Pharmacy and Pharmaceutical Sciences Commons^™

Mitigating The Risk Of Qtc Prolongation When Using Haloperidol For Acute Treatment Of Cannabinoid Hyperemesis Syndrome In Adolescents And Young Adults, Sandra Merino, Lissette Tordera, Allison Jun, Sun Yang

Pharmacy Faculty Articles and Research

Background/Objectives: Cannabinoid Hyperemesis Syndrome (CHS), associated with long-term cannabinoid use, has been increasingly observed in emergency room visits as more states in the U.S. have legislatively permitted medical and recreational marijuana use. The acute management of CHS primarily focuses on antiemetic treatment and supportive care. However, both the condition itself and the antiemetic drugs, such as haloperidol, may cause QTc prolongation. Methods: We reported two adolescent cases admitted to the emergency department for acute antiemesis management of CHS who received haloperidol treatment. A literature review was performed through October 2024 for previously published cases of QTc prolongation and/or …

Fda Approval Of Zuranolone: A Breakthrough Treatment For Postpartum Depression, Connor Dains, Makayla Eversole, Kiley Devoll, Daniella Egbujor, Marisa Petrunich, Madilyn Paphanchith, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza

Pharmacy and Wellness Review

Postpartum depression (PPD) is a serious medical condition that increases the risk of postpartum mortality and affects the ability of a postpartum individual to take care of their newborn. Until 2023, intravenously-administered brexanolone was the only Food and Drug Administration (FDA)-approved medication for PPD. Brexanolone’s route of administration poses significant barriers to accessibility and convenience. Other treatment options, such as psychotherapy and antidepressants, often require long-term commitment and may not provide rapid relief for severe symptoms. In August 2023, the FDA approved zuranolone as an oral medication for PPD, which enhances treatment accessibility and offers patients a more flexible, outpatient …

Effects Of Sex And Estrous Cycle On Extended-Access Oxycodone Self-Administration And Cue-Induced Drug Seeking Behavior, Bhumiben P Patel, Jessica A Loweth

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Increasing evidence indicates that sex is a factor that impacts the abuse liability and relapse vulnerability of prescription opioids like oxycodone. However, while women are more likely than men to be prescribed and to use these drugs, the impact of sex and ovarian hormones on prescription opioid use and relapse vulnerability remains unclear. Accurately assessing these measures is complicated by the fact that chronic opioid exposure can lower ovarian hormone levels and cause cycle irregularities.

METHODS: Adult male and female Sprague-Dawley rats self-administered oxycodone (0.1 mg/kg/infusion) under extended-access conditions (6 h/day, 10 days) followed by forced abstinence. Separate groups …

The Efficacy Of Cannabis As A Substitute Addiction For Opiates, Clark Furlong

Theses and Graduate Projects

Background: Approaches to opiate addiction focus on abstinence and/or a harm reduction model that often utilizes substitute medications. Methadone and suboxone are the most prescribed drugs for opiate maintenance therapy. The long-term side effect profile and health consequences are undesirable. Research is looking for healthier alternatives.

Purpose: Opiate maintenance therapy participants have a mortality rate greater than twelve times that of the normal population, we seek to discover if cannabis can be a useful/safer alternative.

Methods: Following a comprehensive literature review a 7-question online survey was designed with SurveyMonkey to gauge current Augsburg students’ perception of cannabis as an alternative …

Unmc Quick Checks: An “Opt-Out” Model For Health Profession Student Appointments With Mental Health Counseling Services, Hannah K. Tandon Md, Taylor J. Kratochvil Md, Ms, Katherine L. Keiser Ms, Limhp, Nicole J. Kent Bs, Kaitlyn E. Schultis Bs, Jeffrey W. Knapp Msw, Jeffrey P. Gold

Innovations in Health Sciences Education Journal

Background: Health professions trainees experience high rates of anxiety and depression but are often reluctant to seek help. Institutional outreach during pre-clinical training may identify vulnerable students, improve resource awareness, and destigmatize psychological counseling. The University of Nebraska Medical Center (UNMC) Quick Check program is a novel opt-out program connecting health professions students to mental health counselors.

Objective: The purpose of this study was to evaluate student perceptions and utilization of mental health resources after participation in the UNMC Quick Check program.

