Pharmacy and Pharmaceutical Sciences Commons^™

The Effects Of Dexmedetomidine On Preventing/Decreasing Severity Of Delirium When Given To Surgical Intensive Care Unit Patients: A Systematic Review Of Randomized Control Trials, Lindsey Hettish

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The purpose of this systematic review was to integrate research evidence from studies published from 2010 to 2020 on the relationship between administration of dexmedetomidine and severity/prevalence of postprocedural delirium in patients in the surgical intensive care unit. In this review, clinical trial studies were recovered by searching the MEDLINE Complete and PubMed databases and utilizing MeSH terminology search. The MeSH terms utilized to search for applicable articles on PubMed included: “intensive care units” or “critical care” or “critical care nursing”, and “delirium”, “dexmedetomidine”, and “surgical procedures, operative”. On MEDLINE Complete, the search terms utilized were “ICU or intensive care …

Opioid And Naloxone Training In A Rural School District, Allyson C. Waldron

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic is a national health emergency in the United States, with over 128 people dying each day due to an opioid overdose. It is estimated that 4.3 million people over the age of 12 use opioids without a medical need, and 1.3 million youth ages 12-17 use opioids inappropriately. Drug overdose deaths have become the leading cause of accidental death in the United States, prompting the U.S. Surgeon General and the World Health Organization to advise that more Americans have access to naloxone and understand how to use this life-saving drug correctly. Naloxone is an opioid antagonist, used …

Compounded Gabapentin For Felines: Associated Metabolic Processes And Analysis Of Potency, Johnny Altwal

Student Scholar Symposium Abstracts and Posters

Pharmaceutical compounding provides pharmacists and clinicians the opportunity to create unique drug formulations that are better suited to a specific patient’s needs. This is especially prevalent in veterinary medicine where clinicians treat a variety of maladies in a large number of species, thereby requiring unique formulations to more easily deliver drugs to animals. Several examples of compounded veterinary formulations with sub-therapeutic potencies have been published, but none examine compounded gabapentin. Gabapentin is frequently compounded into an oral suspension for veterinary use from tablets or capsules for the purpose of pain management in felines and other small animals. The project’s goals …

Pharmacist Pilot Project To Reduce Hypoglycemic Events On Internal Medicine Unit, Carly Barnes, Pamela Levine

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

No abstract provided.

Mental Health Stigma Among Pharmacy Professionals And The Need For Continuing Education, Victoria Dale

Honors Theses

Background. The mental health stigma of pharmacists, the most accessible health professional, can have a significant impact on not only how these patients seek treatment, but also their quality of life (Mey et al., 2013). This study intends to explore mental health stigma among pharmacists and also examine the need for continuing education focused on mental health.

Methods. This study was a descriptive cross-sectional study that employed a self-administered online survey. The subjects were pharmacist members of the Mississippi Pharmacists Association (MPhA). Demographic characteristics were collected. The level of mental health stigma among the respondents was examined using the Community …

A Comprehensive Examination Of Pharmacy Technician Requirements And Pharmacists’ Perceptions Of The Role Of Technicians, Courtney Hahs

Honors Theses

Pharmacy technicians play a crucial role in assisting pharmacists and allowing a pharmacy to function properly and provide care to patients. While technicians take on many tasks in a pharmacy, their role has started to evolve and expand. The first purpose of this study was to determine how states differ regarding the following pharmacy technician roles and requirements: whether or not technicians are licensed and/or certified, mandated technician-to-pharmacist ratio, whether or not technicians are allowed to take or give verbal prescriptions, verify filled prescriptions, and provide immunizations. The second purpose was to analyze how pharmacists across the United States viewed …

Muc13 Enhances Colorectal Cancer Metastasis, Kyle Doxtater

Theses and Dissertations (ETD)

Colorectal cancer (CRC) is one of the most prevalent cancer worldwide with a 5% lifetime incidence in developed countries. It is third most common cause of cancer related death in the United States and the second deadliest when men and women are combined. Encouragingly due to changes in dietary lifestyle, screening colonoscopy, and advancement in treatments the mortality has decreased in recent years. Most sporadic CRCs develop from polyploid adenomas and are preceded by intramucosal carcinomas (stage 0), which can progress into more malignant forms. This developmental process is known as the adenoma-carcinoma sequence. Early detection and endoscopic removal are …

