Pharmacy and Pharmaceutical Sciences Commons^™

Pharmacy Newsletter : September 2018, Pharmacy Department

Department of Pharmacy Archives

Content:

• Stress Ulcer Prophylaxis
• New Update: Direct Oral Anti-Coagulants (DOACs)
• Case Study: Use of Cholestyramine for Management Of Digoxin Toxicity
• Updates : Use of Doxycycline in Children
• Serotonin Syndrome – Myths & Misconceptions

Formulation And Stability Study Of Eslicarbazepine Acetate Oral Suspensions For Extemporaneous Compounding, Fang Zhao, Vivek S. Dave, Mazin Z. Mar, Jonathan R. Perri

Pharmacy Faculty/Staff Publications

Eslicarbazepine acetate is an anticonvulsant drug with a recent U.S. Food and Drug Administration approval for expanded use in children and adolescents. Currently, eslicarbazepine acetate is only available in the U.S. as 200-mg to 800-mg strength tablets (Aptiom), which are not easy to administer for pediatric patients. This study was initiated to develop an oral suspension formulation for extemporaneous compounding by pharmacists and to generate stability data for storage recommendations. Nine suspension formulations of eslicarbazepine acetate were prepared from Aptiom tablets and commercially available liquid vehicles using the standard mortar/pestle method. The vehicles varied mainly in their solvents, viscosities, and …

Burden Of Lipohypertrophy Among Insulin Dependent Diabetes Mellitus Patients In China: An Analysis Of Outcomes And Impact Of Pen Needle Reimbursement Policy, Arthi Chandran

Dissertations and Theses

Background

Diabetes is a global epidemic and with an aging population accompanied by rapid urbanization China ranks highest in disease prevalence and associated burden. Independent of diabetes type, insulin is an eventual and costly requirement for disease management. The consequences of insulin administration however are poorly understood. Lipohypertrophy (LH) is one such consequence. It is hypothesized that method of insulin delivery and poor delivery technique are significant risk factors for this condition which is believed to alter insulin pharmacodynamics. Subsequently, insulin pen needles are a critical component of care however access to pen needles varies across China.

Objective

The objective …

Bivalirudin Anticoagulation Dosing Protocol For Extracorporeal Membrane Oxygenation: A Retrospective Review., Jared W. Netley Pharmd, Mpa , Bcps, James Roy Pharmd, Joseph Greenlee Iii Md, Shaun Hart Np, Michael Todt Pharmd, Bryan Statz Pharmd

Parkview Pharmacy Department

Anticoagulation with unfractionated heparin during extracorporeal membrane oxygenation (ECMO) is common, but alternative agents are being evaluated for safety and efficacy. The objective of this analysis was to assess if a comprehensive bivalirudin dosing and monitoring protocol effectively guides dose adjustments and monitoring of bivalirudin in patients during ECMO. Our analysis included 11 patients who received bivalirudin during ECMO therapy and had dosing managed using our hospital derived protocol. Patients treated over a 1-year period were included in this retrospective analysis. Clinical characteristics and changes in activated partial thromboplastin time (aPTT) were evaluated from medical records to determine the efficacy …

Evaluasi Kesesuaian Penulisan Resep Pada Kasus Ispa Non Pneumonia Di Poli Mtbs Puskesmas Kecamatan Cengkareng, Jakarta, Rani Sauriasari, Annisa Azka Hikmawati Aulia, Adisa Swastika

Pharmaceutical Sciences and Research

Acute respiratory infections (ARI) is one of the major health problems in Indonesia. There are three classifications of cases of ARI, consist of pneumonia, severe pneumonia and non pneumonia. This study aimed to find an overview of the use of antibiotics and the evaluation of suitability prescriptions performed in cases of non pneumonia Acute Respiratory Infections (ARI) in IMCI Polyclinic, Cengkareng District Community Health Centre (Puskesmas Cengkareng), West Jakarta. Evaluation for the prescription suitability was useful to find the percentage of the suitability of prescribing on the existing management. This activity was done using retrospective method with data of 100 …

Evaluasi Kesesuaian Dosis Pada Pasien Pediatri Bronkitis Akut Di Rumah Sakit Tentara Kartika Husada Kubu Raya, Variandini Aldhila Kharis, Rise Desnita, Hariyanto Ih

