Pharmacy and Pharmaceutical Sciences Commons^™

Altered Cell-Surface Receptor Levels Result From Fructose Advanced Glycation End Product-Induced Inflammation, Matthew Stryker, Regina Blackley, Melinda E. Lull

Doctoral External Publications

Objective: As a result of the heightened reactivity fructose demonstrates compared to glucose and our current knowledge of glucose advanced glycation end-products, the aim of this research was to further elucidate the proinflammatory pathways involved in the response to fru-AGE exposure, including the effects of fru-AGEs on cell-surface receptor expression. We hypothesized that once microglia were activated in response to fru-AGE exposure, there would be an increase in the expression of RAGE and TLR4 to facilitate the proinflammatory cascade.

Educating Pharmacists And The Public About The Role Of Over-The-Counter Medications In The Management Of Autism Spectrum Disorders, Jillian M. Bankoff, Melinda E. Lull

Doctoral External Publications

Over-the-counter (OTC) medications are used by various populations as an adjunct to help improve various aspects of life, such as sleep cycles, disease prevention, and mood. The purpose of this study is to compile all of the available data from human trials of over-the-counter medications used in patients with Autism Spectrum Disorders (ASD). OTCs have been used in the treatment of ASD to minimize social impairments, suppress repetitive behaviors, and enhance quality of sleep to improve daytime behaviors. Ultimately, the main objectives of this project are to educate pharmacists and the public (both patients and their families) about the role …

Development And Implementation Of Peer-Led Weekly Review Sessions And The Assessment Of Their Impact On Student Learning, Alyssa L. Ashworth, Inlok Lam, Nicole E. Moore, Melinda E. Lull

Doctoral External Publications

Peer tutoring services for a pathophysiology and therapeutics course have historically been made available to pharmacy students, but they were greatly underutilized. The role of peer tutors had been exclusively to hold office hours during which students could ask questions or review material. Peer tutoring services were updated and expanded based on the needs of the students. The objectives of this project were to develop, implement, and assess the impact of peer-led organized weekly review sessions in a pathophysiology and therapeutics course.

An Examination Of The Effects Of Atorvastatin And Parathyroid Hormone On Osteoblast Activity, Inlok Lam, Andrea Traina, Melinda E. Lull

Doctoral External Publications

HMG-CoA reductase inhibitors, also known as statins, are a ubiquitous class of medication used for lowering cholesterol. In-vitro and animal studies have suggested that statins can activate osteoblast differentiation and have anabolic effects on bones; however, observational and experimental studies in humans have shown conflicting results.1-5 The exact mechanism of statins on bone growth is unknown; however, there are several hypotheses. The “Lipid Hypothesis” (Figure 1) suggests that lipid oxidation leads to activation of PPARγ, and production of isoprostanes including isoPGF2α and isoPGEα. PPARγ is associated with inhibition of osteoblast differentiation, while isoprostanes markers are associated with the induction of …

Formulation And Stability Of An Extemporaneously Compounded Oral Solution Of Chlorpromazine Hcl, Daniel L. Prohotsky, Katherine Juba, Fang Zhao

Pharmacy Faculty/Staff Publications

Chlorpromazine is a phenothiazine antipsychotic which is often used in hospice and palliative care to treat hiccups, delirium, and nausea. With the discontinuation of the commercial oral solution concentrate, there is a need to prepare this product by extemporaneous compounding. This study was initiated to identify an easy-to-prepare formulation for the compounding pharmacist. A stability study was also conducted to select the proper storage conditions and establish the beyond-use date. Chlorpromazine HCl powder and the Ora-Sweet® syrup vehicle were used to prepare the 100 mg/mL solution. Once the feasibility was established, a batch of the solution was prepared and packaged …

Sitagliptin Associated Pancreatic Carcinoma: A Review Of The Fda Aers Database, Angela Nagel, Gabriela Cipriano, Nabila Ahmed-Sarwar, Robbert Van Manen, Jack Brown

Pharmacy Faculty/Staff Publications

Purpose: Sitagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor used in the treatment of type 2 diabetes mellitus in adults, as adjunct to diet and exercise to improve glycemic control. During phase III studies, sitagliptin was shown to cause toxicity to the pancreas, including pancreatitis. To date there is limited information available regarding its association with pancreatic carcinoma. Our goal was to qualitatively and quantitatively review available information in the AERS database in order to provide clinicians with a general understanding of the comparative occurrence of sitagliptin use and pancreatic carcinoma and any clinically relevant characteristics that may be useful in …

