Pharmacy and Pharmaceutical Sciences Commons^™

A Pilot Chemical And Physical Stability Study Of Extemporaneously Compounded Levetiracetam Intravenous Solution, Chenzira D. Raphael, Fang Zhao, Susan E. Hughes, Katherine Juba

Doctoral External Publications

Levetiracetam is a commonly used antiepileptic medication for tumor-related epilepsy. However, the 100 mL intravenous (IV) infusion volume can be burdensome to imminently dying hospice patients. A reduced infusion volume would improve patient tolerability. The purpose of this study was to evaluate the stability of 1000 mg/25 mL (40 mg/mL) levetiracetam IV solution in sodium chloride 0.9%. We prepared levetiracetam 40 mg/mL IV solution and added it to polyvinyl chloride (PVC) bags, polyolefin bags, and polypropylene syringes. Triplicate samples of each product were stored at refrigeration (2–8°C) and analyzed on days 0, 1, 4, 7, and 14. Samples were subjected …

Stability Of Extemporaneously Prepared Sodium Benzoate Oral Solution, Andrew S. Decker, Melinda E. Lull, David Hutchinson

Pharmacy Faculty/Staff Publications

Purpose: Sodium benzoate (NaC7H5O2), a common food preservative, is the salt form of benzoic acid. It is used as an alternative treatment in patients with hepatic encephalopathy or urea cycle disorders as it is believed help stimulate ammonia removal via a non-urea cycle based pathway. Despite its use, sodium benzoate is not an FDA approved medication and has no commercially available oral formulations, although an IV formulation is available in combination with sodium phenylacetate (Ammonul®). The objectives of this study were to prepare a sodium benzoate solution and determine the stability of an extemporaneously prepared oral solution over a 90-day …

Too Many Cooks In The Kitchen? Interdisciplinary Team Discharge Clinic Prevents Hospital Readmissions, Nabila Ahmed-Sarwar, Lauren Decaporale-Ryan, Shaula Woz, Katie Lashway, Karen Mahler, Tracy Lewis, Robbyn Upham

Pharmacy Faculty/Staff Publications

Establishment of Interdisciplinary healthcare teams have shown to improve health outcomes and lower readmission rates in medically complex patients during hospitalization. Exploration of interventions has happened largely during the pre-discharge phase rather than post-discharge. To extend the team based approach, we implemented a pilot study of an interdisciplinary discharge clinic to determine what impact a biopsychosocial approach to care can have on hospital readmission rates. This work was conducted at a large family medicine residency-based practice, and facilitated by a physician, behavioral health clinicians, a clinical pharmacist, nurse care managers, and medical assistant. Patients were seen in the discharge clinic …

Preparation And Evaluation Of Phospholipid-Based Complex Of Standardized Centella Extract (Sce) For The Enhanced Delivery Of Phytoconstituents, Suprit Saoji, Nishikant Raut, Pradip Dhore, Chandrashekhar D. Borkar, Michael Popielarczyk, Vivek S. Dave

Pharmacy Faculty/Staff Publications

In the present study, a phospholipid-based complex of standardized Centella extract (SCE) was developed with a goal of improving the bioavailability of its phytoconstituents. The SCE-phospholipid complex was prepared by solvent evaporation method and characterized for its physicochemical and functional properties. Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), scanning electron microscopy (SEM), photomicroscopy, and powder x-ray diffraction (PXRD) were used to confirm the formation of Centella naturosome (CN). The prepared complex was functionally evaluated by apparent solubility, in vitro drug release, ex vivo permeation, and in vivo efficacy studies. The prepared CN exhibited a significantly higher (12-fold) aqueous …

A Solid Dispersion Based On Milk-Micelle As A Drug-Carrier For The Enhancement Of The Aqueous Solubility Of Ritonavir, Pradip Dhore, Suprit Saoji, Nishikant Raut, M. Bernardez, Rahul V. Haware, Vivek S. Dave

Pharmacy Faculty/Staff Publications

The goal of present investigation was to evaluate the feasibility of formulating a solid-dispersion using milk-micelles as drug-carriers, to enhance the aqueous solubility of ritonavir.