Pharmaceutical Sciences and Research

Selection and usage of rational drugs determine the success of expected therapeutic effect, especially for pediatrics. Acute bronchitis in pediatrics is one of the highest incidents of Acute Respiratory Infection (ARI) in Army Hospital Kartika Husada Kubu Raya. This study aimed to evaluate rationality of drug doses conformity in outpatient pediatric acute bronchitis in Army Hospital Kartika Husada Kubu Raya on 2015. This research was a descriptive observational research with cross-sectional design. The sample was taken with purposive sampling amounted to 36 prescriptions. Then the evaluation of drug doses conformity was counted according to the literature. The results showed that …

Pemodelan Molekul Turunan P-Metoksi Sinnamoil Hidrazida Sebagai Inhibitor Checkpoint Kinase 1 Dan Inhibitor Aromatase Secara In Silico, Galih Satrio Putra, Melanny Ika Sulistyowatya, Juni Ekowati, Tutuk Budiati

Pharmaceutical Sciences and Research

The development of anticancer drugs from ethyl p-methoxycinnamate (EPMC) derivatives has been done to compounds high activity in inducing cancer cells apoptosis and minimal side effects. p-Methoxycinnamoyl hydrazide derivates, modified from EPMC structure, were docked into the ligand-binding pocket of Check point kinase 1 enzymes (2YWP) and the aromatase enzyme (3S7S) using software Molegro Virtual Docker (MVD) Ver.5.5. We compared the Rerank score of native ligand with p-Methoxycinnamoyl hydrazide derivates. Rerank scores of compounds 4b and 4c (-99.98 Kcal/mol and -99.80 Kcal/mol) were lower than the native ligand A42 in inhibiting the enzyme checkpoint kinase 1. Rerank values of p-Methoxycinnamoyl …

L-Citrulline As Alternative Pharmacological Substance In Protecting Against Cardiovascular Disease, Andrea Laurentius, Gregorius Bhaskara Wikanendra, Tzeto Han Cong, Wawaimuli Arozal

Pharmaceutical Sciences and Research

Cardiovascular disease (CVD) has taken up to average 30% of death diagnoses in the world. Prevalent attempts of physicians to treat this disease came down to focus on using drugs with their specific mechanism of action. Since the method only cures the symptoms and need to be pharmacologically monitored, physicians and scientists have been struggling to find other treatment strategies. This problem led us to search for another substance dealing with CVD via preventive therapy, which does not require such close monitoring by physicians in its use. The answer relies on using L-citrulline as potential therapeutics in treating and preventing …

Recombinant Human Proteoglycan-4 Reduces Phagocytosis Of Urate Crystals And Downstream Nuclear Factor Kappa B And Inflammasome Activation And Production Of Cytokines And Chemokines In Human And Murine Macrophages, Marwa Qadri, Gregory D. Jay, Ling X. Zhang, Wendy Wong, Anthony M. Reginato, Changqi Sun, Tannin A. Schmidt

Pharmacy Faculty Articles and Research

Microbial biofilms are organized communities of cells that are associated with a wide spectrum of resistant and chronic infections that lead to the treatment failure. Accordingly, there is an urgent demand to create novel effective therapeutic drugs that can inhibit biofilm formation with new mechanisms of action to surmount the current escalating resistance. In this study, in silico hybrid model was utilized to develop three novel short linear peptides (4, 5, and 6) with potential biofilm inhibiting activities (scores > 1.0). The peptides were composed of cationic and hydrophobic residues. They were synthesized using solid-phase strategy. Synthesized peptides were purified and …

Hypoglycemic, Hypolipidemic And Antioxidant Effects Of Iridoid Glycosides Extracted From: Corni Fructus: Possible Involvement Of The Pi3k-Akt/Pkb Signaling Pathway, Jiefang Kang, Chen Guo, Rodolfo Thome, Ning Yang, Yuan Zhang, Xing Li, Xiaoyan Cao

Department of Neurology Faculty Papers

Iridoid glycosides (CIG) are the major component of Corni fructus. In this work, we researched the antioxidative, hypoglycemic and lowering blood lipids effects of CIG on diabetic mice induced by a high-fat diet (HFD) and streptozotocin (STZ). Furthermore, to investigate the molecular mechanism of action, the phosphorylation and protein expression of phosphoinositide 3-kinase (PI3K) and its downstream proteins, such as insulin receptor (INSR), protein kinase B (Akt/PKB) and glucose transporter 4 (GLUT4) have been detected. The results showed that CIG significantly improved oral glucose tolerance in diabetic mice. Biochemical indices also revealed that CIG had a positive effect on lipid …

Exploring The Role Of Ceftaroline In The Treatment Of Community-Acquired Pneumonia, Zachary Meyer

