Other Pharmacy and Pharmaceutical Sciences Commons^™

Challenges And Future Perspective Of Gastroretentive Mucoadhesive Dosage Forms, Rayhan Akbar, Heri Setiawan, Baitha Palanggatan Maggadani, Raditya Iswandana, Kurnia Sari Setio Putri

Pharmaceutical Sciences and Research

Gastroretentive Mucoadhesive Dosage Form (GMDF) is one type of Gastroretentive Drug Delivery System (GRDDS) technology designed to exploit the adhesiveness of dosage forms in the gastric mucosa. This aims to increase drug residence time, enhance drug solubility and absorption, and ultimately improve drug bioavailability and therapeutic effect. Various studies have explored the use of different polymers to develop GMDF systems and dosage forms. However, despite extensive research in this field, there are still limited GMDF products approved by the US FDA and INA FDA. Therefore, this review addresses the challenges in developing GMDF, its current state, and potential future opportunities. …

Recent Updates On Dried Blood Spot And Volumetric Absorptive Microsampling As Microsampling Technique For Antiepileptic Drug Determination: A Systematic Review, Asmiladita Pridilla, Yahdiana Harahap, Denni Joko Purwanto, Baitha Palanggatan Maggadani

Pharmaceutical Sciences and Research

Implementation of Therapeutic Drug Monitoring (TDM) can be useful for patients with uncontrolled seizures. This review article aims to collect and compare the recent development of bioanalytical methods for antiepileptic drugs using microsampling techniques, namely DBS (Dried Blood Spot) and VAMS (Volumetric Absorptive Microsampling). Studies were searched through databases, namely Science Direct, Pubmed, and the Google Scholar search engine using pre-determined keywords. Studies published between 2019 and 2024 and used micro-sampling techniques for antiepileptic drug analysis were included. Non-English studies, non-related studies, duplication, and full text unavailable were excluded. Primary sources were used to build a conclusion regarding the purpose …

Biosynthesis Of Agnps Mediated By Equisetum Debile Roxb. Herb Water Extract And Its Potency As An Antioxidant, Yuni Retnaningtyas, Alviani Dwi Karmilasari, Endah Puspitasari

Pharmaceutical Sciences and Research

Silver nanoparticles (AgNPs) are metal nanoparticles currently under development. AgNPs are recognized for their remarkable stability, low reactivity, and advantageous biological properties, including antioxidant activity. Phenolic compounds derived from the Equisetum debile Roxb. (Ed-R) herb have the potential to be explored as bio-reduction and capping agents in the synthesis of silver nanoparticles. The primary objective of this study is to synthesize AgNPs using a water extract from Ed-R herb and to assess their antioxidant activity. The optimal composition for the biosynthesis of AgNPs comprises 10% Ed-R water extract, 8.0 mM AgNO₃, and deionized water in a ratio of …

Application Of Pvp Va 64 And Poloxamer 188/407 In Solid Dispersion Technology For Improving Solubility Of Valsartan, Sulastari Cahyani, Teuku Nanda Saifullah Sulaiman, Marlyn Dian Laksitorini

Pharmaceutical Sciences and Research

Valsartan, Biopharmaceutical Classification System (BCS) class II drug, exhibits pH-dependent solubility in the gastrointestinal tract, which increases at pH levels above 5. Its low solubility results in a bioavailability of only 23%, necessitating efforts to enhance it. This study aims to improve the solubility of valsartan using a solid dispersion system. Polyvinylpyrrolidone/vinyl acetate 64 (PVP VA 64), a hydrophilic polymer, was incorporated to inhibit the recrystallization of valsartan, while poloxamer 188 and poloxamer 407, used as surfactants, aimed to enhance valsartan’s solubility and intrinsic dissolution rate. Valsartan solid dispersions were prepared using the spray drying method, and the optimal formulation …

Global Perspective Of The Risks Of Falsified And Counterfeit Medicines: A Critical Review Of The Literature, Aonghus J. Feeney, Jeffery A. Goad, Gerard T. Flaherty

Pharmacy Faculty Articles and Research

Background

Methods

Identifying The Roles Of Mir-17 In Ciliogenesis And Cell Cycle, Ashwaq Alanazi, Ayan K. Barui, Ashraf M. Mohieldin, Ankan Gupta, Ramani Ramachandran, Surya M. Nauli