Copd: Optimizing Treatment, Nabila Ahmed-Sarwar, Deirdre P. Pierce, David C. Holub

Pharmacy Faculty/Staff Publications

A guideline update and an expanded armamentarium have many physicians wondering how best to treat patients with COPD. Chronic obstructive pulmonary disease (COPD) carries a high disease burden. In 2012, it was the 4th leading cause of death worldwide.1,2 In 2015, the World Health Organization updated its Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, classifying patients with COPD based on disease burden as determined by symptoms, airflow obstruction, and exacerbation history.3 These revisions, coupled with expanded therapeutic options within established classes of medications and new combination drugs to treat COPD (TABLE 1),3-6 have led to questions about interclass …

Formulation Of A Drug-Phospholipid Complex (Naturosome) To Enhance The Aqueous Solubility Of Standardized Extract Of Centella Asiastica (Sce), Suprit Saoji, Nishikant Raut, Pradip Dhore, M. Bernardez, Rahul V. Haware, Vivek S. Dave

Pharmacy Faculty/Staff Publications

Purpose:

To evaluate the enhancement of aqueous solubility of standardized extract of Centella asiastica, a natural drug with known anti- Alzheimer’s activity, by formulating its complex (Naturosome) with a phospholipid - Phospholipon® 90H.

The Enhancement Of The Aqueous Solubility Of Ritonavir Via Formulation Of A Drug-Phospholipid Complex, Suprit Saoji, Nishikant Raut, Pradip Dhore, R. G. Diware, M. Bernardez, Rahul V. Haware, Vivek S. Dave

Pharmacy Faculty/Staff Publications

Objective: To evaluate the enhancement of aqueous solubility of a poorly water soluble drug ritonavir by forming its complex with a phospholipid (Phospholipon®90H).

The Role Of Pharmacists In Lgbtq Health, Cecilia M. Plaza, Jennifer Mathews, Tari Hanneman

Pharmacy Faculty/Staff Publications

Pharmacists are one of the most accessible healthcare providers and often can serve as the first point of contact for patients with the healthcare system. This session explored the role of that pharmacist on the healthcare team related to LGBTQ health. The new Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes were discussed as well as current efforts within pharmacy education in LGBTQ health education. The speakers also addressed barriers to LGBTQ education and practice along with potential solutions.

Medical Marijuana And Pharmacy Practice, Karl G. Williams

Pharmacy Faculty/Staff Publications

By way of the Compassionate Care Act of 2014, New York has become the 23^rd state to create a process that will permit patients suffering from a “serious condition” to receive medical marijuana (or “cannabis”). Among those, it is the second state to prohibit the crude delivery system of smoking (Minnesota), and the third to involve pharmacists in the dispensing process (Connecticut and Minnesota). Because virtually every practicing pharmacist in New York will be caring for patients receiving some form of cannabinoid therapy, it is important to discuss the basic outlines established by the law and regulations.

A Modified Potency Test Strategy For Iv Admixtures Prepared By Robotic Systems, Fang Zhao, Vivek S. Dave, Susan E. Hughes

Pharmacy Faculty/Staff Publications

Introduction:

Robotic systems are increasingly used for compounding sterile IV admixtures (1-5). In addition to routine gravimetric checks, initial and periodic drug potency analysis by high-performance liquid chromatography (HPLC) is desired to verify the system accuracy. However, the conventional HPLC test procedures often result in unexpected failures (1-2).

This study was initiated to develop a modified HPLC test strategy to eliminate the common source of variability and focus the effort on the accuracy of robotic system.

Effective Use Of Team Based Learning In A Flipped Classroom, Nabila Ahmed-Sarwar

Pharmacy Faculty/Staff Publications

This roundtable presentation highlighted the components of team based learning activities in a flipped classroom. The instructional techniques to maximize knowledge application and critical thinking are described. Additional student performance and level of satisfaction with this course design in comparison to lecture based course design in previous years is evaluated.

Test Question Editing Workshop - Improve Your Test Item Writing Skills Through Editing, Jennifer Mathews, Jane M. Souza

Pharmacy Faculty/Staff Publications

This workshop will be 75% hands-on editing of test questions. After an overview of learning objectives for the session and instruction on identifying common errors, participants will be provided a list of test questions containing errors frequently found in exams. They will be asked to edit the questions to improve the overall quality of the test items. Edited questions will be shared with all attendees. Through this process, participants will hone their skills at both writing and editing items.

