Pharmacy and Pharmaceutical Sciences Commons^™

Irisin Evokes Bradycardia By Activating Cardiac-Projecting Neurons Of Nucleus Ambiguus., Eugen Brailoiu, Elena Deliu, Romeo A Sporici, Gabriela Cristina Brailoiu

College of Pharmacy Faculty Papers

Irisin is a newly identified hormone induced in muscle and adipose tissues by physical activity. This protein and its encoding gene have been identified in the brain; in addition, the precursor for irisin, FNDC5, can cross the blood-brain barrier. The fact that irisin is secreted during exercise together with the lower resting heart rate in athletes prompted us to investigate the effect of irisin on cardiac-projecting vagal neurons of nucleus ambiguus, a key regulatory site of heart rate. In vitro experiments in cultured nucleus ambiguus neurons indicate that irisin activates these neurons, inducing an increase in cytosolic Ca(2+) concentration and …

Evaluation Of A Pharmacist-Led Medication Assessment Used To Identify Prevalence Of And Associations With Polypharmacy And Potentially Inappropriate Medication Use Among Ambulatory Senior Adults With Cancer., Ginah Nightingale, Emily Hajjar, Kristine Swartz, Jocelyn Andrel-Sendecki, Andrew Chapman

College of Pharmacy Faculty Papers

PURPOSE: The use of multiple and/or inappropriate medications in seniors is a significant public health problem, and cancer treatment escalates its prevalence and complexity. Existing studies are limited by patient self-report and medical record extraction compared with a pharmacist-led comprehensive medication assessment.

PATIENTS AND METHODS: We retrospectively examined medication use in ambulatory senior adults with cancer to determine the prevalence of polypharmacy (PP) and potentially inappropriate medication (PIM) use and associated factors. PP was defined as concurrent use of five or more and less than 10 medications, and excessive polypharmacy (EPP) was defined as 10 or more medications. PIMs were …

No Evidence Of A Drug-Drug Interaction Between Letermovir (Mk-8228) And Mycophenolate Mofetil, Wl Marshall, C. Badshah, F. Liu, Walter K. Kraft, Md, F. Colon-Gonzalez, A. Van Schanke, Cr. Cho, E. Hulskotte, Jr Butterton, Ee Marcantonio

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Introduction:

Letermovir (MK-8228) is a potent, oncedaily inhibitor of the cytomegalovirus (CMV) terminase complex that is being developed for the prophylaxis of CMV infection in transplant patients. This study evaluated the pharmacokinetic interactions, safety, and tolerability of letermovir when coadministered in healthy subjects with mycophenolate mofetil (MMF), which is the morpholinoethyl ester prodrug of mycophenolic acid (MPA).

Methods:

This was an open-label trial in 14 healthy female subjects that explored the pharmacokinetic parameters of a single 1 g oral dose of MMF administered alone on Day 1 and coadministered on Day 12 with 480 mg oral once-daily letermovir given on …

Pharmacist Consult Service In Geriatric Trauma Patients, Vanessa M. Gleason, Pharm D., Rohit A. Moghe, Pharm D., Msph, Cde, Doris Warner, Msn, Rn, Cen, Michael S. Weinstein, Md, Facs

Pharmacy Presentations, Posters, and Grand Rounds

Introduction

• Geriatric patients (> 65 years of age) have a 3-5% incremental increase in annual occurrence of trauma making it a top five leading cause of death in this population.

• The mortality rate ranges from 15-30%, which is 4-5 times higher than younger patients.

• In 2011, data from the Pennsylvania Trauma Systems Foundation (PTSF) demonstrated nearly 32% of injured patients statewide and nearly 50% of the trauma patients at Thomas Jefferson University Hospital (TJUH) were > 65 years.

• Most geriatric patients have comorbidities that are treated with many medications, which may predispose them for falls.

• Although …

Overview And Impact Of Implementation Of A Pharmacy Concierge Service, William Balas, Phd, Christine H. Delash, Pharm.D, Brian G. Swift, Pharm.D., Mba, Lynda Thomson, Pharm D., Cacp

Pharmacy Presentations, Posters, and Grand Rounds

Problem / Issue:

Patients are at risk for adverse events and re-admissions due to outpatient medication errors and non-adherence to prescribed medication regimens. Patients are especially at risk for medication errors and misunderstanding of prescribed medication regimens during the transition of care process from the inpatient to outpatient setting.

