Pharmacy and Pharmaceutical Sciences Commons^™

Design, Implementation, And Evaluation Of A Pharmacist-Led Outpatient Benzodiazepine-Tapering Clinic, Tania Gregorian, Kristin Bradley, Scott Campbell, Rachel Mashburn, Richard Beuttler, Michelle S. Keller

Pharmacy Faculty Articles and Research

Background

Benzodiazepines are commonly used among older adults, despite well-known risks. Clinical pharmacists can lead tapering efforts, leveraging their clinical expertise and relieving time-pressured primary care providers.

Objectives

The objective of this study is to describe the design, implementation, and evaluation of an outpatient pharmacist-led benzodiazepine-tapering clinic.

Practice description

The clinic is based within a community medical group associated with a large academic health system in Los Angeles, California.

Practice innovation

The clinic is staffed by clinical pharmacists and supervised by a psychiatrist. The initial visit consists of patient education, design of patient-driven tapering schedule, and medical history review. Follow-up …

Bioassay-Guided Isolation Of Iridoid Glucosides From Stenaria Nigricans, Their Biting Deterrence Against Aedes Aegypti (Diptera: Culicidae), And Repellency Assessment Against Imported Fire Ants (Hymenoptera: Formicidae), Fazila Zulfiqar, Abbas Ali, Zulfiqar Ali, Ikhlas A. Khan

Faculty and Student Publications

In our natural product screening program, we screened natural products for their repellency and toxicity against insect vectors. Methanolic extract of aerial parts of Stenaria nigricans (Lam.), with no published chemistry, was tested for repellency against mosquitoes and imported hybrid fire ants. Methanolic extracts showed biting deterrence similar to DEET (N,N-diethyl-3-methylbenzamide) against Aedes aegypti L. Based on this activity, the crude extract was fractionated into chloroform, ethyl acetate, and methanol subfractions. The active methanolic subfraction was further fractionated into 13 subfractions. These fractions were tested for their biting deterrence against Ae. Aegypti. Active subfractions were further characterized to identify the …

Synthesis And Inhibitory Activity Of Machaeridiol-Based Novel Anti-Mrsa And Anti-Vre Compounds And Their Profiling For Cancer-Related Signaling Pathways, Mallika Kumarihamy, Siddharth Tripathi, Premalatha Balachandran, Bharathi Avula

Faculty and Student Publications

Three unique 5,6-seco-hexahydrodibenzopyrans (seco-HHDBP) machaeridiols A–C, reported previously from Machaerium Pers., have displayed potent activities against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium, and E. faecalis (VRE). In order to enrich the pipeline of natural product-derived antimicrobial compounds, a series of novel machaeridiol-based analogs (1–17) were prepared by coupling stemofuran, pinosylvin, and resveratrol legends with monoterpene units R-(−)-α-phellandrene, (−)-p-mentha-2,8-diene-1-ol, and geraniol, and their inhibitory activities were profiled against MRSA ATCC 1708, VRE ATCC 700221, and cancer signaling pathways. Compounds 5 and 11 showed strong in vitro activities with MIC values of 2.5 μg/mL and 1.25 μg/mL against MRSA, respectively, and …

Hiv-1 Tat Upregulates The Receptor For Advanced Glycation End Products And Superoxide Dismutase-2 In The Heart Of Transgenic Mice, Alaa N. Qrareya, Nason S. Wise, Emmanuel R. Hodges, Fakhri Mahdi

Faculty and Student Publications

Cardiovascular disorder (CVD) is a common comorbidity in people living with HIV (PLWH). Although the underlying mechanisms are unknown, virotoxic HIV proteins, such as the trans-activator of transcription (Tat), likely contribute to CVD pathogenesis. Tat expression in mouse myocardium has been found to induce cardiac dysfunction and increase markers of endothelial toxicity. However, the role that Tat may play in the development of CVD pathogenesis is unclear. The capacity for Tat to impact cardiac function was assessed using AC16 human cardiomyocyte cells and adult male and female transgenic mice that conditionally expressed Tat [Tat(+)], or did not [Tat(−)]. In AC16 …

Immunomodulatory Effects Of Plant Extracts From Salvia Deserta Schang. And Salvia Sclarea L., Aizhan Zhussupova, Gaziza Zhumaliyeva, Vyacheslav Ogay, Assel Issabekova