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of File TM Jr, Low DE, Eckburg PB, Talbot GH, Friedland HD, Lee J, Llorens L, Critchley IA, Thye DA, FOCUS 1 investigators. FOCUS 1: a randomized, double-blinded, multicentre, Phase III trial of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in community-acquired pneumonia. J Antimicrob Chemother. 2011 Apr;66 Suppl 3:iii19-32. doi: 10.1093/jac/dkr096

Uplc-Ms/Ms Analysis Of Dextromethorphan-O-Demethylation Kinetics In Rat Brain Microsomes, Barent N. Dubois, Reza Mehvar

Pharmacy Faculty Articles and Research

Formation of dextrorphan (DXT) from dextromethorphan (DXM) has been widely used to assess cytochrome P450 2D (CYP2D) activity. Additionally, the kinetics of CYP2D activity have been well characterized in the liver microsomes. However, studies in brain microsomes are limited due to the lower microsomal content and abundance of CYP2D in the brain relative to the liver. In the present study, we developed a micro-scale enzymatic incubation method, coupled with a sensitive UPLC-MS/MS assay for the quantitation of the rate of DXT formation from DXM in brain microsomes. Rat brain microsomes were incubated with different concentrations of DXM for various times. …

The Next Generation: A Novel Diabetes Elective Course For Pharmacy Students, Catherine Hedigan, Mirna Rezkalla, Matthew Ta, Amy M. Egras, Pharmd, Bcps, Bc-Adm

College of Pharmacy Posters

Background

• 30.3 million people or nearly 10% of the United States are diagnosed with diabetes
• Patients with uncontrolled diabetes often have many clinicians, including pharmacists, to help control their diabetes
• Clinicians that can empathize with patients have shown to improve patient satisfaction and outcomes2
• The Diabetes Immersion elective at Thomas Jefferson University College of Pharmacy is offered to third-year pharmacy students to provide additional knowledge about diabetes through hands-on learning and guest lecturers
• The class emphasizes a well-rounded understanding of diabetes touching on topics that may not otherwise be covered in required courses due to time constraints

Development Of Novel Therapies For The Treatment Of Inflammatory Bowel Disease, Shrey Kanvinde

Theses & Dissertations

Inflammatory bowel disease (IBD) is a chronic and remittent inflammation of the gastrointestinal tract (GIT). Despite extensive research efforts, there is no cure nor a well-defined pathogenesis for IBD. Loss of epithelial barrier function, increased colonic immune cell infiltration and upregulation of pro-inflammatory cytokines are the hallmarks of IBD. Despite treatments like painkillers, aminosalicylates, steroids, and biologics, almost 70% patients require surgery at least once in their life time. The main limitation with most of the current treatments is they are either absorbed systemically or administered systemically resulting in adverse side effects. As a result, there is a huge unmet …

Polymeric Nanocarriers Delivering Anticancer Agents For The Treatment Of Chemoresistant Prostate Cancer And Lung Metastatic Melanoma, Ruinan Yang

Theses & Dissertations

The aims of this thesis is to first develop novel combination chemotherapies of two anticancer agents and their appropriate drug delivery platforms to treat chemoresistant prostate cancer, and second develop a polymeric conjugate of a biodegradable polymer and novel tubulin destabilizer to treat lung metastatic melanoma.

In Chapter 1, a general introduction of polymeric nanocarriers including polymeric micelles and polymer drug conjugates for cancer therapy was given. In Chapter 2, we described a combination therapy of paclitaxel (PTX) polymer conjugate and cyclopamine (CYP) polymer conjugate, which had the potential to treat chemoresistant prostate cancer. We first synthesized mPEG-b-PCC-g-PTX-g-DC (P-PTX) …

Astromimetics: The Dawn Of A New Era For (Bio)Materials Science?, Vuk Uskoković, Victoria M. Wu

Pharmacy Faculty Articles and Research

Composite, multifunctional fine particles are likely to be at the frontier of materials science in the foreseeable future. Here we present a submicron composite particle that mimics the stratified structure of the Earth by having a zero-valent iron core, a silicate/silicide mantle, and a thin carbonaceous crust resembling the biosphere and its biotic deposits. Particles were formulated in a stable colloidal form and made to interact with various types of healthy and cancer cells in vitro. A selective anticancer activity was observed, promising from the point of view of the intended use of the particles for tumor targeting across the …

August 2018, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Bioinformatic Analysis Of Endogenous And Exogenous Small Rnas On Lipoproteins, Ryan M. Allen, Shilin Zhao, Marisol A. Ramirez Solano, Wanying Zhu, Danielle L. Michell, Yuhuan Wang, Yu Shyr, Praveen Sethupathy, Macrae F. Linton, Gregory A. Graf, Quanhu Sheng, Kasey C. Vickers