Stability Of Glutamate-Aspartate Cardioplegia Additive Solution In Polyolefin Iv Bags, Steven D. Rush, Stephanie E. Kim, Susan E. Hughes, Justine M. Gilbert, Peter P. Ciancaglini, Fang Zhao

Doctoral External Publications

Objective: Glutamate-aspartate cardioplegia additive solution (GACAS) is used to enhance myocardial preservation and left ventricular function during some cardiac surgeries. This study was designed to evaluate the stability of compounded GACAS stored in sterile polyolefin intravenous (IV) bags. The goal is to extend the default USP beyond-use date (BUD) and reduce unnecessary inventory waste.

Methods: GACAS was compounded and packaged in sterile polyolefin 250 mL IV bags. The concentration was 232 mM for each amino acid. The samples were stored under refrigeration (2°C-8°C) and analyzed at 0, 1, and 2 months. At each time point, the samples were evaluated by …

Implementation Of A Student Development Workshop Series To Supplement A Traditional Curriculum, Melinda E. Lull, Jennifer Mathews

Pharmacy Faculty/Staff Publications

Preparing students to be successful in the classroom and as professionals requires more than didactic education. Academic programs primarily address the academic needs of students based on curricular and assessment goals but often fail to fully prepare students to successfully face the challenges they experience in school and after graduation. To truly prepare students, teachers must address their needs in domains outside the classroom. This session explores student development programs aimed at improving students’ academic, personal, and future professional success as a supplement to the traditional didactic education.

Learning goals:

• Reflect on current teaching and advising methods.

• Use …

Expanding The Role Of Peer Tutors Through The Use Of Online Quizzes, Melinda E. Lull, Jennifer Mathews

Pharmacy Faculty/Staff Publications

Peer tutors are commonly used in higher education as a way to provide additional resources for student learning. Self‐testing, a type of formative assessment tool, provides students with a study tool that can help identify areas of weakness that require focus. Despite their usefulness, this type of additional learning resource can often be time consuming for faculty members, limiting its successful use across multiple courses. The use of peer tutors has been investigated and shown to provide advantages to both students utilizing tutoring services and tutors alike. Educating peer tutors to be involved in the academic process by preparing study …

Analyzing Pain Medication Use And Adherence In Patients With Myotonic Dystrophy And Facioscapulohumeral Dystrophy, Bryan Fitzgerald, Amy L. Parkhill

Pharmacy Faculty/Staff Publications

Objectives: Myotonic dystrophy (DM) and facioscapulohumeral dystrophy (FSHD) are two of the most common muscular dystrophies in adults. It has been reported that patients with these two disorders may suffer from pain and inadequate pain management. The purpose of this study is to analyze the current use of pain medications and develop a survey to assess pain medication use and adherence in this patient population.

Methods: Patients registered in the National Registry for DM and FSHD at the University of Rochester were surveyed on pain medication use and the most significant problem of their disease. After analysis of these surveys, …

Programming Macrophage Inflammation Resolution: The Role Of Omega-3 Polyunsaturated Fatty Acids, Boris Krasnov, Mathew Lombardozzi, Maria Caraballo, Ramil Sapinoro

Pharmacy Faculty/Staff Publications

It was previously thought that resolution of inflammation was a passive process, but recent emerging research has identified that resolution is an active process and that dual acting lipid mediators derived from essential omega-3 polyunsaturated fatty acids (PUFAs) have both anti-inflammatory (reducing neutrophil access to the inflamed tissue) and pro-resolving (removal of apoptotic cells by macrophages in the inflamed site) actions. The objective of our study was to determine the role of omega-3 PUFAs in programming phenotypic changes in treated macrophages. The polarization of macrophages during inflammatory responses to functionally distinct phenotypes may play a role in both inflammation and …

Drug-Drug Interactions Among Hepatitis C Virus (Hcv) And Human Immunodeficiency Virus (Hiv) Medications, Kirpal Kaur, Mona A. Gandhi, Judianne Slish

Doctoral External Publications

One-fourth of individuals diagnosed with the human immunodeficiency virus concomitantly have the hepatitis C virus infection. Since the discovery of highly active antiretroviral therapy, liver complications have become the leading cause of morbidity and mortality in HIV-HCV coinfected individuals. Optimal treatment in this patient population is critical, as coinfection has been linked to deterioration of both disease states. The objective of this review article is to highlight the current literature on drug-drug interactions between HIV and HCV treatments. The management of the treatment of coinfection patients has been covered extensively in numerous other publications.

