Pharmacy and Pharmaceutical Sciences Commons^™

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 …

Physical Properties And Solubility Studies Of Nifedipine-Peg 1450/Hpmcas-Hf Solid Dispersions, Rahul V. Haware, Bhavani Prasad Vinjamuri, Monika Gavireddi, Vivek S. Dave, Deepak Gupta, Mahavir B. Chougule, William C. Stagner

Pharmacy Faculty/Staff Publications

Low-order high-energy nifedipine (NIF) solid dispersions (SDs) were generated by melt solvent amorphization with polyethylene glycol (PEG) 1450 and hypromellose acetate succinate (HPMCAS-HF) to increase NIF solubility while achieving acceptable physical stability. HPMCAS-HF was used as a crystallization inhibitor. Individual formulation components, their physical mixtures (PMs), and SDs were characterized by differential scanning calorimetry, powder X-ray diffraction, and Fourier transform infrared spectroscopy (FTIR). NIF solubility and percent crystallinity (PC) were determined at the initial time and after 5 days stored at 25 °C and 60% RH. FTIR indicated that hydrogen bonding was involved with the amorphization process. FTIR showed that …

Assessment Of The Use Of Non-Pharmacological Methods For Managing Depression In Patients With Myotonic Dystrophy (Dm) And Facioscapulohumeral Muscular Dystrophy (Fshd), Mackenzie Roberts, Amy L. Parkhill, Deidre Skalla, Kimberly Miller

Pharmacy Faculty/Staff Publications

Background: Myotonic dystrophy (DM) and facioscapulohumeral muscular dystrophy (FSHD) are two types of muscular dystrophies with multi-system manifestations.

Purpose: The purpose of this study was to determine 1: the prevalence of depression in patients with myotonic dystrophy (DM) and facioscapulohumeral muscular dystrophy (FSHD) and 2: which non-pharmacological methods DM and FSHD patients are using to manage their depression.

Methods: A survey was conducted using the online system, Qualtrics. The voluntary and anonymous survey was emailed to 1,205 eligible patients from the National Registry for DM and FSHD Patients and Family Members at the University of Rochester. Participants were at least …

Empathy And The Development Of Affective Skills, Anna Ratka

Pharmacy Faculty/Staff Publications

Empathy, the most important human attribute that matters in every aspect of life, is essential in health care. Provision of patient-centered care requires empathic health care practitioners. The correlation between empathy of health care providers and improved patient adherence, satisfaction, and treatment outcomes is well-established. Scholarly evidence shows positive correlations between empathy and affective domains and confirms that soft skills are grounded in empathy. Empathic students have stronger affective skills and are capable to acquire, develop, reinforce, and display strong affective behaviors, abilities, and attitudes. As an innate quality, empathy is malleable. The level of empathy can be influenced by …

Antimicrobial Susceptibility Trends Observed In Urinary Pathogens Obtained From New York State, Elliot L. Rank, Thomas Lodise, Lisa M. Avery, Eve Bankert, Erica Dobson, Ghinwa Dumyati, Stephen Hassett, Marina Keller, Matthew Pearsall, Theresa Lubowski, Joseph J. Carreno

Pharmacy Faculty/Staff Publications

International guidelines recommend using local susceptibility data to direct empiric therapy for acute uncomplicated cystitis. We evaluated outpatient urinary isolate susceptibility trends in New York State. Nitrofurantoin had the lowest resistance prevalence whereas trimethoprim-sulfamethoxazole and fluoroquinolones had higher prevalences. This study highlights the need for local outpatient antimicrobial stewardship programs.

Basics Of Compounding: Vehicles For Compounded Oral Liquid Medications: A Review, Kara Cutaia, Lipika Chablani, Fang Zhao

Pharmacy Faculty/Staff Publications

Compounded oral liquid medications play an important role in addressing the unmet needs of special patient populations, including pediatric, geriatric, and tube fed patients. The use of manufactured vehicles can streamline the compounding activities for pharmacists. In recent years, there is an increase in the availability of manufactured vehicles with various promotional features. This article uses the general formulation principles as a guide to compare and contrast the manufactured vehicles regarding their physicochemical properties, presence of preservatives and dyes, organoleptic properties, and ease of use. A summary table is provided as a reference tool to assist pharmacists in selecting the …

Early Detection Of Capping Risk In Pharmaceutical Compacts, Xiaochi Xu, Chaitanya Krishna Prasad Vallabh, Stephen W. Hoag, Vivek S. Dave, Centin Cetinkaya

