Pharmacy and Pharmaceutical Sciences Commons^™

Physical And Chemical Stability Of Dexamethasone Sodium Phosphate In Intravenous Admixtures Used To Prevent Chemotherapy-Induced Nausea And Vomiting, Ina Buga, Joy Uzoma, Kristin Reindel, Kateryna Rashid, Tuong Diep, Pamela Mccartan, Fang Zhao

Pharmacy Faculty/Staff Publications

Purpose: Dilute intravenous (IV) admixtures of dexamethasone sodium phosphate (DSP) are becoming increasingly used in antiemetic regimens to prevent chemotherapy-induced nausea and vomiting (CINV). Based on its chemical structure and previous studies, DSP is known to be susceptible to hydrolysis and oxidation under certain conditions. There are limited data to directly support the selection of IV diluents, storage conditions, and beyond-use dates for the dilute IV solutions of DSP used in the antiemetic regimens. This study was designed to investigate these parameters. Methods: A stability-indicating high-performance liquid chromatography (HPLC) method was first developed for the analysis of DSP. Commercially available …

Prevalence, Determinants, And Characteristics Of Extemporaneous Compounding In Jordanian Pharmacies, Hatim S. Alkhatib, Sara Jalouqa, Nour Maraqa, Anna Ratka, Eman Elayeh, Suha Al Muhaissen

Pharmacy Faculty/Staff Publications

Background:

Pharmaceutical compounding is an essential component in pharmacy practice allowing pharmacists to provide dosage forms or strengths that are commercially unavailable. Medications compounded for patient-specific needs contribute to personalized medicine. Extemporaneous compounding provided by pharmacies overcomes the market shortage of these therapeutic products. The aim of this study is to investigate and characterize the prevalence, characteristics, and determinants of extemporaneous compounding in Jordanian pharmacies.

Methods:

This study was based on a cross-sectional questionnaire and included 431 randomly selected pharmacies in the twelve governorates of the country. Data were collected via face to face interviews of pharmacists who voluntarily and …

A Review Of The Food And Drug Administration Adverse Event Reporting System For Tramadol-Related Hypoglycemia, Katherine Juba, Robbert Van Manen, Shawn E. Fellows

Pharmacy Faculty/Staff Publications

Background: Hypoglycemia is a rare adverse effect of tramadol that is described in the medical literature and package insert. Objective: The purpose of this study was to review reports of tramadol and hypoglycemia in the Food and Drug Administration Adverse Event Reporting System (FAERS) database to determine a potential association. Methods: Disproportionality analysis with Bayesian correction was used to compare tramadol and hypoglycemia with other medications in FAERS. The results were considered significant if the fifth percentile of the Empirical Bayesian geometric mean distribution (EB05) >2. Logistic regression odds ratios was used to determine if age, diabetes medications, and renal …

172. Risk Factors For 30-Day Mortality In Patients With Staphylococcus Aureus Bacteremia At A Community Hospital: A Prospective Case–Control Study, Charles Hoffmann, Gordon Watkins, Patrick Desimone, Peter Hallisey, David Hutchinson, Stephen Colodny, Jeffrey Burkey, Amanda Michael, Jo-Anne Klein, Christina Welc

Pharmacy Faculty/Staff Publications

Background:

Staphylococcus aureus bacteremia (SAB) is associated with 30-day all-cause mortality rates approaching 20–30%. The purpose of this case–control study was to evaluate risk factors for 30-day mortality in patients with SAB at a community hospital.

