Pharmacy and Pharmaceutical Sciences Commons^™

Safety Of 10,000 Unit Unfractionated Heparin Boluses For Acute Myocardial Infarction In The Emergency Department, Emma Pastula Pharmd, Sarah Meeks Pharmd, Amber Ooley Pharmd, Bcps, Bcccp, Sarah Ferrell Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

The purpose of this retrospective chart-review study is to evaluate the safety and efficacy of a 10,000 unit unfractionated heparin bolus in the emergency department prior to PCI. • The primary objective was percentage of ACT values within goal range of 250-300 seconds. • Secondary objectives included major bleeding rate, weight-based UFH bolus dose in comparison to guideline recommended bolus dose, percentage of initial ACT values within goal range, protamine use, and need for additional UFH boluses.

Covid-19 Vaccination In Africa: A Case Of Unsatisfied Expectation And Ill-Preparedness, Osmond C. Ekwebelem, Phemelo Tamasiga, Abullhai Tunde Abonde, Ismaeel Yunusa Ph. D., Uju Nwauzoma, Helen Onyeaka

Faculty Publications

With a population of 1.3 billion people, of which 56% reside in rural settings, Africa seemed ill-prepared to handle the distribution of a COVID-19 vaccine. In addition, the capacity needed for a successful COVID- 19 vaccination campaign in Africa surpassed the available resources in local and state health agencies. As a result, African governments were advised to coordinate resources, health officials, and vaccinators, including local health practitioners, medical technicians, and pharmacists for the largest-ever vaccination campaign in Africa. Although the rolling out of the SARS-COV-2 vaccine was, as expected, slow in many African countries, and not yet enough to cover …

Hgf-Mediated C-Met Signaling In Human Corneal Epithelial Cells., Kate Tarvestad

Electronic Theses and Dissertations

Vision is often regarded as the primary sense of humans. The cornea is the main refractive tissue that permits light through to the retina, allowing a clear image. When the cornea sustains damage, it opens a pathway for infection and blindness through fibrotic processes. Healing the corneal tissue is critical for vision restoration and pain alleviation. Growth factors and their cognate receptors are currently under investigation as tools to restore proper corneal physiology. We hypothesize that manipulating the hepatocyte growth factor (HGF)/ c-Met signaling pathway is one route to promote quality corneal healing. This thesis investigates the signaling, trafficking, and …

Computer-Aided Drug Discovery For Helicobacter Pylori, Nicole Ann Vita

Theses and Dissertations (ETD)

Helicobacter pylori is a high-priority drug-resistant pathogen and is currently the only bacteria considered to be a class I carcinogen and there is a critical need to identify novel chemical matter to treat H. pylori infections. Hp is responsible for greater than 60% of gastric cancer related deaths and 89% of all gastric cancer morbidities. In a previous study, our lab identified novel Hp thienopyrmidine inhibitors that target respiratory complex I, an essential enzyme in respiration. Respiratory complex I is a large asymmetric multidomain and membrane bound enzyme and due to these innate features, it is not practical for biophysical …

Effects Of Glp-1 Receptor Agonists On Cardiovascular Outcomes In Patients With Type 2 Diabetes And Chronic Kidney Disease: A Systematic Review And Meta-Analysis, Michael Kelly, Jelena Lewis, Hindu Rao, Jessica Carter, Ivan Portillo, Richard Beuttler

College of Pharmacy Faculty Papers

AIM: To evaluate the cardiovascular outcomes of glucagon-like peptide-1 receptor agonists (GLP1-RA) in patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD).

MATERIALS AND METHODS: We searched PubMed, Ovid MEDLINE, CINAHL, and Web of Science databases for randomized controlled trials reporting event rates for a composite cardiovascular outcome of cardiovascular death, myocardial infarction, and stroke in patients with T2DM and CKD receiving GLP1-RA or placebo. Studies were restricted to those reporting specific event rates for patients with CKD separately from the overall population. We conducted a meta-analysis using a random-effects model. This meta-analysis was registered on PROSPERO (CRD42022320157). …

Evaluation Of Therapies For Treatment Of Hyponatremia, Laura Fischer Pharmd Candidate, Jennifer Sposito Pharmd, Blake Burton Pharmd, Bcps, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: Characterize the use and assess the efficacy of tolvaptan and urea in the treatment of patients who were admitted to the hospital with chronic hyponatremia.

