Pharmacy and Pharmaceutical Sciences Commons^™

Evaluation Of Pharmacy-Implemented Medication Reconciliation Directed At Antiretroviral Therapy In Hospitalized Hiv/Aids Patients [Letter], Megan A. Corrigan, Kendra Atkinson, Beverly E. Sha, Christopher W. Crank

Scholarship and Professional Work – COPHS

Short communications published in Annals of Pharmacotherapy, 44(1).

Nutrition Support Therapy In Acute Kidney Injury: Distinguishing Dogma From Good Practice, Jane M. Gervasio, Ann B. Cotton

Scholarship and Professional Work – COPHS

Acute kidney injury (AKI) is a frequently observed complication in critically ill patients. Its presentation may range from the early risk of renal dysfunction to complete renal failure. Morbidity and mortality in the AKI patient increase with the decline of renal function. Appropriate nutrition therapy is essential in the medical management of the AKI patient. Assessment of nutritional requirements should take into account the patient’s underlying complication, comorbid medical conditions, and severity of the renal dysfunction. Various stages of AKI determine the direction of nutrition therapy. Additionally, understanding the macro- and micronutrient modifications and electrolyte and vitamin alterations that should …

Enhanced Student Learning And Public Health Awareness Through Capstone Projects, Jane M. Gervasio, Carriann E. Richey, Bruce G. Hancock, Iftekhar Kalsekar, Julie M. Koehler, Mary H. Andritz

Scholarship and Professional Work – COPHS

Abstract from the 110th Annual Meeting of the American Association of Colleges of Pharmacy, Boston, MA, July 18-22, 2009.

Developing An Assay To Profile Upregulated Trek-1, A Stretch-Activated Potassium Channel, In Prostate Cancer, Susan Abigal Surber

Undergraduate Honors Thesis Collection

Prostate cancer is the second leading cause of cancer death in American men. The disease prognosis is significantly limited by the finite therapeutic treatments. The limited treatment options are made worse by the significant reduction in the quality of life that often results from the severe side effects produced by these treatments.1 Therefore, any improvements of current treatments would be advantageous to the clinical setting. Recently, TREK-1, a tandem-pore domain (K2P) potassium channel, has been shown to be upregulated in prostate cancer, but absent in normal prostate tissue.2 The observation that TREK-1 expression is correlated with tumor malignancy suggests that …

Sildenafil For The Treatment Of Pulmonary Hypertension In Pediatric Patients, Alice J. Huddleston, Chad A. Knoderer, Jennifer L. Morris, Eric S. Ebenroth

Scholarship and Professional Work – COPHS

Sildenafil is a phosphodiesterase 5 inhibitor widely used for the treatment of pulmonary hypertension in children. Despite limited available safety and efficacy evidence, use of sildenafil continues to increase. To date, sildenafil use for pediatric pulmonary hypertension has been characterized for 193 children through 16 studies and 28 case series and reports. The primary efficacy data suggest that sildenafil is beneficial for facilitating the weaning of inhaled nitric oxide in children after cardiac surgery. Compiled safety data suggest that sildenafil is well tolerated among children with idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with congenital heart disease. This …

Administrators’ Perceptions Of Medication Management In Assisted Living Facilities: Results From Focus Groups, Priscilla T. Ryder, Melanie Joseph, Marnie Zuckermann, Ilene H. Zuckermann

Scholarship and Professional Work – COPHS

Objective: Assisted living (AL) residents are vulnerable to adverse events as a result of using numerous medications and frequently need assistance in administering medications. Very little is known, however, about the ways in which medications are managed within this level of care. Design: AL administrators from the metropolitan Baltimore, Maryland area were invited to participate in focus groups to explore issues involved in medication management.