Methods:

As part of an antimicrobial stewardship program (ASP) initiative mandating Infectious Diseases consultation for episodes of SAB, our ASP prospectively monitored all cases of SAB at a 341-bed community hospital in Jefferson Hills, PA from April 2017–February 2019. Cases included patients with 30-day mortality from the initial positive blood culture. Only the first episode of SAB was included; patients were excluded if a …

2103. Emergency Department (Ed) Stewardship: Stratifying Ed Sepsis Order Sets By Penicillin (Pcn) Allergy Severity, Mary L. Staicu, Maryrose Laguio-Vila, Allison Ramsey, Kelly Conn, Kristin Woodring

Pharmacy Faculty/Staff Publications

Background:

The Surviving Sepsis Campaign Guidelines recommends administration of broad-spectrum antibiotics within 1 hour of sepsis diagnosis; electronic order sets drive antibiotic selection with pre-populated regimens based on the suspected infectious indication. Given the low rate of cephalosporin cross-reactivity in patients with a PCN allergy, we modified our ED sepsis order set (Images 1 and 2) to include cephalosporin options in patients with reported mild-to-moderate PCN reaction histories. This was a single-center, retrospective analysis evaluating the impact of this change on antibiotic prescribing and associated outcomes.

Methods:

An electronic medical record (EMR) report identified patients ≥18 years of age with …

Glucosamine Hcl-Based Solid Dispersions To Enhance The Biopharmaceutical Properties Of Acyclovir, Darshan R. Telange, Snehal B. Bhagat, Arun T. Patil, Milind J. Umekar, Anil M. Pethe, Nishikant Raut, Vivek S. Dave

Pharmacy Faculty/Staff Publications

The objective of the work presented here was to assess the feasibility of using glucosamine HCl as a solid-dispersion (SD) carrier to enhance the biopharmaceutical properties of a BCS class III/IV drug, acyclovir (ACV). The solid-dispersions of acyclovir and glucosamine HCl were prepared by an ethanol-based solvent evaporation method. The prepared formulations characterized by photomicroscopy, scanning electron microscopy (SEM), differential scanning calorimetry (DSC), Fourier transforms infrared spectrophotometry (FTIR), powder x-ray diffractometry (PXRD) and drug content analysis. The functional characterization of ACV-SD was performed by aqueous solubility evaluation, dissolution studies, fasted versus fed state dissolution comparison, ex vivo permeability, and stability …

Penicillin Allergy Assessment And Skin Testing In The Outpatient Setting, Wesley D. Kufel, Julie Ann Justo, P. Brandon Bookstaver, Lisa M. Avery

Pharmacy Faculty/Staff Publications

Penicillin allergies are among of the most commonly reported allergies, yet only 10% of these patients are truly allergic. This leads to potential inadvertent negative consequences for patients and makes treatment decisions challenging for clinicians. Thus, allergy assessment and penicillin skin testing (PST) are important management strategies to reconcile and clarify labeled penicillin allergies. While PST is more common in the inpatient setting where the results will immediately impact antibiotic management, this process is becoming of increasing importance in the outpatient setting. PST in the outpatient setting allows clinicians to proactively de-label and educate patients accordingly so beta-lactam antibiotics may …

Penicillin Allergy Skin Testing In The Inpatient Setting, Julie Ann Justo, Wesley D. Kufel, Lisa M. Avery, P. Brandon Bookstaver

Pharmacy Faculty/Staff Publications

The consequences of a documented penicillin allergy in the medical record are especially troublesome in acutely ill, hospitalized patients. A penicillin allergy label may lead to alternative or second line therapies resulting in adverse drug events, negative clinical outcomes and increased costs. Reconciling penicillin allergies is a necessity to facilitate early, optimal therapy and is a shared responsibility among the healthcare team. Penicillin skin testing (PST) has been utilized successfully in hospitalized patients to de-label erroneous penicillin allergies and optimize antibiotic therapy. This targeted review aims to discuss the practical development and implementation of PST in the inpatient setting. This …

A Systematic Review Of The Evidence Behind Use Of Reduced Doses Of Acetaminophen In Chronic Liver Disease, Anne Schweighardt, Katherine Juba

Pharmacy Faculty/Staff Publications

Acetaminophen is among the most commonly used nonopioid analgesics, but significant variation exists in its prescribing practices for cirrhosis patients. Our primary objective was to describe the quality of evidence supporting or refuting the use of acetaminophen in patients with hepatic dysfunction. A comprehensive literature review of PubMed, Cochrane Library, Web of Science, and International Pharmaceutical Abstracts using the search terms “acetaminophen,” “paracetamol,” “chronic liver disease,” “cirrhosis,” and “hepatic disease” for studies describing changes in acetaminophen metabolism in patients with hepatic dysfunction was conducted. Twelve studies and four abstracts were included. Ten studies and three abstracts were pharmacokinetic studies. Two …