Pharmacy Faculty Articles and Research

Emerging evidence suggests a significant contribution of primary cilia to cell division and proliferation. MicroRNAs, especially miR-17, contribute to cell cycle regulation and proliferation. Recent investigations have highlighted the dysregulated expression of miR-17 in various malignancies, underlining its potential role in cancer. However, the correlation between primary cilia and miR-17 has yet to be fully elucidated. The present study examines the presence of miR-17 in primary cilia. The miR-17 expression is studied in selected ciliary protein knockdown cells. Using in situ hybridization (ISH), we identified the subcellular localization of miR-17 in both cilium and cell body. We confirmed the importance …

Tirzepatide Protects Against Hepatic Oxidative Stress In High-Fat Induced Obesity In Male Rats, Ashraf Jameel Alathary, Zahraa Jawad Kadhim

Maaen Journal for Medical Sciences

Background

Obesity is a prevalent health issue that affects people of all ages at a high rate. Tirzepatide (TZP) is a hypoglycemic medication that acts as a dual antagonist for both the GIP-1 and GIP receptors. Previous reports have shown that TZP treatment demonstrated substantial weight reduction as well as lipid-modulating effects in obese and overweight individuals.

Objective

The aim from this study is to examine the potential protective effect of TZP on oxidative stress status and HFD induced obesity in male rats.

Methods

This research employed a total of 28 adult male Sprague-Dawley rats. Normal control group involved seven …

One More Negative Regulator Of Ac6: S-Nitrosylation, Isabella Cattani-Cavalieri, Rennolds S. Ostrom

Pharmacy Faculty Articles and Research

"In this issue of the Journal, Maghsoudi and colleagues (pp. 82–96) report a series of studies that delineate the biochemical and pharmacological mechanism of this resistance (4). The study focuses on adenylyl cyclase (AC), an enzyme crucial for pulmonary vasodilation through its action of synthesizing cAMP. There are nine isoforms of AC (AC1–AC9) that are all stimulated by Gs but otherwise are distinct in their regulatory qualities, subcellular localization, and expression profiles throughout the body (5). AC6 plays a significant role in fetal and neonatal lung, especially in pulmonary artery smooth muscle cells, where …

Central Nervous System Antiviral Pharmacology, Sean N. Avedissian

Theses & Dissertations

Soon after viral infection, viruses like Human Immunodeficiency Virus (HIV) and SARS-CoV-2 can disseminate throughout the body and establish reservoirs in the central nervous system (CNS). The persistence of viruses in cells of these reservoirs is a major obstacle to virus eradication. This is due to the abundance of cells/receptors that these viruses utilize to gain entry into cells found at these various reservoir sites. Consequently, these same anatomical sites also may be pharmacologic sanctuaries, as evidenced by concentrations of antiretroviral drugs (ARVs) and antivirals (AVs) that are lower in reservoirs than those in peripheral blood; in some cases, these …

Pharmacokinetics And Tissue Distribution Of A Lipid-Based Extended-Release Nano-Formulation Of Mo-Oh-Nap Tropolone To Enhance Pulmonary Delivery For The Treatment Of Pulmonary Metastatic Osteosarcoma, Wafaa N. Aldhafiri

Theses & Dissertations

Osteosarcoma is the most common primary bone tumor in children and adolescents. Metastasis is prevalent in 25% of patients, at diagnosis, with the lungs being the most common metastatic site. Pulmonary metastatic osteosarcoma is a significant therapeutic challenge with a 5-year survival rate of ≤30%. Patients with pulmonary metastatic disease at diagnosis receive the same standard of care as patients with local disease, which hasn’t changed over the past 30 years. The treatment and prevention of pulmonary metastatic osteosarcoma represents a significant critical and unmet need.

