Pharmacy and Pharmaceutical Sciences Commons^™

Impact Of In-House Specialty Pharmacy On Access To Novel Androgen Axis Inhibitors In Men With Advanced Prostate Cancer, Anna Driscoll, Nathan Handley, Md, Mba, Adam Binder, Siobhan Henry, W. Kevin Kelly, Do

Phase 1

Introduction: Novel androgen axis inhibitors are standard of care treatments in advanced prostate cancer. The billed amounts for these medications are often very high, which may create significant financial toxicity for patients and lead to delays in treatment. Our institution implemented an in-house specialty pharmacy in 2014, that provides these medications and evaluates copay assistance options for all patients. We evaluated the program’s impact on out of pocket cost (OOP) and turnaround time (TAT).

Methods: We reviewed available internal specialty pharmacy records to identify prescriptions for abiraterone or enzalutamide filled between 1/1/17 and 12/31/18. Payments were stratified by primary payment …

Targeting The Rage Signaling Pathway To Ameliorate The Complications Of Diabetes, Stephen James Dansereau

Legacy Theses & Dissertations (2009 - 2024)

Diabetes is a global health epidemic that can be devastating to those afflicted,

Reflections On The Effects Of Federalism On Opioid Policy, Matthew B. Lawrence

Faculty Articles

One thing we have seen today that we talk about in health law all the time is how the policy, the laws and institutions up at the 10,000 foot level, can so dramatically influence the personal, people’s lived experiences. Our speakers today have done a really great job of drawing out abstract institutional questions and also showing us how those questions have influenced the lives of real people in often tragic ways. Another thing we have seen that we talk about in administrative law all the time is the importance of expertise, especially given how hard it is to trace …

ฤทธิ์การต้านมะเร็งของสารไบแซนโทนจากไลเคน Usnea Aciculifera ต่อเซลล์มะเร็งลำไส้ใหญ่และทวารหนักของมนุษย์, ณัฏธิดา เมฆสุกใส

Chulalongkorn University Theses and Dissertations (Chula ETD)

ไบแซนโทน (Bixanthones) เป็นกลุ่มสารชีวสังเคราะห์ที่มีโครงสร้างทางเคมีหลักเป็น xanthone ซึ่งเกิดจาก xanthone monomer สองโมเลกุลมาเชื่อมต่อกันด้วยพันธะแบบต่างๆแล้วเกิดเป็นสารไบแซนโทนขึ้นหลากหลายชนิดและสามารถพบได้ในแหล่งธรรมชาติ ได้แก่ พืช เชื้อรา และไลเคน ฤทธิ์ทางเภสัชวิทยาหลักของสารกลุ่มนี้ที่พบ ได้แก่ ฤทธิ์ต้านจุลชีพ ฤทธิ์ต้านอนุมูลอิสระ และฤทธิ์ต้านมะเร็ง จากการศึกษาที่ผ่านมาพบว่า สารไบแซนโทนที่สกัดได้จากพืชและเชื้อราหลายชนิดมีฤทธิ์ในการต้านเซลล์มะเร็งต่างๆ ได้ เช่น เซลล์มะเร็งเม็ดเลือดขาว (P388) เซลล์มะเร็งปอด (LL2 และ H520) เซลล์มะเร็งเต้านม (MCF-7) เซลล์มะเร็งหลอดอาหาร (TE1 และ KYSE-150) และเซลล์มะเร็งต่อมลูกหมาก (DU-145) เป็นต้น แต่อย่างไรก็ตามยังไม่เคยมีรายงานการศึกษาฤทธิ์ต้านมะเร็งและกลไกการออกฤทธิ์ของสารไบแซนโทนที่สกัดได้จากไลเคนในเซลล์มะเร็งลำไส้ใหญ่และทวารหนักมาก่อน ในงานวิจัยนี้จึงสนใจที่จะศึกษาฤทธิ์ต้านมะเร็งของสารไบแซนโทนทั้ง 8 ชนิดที่สกัดได้จากไลเคน Usnea aciculifera ในเซลล์มะเร็งลำไส้ใหญ่และทวารหนัก ได้แก่ เซลล์ HT-29 ผลการศึกษาพบว่า สารไบแซนโทนสองชนิด ได้แก่ TT-03 และ TT-08 สามารถยับยั้งการรอดชีวิตและมีความเป็นพิษต่อเซลล์มะเร็ง HT-29 มากที่สุด โดยพบว่า สารไบแซนโทน TT-08 มีความเป็นพิษต่อเซลล์ปกติ PCS201-010 น้อยกว่าสารไบแซนโทน TT-03 และมีค่าดัชนีความจำเพาะ (selectivity index) ของเซลล์ลำไส้ปกติ CRL-1790 ต่อเซลล์มะเร็ง HT-29 เท่ากับ 1.95 ดังนั้นผู้วิจัยจึงเลือกสารไบแซนโทน TT-08 มาทำการศึกษาต่อไป จากการศึกษาต่อในระดับเซลล์และโมเลกุล พบว่า สารไบแซนโทน TT-08 มีความเป็นพิษต่อเซลล์มะเร็ง HT-29 แปรผันตามความเข้มข้นและระยะเวลาที่ใช้ทดสอบโดยมีค่าความเข้มข้นที่ทำให้เซลล์ตายร้อยละ 50 เท่ากับ 3.87± 0.13, 2.05 ± 0.06 และ 1.51± 0.11 ไมโครโมลาร์ หลังจากได้รับสารนาน 24, 48 และ 72 ชั่วโมง และสามารถยับยั้งการเจริญเติบโตของเซลล์มะเร็งผ่านการชักนำให้เกิดการหยุดของวัฏจักรเซลล์ที่ระยะ S …

