Pharmacy and Pharmaceutical Sciences Commons^™

Foundational Research And Nih Funding Enabling Emergency Use Authorization Of Remdesivir For Covid-19, Ekaterina Galkina Cleary, Matthew J. Jackson, Zoë Folchman-Wagner, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Emergency Use Authorization for remdesivir months after discovery of COVID-19 is unprecedented. Typically, decades of research and public-sector funding are required to establish the mature body of foundational research requisite for efficient, targeted drug discovery and development. This work quantifies the body of research related to remdesivir’s biological target, RNA-dependent RNA polymerase (RdRp), or parent chemical structure, nucleoside analogs (NcAn), through 2019, as well as NIH funding for this research 2000–2019. There were 6,567 RdRp-related publications in PubMed, including 1,263 with NIH support, and 11,073 NcAn-related publications, including 2,319 with NIH support. NIH support for RdRp research comprised 2,203 Project …

The Other Epidemic, Bruce Deighton

HCA Healthcare Journal of Medicine

The epidemic level of opioid abuse in the U.S. population continues to present a major challenge to our society and to the medical profession. Medical education has a significant role in improving screening, diagnosis, appropriate treatment and management of opioid use disorder. Addressing the problem of overprescribing opioids through physician education, surveillance and opioid management has resulted in significant improvement, translating to fewer overdose deaths from prescription opioids. Graduate medical education can increase access to care by training more addiction medicine specialists, and training other physicians to prescribe buprenorphine and provide access to medically assisted care.

Evaluation Of Pharmacist- Or Nurse-Driven Long-Acting Insulin Titration Protocol In Adult Primary Care Patients With Type 2 Diabetes, Ruth Manzi, Corinn Martineau, Carmine Laporta, Mary Muca, Samantha Marrier, Donald Medd, Jennifer Aronson

Journal of Maine Medical Center

INTRODUCTION

Studies have supported protocolized insulin titration to optimize insulin therapy. We implemented a long acting insulin titration (LAIT) protocol in a primary care setting to aid patients achieve optimal control of their diabetes. The purpose of the study was to evaluate the performance of the LAIT protocol.

METHODS

This retrospective analysis included patients ≥18 years with type 2 diabetes (T2D) and a hemoglobin A1c (A1C) >8% who were managed as outpatients at clinics within our health care system. We collected demographic and clinical data before and after a patient’s enrollment in the LAIT protocol. Our primary outcome measure was …

Oral Anticoagulants For Nonvalvular Atrial Fibrillation In Frail Elderly Patients: Insights From The Aristophanes Study, G. Y. H. Lip, A. V. Keshishian, A. L. Kang, A. D. Dhamane, X. Luo, X. Li, N. Balachander, L. Rosenblatt, J. Mardekian, X. Pan, M. Di Fusco, A. B. Garcia Reeves, Huseyin Yuce, S. Deitelzweig

Publications and Research

Background

Patient frailty amongst patients with nonvalvular atrial fibrillation (NVAF) is associated with adverse health outcomes and increased risk of mortality. Additional evidence is needed to evaluate effective and safe NVAF treatment in this patient population.

Objectives

This subgroup analysis of the ARISTOPHANES study compared the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) amongst frail NVAF patients prescribed nonvitamin K antagonist oral anticoagulants (NOACs) or warfarin.

Methods

This comparative retrospective observational study of frail, older NVAF patients who initiated apixaban, dabigatran, rivaroxaban or warfarin from 01JAN2013‐30SEP2015 was conducted using Medicare and 3 US commercial claims databases. To compare …

Veterinarians’ Attitudes And Practices Regarding Opioid-Related Vet Shopping Practices In Tri-State Appalachian Counties: An Exploratory Study, Falguni C Patel, Jeffrey A Raines, Richard W Kim, Karen Gruszynski, Robert E Davis, Manoj Sharma, Gilbert Patterson, Jason W Johnson, Vinayak K Nahar

Faculty, Staff and Students Publications

BACKGROUND: The opioid crisis continues to grow in the United States with 46,700 drug overdose deaths due to opioids in 2017 alone. Vet shopping, the practice of soliciting veterinarians for prescription medications, has been receiving national media attention in recent years. A 2014 review of Prescription Monitoring Drug Programs found less than 10 veterinary shoppers nationwide. Still much is unknown about the role of vet shopping and the opioid crisis. This study sought to understand the practice of vet shopping through the eyes of veterinarians practicing in Appalachian counties within the states of Kentucky, Tennessee, and Virginia, United States.