Faculty and Student Publications

Medicines, their safety, effectiveness and quality are indispensable factors of national security, important on a global scale. The COVID-19 pandemic has once again emphasized the importance of improving the immune response of the body in the face of severe viral infections. Plants from the Salvia L. genus have long been used in traditional medicine for treatment of inflammatory processes, parasitic diseases, bacterial and viral infections. The aim of the current study was to evaluate the immunomodulatory effects of plant extracts LS-1, LS-2 from Salvia deserta Schang. and LS-3, LS-4 from Salvia sclarea L. plants growing in southern Kazakhstan by conventional …

Phytochemical Investigation Of Egyptian Spinach Leaves, A Potential Source For Antileukemic Metabolites: In Vitro And In Silico Study, Shimaa M. Abdelgawad, Mona H. Hetta, Mohamed A. Ibrahim, Premalatha Balachandran

Faculty and Student Publications

Spinacia oleracea L., Amaranthaceae, leaves cultivated in Egypt demonstrated a potential antileukemic activity against the chronic myeloid leukemia, K562 cell line. Thus, the aim of this study is to carry out a phytochemical investigation of S. oleracea leaves as well as the isolation of its antileukemic phytoconstituents. Phytochemical investigation of S. oleracea leaves resulted in the isolation of seventeen known compounds. The biological study revealed that compounds hexaprenol, phytol, and 18-[(1-oxohexadecyl) oxy]-9-octadecenoic acid exhibited a remarkable antiproliferative activity against K562 cells in vitro. A mechanistic in silico study showed that hexaprenol, phytol, and 18-[(1-oxohexadecyl) oxy]-9-octadecenoic acid exhibited a strong binding …

September / October 2022, Randy Curry, Cindy Brooks

RURAL ROCKS

PLS presents the 7^th Annual Substance Use Disorder Seminar with Dr. Jake Nichols.

Changes In The Regulation Of The Unfolded Protein Response During Aging In Peromyscus, Elham Soltanmohammadi

Theses and Dissertations

Endoplasmic reticulum (ER) stress has been linked to various metabolic pathologies, neurodegeneration, and aging. Although various mechanistic aspects of the resulting unfolded protein response (UPR) have been elucidated, its regulation in genetically diverse populations remains elusive. In the present study we evaluated the expression of chaperones BiP/GRP78, GRP94 and calnexin (CANX) in the lungs, liver, and brain of 7 months old and 2–3 years old outbred deer mice P. maniculatus and P. leucopus. Chaperones’ _expression was highly variable between species, tissues and ages suggesting that levels of expression of individual chaperones do not change consistently during aging. Despite this variation, …

Genomic Analysis Workflows To Identify Mutational Signatures And Structural Variations In Ovcar8 Cells And Rad51d-Deficient Mouse Embryonic Fibroblasts, Manli Yang

Theses and Dissertations

Specific genomic profiles associated with exposure to DNA damaging agents have been identified in cancer related genes, revealing that mutational patterns can be carcinogen- specific. However, there have been limited efforts to demonstrate similar clear relationships for endogenous mutational processes. One endogenous source of mutations is contamination of the deoxynucleotide pool with damaged bases that, if incorporated into DNA, cause mutations.

The Catalog of Somatic Mutations In Cancer (COSMIC) represents an international effort to characterize mutations in cancer. A mutational signature is the pattern of mutations generated by a mutational process. Each mutational process contains two parts: DNA damage and …

Development Of Peptidomimetic Inhibitors Targeting The Polo Box Domain Of Plk1 As Potential Cancer Therapeutics, Jessy Mariam Stafford

Theses and Dissertations

PLK1 overexpression has shown to be associated with tumor progression and an unfavorable prognosis in a wide variety of cancer types. Interfering with PLK1 genetically and chemically induces apoptotic cell death in cancer cells thus confirming PLK1 as a validated anticancer target. From a drug discovery perspective, PLK1 offers two functionally distinct, essential, and interconnected target sites in one molecule. These are the ATP binding kinase domain (KD) and the unique Polo Box Domain (PBD), where the interplay between these results in dynamic structural regulation of catalytic activity and sub cellular localization. Since the KD is conserved among kinases and …

Peromyscus Maniculatus Bairdii And Peromyscus Maniculatus Sonoriensis Polymorphisms, Matthew Dixon Lucius