Extended-Release Hydrocodone: The Devil In Disguise Or Just Misunderstood?, Anne Schweighardt, Katherine Juba

Pharmacy Faculty/Staff Publications

Opioid abuse in the United States increased significantly over the past decade, leading to opioid-related deaths. Approval of Zohydro ER, a product that lacks an abuse-deterrent formulation, has provoked media controversy and aggressive legislative action from multiple stakeholders. Only the American Academy of Pain Management has released a position statement on this medication, and individual opinion varies. Additional single-entity extended-release hydrocodone formulations are in the pipeline, and Zohydro ER's limited clinical utility may make the controversy associated with its approval a moot point. As with other opioids, providers will need to assess individual patient risk versus benefit when prescribing Zohydro …

Student Self-Screening For Methicillin-Resistant Staphylococcus Aureus (Mrsa) Nasal Colonization In Hand Hygiene Education, Tia Lum, Kristin F. Picardo, Theresa Westbay, Amber Barnello, Lynn Fine, Jill Lavigne

Doctoral External Publications

Objective. To determine the feasibility and effectiveness of adding a hand hygiene exercise in self-screening for Methicillin-Resistant Staphylococcus Aureus (MRSA) nasal colonization to a health care delivery course for first-year pharmacy (P1) students.

Design. About one month after students were trained in hand hygiene technique and indications, faculty members demonstrated how to self-screen for MRSA nasal colonization. Students were then asked to screen themselves during the required class time. Aggregated class results were shared and compared to prevalence estimates for the general population and health care providers.

Assessment. The 71 students present in class on the day of the self-screening …

Once-Weekly Exenatide As Adjunct Treatment Of Type 1 Diabetes Mellitus In Patients Receiving Continuous Subcutaneous Insulin Infusion Therapy, Andrea N. Traina, Melinda E. Lull, Adrian C. Hui, Toni M. Zahorian, Jane Lyons-Patterson

Pharmacy Faculty/Staff Publications

Objective

The use of once-weekly exenatide in type 2 diabetes mellitus is well supported, but little is known about its effectiveness in type 1 diabetes. The objective of this study was to determine the clinical efficacy of once-weekly exenatide on glycemic control in patients with type 1 diabetes when added to basal-bolus insulin therapy.

Methods

For this retrospective study, patients with type 1 diabetes, aged 18 years and older, receiving continuous subcutaneous insulin infusion, using a continuous glucose monitoring device or regularly measuring blood glucose levels and receiving 2 mg of exenatide once weekly for at least 3 months were …

Expanding The Role Of Pharmacology Tutors Through The Use Of Online Quizzes, Melinda E. Lull, Nicole E. Moore, Matthew Stryker, Jennifer Mathews

Pharmacy Faculty/Staff Publications

Objectives: Pharmacology tutors have been available each semester for the past two years, but have been under-utilized by the student population. The primary objective of this study was to use innovative methods to increase the use of tutors in pharmacology courses.

The Use Of Student Development Workshops To Supplement The Traditional Pharmacy Curriculum, Melinda E. Lull, Jennifer Mathews

Pharmacy Faculty/Staff Publications

Objectives: Preparing students to be successful in the classroom and as practitioners requires more than didactic education. The objectives of this study were to develop and assess a series of student development workshops aimed at addressing supplementary professional and academic needs of pharmacy students.

Enhancing Ambulatory Care Appes By Incorporating Patient-Centered Medical Home Principles, Nabila Ahmed-Sarwar, Angela Nagel

Pharmacy Faculty/Staff Publications

Objective: Incorporation of various clinical activities during ambulatory care APPEs to achieve exposure to the five principals of a patient centered medical home (PCMH) provide Pharm.D. Candidates at the Wegmans School of Pharmacy with a strong foundation for a future practice in patient centered care.