RESULTS: …

The Impact Of An International Interprofessional Experience On Perceptions Of Pharmacist-Physician Relationships, Miranda R. Andrus, Emily A. Powell, Katherine Moody, Taylor D. Steuber

International Journal of Health Sciences Education

Objective. To assess the impact of this international interprofessional learning experience on perceptions of pharmacist-physician relationships and interprofessional teams.

Methods. Medical and pharmacy students completed a one-week interprofessional medical mission experience in the Dominican Republic. Anonymous surveys were administered to 17 students before and after completion to measure perceptions of pharmacist-physician relationships and interprofessional teams. Responses were matched and changes in perceptions were analyzed using the Wilcoxon Signed Rank test. The SPICE-R2 instrument was administered after the experience to measure attitudes toward interprofessional teams.

Results. Of the 17 participants, 100% responded to all surveys. Significant improvements were seen in the …

Comparative Molecular Transporter Properties Of Cyclic Peptides Containing Tryptophan And Arginine Residues Formed Through Disulfide Cyclization, Eman H. M. Mohammed, Dindyal Mandal, Saghar Mozaffari, Magdy Abdel-Hamied Zahran, Amany Mostafa Osman, Rakesh Kumar Tiwari, Keykavous Parang

Pharmacy Faculty Articles and Research

We have previously reported cyclic cell-penetrating peptides [WR]₅ and [WR]₄ as molecular transporters. To optimize further the utility of our developed peptides for targeted therapy in cancer cells using the redox condition, we designed a new generation of peptides and evaluated their cytotoxicity as well as uptake behavior against different cancer cell lines. Thus, cyclic [C(WR)_xC] and linear counterparts (C(WR)_xC), where x = 4–5, were synthesized using Fmoc/tBu solid-phase peptide synthesis, purified, and characterized. The compounds did not show any significant cytotoxicity (at 25 µM) against ovarian (SK-OV-3), leukemia (CCRF-CEM), gastric adenocarcinoma (CRL-1739), breast …

Nanoparticle-Mediated Drug Delivery For The Treatment Of Cardiovascular Diseases, Rajasekharreddy Pala, Vt Anju, Madhu Dyavaiah, Siddhardha Busi, Surya M. Nauli

Pharmacy Faculty Articles and Research

Cardiovascular diseases (CVDs) are one of the foremost causes of high morbidity and mortality globally. Preventive, diagnostic, and treatment measures available for CVDs are not very useful, which demands promising alternative methods. Nanoscience and nanotechnology open a new window in the area of CVDs with an opportunity to achieve effective treatment, better prognosis, and less adverse effects on non-target tissues. The application of nanoparticles and nanocarriers in the area of cardiology has gathered much attention due to the properties such as passive and active targeting to the cardiac tissues, improved target specificity, and sensitivity. It has reported that more than …

Iv Amiodarone Vs Iv Sotalol For The Use In Postoperative Junctional Ectopic Tachycardia (Jet): A Randomized Study, Tanner Isaacson

Research Days

No abstract provided.

Development Of Fluorescent Hyaluronic Acid Nanoparticles For Intraoperative Tumor Detection, Nicholas E. Wojtynek

Theses & Dissertations

Surgical resection remains to be the primary treatment for the majority of solid tumors, including breast cancer. The complete removal of the primary tumor, local metastases, and metastatic lymph nodes dramatically improve a patient’s treatment outcome and prognosis. Nevertheless, surgeons are limited to tactile and visual cues in distinguishing malignant and healthy tissue. This can result in a positive surgical margin (PSM), which occurs when tumor goes undetected and is left behind in the surgical cavity. PSMs decreases a patient’s prognosis and necessitate additional treatment in the form of surgery, radiation, and chemotherapy. An emerging imaging modality, known as fluorescence-guided …