Posaconazole Tablet Pharmacokinetics: Lack Of Effect Of Concomitant Medications Altering Gastric Ph And Gastric Motility In Healthy Subjects., Walter K. Kraft, Peter S. Chang, Marlou L P S Van Iersel, Hetty Waskin, Gopal Krishna, Wendy M Kersemaekers

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Posaconazole oral suspension is an extended-spectrum triazole that should be taken with food to maximize absorption. A new posaconazole tablet formulation has demonstrated improved bioavailability over the oral suspension in healthy adults in a fasting state. This study evaluated the effects of concomitant medications altering gastric pH (antacid, ranitidine, and esomeprazole) and gastric motility (metoclopramide) on the pharmacokinetics of posaconazole tablets. This was a prospective open-label 5-way crossover study in 20 healthy volunteers. In each treatment period, a single 400-mg dose (4 100-mg tablets) of posaconazole was administered alone or with 20 ml antacid (2 g of aluminum hydroxide and …

Neonatal Abstinence Syndrome In Methadone Exposed Infants: Role Of Genetic Variability, Andrea L. Fielder, J. K. Coller, M. R. Hutchinson, Ross R. Haslam, Nona Lu, Susan C. Adeniyi-Jones, Michelle Ehrlich, Walter K. Kraft

Department of Pharmacology and Experimental Therapeutics Posters

Poster presented at: CPDD Scientific Meeting, San Juan, PR.

Aims: NAS incidence & severity in infants exposed to methadone during gestation is independent of maternal methadone dose. The incidence & severity of NAS could be in part due to genetic variability of key genetic loci related to opioid response; the interleukin-1beta (IL-1B) & mu opioid receptor (OPRM1) genes. This study aimed to investigate the impact of genetic variability in IL-1B -31 or OPRM1 A118G on NAS incidence (treatment required) & severity (dose of morphine).

Methods: This pilot study collected cheek cells from 71 methadone exposed infants; 46 …

An Interprofessional Falls Assessment Clinic Model To Develop Collaborative Team Skills Among Health Professional Students, Tracey Vause-Earland, Ms, Otr/L, Leigh Ann Hewston, Pt, Med, Cecilia Borden, Edd, Msn, Brooke Salzman, Md, Emily Hajjar, Pharmd, Ellen Furman, Msw, Christine Hsieh, Md, Susan Parks, Md

Department of Occupational Therapy Posters and Presentations

BACKGROUND

• Older adults are at increased risk for falls and fall related injuries, leading to loss of independence, disability, and increased mortality.
• Preventing injury and falls is a national Healthy People 2010 objective. However, physicians and other health professionals frequently fail to incorporate known evidence into usual care. Screening for falls is not consistently performed as an essential assessment in older adults by primary care providers.
• Multidisciplinary assessment can be an important component in preventing falls in community dwelling adults.
• In new practice models, such as the Chronic Care Model, there is an emphasis on interdisciplinary collaboration, however health professions …

Einstein's Medication Reach Program Enhances Patient Care, Deborah Hauser Rph, Mha

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Tumor Radiation Therapy Creates Therapeutic Vaccine Responses To The Colorectal Cancer Antigen Gucy2c., Matthew Witek, Erik S Blomain, Michael Sullivan Magee, Bo Xiang, Scott A Waldman, Adam E. Snook

Department of Pharmacology and Experimental Therapeutics Faculty Papers

PURPOSE: Radiation therapy (RT) is thought to produce clinical responses in cancer patients, not only through direct toxicity to cancer cells and supporting tumor stroma cells, but also through activation of immunologic effectors. More recently, RT has potentiated the local and systemic effects of cancer immunotherapy (IT). However, combination regimens that maximize immunologic and clinical efficacy remain undefined.

METHODS AND MATERIALS: We evaluated the impact of local RT on adenoviral-mediated vaccination against the colorectal cancer antigen GUCY2C (Ad5-GUCY2C) in a murine subcutaneous tumor model using mouse CT26 colon cancer cells (CT26-GUCY2C). Immune responses were assessed by ELISpot, and clinical responses …

Managing The Innovation Supply Chain To Maximize Personalized Medicine., Scott A. Waldman, Andre Terzic

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Personalized medicine epitomizes an evolving model of care tailored to the individual patient. This emerging paradigm harnesses radical technological advances to define each patient's molecular characteristics and decipher his or her unique pathophysiological processes. Translated into individualized algorithms, personalized medicine aims to predict, prevent, and cure disease without producing therapeutic adverse events. Although the transformative power of personalized medicine is generally recognized by physicians, patients, and payers, the complexity of translating discoveries into new modalities that transform health care is less appreciated. We often consider the flow of innovation and technology along a continuum of discovery, development, regulation, and application …