Pharmacy Faculty/Staff Publications

Capping is a common mechanical defect in tablet manufacturing, exhibited during or after the compression process. Predicting tablet capping in terms of process variables (e.g. compaction pressure and speed) and formulation properties is essential in pharmaceutical industry. In current work, a non-destructive contact ultrasonic approach for detecting capping risk in the pharmaceutical compacts prepared under various compression forces and speeds is presented. It is shown that the extracted mechanical properties can be used as early indicators for invisible capping (prior to visible damage). Based on the analysis of X-ray cross-section images and a large set of waveform data, it is …

Stability And Compatibility Of Diphenhydramine Hydrochloride In Intravenous Admixtures: A New Look At An Old Drug, Daniel Sabins, Tuong Diep, Pamela Mccartan, Shashi Patel, Fang Zhao

Doctoral External Publications

Purpose: Intravenous (IV) admixtures of diphenhydramine are widely used in hospitalized patients to prevent or treat hypersensitivity reactions. However, there is limited data to support the admixture preparation in this manner. This study was designed to investigate the stability and compatibility of diphenhydramine in IV admixtures with a goal to establish a 14-day beyond-use dating with storage under refrigeration. Methods: The commercially available 50 mg/mL diphenhydramine hydrochloride injection vials were used to prepare the 0.2 and 1.0 mg/mL IV admixtures in 0.9% sodium chloride injection and 5% dextrose injection in 50 mL polyvinyl chloride (PVC) bags. The IV bags were …

Formulation And Stability Study Of Eslicarbazepine Acetate Oral Suspensions For Extemporaneous Compounding, Fang Zhao, Vivek S. Dave, Mazin Z. Mar, Jonathan R. Perri

Pharmacy Faculty/Staff Publications

Eslicarbazepine acetate is an anticonvulsant drug with a recent U.S. Food and Drug Administration approval for expanded use in children and adolescents. Currently, eslicarbazepine acetate is only available in the U.S. as 200-mg to 800-mg strength tablets (Aptiom), which are not easy to administer for pediatric patients. This study was initiated to develop an oral suspension formulation for extemporaneous compounding by pharmacists and to generate stability data for storage recommendations. Nine suspension formulations of eslicarbazepine acetate were prepared from Aptiom tablets and commercially available liquid vehicles using the standard mortar/pestle method. The vehicles varied mainly in their solvents, viscosities, and …

Pharmaceutical Care Management Association V. Rutledge, John J. Crean, Karl Williams

Doctoral External Publications

On June 8, 2018 the federal Eighth Circuit Court of Appeals announced its decision concerning Arkansas' attempt to regulate perceived unfair payment practices of pharmacy benefit managers (PBMs) in the case Pharmaceutical Care Management Association v. Rutledge.¹ Because pharmacies across the country face similar problems, and this ruling may influence other federal appellate courts, review and discussion is useful for the purpose of making strategic decisions.

Salts Of Therapeutic Agents: Chemical, Physicochemical, And Biological Considerations, Deepak Gupta, Deepak Bhatia, Vivek S. Dave, Vijaykumar B. Sutariya, Sheeba Varghese Gupta

Pharmacy Faculty/Staff Publications

The physicochemical and biological properties of active pharmaceutical ingredients (APIs) are greatly affected by their salt forms. The choice of a particular salt formulation is based on numerous factors such as API chemistry, intended dosage form, pharmacokinetics, and pharmacodynamics. The appropriate salt can improve the overall therapeutic and pharmaceutical effects of an API. However, the incorrect salt form can have the opposite effect, and can be quite detrimental for overall drug development. This review summarizes several criteria for choosing the appropriate salt forms, along with the effects of salt forms on the pharmaceutical properties of APIs. In addition to a …

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

Doctoral External Publications

The stability of extemporaneously prepared sodium benzoate oral suspension in cherry syrup and Ora-Sweet was studied. Oral solutions of 250-mg/mL sodium benzoate were prepared in either cherry syrup or Ora-Sweet. To a beaker, 50 grams of Sodium Benzoate Powder USP was dissolved and filtered, the solution was divided equally into two parts, and each aliquot was added into two separate calibrated 100-mL amber vials. In the first vial, cherry syrup was added to make a final volume of 100 mL. In the second vial, Ora-Sweet was added to give a final volume of 100 mL. This process was repeated to …

Drug-Phospholipid Complex-Loaded Matrix Film Formulation For The Enhanced Transdermal Delivery Of Quercetin, Darshan R. Telange, Kuldeep D. Wavare, Arun T. Patil, Milind J. Umekar, Sridhar Anand, Vivek S. Dave

