Pharmacy and Pharmaceutical Sciences Commons^™

A Retrospective Review Of The Effects Of Patient Financial Assistance On Glycemic Control In Adults With Type 1 And Type 2 Diabetes Mellitus, Renee Kuess, Rachele Subik, Alexander Hill, Ron Carico Jr

Marshall Journal of Medicine

This study examined the effects of patient financial assistance on glycemic control in patients with type I and type II diabetes mellitus. Records for patients in our institution's endocrinology clinic who were enrolled in patient financial assistance were reviewed retrospectively. Patients were included if they were age 18 years or older, diagnosed with type I or II diabetes mellitus, enrolled in patient assistance through either manufacturer programs or our institution’s program, and had at least 6 months of glycemic data (i.e., A1c) prior to patient assistance enrollment and 6 months after, excluding 6 months of washout immediately after enrollment. A1c …

Unlocking Hope: Mirtazapine's Promise In Obsessive-Compulsive Disorder Treatment, Rebecca K. Hicks, Iram Kingson, Jordan Gaal, Suzanne Holroyd

Marshall Journal of Medicine

Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). While selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) are first-line treatments for OCD, a significant proportion of patients remain refractory to these interventions. Mirtazapine, an atypical antidepressant with unique pharmacological properties, has emerged as a potential adjunctive therapy for treatment-resistant OCD. This review synthesizes existing evidence regarding the efficacy and safety profile of mirtazapine in OCD management. We analyze clinical trials, observational studies, and case reports, distinguishing high- vs. low-quality evidence, and discuss mechanisms underlying mirtazapine's therapeutic effects. Additionally, …

In Vitro Dihalobenzene Nephrotoxicity In Isolated Kidney Cells, Jana Ahmed Sherif

Theses, Dissertations and Capstones

Brominated and chlorinated benzenes are common industrial chemicals linked to kidney injury. This study evaluated the nephrotoxicity of several mono- and dihalogenated derivatives using isolated kidney cells from male Fischer 344 rats. LDH release and trypan blue exclusion were measured after 30- and 60-minute exposures to 0.25–1.0 mM to test compounds. Toxicity increased with increased concentration and longer times. Mixed-halogen bromobenzenes, particularly 1-bromo-4-chlorobenzene, showed one of the highest toxicity levels, while 1,4dichlorobenzene was the most toxic chlorobenzene. Antioxidants (glutathione, ascorbate, and αtocopherol) markedly reduced injury, indicating oxidative mechanisms play a role in toxicity. cytochromes P450 (CYP) inhibitors (piperonyl butoxide and …

Evaluation Of The Physical Properties And In Vitro Safety Of Chitosan-Quercus Infectoria Topical Gel, Rani Naga Rakshitha Tillapudi

Theses, Dissertations and Capstones

Due to ongoing inflammation, inadequate blood flow, oxidative stress, and reduced tissue regeneration, chronic diabetic wounds heal slowly, which is a serious health concern. It is important to examine novel strategies that tackle these issues because conventional treatments frequently fail. Therefore, this study examined the physical properties and biocompatibility of a novel topical gel formulated with chitosan and Quercus infectoria gall extract.

Over 28 days, pH, spreadability, texture, homogeneity, color, and drug concentration were assessed. UV-visible spectrophotometry and FTIR analysis were used to establish chemical stability. The MTT assay was used to test its safety in human dermal fibroblast adult …

Nanocomposite Mediated Delivery Of 5-Fluorouracil Using Silver Nanoparticles To Promote Wound Healing, Kamal Nath Kasi

Theses, Dissertations and Capstones

Chronic wounds, particularly in diabetic patients, remain a significant clinical challenge due to the complex interaction of persistent infection, chronic inflammation, and impaired cellular regeneration. Conventional drug therapies often fail to achieve effective treatment due to rapid drug degradation, poor targeting, and localized toxicity. This study explores a nanotechnology-based approach by developing and evaluating 5-FU loaded AgNP (AgNP–5FU) as a controlled drug delivery system. AgNP (AgNP) were synthesized and characterized using scanning electron microscopy (SEM), energy dispersive X-ray (EDX) analysis, particle size, and zeta potential analysis, while Fourier Transform Infrared Spectroscopy (FTIR) analysis suggested possible interaction between 5-FU and the …

Development And In Vitro Characterization Of 5-Fluorouracil–Loaded Plga Nanoparticles For Controlled Drug Delivery, Kavya Yandapalli

