Pharmacy and Pharmaceutical Sciences Commons^™

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.

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 …

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 …

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 …

Comprehensive Medication Management: Implications For The Patient And Pharmacist, Alexander Delucenay, Barry Bunting, Hayden Brayer, Karl Williams

Pharmacy Faculty/Staff Publications

Since 1979, state pharmacy practice laws have begun to allow pharmacists to provide advanced levels of care in collaboration with prescribers. These might be termed medication therapy management, collaborative practice, comprehensive medication management and other variations. Invariably, pharmacists working closely with prescribers and patients in care of chronic disease have achieved dramatic results including improvement in surrogate markers, decreased rates of secondary large organ disease, decreased mortality, decreased hospitalizations, and as a result decreased spending.^1-28

This paper will discuss the profound impact of advanced practice models on patient care and the health care system, the current status of New …

Practical Use Of Blactchford Score, Shawn E. Fellows, Jamie M. Rosini

Pharmacy Faculty/Staff Publications

Aim: To retrospectively evaluate the use of proton pump inhibitor infusions.

Methods: A retrospective chart review was conducted of all patients who received an 80 mg bolus of esomeprazole follow by an infusion at 8 mg/hr. An analysis was performed to determine if a Blatchford Score of > 5 was a predictor of upper gastrointestinal ulcers.

Results: 300 patients received high dose esomeprazole over a 15 month period. 32% had an ulcer identified on endoscopy. Gastritis and esophagitis were the second most common diagnosis accounting for 16% of patients. A Blatchford Score of >5 as a predictor of upper gastrointestinal ulcers …

Methadone And Corrected Qt Prolongation In Pain And Palliative Care Patients: A Case–Control Study, Katherine Juba, Tina M. Khadem, David Hutchinson, Jack Brown

Pharmacy Faculty/Staff Publications

Background: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients.

Objective: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool.

Design: We performed a case–control study of adult inpatients receiving ME for pain management.

Settings/Subjects: Adult inpatients receiving ME with a QTc >470 msec (males) and …

A Pilot Stability Study Of Dehydroepiandrosterone Rapid-Dissolving Tablets Prepared By Extemporaneous Compounding, Steven D. Rush, Charlene Vernak, Fang Zhao

Pharmacy Faculty/Staff Publications

Dehydroepiandrosterone supplementation is used to treat a variety of conditions. Rapid-dissolving tablets are a relatively novel choice for compounded dehydroepiandrosterone dosage forms. While rapid-dissolving tablets offer ease of administration, there are uncertainties about the physical and chemical stability of the drug and dosage form during preparation and over long-term storage. This study was designed to evaluate the stability of dehydroepiandrosterone rapid-dissolving tablets just after preparation and over six months of storage. The Professional Compounding Centers of America rapid-dissolving tablet mold and base formula were used to prepare 10-mg strength dehydroepiandrosterone rapid-dissolving tablets. The formulation was heated at 100°C to 110°C …

Assessing Student Perceptions Of The Pharm.D. Degree At A Private Tertiary Medical University In India, Kobi T. Nathan, Kelly Conn, Christine R. Birnie

Pharmacy Faculty/Staff Publications

Background: Pharmacy education in India has expanded to include the Doctorate of Pharmacy degree (Pharm.D.). With clinical practice in early development, job opportunities in India are limited. Graduates often consider pharmacy opportunities abroad.

Aims: This study compares Indian students’ career aspirations related to the Pharm.D. degree before and after beginning their programmes.

Methods: A 5-point Likert scale paper survey with open ended questions was distributed to all Pharm.D. students (Year 1- 6) at a medical university in India.

Results: With a response rate of 83% (144/173), over half of the students’ primary goal was to pursue careers abroad post-graduation (54.2% …

Evidence For The Use Of ‘‘Medical Marijuana’’ In Psychiatric And Neurologic Disorders, Christopher Noel

Pharmacy Faculty/Staff Publications

Introduction: Cannabis is listed as a Schedule I substance under the Controlled Substances Act of 1970, meaning the US federal government defines it as an illegal drug that has high potential for abuse and no established medical use; however, half of the states in the nation have enacted “medical marijuana” (MM) laws. Clinicians must be aware of the evidence for and against the use of MM in their patients who may consider using this substance.

Methods: A PubMed database search was performed using the text string: “Cannabis”[Mesh] OR “Marijuana Abuse”[Mesh] OR “Medical Marijuana”[Mesh] OR “Marijuana Smoking”[Mesh] OR “cannabi*” OR “tetrahydrocannabinol.” …

An Evaluation Of The Impact Of Immediate Compared To Delayed Feedback On The Development Of Counselling Skills In Pharmacy Students, Alexander Delucenay, Kelly Conn, Anthony Corigliano

Pharmacy Faculty/Staff Publications

Background: Simulation-based counselling using standardised patients (SPs) provide pharmacy students an authentic approach to training; limited data exists regarding student performance using immediate feedback approaches.