Pharmaceutical Sciences Faculty Publications

To comprehensively study extracellular small RNAs (sRNA) by sequencing (sRNA-seq), we developed a novel pipeline to overcome current limitations in analysis entitled, “Tools for Integrative Genome analysis of Extracellular sRNAs (TIGER)”. To demonstrate the power of this tool, sRNA-seq was performed on mouse lipoproteins, bile, urine and livers. A key advance for the TIGER pipeline is the ability to analyse both host and non-host sRNAs at genomic, parent RNA and individual fragment levels. TIGER was able to identify approximately 60% of sRNAs on lipoproteins and >85% of sRNAs in liver, bile and urine, a significant advance compared to existing software. …

Self-Assembling Bioaffinity Hydrogels For Localized Antibody Delivery, Wen Liu

Electronic Theses and Dissertations

The scope of illnesses that are being treated using monoclonal antibodies (mAbs) has been expanding from cancers to autoimmune diseases due to their high specificity to their molecular target. Because many of the new mAbs are aimed to modulate the immune system, an emerging concern is that patients with chronic illnesses are subjected to immune-related Adverse Events (irAEs). Loss of immunological tolerance to self-antigens or increased susceptibility to infections have been documented in some mAb treatments. Localized sustained release of mAb at disease sites might mitigate the risk of such toxicities. Antibody drugs are formulated typically for parenteral delivery because …

Effects Of Natural Antioxidants On Motor And Cognitive Deficits In An Animal Model Of Aging And Obesity And Dopaminergic-Like Sh-Sy5y Cell Line, Sneha Potdar

Electronic Theses and Dissertations

Aging is a universal phenomenon. One of the greatest challenges faced by the elderly population is to sustain a healthy standard of living. Advancing age is associated with increased motor and cognitive deficits. Loss of balance, falls, hip fractures, and poor memory all contribute to a decline in the quality of life of the aging population. While ongoing research is making advances to find therapeutic interventions for neurodegenerative disorders like Parkinson’s and Alzheimer’s diseases, there is a pressing need to address deficits associated with normal aging.

Increase in oxidative stress and a decline of antioxidant mechanisms with aging have been …

Research News. Grants, 2018. Volume 1, University Of Mississippi. School Of Pharmacy, Soumyajit Majumdar

Grants (2015-)

Grants and contracts awarded during January-June 2018

Medication Exposure Patterns In Primary Care Patients Prescribed Pharmacogenetically Actionable Opioids, Mitchell R. Knisely, Janet S. Carpenter, Marion E. Broome, Ann M. Holmes, Diane Von Ah, Todd Skaar, Claire Burke Draucker

The Qualitative Report

Current approaches to assessing medication exposure fail to capture the complexity of the phenomenon and the context in which it occurs. This study’s purpose was to develop a typology of subgroups of patients who share common patterns of medication exposure. To create the typology, we used an exemplar sample of 30 patients in a large public healthcare system who had been prescribed the pharmacogenetically actionable opioids codeine or tramadol. Data related to medication exposure were drawn from large data repositories. Using a person-oriented qualitative approach, eight subgroups of patients who shared common patterns of medication exposure were identified. The subgroups …

Targeting Neuropeptides To Bone Fractures For Accelerated Healing, Nicholas A. Young, Jeffery J. Nielsen, Philip S. Low

The Summer Undergraduate Research Fellowship (SURF) Symposium

In patients over the age of 65 especially, bone fractures represent a significant disease burden. Non-invasive drug therapies are not available for bone fractures which represents a problem for this population. Vasoactive intestinal peptide (VIP) and Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP), two neuromodulator peptides in the glucagon superfamily, have demonstrated positive regulation of osteoblast proliferation and activity. Using acidic oligopeptides, we have developed ligands that target to and accumulate at fracture sites. These targeting ligands can be synthesized in sequence with bone anabolic peptides to minimize off target effects and increase potency at the fracture site to create safer and …

Research News. Publications, 2018. Volume 1, University Of Mississippi. School Of Pharmacy, Soumyajit Majumdar

Publications (2015-)

Publications that appeared during the period January 1 through June 30, 2018

Dietary Inclusion Of Enriched Chicken Bone Broth Prevents Trigeminal Sensitization Meditated By Early Life Stress, Orion Peterson