Theses, Dissertations and Capstones

Non-Alcoholic Fatty Liver Disease (NAFLD) is a progressive metabolic disorder characterized by excessive lipid accumulation in hepatocytes and chronic inflammation. Nanoparticle-based drug delivery systems offer a promising strategy to enhance therapeutic efficacy while minimizing systemic toxicity. The objective of this study is to formulate and characterize 5-FU–loaded PLGA nanoparticles and evaluate their in vitro performance. 5-FU–loaded PLGA nanoparticles were prepared using the double emulsion solvent evaporation method. The nanoparticles were characterized by particle size, polydispersity index, zeta potential and SEM. Drug encapsulation efficiency, loading capacity and in vitro drug release studies were conducted. The formulated nanoparticles exhibited sizes within the …

Developing Curcumin Analogues For Treating Breast Cancer, Tulasi Laxmi Nutalapati

Theses, Dissertations and Capstones

Breast cancer is still one of the most common types of cancer and one of the most common causes of cancer-related deaths in women around the world. Despite significant advances in early detection and treatment strategies, drug resistance, systemic toxicity, and poor outcomes in aggressive subtypes continue to limit the overall effectiveness of cancer therapy. Natural compounds have become promising anticancer agents because they can target many different things and are not very toxic. Curcumin has shown promise as an anticancer drug, but it cannot be used in the clinic because it does not absorb well, breaks down quickly, and …

Confronting The Mental Health Crisis: Structural Inequities, Market Pressures, And The Role Of Pharmacy Solutions, Kasi Gorli, Thomas L. Pile, Craig Kimble, Alberto Coustasse

Management Faculty Research

The mental health crisis in the US is severe, with depression and anxiety leading causes of disability among young adults. The mental health services market is growing, but access to care remains inconsistent, particularly in rural and underserved areas. Pharmacists are playing a crucial role in mental health care, improving medication adherence and patient outcomes through collaborative practice agreements. Systemic reform is needed to address barriers such as affordability and social determinants, with pharmacists integral to closing care gaps.

Intelligent Pharmacy: Leveraging Ai And Automation To Enhance Patient Care And Pharmacist Roles, Craig Kimble, Alberto Coustasse, Kasi Gorli, Thomas L. Pile

Management Faculty Research

AI and automation in pharmacies enhance clinical care, operational efficiency, and workforce optimization, with widespread adoption in hospitals and retail chains. Key benefits include reduced medication errors, improved patient satisfaction, and increased pharmacist productivity, allowing focus on higher-value clinical roles. Challenges include high initial costs, cybersecurity concerns, and resistance to change, necessitating thoughtful planning and stakeholder engagement. Preparing pharmacy students for technology-driven environments is essential for successful AI integration and ethical oversight in pharmacy practice.

Use Of Naltrexone For Treating Binge Eating And Food Obsession Related To Trauma: A Case Report And Literature Review, Rebecca K. Hicks, Iram Kingson, Jordan Gaal, Suzanne Holroyd

Marshall Journal of Medicine

Impulse-control disorders, including those related to eating behaviors, are complex conditions with limited pharmacologic treatment options. While naltrexone is primarily used for opioid and alcohol dependence, emerging research suggests it may also be effective in managing a variety of impulse-driven conditions. As a pure opioid antagonist, naltrexone’s mechanism of action involves the inhibition of opioid receptors on dopaminergic neurons involved in the reward pathway of the brain, thereby reducing the reinforcing effects of substances such as alcohol and opioids. Research suggests that through this mechanism of action, naltrexone shows promise in treating impulsive behaviors also driven by the reward pathway, …

The Promise Of Psilocybin-Assisted Therapy For Opioid Use Disorder, Craig Kimble, Alberto Coustasse

Management Faculty Research

The opioid epidemic presents a profound and escalating public health and economic crisis in the United States. According to the CDC, the economic burden of opioid use disorder and fatal opioid overdose in the U.S. reached an estimated $1.02 trillion in 2017 alone, encompassing healthcare costs, lost productivity, criminal justice expenditures, and premature mortality. While current pharmacologic treatments—such as methadone, buprenorphine, and naltrexone—have proven efficacy, they are not without limitations, including high relapse rates, issues with compliance, stigma, and insufficient engagement in long-term recovery. These shortcomings necessitate an exploration of innovative, cost-effective interventions. One such promising alternative is psilocybin-assisted therapy. …

Blended Learning Course In Medical Affairs To Improve Exposure And Interest In Pharmaceutical Industry Careers, Nandini Manne, Gayle Brazeau, Craig Kimble

Pharmacy Practice & Administration

Objective: This study aimed to evaluate students’ knowledge and perceptions of career options and their knowledge of the pharmaceutical industry based on pre-post module quizzes, reflections, and team presentations in a hybrid medical affairs elective certification course.