Pharmacy Faculty/Staff Publications

A novel quercetin-phospholipid-complex(QPLC)-loaded matrix film for improved transdermal delivery of quercetin was developed. The QPLC formulation, prepared using a solvent-evaporation method, was optimized using a central-composite design. The optimized QPLC formulation was characterized by particle size and zeta potential analysis, thermal analysis, Fourier transform infrared spectroscopy (FTIR), and proton nuclear magnetic resonance spectroscopy (1H-NMR). QPLC formulation was functionally evaluated for solubility and in vitro dissolution of quercetin. Matrix films of pure quercetin (Q-MF)or QPLC QPLC-MF) were prepared using a solvent casting method. The prepared Q-MF and QPLC-MF were characterized for weight uniformity, folding endurance, moisture content, and moisture uptake. The …

Herpes Zoster Subunit Vaccine For The Prevention Of Herpes Zoster, Melanie Symoniak, Pejman Farrokh, Mona A. Gandhi, Judianne Slish

Pharmacy Faculty/Staff Publications

Purpose Published literature on the efficacy and safety of the herpes zoster (HZ) subunit vaccine (HZ/su vaccine) in reducing the risks of HZ and postherpetic neuralgia (PHN) in adults 50 years of age and older, as well as the vaccine’s properties and efficacy relative to live attenuated vaccine, is reviewed.

Summary HZ/su vaccine (Shingrix, GlaxoSmithKline) is a recently Food and Drug Administration (FDA)–approved vaccine indicated for the prevention of HZ in adults 50 years of age and older. Based on several Phase III trials, the Advisory Committee on Immunization Practices has preferentially recommended HZ/su vaccine over a live attenuated vaccine …

Impact Of Outpatient Vs Inpatient Absssi Treatment On Outcomes: A Retrospective Observational Analysis Of Medical Charts Across Us Emergency Departments, P. Brandon Bookstaver, Timothy C. Jenkins, Edward Stenehjem, Shira Doron, Jack Brown, Shannon H. Goldwater, Carlos Lopes, Angela Haynes, Chuka Udeze, Yifan Mo, Patrick Gllard, Yan Liu, Katelyn Keyloun

Pharmacy Faculty/Staff Publications

Background

The objective of this study was to characterize treatment of patients with acute bacterial skin and skin structure infections (ABSSSIs) and describe the association between hospital admission and emergency department (ED) visits or readmissions within 30 days after initial episode of care (IEC).

Methods

This was a retrospective, observational, cohort study of adults with ABSSSI who presented to an ED between July 1, 2012, and June 30, 2013. Patient, health care facility, and treatment characteristics, including unplanned ED visits or readmissions, were obtained through manual chart review and abstraction. Adjusted logistic regression analysis examined likelihood of all-cause unplanned ED …

The Relationship Between Prior Experiences In Mathematics And Pharmacy School Success, Kelly M. Conn, Christine R. Birnie, David Mccaffrey, Jack Brown

Pharmacy Faculty/Staff Publications

Objective. To assess students’ pre-pharmacy math experiences, confidence in math ability, and relationship between experiences, confidence, and grades in math-based pharmacy courses.

Methods. A cross-sectional survey of first year to third year pharmacy students was conducted. Students reported type of pre-pharmacy math courses taken, when they were taken [high school (HS) vs. college] and year of HS and college graduation. Students rated their confidence in math ability using the previously validated 11-item Fogerty Math Confidence Scale (Cronbach alpha=0.92). Math grade point average (GPA), Pharmacy College Admission Test quantitative (PCAT quant) scores, and grades (calculations and kinetics) were obtained from transcripts …

Stability Of Extemporaneously Prepared Ophthalmic Solutions For Mydriasis, Nicole A. Camp, Jennifer T. Nadra, Susan E. Hughes, Justine M. Gilbert, Fang Zhao

Doctoral External Publications

Purpose Results of an evaluation of the physical and chemical stability of extemporaneously prepared adult and pediatric ophthalmic solutions containing combinations of phenylephrine, tropicamide, and cyclopentolate are reported.