Setting and Participants: Four administrators from smaller (15 beds or fewer) and six larger (more than 15 beds) certified AL facilities serving primarily older residents participated. Administrators must have served in their position at least …

Association Of Antipsychotic Use With Hospital Events And Mortality Among Medicare Beneficiaries Residing In Long-Term Care Facilities, Linda Simoni-Wastila, Priscilla T. Ryder, Jingjing Qian, Ilene H. Zuckermann, Thomas Shaffer, Lirong Zhao

Scholarship and Professional Work – COPHS

Objective—Antipsychotic (AP) utilization has grown significantly in long-term care (LTC) settings. Although a growing literature associates AP use with higher mortality in elderly with dementia, the association of APs with hospital events is unclear. The authors examine prevalence and trends in AP use by Medicare beneficiaries residing in LTC and the association of APs and other drug use variables with hospital events and mortality.

Design—Retrospective analysis using sequential multivariate Cox proportional hazards models.

Setting—Medicare Current Beneficiary Survey linked to Institutional Drug Administration and Minimum Data Set files.

Participants—A total of 2,363 LTC Medicare beneficiaries, 1999–2002. Measurements—Trends in LTC AP use …

Treatment Of Metastatic Renal Cell Carcinoma, David J. Reeves, Chin Y. Liu

Scholarship and Professional Work – COPHS

Purpose

To review the treatment of metastatic renal cell carcinoma (RCC), including the use of new targeted therapies.

Methods

A search of MEDLINE (1966 to August 2008) and American Society of Clinical Oncology Meeting abstracts (2005 to May 2008) was preformed using the search terms bevacizumab, everolimus, interferon-alfa (IFN-α), interleukin-2 (IL-2), sorafenib, sunitinib, temsirolimus, and RCC. Articles most pertinent to the treatment of metastatic RCC are reviewed.

Results

The treatment of metastatic RCC has undergone a paradigm shift over the past 5 years from biologic response modifiers to new targeted therapies. Historically, response rates for the biological response modifiers, aldesleukin …

Retrospective Evaluation Of Venous Thromboembolism Prophylaxis In The Adult Cancer Population, David J. Reeves, Chin Y. Liu

Scholarship and Professional Work – COPHS

Study objectives. Hospitalized cancer patients are at an increased risk for venous thromboembolism (VTE) and it is recommended they receive pharmacologic prophylaxis unless otherwise contraindicated. The majority of data supporting this recommendation comes from sub-group analyses and extrapolation of data gathered in general medical/surgical patients. This study seeks to assess the safety and efficacy of VTE prophylaxis in cancer patients admitted to our institution.

Methods. Charts of patients 18—89 years of age receiving VTE prophylaxis with unfractionated heparin, low molecular weigh heparin, or fondaparinux while admitted to Karmanos Cancer Center between September and October 2007 were retrospectively reviewed. Risk factors …

National Survey Of Introductory Pharmacy Practice Experience Programs, Patricia L. Darbishire, Trish Devine, Michael R. Holowatyj, Andrew N. Schmelz

Scholarship and Professional Work – COPHS

Objective: The objective of this study was to identify commonalities and provide a descriptive overview of key program elements and oversight of U.S. introductory pharmacy practice experience (IPPE) programs.

Methods: A Web-based questionnaire, consisting of 40 questions, was sent to 91 schools of pharmacy. The questionnaire addressed the following IPPE program topics, in addition to school demographics: program oversight, experience site selection, program structure, relationship to didactic curriculum, and quality assurance issues.

Results: Forty-six schools of pharmacy responded resulting in a response rate of 50.5%. Results identified commonalities in each of the key areas, as well as identifying multiple discrepancies …

Enhanced Student Learning And Scholarly Productivity Through Capstone Projects, Bruce G. Hancock, Jane M. Gervasio, Iftekhar Kalsekar, Julie M. Koehler, Mary H. Andritz

Scholarship and Professional Work – COPHS

Abstract from the American Association of Colleges of Pharmacy/Association of Faculties of Pharmacy of Canada Annual Meeting, Chicago, IL, July 16-24, 2008.

Impact Of Decmedetomidine On Opioid And Benzodiazepine Dosing Requirements In Children., Amy E. Helvie, Chad A. Knoderer, Iftekhar D. Kalsekar, Brandon T. Kibby, Michael S. Mazurek

Scholarship and Professional Work – COPHS

Poster presented at: Annual Update on Pediatric Cardiovascular Disease; February 2008; Scottsdale Arizona.