Qualitative Research In Pharmacy Education: An Exploration Of Pharmacy Education Researchers' Perceptions And Experiences Conducting Qualitative Research, Antonio A. Bush, Mauriell Amechi, Adam Persky

Educational Leadership & Workforce Development Faculty Publications

Objective. To investigate pharmacy education researchers’ experiences in conducting qualitative research and their perceptions of qualitative research in pharmacy education

Methods. A phenomenological approach was used to conduct one-time, in-depth interviews with 19 participants from 12 schools and colleges of pharmacy. Interview transcripts were coded and themes were identified using a modified form of the Sort and Sift, Think and Shift method of data analysis.

Results. Faculty members were the largest subgroup in the sample, followed by graduate students, postdoctoral fellows/scholars, and residents. Pharmacy education researchers had varying levels of training in conducting qualitative research and some had none at …

Impact Of Extended Interval Inr Testing During The Covid-19 Pandemic, Jordan Holder Pharmd, Maryam Noureldin Pharmd, Bcps,Bcacp, Priya Verma Pharmd

Parkview Pharmacy Department

2020 ASHP Midyear Clinical Meeting

Objective: To determine if extended INR interval monitoring during the COVID-19 pandemic would significantly impact TTR or be associated with emergency department (ED) visits and hospitalizations with bleeding or clotting events.

An Evaluation Of Vancomycin Use In Patients With Urosepsis, Curtis Stump Pharmd, Shahinda Mohmed, Dustin D Linn Pharmd, Rph, Bcccp

Parkview Pharmacy Department

Poster Presentation

Background and Objective:

Urosepsis is an infection that originates from the urinary tract and accounts for 9% of all sepsis cases. 1 Pathogens commonly associated with urosepsis include E. coli, Proteus spp., Enterobacter spp., Klebsiella spp., and P. aeruginosa, and gram-positive bacteria (5% of cases). Sepsis treatment guidelines do not provide specific recommendations for the management of urosepsis; however, they state to utilize anti-MRSA agents, such as vancomycin, when risk factors for MRSA exist. 2 The prevalence of urosepsis caused by gram-positive organisms has been reported at low rates. The objective of this study is to evaluate how …