Theses and Dissertations

Sequencing technology has advanced greatly over the past couple of decades. This has led to many studies developing hypotheses based on genomic data. This requires many genomic studies to have up-to-date information on the species’ or subject’s genome being investigated. If a study does not have accurate or up-to-date background information, then they cannot fully develop their theories that are being established. In this study, I utilize outbred Peromyscus maniculatus, deer mice that are genetically diverse, to record the polymorphisms that are found throughout the Peromyscus maniculatus genome. I first explore the differences between the polymorphisms found in Peromyscus …

Influence Of Pregabalin Maintenance On Cannabis Effects And Related Behaviors In Daily Cannabis Users, Joshua A Lile, Joseph L Alcorn, Lon R Hays, Thomas H Kelly, William W Stoops, Michael J Wesley, Philip M Westgate

Faculty, Staff and Student Publications

No medications are approved for cannabis use disorder (CUD), though a small clinical trial demonstrated that the voltage-dependent calcium channel (VDCC) ligand gabapentin reduced cannabis use in treatment seekers. VDCCs are modulated by cannabinoid (CB) ligands, and there are shared effects between CB agonists and VDCC ligands. This overlapping neuropharmacology and the initial clinical results supported the evaluation of pregabalin, a "next-generation" VDCC ligand, as a CUD medication. Two separate placebo-controlled, double-blind, counterbalanced, within-subjects human laboratory studies tested placebo and 300 (N = 2 females, 11 males; Experiment [EXP] 1) or 450 (N = 3 females, 11 males; …

Sharksrx Newsletter Fall 2022, Nova Southeastern University

NSU Sharks Rx

No abstract provided.

Synthesis Of Alginate/Hydroxyapatite Beads For Acetaminophen Delivery, Anesylvia Angan, Nonni Soraya Sambudi

Makara Journal of Science

Conventional drug delivery systems usually involve the intake of multiple drugs, which could amplify the risk of overdosing. Acetaminophen is a widely used pain relief substance that is prone to accidental overdosing. Hence, a controlled drug delivery system is needed to ensure its efficacy. A nanocomposite hydroxyapatite/alginate system that was used as a drug carrier for acetaminophen was synthesized through the sol-gel method, and the mechanism underlying its controlled drug delivery was investigated. Spherical nanocomposite bead samples were synthesized by incorporating 5 wt%, 10 wt%, and 15 wt% hydroxyapatite into mixtures containing alginate. The mixtures were then dropped into calcium …

Functional Assessment Of Missense Variants In The Abcc6 Gene Implicated In Pseudoxanthoma Elasticum, A Heritable Ectopic Mineralization Disorder., Luke Kowal, Jianhe Huang, Hongbin Luo, Jagmohan Singh, Adam E Snook, Jouni Uitto, Qiaoli Li

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Pseudoxanthoma elasticum, a heritable multisystem ectopic mineralization disorder, is caused by inactivating mutations in the ABCC6 gene. The encoded protein, ABCC6, a transmembrane transporter, has a specialized efflux function in hepatocytes by contributing to plasma levels of inorganic pyrophosphate, a potent inhibitor of mineralization in soft connective tissues. Reduced plasma inorganic pyrophosphate levels underlie the ectopic mineralization in pseudoxanthoma elasticum. In this study, we characterized the pathogenicity of three human ABCC6 missense variants using an adenovirus-mediated liver-specific ABCC6 transgene expression system in an Abcc6

Pharmacists’ Response To The Opioid Crisis: A California Naloxone Survey, Jerika T. Lam, Moom Roosan, Mary A. Gutierrez, Enrique Seoane-Vazquez

Pharmacy Faculty Articles and Research

This study aimed to assess pharmacists’ response to the current opioid crisis in California, particularly regarding the prevalence of naloxone furnishing (or dispensing without a prescription) and prescriptions for medication-assisted treatment (MAT) drugs for opioid use disorder (OUD) to patients and consumers.