Impact Of Specialty Pharmacy Services On Pneumococcal Vaccination Rates In A Large Inflammatory Bowel Disease Population, Jessica Offerle Pharmd, Tara Jellison Pharmd, Mba,Fashp, Michele Walters Pharmd, Bcps, Bcidp, Toni Zahorian Pharmd, Bcacp

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: The purpose of this study is to assess the impact of clinical specialty pharmacy services and education on compliance with vaccine recommendations in subjects with IBD.

Continued Use Of Proton Pump Inhibitors And Risk For Recurrence Of Clostridium Difficile Infection-A Retrospective Study, Cecilia Schowe Pharmd Candidate, Breia Leavell Pharmd Candidate, Cole Luty Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To determine if the continued use of proton pump inhibitors leads to an increased risk of recurrent Clostridium difficile infections.

Evaluation Of Rituximab Use At Parkview Health, Sarah Stopczynski Pharmd Candidate, Jesse Christman Pharmd, Bcop, Kristen Christman Pharmd, Bcps, Jamie Gaul Pharmd, Bcps

Parkview Pharmacy Department

Poster Presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: Characterize the use of rituximab at Parkview Health by differentiating between inpatient and outpatient use as well as evaluate indications for use, incidence of documented infusion reactions, and biosimilar use.

Characterizing Appropriate Use Of Octreotide Continuous Infusions For Gastroesophageal Bleeding, Austin Harris Pharmd, Curtis Stump Pharmd, Luke Keller Pharmd, Bcps, Bcccp

Parkview Pharmacy Department

Poster Presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Objective: To characterize the appropriate use of octreotide infusions for gastroesophageal bleeding at a community hospital system to pursue guideline-driven standardization of care.

Evaluation Of Intravenous Loop Diuretic Use In Acute Decompensated Heart Failure In A Community Hospital, Catherine Eichler Pharmd, Cole Luty Pharmd, Kris Howard Pharmd, Aacc

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition

Objective: To characterize the use of intravenous loop diuretics in patients hospitalized with fluid overload secondary to acute decompensated heart failure (ADHF) within the heart failure service of a community hospital

Medication Use Evaluation Of Angiotensin Ii, Kevin Baumgartner Pharmd, Dustin D Linn Pharmd, Bcccp, Michael Todt Pharmd

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition

Background: Angiotensin II is a vasopressor agent used for septic shock and has been found to effectively raise the blood pressure in patients who did not respond to other conventional high dose vasopressors. Angiotensin II’s wholesale acquisition cost (WAC) of $1800 per vial creates a significant financial burden for health care institutions. A limited warranty manufacturer program replaces angiotensin II vials in patients not achieving an increase in mean arterial pressure (MAP) of at least 10 mmHg or to >65mmHg within the first 3 hours of initiation.

Objective: Evaluate compliance …

Impact Of Pharmacist-Led Direct Oral Anticoagulant Monitoring On Appropriate Medication Use, Bhavika Patel Pharmd, Kenneth Wiley Pharmd, Bcacp, Alicia Sawmiller Pharmd, Bcacp

Parkview Pharmacy Department

Poster presentation completed at ASHP Midyear Clinical Conference & Exhibition.

Background: Direct oral anticoagulants (DOACs) are the preferred treatment for patients with venous thromboembolism and atrial fibrillation and are an attractive alternative to vitamin K antagonists in multiple indications for long-term anticoagulation. Although DOACs require less frequent clinical monitoring than vitamin K antagonists and their standardized dosing is often more convenient for patients, these medications still require monitoring. Medication adherence, monitoring renal function, hepatic function and drug interactions are important safety concerns for managing patients on DOAC therapy. Previous studies have shown pharmacist can impact monitoring, dosing and adherence to …

Pharmacogenomics Translation In A Community Medical Context Using A Diffusion Of Innovations Framework: Provider Perspectives And Evaluation Implications, Sabrina Ewald Holley

Dissertations

Translation, in the context of medical research, is a process that describes how knowledge and innovation move and change into real world applications and outcomes. This study explores the translation of a medical innovation, pharmacogenomics (PGx), from research into clinical practice using the perspectives of medical providers in a community setting. PGx is the influence of a person’s genetics on drug response. Despite being available for over a decade, PGx testing is not widely adopted. Prior research primarily examined PGx translation in large academic medical centers, but not much is known about it in community practice settings. A better understanding …

Impact Of Colchicine On Mortality And Morbidity In Covid-19: A Systematic Review., Devang Sanghavi, Pankaj Bansal, Ikwinder Preet Kaur, Mohsin Sheraz Mughal, Chandana Keshavamurthy, Austin Cusick, Jennifer Schram, Siva Naga S Yarrarapu, Abhishek R Giri, Nirmaljot Kaur, Pablo Moreno Franco, Andy Abril, Fawad Aslam

Pharmacy Articles

INTRODUCTION: Colchicine, because of its anti-inflammatory and possible anti-viral properties, has been proposed as potential therapeutic option for COVID-19. The role of colchicine to mitigate "cytokine storm" and to decrease the severity and mortality associated with COVID-19 has been evaluated in many studies.