Methods: A qualitative research design was used to analyze the reflections of 19 students enrolled in the Accreditation Council for Medical Affairs Pharmaceutical Industry Training Certificate elective at Marshall University during spring 2023. The course used 7 modules from the Medical Affairs Competency Certificate offered by the Accreditation Council for Medical Affairs. Students completed premodule and postmodule quizzes, engaged in discussions with industry …

In Vivo Evaluation Of Novel Nanoparticles And Repurposed Pharmaceuticals To Combat Antimicrobial Resistance, Sarah E. Evans

Theses, Dissertations and Capstones

In a 2019 report by the Centers for Disease Control and Prevention (CDC), infections resistant to antibiotic treatment amount to about three million infections and 48,000 deaths. Antimicrobial resistance is an escalating global threat as existing antibiotics lose efficacy over time. The project described is focused on partnering with pharmaceutical researchers and producers to test new nanoparticle-based or repurposed compounds. The central hypothesis of this thesis is that pharmaceutical formulations such as nanoparticles may provide a cost-effective means of combating the emerging antimicrobial resistance. The nanoparticle compounds allowed for a wide range of customization for the pharmaceutical design, since the …

Regulation Of Human Il-9 Production By Lipid Metabolism, Swetha Peesari

Theses, Dissertations and Capstones

T lymphocytes contribute to host defense and inflammation producing cytokines in response to antigenic stimuli. CD4 T cell activation induces dramatic changes to cellular metabolism for supporting their growth and differentiation into effector subsets. Distinct subsets have been named Th1, Th2, Th9, Th17, Th22, Tfh and Treg based on their characteristic effector cytokines and transcription factors expressed. Th9 cells are one of the most recent subsets identified. While the cytokines IL-4, TGF-β and IL-21 promote differentiation into Th9 cells, metabolic factors regulating this process remain poorly understood. We hypothesized that lipid metabolism could regulate Th9 cell differentiation which may have …

Nutrition Assessment Of Substance Use Population Compared To Control Population, Lalitha Indrani Dasari

Theses, Dissertations and Capstones

This study aims to evaluate and compare the nutritional status of individuals undergoing treatment for substance use disorder (SUD) with a matched control population. Poor nutrition, micronutrient deficiencies and malabsorption are common in individuals with SUD, potentially affecting recovery outcomes. This study involves collection of biometric data, demographic information, conducting a structured nutrition survey and performing a one-time blood draw of 35ml to assess key nutritional markers such as lipid panel, folic acid, vitamin B12, vitamin D, thyroid stimulating hormone (TSH), magnesium, selenium, chromium, zinc, copper and lithium. While the original protocol was designed to recruit approximately 110 participants across …

Evaluation Of Disulfiram And Derivatives As Antimicrobial Adjuvants, Surya Bhaskar Karuturi

Theses, Dissertations and Capstones

Disulfiram (Antabuse) is an oral drug used for the treatment of alcohol dependence. Previous studies showed that disulfiram has antibiotic activity on multidrug-resistant bacteria. Here disulfiram was further evaluated for its ability to increase the potency of existing antimicrobials against the bacteria and yeast by acting as a drug adjuvant. Microbial cultures were treated with antibiotic or antifungal drugs in combination with disulfiram and its derivatives to determine whether potency is increased. The structure activity relationship (SAR) of disulfiram analogs was assessed against a triazole resistant Aspergillus panel. It showed that the shorter chained analogs of disulfiram are more potent …

Investigating The Extent To Which Diet-Induced Obesity Alters Gene Expression In Hematopoietic Stem And Progenitor Cells Following Influenza Immunization In Mice, Chaitanya Lahari Chowdary Pathipati

Theses, Dissertations and Capstones

Vaccines are a vital tool in preventing diseases, but their effectiveness varies depending on factors like diet and body weight. Obese individuals often experience reduced vaccine protection, as seen with influenza vaccines, where they have twice the risk of getting the flu compared to healthy-weight individuals after vaccination. This study aims to understand why obesity weakens vaccine effectiveness, focusing on the role of blood-forming stem cells in the bone marrow, known as hematopoietic stem and progenitor cells (HSPCs). These cells are crucial for producing immune cells that defend the body against infections. Previous research has shown that diet-induced obesity alters …

Utilizing Probiotics To Reduce Diet Induced Dysbiosis And Inflammation In Myelodysplastic Syndromes Susceptible Mice, Tejaswee Bolloju