Novel Drugs Approved In 2021-2022, Michael Do, Bona Shin, Elaina Lioudis, Emaleigh Munn

Transformative Medicine

This article provides an abbreviated overview of the newly Federal Drug Administration (FDA)approved novel drugs of 2021-2022 with their respective approved indication(s). The FDA serves as the governing body that regularly evaluates and approves medications that will eventually be introduced to the market for routine use. These medications include both drugs that are the same or related to previously approved products (e.g., Extended indications of priorly approved medications) and novel drugs. By definition, a novel drug is an innovative product which serves to improve quality care in patient populations with unmet or advanced medical needs to overall advance patient care …

Comparative Study Of High-Performance Thin-Layer Chromatography And Antioxidant Potential Of Hydrocotyle Asiatica Mother Tincture Used In Homoeopathy, Rakhi Mishra, Binit Kumar Dwivedi, Deepshikha Gupta

Indian Journal of Research in Homoeopathy

Background: Hydrocotyle asiatica has a therapeutic significance in the Indian system of medicine due to its rich antioxidant activity. In Homoeopathy, Hydrocotyle asiatica is used for the treatment of jaundice, skin diseases, dropsy, elephantiasis, leprosy, gonorrhea, leucorrhea, and nervous debility. It contains the abundant triterpene glycoside Asiatic acid which shows cytotoxic activity on cancer cells. Its homoeopathic mother tincture is a major source of antioxidant compounds, which is responsible for its overall pharmacological activity.

Objectives: This study was done to evaluate antioxidant activity and High-Performance Thin-Layer Chromatography study of Hydrocotyle asiatica in-house homoeopathic mother tincture and market samples. …

Silver Nanoparticles Formulation Of Flower Head’S Polyphenols Of Cynara Scolymus L.: A Promising Candidate Against Prostate (Pc-3) Cancer Cell Line Through Apoptosis Activation, Shady Swidan, Amgad Khedr, Marwa Goda, Abdelaziz Farrag, Ali Nasr, Mohamed Nafie, Maged Abdel-Kader, Jihan Badr, Reda Abdelhameed

Pharmacy

Cynara scolymus L. (Family: Compositae) or artichoke is a nutritious edible plant widely used for its hepatoprotective effect. Crude extracts of flower, bract, and stem were prepared and evaluated for their in vitro antioxidant activity and phenolic content. The flower crude extract exhibited the highest phenolic content (74.29 mg GAE/gm) as well as the best in vitro antioxidant activity using total antioxidant capacity (TAC), ferric reducing antioxidant power (FEAP), and 1,1-diphenyl-2-picrylhyazyl (DPPH) scavenging assays compared with ascorbic acid. Phenolic fractions of the crude extracts of different parts were separated and identified using high-performance liquid chromatography HPLC-DAD analysis. The silver nanoparticles …

Positive Patient Postoperative Outcomes With Pharmacotherapy: A Narrative Review Including Perioperative-Specialty Pharmacist Interviews., Richard H Parrish, Heather Monk Bodenstab, Dustin Carneal, Ryan M Cassity, William E Dager, Sara J Hyland, Jenna K Lovely, Alyssa Pollock, Tracy M Sparkes, Siu-Fun Wong

Pharmacy Articles

The influence of pharmacotherapy regimens on surgical patient outcomes is increasingly appreciated in the era of enhanced recovery protocols and institutional focus on reducing postoperative complications. Specifics related to medication selection, dosing, frequency of administration, and duration of therapy are evolving to optimize pharmacotherapeutic regimens for many enhanced recovery protocolized elements. This review provides a summary of recent pharmacotherapeutic strategies, including those configured within electronic health record (EHR) applications and functionalities, that are associated with the minimization of the frequency and severity of postoperative complications (POCs), shortened hospital length of stay (LOS), reduced readmission rates, and cost or revenue impacts. …

Effectiveness And Safety Of Apixaban Vs Warfarin Among Venous Thromboembolism Patients At High-Risk Of Bleeding, Alexander T. Cohen, Janvi Sah, A. D. Dhamane, Theodore Lee, Lisa Rosenblatt, Patrick Hlavacek, Birol Emir, Allison V. Keshishian, Huseyin Yuce, Xuemei Luo

Publications and Research

This study evaluated effectiveness and safety of apixaban versus warfarin among venous thromboembolism patients at high-risk of bleeding (defined as having at least one of the following bleeding risk factors: ≥75 years; used antiplatelet, NSAIDs, or corticosteroids; had prior gastrointestinal bleeding or gastrointestinal-related conditions; late stage chronic kidney disease). Adult venous thromboembolism patients initiating apixaban or warfarin with ≥1 bleeding risk factor were identified from Medicare and four commercial claims databases in the United States. To balance characteristics between apixaban and warfarin patients, stabilized inverse probability treatment weighting was conducted. Cox proportional hazards models were used to estimate the risk …