A Computational Analysis Of Selective Metabolism Of Bupropion By Cytochrome P450 2b6, Alyssa Santos

Honors Scholar Theses

Bupropion is an antidepressant and smoking cessation aid that is extensively metabolized by cytochrome P450 (CYP) 2B6. It is a highly lipophilic chiral drug that undergoes stereoselective metabolism with preference for the (S)-enantiomer. Despite chemical reasons for why bupropion can be metabolized by other CYP isozymes, clinically, bupropion is preferentially metabolized by CYP2B6, and at certain concentrations, CYP2E1, CYP2C19, and CYP3A4. A computational analysis with simulated molecular docking was performed using two different scoring algorithms to analyze the specific amino acid interactions between bupropion and various CYP isozymes. Trials were run using one stereoisomer of bupropion (R …

The Role Of Src In Nsclc Cell And Lung Fibroblast Migration On 3d Cell-Derived Matrix., Austin M Krueger

Electronic Theses and Dissertations

Lung cancer is responsible for the most cancer deaths between males and females, with a 6% five-year survival rate. Cancer metastasis is one of the leading causes of lung cancer lethality. Our lab has developed a method to culture cells on cell-derived matrix (CDM) and study cell-ECM interactions. This study utilized multiple cell migration methods to investigate the migration of NSCLC cells and IMR90 lung fibroblasts, both together and independently, on 2D plastic and 3D CDM. Our results showed that inhibiting Src, a significant influencer of cell migration and member of integrin activation, blocked cancer cell migration on 2D and …

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 …

Intravenous Smart Pumps During Actual Clinical Use: A Descriptive Comparison Of Primary And Secondary Infusion Practices., Karen K Giuliano, Daleen Penoyer, Rebecca S. Mahuren, Melody Bennett

Parkview Pharmacy Department

This descriptive observational study was conducted to increase understanding of medication administration practices during actual clinical use between 2 commonly used, different types of intravenous (IV) smart pumps. Compliance with manufacturer-recommended setup requirements for both primary and secondary infusions and secondary medication administration delay was compared between a head-height differential system and a cassette system. A total of 301 medication administration observations were included in this study: 102 (34%) for the linear peristaltic IV smart pump (medical-surgical: N = 51; critical care: N = 51) and 199 (66%) for the cassette pump (medical-surgical: N = 88; critical care: N = …

Emotion Regulation Among Adults With Asthma: Links With Short-Acting Inhaler Medication Overuse And Utilization Of Acute Medical Care, Victoria A. Green

Honors Theses

Effective control of asthma symptoms requires daily self-management activities, including use of short-acting or “rescue” inhaled medications. Overuse of short-acting inhaled medications, such as albuterol, can have negative side-effects, including respiratory infections and worse asthma symptom control. Existing research suggests that emotion plays an important role in airway inflammation and asthma symptom control. The objective of this study was to determine whether difficulties regulating emotion was associated with overuse of short-acting inhaled medications and acute medical care usage in adults with asthma. The sample included 401 adults with asthma recruited from an online panel of adults with chronic respiratory disease. …

The Role Of Cannabinoid Receptor 2 In Zebrafish Toxicities Following Developmental Exposure To Thc Or Cbd, Haley Watts

Honors Theses

As the laws concerning the regulation of Cannabis Sativa change across the globe, maternal use of cannabinoid-containing products during pregnancy is a greater concern than ever before. Little research has been conducted on the consequences of maternal use and developmental exposure to ∆9-tetrahydrocannabinol (THC) and cannabidiol (CBD. In this study, larval zebrafish (Danio rerio) were used to measure CBD and THC-mediated adverse outcomes including effects on larval length, eye area, and behavior in the cnr^+/+ and cnr2^-/- zebrafish strains where we discovered that cannabinoid exposure results in a decrease in each of these endpoints. Adult …

Proficiency Of Mississippi Pharmacy Staff In Communicating With Spanish-Speaking Patients, Caroline Kreh