Ccne1 Amplification As A Predictive Biomarker Of Chemotherapy Resistance In Epithelial Ovarian Cancer, Justin W. Gorski, Frederick R. Ueland, Jill M. Kolesar

Obstetrics and Gynecology Faculty Publications

Ovarian cancer is the most-deadly gynecologic malignancy, with greater than 14,000 women expected to succumb to the disease this year in the United States alone. In the front-line setting, patients are treated with a platinum and taxane doublet. Although 40-60% of patients achieve complete clinical response to first-line chemotherapy, 25% are inherently platinum-resistant or refractory with a median overall survival of about one year. More than 80% of women afflicted with ovarian cancer will recur. Many attempts have been made to understand the mechanism of platinum and taxane based chemotherapy resistance. However, despite decades of research, few predictive markers of …

Phenylpyrazalopyrimidines As Tyrosine Kinase Inhibitors: Synthesis, Antiproliferative Activity, And Molecular Simulations, Bhupender S. Chhikara, Sajda Ashraf, Saghar Mozaffari, Nicole St. Jeans, Dindyal Mandal, Rakesh Kumar Tiwari, Zaheer Ul-Haq, Keykavous Parang

Pharmacy Faculty Articles and Research

N1-(α,β-Alkene)-substituted phenylpyrazolopyrimidine derivatives with acetyl and functionalized phenyl groups at α- and β-positions, respectively, were synthesized by the reaction of 3-phenylpyrazolopyrimidine (PhPP) with bromoacetone, followed by a chalcone reaction with differently substituted aromatic aldehydes. The Src kinase enzyme assay revealed modest inhibitory activity (half maximal inhibitory concentration, IC₅₀ = 21.7–192.1 µM) by a number of PhPP derivatives. Antiproliferative activity of the compounds was evaluated on human leukemia (CCRF-CEM), human ovarian adenocarcinoma (SK-OV-3), breast carcinoma (MDA-MB-231), and colon adenocarcinoma (HT-29) cells in vitro. 4-Chlorophenyl carbo-enyl substituted 3-phenylpyrazolopyrimidine (10) inhibited the cell proliferation of HT-29 and SK-OV-3 by 90% …

Baclofen-Induced Changes In The Resting Brain Modulate Smoking Cue Reactivity: A Double-Blind Placebo-Controlled Functional Magnetic Resonance Imaging Study In Cigarette Smokers, Ariel Ketcherside, Kanchana Jagannathan, Sudipto Dolui, Nathan Hager, Nathaniel Spilka, Chaela Nutor, Hengyi Rao, Teresa Franklin, Reagan Wetherill

Psychology Faculty Publications

Objective: Smoking cue-(SC) elicited craving can lead to relapse in SC-vulnerable individuals. Thus, identifying treatments that target SC-elicited craving is a top research priority. Reduced drug cue neural activity is associated with recovery and is marked by a profile of greater tonic (resting) activation in executive control regions, and increased connectivity between executive and salience regions. Evidence suggests the GABA-B agonist baclofen can reduce drug cue-elicited neural activity, potentially through its actions on the resting brain. Based on the literature, we hypothesize that baclofen’s effects in the resting brain can predict its effects during SC exposure.

Methods: In this longitudinal, …

Pharmacological Prevention Of Atrial Fibrillation After Cardiac Surgery With And Without The Use Of Nonsteroidal Anti-Inflammatory Drugs, Laura Neubauer, Radhan Gopalani, Faaria Quadri, Mario Pascual, Heidi Clarke, Andrea Marr-Peralto

All Publications

Purpose: Atrial fibrillation after cardiac surgery (AFACS) is the most common complication following open heart procedures, with significantly increased morbidity and mortality associated with its occurrence¹. A previous study done at Baptist Hospital of Miami (BHM) showed a decrease in the incidence of AFACS from 36% to 22% after implementation of a prevention protocol that includes guideline-directed therapy with a beta-blocker and amiodarone. The protocol also includes nonsteroidal anti-inflammatory drugs (NSAIDs) modeled after a study published in 2004 that showed that NSAIDs lowered the incidence of postoperative atrial fibrillation by 65% when they were used in the postoperative …