Interactions Of Marine Sulfated Glycans With Antithrombin And Platelet Factor 4, Wenjing Zhang, Weihua Jin, Vitor H. Pomin, Fuming Zhang

Faculty and Student Publications

The molecular interactions of sulfated glycans, such as heparin, with antithrombin (AT) and platelet factor 4 (PF4) are essential for certain biological events such as anticoagulation and heparin induced thrombocytopenia (HIT). In this study, a library including 84 sulfated glycans (polymers and oligomers) extracted from marine algae along with several animal-originated polysaccharides were subjected to a structure-activity relationship (SAR) study regarding their specific molecular interactions with AT and PF4 using surface plasmon resonance. In this SAR study, multiple characteristics were considered including different algal species, different methods of extraction, molecular weight, monosaccharide composition, sulfate content and pattern and branching vs. …

Inhibition Of Sars-Cov-2 Wild-Type (Wuhan-Hu-1) And Delta (B.1.617.2) Strains By Marine Sulfated Glycans, Rohini Dwivedi, Poonam Sharma, Marwa Farrag, Seon Beom Kim

Faculty and Student Publications

The Coronavirus disease pandemic has steered the global therapeutic research efforts toward the discovery of potential anti-severe acute respiratory syndrome coronavirus (SARS-CoV-2) molecules. The role of the viral spike glycoprotein (S-protein) has been clearly established in SARS-CoV-2 infection through its capacity to bind to the host cell surface heparan sulfate proteoglycan (HSPG) and angiotensin-converting enzyme-2. The antiviral strategies targeting these 2 virus receptors are currently under intense investigation. However, the rapid evolution of the SARS-CoV-2 genome has resulted in numerous mutations in the S-protein posing a significant challenge for the design of S-protein-targeted inhibitors. As an example, the 2 key …

Modulation Of Hepatic Amyloid Precursor Protein And Lipoprotein Receptor-Related Protein 1 By Chronic Alcohol Intake: Potential Link Between Liver Steatosis And Amyloid-Β, Jerome Garcia, Rudy Chang, Ross A. Steinberg, Aldo Arce, Joshua Yang, Peter Van Der Eb, Tamara Abdullah, Devaraj V. Chandrashekar, Syndey M. Eck, Pablo Meza, Zhang-Xu Liu, Enrique Cadenas, David H. Cribbs, Neil Kaplowitz, Rachita K. Sumbria, Derick Han

Pharmacy Faculty Articles and Research

Heavy alcohol consumption is a known risk factor for various forms of dementia and the development of Alzheimer’s disease (AD). In this work, we investigated how intragastric alcohol feeding may alter the liver-to-brain axis to induce and/or promote AD pathology. Four weeks of intragastric alcohol feeding to mice, which causes significant fatty liver (steatosis) and liver injury, caused no changes in AD pathology markers in the brain [amyloid precursor protein (APP), presenilin], except for a decrease in microglial cell number in the cortex of the brain. Interestingly, the decline in microglial numbers correlated with serum alanine transaminase (ALT) levels, suggesting …

Development Of Tlc Fingerprinting Profile Of Shadanga Paniya – An Ayurvedic Formulation To Treat Symptoms Of Covid-19, Mehta D. Mehul, Kunal M. Gohil, Krunal A. Doshi

International Journal of Health and Allied Sciences

BACKGROUND: Shadanga Paniya is a compound Ayurvedic formulation that contains six ingredients. Ayurvedic Physicians have been using Shadanga Paniya to treat fever for ages. Symptoms of COVID-19 are also being treated by Shadanga Paniya. However, the Shadanga Paniya has not reported standardisation.

AIMS: To prepare Shadanga Paniya as per the standard classical protocol. To carry out qualitative tests, standardisation and TLC profile development for Shadanga Paniya.

