Pharmacy and Pharmaceutical Sciences Commons^™

Treatment Of Metastatic Renal Cell Carcinoma, David J. Reeves, Chin Y. Liu

Scholarship and Professional Work – COPHS

Purpose

To review the treatment of metastatic renal cell carcinoma (RCC), including the use of new targeted therapies.

Methods

A search of MEDLINE (1966 to August 2008) and American Society of Clinical Oncology Meeting abstracts (2005 to May 2008) was preformed using the search terms bevacizumab, everolimus, interferon-alfa (IFN-α), interleukin-2 (IL-2), sorafenib, sunitinib, temsirolimus, and RCC. Articles most pertinent to the treatment of metastatic RCC are reviewed.

Results

The treatment of metastatic RCC has undergone a paradigm shift over the past 5 years from biologic response modifiers to new targeted therapies. Historically, response rates for the biological response modifiers, aldesleukin …

Retrospective Evaluation Of Venous Thromboembolism Prophylaxis In The Adult Cancer Population, David J. Reeves, Chin Y. Liu

Scholarship and Professional Work – COPHS

Study objectives. Hospitalized cancer patients are at an increased risk for venous thromboembolism (VTE) and it is recommended they receive pharmacologic prophylaxis unless otherwise contraindicated. The majority of data supporting this recommendation comes from sub-group analyses and extrapolation of data gathered in general medical/surgical patients. This study seeks to assess the safety and efficacy of VTE prophylaxis in cancer patients admitted to our institution.

Methods. Charts of patients 18—89 years of age receiving VTE prophylaxis with unfractionated heparin, low molecular weigh heparin, or fondaparinux while admitted to Karmanos Cancer Center between September and October 2007 were retrospectively reviewed. Risk factors …

National Survey Of Introductory Pharmacy Practice Experience Programs, Patricia L. Darbishire, Trish Devine, Michael R. Holowatyj, Andrew N. Schmelz

Scholarship and Professional Work – COPHS

Objective: The objective of this study was to identify commonalities and provide a descriptive overview of key program elements and oversight of U.S. introductory pharmacy practice experience (IPPE) programs.

Methods: A Web-based questionnaire, consisting of 40 questions, was sent to 91 schools of pharmacy. The questionnaire addressed the following IPPE program topics, in addition to school demographics: program oversight, experience site selection, program structure, relationship to didactic curriculum, and quality assurance issues.

Results: Forty-six schools of pharmacy responded resulting in a response rate of 50.5%. Results identified commonalities in each of the key areas, as well as identifying multiple discrepancies …

Enhanced Student Learning And Scholarly Productivity Through Capstone Projects, Bruce G. Hancock, Jane M. Gervasio, Iftekhar Kalsekar, Julie M. Koehler, Mary H. Andritz

Scholarship and Professional Work – COPHS

Abstract from the American Association of Colleges of Pharmacy/Association of Faculties of Pharmacy of Canada Annual Meeting, Chicago, IL, July 16-24, 2008.

Impact Of Decmedetomidine On Opioid And Benzodiazepine Dosing Requirements In Children., Amy E. Helvie, Chad A. Knoderer, Iftekhar D. Kalsekar, Brandon T. Kibby, Michael S. Mazurek

Scholarship and Professional Work – COPHS

Poster presented at: Annual Update on Pediatric Cardiovascular Disease; February 2008; Scottsdale Arizona.

Fenoldapam For Acute Kidney Injury In Children, Chad A. Knoderer, Jeffrey D. Leiser, Corina Nailescu, Mark W. Turrentine, Sharon P. Andreoli

Scholarship and Professional Work – COPHS

We report two cases of children with severe cardiomyopathy requiring treatment with ventricular assist devices who developed acute kidney injury and were treated with fenoldopam. Therapy with fenoldopam appeared successful in one case in that renal replacement therapy was avoided with improvement in urine output and renal function. These are the first reported cases of fenoldopam use in children with acute kidney injury receiving mechanical circulatory support.

