Pharmacy and Pharmaceutical Sciences Commons^™

Evaluate Opioid Prescribing Trends For Elderplace, A Program For All-Inclusive Care For The Elderly (Pace), Jacqueline Figueras, Loann Wong, Sharon Leigh

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2021

Background

• Providence ElderPlace in Oregon is the fifth-largest PACE program in the country that offers wraparound nursing home-eligible medical and social services to over 1600 community-dwelling seniors who are medically frail with complex medication regimens. • Many elderly patients suffer from chronic nonmalignant pain which may affect their function and quality of life. • The Centers for Disease Control and Prevention (CDC) reports a 7.7% increase in drug overdoses and opioid deaths in the aging population from 2013 to 2014. • In 2015-2016 elderly adults obtained an annual average of 774 Morphine Milligram Equivalents (MME) of outpatient prescriptions for …

Financial Impact Of A Regional Antimicrobial Stewardship Cost Saving Initiative In A Large Integrated Health Care System, Van Nguyen, Colton Taylor, Alyssa B Christensen, Brent Footer

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2021

Background

• Since 2017, antimicrobial stewardship is a Centers for Medicare & Medicaid Services (CMS) and The Joint Commission (TJC) requirement for all acute care hospitals, critical access hospitals, and nursing care centers. •Given the current evidence supporting the utilization of extended-infusion beta-lactams, the system transitioned all its acute care facilities within the region to extended-infusion piperacillin/tazobactam (TZP) in March 2016 •According to Bauer et al, the median length of stay and hospital costs were significantly less for patients admitted to the ICU who received extended-infusion cefepime for bacteremia and/or pneumonia

Purpose

The purpose of this study was to evaluate …

Impact Of Pharmacist Led Provider Education On Outpatient Copd Management, Erica Dominguez, Ben Rosati, Trevor Laursen

Providence Pharmacy PGY2 Program at Providence Medical Group 2021

Purpose

To evaluate the efficacy of provider education on adherence to guideline directed therapy in outpatient chronic obstructive pulmonary disease (COPD) management in South Oregon PMG clinics.

Background

• COPD is the third most common cause of death in the US • The CDC reports costs attributable to COPD in 2010 were $32.1 billion projected to have increased to $49 billion by 2020 • Direct healthcare costs include detection, prevention, physician office visits, hospitalizations, home care, and medications hospitalizations accounting for about 45 50% of these direct costs • Clinical burden of uncontrolled COPD has been shown to impact quality …

Assessing The Effect Of An Electronic Health Record Order Entry Guideline On Duration Of Outpatientantimicrobial Therapy Prescribed For Uncomplicated Urinary Tract Infections, Kasey Rubin, Chelsea Houshour, Christine Doran

Providence Pharmacy PGY2 Program at Providence Medical Group 2021

Background

• Fifty percent of antibiotics prescribed in the outpatient setting are unnecessary1. •Outside of unnecessary prescribing, the antibiotics chosen can be incorrect with an inappropriate duration of therapy1. •It has been estimated that resistant infections affect nearly 3 million Americans annually and are the cause of 35,000 deaths each year with added costs up to $33.2 billion dollars1. •The Centers for Disease Control (CDC) recommends that outpatient antimicrobial stewardship programs identify “high priority conditions.” •Examples of high priority conditions include acute respiratory infections, urinary tract infections (UTI)and skin and soft tissue infections (SSTI).2 •Antibiotics are not associated with a …

An Evaluation Of The Use Of Tranexamic Acid In The Treatment Of Bradykinin-Mediated Angioedema In The Emergency Department, Sarah Yb Kim, Carol Keller

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers 2021

Background

Bradykinin mediated angioedema is an overarching term that includes idiopathic angioedema, angiotensin converting enzyme inhibitor (ACEi) induced angioedema and hereditary angioedema (HAE). •This is an emergent condition that must be treated with the utmost urgency due to the fatal outcomes associated with the rapid constriction of the throat. •Bradykinin mediated angioedema is treated differently from histamine associated angioedema due to its resistance to corticosteroids and antihistamines. •HAE and ACEi induced angioedema are treated similarly but there is a lack of unanimity in the first line pharmacologic treatment. •Current treatment options include fresh frozen plasma, bradykinin-2 receptor antagonists, plasma-kallikrein inhibitors …

