Pharmacy and Pharmaceutical Sciences Commons^™

Improving A Curriculum Through Incremental Changes Based On Programmatic Assessment Results, Batoul Senhaji-Tomza, Suzanne R. Soliman, Paramita Basu

Touro College of Pharmacy (New York) Publications and Research

Objectives: To describe implementation of incremental curriculum changes aimed at addressing identified gaps via subjective and objective programmatic assessment in a 2 + 2 curriculum.

Method: After low first-time NAPLEX pass rates for two consecutive class years, subjective and objective assessment of a 2 + 2 curriculum was conducted. The curriculum was benchmarked to the other existing 2 + 2 program. Other assessments that occurred include: intensive course content review, course credit number versus instructional time audit, vertical and horizontal topical sequence revision in the clinical, basic sciences and social and behavioral course sequences, faculty/student feedback and focus groups; outside …

Medication-Induced Hypokalemia, Keith Veltri, Carly Mason

Touro College of Pharmacy (New York) Publications and Research

The authors present an introduction to hypokalemia and then discuss a case report on a patient with medication-induced hypokalemia.

Evaluating The Effects Of An Interdisciplinary Practice Model With Pharmacist Collaboration On Hiv Patient Co-Morbidities, Rebecca Cope, Leonard Berkowitz, Rebecca Arcebido, Jun-Yen Yeh, Nathan Trustman, Agnes Cha

Touro College of Pharmacy (New York) Publications and Research

Treatment of HIV now occurs largely within the primary care setting, and the principal focus of most visits has become the management of chronic disease states. The clinical pharmacist’s potential role in improving chronic disease outcomes for HIV patients is unknown. A retrospective cohort study was performed for HIV-positive patients also diagnosed with diabetes, hypertension, or hyperlipidemia. Characteristics and outcomes in 96 patients treated by an interdisciplinary team which included a clinical pharmacist (i.e., the intervention group) were compared to those in 50 patients treated by an individual healthcare provider (i.e., the control group). Primary outcomes were changes from baseline …

Customized Order-Entry Sets Can Prevent Antiretroviral Prescribing Errors: A Novel Opportunity For Antimicrobial Stewardship, Yi Guo, Philip Chung, Caryn Weiss, Keith Veltri, Grace Y. Minamoto

Touro College of Pharmacy (New York) Publications and Research

Background: Patients with human immunodeficiency virus (HIV) infection on antiretroviral (ARV) therapy are at increased risk for medication errors during transitions of care between the outpatient and inpatient settings. This can lead to treatment failure or toxicity. Previous studies have emphasized the prevalence of medication errors in such patients, but few have reported initiatives to prevent errors from occurring.

Methods: The study was conducted in a 1,400-bed health care center with a state-designated Acquired Immunodeficiency Syndrome (AIDS) Center in the Bronx, New York. The antimicrobial stewardship team and HIV specialists developed customized order-entry sets (COES) to guide ARV …

Geographic Variation In Antidiabetic Agent Adherence And Glycemic Control Among Patients With Type 2 Diabetes, Eleanora Tan, Wenya Yang, Bo Pang, Mingliang Dai, F. Ellen Loh, Paul Hogan

Touro College of Pharmacy (New York) Publications and Research

BACKGROUND: Medication nonadherence is an imperative public health concern. Among patients with type 2 diabetes mellitus (T2DM), poor adherence to antidiabetic agents is strongly associated with suboptimal glycemic control. Poor adherence and hyperglycemia greatly increase diabetes-related morbidity and mortality. At a national level, diabetes drug adherence using average proportion of days covered (PDC) is estimated to range between 36% and 81%, with an estimated range for diabetes control between 38% and 47%. At a state level no such studies exist.