Aims: To compare grades of students receiving immediate feedback verses (vs.) delayed feedback.

Methods: A pre-trial assessment of student perceptions and an unblinded randomised trial comparing immediate and delayed feedback. Third year pharmacy students (n=153) counselled SPs in four clinical “experiences”; student grades were the primary outcome. Student t-test and repeated measures were used to compare grades between groups and grades over time.

Results: During pre-trial surveys 50% of students preferred immediate feedback, 22% …

Current And Evolving Approaches For Improving The Oral Permeability Of Bcs Class Iii Or Analogous Molecules, Vivek S. Dave, Deepak Gupta, Monica Yu, Phong Nguyen, Sheeba Varghese Gupta

Pharmacy Faculty/Staff Publications

The Biopharmaceutics Classification System (BCS) classifies pharmaceutical compounds based on their aqueous solubility and intestinal permeability. The BCS Class III compounds are hydrophilic molecules (high aqueous solubility) with low permeability across the biological membranes. While these compounds are pharmacologically effective, poor absorption due to low permeability becomes the rate-limiting step in achieving adequate bioavailability. Several approaches have been explored and utilized for improving the permeability profiles of these compounds. The approaches include traditional methods such as prodrugs, permeation enhancers, ion-pairing, etc., as well as relatively modern approaches such as nanoencapsulation and nanosizing. The most recent approaches include a combination/hybridization of …

Kaempferol-Phospholipid Complex: Formulation, And Evaluation Of Improved Solubility, In Vivo Bioavailability, And Antioxidant Potential Of Kaempferol, Darshan R. Telange, Arun T. Patil, Anil M. Pethe, Amol A. Tatode, Sridhar Anand, Vivek S. Dave

Pharmacy Faculty/Staff Publications

The current work describes the formulation and evaluation of a phospholipid complex of kaempferol toenhance the latter’s aqueous solubility, in vitro dissolution rate, in vivo antioxidant and hepatoprotectiveactivities, and oral bioavailability. The kaempferol-phospholipid complex was synthesized using a freeze-drying method with the formulation being optimized using a full factorial design (32) approach. The resultsinclude the validation of the mathematical model in order to ascertain the role of specific formulation andprocess variables that contribute favorably to the formulation’s development. The final product wascharacterized and confirmed by Differential Scanning Calorimetry (DSC), Fourier Transform InfraredSpectroscopy (FTIR), Proton Nuclear Magnetic Resonance Spectroscopy (1H-NMR), and …

Formulation And Characterization Of An Apigenin-Phospholipid Phytosome (Aplc) For Improved Solubility, In Vivo Bioavailability, And Antioxidant Potential, Darshan R. Telange, Arun T. Patin, Anil M. Pethe, Harshal Fegade, Sridhar Anand, Vivek S. Dave

Pharmacy Faculty/Staff Publications

The apigenin-phospholipid phytosome (APLC) was developed to improve the aqueous solubility, dissolution, in vivo bioavailability, and antioxidant activity of apigenin. The APLC synthesis was guided by a full factorial design strategy, incorporating specific formulation and process variables to deliver an optimized product. The design-optimized formulation was assayed for aqueous solubility, in vitro dissolution, pharmacokinetics, and antioxidant activity. The pharmacological evaluation was carried out by assessing its effects on carbon tetrachloride-induced elevation of liver function marker enzymes in a rat model. The antioxidant activity was assessed by studying its effects on the liver antioxidant marker enzymes. The developed model was validated …

Fructose Alters Cell Survival And Gene Expression In Microglia And Neuronal Cells Lines, Drew P. Seidel, Susan Denapoli, Thomas S. Maciulewicz, Melinda E. Lull

Pharmacy Faculty/Staff Publications

Purpose: Microglia are macrophages that are found primarily in the CNS and play a crucial role in maintaining a healthy brain by engulfing invading microorganisms, releasing inflammatory mediators, and pruning dead cells. Microglia can become activated in response to certain stimuli which causes them to transition into a pro-inflammatory state, and can sometimes become chronically activated which can result in neuronal damage. Studies have shown a causal relationship between this activation and sugars such as fructose and glucose. We sought to understand the role of sugars in microglial activation and the subsequent effects on neuron health.