Evaluation Of Clinical Pharmacist Management Trends For Depression, Adam Olesen, Kelsie Fiss, Judy Wong

Providence Pharmacy PGY2 Program at Providence Medical Group 2021

Background

• Depression affects almost 10 of Americans over 18 years old 1 • Per the Centers for Disease and Control Prevention, the 2020 COVID 19 pandemic has led to an increase in adults struggling with mental health 1 • There is currently a shortage of mental health prescribers, with over half of all counties within the United States not having a single psychiatrist 2 • Southern Oregon also has a shortage of mental health prescribers, resulting in longer wait times for care • Evidence demonstrates that depression managed by pharmacists in the primary care setting led to increased follow …

Review Of Prophylactic Anticoagulation Strategies And Outcomes For Covid-19 Patients (Research In Progress), Caleb Galindo, Pamela Levine, Melanie Geer

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2021

Background

In March of 2020, the World Health Organization (WHO) declared the spread of COVID-19 a global pandemic. •Though largely considered a respiratory disease, research continues to demonstrate additional impacts of COVID-19 on other organ systems.2, 3 •A key characteristic of COVID-19 is marked inflammation leading to hypercoagulability.2, 3, 6 •Infected patients are at a higher risk of developing thromboembolic events (VTE and stroke) compared to healthy adults. 2, 3, 6 •Some clinicians have trialed varying anticoagulation strategies for patients with COVID-19 based on coagulation parameters such as D-dimer.4, 5, 6 •Multiple expert groups have released preliminary guidance on anticoagulation …

Optimizing The Role Of Clinical Pharmacy Services In Transitions Of Care, Dj Clark, Clara Mikhaeil, Karen White

Providence Pharmacy PGY2 Program at Providence Medical Group 2021

Purpose

Health & Services The purpose of this project is to improve clinical outcomes in patients transitioning from inpatient to outpatient care by optimizing the process that primary care pharmacists use to perform comprehensive medication reviews.

Background

• Transitions of care from the inpatient to outpatient setting is an area of great opportunity for improving patient outcomes. • One prospective cohort study found that 20% of patients discharged from the hospital to home experienced an adverse event within 3 weeks of discharge. Of these adverse events, 66% were medication related.1 • Another observational study found that 14% of patients had …

Impact Of The Geriatric Mini-Fellowship On Prescribing Patterns Of The Primary Care Providers, Amy Zahn, Sharon Leigh

Providence Pharmacy PGY1 Program at Providence Milwaukie and Providence Newberg Medical Centers 2021

Background

• Geriatric patients are likely to experience adverse drug events related to high-risk medication use. Polypharmacy is also common and has a significant impact on the health of older adults. •The American Geriatric Society Beers Criteria lists potentially inappropriate medications for older adults.1 •Current literature suggests that Implementing interventions and deprescribing practices have a role in reducing costly hospitalizations. •STOPP (Screening Tool of Older People’s Prescriptions) was designed to address polypharmacy.2 •Medication review and follow-up services for older, polypharmacy patients lowered medication-related costs.3 •Projections suggest there is an insufficient supply of geriatrician services.4 •Per person personal health care spending …

Evaluation And Implementation Of A New Phenobarbital Protocol For Alcohol Withdrawal Management In The Emergency Department, Sarah J. Kim, Sara Clark, Joshua L. Floyd

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2021

Background

• Alcohol withdrawal syndrome can lead to substantial health care costs and mortality. • Although historically benzodiazepines (BZDs) are considered the mainstay treatment for alcohol withdrawal, some studies have shown that phenobarbital may be the safer and preferred alternative option. • Advantages of phenobarbital are its mechanism of action, more predictable pharmacokinetics, and greater therapeutic index. • A prospective study by Rosenson et al. 2012 found that a single 10 mg/kg IV dose of phenobarbital versus standardized lorazepam protocol resulted in decreased ICU admissions (8% vs. 25%). • A retrospective study by Tidewell et al. 2018 demonstrated shorter hospital …