Methods: The APPE is designed to engage students in activities involving the five principals of a PCMH practice. Students that are assigned to complete their Ambulatory Care APPE at one of two Level 3 National Committee for Quality Assurance (NCQA) certified PCMH Family Medicine Residency Training Practices are directly involved in engaging patients in decision …

A Transgender Health Care Panel Discussion In A Required Diversity Course, Amy L. Parkhill, Jennifer Mathews, Scott Fearing, Jeanne Gainsburg

Pharmacy Faculty/Staff Publications

OBJECTIVES: To examine the impact of a panel discussion on transgender health care on first-year (P1) pharmacy students' knowledge and understanding of transgender experiences in an Introduction to Diversity course.

DESIGN: The panel consisted of both transgender males and females. After panelists shared their healthcare experiences, students asked them questions in a moderated setting. Students completed evaluations on the presentation and learning outcomes. They also wrote a self-reflection paper on the experience.

ASSESSMENT: Ninety-one percent of students agreed that they could describe methods for showing respect to a transgender patient and 91.0% evaluated the usefulness of the presentation to be …

Nanotoxicity In Cells Of The Immune System, Jonathan J. Pelc

Science Scholars

Nanoparticles (NPs) provide a new medical approach to drug therapy. As with every new approach, safety precautions need to be taken, and the immediate and long-term effects for many NPs are still unclear. When administering a medical treatment into the human body, the first issue that needs to be addressed is host detection of the medicine and inflammation as a possible result of the treatment. If a new NP treatment causes inflammation before it releases its medicine, that treatment may be ineffective, even damaging to the patient. Small metallic and organic particles have been shown to elicit an inflammatory responses …

Design Of A Problem-Based Learning Pain And Palliative Care Elective Course, Katherine Juba, Bernard P. Ricca

Pharmacy Faculty/Staff Publications

Objective

To implement and evaluate a problem-based learning (PBL) pain and palliative care elective course to develop studentsʼ pain and symptom management pharmacotherapy knowledge, clinical reasoning process, and self-directed learning skills.

Methods

Each week students received a patient case to independently develop an assessment and plan for each pain and symptom management problem. During class the students discussed their findings within small groups in preparation for a large-group discussion with the instructor. Studentsʼ course grades were based on weekly pre-class case preparation, individual case studies, and self-reflection questions. To assess knowledge gained over the semester a free-response pre- and post-course …

Analysis Of Compounded Pharmaceutical Products To Teach The Importance Of Quality In An Applied Pharmaceutics Laboratory Course, Alyssa M. Pignato, Christine R. Birnie

Doctoral External Publications

Objective. To assess the effectiveness of a product-analysis laboratory exercise in teaching students the importance of quality in pharmaceutical compounding.

Design. Second-year pharmacy students (N=77) participated in a pharmaceutical compounding laboratory exercise and subsequently analyzed their final product using ultraviolet (UV) spectrometry.

Assessment. Reflection, survey instruments, and quiz questions were used to measure how well students understood the importance of quality in their compounded products. Product analysis showed that preparations compounded by students had an error range of 0.6% to 140%, with an average error of 23.7%. Students’ reflections cited common sources of error, including inaccurate weighing, contamination, and product …

Education In Pediatrics In Us Colleges And Schools Of Pharmacy, William Allan Prescott, Elizabeth M. Dahl, David Hutchinson

Pharmacy Faculty/Staff Publications

Objective. To determine the extent to which pediatrics is taught at US doctor of pharmacy (PharmD) programs and to characterize what is being taught and how.

Methods. A 40-question online survey instrument was sent to accredited and candidate-status US PharmD programs.

Results. Of 86 participating programs (67.2% response rate), 81 (94.2%) indicated that pediatric topics were included in their required classroom curricula (mean, 21.9 contact hours). A pediatric elective course was offered by 61.0% of programs (mean, 25.9 contact hours). Advanced pharmacy practice experiences (APPEs) in pediatrics were offered by 97.4% of programs, with an average of 27 students per …

Advanced Screencasting With Embedded Assessments In Pathophysiology And Therapeutics Course Modules, Ashley Woodruff, Megan Jensen, William Loeffler, Lisa M. Avery

Pharmacy Faculty/Staff Publications

Objective. To implement and assess the effectiveness of a hybrid learning model using advanced screencasting with embedded assessments in pathophysiology and therapeutics modules.

Design. Two pathophysiology and therapeutics course modules on viral hepatitis and the clinical pharmacokinetics of aminoglycosides were chosen for study. The preclass portion of the hybrid model involved student completion of interactive e-lectures that were created with the use of advanced screencasting and included embedded assessments. Students viewed the e-lectures and completed the assessment questions prior to in-class lecture.