Honors Theses

Pharmacists play a crucial role in patient care; they must be able to communicate effectively with patients to convey health information. Given the linguistic diversity of Mississippi, pharmacists will likely encounter Spanish-speaking patients in the course of their practice. Previous studies have investigated various indicators of pharmacists’ ability to communicate with Spanish-speaking patients; however, no existing studies regarding Mississippi pharmacy staff members’ ability to communicate with Spanish-speaking patients were found. The objectives of this study were to measure Mississippi pharmacists’ confidence, satisfaction, proficiency, use of resources, and level of education related to communicating with Spanish-speaking patients. The sample was composed …

Computational Design Of Β-Fluorinated Morphine Derivatives For Ph-Specific Binding, Nayiri Alexander, Makena Augenstein, Angelina Sorensen, Matthew Gartner

Student Scholar Symposium Abstracts and Posters

Opioids such as morphine are important pain-relieving drugs but also carry a risk of harmful side effects including addiction. Morphine is active in both healthy and inflamed tissue, however, decreasing the pKa of the biochemically-active amine group can promote selective binding in the more acidic conditions of inflamed tissue and reduce harmful side effects associated with opioids. Herein, we explore the impact of fluorination on the pKa of fluoromorphine derivatives to identify which will bind selectively in inflamed tissue. Theoretical pKa values are determined at the M06-2X(SMD)/aug-cc-pVDZ level of theory to calculate the ΔGaq" …

Unlocking Knowledge To Benefit The Patient : How Connecting Km And Qrm Can Strengthen Science And Risk-Based Decision Making, Martin J. Lipa

Doctoral

This thesis explored knowledge management effectiveness in the pharmaceutical sector and included an examination of the critical relationship between knowledge management (KM) and quality risk management (QRM) as the dual enablers of an effective pharmaceutical quality system. The primary research objectives were to improve understanding and effectiveness of the interdependency between KM and QRM and to improve knowledge management across the pharmaceutical product lifecycle, starting with a focus on knowledge transfer during technology transfer. The thesis explored how improved KM across the product lifecycle coupled with thoughtful and intentional connectivity between KM and QRM as defined by this study could …

Pharmacists’ Role In The Management Of Patients Receiving Dual Or Triple Antithrombotic Therapy, Laura Neubauer, Radhan Gopalani, Kristen De Almeida

All Publications

Purpose: Patients on dual and triple antithrombotic therapy present the therapeutic dilemma of mitigating bleed risk while sustaining antithrombotic efficacy. Lack of literature and variability in existing published guidance potentiates inconsistent management of these patients. Furthermore, suboptimal dosing of direct oral anticoagulants is relatively common. One study reported as high as 43% of patients receive higher and 13% receive lower than clinically indicated doses. These findings were associated with a significantly increased risk of major bleeding and incidence of stroke, thus highlighting the importance of selecting an ideal regimen. The purpose of this project is to highlight pharmacists’ role in …

Optimizing Empiric Vancomycin Use In Febrile Neutropenia Patients, Nicole Tadros, Erika Dittmar, Radhan Gopalani

All Publications

Introduction: Febrile neutropenia (FN) is a complication of chemotherapy resulting in a temperature 100.4⁰F or greater plus an absolute neutrophil count (ANC) below 500 cells/mm³ or an ANC below 1000 cells/mm³ and expected to decrease below 500 cells/mm³ within 48 hours. Timely administration of broad-spectrum antimicrobial therapy is a cornerstone for the initial management of FN. However, prolonged empiric antimicrobial treatment can lead to resistance and toxicity. National guidelines and published literature do not support vancomycin as a routine part of empiric antimicrobial regimens in FN; it is only recommended in patients with specific clinical indications. This …

Evaluation Of Antiplatelet-Related Bleeding Events In A Community Hospital, Frank C. Moreno Exposito, Heidi Clarke, Erika Dittmar