Antibiotic Durations For Skin And Soft Tissue Infections In Pediatric Urgent Care Clinics, Megan Hamner, Amanda Nedved, Holly Austin, Donna Wyly, Alaina N. Burns, Diana King, Brian R. Lee, Rana El Feghaly

Posters

Background: Skin and soft tissue infections (SSTIs) are the second most common diagnosis leading to pediatric antibiotic prescriptions in the outpatient setting after respiratory diagnoses. However, most antibiotic stewardship programs have mainly focused on the latter. Children seen in the ambulatory setting for SSTIs often receive >7 days of antibiotics, although current society guidelines recommend 5-7 days for most diagnoses.


Objective: To determine the baseline percentage of patients receiving antibiotic prescriptions for >7 days for SSTIs in urgent care clinics (UCC)s of a pediatric health system and to evaluate factors that influence providers towards longer durations.


Design/Methods: We built a …

Multimodal Pain Control In Common Neonatal Surgeries: Post-Operative Pain Protocol Reduces Opiate Exposure And Side Effects, Jamesia Donato, Nefertari Terrill-Jones, Ashley K. Sherman, Warren Teachout, Stephanie Prince, Alexandra Oschman, Daphne Reavey, Darian Younger, Tamorah R. Lewis

Posters

Background: Opioids are the primary post-operative (post-op) analgesic in neonates. Side effects include hypotension, apnea and ileus. Previous studies show IV acetaminophen decreases opiate need in specific populations including cleft palate repair, cardiac surgery. The effect of IV acetaminophen as part of a post-op pain algorithm is not known in common neonatal surgical procedures.


Objective: To determine if (a) a post-op pain algorithm including IV acetaminophen and (b) IV acetaminophen exposure reduces cumulative opioid requirements in neonates undergoing common surgeries in the NICU.


Design/Methods: This is a retrospective cohort study comparing cumulative post-operative opiate exposure between infants with common surgeries …

Response To Dexamethasone Predicts Diagnosis Of Severe (Type 2) Bronchopulmonary Dysplasia Or Death, Christopher R. Nitkin, Keith Feldman, Alain Cuna, Alexandra Oschman, William E. Truog, Michael Norberg, Jane Taylor, Tamorah Lewis

Posters

Background: Bronchopulmonary dysplasia (BPD) is the most common respiratory morbidity after preterm birth but requires diagnosis at 36 weeks postmenstrual age (PMA). Dexamethasone is often used to treat infants at high-risk of BPD. The ability for earlier prediction of BPD, based on steroid response, could be useful as a surrogate marker for new therapies.


Objective: To construct a model that predicts severe BPD or death at 36 weeks PMA based on clinical response to dexamethasone.


Design/Methods: Retrospective chart review of preterm infants treated with dexamethasone between 2010-2020 at a Level IV NICU with data collected on demographics, age of steroid …

School Of Pharmacy Class Of 2020 & 2021 Hooding Program, Cedarville University

Doctor of Pharmacy Hooding Ceremony

No abstract provided.

Maintaining Outcomes With Virtual Delivery Of Pharmacy Grand Rounds, Amber Rexwinkle Pharmd, Med, Bcop, Bonnie Butler Med, Nephy George Pharmd, Diane Hecht Pharmd, Med, Chcp, Tiffany Kofroth Cpht-Adv, Cspt, Phtr, Marisa Mendoza Pharmd, Chcp, Cphq, Rebecca Tirrell Mls

2021 Education Week Posters

Second place winner in the 2021 Education Week Poster Competition

Division of Pharmacy, Pharmacy Continuing Education Programs

Data For "Subtype-Selective Positive Modulation Of Sk Channels Depends On The Ha/Hb Helices", Miao Zhang, Meng Cui

Pharmacy Faculty Data Sets

In the activated state of small-conductance Ca²⁺-activated potassium (SK) channels, calmodulin interacts with the HA/HB helices and the S4-S5 linker. CyPPA potentiates SK2a and SK3 channel activity but not the SK1 and IK subtypes. Here, we report that the subtype-selectivity of CyPPA relies on the HA/HB helices. Mutating residues in the HA (V420) and HB (K467) helices of SK2a channels to their equivalent residues in IK channels diminished the potency of CyPPA. CyPPA elicited prominent responses on mutant IK channels with an arginine residue in the HB helix substituted for its equivalent lysine residue in the SK2a channels …