Fenoldapam For Acute Kidney Injury In Children, Chad A. Knoderer, Jeffrey D. Leiser, Corina Nailescu, Mark W. Turrentine, Sharon P. Andreoli

Scholarship and Professional Work – COPHS

We report two cases of children with severe cardiomyopathy requiring treatment with ventricular assist devices who developed acute kidney injury and were treated with fenoldopam. Therapy with fenoldopam appeared successful in one case in that renal replacement therapy was avoided with improvement in urine output and renal function. These are the first reported cases of fenoldopam use in children with acute kidney injury receiving mechanical circulatory support.

Use Of Sildenafil To Facilitate Weaning From Inhaled Nitric Oxide In Children With Pulmonary Hypertension Following Surgery For Congenital Heart Disease, Jaclyn E. Lee, Simon C. Hillier, Chad A. Knoderer

Scholarship and Professional Work – COPHS

Pulmonary hypertension frequently complicates the postoperative management of patients after congenital cardiac surgery. Inhaled nitric oxide is an effective treatment option, but rebound pulmonary hypertension can occur upon its withdrawal. Sildenafil may facilitate its withdrawal by restoring cyclic guanosine monophosphate availability via phosphodiesterase-5 inhibition. The purpose of this study was to evaluate the use of sildenafil in facilitating weaning from inhaled nitric oxide after congenital cardiac surgery in patients who had previously failed weaning, and to compare the effects of sildenafil on pulmonary and systemic hemodynamics. Children who received sildenafil after cardiovascular surgery during a 23-month period at Riley Hospital …

Survey Of Congenital Heart Surgeons’ Preferences For Antimicrobial Prophylaxis For Pediatric Cardiac Surgery Patients, Chad A. Knoderer, Emily M. Anderson, Elaine G. Cox

Scholarship and Professional Work – COPHS

Patients with congenital heart defects are a unique population with generally immature immune systems. Fragility in the postoperative period may contribute to surgical site infections (SSIs), a life threatening complication for this population. The need for postoperative antimicrobial prophylaxis for these patients is a standard of care that is indisputable. When choosing an antimicrobial regimen for surgical prophylaxis, consideration should be given to balancing the prevention of nosocomial infections, avoiding emergence of bacterial resistance, and minimizing drug toxicities and cost.

Racial And Ethnic Disparities In Treatment Of Dementia Among Medicare Beneficiaries, Ilene H. Zuckerman, Priscilla T. Ryder, Linda Simoni-Wastila, Thomas Shaffer, Masayo Sato, Lirong Zhao, Bruce Stuart

Scholarship and Professional Work – COPHS

Objectives—Numerous studies have documented disparities in health care utilization between non-Hispanic White and minority elders. We investigated differences in anti-dementia medication use between non-Hispanic White and minority community-dwelling Medicare beneficiaries with dementia.

Methods—Using multivariate analysis with generalized estimating equations, we estimated prevalence ratios (PRs) for anti-dementia medication use by race/ethnicity for 1,120 beneficiaries with dementia from years 2001 through 2003 of the Medicare Current Beneficiary Survey.

Results—After adjusting for demographics, socioeconomics, health care access and utilization, comorbidities, and service year, we found that anti-dementia medication use was approximately 30% higher among non-Hispanic Whites compared to other racial/ethnic groups (PR = …

Different Requirements Of The Swi/Snf Complex For Robust Nucleosome Displacement At Promoters Of Heat Shock Factor And Msn2- And Msn4-Regulated Heat Shock Genes, Tamara Y. Erkina, P. A. Tschetter, Alexander M. Erkine

Scholarship and Professional Work – COPHS

The stress response in yeast cells is regulated by at least two classes of transcription activators—HSF and Msn2/4, which differentially affect promoter chromatin remodeling. We demonstrate that the deletion of SNF2, an ATPase activity-containing subunit of the chromatin remodeling SWI/SNF complex, eliminates histone displacement, RNA polymerase II recruitment, and heat shock factor (HSF) binding at the HSP12 promoter while delaying these processes at the HSP82 and SSA4 promoters. Out of the three promoters, the double deletion of MSN2 and MSN4 eliminates both chromatin remodeling and HSF binding only at the HSP12 promoter, suggesting that Msn2/4 activators are primary determinants of …

Expansion Of Experiential Learning Opportunities Through Medication Reconciliation Participation, Jane M. Gervasio, Julie M. Koehler, Kevin M. Tuohy, Julie L. Williams, Mary H. Andritz

Scholarship and Professional Work – COPHS

Abstract from the American Association of Colleges of Pharmacy Annual Meeting, Orlando, FL, July 12-18, 2007.