MATERIALS AND METHODS: All the ingredients of Shadanga Paniya wiz. Nagarmotha, Pittapapada, Khasa, Lal Chandana, Sugandhbala and Sunthi were taken in equal amounts. All these ingredients are heated over mild heat with water. The …

Is Three Company Or A Crowd? Comparing And Contrasting U.S. And European Clostridioidesdifficile Clinical Practice Guidelines, Jordan Jones, Aditya Pradhan, Morgan E. Pizzuti, Christopher M. Bland, P. Brandon Bookstaver

Faculty Publications

In 2021, the American College of Gastroenterology (ACG), the Infectious Diseases Society of America in conjunction with the Society for Healthcare Epidemiology of America (IDSA/SHEA), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) published updated clinical practice guidelines (CPGs) for the management of Clostridioides difficile infections. The differences, sometimes subtle, between these guideline recommendations have caused some debate among clinicians. This paper delves into select key recommendations from each respective CPG and analyzes the differences and evidence associated with each. One primary difference between the CPGs is the preference given to fidaxomicin over vancomycin for initial treatment …

Preparation, Characterization And Pharmacokinetics Of Tolfenamic Acid-Loaded Solid Lipid Nanoparticles, Wei Xu, Zhaoyou Deng, Yifei Xiang, Dujuan Zhu

Faculty and Student Publications

The clinical use of nonsteroidal anti-inflammatory drugs is limited by their poor water solubility, unstable absorption, and low bioavailability. Solid lipid nanoparticles (SLNs) exhibit high biocompatibility and the ability to improve the bioavailability of drugs with low water solubility. Therefore, in this study, a tolfenamic acid solid lipid nanoparticle (TA-SLN) suspension was prepared by a hot melt–emulsification ultrasonication method to improve the sustained release and bioavailability of TA. The encapsulation efficiency (EE), loading capacity (LC), particle size, polydispersity index (PDI), and zeta potential of the TA-SLN suspension were 82.50 ± 0.63%, 25.13 ± 0.28%, 492 ± 6.51 nm, 0.309 ± …

Prescribing Controlled Substances Goes Electronic, Alberto Coustasse, Craig Kimble, Ken Maxik

Management Faculty Research

With the Affordable Care Act in 2010 came interoperability and meaningful use requirements. Part of these requirements included the implementation of electronic medical records (EMRs), which was a crucial part of achieving these standards. With EMRs, prescribers began sending electronic prescriptions. EMRs can provide advanced decision support when writing prescriptions, and they include features such as auto populating the quantity prescribed, formulary information, therapeutic duplications, warnings about interactions, or other potential clinical or regulatory issues. This system results in enhanced patient care and a more streamlined dispensing process. In addition, electronic prescriptions for controlled substances (EPCS) has become more widely …

Why Angiotensin Ii Is A Poor Choice For Circulatory Support Of Ventilated Covid-19 Patients Compared To Vasopressin, Robert C. Speth, Michael Bader

HPD Articles

Early in the COVID-19 pandemic when it was first reported that SARS-CoV-2 used membrane-bound angiotensin-converting enzyme-2 (ACE2) as its receptor for entry into cells, warnings were raised against the use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) because of their potential to increase ACE2 expression. These reports ignored the adverse effects that the renin-angiotensin system (RAS) exerts on the cardiovascular system and kidneys via its primary hormone angiotensin (Ang) II acting upon AT receptors that could exacerbate the cytokine storm induced by SARS-CoV-2 . At one point it was even recommended that COVID-19 patients suffering from cardiovascular …

Exploratory Analysis Of Outpatient Visits For Us Adults Diagnosed With Lupus Erythematosus: Findings From The National Ambulatory Medical Care Survey 2006–2016, Salena Marie Preciado, Khaled A. Elsaid, Souhiela Fawaz, Lawrence Brown, Enrique Seoane-Vazquez, Marc Fleming, Yun Wang

Pharmacy Faculty Articles and Research

The study aims to assess office-based visit trends for lupus patients and evaluate their medication burden, chronic conditions, and comorbidities. This cross-sectional study used data from the National Ambulatory Medical Care Survey (NAMCS), a survey sample weighted to represent national estimates of outpatient visits. Adult patients diagnosed with lupus were included. Medications and comorbidities that were frequently recorded were identified and categorized. Descriptive statistics and bivariate analyses were used to characterize visits by sex, age, race/ethnicity, insurance type, region, and reason for visit. Comorbidities were identified using diagnosis codes documented at each encounter. There were 27,029,228 visits for lupus patients …