Aggressive Anesthetic Management Of A Patient With Severely Dilated Cardiomyopathy For Non Cardiac Surgery, Muhammad F. Sarwar, Nabila Ahmed-Sarwar, David Vent

Pharmacy Faculty/Staff Publications

We report a case of a 37 year old man, with history of rhabdomyosarcoma as a child. Patient developed severe dilated cardiomyopathy secondary to the treatment of the cancer. He presented for resection of the small bowel. An intra-aortic balloon pump (IABP) was placed preoperatively for mechanical cardiac support. A combined general/epidural technique was used for the surgery. Transesophageal echocardiogram (TEE) was used to monitor patients cardiac status intraoperatively. Patient remained hemodynamically stable and tolerated the procedure well.

Effects Of Fructose-Derived Advanced Glycation End Products On Acetylation Of Histones In The Brain, Alissa K. Cornacchia, Mackenzie Hall, Melinda E. Lull

Undergraduate External Publications

Objective: The objective of this study was to determine the effects of fructose and their advanced glycation end products (fru-AGES) on histone acetylation in microglia, the immune cells of the brain.

Significance: Fru-AGES primarily form as a result of non-enzymatic reactions between fructose and proteins. One result is inflammation in the brain, which can be directly correlated to increased microglia activity. Microglial activity has been shown to be associated with the acetylation of histones, resulting in a change in transcription of inflammatory genes. Elucidation of a direct link between fructose, fru-AGES and histone acetylation would increase understanding the pathophysiology of …

Drug-Excipient Compatibility Studies In Formulation Development: Current Trends And Techniques, Vivek S. Dave, Rahul V. Haware, Nikhil A. Sangave, Matt Sayles, Michael Popielarczyk

Pharmacy Faculty/Staff Publications

The safety, efficacy, quality and stability of a formulation are the cornerstones of any new drug development process. In order to consistently maintain these attributes in a finished dosage form, it is important to have a comprehensive understanding of the physico-chemical characteristics of the active pharmaceutical ingredient (API), as well as all other components (e.g. excipients, manufacturing aids, packaging materials) of the drug product. In a new drug development process, a detailed characterization of the API and other formulation components is usually carried out during the preformulation stage. The preformulation stage involves characterization of several aspects of the API including …

Self-Directed Learning Through Journal Use In An Elective Pharmacy Course, Melinda E. Lull, Casey U. Slevinski, Andrea N. Traina

Pharmacy Faculty/Staff Publications

Introduction: The objective of this study was to implement and assess the use of electronic self-directed learning journals in a one-semester pharmacy elective course as a development tool to promote self-learning amongst students.

Description of Course: In a toxicology doctor of pharmacy elective course, students completed self-directed assignments based on in-class material in an electronic journal. Students participated in group discussions based on the assignment. Journals were graded for completeness and pursuit of individual interests was encouraged.

Evaluation: Students responded positively to journal assignments and their educational value. Faculty members also recognised a high level of learning by students based …

Mucosal Delivery Of Particulate Breast Cancer Vaccine, Lipika Chablani, Nihal S. Mulla, Periasamy Selvaraj, Martin J. D'Souza

Pharmacy Faculty/Staff Publications

Vaccination has been widely used as a mode of protection against various diseases by taking advantage of host's immune system. Even though vaccination has provided relief from many infectious diseases, vaccination for cancer still remains a challenge. Cancer is caused by mutated cell functioning leading to uncontrolled growth in the organ of genesis and further possible metastasis worsens the situation. In spite of various current therapies such as surgery, chemotherapy and radiation therapy, we are still lacking behind in the race with this evolving disease. There are two major approaches for vaccination: prophylactic or therapeutic. Prophylactic vaccines find their applications …

The Hispanic Pharmacist: Value Beyond A Common Language, Gabriela C. Cipriano, Carlota O. Andrews

Pharmacy Faculty/Staff Publications

Objective: To highlight the added value of bilingual Hispanic pharmacists in the care of Hispanic patients by sharing their patients’ language and culture.

Summary: Inability to speak and/or write in the patients’ native language severely impairs our best efforts to deliver good health care. This is a widely recognized cause of non-compliance or less than favorable possible health outcomes in Hispanic patients. What has received less attention, however, is that the ability to speak Spanish alone may not remove completely the barrier for non-compliance among Hispanics. Bilingual Spanish–English pharmacists do not have the language barrier, but if they do not …