Pharmacy and Pharmaceutical Sciences Commons^™

Identifying Patterns In Health Care Disparities And Barriers To Health Care In Rural Tanzania, Karlee Platts, Christina Sanborn, Melinda E. Lull

Pharmacy Faculty/Staff Publications

Tanzania is a country in East Africa with a population of 55 million people. HIV/AIDs, malaria and nutritional deficiencies claim the lives of many each year across Tanzania. The World Health Organization (WHO) reported in 2013 that approximately 70 percent of the population of Tanzania live in more rural areas where access to healthcare, health education, and medications for these diseases may be limited. The objective of this study was to illuminate significant health disparities in rural Tanzania based on literature and direct observations to identify barriers to quality health care.

A comprehensive literature evaluation was completed on reports published …

The Report Of The 2016-2017 Professional Affairs Standing Committee: Formally Embracing And Engaging Preceptors In The Academy — The Time Has Come, Karen Whalen, Daniel S. Aistrope, Jason Ausili, Kathleen H. Besinque, Elizabeth A. Cardello, Philip M. Hritcko, George E. Mackinnon Iii, Eric Maroyka, Elizabeth Sutton Burke, I. Shane Trent, Lynette R. Bradley-Baker

Pharmacy Faculty/Staff Publications

EXECUTIVE SUMMARY

The 2016-2017 AACP Professional Affairs Committee (PAC) was charged to examine strategies to include adjunct/affiliate preceptors as AACP members and to determine the value proposition of AACP membership for this group of educators. The PAC defined adjunct/affiliate preceptors as preceptors who are neither full-time employees nor have a primary employment commitment (≥50% of the preceptor’s work salary) at a school/college of pharmacy. Specific charges to the PAC included: recommend an approach to increase the number of adjunct/affiliate preceptors as AACP members, examine AACP membership from an adjunct/affiliate preceptor value perspective, and prepare a concise summary of available literature …

In Vitro Evaluation Of Eslicarbazepine Delivery Via Enteral Feeding Tubes, Kristin Reindel, Fang Zhao, Susan Hughes, Vivek S. Dave

Doctoral External Publications

Purpose: The feasibility of preparing an eslicarbazepine acetate suspension using Aptiom tablets for administration via enteral feeding tubes was evaluated. Methods: Eslicarbazepine acetate suspension (40 mg/mL) was prepared using Aptiom tablets after optimizing the tablet crushing methods and the vehicle composition. A stability-indicating high-performance liquid chromatography (HPLC) method was developed to monitor the eslicarbazepine stability in the prepared suspension. Three enteric feeding tubes of various composition and dimensions were evaluated for the delivery of the suspensions. The suspension was evaluated for the physical and chemical stability for 48 hours. Results: The reproducibility and consistency of particle size reduction was found …

Influence Of Carrier (Polymer) Type And Drug-Carrier Ratio In The Development Of Amorphous Dispersions For Solubility And Permeability Enhancement Of Ritonavir., Pradip W. Dhore, Vivek S. Dave, Suprit D. Saoji, Deepak Gupta, Nishikant A. Raut

Pharmacy Faculty/Staff Publications

The influence of the ratio of Eudragit® L100-55 or Kolliphor® P188 on the solubility, dissolution, and permeability of ritonavir was studied with a goal of preparing solid dispersions (SDs) of ritonavir. SDs were formulated using solvent evaporation or lyophilization techniques, and evaluated for their physical-chemical properties. The dissolution and permeability assessments of the functionality of the SDs were carried out. The preliminary functional stability of these formulations was assessed at accelerated storage conditions for a period of six months. Ritonavir: Eudragit® L100-55 (RE, 1:3) SD showed a 36-fold higher solubility of compared with pure ritonavir. Similarly, ritonavir:Kolliphor® P188 (RP, 1:2) …

Emerging Technologies For The Non-Invasive Characterization Of Physical-Mechanical Properties Of Tablets, Vivek S. Dave, Hend I. Shahin, Susanne R. Youngren-Ortiz, Mahavir B. Chougule, Rahul V. Haware

Pharmacy Faculty/Staff Publications

The density, porosity, breaking force, viscoelastic properties, and the presence or absence of any structural defects or irregularities are important physical-mechanical quality attributes of popular solid dosage forms like tablets. The irregularities associated with these attributes may influence the drug product functionality. Thus, an accurate and efficient characterization of these properties is critical for successful development and manufacturing of a robust tablets. These properties are mainly analyzed and monitored with traditional pharmacopeial and non-pharmacopeial methods. Such methods are associated with several challenges such as lack of spatial resolution, efficiency, or sample-sparing attributes.

Recent advances in technology, design, instrumentation, and software …

Sertraline And Phenytoin Drug Interaction In A Geriatric Patient, Kobi T. Nathan, Heather A. Hopkins, Stefanie E. Diloreto, Nhon A. Ta, Thomas V. Caprio

Pharmacy Faculty/Staff Publications

This report presents the case of a 78-year-old man residing in a nursing home who presented with a 2-month history of increasing lethargy and confusion. These symptoms coincided with the initiation of sertraline in the patient. Among other medications, he was also taking phenytoin. The medical team concluded that the cause of the patient’s lethargy and confusion was a drug interaction between sertraline and phenytoin. Phenytoin was held, while the sertraline was slowly tapered to discontinuation. The patient’s symptoms resolved soon thereafter. Future research is needed to better guide clinicians in appropriate selection, dosing, and monitoring of selective serotonin reuptake …

Comprehensive Medication Management: Implications For The Patient And Pharmacist, Alexander Delucenay, Barry Bunting, Hayden Brayer, Karl Williams