Methods A stability study was conducted to help determine the feasibility of innovative formulations to meet an unmet clinical need for combination mydriatic ophthalmic eyedrops. An adult mydriatic ophthalmic solution containing phenylephrine hydrochloride 2.5% and tropicamide 1.0% and a pediatric formulation containing phenylephrine hydrochloride 2.5%, tropicamide 0.5%, and cyclopentolate hydrochloride 0.5% were prepared using proper aseptic techniques. Triplicate samples of each formulation were stored for 60 days at refrigeration temperatures (2–8 °C) …

Administration Of Long-Acting Injections, Christopher Noel, Karl Williams

Pharmacy Faculty/Staff Publications

Expanding the scope of pharmacy practice demonstrates that the profession has been successful at improving public health. Despite being a late adopter, New York's limited experience with vaccines has improved immunization rates and lowered rates of disease. During emergencies, the 2017-2018 flu season for example, the state has turned to pharmacists to go beyond what the pharmacy practice law permits, in this case enabling immunizations in pediatric patients.¹ This illustrates recognition of untapped potential within the profession to contribute to the public health. Another opportunity for pharmacists to enhance the public health is embodied in a Bill introduced in …

Variation Between Point-Of-Care And Laboratory Hba1ctesting In Clinical Practice, Shawn E. Fellows, Gabriela Cipriano

Pharmacy Faculty/Staff Publications

Aims: The aim of this study was to identify potential disparities between Point-Of-Care Testing (POCT) and laboratory hemoglobinH bA1c reporting at a Federally Qualified Health Center (FQHC).
Methods: The electronic medical record was reviewed to identify POCT HbA1c done at a FQHC and centralized laboratory HbA1c performed on the same day. Manual data extraction was used to identify potential variables that could account for disparities between POCT and laboratory testing.
Results: A total of 42 samples in 40 patients were identified. The median HbA1c difference was 1.5mmol/mol (0.15%) and ranged from -26-52 mmol/mol (-2.4 to 4.8%). Of the patients in …

Correlation Of Solid Dosage Porosity And Tensile Strength With Acoustically Extracted Mechanical Properties, Xiaochi Xu, Connor Mack, Zachary J. Cleland, Chaitanya Krishna Prasad Vallabh, Vivek S. Dave, Centin Cetinkaya

Doctoral External Publications

Currently, the compressed tablet and its oral administration is the most popular drug delivery modality in medicine. The accurate porosity and tensile strength characterization of a tablet design is vital for predicting its performance such as disintegration, dissolution, and drug-release efficiency upon administration as well as ensuring its mechanical integrity. In current work, a non-destructive contact ultrasonic approach and an associated testing procedure are presented and employed to quantify and relate the acoustically extracted mechanical properties of pharmaceutical compacts to direct porosity and tensile strength measurements. Based on a comprehensive set of experimental data, it is demonstrated how strongly the …

Ciprofloxacin For The Treatment Of Cardiobacterium Hominis Prosthetic Valve Endocarditis, Lisa M. Avery, Catherine B. Felberbaum, Muhammad Hasan

Pharmacy Faculty/Staff Publications

Prosthetic valve endocarditis due to Cardiobacterium hominis is rare and recommended therapy includes a third generation cephalosporin. We report a case of Cardiobacterium hominis endocarditis post transcatheter aortic valve replacement in a patient with significant beta-lactam antimicrobial sensitivities who was successfully treated with ciprofloxacin monotherapy in conjunction with surgery.

Telepharmacy And The Law, Hailey Button, Karl Williams

Doctoral External Publications

Recently, an "Advisory Notice" was placed on the website of the New York State Board of Pharmacy entitled "Automated Dispensing Machines" that provide "drugs for sale to customers outside of their respective registered pharmacy areas", and that it "considers this to be a violation of state law"¹. In support, the Notice cited the Education Law relating to the profession of pharmacy² and Regulations of the Commissioner of Education³. Finally, ownership of the pharmacy and the Supervising Pharmacist are responsible for compliance and "may be subject to disciplinary and unprofessional conduct action". The Notice did not …

Hydrochloric Acid Infusion For The Treatment Of Metabolic Alkalosis In Surgical Intensive Care Unit Patients, Jason D. Guffey, Curtis E. Haas, Amber Crowley, Kathryn A. Connor, David C. Kaufman

Pharmacy Faculty/Staff Publications

Background: Older reports of use of hydrochloric acid (HCl) infusions for treatment of metabolic alkalosis document variable dosing strategies and risk. Objectives: This study sought to characterize use of HCl infusions in surgical intensive care unit patients for the treatment of metabolic alkalosis. Methods: This retrospective review included patients who received a HCl infusion for >8 hours. The primary end point was to evaluate the utility of common acid-base equations for predicting HCl dose requirements. Secondary end points evaluated adverse effects, efficacy, duration of therapy, and total HCl dose needed to correct metabolic alkalosis. Data on demographics, potential causes of …

The Prevention And Control Of Cancer By Metformin In Patients With Type 2 Diabetes: A Systematic Mapping Review Protocol, Michelle Price, Gabriela Cipriano, Albania Mitchell

Lavery Library Faculty/Staff Publications

No abstract provided.

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 …