Evaluation Of The Appropriate Weaning Of Neonatal Morphine Solution (Nms) In The Treatment Of Neonatal Abstinence Syndrome (Nas) And Its Effect On Length Of Stay (Los), Nicole Hollinger, Pharmd Candidate, Christopher Hvisdas, Pharmd Candidate, Maria Samohod, Md Candidate, Tara E. Decerbo, Pharmd, Janet Larson, Md, Kristin Mckenna, Md, Lindsey Roke, Pharmd

Pharmacy Presentations, Posters, and Grand Rounds

Purpose: Neonates suffering from NAS receive NMS to treat withdrawal symptoms associated with this disease. Frequent NMS dosing and close monitoring are required to ensure adequate symptom control and prevent adverse events. Maximum dose achieved, titration, severity of disease, and variance in in-utero exposure to addictive drugs all contribute to length of stay. The primary objective of this drug utilization evaluation is to assess adherence to current institutional guidelines for titrating neonates and infants off NMS and to identify opportunities for improvement to potentially decrease length of stay in this population.

Methods: A retrospective chart review of neonates …

An Institution Wide Interdisciplinary Protocol For Improving The Recognition And Treatment Of Sepsis In Patients Presenting To The Emergency Department, Glenn Oettinger, Pharmd, Bcps

Pharmacy Presentations, Posters, and Grand Rounds

Objectives of this presentation were to describe our severe sepsis protocol, tools for sepsis identification, management, and staff education, as well as results of our research demonstrating the impact of this initiative on mortality.

Presented at: UHC Annual Conference 2013 in Atlanta, GA

36 PowerPoint slides.

Clevidipine For Acute Blood Pressure Management In The Neurological Intensive Care Unit, Dorota K. Szarlej, Pharmd, Jessica L. Mckeon, Pharmd, Akta S. Patel, Pharmd, Bcps, Amber King

College of Pharmacy Faculty Papers

Clevidipine is a third generation intravenous dihydropyridine calcium channel antagonist approved for treatment of acute hypertension when oral therapy is not feasible or desirable. It is an arterial vasodilator that is metabolized by plasma esterases; therefore, it is eliminated independently of the liver and kidney.1 Clevidipine has been studied for the control of perioperative hypertension2-5 as well as for the management of hyper-tensive crises6 when immediate blood pressure control is clinically necessary. Benefits include its tolerability, rapid onset and offset, and easy titration with predictable response. Other continuously infused intravenous antihypertensives used in the neurocritical care patient population include nicardipine, …

The Impact Of Community Use Of Novel Oral Anticoagulants On An Academic Medical Center, Luis Eraso, Md, Taki Galanis, Md, Kristina Kipp, Pharm.D., Walter K. Kraft, Md, Michael Palladino, Pharm.D., Cacp, Alejandro Perez, Md, Kimberle Ferebee-Spruill, Crnp, Geno Merli, Md, Brian G. Swift, Pharm.D., Mba, Lynda Thomson, Brittany Vining

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Warfarin has been a mainstay of therapy for treatment and prevention of venous thromboembolic disease (VTED) and prevention of stroke and systemic embolism for over 50 years. Recent FDA approval of several novel oral anticoagulants has offered more extensive treatment options for management of these disease states.

The availability of the novel anticoagulants offers an attractive alternative to warfarin therapy for patients due to their convenience of use. In comparison to warfarin, dabigatran, rivaroxaban and apixaban offer: - a fixed dosage regimen

- a relatively small potential drug interaction profile

- minimal laboratory monitoring

- little to no dietary restrictions. …

What’S Your Line? Defining Pharmacists' Role In Jejunostomy Tube Medication Administration, Jamie M. Gomes, Pharmd, Gloria M. Espinosa, Pharmd, Brian P. Roslund, Pharmd, Bcps, Joanne Heil, Pharmd, Bcps

Pharmacy Presentations, Posters, and Grand Rounds

Enteral nutrition is preferred over parenteral nutrition in patients with inadequate oral intake for an extended period of time. Enteral feeding helps preserve the functioning of the gastrointestinal (GI) tract. 1 Feeding tubes provide access to the GI tract allowing administration of medication while unable to swallow. Drug therapy is complicated by drug formulation, absorption site, first-pass elimination, as well as the size and placement of the tube.1-3 Medication errors revolving around administration via enteral feeding tubes represent a need for education and implementation of hospital guidelines.