Evaluating The Association Between Vasopressin Use And In-Hospital Mortality In Patients With Septic Shock, Michael Pasqualicchio, Heidi Clarke, Jonathan Kline, Payal Patel

All Publications

Purpose/Background: The Surviving Sepsis Campaign recommends norepinephrine as the first-line vasopressor in patients with septic shock to maintain a mean arterial pressure (MAP) of at least 65 mmHg. The guideline also makes a weak recommendation (2B) to use vasopressin as an adjuvant therapy to raise MAP to goal or to reduce the norepinephrine rate required to maintain the goal MAP. The recommendation is based on conflicting results of the VASST trial that showed no significant difference in 28-day all-cause mortality between patients managed with norepinephrine alone compared to norepinephrine and vasopressin. However, in subgroup analysis, the VASST trial showed mortality …

Transition From Fixed-Dosing To Symptom-Triggered Management Of Alcohol Withdrawal Syndrome In The Intensive Care Unit Of A Community Hospital, Marianela Robainas, Heidi Clarke, Claudia Chang, Frances Ordieres Gonzalez, Lorenzo Porras Jr.

All Publications

Background/Purpose: In the United States, 2 to 7% of heavy alcohol users admitted to the hospital for general medical care will develop severe alcohol withdrawal (AW) requiring treatment. The most dangerous complications of AW are delirium tremens and seizures. Benzodiazepines (BZD) are considered first-line therapy, with varying modality options available to providers. Fixed-dosing has historically been used to manage AW. However, studies suggest that symptom-triggered therapy (STT) can decrease length of stay and BZD duration of therapy. The purpose of this study was to evaluate the current fixed-dose protocol and outline the transition to STT in the intensive care unit …

Incorporating A Clinical Pharmacist In An Outpatient Palliative Care Team, Crystal Rim, Sharon Leigh, Linda Desitter, Mary Grant, Dana Nguyen

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers 2020

Title: Incorporating a clinical pharmacist in an outpatient palliative care team

Crystal Rim, PharmD; Sharon Leigh, PharmD, BCPS; Linda De Sitter MD, MPH; Mary Grant, ANP; Dana Nguyen, PharmD

Palliative care is a growing field in medicine that focuses on delivering care that improves quality of life for patients with serious illnesses. Often, the goals of palliative care differ from traditional goals of medicine. Currently, there is limited data demonstrating the integration of pharmacists in the palliative care setting. The purpose of this quality improvement is to evaluate the clinical pharmacist’s role within an outpatient palliative care team when performing …

First-In-Human Studies Of Mw01-6-189wh, A Brain-Penetrant, Antineuroinflammatory Small-Molecule Drug Candidate: Phase 1 Safety, Tolerability, Pharmacokinetic, And Pharmacodynamic Studies In Healthy Adult Volunteers, Linda J. Van Eldik, Lumy Sawaki, Karen Bowen, Daniel T. Laskowitz, Robert J. Noveck, Byron Hauser, Lynn Jordan, Tracy G. Spears, Huali Wu, Kevin Watt, Shruti Raja, Saktimayee M. Roy, D. Martin Watterson, Jeffrey T. Guptill

Sanders-Brown Center on Aging Faculty Publications

MW01-6-189WH (MW189) is a novel central nervous system-penetrant small-molecule drug candidate that selectively attenuates stressor-induced proinflammatory cytokine overproduction and is efficacious in intracerebral hemorrhage and traumatic brain injury animal models. We report first-in-human, randomized, double-blind, placebo-controlled phase 1 studies to evaluate the safety, tolerability, and pharmacokinetics (PK) of single and multiple ascending intravenous doses of MW189 in healthy adult volunteers. MW189 was safe and well tolerated in single and multiple doses up to 0.25 mg/kg, with no clinically significant concerns. The most common drug-related treatment-emergent adverse event was infusion-site reactions, likely related to drug solution acidity. No clinically concerning changes …