Vancomycin Dosing Practices Among Critical Care Pharmacists: A Survey Of Society Of Critical Care Medicine Pharmacists, Alexander H. Flannery, Drayton A. Hammond, Douglas R. Oyler, Chenghui Li, Adrian Wong, Andrew P. Smith, Qiu Min Yeo, Whitney Chaney, Caitlin E. Pfaff, Angela M. Plewa-Rusiecki, Paul Juang

Pharmacy Practice and Science Faculty Publications

Introduction: Critically ill patients and their pharmacokinetics present complexities often not considered by consensus guidelines from the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists. Prior surveys have suggested discordance between certain guideline recommendations and reported infectious disease pharmacist practice. Vancomycin dosing practices, including institutional considerations, have not previously been well described in the critically ill patient population.

Objectives: To evaluate critical care pharmacists' self-reported vancomycin practices in comparison to the 2009 guideline recommendations and other best practices identified by the study investigators.

Methods: An online survey developed by the …

Utilization Of A Community Pharmacy-Based Service For The Treatment Of Uncomplicated Urinary Tract Infections In Scotland, Robert Borchardt

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: In November 2013, Scotland piloted a program in Grampian for the treatment of Urinary Tract Infections (UTIs) in community pharmacies, increasing health access for patients and reducing general practitioner workload. This program became known as ‘Pharmacy First’ and was later implemented nationwide in November 2017. This paper seeks to understand utilization of the Pharmacy First program across Scotland by patients and potential barriers to access.

Methods: Using data from the Prescribing Information System collected by the National Health Service of Scotland from July 2013 to April 2019, orders for uncomplicated UTIs were gathered by examining all nitrofurantoin and trimethoprim …

Dalbavancin In The Community Emergency Department, Wesley Johnson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction

Dalbavancin is an antibiotic within the class of medications known as lipoglycopeptides. This medication is given to patients presenting to the hospital with acute skin and skin-structure infections (ABSSSI). This is a unique medication because it is given as a one-time dose in the outpatient setting and it could prevent patients from requiring admission to the hospital.

Methods

The emergency department (ED) at Good Samaritan community hospital performed a trial period with dalbavancin and data was collected from November 2018 to March 2020. Retrospective chart review was performed to obtain patient data and outcomes. Patients would be contacted by …

Timely Follow Up Care After Initiation Of Adhd Medication In Children: A Quality Improvement Project, Rebecca Haas

DNP Scholarly Projects

Background: Enhancing medication safety, strengthening compliance and mitigating side effects requires close monitoring. A child, defined by Centers for Medicare and Medicaid Services, as being between the ages of 6 years and 12 years of ages, with Attention Deficit Hyperactivity Disorder (ADHD) must have an initial medication visit within 30 days of a first-time trial of ADHD medication. Increasing staff awareness of organizational policy of expected timeframe for medication checks and annotating appointment slots as initial medication checks will decrease the number of days between the first-time trial of ADHD medication and a child’s medication assessment. Methods: The Model for …

Measuring The Effects Of Lobinaline-N-Bioxide (419) On Alcohol Consumption, Nicotine Locomotor Sensitization, And Conditioned Place Preference In Mice And Rats, Cocanut M. Suhail

Theses and Dissertations--Medical Sciences

Objective: Novel drug 419 was examined to see the effect it has in vivo mice and rats on alcohol consumption, nicotine locomotor sensitization, and conditioned place preference (CPP) models regarding behavioral tests on dopamine transporter activity.

Methods: Mice and rats were used to see how they react to the drug 419 and control vehicle, in each of the models. The animals were assessed to pre- and post- drug administration of novel drug 419. We examined each model to see the association between how drug 419 will help with treating drug abuse.