Assessment. Preimplementation and postimplementation test scores were compared and student survey data were analyzed. Test scores improved significantly …

Stability Of Levetiracetam Oral Solution Repackaged In Oral Plastic Syringes, Daniel Prohotsky, Susan Hughes, Fang Zhao

Doctoral External Publications

Purpose The long-term stability of levetiracetam solution in oral syringes was investigated in order to define a suitable beyond-use date and demonstrate the feasibility of storing prepared syringes for extended periods as an alternative to commercial levetiracetam unit dose cups.

Methods Levetiracetam oral solution (100 mg/mL) was drawn into 1- and 10-mL amber polypropylene oral syringes. Triplicate samples of the syringe preparations were stored at refrigeration (2–8 °C) or room temperature (20–25 °C) and evaluated at monthly intervals for up to six months. At each time point, the samples were visually inspected and levetiracetam stability was assessed via pH measurement …

Cancer Vaccines: A Ray Of Hope, Lipika Chablani

Pharmacy Faculty/Staff Publications

In lieu of an abstract, here are the article's first two paragraphs:

Recent cancer statistics review by Surveillance, Epidemiology, and End Results (SEER) Program by National Cancer Institute (NCI) shows that cancer is the second most leading cause of death after heart diseases. Cancer incidence has grown from 19.2% to 23.3% from 1975 to 2010 (Figure 1)[1]. Lung cancer remains to be the most fatal form of cancer followed by colorectal, breast and prostate cancer in the country (Table 1)[1]. Regardless of several treatment options, cancer remains to be a unique challenge for both patients and the healthcare providers. Several …

A Review Of The Role Of Melatonin In Irritable Bowel Syndrome, Nicole R. Brinn, Mona A. Gandhi

Doctoral External Publications

Irritable bowel syndrome (IBS) is a troubling disease experienced worldwide. The presentation of symptoms varies from patient to patient, and current prescription treatments can be inadequate in resolving symptoms. This article explores the available scientific literature supporting the use of melatonin in alleviating IBS symptoms.

Computer Testing To Document Student Achievement Of Learning Outcomes, Richard O'Brocta

Pharmacy Faculty/Staff Publications

In lieu of an abstract, here is the letter's first paragraph:

To the Editor. Every course should have published learning outcomes describing what students should be able to do upon successful completion of the course.1 Assessing how well the students have achieved the learning outcomes for the course is very important as this can provide evidence of learning for the student and a measure of the effectiveness of the course. Evidence of learning is important for accreditation purposes and can provide data that can be used to improve the course.2 Documenting student achievement of outcomes can be …

Acquisition Of Medication For Short-Term Medical Mission Trips, Christine R. Birnie

Pharmacy Faculty/Staff Publications

In lieu of an abstract, here is the article's first paragraph:

Each year, increasing numbers of pharmacists and pharmacy students participate in medical mission trips around the world. The Christian Pharmacist Fellowship International (CPFI) partners with Global Health Outreach (GHO) to ensure that one or two pharmacists are included on each of their multi-disciplinary medical trips. Over the past years, the number of pharmacists participating on these trips has increased from 20 pharmacists in 2002 to 78 pharmacists in 2012.¹ In recent years, pharmacy students have also become active team members, and several schools are now organizing medical mission …

Empowering Students With Assessment Data, Jane M. Souza, Karen D.C. Bobak

Pharmacy Faculty/Staff Publications

Students’ perspective on assessment may be limited to summative grades for semester performance. However, providing access to data tracking their progress formatively could empower them to be more proactive in preparing for success. Examples of empowering students through access to data will be shared from two campuses. One campus will demonstrate how requiring students to reflect on longitudinal reports of their performance on learning outcomes can assist in targeting their studies. The second campus will exhibit how assessment data can be linked to peer mentoring. Participants will strategize how to engage students actively in the use of assessment data.

Using Embedded Assessments To Track Accreditation Standards And Generate Evidence-Based Curriculum Maps, Jane M. Souza

Pharmacy Faculty/Staff Publications

St. John Fisher College mined existing course-level assessments to address accreditation standards at the course, curricular, and student levels. This presentation demonstrated a strategy for coding existing test bank items to correspond to learning outcomes and accreditation standards and then using the data for multiple audiences. It also exemplified how an existing rich data source can simultaneously track student longitudinal progress, test bank item performance, and density of curriculum coverage. Strategies are offered to implement this embedded assessment approach to evidence-based curriculum mapping.