Imatinib-Induced Interstitial Pneumonitis – A Literature Review And Case Report, Olga Hilda Orasan, Andreea Maria Stefan, Iulia Minciuna, Adela Sitar-Taut, George Ciulei, Simina Tarmure, Ioana Para, Flaviu Muresan, Ovidiu Fabian, Sorina Cezara Coste, Vasile Negrean, Angela Cozma, Laura Urian

Journal of Mind and Medical Sciences

Imatinib is generally well tolerated, with mild common side effects such as nausea and vomiting, diarrhea, muscle cramps, fatigue, skin rash and edema; however, pulmonary complications are uncommon. A 73-year-old woman undergoing one month treatment with Imatinib for chronic myeloid neoplasm associated with eosinophilia was admitted for sudden alteration of her performance status, dyspnea at rest and productive cough. On clinical examination, the patient was hypoxic (oxygen saturation on room air was 87%), and auscultation of her lungs revealed diffuse bilateral fine crackles. Computed tomography showed bilateral pulmonary interstitial syndrome. Imatinib was discontinued and the patient received systemic corticosteroid therapy …

Risk Factors, Predictive Markers And Prevention Strategies For Intrauterine Fetal Death. An Integrative Review, Roxana Bohiltea, Natalia Turcan, Christina M. Cavinder, Ionită Ducu, Ioana Paunica, Liliana Florina Andronache, Monica Mihaela Cirstoiu

Journal of Mind and Medical Sciences

According to World Health Organization (WHO), fetal death is defined as the death of the fetus prior to its complete expulsion, independent of the duration of pregnancy, thus only ascribing the term stillbirth to fetal deaths in the case of pregnancies after 28 weeks of gestation. The great progress of perinatology care is reflected in a significant reduction in the rate of stillbirths, especially in well-developed countries, with approximately 98% of stillbirth cases now occurring in poor and developing countries. Stillbirth powerfully impacts both the patient and the practitioner. Because nearly half of stillbirth cases result from apparently uncomplicated pregnancies, …

Coronavirus Disease 2019 (Covid-19), Matthew Dunbar

Pharmacy Student Scholarship

No abstract provided.

Dementia: Types, What They Are And How They Differ, Jessica N. Schnetzer

Honors Thesis

Dementia: types, what they are and how they differ centers on the known and unknown complexities of dementia. Dementia is a very complex cognitive disease that consumes the brain, an organ of which we know very little about. Even so, this common disorder is actively being researched and is the topic of special interest of this thesis research. Described are Alzheimer’s disease, Creutzfeldt-Jakob disease, Frontotemporal dementia, Huntington’s disease, Korsakoff’s syndrome, Lewy body dementia, Parkinson’s dementia, and Vascular dementia, focusing on what they are, their specific risks, diagnosis, treatment, and their differing progressions. Guidance of this study provided by thesis director …

Using Medical Claims Database To Develop A Population Disease Progression Model For Leuprorelin-Treated Subjects With Hormone-Sensitive Prostate Cancer, Yixuan Zou, Fei Tang, Jeffery C. Talbert, Chee M. Ng

Pharmacy Practice and Science Faculty Publications

Androgen deprivation therapy (ADT) is a widely used treatment for patients with hormone-sensitive prostate cancer (PCa). However, duration of treatment response varies, and most patients eventually experience disease progression despite treatment. Leuprorelin is a luteinizing hormone-releasing hormone (LHRH) agonist, a commonly used form of ADT. Prostate-specific antigen (PSA) is a biomarker for monitoring disease progression and predicting treatment response and survival in PCa. However, time-dependent profile of tumor regression and growth in patients with hormone-sensitive PCa on ADT has never been fully characterized. In this analysis, nationwide medical claims database provided by Humana from 2007 to 2011 was used to …

The Use Of Urine Drug Testing For Risk Stratification And Efficacious Drug Monitoring In Pain Management Settings, Ahmad I. Hasan, Kareem Elhage, Brendan Farley, Khaled J. Saleh

Medical Student Research Symposium

Objective: To understand the current landscape of urine drug testing (UDT) guidelines as part of risk assessment for opioid abuse, and to offer recommendations towards adopting universal screening guidelines.