MO-OH-Nap tropolone is a novel small molecule with cytotoxic activity across multiple human osteosarcoma …

Characterization Of Population Pharmacokinetics And Associated Interindividual Variability Of Drugs Used In Mass Drug Administration Against Lymphatic Filariasis, Abdullah Alshehri

Theses & Dissertations

Lymphatic filariasis (LF) is a mosquito-borne filarial infection that affects the lymphatic system. The progression of the disease is associated with severe comorbidities and social stigma among patients. The World Health Organization has categorized the disease as a public health problem, and it has been targeted by mass drug administration (MDA) campaigns over the past two decades. Several preventive chemotherapies have been used in MDA campaigns against LF, including a combination of three anti-filarial drugs (IDA therapy): albendazole (ALB), diethylcarbamazine (DEC), and ivermectin (IVM). Other antiparasitic drugs, such as moxidectin (MOX), are still under investigation for their activity against LF. …

Diesel Exhaust Particles Alter Mitochondrial Bioenergetics And Camp Producing Capacity In Human Bronchial Epithelial Cells, Isabella Cattani-Cavalieri, Marina Trombetta-Lima, Hong Yan, Ana L. Manzano-Covarrubias, Hoeke A. Baarsma, Asmaa Oun, Melissa Mol Van Der Veen, Emily Oosterhout, Amalia M. Dolga, Rennolds S. Ostrom, Samuel Santos Valenca, Martina Schmidt

Pharmacy Faculty Articles and Research

Introduction: Air pollution from diesel combustion is linked in part to the generation of diesel exhaust particles (DEP). DEP exposure induces various processes, including inflammation and oxidative stress, which ultimately contribute to a decline in lung function. Cyclic AMP (cAMP) signaling is critical for lung homeostasis. The impact of DEP on cAMP signaling is largely unknown.

Methods: We exposed human bronchial epithelial (BEAS-2B) cells to DEP for 24–72 h and evaluated mitochondrial bioenergetics, markers of oxidative stress and inflammation and the components of cAMP signaling. Mitochondrial bioenergetics was measured at 72 h to capture the potential and accumulative effects of …

Impact Of A Pharmacist-Led Hcv Treatment Program At A Federally Qualified Health Center, Jerika T. Lam, Sharon Xavioer

Pharmacy Faculty Articles and Research

Pharmacists are key players who can help to eliminate the hepatitis C virus (HCV) epidemic in the United States. This pilot retrospective study evaluated the impact of a pharmacist-led HCV treatment program in a federally qualified health center (FQHC) primary care clinic setting. The primary outcome was to assess sustained virologic response (SVR) rates 12 weeks after patients were initiated and completed their oral direct acting antiviral (DAA) treatment regimens. Methods: This pilot retrospective study included historical analyses of patients who received DAA treatment in the pharmacist-led HCV treatment program in a FQHC clinic between 1 January 2019 and 31 …

Transitions Of Care Practice Models: Innovations Across Different Health Settings, Laressa Bethishou, Noah Fang

Pharmacy Faculty Articles and Research

"Being discharged from a hospital may be a joyous occasion for a patient with a long length of stay, but this process may also be riddled with medication issues. With a deluge of new medications, unclear instructions, and new costs that may be unaffordable, many patients face challenges that are all too common. Additionally, the medication list may be fraught with discrepancies of missing or inaccurate home medications, duplicate therapies of new medications prescribed, or drug-drug interactions of old and new medications.

Pharmacists and pharmacy personnel who support patients during transitions of care (TOC) are very familiar with the consequences …

The Role Of Pharmacy In Supporting Safe And Effective Transitions Of Care, Laressa Bethishou

Pharmacy Faculty Articles and Research

Goal To inform pharmacists and pharmacy technicians of the importance of and processes for conducting transitions of care when patients are moving among healthcare settings.
Summary A narrative review of recent events and research into transitions of care (TOCs) — the movement of patients from one healthcare setting to another. To be conducted safely and effectively, the entire patient care team must optimize patient care and communicate up-to-date information among its members. As the medication experts on the healthcare team, pharmacists are well poised to receive and share information that impacts medication use and patient safety. Pharmacy technicians can play …

Microencapsulation Of Cosmos Caudatus Kunth Extract Using Sodium Alginate And In Vitro Antioxidant Activity Test, Safina Samara Nur Fadlila, Oktavia Eka Puspita, Zubaidah Ningsih, Anna Safitri