Implementation Of Three Times Daily Small Volume Parenteral (Svp) Processing Using Lean Methodology, Phuoc Lynsey Le, Pharmd, Dominick Bulone, Pharmd, Akta S. Patel, Pharmd, Bcps, Glenn Oettinger, Pharmd, Bcps, Dennis Delisle, Mhsa, Pmp

Pharmacy Presentations, Posters, and Grand Rounds

Clinical Importance

• Small volume parenteral (SVP) medications are batch-processed once daily at a 900+ bed academic medical center
• Labels are printed 36 hours before medications are due and prepared and delivered for a 24-hour period
• Therapy changes, discontinuations or patient transfers lead to increased rework, missing doses, and ultimately waste
• Lean methodology was originally developed as a production philosophy and quality
• system with an emphasis on problem solving, partnership, and process improvement1-3
• The Lean philosophy emphasizes the continual identification and elimination of waste in order to maximize value1
• Lean has been used in healthcare with great success4-5

Rituximab Treatment For Antibody-Mediated Rejection (Amr) Following Heart And Kidney Transplant, Laura Falconieri, Ba, Pharmd, Cheryl A. Abbas, Pharmd

Pharmacy Presentations, Posters, and Grand Rounds

Background

Antibody Mediated Rejection (AMR)1,2

• Rejection that occurs due to antibodies against donor-specific antigen (DSA)

– Antibodies activate complement system

– Leads to cell death and tissue necrosis

• Risk Factors

– Pregnancy

– Blood transfusions

– Prior transplantation

• Types of AMR

– Hyperacute

• Occurs within minutes of graft transplantation causing death of the graft

• Due to pre-formed antibodies present in high titers

• Rarely occurs now due to universal cross-matching

– Acute

• Occurs within a few days of transplantation causing graft dysfunction

• Due to pre-formed antibodies or antibodies that develop de novo after …

Use Of Apheresis And Insulin For Hypertriglyceridemia-Induced Pancreatitis And Diabetic Ketoacidosis, Drew Kirk, Pharmd, Cara Mcdaniel, Pharmd, Bcps, Rohit A. Moghe, Pharmd, Msph, Cde

Pharmacy Presentations, Posters, and Grand Rounds

CLINICAL RELEVANCE

• Acute pancreatitis (AP) is a common gastrointestinal disease that may result in multiple organ failure and death¹

– Gallstones & alcohol are the most common causes of AP¹

– Hypertriglyceridemia (HTG) causes 1-4% of cases, and should be suspected if triglycerides (TG) are > 1,000 mg/dL in the absence of gallstones or history of significant alcohol use¹

– Clinical management of hypertriglyceridemia-induced pancreatitis (HTGP) is based primarily on anecdotal evidence and case reports

• Concurrent diabetic ketoacidosis (DKA) and AP have been described in the literature

– DKA may be a risk factor for AP, but it …

Increased Levels Of Plasma Soluble Sema4d In Patients With Heart Failure., Qiongyu Lu, Ningzheng Dong, Qi Wang, Wenxiu Yi, Yuxin Wang, Shengjie Zhang, Haibo Gu, Xin Zhao, Xiaorong Tang, Boquan Jin, Qingyu Wu, Lawrence F Brass, Li Zhu

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Semaphorin 4D (Sema4D/CD100) is a 150-kDa transmembrane glycoprotein expressed by platelets and T-cells. When these cells are activated, Sema4D is cleaved proteolytically, generating a biologically active 120-kDa fragment (soluble Sema4D) capable of targeting receptors on platelets, B-cells, endothelial cells and tumor cells. However, its plasma levels and significance in heart failure (HF) have not been reported. In this study, we established an ELISA and detected soluble Sema4D in human plasma. In healthy controls, plasma Sema4D levels were higher in men than women (5.15±3.30 ng/mL, n = 63, vs. 4.19±2.39 ng/mL, n = 63, P

Identification Of Distant Drug Off-Targets By Direct Superposition Of Binding Pocket Surfaces., Marcel Schumann, Roger S Armen

College of Pharmacy Faculty Papers

Correctly predicting off-targets for a given molecular structure, which would have the ability to bind a large range of ligands, is both particularly difficult and important if they share no significant sequence or fold similarity with the respective molecular target ("distant off-targets"). A novel approach for identification of off-targets by direct superposition of protein binding pocket surfaces is presented and applied to a set of well-studied and highly relevant drug targets, including representative kinases and nuclear hormone receptors. The entire Protein Data Bank is searched for similar binding pockets and convincing distant off-target candidates were identified that share no significant …