Theses, Dissertations and Capstones

Human gut microbiota is helpful in digestion by helping in breaking complex carbohydrates, proteins, fats and fibers and many other physiological functions. The Western diet which is high in fat and carbo hydrate percentage alters gut microbiota and leads to growth of pathogenic bacteria and altered gut flora referred to as dysbiosis, which in turn cause gut inflammation and increased permeability of gut and it causes translocation of Lipopolysaccharides (LPS) which causes low grade systemic inflammation. Disturbance in gut microbiota correlated with metabolic conditions like obesity and leads to progression of hematologic diseases like Myelodysplastic Syndromes (MDS). Myelodysplastic syndromes are …

Payment Disrupters And Opportunities: Key Trends That Impacted Pharmacy In 2024, Craig Kimble, Thomas Pile, Alberto Coustasse

Management Faculty Research

In 2023, the United States experienced the most significant increase in prescription drug spending (13.6%), totaling $89 billion.1 This was driven by higher utilization and the introduction of new, expensive specialty and biotech drugs. In 2024, other factors continue to drive costs and disrupt the pharmacy landscape, including the implementation of new business models, pharmacy benefit manager (PBM) practices, the rebate system, regulatory changes, advancements in provider status, and potential Federal Trade Commission (FTC) interventions.

The Impact And Potential Of Digital Health Technologies, Craig Kimble, Thomas Pile, Alberto Coustasse

Pharmacy Practice & Administration

Digital technologies and smart devices are now used in every aspect of our lives. Further innovation in the digital health realm is growing and has the potential to reduce inefficiencies in the health care system by sharing health data with providers, decreasing costs related to unnecessary health care visits and improving patients’ quality of life and clinical outcomes by better tailoring treatment to the individual’s health needs.

Naloxone And Dexmedetomidine Reversal Of The Effects Of Methamphetamine And Fentanyl Co-Administration, Wesley R. Tackett

Theses, Dissertations and Capstones

Agitation is common amongst individuals who have taken methamphetamine (METH) when they arrive at the emergency room (ER). Fentanyl (FENT) and other opioids can mask this agitation which could then unexpectedly present after the reversal of these drugs by naloxone (NLX). Commonly used medications for agitation caused by METH include benzodiazepine sedatives (like alprazolam and similar drugs), but these drugs can produce dangerous sedation and inhibition of breathing when combined with opioids such as FENT. Therefore, the purpose of this MS thesis project was to use a rat model of METH-FENT overdose to test the ability of opioid antagonist NLX …

Modulation Of Diet-Induced Gut Inflammation In Slowing Initiation Of Hematologic Malignancies, Esther Nyarkoa Mensah

Theses, Dissertations and Capstones

The intestinal tract serves as a host to an extremely complex microbial system. Microbes in the gut regulate their metabolism in response to chemicals generated by other microorganisms as well as nutrition supply from dietary intake. Alterations in gut bacteria have been implicated in the development of metabolic disorders such as obesity and the progression of diseases such as Myelodysplastic syndromes (MDS). Although the cause of obesity is multifactorial, the consumption of high-fat or sugar-rich diets (Western diets) has been proposed as a significant contributor to this global epidemic. Obesity is a major public health concern that has been extensively …

Increasing The Efficacy Of Actinomycin D With Resveratrol In Aerodigestive Tract Cancers, Lukmon Morenikeji Raji

Theses, Dissertations and Capstones

Chemotherapy poses a significant challenge for cancer patients due to drug-associated toxicity, which often results from their effects on both healthy (normal) and cancerous cells. While various options aim to reduce toxicity and optimize beneficial effects, a comprehensive solution remains elusive. Cyclotherapy is one such approach developed to protect normal cells from the toxic effects of chemotherapy drugs. The basic principle underlying cyclotherapy is p53- dependent cell cycle arrest of normal cells while killing cancer cells via a p53-independent mechanism using a second drug. In our research, we investigated the inhibitory effects of a combination of two low-dose anticancer drugs, …

Artificial Intelligence Is Revolutionizing Controlled Substance Diversion Detection, Brian Cox, Alberto Coustasse, Craig Kimble

Management Faculty Research

In community and institutional health care sectors, artificial intelligence (AI) use is expanding. AI is being tapped broadly in operations, customer service, and scheduling, with major pharmacy chains such as Kroger, CVS, and Walgreens, already starting to implement AI applications in their pharmacies. So far, Kroger has begun to use AI for employee onboarding and training processes, CVS is applying AI in negotiations with suppliers, and Walgreens is using it to streamline vaccine scheduling. With these advances in major pharmacy chains, the next extensive application for AI has become clearer: diversion monitoring. Diversion occurs in health care settings when a …