Background: There has been an opioid epidemic within the United States, and the role of prescription opioids has been well established. Despite proposed recommendations, there has yet to be a published universal screening guideline on the use of UDT in the setting of opioid abuse risk stratification as well as postoperative drug monitoring.

Methods: We explored current guidelines for UDT on two levels. First, we explore general indications for UDT within …

Flavonoids And Other Polyphenols Act As Epigenetic Modifiers In Breast Cancer., Priyanga Selvakumar, Aja Badgeley, Paige Murphy, Hina Anwar, Urvashi Sharma, Katharine Lawrence, Ashakumary Lakshmikuttyamma

College of Pharmacy Faculty Papers

Breast cancer is a common cancer that occurs due to different epigenetic alterations and genetic mutations. Various epidemiological studies have demonstrated an inverse correlation between breast cancer incidence and flavonoid intake. The anti-cancer action of flavonoids, a class of polyphenolic compounds that are present in plants, as secondary metabolites has been a major topic of research for many years. Our review analysis demonstrates that flavonoids exhibit anti-cancer activity against breast cancer occurring in different ethnic populations. Breast cancer subtype and menopausal status are the key factors in inducing the flavonoid's anti-cancer action in breast cancer. The dose is another key …

Serum Amyloid A Is Not Incorporated Into Hdl During Hdl Biogenesis, Ailing Ji, Xuebing Wang, Victoria P. Noffsinger, Drew Jennings, Maria C. De Beer, Frederick C. De Beer, Lisa R. Tannock, Nancy R. Webb

Saha Cardiovascular Research Center Faculty Publications

Liver-derived serum amyloid A (SAA) is present in plasma where it is mainly associated with HDL and from which it is cleared more rapidly than are the other major HDL-associated apolipoproteins. Although evidence suggests that lipid-free and HDL-associated forms of SAA have different activities, the pathways by which SAA associates and disassociates with HDL are poorly understood. In this study, we investigated SAA lipidation by hepatocytes and how this lipidation relates to the formation of nascent HDL particles. We also examined hepatocyte-mediated clearance of lipid-free and HDL-associated SAA. We prepared hepatocytes from mice injected with lipopolysaccharide or an SAA-expressing adenoviral …

Immunogenicity In Clinical Practice And Drug Development: When Is It Significant?, Valentina Shakhnovich, Bernd Meibohm, Amy Rosenberg, Andrzej M. Kierzek, Rachel Hasenkamp, Ryan S. Funk, Craig J. Thalhauser, Piet H. Van Der Graaf, Yow Ming C. Wang, Lora Hamuro

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Expression Of Tryptophan 2,3-Dioxygenase In Metastatic Uveal Melanoma, Mizue Terai, Eric R Londin, Ankit Rochani, Emma Link, Bao Lam, Gagan Kaushal, Alok Bhushan, Marlana Orloff, Takami Sato

Kimmel Cancer Center Faculty Papers

Uveal melanoma (UM) is the most common primary eye malignancy in adults and up to 50% of patients subsequently develop systemic metastasis. Metastatic uveal melanoma (MUM) is highly resistant to immunotherapy. One of the mechanisms for resistance would be the immune-suppressive tumor microenvironment. Here, we have investigated the role of tryptophan 2,3-dioxygenase (TDO) in UM. Both TDO and indoleamine 2,3-dioxygenase (IDO) catalyze tryptophan and produce kynurenine, which could cause inhibition of T cell immune responses. We first studied the expression of TDO on tumor tissue specimens obtained from UM hepatic metastasis. High expression of TDO protein was confirmed in all …

Lavender Aromatherapy: Ready For Prime-Time Office Use?, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The editor-in-chief of Journal of Patient-Centered Research and Reviews comments on the perioperative use of lavender aromatherapy and its potential to relieve pain and anxiety during minor primary care office procedures.

Anaphylaxis Diagnosis And Management In The Emergency Department Of A Tertiary Hospital In The Philippines, Michelle Joy De Vera, Iris Conela Tagaro

Ateneo School of Medicine and Public Health Publications

Background:
In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.

Objective:
Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.

Methods:
Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the …