Results: We found that in alcohol consumption model the …

Meaningful Measurement Matters: Defining Potentially Inappropriate Medication Use To Target Cognitive Outcomes, Ashley I. Martinez

Theses and Dissertations--Pharmacy

Preventable and unintended consequences of medication use occur in more than 25% of ambulatory and hospitalized patients, and nearly half of long-term care patients. Unfortunately, many medications used to treat common health conditions in older adults (such as anxiety, behavioral disturbances, incontinence, insomnia, depression, and pain) have also been linked to cognitive impairment and decline. Recently, substantial efforts to investigate medications and medication classes that may be associated with cognitive impairment and decline in older adults have been undertaken. Unfortunately, studies have used a wide variety of different tools to define “potentially inappropriate medication” (PIM) use, and no published literature …

Relationship Between Initial Prescription Opioid Exposure Length And Future Opioid Use Disorder Diagnosis In Opioid Naive Adolescents, Eric Lindahl

Theses and Dissertations--Pharmacy

Objectives: The long-term risks associated with the use of short-term prescription opioids in opioid naïve adolescents in not well characterized. The purpose of this study was to explore the potential association between the days’ supply of the initial prescription opioid exposure and the rates of diagnosed OUD in the subsequent 3-year period. Methods: We conducted a retrospective cohort study using a nationwide database of commercially-insured adolescents aged 12-17 at the time of the index opioid fill. A multivariable Cox Proportional Hazard regression model was developed to analyze the association of interest while accounting for known risk factors for the development …

The Impact Of Bone Marrow Transplantion On Patients With Psychiatric Diagnoses: Medication Adherence Assessment, Brittany Galop

Theses and Dissertations--Pharmacy

Objectives: We investigated whether there is a measurable difference in medication utilization for psychiatric conditions before and after bone marrow transplantation (BMT). Previous studies have identified a potential association between psychiatric conditions and immune function. We hypothesized that medication utilization for psychiatric diagnoses would be impacted by BMT.

Methods: This study was a retrospective, quasi-experimental cohort design. De-identified data was compiled from the Truven database for patients ranging from January 2009 through December 2016. Two measurements of medication utilization, proportion of days covered (PDC) and medication possession ratio (MPR) were calculated for each included Medispan-defined class of medications before analyzing …

Population Pharmacokinetic Modeling And Genetic Association Analysis In Infants With Neonatal Abstinence Syndrome Receiving Morphine Or Clonidine, Fei Tang

Theses and Dissertations--Pharmacy

Neonatal abstinence syndrome, or NAS, is a postnatal opioid withdrawal syndrome occurring in 55% to 94% of neonates as a result of in utero exposure to opioids. It has emerged as a significant public health issue, as its incidence more than quadrupled in the past decade. There is significant variability in disease severity and treatment outcomes in neonates with NAS due to patient-specific factors and treatment- or site-specific factors. To understand what contributes to variability in length of hospital stay and other outcomes in neonates with NAS, we assessed population pharmacokinetics (PK) of clonidine and morphine, and we investigated potential …

Extensively Drug-Resistant Pseudomonas Aeruginosa In Vitro Susceptibility And Mechanisms Of Resistance, Chanah Gallagher

Theses and Dissertations--Pharmacy

Pseudomonas aeruginosa causes severe healthcare-associated infections. Forty-eight extensively drug-resistant (XDR)-P. aeruginosa isolates were selected from 287 isolates collected for evaluation based on clinical susceptibility data. In vitro activity of commonly utilized antimicrobials (i.e. antipseudomonal beta-lactams, aminoglycosides, fluoroquinolones, and polymyxins) plus ceftolozane-tazobactam, ceftazidime-avibactam, and aztreonam-avibactam against XDR-P. aeruginosa were determined. The mechanism of resistance profile was determined through phenotypic expression analysis. Overall, polymyxin B and colistin were 100% susceptible. Apart from the polymyxins, ceftolozane-tazobactam had the highest susceptibility (94%) followed by ceftazidime-avibactam (90%) and amikacin (83%). Ceftolozane-tazobactam activity was not significantly different from ceftazidime-avibactam (p=0.6831). Only 40% of isolates …