Use Of Sildenafil To Facilitate Weaning From Inhaled Nitric Oxide In Children With Pulmonary Hypertension Following Surgery For Congenital Heart Disease, Jaclyn E. Lee, Simon C. Hillier, Chad A. Knoderer

Scholarship and Professional Work – COPHS

Pulmonary hypertension frequently complicates the postoperative management of patients after congenital cardiac surgery. Inhaled nitric oxide is an effective treatment option, but rebound pulmonary hypertension can occur upon its withdrawal. Sildenafil may facilitate its withdrawal by restoring cyclic guanosine monophosphate availability via phosphodiesterase-5 inhibition. The purpose of this study was to evaluate the use of sildenafil in facilitating weaning from inhaled nitric oxide after congenital cardiac surgery in patients who had previously failed weaning, and to compare the effects of sildenafil on pulmonary and systemic hemodynamics. Children who received sildenafil after cardiovascular surgery during a 23-month period at Riley Hospital …

Survey Of Congenital Heart Surgeons’ Preferences For Antimicrobial Prophylaxis For Pediatric Cardiac Surgery Patients, Chad A. Knoderer, Emily M. Anderson, Elaine G. Cox

Scholarship and Professional Work – COPHS

Patients with congenital heart defects are a unique population with generally immature immune systems. Fragility in the postoperative period may contribute to surgical site infections (SSIs), a life threatening complication for this population. The need for postoperative antimicrobial prophylaxis for these patients is a standard of care that is indisputable. When choosing an antimicrobial regimen for surgical prophylaxis, consideration should be given to balancing the prevention of nosocomial infections, avoiding emergence of bacterial resistance, and minimizing drug toxicities and cost.

Racial And Ethnic Disparities In Treatment Of Dementia Among Medicare Beneficiaries, Ilene H. Zuckerman, Priscilla T. Ryder, Linda Simoni-Wastila, Thomas Shaffer, Masayo Sato, Lirong Zhao, Bruce Stuart

Scholarship and Professional Work – COPHS

Objectives—Numerous studies have documented disparities in health care utilization between non-Hispanic White and minority elders. We investigated differences in anti-dementia medication use between non-Hispanic White and minority community-dwelling Medicare beneficiaries with dementia.

Methods—Using multivariate analysis with generalized estimating equations, we estimated prevalence ratios (PRs) for anti-dementia medication use by race/ethnicity for 1,120 beneficiaries with dementia from years 2001 through 2003 of the Medicare Current Beneficiary Survey.

Results—After adjusting for demographics, socioeconomics, health care access and utilization, comorbidities, and service year, we found that anti-dementia medication use was approximately 30% higher among non-Hispanic Whites compared to other racial/ethnic groups (PR = …

Different Requirements Of The Swi/Snf Complex For Robust Nucleosome Displacement At Promoters Of Heat Shock Factor And Msn2- And Msn4-Regulated Heat Shock Genes, Tamara Y. Erkina, P. A. Tschetter, Alexander M. Erkine

Scholarship and Professional Work – COPHS

The stress response in yeast cells is regulated by at least two classes of transcription activators—HSF and Msn2/4, which differentially affect promoter chromatin remodeling. We demonstrate that the deletion of SNF2, an ATPase activity-containing subunit of the chromatin remodeling SWI/SNF complex, eliminates histone displacement, RNA polymerase II recruitment, and heat shock factor (HSF) binding at the HSP12 promoter while delaying these processes at the HSP82 and SSA4 promoters. Out of the three promoters, the double deletion of MSN2 and MSN4 eliminates both chromatin remodeling and HSF binding only at the HSP12 promoter, suggesting that Msn2/4 activators are primary determinants of …

Expansion Of Experiential Learning Opportunities Through Medication Reconciliation Participation, Jane M. Gervasio, Julie M. Koehler, Kevin M. Tuohy, Julie L. Williams, Mary H. Andritz

Scholarship and Professional Work – COPHS

Abstract from the American Association of Colleges of Pharmacy Annual Meeting, Orlando, FL, July 12-18, 2007.