Assessing Real-World Spot Urine Sodium Values During Continuous Intravenous Infusion Of Loop Diuretics, Rachel Propst, Michael Akers

Pharmacy Posters

• The use of spot urine sodium (UNa)>60 mmol/L as an objective measure to guide diuretic therapy in patients receiving bolus intravenous loop diuretics has been associated with increased weight loss and decreased length of stay.
• There is limited published data evaluating UNa use in patients receiving continuous intravenous loop diuretic infusions.

Preventive Healthcare Services Receipt And Primary Care Provider Utilization Among People Who Inject Drugs, E K. Nenninger, Kinna Thakarar

Costas T. Lambrew Research Retreat 2021

Introduction:

People who inject drugs (PWID) face barriers to accessing primary care providers (PCPs) and preventive services, but are at increased risk for preventable infections

Preventive services can be accessed through PCPs, or while hospitalized or at community organizations like syringe service programs (SSPs)

Ketamine Infusions For Post-Cesarean Pain In Patients With Opioid Use Disorder, Talitha Budi, Johanna Cobb, Wendy Craig, Heather Turcotte, Janelle Richard, Aurora Quaye

Costas T. Lambrew Research Retreat 2021

Discussion:

• Opioid consumption may be reduced during ketamine infusion without significant side effects

• Further investigation planned with a prospective, randomized, double-blind, placebo-controlled trial.

Frequency Of Genetic Polymorphisms Of Cyp2c19 In Native Hawaiian, And Asian And Pacific Islander Subgroups: Implications For Personalized Medicine, Khalifa Y. Alrajeh, Youssef Roman Dr

Graduate Research Posters

Pharmacogenetic testing, where prescriptions are tailored to the individual patient based on his/her genetic makeup, increases the ability to predict individual drug response. However, little is known about the prevalence of clinically actionable pharmacogenes in diverse populations. This study seeks to assess the prevalence of select drug-gene alleles that are implicated in the metabolism of commonly prescribed drugs, so-called Very Important Pharmacogenes (VIPs). The results of this study will fill in the gaps of knowledge of VIPs in underrepresented populations and characterize their potential risk for drug adverse events or due to their underlying genetic polymorphisms, especially in patients of …

Peptidomimetic And Non- Peptidomimetic Derivatives As Possible Sars-Cov-2 Main Protease (Mpro) Inhibitors, Mohammed A. Al Awadh, Mohini S. Ghatge Ph.D, Mona A. Al Khairi, Faik N. Musayev, Akua K. Donkor, Mohammed H. Al Mughram, Abdelsattar M. Omar Ph.D, Moustafa M. El-Araby Ph.D, Martin K. Safo Ph.D

Graduate Research Posters

To design novel inhibitors of the SARS-CoV-2 main protease (Mpro), we investigated the binding mode of the recently reported α-ketoamide inhibitors of this enzyme. Following, we utilized in-silico screening to identify 168 peptidomimetic and non-peptidomimetic compounds that are high probability Mpro binding candidates. The compounds were synthesized in 5 to 10 mg for initial screening for their potential inhibition of Mpro using Fluorescence Resonance Energy Transfer (FRET) assay. The study was conducted using the main protease, MBP-tagged (SARS-CoV-2) Assay Kit (BPS Bioscience, #79955-2), and the fluorescence due to enzymatic cleavage of substrate measured using BMG LABTECH CLARIOstar™, a fluorescent microplate …

Pharmacogenomics And Ssris Appropriateness In Older Community Dwelling African Americans, Wint War Phyo, Lana Sargent, Elvin T. Price

Graduate Research Posters

Background: Depressive and anxiety disorders are among the most common illnesses experienced by older adults (age > 60). The selective serotonin reuptake inhibitors (SSRIs) are preferred class of antidepressants for these disorders due to their high efficacy and safety profiles among older adults. However, SSRIs are metabolized by highly polymorphic cytochrome P450 enzymes, specifically CYP2D6 and CYP2C19. This can lead to variable dose-response outcomes, especially among older African American population.