Methods: For this limited pilot study, second-year pharmacy students were assigned to UNMC Quick Check appointments with UNMC …

Formative Research About Shared Decision Making In The Treatment Of Opioid Use Disorder In Pregnant Women, Ruth Jeminiwa, Phd, Fadel Dadabaev, Pharmd, Heeyoung Kim, Pharmd, Caroline Popielaski, Pharmd, Sohyeon Park, Pharmd, Meghan Gannon, Phd Msph, Diane Abatemarco, Phd, Msw, Ronald Myers, Phd, Dsw

College of Pharmacy Posters

Background

• Shared Decision Making (SDM) is an evidence-based practice that involves a discussion between a health care professional and patient to reach a mutual agreed upon treatment plan.(1)
• A recent nationally-representative study indicates that only 39% of physicians use SDM for 50% or fewer Pregnant Women with Opioid Use Disorders (PWOUD).(2)
• Little is known about factors that affect SDM among PWOUD. This research project aimed to address this knowledge gap.

Naloxone: From Legislation To Distribution, Kailyn Elliot, Emily Stewart, John Delfeld

2024 Swedish Learning and Celebration Day

No abstract provided.

Pharmacokinetic Analysis Of A Phenobarbital Overdose Treated With Urinary Alkalinization Alone, Justin Seltzer, Jeremy Hardin, Henrik Galust, Nathan Friedman, Bryan Corbett, Richard F Clark

Faculty, Staff and Student Publications

Phenobarbital is a long-acting barbiturate used to treat alcohol withdrawal and epilepsy. Acute overdoses present with varying levels of central nervous system depression and large overdoses can be life threatening. Phenobarbital is an attractive candidate for enhanced elimination using urinary alkalinization given it is a weak acid with a long half-life and extensive urinary elimination. Limited human data exist regarding use of urine alkalinization for the treatment of phenobarbital overdose. We present a fourteen-year-old female who was treated with urinary alkalinization alone following an intentional ingestion of 3800 mg (84.4 mg/kg) of phenobarbital tablets. Urine drugs of abuse screening was …

A Cost-Effectiveness Analysis Of Telehealth Vs. Office-Based Delivery Of Buprenorphine At The Addiction And Substance Abuse Program (Asap) Clinic - University Of New Mexico Hospital: A Societal Perspective, Rana Alkhafaji

Pharmaceutical Sciences ETDs

This study evaluates the cost-effectiveness of office-based versus telehealth delivery of buprenorphine treatment for opioid use disorder (OUD). A retrospective chart review of 135 patients at the University of New Mexico Hospital's Addiction and Substance Abuse Program compared retention rates and costs between the two settings. Retention was defined as continuous treatment for at least six months. No statistically significant difference in retention rates was found, with 51% for office-based and 42% for telehealth. However, office-based treatment had higher total costs, with an incremental cost-effectiveness ratio of $3,750 per 1% increase in retention. The findings suggest telehealth is a cost-effective …

Student Pharmacists Educating Patients On Proper Disposal Of Unused Opioid Medications, Ashley Ann Uy, Jessica Cao, Anthony Esposito, Colleen Carrigan, Siddharth Pant, Ashley Kim, Kaylen Louie, Efrain Santiago, Richard Pacitti, Pharmd, Mba, Fashp, Joseph Stavish, Pharmd, Msph, Nicholas Leon, Pharmd, Bcacp, Fcpp

Health Equity and Quality Improvement (HEQI) Summit

Background

• The opioid epidemic is a public health crisis characterized by illicit drug abuse like heroin, fentanyl, and opioid medications (oxycodone and morphine)
• Improper disposal of unused opioids contribute to the opioid epidemic
• Jefferson Health places high importance on opioid stewardship to mitigate the public health risks associated with unused opioids.

Opioid Prescription Rates Before And After Alto Program And Various Factors Affecting Emergency Department Opioid Prescription Rates, Neel B. Patel, James F. Baird

Rowan-Virtua Research Day

Opioid prescription rates vary between patient population, diagnosis, location, and emergency department characteristics. High prescription rates offer an avenue for potential opioid addiction and overdoses. Alternatives to opioids (ALTO) is a new program already implemented in certain emergency departments to help change opioid prescription rates by introducing new protocols for first line treatments for pain management. With current trends still showing that South Jersey opioids prescription rates are the highest in the state of New Jersey, ALTO was introduced at Inspira Health Network located in South Jersey. This study retrospectively analyzed opioids prescription rates for abdominal pain, renal colic, migraines, …

Education Of The Effects Of Obesity Medications And A Stepwise Approach To Mitigate Prevalence And Encourage Lifestyle Medicine For Primary Care Physicians, Kiely M. Curran