Fibroblast Growth Factor-2 (Fgf2) And Syndecan-1 (Sdc1) Are Potential Biomarkers For Putative Circulating Cd15+/Cd30+ Cells In Poor Outcome Hodgkin Lymphoma Patients., Rajendra Gharbaran, Andre Goy, Takemi Tanaka, Jongwhan Park, Chris Kim, Nafis Hasan, Swathi Vemulapalli, Sreeja Sarojini, Madalina Tuluc, Kip Nalley, Pritish Bhattacharyya, Andrew Pecora, K Stephen Suh

College of Pharmacy Faculty Papers

BACKGROUND: High risk, unfavorable classical Hodgkin lymphoma (cHL) includes those patients with primary refractory or early relapse, and progressive disease. To improve the availability of biomarkers for this group of patients, we investigated both tumor biopsies and peripheral blood leukocytes (PBL) of untreated (chemo-naïve, CN) Nodular Sclerosis Classic Hodgkin Lymphoma (NS-cHL) patients for consistent biomarkers that can predict the outcome prior to frontline treatment.

METHODS AND MATERIALS: Bioinformatics data mining was used to generate 151 candidate biomarkers, which were screened against a library of 10 HL cell lines. Expression of FGF2 and SDC1 by CD30+ cells from HL patient samples …

Heart Failure Transition Of Care Program: The Pharmacist’S Role In Reducing Readmissions, Joseph Favatella, Pharmd Candidate 2013, Joanne Heil, Pharmd, Bcps

College of Pharmacy Faculty Papers

Presented at: ASHP Mid-Year Clinical Meeting in Las Vegas.

Introduction & Background

Current Trends¹

•Approximately 19.6% of Medicare patients are readmitted to the hospital within 30 days

•These readmissions accounted for $15 billion of Medicare spending in 2009

Changes Coming

•As part of the Affordable Care Act, Medicare will not be reimbursing hospitals for patients readmitted within 30 days of discharge

•Hospitals have already begun improving discharge protocols to provide a greater continuity of care and minimize the financial loss of future readmissions

A Model²

•Boston University Medical Center's Re-Engineered Discharge (RED) was the first program to improve …

The Use Of Glucarpidase In An Open-Label Treatment Protocol As Adjunctive Treatment For A Patient With Delayed Methotrexate Elimination, Cheryl A. Abbas, Pharmd, Anne Marie Valorie-Oberle, Bs, Pharmd, Bcop

College of Pharmacy Faculty Papers

Presented at: ASHP Clinical MidYear Meeting in Las Vegas.

Background

Methotrexate (MTX)

• Cytotoxic agent that competitively inhibits dihydrofolate reductase (DHFR), the intracellular enzyme responsible for converting folic acid to reduced folate inhibitors, necessary for DNA synthesis
• Used since 1948 in the treatment of various malignancies and as a disease-modifying agent in rheumatoid arthritis and psoriasis
• High-dose mexthotrexate (HDMTX) began in 1960s solely or in combination with other chemotherapeutic agents

Methotrexate Toxicity

• Almost exclusively cleared through the kidneys
  • Precipitation of drug occurs in the renal tubules
  • Prolonged elevations of systemic MTX concentrations results in potential serious toxicity
• Increased use of HDMTX …

Limited Sampling Estimates Of Epigallocatechin Gallate Exposures In Cirrhotic And Noncirrhotic Patients With Hepatitis C After Single Oral Doses Of Green Tea Extract., Dina Halegoua-De Marzio, Walter K. Kraft, Constantine Daskalakis, Xie Ying, Roy L Hawke, Victor J. Navarro

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Epigallocatechin-3-gallate (EGCG) has antiangiogenic, antioxidant, and antifibrotic properties that may have therapeutic potential for the treatment of cirrhosis induced by hepatitis C virus (HCV). However, cirrhosis might affect EGCG disposition and augment its reported dose-dependent hepatotoxic potential.

OBJECTIVE: The safety, tolerability, and disposition of a single oral dose of EGCG in cirrhotic patients with HCV were examined in an exploratory fashion.