Developing A Pharmacy Professional Elective Course: Underserved Populations, Courtney Ann Hedrick

Undergraduate Honors Thesis Collection

Objectives. To ascertain the current curriculum exposure, knowledge, and interest in medically underserved populations of 3rd and 4th year professional pharmacy students enrolled at Butler University. Methods. An eleven item survey was designed, involving multiple choice, Likert scale, and open response questions. The survey was administered through the web-based survey software company, Survey Monkey, utilizing the Butler College of Pharmacy and health Sciences email listserv to all P3 and p4 students. Results. P3 and P4 students showed a high degree of interest in taking a professional elective focusing on medically underserved populations. Many of these students also felt the current …

Pharmacy Security: A Survey On Pharmacists' Perceptions And And Preparedness To Handle Prescription Fraud And Pharmacy Robbery, Amy Nicole Lenell

Undergraduate Honors Thesis Collection

Objective: To evaluate the perceptions of the community pharmacist with respect to prescription fraud and pharmacy robbery as well as their preparedness to handle such situations, with the intent to assess the need for a continuing education program on this topic. Methods: A survey was sent to licensed Indiana pharmacists using a listserv provided by Butler University. Only data from pharmacists currently practicing in the community (retail) setting was accepted and analyzed. The survey includes questions regarding prescription fraud, pharmacy robbery, security measures and demographics. Results: Of 1000 surveys sent, 80 surveys were returned, 47 met selection criteria, and 43 …

Asthma In Focus, Shaunta' M. Ray, Sarah Nisly

Scholarship and Professional Work – COPHS

Book review of Asthma in Focus, by Anna Murphy.

Tobramycin-Induced Hepatotoxicity, Sarah A. Nisly, Shaunta' M. Ray, Robert A. Moye

Scholarship and Professional Work – COPHS

OBJECTIVE. To report a case of tobramycin-induced hepatotoxicity. CASE

SUMMARY: A 20-year-old female was hospitalized for treatment of Pseudomonas aeruginosa bacteremia and osteomyelitis. Empiric intravenous antibiotic therapy with piperacillin/tazobactam, vancomycin, and ciprofloxacin was started, and based on the results of culture and sensitivity testing, was changed to intravenous ceftazidime and tobramycin 70 mg every 8 hours on hospital day 3. Liver enzyme levels then increased over days 3–6. Tests for hepatitis A, B, and C were all nonreactive, and HIV testing was negative. On day 8, therapy was changed from ceftazidime to piperacillin/tazobactam and the tobramycin dose was increased …

Management Of Anthracycline Extravasation Injuries, David J. Reeves

Scholarship and Professional Work – COPHS

OBJECTIVE: To review the evidence for the management of anthracycline extravasation and determine the optimal treatment of such injuries.

DATA SOURCES: A search of MEDLINE (1966–February 2007) and International Pharmaceutical Abstracts (1970–February 2007) was performed using the search terms anthracyclines and extravasation.

DATA SYNTHESIS: Extravasation of anthracyclines can have devastating effects. After infiltration of these drugs into the interstitial tissue, damage may range from mild erythema and pain to severe tissue necrosis. Many agents have been studied in the management of these injuries; however, few have demonstrated efficacy and treatment remains controversial. Nonpharmacologic modalities shown to limit extravasation injuries include …

2005 American Society For Parenteral And Enteral Nutrition (A.S.P.E.N.) Standards And Guidelines Survey, David Seres, Charlene Compher, Douglas Seidner, Laura Byham-Gray, Jane M. Gervasio, Stephen Mcclave, A.S.P.E.N. Standards And Guidelines Committees

Scholarship and Professional Work – COPHS

An online survey about the use and format of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Standards and Guidelines documents was conducted. The survey was sent to A.S.P.E.N. members, and an acceptable number of responses were received (470, or 9% of those surveyed). Most respondents indicated an overall satisfaction with the standards and guidelines and suggested format changes, many of which will be incorporated into future guidelines and standards. The results of this survey are presented here for general interest. Changes in the process with which A.S.P.E.N. produces standards and guidelines are discussed.