OBJECTIVE: To evaluate the role of colchicine on morbidity and mortality in COVID-19 patients.

METHODS: This systematic review was conducted in accordance with the PRISMA recommendations. The literature search was conducted in 6 medical databases from inception to February 17, 2021 to identify studies evaluating colchicine as a therapeutic agent in COVID-19. All included studies were evaluated …

Biomarkers In The Development Of Individualized Treatment Regimens For Colorectal Cancer, Madison Crutcher, Scott A Waldman

Department of Surgery Faculty Papers

Introduction: Colorectal cancer (CRC) is the third most common and second most deadly malignancy in the world with an estimated 1. 9 million cases and 0.9 million deaths in 2020. The 5-year overall survival for stage I disease is 92% compared to a dismal 11% in stage IV disease. At initial presentation, up to 35% of patients have metastatic colorectal cancer (mCRC), and 20-50% of stage II and III patients eventually progress to mCRC. These statistics imply both that there is a proportion of early stage patients who are not receiving adequate treatment and that we are not adequately treating …

Epidemiology, Outcomes And Tolerability Of Protracted Treatment Of Nontuberculous Mycobacterial Infections At A Community Teaching Hospital In The Southeastern United States, Yuwei Vivian Tsai, Carolina Derrick, Ismaeel Yunusa Ph.D., Sharon Weissman, Majdi N. Al-Hasan, Julie Ann Justo Pharm.D., P. Brandon Bookstaver Pharm.D.

Faculty Publications

Nontuberculous mycobacterial (NTM) infections present a treatment challenge for clinicians and patients. There are limited data about current susceptibility patterns and treatment outcomes in U.S. adults. This was a 10-year, single-center, retrospective, observational cohort study of adults with a positive NTM culture and clinical suspicion of infection between 1 January 2010 and 30 June 2020. The primary objective was to identify predictors for favorable treatment outcomes. Key secondary objectives were characterization of NTM epidemiology, susceptibility profiles, and safety and tolerability of treatment, including the proportion of subjects with an antimicrobial change and the reasons for the change. Of 250 subjects …

Membrane-Active Cyclic Amphiphilic Peptides: Broad-Spectrum Antibacterial Activity Alone And In Combination With Antibiotics, Eman H. M. Mohammed, Sandeep Lohan, Tarra Ghaffari, Shilpi Gupta, Rakesh K. Tiwari, Keykavous Parang

Pharmacy Faculty Articles and Research

We designed a library of 24 cyclic peptides containing arginine (R) and tryptophan (W) residues in a sequential manner [RnWn] (n = 2–7) to study the impact of the hydrophilic/hydrophobic ratio, charge, and ring size on the antibacterial activity against Gram-positive and Gram-negative strains. Among peptides, 5a and 6a demonstrated the highest antimicrobial activity. In combination with 11 commercially available antibiotics, 5a and 6a showed remarkable synergism against a large panel of resistant pathogens. Hemolysis (HC50 = 340 μg/mL) and cell viability against mammalian cells demonstrated the selective lethal action of 5a against bacteria over …

Takeda Pharmaceutical Rare Hematology Strategic Audit, Brian Duval

Honors Program: Senior Projects (Public)

Takeda Pharmaceutical Company is a large Japanese-based multinational pharmaceutical company that manufactures treatments for many different diseases. It is the largest pharmaceutical company in Asia and has a significant share in markets across the world. This report focuses specifically on Takeda’s treatments for rare bleeding disorders under its Rare Diseases & Hematology division. Using internal and external analysis tools, this report seeks to understand how Takeda has created and sustained competitive advantages in the complex environment of the pharmaceutical industry. Specific tools used to highlight this include Porter’s Five Forces and PESTEL analyses. This report also examines the environment surrounding …

The Glycemic, Cholesterol, And Weight Effects Of L-Carnitine In Diabetes: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Jennifer Ko, Eva Y. Wong, Huyentran N. Tran, Rebecca J.C. Tran, Diana X. Cao

Pharmacy Faculty Articles and Research

Introduction

L-carnitine possibly impacts insulin sensitivity and glucose metabolism. However, its therapeutic role in diabetes is poorly understood.