Rupture Test And Bioavailability Of Oil-Soluble Vitamins, Lipika Chablani

Pharmacy Faculty/Staff Publications

In lieu of an abstract, here is the article's first paragraph:

Bioavailability of multi-vitamins as dietary supplements has always been a concern. Dissolution studies have been successfully used to predict drug release of bioactive molecules, but with vitamins there are some exceptions. United State Pharmacopoeia (USP) defines the dissolution requirements of multi-vitamin supplements based on the composition and type of dosage form. As oil-soluble vitamins do not meet the criterion of “dissolution”, the performance of dosage forms containing such vitamins is evaluated by disintegration studies primarily. Dissolution studies are not applicable for such dosage forms [1].

Dose Ratios Between High Dose Oral Morphine Or Equivalents And Oral Methadone, Megan S. Chatham, Elizabeth S. Dodds Ashley, Jefferson S. Svengsouk, Katherine Juba

Pharmacy Faculty/Staff Publications

Background: Methadone is a commonly used opioid in hospice and palliative care for patients with refractory pain. Various methadone dose conversion methods utilize progressively higher morphine equivalent dose (MED) to methadone dose ratios to compensate for increased methadone potency with escalating opioid doses.

Objective: The purpose of this study was to determine the dose ratio between equianalgesic doses of high dose oral morphine (daily doses >1200 mg morphine or MED) and oral methadone.

Methods: This study was a retrospective chart review of 324 patients who received methadone at Strong Memorial Hospital or the associated outpatient clinic during a nine-month period …

Morphine And Hydromorphone-Induced Hyperalgesia In A Hospice Patient, Katherine Juba, Robert G. Wahler, Susan M. Daron

Pharmacy Faculty/Staff Publications

Opioids including morphine and hydromorphone are widely used for control of moderate to severe pain and dyspnea in hospice and palliative care patients. Accumulation of the active morphine-3-glucuronide (M3G) and hydromorphone-3-glucuronide (H3G) metabolites is one proposed mechanism for the development of neuroexcitatory effects including allodynia and opioid-induced hyperalgesia (OIH). We report the case of a 43-year-old female hospice patient with metastatic non-small cell lung cancer who initially developed allodynia following morphine administration and again following administration of hydromorphone. The allodynia resolved both times following the discontinuation of the opioid and rotation to a different opioid regimen. Potential opioid-induced neuroexcitatory treatment …

Evolution Of Preprofessional Pharmacy Curricula, Brenda L. Gleason, Mark V. Siracuse, Nader H. Moniri, Christine R. Birnie, Curtis T. Okamoto, Michael A. Crouch

Pharmacy Faculty/Staff Publications

Objectives. To examine changes in preprofessional pharmacy curricular requirements and trends, and determine rationales for and implications of modifications.

Methods. Prerequisite curricular requirements compiled between 2006 and 2011 from all doctor of pharmacy (PharmD) programs approved by the Accreditation Council of Pharmacy Education were reviewed to ascertain trends over the past 5 years. An online survey was conducted of 20 programs that required either 3 years of prerequisite courses or a bachelor’s degree, and a random sample of 20 programs that required 2 years of prerequisites. Standardized telephone interviews were then conducted with representatives of 9 programs.

Results. In 2006, …

Stability Of Diluted Adenosine Solutions In Polyolefin Infusion Bags, Elise Almagambetova, David Hutchinson, Danielle M. Blais, Fang Zhao

Doctoral External Publications

Background

Intravenous or intracoronary adenosine is used in the cardiac catherization lab to achieve maximal coronary blood flow and determine fractional flow reserve.

Objective

To determine the stability of adenosine 10 and 50 µg/mL in either 0.9% sodium chloride injection or 5% dextrose injection in polyolefin infusion bags stored at 2 temperatures, refrigeration (2°C-8°C) or controlled room temperature (20°C-25°C).

Methods

Adenosine 10 µg/mL and 50 µg/mL solutions were prepared in 50 mL polyolefin infusion bags containing 0.9% sodium chloride injection or 5% dextrose injection and stored at controlled room temperature or under refrigeration. Each combination of concentration, diluent, and storage …