Pharmacy Faculty/Staff Publications

Since 1979, state pharmacy practice laws have begun to allow pharmacists to provide advanced levels of care in collaboration with prescribers. These might be termed medication therapy management, collaborative practice, comprehensive medication management and other variations. Invariably, pharmacists working closely with prescribers and patients in care of chronic disease have achieved dramatic results including improvement in surrogate markers, decreased rates of secondary large organ disease, decreased mortality, decreased hospitalizations, and as a result decreased spending.^1-28

This paper will discuss the profound impact of advanced practice models on patient care and the health care system, the current status of New …

Compounded Apixaban Suspensions For Enteral Feeding Tubes, Maria Caraballo, Seda Donmez, Kobi T. Nathan, Fang Zhao

Doctoral External Publications

Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of seven days.

Methods: Apixaban suspensions were prepared from commercially available 5 mg Eliquis® tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride (PVC), with varying lengths and diameters, were included in the study. They were mounted on …

Practical Use Of Blactchford Score, Shawn E. Fellows, Jamie M. Rosini

Pharmacy Faculty/Staff Publications

Aim: To retrospectively evaluate the use of proton pump inhibitor infusions.

Methods: A retrospective chart review was conducted of all patients who received an 80 mg bolus of esomeprazole follow by an infusion at 8 mg/hr. An analysis was performed to determine if a Blatchford Score of > 5 was a predictor of upper gastrointestinal ulcers.

Results: 300 patients received high dose esomeprazole over a 15 month period. 32% had an ulcer identified on endoscopy. Gastritis and esophagitis were the second most common diagnosis accounting for 16% of patients. A Blatchford Score of >5 as a predictor of upper gastrointestinal ulcers …

Methadone And Corrected Qt Prolongation In Pain And Palliative Care Patients: A Case–Control Study, Katherine Juba, Tina M. Khadem, David Hutchinson, Jack Brown

Pharmacy Faculty/Staff Publications

Background: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients.

Objective: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool.

Design: We performed a case–control study of adult inpatients receiving ME for pain management.

Settings/Subjects: Adult inpatients receiving ME with a QTc >470 msec (males) and …

A Pilot Stability Study Of Dehydroepiandrosterone Rapid-Dissolving Tablets Prepared By Extemporaneous Compounding, Steven D. Rush, Charlene Vernak, Fang Zhao

Pharmacy Faculty/Staff Publications

Dehydroepiandrosterone supplementation is used to treat a variety of conditions. Rapid-dissolving tablets are a relatively novel choice for compounded dehydroepiandrosterone dosage forms. While rapid-dissolving tablets offer ease of administration, there are uncertainties about the physical and chemical stability of the drug and dosage form during preparation and over long-term storage. This study was designed to evaluate the stability of dehydroepiandrosterone rapid-dissolving tablets just after preparation and over six months of storage. The Professional Compounding Centers of America rapid-dissolving tablet mold and base formula were used to prepare 10-mg strength dehydroepiandrosterone rapid-dissolving tablets. The formulation was heated at 100°C to 110°C …

Assessing Student Perceptions Of The Pharm.D. Degree At A Private Tertiary Medical University In India, Kobi T. Nathan, Kelly Conn, Christine R. Birnie

Pharmacy Faculty/Staff Publications

Background: Pharmacy education in India has expanded to include the Doctorate of Pharmacy degree (Pharm.D.). With clinical practice in early development, job opportunities in India are limited. Graduates often consider pharmacy opportunities abroad.

Aims: This study compares Indian students’ career aspirations related to the Pharm.D. degree before and after beginning their programmes.

Methods: A 5-point Likert scale paper survey with open ended questions was distributed to all Pharm.D. students (Year 1- 6) at a medical university in India.

Results: With a response rate of 83% (144/173), over half of the students’ primary goal was to pursue careers abroad post-graduation (54.2% …

Evidence For The Use Of ‘‘Medical Marijuana’’ In Psychiatric And Neurologic Disorders, Christopher Noel

Pharmacy Faculty/Staff Publications

Introduction: Cannabis is listed as a Schedule I substance under the Controlled Substances Act of 1970, meaning the US federal government defines it as an illegal drug that has high potential for abuse and no established medical use; however, half of the states in the nation have enacted “medical marijuana” (MM) laws. Clinicians must be aware of the evidence for and against the use of MM in their patients who may consider using this substance.

Methods: A PubMed database search was performed using the text string: “Cannabis”[Mesh] OR “Marijuana Abuse”[Mesh] OR “Medical Marijuana”[Mesh] OR “Marijuana Smoking”[Mesh] OR “cannabi*” OR “tetrahydrocannabinol.” …

An Evaluation Of The Impact Of Immediate Compared To Delayed Feedback On The Development Of Counselling Skills In Pharmacy Students, Alexander Delucenay, Kelly Conn, Anthony Corigliano

Pharmacy Faculty/Staff Publications

Background: Simulation-based counselling using standardised patients (SPs) provide pharmacy students an authentic approach to training; limited data exists regarding student performance using immediate feedback approaches.

Aims: To compare grades of students receiving immediate feedback verses (vs.) delayed feedback.

Methods: A pre-trial assessment of student perceptions and an unblinded randomised trial comparing immediate and delayed feedback. Third year pharmacy students (n=153) counselled SPs in four clinical “experiences”; student grades were the primary outcome. Student t-test and repeated measures were used to compare grades between groups and grades over time.

Results: During pre-trial surveys 50% of students preferred immediate feedback, 22% …