Navigating The Path To Safe Compounding In Health Systems, Thomas Pile, Craig Kimble, Alberto Coustasse

Management Faculty Research

Across the country health systems are facing increasing drug shortages that are forcing pharmacists to rely far more heavily on compounding to meet the needs of patients. Additionally, several high-profile compounding incidents have helped highlight the importance of ensuring best practices are followed during sterile and nonsterile compounding to support patient safety and high-quality care. Specifically, in 2022, 160 drug shortages were reported in pharmacies. From January 1, 2023, to March 31, 2023, 47 drug shortages were reported, 55% of which were for injectables. In response, compounding has increasingly become a solution to bridge that gap.

Eruptive Lentigines Confined To Resolving Psoriatic Plaques Following Treatment With Guselkumab, Jacob R. Kilgore Md, James C. Curry, Shane E. Cook Md

Marshall Journal of Medicine

Eruptive lentigines in the area of resolving psoriatic plaques has been well documented in the literature following successful treatment with multiple therapies. This is historically associated with light treatment but has been expanded to include other therapies such as anti-tumor necrosis factor therapies and, more recently, some biologics⁵. Guselkumab (Tremfya) is an IgG1λ monoclonal antibody used in the treatment of plaque psoriasis with only one case of eruptive lentigines confined to resolving psoriatic plaques (ELRP) noted as a side effect. We present the second such case of ELRP associated with successful treatment of plaque psoriasis with Guselkumab, as …

Closed-System Transfer Devices Reduce Exposure To Contaminants, Ken Maxik, Craig Kimble, Alberto Coustasse

Management Faculty Research

Closed-system transfer devices (CSTDs) are used during the preparation of hazardous drugs (HDs) as a mechanism to reduce the transfer of drugs or vapors into the environment. When evaluating these systems, pharmacists should consider which drugs in the pharmacy would benefit the safety of health care workers and patients using the systems. Medication types include neoplastic agents, such as bleomycin, cisplatin, and methotrexate, and other agents, such as cyclosporine, oxytocin, and progesterone.

Effects Of Disulfiram On The Metabolome Of Mrsa, Surya Teja Naidu

Theses, Dissertations and Capstones

Disulfiram, known as Antabuse®, is an oral drug for the treatment of alcohol dependence. Previous studies have indicated that disulfiram (DSF) exhibits antibacterial effects, particularly against Gram-positive bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA). Our study delves into the antibacterial mechanism of DSF in MRSA through High-Pressure Liquid Chromatography (HPLC) metabolomics, investigating the underlying mechanism of DSF effects on thiamine and amino acid metabolism. Thiamine pyrophosphate (TPP) plays a crucial role as a cofactor for critical enzymes such as transketolase, pyruvate dehydrogenase, and 2-oxoglutarate dehydrogenase. These enzymes are integral to the carbohydrate metabolism process within bacterial cells. TPP also contributes …

Pharmacology Of Disulfiram As An Antibacterial Agent, Yogesh Meka

Theses, Dissertations and Capstones

Disulfiram (Antabuse®) is an oral prescription drug used to treat alcohol abuse disorder (AUD). Disulfiram (DSF) and its metabolites act on the body by inhibiting multiple enzymes involved in alcohol metabolism. This study aims to understand the pharmacology of disulfiram as an antibacterial medication. Previous studies on DSF showed antibiotic activity against multidrug-resistant Staphylococcus aureus strains (MRSA). The initial aim of this study was to decipher the mechanisms involved in inhibiting bacterial growth by DSF, which was done by performing biochemical studies. The studies revealed that DSF had antagonistic effects on redox buffering and energy production. Another aim of this …

Elucidating The Impact Of Western Diet On Bone Marrow Cytokine Signatures: Understanding Poor Outcomes In Susceptibility To Infection And Progression Of Cancer, Lahari Kondeti

Theses, Dissertations and Capstones

Among other disease outcomes, obesity is associated with 1) reduction in long-lasting immune protection and 2) acquisition of cancer. Given our interest in hematopoietic stem and progenitor cell (HSPC) dynamics, we questioned if similar mechanisms in the bone marrow microenvironment contribute to obesity-induced HSPC alterations responsible for 1) decreased immune protection and 2) transformation of HSPCs in the pathogenesis of hematologic malignancies. The negative effects of obesity on immune protection are most notably established in influenza models. Influenza infection susceptibility is increased and influenza vaccine-induced immunity wains in obese individuals. Ongoing studies aim to define mechanisms for waning immunity at …