OBJECTIVE: To estimate the level of medication adherence to antidiabetic agents and of diabetes control, and their association among patients …

Majority Of Hiv/Hcv Patients Need To Switch Antiretroviral Therapy To Accommodate Direct Acting Antivirals, Rebecca Cope, Aaron Pickering, Thomas Glowa, Samantha Faulds, Peter Veldkamp, Ramakrishna Prasad

Touro College of Pharmacy (New York) Publications and Research

The impact of drug–drug interactions (DDIs) between interferon-free direct acting antiviral (DAA) regimens and antiretrovirals (ART) among HIV/HCV co-infected individuals in clinical practice settings is unknown. A singlecenter, retrospective chart review of co-infected patients was conducted from June 2014 to February 2015. Significant interactions between simeprevir (SMV), ledipasvir (LDV), and paritaprevir/ritonavir/ombitasvir plus dasabuvir (3D regimen) with ART were identified based on available literature. SMV had the largest number of DDIs and was further investigated to determine the feasibility of ART switch to allow for DAA use. Of 127 subjects, 23% had advanced liver disease; 86% of those with known HCV …

Evaluate To Learn: Integrating Assessment Data To Improve Outcome Of A Didactic Biomedical Science Course, Paramita Basu, John Fisher, Batoul Senhaji-Tomza, Suzanne R. Soliman

Touro College of Pharmacy (New York) Publications and Research

Objectives: To describe the evaluation system used to identify curricular issues within a pre-clinical biomedical science course in a Pharm.D program and report the difference in outcome after implementation of the resulting changes.

Method: Course content, sequence of delivery and integration of topics with other courses in the relevant tracks were reviewed to identify discrepancies. Evaluation feedback from students and faculty were obtained from E-value online course evaluation system, and end of course discussion reports. Student performance in the course before and after implementing the recommended changes were compared to assess their effectiveness.

Results: Content duplications and …

Treatment Outcomes For Infections Caused By “Spice” (S–Serratia, P–Pseudomonas Aeruginosa, I–Indole Positive Proteus, C–Citrobacter, E– Enterobacter) Organisms: Carbapenem Versus Non-Carbapenem Regimens, Stanley Moy, Roopali Sharma

Touro College of Pharmacy (New York) Publications and Research

Background. Techniques to identify AmpC β-lactamases in SPICE organisms are not yet optimized for the clinical laboratory and are not routinely done. Clinicians are often left with an uncertainty on the choice of antibiotic when a SPICE organism is isolated. The purpose of this study is to evaluate the outcomes of carbapenem versus non-carbapenem regimens in treating bacteremia or urinary tract infection (UTI) from a SPICE organism in a “real-world” setting.

Methods. This was a single-center, retrospective, case-cohort study consisting of adult patients who had clinical infection with a SPICE organism isolated from blood or urine cultures. Patients …

Sglt2 Inhibitors For Type 2 Diabetes Mellitus Treatment, Raymond A. Plodkowski, Megan E. Mcgarvey, Heather M. Huribal, Keith Reisinger-Kindle, Bradley Kramer, Mordecai Solomon, Quang T. Nguyen

College of Osteopathic Medicine (TUN) Publications and Research

SGLT2 inhibitors are plausible second-line drugs that provide powerful additional A1c-lowering effects while inducing weight loss without hypoglycemia.

A Randomized Prospective Study On Outcomes Of An Empathy Intervention Among Second-Year Student Pharmacists, Kajua B. Lor, Julie T. Truong, Eric J. Ip, Mitchell J. Barnett

Faculty Publications & Research of the TUC College of Pharmacy

Objective. To determine the impact of a single, 3-day intervention on empathy levels as measured by the validated Jefferson Scale of Empathy-Health Profession Students version (JSE-HPS).

Methods. Forty second-year student pharmacists were recruited to participate in a non-blinded prospective study. Subjects were randomized to an intervention group (n=20) or control group (n=20) and completed the JSE-HPS at baseline, 7 days postintervention, and 90 days postintervention. The intervention group consisted of a 3-day simulation, each day including a designated activity with loss of dominant hand usage, vision, and speech.

Results. The 3-day simulation increased empathy levels in the intervention group compared …

Off-Label Use Of Transmucosal Ketamine As A Rapidacting Antidepressant: A Retrospective Chart Review, Linda Nguyen, Patrick J. Marshalek, Cory B. Weaver, Kathy J. Cramer, Scott E. Pollard, Rae Reiko Matsumoto

Faculty Publications & Research of the TUC College of Pharmacy

Objective: This study evaluated the effectiveness and safety of subanesthetic doses of ketamine using an off-label, transmucosal administration route in patients with treatment-resistant depression.

Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant major depressive disorder. Seventeen such patients who received subanesthetic doses of ketamine were included. Patient demographics, efficacy (drug refill, clinician notes), side effects, and concurrent medications were assessed.

Results: Benefit from low-dose transmucosal ketamine was noted in 76% of subjects (average age 48 years, 88% female), with a dose duration lasting 7–14 days. No notable side …

In Planta Production Of Flock House Virus Transencapsidated Rna And Its Potential Use As A Vaccine, Yiyang Zhou, Payal D. Maharaj, Jyothi K. Mallajosyula, Alison A. Mccormick, Christopher M. Kearney

Faculty Publications & Research of the TUC College of Pharmacy

We have developed a transencapsidated vaccine delivery system based on the insect virus, Flock House virus (FHV). FHV is attractive due to its small genome size, simple organization, and non-pathogenic characteristics. With the insertion of a Tobacco mosaic virus (TMV) origin of assembly (Oa), the independently replicating FHV RNA1 can be transencapsidated by TMV coat protein. In this study we demonstrated that the Oa adapted FHV RNA1 transencapsidation process can take place in planta, by using a bipartite plant expression vector system, where TMV coat protein is expressed by another plant virus vector, Foxtail mosaic virus (FoMV). Dual infection in …

Inserting Pharmacists In Primary Care Roles In An Ambulatory Care Setting, Keith Yoshizuka, Katherine K. Knapp, Patricia A. Shane, Debbie H. Lu

Faculty Publications & Research of the TUC College of Pharmacy

In this report, we suggest how pharmacy personnel may be used to alleviate some of the pressures currently impacting health system administrators. We look back to the role(s) of the hospital pharmacy and the hospital pharmacist historically and outline changes that have occurred and how these changes may be helpful to address several problem areas in the ambulatory care venue.

Transdermal Delivery Of Drugs With Microneedles—Potential And Challenges, Kevin B. Ita

Faculty Publications & Research of the TUC College of Pharmacy

Transdermal drug delivery offers a number of advantages including improved patient compliance, sustained release, avoidance of gastric irritation, as well as elimination of pre-systemic first-pass effect. However, only few medications can be delivered through the transdermal route in therapeutic amounts. Microneedles can be used to enhance transdermal drug delivery. In this review, different types of microneedles are described and their methods of fabrication highlighted. Microneedles can be fabricated in different forms: hollow, solid, and dissolving. There are also hydrogel-forming microneedles. A special attention is paid to hydrogel-forming microneedles. These are innovative microneedles which do not contain drugs but imbibe interstitial …

Development Of A Multivalent Subunit Vaccine Against Tularemia Using Tobacco Mosaic Virus (Tmv) Based Delivery System, Sukalyani Banik, Ahd Ahmed Mansour, Ragavan Varadharajan Suresh, Sherri Wykoff-Clary, Meenakshi Malik, Alison A. Mccormick, Chandra Shekhar Bakshi

Faculty Publications & Research of the TUC College of Pharmacy

Francisella tularensisis a facultative intracellular pathogen, and is the causative agent of a fatal human disease known as tularemia. F. tularensis is classified as a Category A Biothreat agent by the CDC based on its use in bioweapon programs by several countries in the past and its potential to be used as an agent of bioterrorism. No licensed vaccine is currently available for prevention of tularemia. In this study, we used a novel approach for development of a multivalent subunit vaccine against tularemia by using an efficient tobacco mosaic virus (TMV) based delivery platform. The multivalent subunit vaccine was formulated …

Survey Of California Pharmacists' Awareness Of And Readiness For The New Authorities Granted By Sb 493: A Pilot Study, Clipper Young, Kajua B. Lor, Gordon C. Mccarter, Robert J. Ignoffo