Graduate Theses/Dissertations

Early life stress is considered a risk factor for development of migraine, which is a prevalent painful neurological disorder involving sensitization and activation of trigeminal neurons, and irritable bowel syndrome, a condition often comorbid with chronic migraine. The focus of my study was to determine the effects of early life stress and dietary inclusion of enriched chicken bone broth on trigeminal nociceptor sensitization and the gut microbiota. Adult Sprague-Dawley male “sender” rats subjected to primary traumatic stress were placed next to breeding or pregnant female rats that served as “receiver” rats (secondary traumatic stress) and in proximity to the offspring …

A Programme For Risk Assessment And Minimisation Of Progressive Multifocal Leukoencephalopathy Developed For Vedolizumab Clinical Trials, Asit Parikh, Kristin Stephens, Eugene Major, Irving Fox, Catherine Milch, Serap Sankoh, Michael H. Lev, James M. Provenzale, Jesse Shick, Mark Patti, Megan Mcauliffe, Joseph R. Berger, David B. Clifford

Neurology Faculty Publications

Introduction Over the past decade, the potential for drug-associated progressive multifocal leukoencephalopathy (PML) has become an increasingly important consideration in certain drug development programmes, particularly those of immunomodulatory biologics. Whether the risk of PML with an investigational agent is proven (e.g. extrapolated from relevant experience, such as a class effect) or merely theoretical, the serious consequences of acquiring PML require careful risk minimisation and assessment. No single standard for such risk minimisation exists. Vedolizumab is a recently developed monoclonal antibody to α4β7 integrin. Its clinical development necessitated a dedicated PML risk minimisation assessment as part of a global preapproval regulatory …

A Clinically Relevant Mouse Model Of Cisplatin-Induced Kidney Injury., Cierra Nichole Sharp

Electronic Theses and Dissertations

Cisplatin is a potent chemotherapeutic used for the treatment of many solid cancers, including testicular, ovarian, and lung cancer. Cisplatin causes many adverse side effects, of which nephrotoxicity leading to acute kidney injury is dose-limiting. Approximately 30% of patients will develop nephrotoxicity with cisplatin, and will either have their next dose of cisplatin lowered, skipped, or be switched to a less nephrotoxic chemotherapeutic altogether. These outcomes are not ideal when trying to treat cancer. Previously, it was believed that patients could recover from cisplatin-induced acute kidney injury with little to no lasting effects, but recent longitudinal studies have shown this …

Pharmaceutical Care Management Association V. Rutledge, John J. Crean, Karl Williams

Doctoral External Publications

On June 8, 2018 the federal Eighth Circuit Court of Appeals announced its decision concerning Arkansas' attempt to regulate perceived unfair payment practices of pharmacy benefit managers (PBMs) in the case Pharmaceutical Care Management Association v. Rutledge.¹ Because pharmacies across the country face similar problems, and this ruling may influence other federal appellate courts, review and discussion is useful for the purpose of making strategic decisions.

An Opportunity For Pharmacists To Help Improve Coordination And Continuity Of Patient Health Care, Jon C. Schommer, Lawrence M. Brown, Ryan (Alyssa) Bortz, Alina Cernasev, Basma T. Gomaa, Keri D. Hager, Lisa Hillman, Olihe Okoro, Serguei V. S. Pakhomov, Paul L. Ranelli

Pharmacy Faculty Articles and Research

Pharmacist workforce researchers are predicting a potential surplus of pharmacists in the United States that might result in pharmacists being available for engagement in new roles. The objective for this study was to describe consumer opinions regarding medication use, the health care system, and pharmacists to help identify new roles for pharmacists from the consumer perspective. Data were obtained from the 2015 and 2016 National Consumer Surveys on the Medication Experience and Pharmacist Roles. Out of the representative sample of 36,673 respondents living in the United States, 80% (29,426) submitted written comments at the end of the survey. Of these, …

Aminoflavone Inhibits Α6-Integrin And Growth Of Tamoxifen Resistant Breast Cancer, Petreena S. Campbell

Loma Linda University Electronic Theses, Dissertations & Projects

Approximately 40% of estrogen receptor positive (ER+) breast cancer patients develop resistance to standard of care agent tamoxifen, while ER negative (ER-) breast cancer patients are intrinsically resistant to tamoxifen. Resistance often promotes metastasis, recurrence and death. Tumor-initiating cells (TICs) represent key contributors to resistance and adhesion protein α6-integrin is a putative TIC biomarker. Investigational agent Aminoflavone (AF) demonstrates efficacy against breast cancer cells irrespective of ER status. Interestingly, we found tamoxifen resistant (TamR) cells and tumors exhibited elevated α6-integrin expression in comparison to their tamoxifen sensitive counterparts. AF effectively disrupted mammospheres enriched for TICs and reduced α6-integrin levels in …