Department of Nutrition Student Projects

My Capstone project is an Educational Manual that emphasizes a healthcare team approach to the treatment and management of obesity. The Educational Manual consists of a standardized protocol in management of obesity in patients and a document with summarized references for primary care providers; and a simplified document for patient education. There is a growing interest in the usage of obesity medications. The purpose of my Capstone project is to provide a simplified manual for the primary care provider to reference to make knowledgeable and patient-centered decisions in the prescription of obesity medications and decisions in weight-management. My methodology included …

Real-World Dispensing Of Buprenorphine In California During Prepandemic And Pandemic Periods, Yun Wang, Alexandre Chan, Richard Beuttler, Marc L. Fleming, Todd Schneberk, Michael Nichol, Haibing Lu

Pharmacy Faculty Articles and Research

Introduction: The opioid overdose crisis in the United States has become a significant national emergency. Buprenorphine, a primary medication for individuals coping with opioid use disorder (OUD), presents promising pharmacokinetic properties for use in primary care settings, and is often delivered as a take-home therapy. The COVID-19 pandemic exacerbated the scarcity of access to buprenorphine, leading to dire consequences for those with OUD. Most existing studies, primarily focused on the immediate aftermath of the COVID-19 outbreak, highlight the challenges in accessing medications for opioid use disorder (MOUDs), particularly buprenorphine. However, these studies only cover a relatively short timeframe. Methods: To …

Retrospective Review Of Phenobarbital Versus Lorazepam For Alcohol Withdrawal Syndrome In The Emergency Department, Spencer Hayashi, Savita Bathija, Pharmd, Bcemp, Paul Vanemmerik, Nishat Mujeeb, Chris De Las Alas

Books, Presentations, Posters, Etc.

Abstract: According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in the US, alcohol use contributes to up to five million emergency department (ED) visits annually. Alcohol withdrawal syndrome (AWS) is a serious and potentially life-threatening condition that can lead to complications such as hallucinations, seizures, and delirium tremens. For many years, the standard treatment for AWS has been symptom-triggered benzodiazepines, often dosed based on symptom scoring tools such as the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) Score. In recent years, the use of phenobarbital for AWS management has gained popularity, and studies investigating its safety and …

Acute Pain Management Of Hospitalized Patients On Medication-Assisted Therapies (Mat) For Opioid Use Disorder (Oud), Ryan Bower, Roland Mikkaeil, Emily H. Hsu, Tracee Mock

Books, Presentations, Posters, Etc.

Abstract: Buprenorphine has been an instrumental tool in Medication Assisted Therapies (MAT) for opioid use disorder (OUD). For hospitalized patients on MAT, the management of acute pain presents a unique challenge to health care providers. A previous study examining buprenorphine discontinuation patterns on medical/surgical floors found that 11.8% of patients had their buprenorphine discontinued due to inadequate analgesia. Furthermore, none of these patients had their buprenorphine restarted prior to discharge. Discontinuation of buprenorphine in hospitalized patients has the potential for wide-reaching implications ranging from risk of withdrawal to relapse secondary to patient loss during the transition from inpatient to outpatient …

A Closer Look At The Humanistic Aspects Of The Opioid Epidemic And Its Implications For Pharmaceutical Ethics And Law, Eriel Burns

Gaines Fellow Senior Theses

This paper elucidates the humanistic elements of this crisis, that is, the ethical challenges it poses and the role of culture in it. The opioid crisis disturbs several bioethics principles as indicated by the fact that it burgeoned out of the health care system as opposed to the illicit environments of the underground market. The book Dreamland by investigative journalist and storyteller, Sam Quinones encapsulates the complexity of the opioid epidemic through research and interviews with important figures related to the crisis such as physicians, people with opioid use disorder, and pharmaceutical sales representatives, among others. Quinones details that the …

The Role Of Microglia In Sex- And Region-Specific Blood-Brain Barrier Integrity During Nicotine Withdrawal, Mohit Kumar, Jack V. Keady, Surya P. Aryal, Marissa Hessing, Christopher I. Richards, Jill R. Turner

Pharmaceutical Sciences Faculty Publications

BACKGROUND: Smoking is the largest preventable cause of death and disease in the United States, with ,5% of quit attempts being successful. Microglia activation and proinflammatory neuroimmune signaling in reward neuro- circuitry are implicated in nicotine withdrawal symptomology. Microglia are integral regulators of blood-brain barrier (BBB) functionality as well; however, whether the effects of nicotine withdrawal on microglia function impact BBB integrity is unknown.