Combination Of Investigational Cell-Based Therapy And Deep Brain Stimulation To Alter The Progression Of Parkinson’S Disease, Nader El Seblani

Theses and Dissertations--Pharmacy

Parkinson’s disease (PD) is the second most common neurodegenerative disorder and the motor symptoms are caused by progressive loss of midbrain dopamine neurons. There is no current treatment that can slow or reverse PD. Our current “DBS-Plus” clinical trial (NCT02369003) features the implantation in vivo of autologous Schwann cells (SCs) derived from a patient’s sural nerve into the substantia nigra pars compacta (SNpc) in combination with Deep Brain Stimulation (DBS) therapy for treating patients with advanced PD.

The central hypothesis of our research is that transdifferentiated SCs within conditioned nerve tissue will deliver pro-regenerative factors to enhance the survival of …

Correlating The Physicochemical Properties Of Magnesium Stearate With Tablet Dissolution And Lubrication, Julie L. Calahan

Theses and Dissertations--Pharmacy

Magnesium stearate (MgSt) is the most commonly used pharmaceutical excipient and is present in over half the tablet formulations on the market. In spite of its popularity as an effective lubricant, it has been repeatedly recognized that there is significant variability between MgSt samples, which can cause inconsistent lubrication between batches of MgSt. The hypothesis of this research is that the batch-to-batch variability in tablet lubrication and dissolution observed in tablet formulations containing different MgSt samples can be correlated with differences in MgSt physicochemical properties (fatty acid salt composition, crystal hydrate form, particle size and surface area). Developing correlations between …

Novel Small Molecule Antifungals For Invasive Fungal Infections, Emily Dennis

Theses and Dissertations--Pharmacy

Human fungal pathogens cause a range of diseases from benign skin conditions (i.e., ringworm) to thrush, mucosal membrane infections, and life-threatening systemic infections including bloodstream infections (i.e., aspergillosis and candidiasis) and Cryptococcal meningitis. These systemic infections occur most often in immunocompromised individuals and have high mortality rates. Current antifungal agents used in the clinic belong to three main classes: the polyenes (e.g., amphotericin B (AmB)), the echinocandins (e.g., caspofungin (CFG)), and the azoles (e.g., fluconazole (FLC)). In addition, the antimetabolite pyrimidine analogue flucytosine is used in combination with AmB. The …

Characterization And Engineering Of Interrupted Adenylation Domains, Taylor A. Lundy

Theses and Dissertations--Pharmacy

Nature has historically served as a prolific source of biologically active molecules produced by plants, fungi, and bacteria termed natural products (NPs). These NPs often serve as therapeutic leads due to their structural diversity and unique mechanisms of action. However, many need modifications to make them more effective or safer for human use. This can be a daunting and complicated task to do via traditional organic chemistry because of their complexity, copious stereocenters, and a multitude of reactive functional groups. For this reason, enzymatic modification of these NP during their biosynthesis is an appealing option. One major class of NPs …

Opioid Use In Vulnerable Populations, Gyeon Oh

Theses and Dissertations--Epidemiology and Biostatistics

Opioid-related negative health outcomes, such as substance use disorder, misuse, and overdose deaths, have risen as long-term opioid use has increased. The benefit of using long-term opioids for pain is yet to be established. The Centers for Disease Control and Prevention provides guidelines for opioid prescribing in chronic pain, but detailed recommendations on opioid prescribing for vulnerable populations are missing due to lack of evidence-based studies. The purpose of this dissertation is to describe patterns and predictors of opioid use and assess outcomes related to prescribing opioid medications in vulnerable populations, specifically older adults with various levels of cognitive function, …