Makara Journal of Science

This study aims to encapsulate Cosmos caudatus K. leaf extract in sodium alginate crosslinked with calcium chloride (CaCl₂) as coating materials through freeze-drying. Antioxidant assays were performed to evaluate the applicability of the microcapsules as antidiabetic medicines. Their characteristics, antioxidant activity, and encapsulation efficiency (EE) were also examined. Results indicated that the concentration of sodium alginate and pH influenced the manufacturing process of the microcapsules. The highest EE was obtained at pH 6 and alginate concentration of 2% (w/v). The IC₅₀ for the antioxidant activity of the microcapsules was 139.96 ± 1.094 μg/mL. Scanning electron microscopy confirmed …

Hepatic Lrp-1 Plays An Important Role In Amyloidosis In Alzheimer's Disease Mice: Potential Role In Chronic Heavy Alcohol Feeding, Devaraj V. Chandrashekar, G. Chuli Roules, Nataraj Jagadeesan, Urvashi R. Panchal, Adenike Oyegbesan, Oghenetega E. Imiruaye, Hai Zhang, Jerome Garcia, Kamaljit Kaur, Sanda Win, Tin A. Than, Neil Kaplowitz, Moom R. Roosan, Derick Han, Rachita K. Sumbria

Pharmacy Faculty Articles and Research

Background

Methods

Mechanistic Study Of Antimicrobial Effectiveness Of Cyclic Amphipathic Peptide [R4W4] Against Methicillin-Resistant Staphylococcus Aureus Clinical Isolates, Ajayi David Akinwale, Keykavous Parang, Rakesh Kumar Tiwari, Jason Yamaki

Pharmacy Faculty Articles and Research

Antimicrobial peptides (AMPs) are being explored as a potential strategy to combat antibiotic resistance due to their ability to reduce susceptibility to antibiotics. This study explored whether the [R₄W₄] peptide mode of action is bacteriostatic or bactericidal using modified two-fold serial dilution and evaluating the synergism between gentamicin and [R₄W₄] against Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA) by a checkered board assay. [R₄W₄] exhibited bactericidal activity against bacterial isolates (MBC/MIC ≤ 4), with a synergistic effect with gentamicin against E. coli (FICI = 0.3) but …

Mechanistic Insight Into The Mode Of Inhibition Of Dietary Flavonoids; Targeting Macrophage Migration Inhibitory Factor, Ali Raza Siddiqui, Mamona Mushtaq, Madiha Sardar, Lubna Atta, Mohammad Nur-E-Alam, Aftab Ahmad, Zaheer Ul-Haq

Pharmacy Faculty Articles and Research

Introduction: The Macrophage Migration Inhibitory Factor (MIF), a key pro-inflammatory mediator, is responsible for modulating immune responses. An array of inflammatory and autoimmune diseases has been linked to the dysregulated activity of MIF. The significance in physiological as well as pathophysiological phenomena underscores the potential of MIF as an attractive target with pharmacological relevance. Extensive research in past has uncovered a number of inhibitors, while the ISO-1, or (S, R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid methyl ester being recognized as a benchmark standard so far. Recent work by Yang and coworkers identified five promising dietary flavonoids, with superior activity compared to the standard …

Effectiveness Of Empiric Carbapenem Versus Non-Carbapenem Therapy For Extended-Spectrum Β-Lactamase Producing Enterobacterales Infections In Non-Intensive Care Unit Patients: A Real-World Investigation In A Hospital With High-Prevalence Of Extended-Spectrum Β-Lactamase Producing Enterobacterales, Amy Y. Kang, Mary Elkomos, Danny Pham, Michelle Guerrero, Deborah Kupferwasser, Loren G. Miller

Pharmacy Faculty Articles and Research

Objective:

To investigate whether empiric carbapenem therapy, compared to empiric non-carbapenem therapy, was associated with improved clinical outcomes among hospitalized, non-intensive care unit (ICU) patients with extended-spectrum β-lactamase (ESBL)-producing Enterobacterales infections.

Methods:

We performed a retrospective cohort study of adult, non-ICU patients admitted with ESBL-producing Enterobacterales infections. Primary outcome was time to clinical stability from the first empiric antibiotic dose. Secondary outcomes were early clinical response and 30-day all-cause hospital readmission. We used multivariate regression methods to examine time to clinical stability.