Faculty Publications & Research of the TUC College of Pharmacy

The recent passing of Senate Bill (SB) 493 – effective on January 1, 2014 – addresses a primary care provider shortage in California by declaring pharmacists as health care providers and authorizing new roles for them in patient care. The aims of this pilot study were to examine California registered pharmacists’ awareness and knowledge of the expanded authorities granted by SB 493 as well as to assess their perception of their own readiness to exercise these new authorities. A cross-sectional, observational study was designed, and a 40-question survey was administered electronically through Qualtrics to adjunct faculty, clinical faculty, and alumni …

Solid Microneedles For Transdermal Delivery Of Amantadine Hydrochloride And Pramipexole Dihydrochloride, Mylien T. Hoang, Kevin B. Ita, Daniel A. Bair

Faculty Publications & Research of the TUC College of Pharmacy

The aim of this project was to study the influence of microneedles on transdermal delivery of amantadine hydrochloride and pramipexole dihydrochloride across porcine ear skin in vitro. Microchannel visualization studies were carried out and characterization of the microchannel depth was performed using confocal laser scanning microscopy (CLSM) to demonstrate microchannel formation following microneedle roller application. We also report, for the first time, the use of TA.XT Plus Texture Analyzer to characterize burst force in pig skin for transdermal drug delivery experiments. This is the force required to rupture pig skin. The mean passive flux of amantadine hydrochloride, determined using a …

Sodium Glucose Co-Transporter 2 Inhibitors In The Treatment Of Type 2 Diabetes Mellitus, Eden Miller, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Type 2 diabetes mellitus (T2DM) is a chronic, progressive disease, control of which typically requires multiple therapies. Current guidelines suggest that, in addition to improving glycemic control, antihyperglycemic therapy should be chosen on the basis of its effects on body weight and the risk of hypoglycemia. The newest class of oral antihyperglycemic agents, the sodium glucose cotransporter 2 (SGLT2) inhibitors, reduces renal glucose reabsorption and increases urinary glucose excretion via an insulin-independent mechanism of action. SGLT2 inhibitors have been shown to improve glycemic control and to reduce body weight and systolic blood pressure, and their use is associated with a …

Meeting Faculty Development Needs Via Inclusive Processes In A Newly Established College Of Pharmacy, Keith Veltri, Suzannah Callaghan, John Fisher, Martha M. Rumore, Rebecca L. Salbu, Shelly Warwick, Deborah Wittman, Suzanne R. Soliman

Touro College of Pharmacy (New York) Publications and Research

Objectives: Professional faculty development is essential in establishing the skills necessary to become both leaders in education and research. Changes were necessary for our College in this area. This study describes the development of a comprehensive faculty development program that is in compliance with the new ACPE Standards 2016.

Methods: In fall 2013, the College reappointed a new chair of the faculty development committee (FDC). A needs assessment survey was created and circulated amongst the faculty members requesting prioritization of several key focus areas and measureable ACPE standard outcomes that were lacking and required immediate attention.

Results: …

Descriptive Study Of Prescriptions For Opioids From A Suburban Academic Emergency Department Before New York's I-Stop Act., Lyncean Ung, Ronald Dvorkin, Steven Sattler, David P. Yens

The School of Health Sciences Publications and Research

Introduction: Controlled prescription opioid use is perceived as a national problem attributed to all specialties. Our objective was to provide a descriptive analysis of prescriptions written for controlled opioids from a database of emergency department (ED) visits prior to the enactment of the I-STOP law, which requires New York prescribers to consult the Prescription Monitoring Program (PMP) prior to prescribing Schedule II, III, and IV controlled substances for prescriptions of greater than five days duration.

Methods: We conducted a retrospective medical record review of patients 21 years of age and older, who presented to the ED between July …

Synthesis And Evaluation Of The Diarylthiourea Analogs As Novel Anti-Cancer Agents, Shengquan Liu, Maggie C. Louie, Vanishree Rajagopalan, Guangyan Zhou, Esmerelda Ponce, Tran Nguyen, Linda Green

Faculty Publications & Research of the TUC College of Osteopathic Medicine

No abstract provided.