Methods: Rat microglia (HAPI) …

Influence Of Key Polymer Attributes, Manufacturing Conditions And Sintering On Abuse Deterrence Of Physical Barrier Type Abuse Deterrent Formulations (Adf), Heather Boyce, Vivek S. Dave, Myke Scoggins, Dan Smith, Steve Byrn, Bhawana Saluja, Wen Qu, Vadim J. Gurvich, Stephen W. Hoag

Pharmacy Faculty/Staff Publications

When sintering us used to treat tablet formulations containing polyethylene oxide (PEO), the polymer particles are able to form stronger bonds thereby increase tablet tensile strength. This increase in strength can make it more difficult for an abuser to break, chew, or grind opioid tablets. A mechanistic study was implemented to understand the key sintering factors that influence tensile strength.

Formulation And Characterization Of The Improved Solubility, In Vivo Bioavailability And Antioxidant Activity Of Apigenin-Phospholipid Complex (Aplc), Sridhar Anand, Darshan R. Telange, Arun T. Patil, Anil M. Pethe, Harshal Fegade, Vivek S. Dave

Pharmacy Faculty/Staff Publications

In the present study a phospholipid based complex of apigenin (APLC) was prepared with a goal of improving its aqueous solubility, dissolution, in vivobioavailability, and antioxidant activity.

Lubricant-Sensitivity Assessment Of Spress® B820 By Near Infrared Spectroscopy: A Comparison Of Multivariate Methods, Vivek S. Dave, Connor Mack, Heather Boyce, Enyioha Ike-Amaechi, Antione Al-Achi, Stephen W. Hoag, Rahul V. Haware

Pharmacy Faculty/Staff Publications

The aim of the present investigation was to compare the predictive performance of PCR and PLS calibration models based on near-infrared spectroscopy (NIRS) data used to monitor lubrication conditions impact on the tablet breaking force (TBF) of SPRESS® B820.

Assessing The Enhancement Of Aqueous Solubility Of Efavirenz Via Lyophilized Milk Based Solid Dispersion Formulations, Nishikant Raut, Pradip Dhore, Suprit Saoji, Vivek S. Dave

Pharmacy Faculty/Staff Publications

No abstract provided.

Lgbtq Pharmacy Guide, Jennifer Mathews

Pharmacy Faculty/Staff Publications

This guide has been developed to help pharmacists and pharmacy staff provide an inclusive and welcoming environment for their LGBTQ patients. When LGBTQ patients do not feel welcomed and included or when they experience a negative encounter at a pharmacy they are less likely to return, which may negatively impact their health if this leads to delays or non-adherence with prescribed medications. This guide will cover key concepts and LGBTQ terms as well as the health disparities faced by LGBTQ people. It includes key tips on how to best care for LGBTQ patients as well as how to make your …

The Role Of Phospholipid As A Solubility- And Permeability-Enhancing Excipient For The Improved Delivery Of The Bioactive Phytoconstituents Of Bacopa Monnieri, Suprit Saoji, Vivek S. Dave, Pradip W. Dhore, Yamini S. Bobde, Connor Mack, Deepak Gupta, Nishikant Raut

Pharmacy Faculty/Staff Publications

In an attempt to improve the solubility and permeability of Standardized Bacopa Extract (SBE), a complexation approach based on phospholipid was employed. A solvent evaporation method was used to prepare the SBE-phospholipid complex (Bacopa Naturosome, BN). The formulation and process variables were optimized using a central-composite design. The formation of BN was confirmed by photomicroscopy, Scanning Electron Microscopy (SEM), Fourier Transform Infrared Spectroscopy (FTIR), Differential Scanning Calorimetry (DSC), and Powder X-ray Diffraction (PXRD). The saturation solubility, the in-vitro dissolution, and the ex-vivo permeability studies were used for the functional evaluation of the prepared complex. BN exhibited a significantly higher aqueous …

Evaluation Of Microparticulate Ovarian Cancer Vaccine Via Transdermal Route Of Delivery, Suprita A. Tawde, Lipika Chablani, Archana Akalkotkar, Martin J. D'Souza

Pharmacy Faculty/Staff Publications

Ovarian cancer is the fifth most commonly occurring malignancy in women, with the highest mortality rate among all the gynecological tumors. Microparticulate vaccine can serve as an immunotherapeutic approach with a promising antigenic delivery system without a need for conventional adjuvants. In this study, a microparticulate vaccine using whole cell lysate of a murine ovarian cancer cell line, ID8 was prepared by spray drying. Further, the effect of interleukins (ILs) such as IL-2 and IL-12 was evaluated in a separate study group by administering them with vaccine particles to enhance the immune response. The vaccine microparticles were administered to C57BL/6 …

The Study Of The Influence Of Formulation And Process Variables On The Properties Of Simvastatin-Phospholipid Complex, Suprit Saoji, Veena S. Belgamwar, Sanket S. Dharashivkar, Aniket A. Rode, Connor Mack, Vivek S. Dave

Pharmacy Faculty/Staff Publications

Objectives: The aim of the present study was to examine the influence of the formulation and process variables on the entrapment efficiency of simvastatin-phospholipid complex (SPC), prepared with a goal of improving the solubility and permeability of simvastatin.