Asthma In Focus, Shaunta' M. Ray, Sarah Nisly

Scholarship and Professional Work – COPHS

Book review of Asthma in Focus, by Anna Murphy.

Tobramycin-Induced Hepatotoxicity, Sarah A. Nisly, Shaunta' M. Ray, Robert A. Moye

Scholarship and Professional Work – COPHS

OBJECTIVE. To report a case of tobramycin-induced hepatotoxicity. CASE

SUMMARY: A 20-year-old female was hospitalized for treatment of Pseudomonas aeruginosa bacteremia and osteomyelitis. Empiric intravenous antibiotic therapy with piperacillin/tazobactam, vancomycin, and ciprofloxacin was started, and based on the results of culture and sensitivity testing, was changed to intravenous ceftazidime and tobramycin 70 mg every 8 hours on hospital day 3. Liver enzyme levels then increased over days 3–6. Tests for hepatitis A, B, and C were all nonreactive, and HIV testing was negative. On day 8, therapy was changed from ceftazidime to piperacillin/tazobactam and the tobramycin dose was increased …

Management Of Anthracycline Extravasation Injuries, David J. Reeves

Scholarship and Professional Work – COPHS

OBJECTIVE: To review the evidence for the management of anthracycline extravasation and determine the optimal treatment of such injuries.

DATA SOURCES: A search of MEDLINE (1966–February 2007) and International Pharmaceutical Abstracts (1970–February 2007) was performed using the search terms anthracyclines and extravasation.

DATA SYNTHESIS: Extravasation of anthracyclines can have devastating effects. After infiltration of these drugs into the interstitial tissue, damage may range from mild erythema and pain to severe tissue necrosis. Many agents have been studied in the management of these injuries; however, few have demonstrated efficacy and treatment remains controversial. Nonpharmacologic modalities shown to limit extravasation injuries include …

2005 American Society For Parenteral And Enteral Nutrition (A.S.P.E.N.) Standards And Guidelines Survey, David Seres, Charlene Compher, Douglas Seidner, Laura Byham-Gray, Jane M. Gervasio, Stephen Mcclave, A.S.P.E.N. Standards And Guidelines Committees

Scholarship and Professional Work – COPHS

An online survey about the use and format of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Standards and Guidelines documents was conducted. The survey was sent to A.S.P.E.N. members, and an acceptable number of responses were received (470, or 9% of those surveyed). Most respondents indicated an overall satisfaction with the standards and guidelines and suggested format changes, many of which will be incorporated into future guidelines and standards. The results of this survey are presented here for general interest. Changes in the process with which A.S.P.E.N. produces standards and guidelines are discussed.

Nutrition In The Critically Ill Patient, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Critical illness presents with the classic response to stress, including hypermetabolism and increased catabolism, resulting in a negative energy and nitrogen balance. These harmful events initiate the immunological response, starting with the systemic inflammatory response syndrome, which, if not resolved, may lead to multiple organ dysfunction syndrome (MODS). Furthermore, patients who do not develop early MODS manifest a compensation anti-inflammatory response syndrome, which suppresses immunity and predisposes the patient to sepsis, thereby ­increasing the risk of late MODS and ultimately death. The use of specialized nutrition support, including enteral nutrition (EN) and parenteral nutrition (PN), has been initiated in an …

Bowel Necrosis Associated With Enteral Feeding, Jane M. Gervasio, Ryan Ednalino, Jennifer Reynolds, Gary P. Zaloga

Scholarship and Professional Work – COPHS

Abstract from Clinical Nutrition Week, Dallas, TX, February 12-15, 2006.