Methods

A systematic review and meta-analysis were conducted using PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception through June 30, 2021. Included studies evaluated the use of L-carnitine in diabetes on fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), weight, or body mass index (BMI). Weighted mean difference (WMD) and 95% confidence intervals (CI) were calculated using the DerSimonian and Laird random-effects model.

Results

Seventeen studies …

Methylone And Mdma Pharmacokinetics Following Controlled Administration In Humans, Lourdes Poyatos, Alfredo Fabrizio Lo Faro, Diletta Berardinelli, Giorgia Sprega, Sara Malaca, Simona Pichini, Marilyn A. Huestis, Esther Papaseit, Clara Pérez-Mañá, Francesco Paolo Busardò, Magí Farré

Institute of Emerging Health Professions Faculty Papers

The aim of this study is to define, for the first time, human methylone and HMMC plasma pharmacokinetics following controlled administration of 50–200 mg methylone to 12 male volunteers. A new LC-MS/MS method was validated to quantify methylone, MDMA, and their metabolites in plasma. The study was a randomized, cross-over, double-blinded and placebo-controlled study, with a total of 468 plasma samples collected. First, 10 µL of MDMA-d5, MDA-d5 and methylone-d3 internal standards were added to 100 µL of plasma. Two mL of chloroform and ethyl acetate 9:1 (v/v) were then added, mixed well and centrifuged. The supernatant was fortified with …

Small-Molecule Protac Mediates Targeted Protein Degradation To Treat Stat3-Dependent Epithelial Cancer, Jinmei Jin, Yaping Wu, Zeng Zhao, Ye Wu

Faculty and Student Publications

The aberrant activation of STAT3 is associated with the etiology and progression in a variety of malignant epithelial-derived tumors, including head and neck squamous cell carcinoma (HNSCC) and colorectal cancer (CRC). Due to the lack of an enzymatic catalytic site or a ligand-binding pocket, there are no small-molecule inhibitors directly targeting STAT3 that have been approved for clinical translation. Emerging proteolysis targeting chimeric (PROTAC) technology-based approach represents a potential strategy to overcome the limitations of conventional inhibitors and inhibit activation of STAT3 and downstream genes. In this study, the heterobifunctional small-molecule-based PROTACs are successfully prepared from toosendanin (TSN), with 1 …

Discovering New Potential Inhibitors To Sars-Cov-2 Rna Dependent Rna Polymerase (Rdrp) Using High Throughput Virtual Screening And Molecular Dynamics Simulations., Dylan Brunt, Phillip M Lakernick, Chun Wu

College of Science & Mathematics Departmental Research

RNA dependent RNA polymerase (RdRp), is an essential in the RNA replication within the life cycle of the severely acute respiratory coronavirus-2 (SARS-CoV-2), causing the deadly respiratory induced sickness COVID-19. Remdesivir is a prodrug that has seen some success in inhibiting this enzyme, however there is still the pressing need for effective alternatives. In this study, we present the discovery of four non-nucleoside small molecules that bind favorably to SARS-CoV-2 RdRp over the active form of the popular drug remdesivir (RTP) and adenosine triphosphate (ATP) by utilizing high-throughput virtual screening (HTVS) against the vast ZINC compound database coupled with extensive …

Protein Phosphatase 2a Regulates Xanthine Oxidase-Derived Ros Production In Macrophages And Influx Of Inflammatory Monocytes In A Murine Gout Model, Sandy Elsayed, Khaled A. Elsaid

Pharmacy Faculty Articles and Research

Background: Gout is a common arthritis, due to deposition of monosodium urate (MSU) crystals which results in IL-1β secretion by tissue-resident macrophages. Xanthine oxidase (XO) catalyzes uric acid (UA) production and in the process, reactive oxygen species (ROS) are generated which contributes to NLRP3 inflammasome activation. Protein phosphatase 2A (PP2A) may be involved in regulating inflammatory pathways in macrophages. The objective of this study was to investigate whether PP2A regulates gout inflammation, mediated by XO activity modulation. We studied UA and ROS generations in MSU stimulated murine bone marrow derived macrophages (BMDMs) in response to fingolimod phosphate, a PP2A activator, …

Effect Of Dedicated Admission Medication Reconciliation On Patient Care In 100-Bed Acute Care Hospital, Judy Mcmanus

Student Scholarly Projects

Practice Problem: Medication reconciliations are often completed inadequately or inaccurately when patients are admitted to the hospital. Findings at the study site identified an average of two pharmacy interventions necessary per admitted patient to correct home medication lists after completion of the medication reconciliation.

