °C. Reactions were conducted under either ambient light or black light bulb (BLB) illumination, with monomer-to-catalyst ratios of 1:1 and 200:1.

Proton nuclear magnetic resonance (¹H NMR) spectroscopy was used to analyze conversion efficiency by tracking the disappearance of monomer signals and appearance of characteristic PCL peaks. Results revealed …

Determining The Bioaccumulation Of Minor Cannabinoids In Zebrafish Larvae, Kamdyn A. Holt

Honors Theses

Due to the increasing prevalence of cannabis product availability and usage in the modern United States, particularly among pregnant individuals, evaluating the bioaccumulation of minor cannabinoids to further understand the adverse effects of cannabinoids during early development is critical. This study quantitated the uptake of eight minor cannabinoids ((∆8-tetrahydrocannabinol (∆8-THC), ∆9-THC, ∆10-THC, cannabidiol (CBD), cannabigerol (CBG), cannabinol (CBN), tetrahydrocannabivarin (THCV), and hexahydrocannabinol (HHC)) in zebrafish larvae following water-borne 2 µM exposures from 6 to 96 hours post fertilization (hpf). Larvae were homogenized at 96 hpf and analyzed using a gas chromatography- mass spectrometry (GC-MS) method developed in this study. Bioconcentration …

Fluorescent Labeling And Size-Dependent Uptake Of Mesoporous Silica Nanoparticles In Ovarian Cancer Tumor Spheroids, Kimberly R. Berardis

Honors Scholar Theses

Ovarian cancer is the most lethal gynecologic malignancy, with most patients presenting at an advanced stage. While surgical debulking improves survival, nonresectable tumors (<1 cm) contribute significantly to morbidity and remain difficult to treat. Nanocarrier-based drug delivery systems offer an innovative approach to targeted therapy and palliation. In vivo models have demonstrated that intraperitoneally delivered mesoporous silica nanoparticles (MSNs) preferentially accumulate in tumors with low systemic exposure, enabling targeted chemo- and radiotherapy.

MSNs are particularly suited for radiotherapeutic delivery, as their strong interactions with tumor extracellular matrices drive selective uptake. Additionally, they exhibit excellent stability under neutron flux, allowing for loading with stable isotopes and irradiation immediately prior to administration. High radionuclide retention after dilution further minimizes systemic exposure and toxicity.

A key …

Canadian Adolescent And Young Athletes Knowledge Of Pain-Relieving Medications, Jackie Vandertuin, Dalya Abdulla, Stephanie Lowther

Internet Journal of Allied Health Sciences and Practice

Purpose: Adolescent knowledge of pain-relieving medications (PRM) and opioids is scant, particularly from a Canadian perspective. Research indicates that athletes will often resort to PRM and opioids to manage their pain, but it is unknown whether athletes are fully informed as to its use and misuse including adverse events that may occur. The purpose of this study is to understand what elite level male athletes know about use, contraindications, and recommendations of pain-relieving medications; particularly opioids to manage their pain. Methods: Using a qualitative, grounded theory approach, we interviewed male athletes to understand their level of knowledge regarding pain-relieving medications, …

The Placebo Effect For Opioid Abuse, Carly Longenecker

D.U.Quark

No abstract provided.

April 2025, Swosu Rural Health Center

RURAL ROCKS

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

Analyzing Social Media Trends In Cosmeceuticals: Insights From Google Trends And Tiktok Analytics, E. Correia, Jenna Mandel, Stephanie R. Jackson Cullison

Department of Dermatology and Cutaneous Biology Faculty Papers

OBJECTIVE: Social media usage has surged, particularly since the COVID-19 pandemic. Dermatology invokes intense interest on social media, and cosmeceuticals are among the most trending topics, offering a unique space for dermatologists to share their expertise. By using tools like Google Trends and TikTok viewership, we aim to capture cosmeceutical trends to guide dermatologists' educational efforts.

METHODS: A Google Trends search from January 2004 to December 2023 was performed on retinol, bakuchiol, salicylic acid, glycolic acid, azelaic acid, hydroquinone, niacinamide, vitamin C serum, and hyaluronic acid. Trend lines were created for each term, and yearly percent differences in relative search …

Implementation Of Staff Education On Suicide Prevention, Julianne Ji, Hannah Cryder, Trista Joy, Isabel Pfingston, Jaylen Wilson, Kelsey Crosby, Ashlyn Mulcahey

Nursing Leadership in Community Engagement Projects

Implementation of Staff Education on Suicide Prevention

Kelsey Crosby, Hannah Cryder, Julianne Ji, Trista Joy, Ashlyn Mulcahey, Isabel Pfingston, and Jaylen Wilson

School of Health Sciences, Seattle Pacific University

NUR4153: Nursing Leadership in Community Engagement

Dr. Bomin Shim

February 26, 2025

Implementation of Staff Education on Suicide Prevention

Our group, consisting of seven nursing students, partnered with an agency dedicated to supporting individuals in recovery from addictions of all forms, including substance use, gambling, and alcohol dependence. The agency focuses on helping them reach their full potential, minimize relapse, and maintain recovery. Elements of the agency’s work include providing two …

March 2025, Swosu Rural Health Center

RURAL ROCKS

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

Role Of Urolithin A In Cancer Therapy, Aanya S. Chauhan, Vinita Karumuru, Mahi P. Yallapu, Anupam Dhasmana

Research Symposium

Background: Cancer is a big health problem around the world, causing many deaths even though there have been improvements in treatments. Some of the main challenges in treating cancer include side effects, resistance to treatments, cancer spreading to other parts of the body (metastasis), and the disease coming back (recurrence). Scientists are looking for safer and better ways to treat cancer. One promising option is using natural substances that come from plants, which are less toxic and have a lot of potential for fighting diseases. One of these substances is Urolithin A (UA), a compound made in the body when …

Investigating The Impact Of Tirzepatide Treatment On Alcohol And Cigarette Consumption, Yvannia Gray, Benjamin Latey, Hayden Mcaffee, Karissa Mccown, Seth Maki, Victoria Nguyen, Andrew Payne

Annual Research Symposium

No abstract provided.