Cyclooxygenase-2 Expression In Hamster And Human Pancreatic Neoplasia, Pamela L. Crowell, C. Max Schmidt, Michele T. Yip-Schneider, Jesse J. Savage, Dean A. Hertzler Ii, William O. Cummings

Scholarship and Professional Work – COPHS

Cyclooxygenase-2 (COX-2) has been implicated in the development of gastrointestinal malignancies. The aim of the present study was to determine COX-2 expression/activity throughout stages of experimental and human pancreatic neoplasia. COX-2 immunohistochemistry was performed in pancreata of hamsters subjected to the carcinogen N-nitrosobis-(2-oxopropyl)amine (BOP) and in human pancreatic tumors. COX-2 activity was determined by prostaglandin E₂ assay in tumor versus matched normal pancreatic tissues. The activity of the COX inhibitor sulindac was tested in the PC-1 hamster pancreatic cancer model. COX-2 expression was elevated in all pancreatic intraepithelial neoplasias (PanINs) and adenocarcinomas. In BOP-treated hamsters, there were significant …

Displacement Of Histones At Promoters Of Saccharomyces Cerevisiae Heat Shock Genes Is Differentially Associated With Histone H3 Acetylation, Tamara Y. Erkina, Alexander M. Erkine

Scholarship and Professional Work – COPHS

Chromatin remodeling at promoters of activated genes spans from mild histone modifications to outright displacement of nucleosomes in trans. Factors affecting these events are not always clear. Our results indicate that histone H3 acetylation associated with histone displacement differs drastically even between promoters of such closely related heat shock genes as HSP12, SSA4, and HSP82. The HSP12 promoter, with the highest level of histone displacement, showed the highest level of H3 acetylation, while the SSA4 promoter, with a lower histone displacement, showed only modest H3 acetylation. Moreover, for the HSP12 promoter, the level of acetylated H3 …

Nutritional Support In The Acute Care Patient Post-Ventricular Assist Device Placement, Abby Re, Jane M. Gervasio, Robert D. Warhurst, Gary P. Zaloga

Scholarship and Professional Work – COPHS

Abstract from American College of Clinical Pharmacy Annual Meeting, San Francisco, CA, October 23-26, 2005.

Blood Glucose Concentration Does Not Correlate With Organ Failure Or Outcome In Trauma Patients Receiving Enteral Nutrition, Jennifer L. Ash, Jane M. Gervasio, Gary P. Zaloga, George H. Rodman Jr.

Scholarship and Professional Work – COPHS

Abstract from American College of Clinical Pharmacy 2005 Spring Practice and Research Forum/Updates in Therapeutics, Myrtle Beach, SC, April 10-13, 2005.

Does The Quantity Of Enteral Nutrition Affect Outcomes In Critically Ill Trauma Patients?, Jennifer L. Ash, Jane M. Gervasio, Gary P. Zaloga, George H. Rodman Jr.

Scholarship and Professional Work – COPHS

Abstract from Clinical Nutrition Week, Orlando, FL, January 29-February 2, 2005.

Chronic Outpatient Sildenafil Therapy For Pulmonary Hypertension In A Child After Cardiac Surgery, Chad A. Knoderer, E. S. Ebenroth, J. W. Brown

Scholarship and Professional Work – COPHS

We report the case of a 14-month-old male with d-transposition of the great arteries, ventricular septal defect, and pulmonary hypertension successfully treated with long-term sildenafil following cardiac surgery. To our knowledge, this is the first published report of long-term sildenafil treatment in a child after corrective cardiac surgery.

Anabolic Agents: Adjuncts To Nutrition Support, Jane M. Gervasio

Scholarship and Professional Work – COPHS

Anabolic agents as adjuncts to nutrition support therapy have been used to improve malnutrition and establish anabolism. Growth hormone, insulin-like growth factor, and anabolic steroids have been studied for their potential to reverse the catabolic process and promote anabolism. This paper reviews several anabolic agents and their possible role in nutrition support therapy.

Clinical Issues Surrounding Once-Daily Aminoglycoside Dosing In Children, Chad A. Knoderer, Julie A. Everett, William F. Buss

Scholarship and Professional Work – COPHS

Aminoglycoside antibiotics are first-line treatment for many infectious diseases in the pediatric population and are effective in adults. The traditional dosing interval in children is every 8–12 hours. Studies in adults reported equivalent efficacy and equal or less toxicity with once-daily regimens. Despite many studies in the adult population, this approach has yet to become standard practice in most pediatric hospitals. Reasons for lack of acceptance of this strategy in children include rapid aminoglycoside clearance, unknown duration of postantibiotic effect, safety concerns, and limited clinical and efficacy data.