PICOT: The PICOT question that guided this project was “In adult patients admitted to a 100-bed acute care hospital (P), how does use of the MATCH toolkit for medication reconciliation process steps (I), compared to the current process of home medication reconciliation completed by the physician prior to nursing or pharmacy team review (C) affect accuracy …

Hypertrophic And Fibrotic Human Pkd Hearts Are Associated With Macrophage Infiltration And Abnormal Tgf-Β1 Signaling, Farideh Amirrad, Gregory A. Fishbein, Robert A. Edwards, Surya M. Nauli

Pharmacy Faculty Articles and Research

Autosomal dominant polycystic kidney disease (PKD) is a hereditary kidney disorder which can affect cardiovascular system. Cardiac hypertrophy and cardiomyopathy in PKD have been reported by echocardiography analyses, but histopathology analyses of human PKD hearts have never been examined. The current studies evaluated human heart tissues from five subjects without PKD (non-PKD) and five subjects with PKD. Our histopathology data of human PKD hearts showed an increased extracellular matrix associated with cardiac hypertrophy and fibrosis. Hypertrophy- and fibrosis-associated pathways involving abnormal cardiac structure were next analyzed. We found that human PKD myocardium was infiltrated by inflammatory macrophage M1 and M2; …

Status Of Toxicology Education In Us Doctor Of Pharmacy Programs, Mohammed A. Islam, Paniz Hazrati, Fred Farris

Health Professions Education

Purpose: Pharmacists play a significant role in toxicology from research to clinical practice. Adequate toxicology content coverage is expected in the curricula of US PharmD programs. The purpose of this study is to evaluate the status of toxicology education in the professional PharmD programs in US schools and colleges of pharmacy.

Method: The websites of 142 pharmacy programs were visited. Pages with PharmD curriculum, course catalog, student handbook were identified and retrieved. The toxicology course titles and catalog descriptions were compiled and uploaded into the qualitative data analysis software, NVivo® 12. A word cloud analysis of the toxicology course descriptions …

Effects Of Chronic Cirrhosis Induced By Intraperitoneal Thioacetamide Injection On The Protein Content And Michaelis–Menten Kinetics Of Cytochrome P450 Enzymes In The Rat Liver Microsomes, Devaraj Venkatapura Chandrashekar, Barent N. Dubois, Mamunur Rashid, Reza Mehvar

Pharmacy Faculty Articles and Research

Chronic intraperitoneal injection of thioacetamide (TAA) in rats has been used as an animal model of human cirrhosis to study the effects of the disease on drug metabolism. However, TAA inhibits P450 enzymes directly and independently of cirrhosis. We investigated the effects of chronic cirrhosis in rats, induced by 10 weeks of intraperitoneal TAA, on the P450 enzymes after a 10-day washout period to eliminate TAA. Liver histology and serum biomarkers of hepatic function confirmed cirrhosis in all animals. Microsomal total P450 content, P450 reductase activity and ethoxycoumarin O-deethylase activity, a general marker of P450 activity, were significantly reduced by …

Electromechanical Effects On Micro And Nano Particles Generated From Drug Delivery Devices And Their Implications In Flow And Deposition Efficiency, Mohammed Ali, Mark Miller

Technology Faculty Publications and Presentations

This experimental investigation was undertaken to quantify the electrostatic charge and aerodynamic size distribution of the medicinal drug particles inhaled through an in-vitro mouth-throat (MT) in order to compare the amount of drugs can be delivered to the human lung while mimicking a patient is either sitting or lying. The MT model is a cadaver-based replica cast of human oral-pharyngeal-laryngeal region. Tested drug aerosols were generated by a commercially available metered dose inhaler (MDI). The MT model was placed inside a humidity (95%) and temperature (37^oC) controlled chamber. Its mouth-inlet was positioned horizontally and vertically to simulate sitting …

Evaluation Of Pharmaceutically Compounded Oral Caffeine On The Impact Of Medication Adherence And Risk Of Readmission Among Preterm Neonates: A Single-Center Quasi-Experimental Study, Gul Ambreen, Manoj Kumar, Amin Ali, Syed Akbar Ali Shah, Syed Muzaffar Saleem, Ayesha Tahir, Muhammad Sohail Salat, Muhammad Shahzad Aslam, Kashif Hussain

Department of Biological & Biomedical Sciences

Background: Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age ≥ 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates.
Methods: We conducted a single-center quasi-experimental study for this quality …