Pharmacy Students’ Attitudes And Perceptions Toward Pharmacogenomics Education, Shanice Coriolan, Nimota Arikawe, Arden Moscati, Lisheng Zhou, Stephanie Dym, Seda Donmez, Adinoyi Garba, Sahsa Falbaum, Zvi Loewy, Melinda E. Lull, Maha Saad, Jane Shtaynberg, Aniwaa Owusu Obeng

Pharmacy Faculty/Staff Publications

Purpose

To evaluate final-year pharmacy students’ perceptions toward pharmacogenomics education, their attitudes on its clinical relevance, and their readiness to use such knowledge in practice.

Methods

A 19-question survey was developed and modified from prior studies and was pretested on a small group of pharmacogenomics faculty and pharmacy students. The final survey was administered to 978 final-year pharmacy students in 8 school/colleges of pharmacy in New York and New Jersey between January and May 2017. The survey targeted 3 main themes: perceptions toward pharmacogenomics education, attitudes toward the clinical relevance of this education, and the students’ readiness to use knowledge …

An Exploratory Study Of Suboxone (Buprenorphine/ Naloxone) Film Splitting: Cutting Methods, Content Uniformity, And Stability, Kristin L. Reindel, Michael J. Deangelis, Alexander S. Ferrara, Kelly Conn, Elizabeth Phillips, Anthony Corigliano, Fang Zhao

Doctoral External Publications

Suboxone films are U.S. Food and Drug Administration approved to treat opioid dependence. While the package insert states that films should not be cut, physicians often prescribe film fractions for treatment and tapering. There is no data to support this practice, and this study was initiated to evaluate cutting methods, content uniformity, and stability of split films. Suboxone 8-mg buprenorphine/2-mg naloxone films were split using four methods: 1) ruler/razor cut, 2) scissor cut, 3) fold/rip, and 4) fold/scissor cut. United States Pharmacopeia Chapter <905> was used to evaluate the weight variation and content uniformity of split films. The stability of split …

The Use Of Aerosolized Ribavirin In Respiratory Syncytial Virus Lower Respiratory Tract Infections In Adult Immunocompromised Patients: A Systematic Review, Lisa M. Avery, Charles Hoffmann, Karen M. Whalen

Pharmacy Faculty/Staff Publications

Introduction: Respiratory syncytial virus (RSV)–associated lower respiratory tract infection (LRTI) is a concern in immunocompromised patients. Aerosolized ribavirin (RBV AER) is used for treatment of RSV LRTI; however, adverse events and rising drug costs remain a challenge for patient management. The purpose of this systematic review is to summarize the efficacy and adverse event profile of RBV AER for the treatment of hospitalized RSV LRTI in immunocompromised adult patients. Methods: A Medline/PubMed, Embase, Google Scholar, Clinicaltrials.gov, and Cochrane Library database search was conducted from 1966 to January 2019 for the use of RBV AER. Search strategy: [(ribavirin OR ICN1229) AND …

The Use Of Aloe Vera In Cancer Radiation: An Updated Comprehensive Review, Carrie-Jo E. Farrugia, Elizabeth Sutton Burke, Mariah E. Haley, Komul T. Bedi, Mona A. Gandhi

Doctoral External Publications

Introduction: Many cancer patients require radiation therapy and often experience adverse effects including erythema, itching, and pain. Aloe vera has been studied for its potential use in the prevention and treatment of radiation related adverse effects as it possesses a variety of properties and is considered an antioxidant and anti-inflammatory agent. Multiple controlled trials have been performed in order to evaluate the efficacy of aloe vera for the prevention and treatment of radiation side effects. Previous systematic reviews have examined the use of aloe vera for radiation-induced skin reactions, however updated literature now includes the use of aloe vera in …