Pulmonary Embolism As An Adverse Drug Event Of Intravenous Immunoglobulin Therapy, Katasha S. Butler, Deborah S. Zeitlin

Scholarship and Professional Work – COPHS

TO THE EDITOR: Intravenous immunoglobulin (IVIG) therapy has gained popularity for the treatment of neuromuscular diseases (i.e., myasthenia gravis, inflammatory myopathy, chronic inflammatory demyelinating polyneuropathy), although adverse events are associated with high-dose IVIG infusions.^1,2 Common adverse reactions to IVIG therapy are anxiety, headache, fever, chills, chest pain, dyspnea, nausea, and abdominal pain.³ More serious adverse events include anaphylaxis, hemolytic anemia, hepatitis C, and thrombosis.³ Studies have shown documented effects of IVIG on blood rheology. It increases plasma viscosity in a dose-related response and may also activate platelets.^2–4 High-dose IVIG therapy is approximately 24–54 g/d.⁴

Accuracy Of Predictive Methods To Estimate Resting Energy Expenditure Of Thermally-Injured Patients, Roland N. Dickerson, Jane M. Gervasio, Marti L. Riley, James E. Murrell, William L. Hickerson, Kenneth A. Kudsk, Rex O. Brown

Scholarship and Professional Work – COPHS

Background

The purpose of this study was to evaluate the bias and precision of 46 methods published from 1953 to 2000 for estimating resting energy expenditure (REE) of thermally injured patients.

Methods

Twenty-four adult patients with ≥20% body surface area burn admitted to a burn center who required specialized nutrition support and who had their REE measured via indirect calorimetry (IC) were evaluated. Patients with morbid obesity, human immunovirus, malignancy, pregnancy, hepatic or renal failure, neuromuscular paralysis, or those requiring a FiO2 >50% or positive end expiratory pressure (PEEP) ≥10 cm H2O were excluded. One steady-state measured REE measurement (MEE) …

Herbal Product Use Among Anticoagulation Patients, Ilene H. Zuckerman, Eileen K. Steinberger, Priscilla T. Ryder, Stuart Haines

Scholarship and Professional Work – COPHS

Warfarin interacts with many conventional drug products and herbal products,^1-3 Given the incompleteness of information on drug-herbal product interactions and the potential for health care practitioners to be unaware of their patients' utilization of herbal products, we surveyed the use of such products among patients receiving warfarin through an anticoagulation clinic. Patients at the University of Maryland Medical System Anticoagulation Clinic were asked to complete an anonymous written questionnaire during their regularly scheduled appointments over one month.

A Comparison Of Renal Phosphorus Regulation In Thermally-Injured And Multiple Trauma Patients Receiving Specialized Nutrition Support, Roland N. Dickerson, Jane M. Gervasio, Justin J. Sherman, Kenneth A. Kudsk, William L. Hickerson, Rex O. Brown

Scholarship and Professional Work – COPHS

To compare phosphorus intake and renal phosphorus regulation between thermally injured patients and multiple trauma patients, 40 consecutive critically ill patients, 20 with thermal injury and 20 with multiple trauma, who required enteral tube feeding were evaluated. Phosphorus intakes were recorded for 14 days from the initiation of tube feeding which was started 1 to 3 days post-injury. Serum for determination of phosphorus concentrations was collected at days 1, 3, 7, and 14 of the study period. A 24-hour urine collection was obtained during the first and second weeks of nutrition support for urinary phosphorus excretion, fractional excretion of phosphorus, …

Accuracy Of Predictive Formulas To Estimate Resting Energy Expenditure Of Thermally Injured Patients, Roland N. Dickerson, Jane M. Gervasio, Marti L. Riley, James E. Murrell, William L. Hickerson, Kenneth A. Kudsk, Rex O. Brown

Scholarship and Professional Work – COPHS

Abstract from the 25th Clinical Congress of the American Society for Parenteral and Enteral Nutrition, Chicago, IL, January 21-24, 2001.