All Publications

Background:Bleeding rate among patients who take high-dose aspirin is approximately 1.92% with an expected 2-3 fold increase after a second antiplatelet is added. Similarly, the addition of an anticoagulant to single or dual antiplatelet therapy results in increased bleeding rates of approximately 13.9% and 15.7% respectively. The concomitant use of antiplatelets and anticoagulants has become a common practice due to the high incidence of clinical conditions for which these agents are used. Hence, reversal of antithrombotic agents is often needed during major bleeding events or invasive procedures. However, the use of antiplatelet reversal is still under-utilized, and its efficacy …

Evaluation Of An Elevated Vte Thromboprophylaxis Guideline For Critically Ill Patients Infected With Covid-19, Tony Nguyen, Heidi Clarke

All Publications

Retrospective studies and systematic-review meta-analysis have shown an association in inducing a prothrombotic state in patients infected with COVID-19. The risk of VTE are compounded in the critically ill. Current practices at Baptist Hospital of Miami (BHM) is to routinely order standard prophylactic dosed chemical thromboprophylaxis for all patients infected with COVID-19. In August 2020 an anticoagulation guidance document was approved to tailor anticoagulation dosing for critically ill COVID-19 patients. At risk patients were based on clinical and laboratory markers such as D-dimer, CRP, and ferritin. Following implementation, our analysis show a statistically significant reduction in the number of treatment …

Evaluation And Optimization Of Medication Related Fall Risk At A Community Hospital, Giselle Chahili, Thomas Wolfel, Heidi Clarke, Erika Dittmar

All Publications

Background: Falls occur commonly in older adults at a rate of 3-5 per 1000 beds in healthcare settings. They can results in increased length of stay, morbidity and mortality, and healthcare costs. Some risk factors include older age, environmental hazards and medications. Currently at BHM, patient’s risk for falling is assessed based on Morse Fall Scale (MFS), which does include drugs as part of its assessment. The purpose of this project is to integrate medication risk evaluation into our current fall assessment.

Methodology: single-centered, retrospective, IRB-reviewed quality improvement project at BHM. We included patients over age 18 who fell with …

Optimization Of Albumin 5% Use In A Community Hospital, Robyn Feldman, Stephanie Palma, Erika Dittmar, Heidi Clarke

All Publications

Background: The debate surrounding the use of crystalloids versus colloids remains a source of controversy due to limited and conflicting evidence. Emerging data favors the use of crystalloids over colloids in addition to cost benefits. Baptist Hospital of Miami (BHM) has evidence-based guidance for albumin 5%, but it is unclear the degree of appropriate usage. The purpose of this study is to assess the prescribing practices of albumin 5% at BHM and optimize appropriate use through pharmacy driven interventions.

Methodology: A single-center, IRB-reviewed, bi-phasic study was conducted within a community hospital. In phase I, a retrospective chart review of patients …

Covid-19: The Vaccine Race Continues, L. Hayley Burgess, Carley Castelein, Andrew Rubio, Mandelin K. Cooper

HCA Healthcare Journal of Medicine

Over a year has passed since the discovery of SARS-CoV-2 and the subsequent COVID-19 pandemic. As mitigation efforts continue, COVID-19 has claimed over half a million lives in the United States and 3.1 million lives globally. The development and availability of vaccines delivering immunity to prevent COVID-19 offers hope to end the pandemic.

Emergency use authorizations from the Food and Drug Administration have been issued in the United States for three vaccines, one each from Pfizer-BioNTech, Moderna and Janssen/J&J. Pfizer-BioNTech and Moderna are both mRNA vaccines with efficacy of 95% and 94.1% respectively, while the vector-based vaccine from Janssen/J&J has …

Diet Significantly Influences The Immunopathology And Severity Of Kidney Injury In Male C57bl/6j Mice In A Model Dependent Manner, John E. Brus, Daniel L. Quan, Kristin J. Wiley, Brittney Browning, Hannah Ter Haar, Riley Lutz, Jeffrey F. Houghton, Joseph Gigliotti

College of Osteopathic Medicine Undergraduate Publications

Diet is a leading causative risk factor for morbidity and mortality worldwide, yet it is rarely considered in the design of preclinical animal studies. Several of the nutritional inadequacies reported in Americans have been shown to be detrimental to kidney health; however, the mechanisms responsible are unclear and have been largely attributed to the development of diabetes or hypertension. Here, we set out to determine whether diet influences the susceptibility to kidney injury in male C57Bl/6 mice. Mice were fed a standard chow diet, a commercially available “Western” diet (WD), or a novel Americanized diet (AD) for 12 weeks prior …