Nutrition In The Critically Ill Patient, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Critical illness presents with the classic response to stress, including hypermetabolism and increased catabolism, resulting in a negative energy and nitrogen balance. These harmful events initiate the immunological response, starting with the systemic inflammatory response syndrome, which, if not resolved, may lead to multiple organ dysfunction syndrome (MODS). Furthermore, patients who do not develop early MODS manifest a compensation anti-inflammatory response syndrome, which suppresses immunity and predisposes the patient to sepsis, thereby ­increasing the risk of late MODS and ultimately death. The use of specialized nutrition support, including enteral nutrition (EN) and parenteral nutrition (PN), has been initiated in an …

Bowel Necrosis Associated With Enteral Feeding, Jane M. Gervasio, Ryan Ednalino, Jennifer Reynolds, Gary P. Zaloga

Scholarship and Professional Work – COPHS

Abstract from Clinical Nutrition Week, Dallas, TX, February 12-15, 2006.

Cyclooxygenase-2 Expression In Hamster And Human Pancreatic Neoplasia, Pamela L. Crowell, C. Max Schmidt, Michele T. Yip-Schneider, Jesse J. Savage, Dean A. Hertzler Ii, William O. Cummings

Scholarship and Professional Work – COPHS

Cyclooxygenase-2 (COX-2) has been implicated in the development of gastrointestinal malignancies. The aim of the present study was to determine COX-2 expression/activity throughout stages of experimental and human pancreatic neoplasia. COX-2 immunohistochemistry was performed in pancreata of hamsters subjected to the carcinogen N-nitrosobis-(2-oxopropyl)amine (BOP) and in human pancreatic tumors. COX-2 activity was determined by prostaglandin E₂ assay in tumor versus matched normal pancreatic tissues. The activity of the COX inhibitor sulindac was tested in the PC-1 hamster pancreatic cancer model. COX-2 expression was elevated in all pancreatic intraepithelial neoplasias (PanINs) and adenocarcinomas. In BOP-treated hamsters, there were significant …

Displacement Of Histones At Promoters Of Saccharomyces Cerevisiae Heat Shock Genes Is Differentially Associated With Histone H3 Acetylation, Tamara Y. Erkina, Alexander M. Erkine

Scholarship and Professional Work – COPHS

Chromatin remodeling at promoters of activated genes spans from mild histone modifications to outright displacement of nucleosomes in trans. Factors affecting these events are not always clear. Our results indicate that histone H3 acetylation associated with histone displacement differs drastically even between promoters of such closely related heat shock genes as HSP12, SSA4, and HSP82. The HSP12 promoter, with the highest level of histone displacement, showed the highest level of H3 acetylation, while the SSA4 promoter, with a lower histone displacement, showed only modest H3 acetylation. Moreover, for the HSP12 promoter, the level of acetylated H3 …

Nutritional Support In The Acute Care Patient Post-Ventricular Assist Device Placement, Abby Re, Jane M. Gervasio, Robert D. Warhurst, Gary P. Zaloga

Scholarship and Professional Work – COPHS

Abstract from American College of Clinical Pharmacy Annual Meeting, San Francisco, CA, October 23-26, 2005.

Blood Glucose Concentration Does Not Correlate With Organ Failure Or Outcome In Trauma Patients Receiving Enteral Nutrition, Jennifer L. Ash, Jane M. Gervasio, Gary P. Zaloga, George H. Rodman Jr.

Scholarship and Professional Work – COPHS

Abstract from American College of Clinical Pharmacy 2005 Spring Practice and Research Forum/Updates in Therapeutics, Myrtle Beach, SC, April 10-13, 2005.