METHODS: Mice were treated with chronic nicotine (12 mg/kg/day) and subjected to 48 hours nicotine withdrawal. Regional BBB permeability, together with messenger RNA and protein expression of tight junction proteins, were assessed. PLX5622 chow was used …

Evidence Synthesis Methodology: Promoting Reproducible Methodology Through Modified Assignments, Laura Lipke, Neyda Gilman

Library Created Resources

Initially, systematic reviews in healthcare served to synthesize findings from clinical studies, aiding comprehensive access to the most effective treatments within evidence-based practice. Over time, their scope has broadened beyond treatment effectiveness, leading to a surge in publication. Consequently, many health science faculty now assign systematic reviews in classrooms without a full grasp of the standardized process, leaving students ill-equipped due to insufficient guidance and resources.

While mastering systematic review techniques is crucial for evidence-based practice, faculty can opt for modified assignments to foster a deeper understanding of the review process. These modified tasks, can be completed within a semester, …

Clinical Practice Guideline For The Management Of Depression In Primary Care, Estrella Catherine Villarreal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: The prevalence of depression poses a significant challenge in primary care, emphasizing the urgent need to address this issue during patient visits. Primary care providers are at the forefront of managing depression, yet they encounter difficulties in screening, diagnosing, assessing, and treating this complex condition. Clinical guidelines serve as valuable tools for primary care providers and practices, offering support in identifying and addressing depression effectively. An evidence-based approach to treating depression in primary care, with a focus on collaborative interventions with behavioral health to enhance depression management for American Indian/Alaskan Native (AI/AN) communities.

Methods: The descriptive analysis was conducted …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

Repurposing Egfr Inhibitors For Oral Cancer Pain And Opioid Tolerance, Maria Daniela Santi, Morgan Zhang, Naijiang Liu, Chi T Viet, Tongxin Xie, Dane D Jensen, Moran Amit, Huilin Pan, Yi Ye

Faculty, Staff and Student Publications

Oral cancer pain remains a significant public health concern. Despite the development of improved treatments, pain continues to be a debilitating clinical feature of the disease, leading to reduced oral mobility and diminished quality of life. Opioids are the gold standard treatment for moderate-to-severe oral cancer pain; however, chronic opioid administration leads to hyperalgesia, tolerance, and dependence. The aim of this review is to present accumulating evidence that epidermal growth factor receptor (EGFR) signaling, often dysregulated in cancer, is also an emerging signaling pathway critically involved in pain and opioid tolerance. We presented preclinical and clinical data to demonstrate how …

Quantification Of Observable Behaviors Following Oral Administration Of Oxycodone And Nalfurafine In Male Rhesus Monkeys, Sally L. Huskinson, Donna M. Platt, Zachary R. Smith, William S. Doyle, C. Austin Zamarripa, Kristen Dunaway, Thomas E. Prisinzano, Kevin B. Freeman

Pharmaceutical Sciences Faculty Publications

BACKGROUND: Recent preclinical studies have investigated the atypical kappa-opioid receptor (KOR) agonist, nalfurafine, as a co-formulary with mu-opioid receptor (MOR) agonists as a potential deterrent for misuse. However, no study has investigated effects of nalfurafine combined with a MOR agonist using an oral route of administration. The objective of the current study was to measure behavioral effects of orally administered oxycodone and nalfurafine, alone and combined, in rhesus monkeys using a quantitative behavioral observation procedure.

METHODS: Adult male rhesus monkeys (N=5) were orally administered vehicle, oxycodone (0.56-1.8mg/kg), nalfurafine (0.001-0.0056mg/kg), or mixtures (1.0mg/kg oxycodone/0.001-0.0056mg/kg nalfurafine) in a Jell-O vehicle at multiple …

Addressing The Crisis: Leveraging The United Nations Sustainable Development Goals To Prepare Student Leaders To Tackle The Opioid Epidemic, Sharon Xavioer, Laressa Bethishou, Madeline Dintzner, Reza Taheri, Jelena Lewis

Pharmacy Faculty Articles and Research

The United States faces several ongoing public health issues including the opioid epidemic. This article describes a new model aimed at providing a framework that incorporates the United Nations (UN) Sustainable Development Goals (SDGs) to develop pharmacy student leaders through education, experiences, and development of critical skills. This holistic approach can serve as an example methodology to equip future leaders across public health domains to tackle many of the critical problems we face today.