Objective: Analyze the frequency of CYP2D6 and CYP2C19 polymorphisms in African American older adults who are taking SSRIs and identify potential inappropriate use of SSRIs in these older adults using the …

Development Of An Online Warfarin Dosing Platform Using R Programming Language To Facilitate Healthcare Professional Duties And Limit Medication Related Errors., Monther Alsultan

Graduate Research Posters

Development of an online warfarin dosing platform using R programming language to facilitate healthcare professional duties and limit medication related errors.

Monther Alsultan, Joshua M. Morriss, Daniel Contaifer Jr, Suad Alshammari; Silas Contaifer, Rachel W Flurie, Dayanjan S. Wijesinghe^#

Department of Pharmacotherapy and Outcome Sciences

Objective: 1) Gain experience in developing platform agnostic, fully operational and clinically relevant web applications for effective pharmacist led patient care. 2) Create a decision- support tool using open source software to facilitate evidence-based management therapy of warfarin in clinical settings where it is available for everyone to use at anytime and anywhere.

Introduction: …

Impact Of A Primary Care Clinical Pharmacist On The Management Of Hepatitis C Viral Infection, Sierra Ferreiira, Adam Normandin, Linh Gagnon, Corinn Martineau

Costas T. Lambrew Research Retreat 2021

Interprofessional care including a pharmacist demonstrates a positive trend towards increasing access to care and improving adherence to Hepatitis C management in a primary care setting.

Safe Injection To Prevent Infection: Specific Injection Practices Are Associated With Hepatitis C Exposure, Suggesting Opportunities For Targeted Harm Reduction Intervention For People Who Inject Drugs In Maine, N P. Sankar, K Murray, D Burris, K Thakarar

Costas T. Lambrew Research Retreat 2021

Background

• The U.S. opioid epidemic has contributed to an increase in infections related to IDU, such as HCV

• Transmission of HCV has been linked to unsafe injection practices

• This study aims to characterize risk factors associated with HCV exposure amongst people who inject drugs in Maine Methods

Equity For All: Providing Accessible Healthcare For Patients Living With Disabilities, Michelle L. Blakely, Sharon E. Connor, Jennifer Ko

Pharmacy Faculty Books and Book Chapters

At the end of this activity, students will be able to:

• Identify relevant resources to assist patients living with disabilities
• Recommend appropriate patient-specific resources to minimize barriers to health
• Identify strategies to enhance the healthcare experience of patients living with disabilities
• Describe the policies that currently exist to enhance care for patients living with disabilities

Let Your Pharmacist Be Your Guide: Navigating Barriers To Pharmaceutical Access, Jennifer Ko, Miranda Steinkopf, Sharon E. Connor

Pharmacy Faculty Books and Book Chapters

At the end of this case, students will be able to: • Describe policy, organizational, and individual factors that contribute to barriers to accessing medications and pharmaceutical care • Identify resources to improve access to affordable medications for uninsured and underinsured patients • Recommend appropriate resources for obtaining affordable medications

Digging Deeper: Improving Health Communication With Patients, Jennifer Ko, Miranda Steinkopf, Abby A. Kahaleh, Sharon Connor

Pharmacy Faculty Books and Book Chapters

At the end of this activity, students will be able to:

• Identify five theories and models that can be used to facilitate the patient-provider health communication process
• Describe opportunities to optimize communication with patients in healthcare settings
• Apply health communication theories within patient care, providing specific approaches and language to utilize

2021 Apothecary, Southwestern Oklahoma State University

Apothecary

It is with great honor we present the 2021 Apothecary issue. This year’s Apothecary was made possible by the provision of generous financial contributions from many stores, businesses, and Southwestern College of Pharmacy alumni. We greatly appreciate and thank you for your continued support.

The Apothecary staff would like to thank Dr. David Ralph and Adina Foust for their patience, countless hours, and unfailing efforts throughout this year. We also want to give huge thanks to the SWOSU Design Studio for their hard work in creating this year’s amazing cover and dividers. You always help bring our ideas to life …