University Of Mississippi Student Perceptions Of The Relationship Between Stimulant Use And Mental Health, Elizabeth Mccutcheon

Honors Theses

College students are situated in a perfect storm for stimulant misuse and mental health issues, while living admits a mental health crisis of never-before-seen proportions, in combination with a global pandemic and the normal amount of stress associated with a university course load. It is important to address college student’s perceptions of the risks and benefits of stimulant use in order to see if they realize the severity of the problem of abuse and address it. The addiction of examining mental health in relation to stimulant abuse can provide new insight to the motivation behind the rise in stimulant abuse …

The Importance Of Continuity Of Care Among Older Adults On Chronic Opioid Therapy, Max Mauney

Honors Theses

The purpose of this study was to define continuity of care and prescriber characteristics among older adults with chronic non-cancer pain who are on long-term opioid therapy. Also, it will evaluate the connection between continuity of care and prescriber characteristics on the risk of opioid-related adverse events among older adults on chronic opioid therapy. The main goal is to observe the relationship between continuity and the related adverse events that may arise.

This study utilized a nested case-control using a 5% random sample of the National Medicare data between 2012 and 2016. This data used a random sample of beneficiaries …

Prevalence Of Adhd And The Nonmedical Use Of Prescription Stimulants Among College Students, Leah Potate

Honors Theses

Objective: The principal objective in this study is to identify the contextual factors predicting the nonmedical use of prescription stimulants among college students who nonmedically use prescription stimulants (NMUPS) for academic reasons.

Participants: 470 college-aged students from varying undergraduate classes

Methods: This study utilized an observational design, which consisted of repeated surveys administered to a sample of undergraduate students at the University of Mississippi. Descriptive statistics were used to assess frequencies of contextual factors regarding the background and exam surveys. Logistic regression models assessed the correlations between the nonmedical use of prescription stimulants and various contextual factors.

Results: The percentage …

Implementation Of The Cognitive Apprenticeship Model For Enhancement Of Advanced Searching Skills In A Pharmacy Academia Rotation: Appendices 1-4, Hilary Jasmin Msis, Kenneth Hohmeier Pharmd, Christina Spivey Pharmd, Phd

Faculty Publications

No abstract provided.

Identification Of Adverse Drug Reactions In Congestive Heart Failure Patients In A Tertiary Care Hospital, West Nusa Tenggara, Indonesia, Dita Marina Lupitaningrum, Putri Ramdaniah, Depi Yuliana

Pharmaceutical Sciences and Research

Congestive Heart Failure (CHF) is a progressive health problem with high mortality and morbidity and has the potential to develop adverse drug reactions (ADRs). This study was conducted to determine the prevalence of potential ADRs, the types of drugs that cause ADRs, the types of ADRs, and the risk factors that affect the ADRs in CHF patients. Data were collected using medical record of hospitalized patient at the West Nusa Tenggara (NTB) Provincial Hospital, Indonesia, in 2017 to 2019. The assessment of the causality and severity of ADRs used the Naranjo algorithm and the Hartwig and Siegel scale. This study …

Managing Polypharmacy In Older Adults With Cancer Across Different Healthcare Settings., Andrew Whitman, Paige Erdeljac, Caroline Jones, Nicole Pillarella, Ginah Nightingale Pharmd, Bcop

College of Pharmacy Faculty Papers

The care of older patients with cancer is becoming increasingly complex. Common challenges for this population include management of comorbidities, safe transitions of care, and appropriate medication use. In particular, polypharmacy-generally defined as the regular use of five or more medications-and inappropriate medication use can lead to adverse effects and poor outcomes in older adults with cancer, including falls, hospital readmissions, cognitive impairment, poor adherence to essential medications, chemotherapy toxicity, and increased mortality. Managing polypharmacy across different cancer care settings is often challenging. Providers face barriers to safe and successful medication management that may include lack of time, absence of …