The Effectiveness Of Serotonin And Tricyclic Antidepressants In Tinnitus Management: A Rapid Review, Dr. Emilie Vos, Dr. Nannette Nicholson, Melinda Johnson, Dr. Karah Gottschalk

Internet Journal of Allied Health Sciences and Practice

Background: Tinnitus can be defined as a health condition characterized by the perception of sound, either in the head and/or ears, in the absence of any external acoustic stimulus. Perception is often quantified by self-report, or the use of patient reported outcome measures (PROMs). The purpose of this rapid review was to evaluate the level and quality of evidence regarding the use of serotonin and norepinephrine reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI), and tricyclic antidepressants as measured by tinnitus patient-reported outcome measures (PROMs) and/or Visual Analog Scales (VAS). Methods: The Cochrane Rapid Review guidelines were followed. The PICO …

Α7 Nicotinic Acetylcholine Receptor Interaction With G Proteins In Breast Cancer Cell Proliferation, Motility, And Calcium Signaling, Murat Oz, Justin R. King, Keun-Hang Susan Yang, Sarah Khushaish, Yulia Tchugunova, Maitham A. Khajah, Yunus A. Luqmani, Nadine Kabbani

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Chronic smoking is a primary risk factor for breast cancer due to the presence of various toxins and carcinogens within tobacco products. Nicotine is the primary addictive component of tobacco products and has been shown to promote breast cancer cell proliferation and metastases. Nicotine activates nicotinic acetylcholine receptors (nAChRs) that are expressed in cancer cell lines. Here, we examine the role of the α7 nAChR in coupling to heterotrimeric G proteins within breast cancer MCF-7 cells. Pharmacological activation of the α7 nAChR using choline or nicotine was found to increase proliferation, motility, and calcium signaling in MCF-7 cells. This effect …

Geospatial Analysis Of Opioid Dispensing Patterns In California: A 2021 Real-World Study, Hongxia Lu, Jianwei Zheng, Yun Wang

Pharmacy Faculty Articles and Research

The misuse and abuse of opioids has become a serious public health threat in the United States. The state of California has been hit particularly hard by the opioid epidemic, with a noticeable increase in opioid-related fatalities and hospitalizations. This brief report paper aims to contribute to the growing literature by conducting a geospatial analysis of opioid dispensing patterns in California in 2021. The primary objective was to identify areas characterized by high-risk opioid dispending patterns and explore possible contributing factors. This retrospective study analyzed data from over 7 million records of opioid and benzodiazepine prescriptions dispensed by outpatient pharmacies …

Alcohol As A Modifiable Risk Factor For Alzheimer’S Disease—Evidence From Experimental Studies, Devaraj V. Chandrashekar, Ross A. Steinberg, Derick Han, Rachita K. Sumbria

Pharmacy Faculty Articles and Research

Alzheimer’s disease (AD) is a progressive neurodegenerative disease characterized by cognitive impairment and memory loss. Epidemiological evidence suggests that heavy alcohol consumption aggravates AD pathology, whereas low alcohol intake may be protective. However, these observations have been inconsistent, and because of methodological discrepancies, the findings remain controversial. Alcohol-feeding studies in AD mice support the notion that high alcohol intake promotes AD, while also hinting that low alcohol doses may be protective against AD. Chronic alcohol feeding to AD mice that delivers alcohol doses sufficient to cause liver injury largely promotes and accelerates AD pathology. The mechanisms by which alcohol can …

Factors Affecting Initiation And Retention Of Medication-Assisted Recovery (Mar) Within A Pilot Pharmacist-Involved Practice Model At A Federally Qualified Healthcare Center (Fqhc) During The Covid-19 Pandemic, Tiffany Nguyen, Thomas Craig Cheetham, Souhiela Fawaz, Richard Beuttler, Sharon Xavioer

Pharmacy Faculty Articles and Research

Background: During the COVID-19 pandemic, opioid-related overdose deaths increased. Although Medication-Assisted Treatment or Recovery (MAT or MAR) is available, initiation and retention rates vary. The goal of this study was to evaluate clinical, demographic, and Social Determinant of Health factors affecting MAR initiation, on-time initiation of medications, and successful retention in the program. The secondary goal was to evaluate the impact of a novel interprofessional practice model incorporating pharmacists. Methods: A retrospective analysis was conducted using electronic health record data from a pilot MAR Program initiated within a California Federally Qualified Healthcare Center. Results: From September 2019 to August 2020, …