Nsu Sharks Rx_Winter 2020, Nova Southeastern University

NSU Sharks Rx

Newsletter

Gynecologic Large Cell Neuroendocrine Carcinoma: A Review, Grant Burkeen, Aman Chauhan, Rohitashva Agrawal, Riva Raiker, Jill M. Kolesar, Lowell B. Anthony, B. Mark Evers, Susanne Arnold

Internal Medicine Faculty Publications

Large cell neuroendocrine carcinomas (LCNEC) are rare, aggressive high-grade neuroendocrine neoplasms within the neuroendocrine cell lineage spectrum. This manuscript provides a detailed review of published literature on LCNEC of gynecological origin. We performed a PubMed search for material available on gynecologic LCNEC. We analyzed 104 unique cases of gynecologic LCNECs, of which 45 were cervical primary, 45 were ovarian, 13 were uterine, and 1 was vaginal. A total of 45 cases of cervical LCNEC were identified with a median age of 36 years. Median overall survival was 16 months. We identified 45 ovarian LCNEC cases in the published literature with …

340b Program Utilization In Rural Us Clinics, William Finley, Heather M. Kruel

Theses, Dissertations and Capstones

Introduction: The 340B program was an effective strategy in reaching more potential patients, providing more comprehensive services, and limiting the gap between affordability and healthcare. The uninsured and underprivileged often are unable to receive medications at the high market price due to the financial situation they face and inflation. The 340B program seeked to mend this issue to help the public and healthcare organizations. The main purpose of this research was to search and evaluate if the 340B program lived up to its purpose of decreasing the cost of medications in rural based clinics.

Methodology: The research strategy developed …

Producing Urban Aerobiological Risk Map For Cupressaceae Family In The Sw Iberian Peninsula From Lidar Technology, Raúl Pecero‐Casimiro, Santiago Fernández‐Rodríguez, Rafael Tormo‐Molina, Inmaculada Silva‐Palacios, Ángela Gonzalo‐Garijo, Alejandro Monroy‐Colín, Juan Francisco Coloma, José María Maya‐Manzano

Articles

Given the rise in the global population and the consequently high levels of pollution, urban green areas, such as those that include plants in the Cupressaceae family, are suitable to reduce the pollution levels, improving the air quality. However, some species with ornamental value are also very allergenic species whose planting should be regulated and their pollen production reduced by suitable pruning. The Aerobiological Index to create Risk maps for
Ornamental Trees (AIROT), in its previous version, already included parameters that other indexes did not consider, such as the width of the streets, the height of buildings and the geographical …

Biopharmaceutical Revolution In Saudi Arabia: Progress And Development, Rihana Alzahran, Elaine Harris

Articles

Purpose This paper aimed to analyze the situation of the biopharmaceutical industry in Saudi Arabia to improve the situation in a way that achieves high levels of development similar to those in Europe, the United States of America (USA), and Japan. Methods To achieve the objective of the study, the authors surveyed 18 out of 21 Saudi pharmaceutical companies that have received licensing for manufacturing from the Saudi Food and Drug Authority (SFDA) to diagnose the situation of manufacturing in relation to biopharmaceuticals. An interview with SFDA officials was carried out as a supplement to the survey. Results Findings revealed …

Dietary Xanthones, Dina M. El-Kersh, Mohamed A. Farag, Hesham R. Elseedi, Omar M. Khattab

Pharmacy

Xanthones, polyphenolic compounds, are one of the most important classes in natural products, as they exhibit variety of pharmacological and health benefits, i.e., anti-obesity, antidiabetic, antioxidant, anti-Alzheimer, anti-inflammatory, and anticancer. Xanthones can be found in higher plants that are used as food sources.

Sickle Cell Disease, Vibhu Bhargava, Dr. Sandeep Barve

Digital Journal of Clinical Medicine

No abstract provided.

A Case Of Mixed Anxiety Depression In The Covid-19 Lockdown, Dr Hrishikesh Solunke, Dr Kishor M

Digital Journal of Clinical Medicine

No abstract provided.