Method: The SPC was prepared using a solvent evaporation method. The influence of formulation and process variables on simvastatin entrapment was assessed using a central composite design. An additional SPC was prepared using the optimized variables from the developed quadratic model. This formulation was characterized for its physical-chemical properties. The functional attributes of the optimized SPC formulation were analyzed by apparent aqueous …

Sharing Success: Expansion Of A Tutor-Run Assessment Method To Multiple Courses And Colleges, Melinda E. Lull, Ashley N. Castleberry, Jennifer L. Mathews, Sarah Thornton, Ryan Mckelvie

Pharmacy Faculty/Staff Publications

Objectives: In 2014, data were presented on a successful pilot program using quizzes written by tutors in a single course at Wegmans School of Pharmacy. The objective of this study was to use the methods from the pilot to expand the program to other pharmacology courses at Wegmans School of Pharmacy as well as the University of Arkansas for Medical Sciences College of Pharmacy.

Methods: Methods from the previous study were replicated, whereby tutors wrote weekly quizzes administered using ExamSoft®. The optional quizzes were openly accessible to students in preparation for course exams. Performance data were collected from students in …

Path To Success: Development Of The Pharmacist Through The Continuum Of Pharmacy School And Beyond, Deirdre P. Pierce, Kathryn A. Connor, Nabila Ahmed-Sarwar, Keith Delmonte, David Mccaffrey, Angela Nagel, Melinda E. Lull, Jennifer L. Mathews, Anne Schweighardt, Judianne Slish, Elizabeth Sutton Burke, Melanie Symoniak, Matthew Zak, Christine R. Birnie Phd, Jack Brown

Pharmacy Faculty/Staff Publications

Objective: To explore the processes and opportunities provided in the co-curriculum of the Wegmans School of Pharmacy (WSoP) that contribute to the development of successful pharmacy graduates.

Methods: Pharmacy career preparation begins at orientation with workshops on emotional intelligence, leadership, and the APhA Career Pathway Evaluation Program. During the P1 through P4 years, the optional Student Development Workshop Series (SDW) offers seminars for students on a variety of topics including time management, exam taking strategies/anxiety management, learning styles, personal “brand” creation, CV/portfolio development, and interview soft skills. All students may participate in the annual WSoP Career Day, which offers networking …

Impact Of A Hospital’S Antibiotic Stewardship Team On Fluoroquinolone Use At A Long- Term Care Facility, Christine L. Rahme, Helen M. Jacoby, Lisa M. Avery

Pharmacy Faculty/Staff Publications

The primary objective of this study was to assess whether a hospital-based antimicrobial stewardship team (H-AST) from an unaffiliated hospital could decrease inappropriate fluoroquinolone use at a local, long-term care facility (LTCF). The H-AST created a multi-faceted intervention campaign that included antibiogram development, provider and family education, and a telephone hotline. Pre- and post-intervention mean defined daily doses per 1000 resident days for antimicrobials were calculated to determine the impact of the campaign. The campaign resulted in a 38.70% decrease in ciprofloxacin utilization, a 16.20% decrease in total FQ consumption, and an 11.68% in total antibiotic consumption. In addition, during …

Sglt-2 Inhibitors: A Novel Mechanism In Targeting Glycemic Control In Type 2 Diabetes Mellitus, Kobi T. Nathan, Nabila Ahmed-Sarwar, Paul M. Werner

Pharmacy Faculty/Staff Publications

OBJECTIVE: To review the chemistry, pharmacology, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, dosing, drug interactions, and administration of canagliflozin, dapagliflozin, and empagliflozin, and comparing the benefit and risk aspects of using these agents in the older adult diabetes patient population.

DATA SOURCES, STUDY SELECTION, DATA EXTRACTION, AND DATA SYNTHESIS: A search of PubMed using the terms "SGLT-2 inhibitors," "canagliflozin," "dapagliflozin," "empagliflozin," "efficacy," and "tolerability" was performed to find relevant primary literature on each of the sodium/glucose cotransporter 2 (SGLT-2) inhibitors currently approved for use in type 2 diabetes. Phase III trials for all agents were included. All English-language articles from 2010 …