METHODS: Eleven patients with hepatitis C and detectable viremia were enrolled. Four had Child-Pugh (CP) class A cirrhosis, 4 had Child-Pugh class B cirrhosis, and 3 were noncirrhotic. After a single oral dose of green tea extract 400 …

Dysregulation Of Mir-31 And Mir-21 Induced By Zinc Deficiency Promotes Esophageal Cancer, Hansjuerg Alder, Cristian Taccioli, Hongping Chen, Yubao Jiang, Karl Smalley, Paolo Fadda, Hatice G. Ozer, Kay Huebner, John Farber, Carlo M. Croce, Louise Fong

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Presented at: Hallmarks and Cancer Conference, October 29-31 in San Francisco.

And AICR Annual Meeting, November 1-2, 2012.

Dietary zinc (Zn) deficiency (ZD) in rats induces an inflammatory gene signature that fuels esophageal squamous cell cancer (ESCC). Using nanoStringTM technology, we show that the inflammation is accompanied by altered expression of specific microRNAs in esophagus, as well as skin, lung, pancreas, liver, prostate, and PBMC, predictive of disease development. Particularly, the ZD esophagus has a microRNA signature resembling human ESCC/tongue SCC miRNAomes with overexpression of miR-31 and miR-21 and downregulation of their respective tumor suppressor targets PPP2R2A and …

Mk-0448, A Specific Kv1.5 Inhibitor: Safety, Pharmacokinetics And Pharmacodynamic Electrophysiology In Experimental Animal Models And In Humans., Behzad B. Pavri, Howard E Greenberg, Walter K. Kraft, Nicole Lazarus, Joseph J Lynch, Joseph J Salata, Mark T Bilodeau, Christopher P Regan, Gary Stump, Li Fan, Anish Mehta, John A Wagner, David E Gutstein, Daniel Bloomfield

Department of Pharmacology and Experimental Therapeutics Faculty Papers

BACKGROUND: -We evaluated the viability of I(Kur) as a target for maintenance of sinus rhythm in patients with a history of atrial fibrillation through the testing of MK-0448, a novel I(Kur) inhibitor. METHODS AND RESULTS: -In vitro MK-0448 studies demonstrated strong inhibition of I(Kur) with minimal off-target activity. In vivo MK-0448 studies in normal anesthetized dogs demonstrated significant prolongation of the atrial refractory period compared with vehicle controls without affecting the ventricular refractory period. In studies of a conscious dog heart failure model, sustained AF was terminated with bolus intravenous MK-0448 doses of 0.03 and 0.1 mg/kg. These data led …

Pharmacologic Management Of The Opioid Neonatal Abstinence Syndrome., Walter K. Kraft, John N Van Den Anker

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Opioid use in pregnant women has increased over the last decade. Following birth, infants with in utero exposure demonstrate signs and symptoms of withdrawal known as the neonatal abstinence syndrome (NAS). Infants express a spectrum of disease, with most requiring the administration of pharmacologic therapy to ensure proper growth and development. Treatment often involves prolonged hospitalization. There is a general lack of high-quality clinical trial data to guide optimal therapy, and significant heterogeneity in treatment approaches. Emerging trends in the treatment of infants with NAS include the use of sublingual buprenorphine, transition to outpatient therapy, and pharmacogenetic risk stratification.

Interprofessional Education In Didactic And Experiential Settings At The Jefferson School Of Pharmacy, Elena M. Umland, Cynthia A. Sanoski, Emily R. Hajjar, Bhavik Shah

College of Pharmacy Faculty Papers

Presented at: 2012 Annual Meeting of the American Association of Colleges of Pharmacy in Kissimmee, Florida.

Objective:

To evaluate the various IPE offerings at a new school of pharmacy at a large academic medical center.

Effect Of Concomitant Medications Affecting Gastric Ph And Motility On Posaconazole Tablet Pharmacokinetics, Walter K. Kraft, P. Chang, Mlps Van Iersel, H. Waskin, G. Krishna, W. Kersemaekers

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Poster presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy (52^nd ICAAC) held in San Francisco 9/9-9/12

Background: Posaconazole (POS) oral suspension is an extended-spectrum triazole that should be taken with food to maximize absorption. A new POS tablet formulation has demonstrated improved bioavailability over oral suspension in healthy adults in the fasting state. This study evaluated the effect of concomitant medications altering gastric pH (antacid, ranitidine, and esomeprazole) and motility (metoclopramide) on the pharmacokinetics of POS tablet.

Methods: This was a prospective, open-label, 5-way crossover study in 20 healthy volunteers. In each treatment period, a single 400-mg (100 …