Results:

Of the 142 patients, 59 (42%) received empiric carbapenems and 83 (58%) received empiric …

Perceptions Of Metabolic Syndrome Management Utilization In Relation To Patient Experience And Health-Related Quality Of Life, Olajide Adekunle, Jon C. Schommer, Yun Wang, Ismaeel Yunusa, Marc L. Fleming, Enrique Seoane-Vazquez, Lawrence M. Brown

Pharmacy Faculty Articles and Research

Background

One factor for the poor health outcomes among adult people with metabolic syndrome (MetS) is poor utilization of disease management resources, which may be attributable to prior experience with pharmacists (PEwP) and perceptions of disease management resource utilization (PMU). Therefore, understanding patients' experience could be critical to improving their perceptions and promoting health outcomes.

Objectives

The study explored the influence of PEwP and PMU on the health-related quality of life (HRQoL) of people with MetS.

Methods

Data on perceptions of healthcare, medication, and pharmacy services utilization, PEwP, and HRQoL were collected using validated tools via an electronic survey. Chi-square …

Proteomic Characterization And Cytotoxic Potential Of Proteins From Cuscuta (Cuscuta Epithymum (L.) Crude Herbal Product Against Mcf-7 Human Breast Cancer Cell Line, Umaima Akhtar, Yamna Khurshid, Bishoy El-Aarag, Basir Syed, Ishtiaq A. Khan, Keykavous Parang, Aftab Ahmed

Pharmacy Faculty Articles and Research

Background

The burden of breast cancer, the second leading cause of death worldwide, is increasing at an alarming rate. Cuscuta, used in traditional medicine for different ailments, including cancer, is known for containing phytochemicals that exhibit anticancer activity; however, the bioactivities of proteins from this plant remain unexplored. This study aimed to screen the cytotoxic potential of proteins from the crude herbal product of Cuscuta epithymum(L.) (CE) harvested from the host plants Alhagi maurorum and Medicago sativa.

Methods

The proteins from CE were extracted using a salting-out method, followed by fractionation with a gel filtration chromatography column. Gel-free shotgun …

Impact Of A Feedback Strategy In A Series Of Communication-Focused Patient Care Simulations, Hindu Rao, Richard Beuttler, Madeline Dintzner, Reza Taheri, Albert Bach, Neeloufar Fakourfar

Pharmacy Faculty Articles and Research

Introduction

Patient care simulations (PCS) and objective structured clinical examinations (OSCE) allow pharmacy students to practice communication. Feedback can help improve communication, but the impact over time is not well understood.

Objective

This study investigated the impact of a feedback strategy on pharmacy students' communication skills over three PCS. It also evaluated the alignment between students' self-scoring and faculty scoring.

Methods

Pharmacy students participated in three sessions (PCS1, OSCE, and PCS3) that were focused on the affective domain. Individualized numerical and narrative feedback was provided to students on their performance after PCS1. Students' communication was scored by faculty graders out …

Assessment Of In-Vitro And In-Vivo Pre-Clinical Pharmacokinetics Of Epz015666; A Novel Small Molecule For Medulloblastoma Treatment, Pratiksha U. Kshirsagar

Theses & Dissertations

Group 3 medulloblastoma (MB) has the worst prognosis of the MB subgroups associated with elevated MYC expression and a 5-year survival rate of

Quantitation of EPZ was performed on a Shimadzu LC-MS/MS system utilizing electrospray ionization operated in positive mode. The validated assay was linear from 0.2 to 500 ng/mL. Metabolic stability studies demonstrated slow intrinsic clearance of EPZ in mouse and human liver microsomes, suggesting no CYP-mediated metabolism. Additionally, EPZ exhibited low binding affinity to plasma and brain proteins and high apparent permeability across artificial membranes, indicating efficient membrane penetration. Drug transporter studies identified EPZ as a substrate of …

Artificial Intelligence Applications For Optimizing Population And Clinical Drug Decision-Making Processes, Khulud Bukhari

Pharmaceutical Sciences (PhD) Dissertations

Introduction: In our study, we evaluated the application of ChatGPT4, an artificial intelligence chatbot, in the pharmacy field, specifically the capability of ChatGPT4 to extract and analyze FDA drug information, conduct a cost-effectiveness analysis of two antibiotics, and identify and classify adverse drugs events (ADE). We compare the results of ChatGPT4 with those from manual searches and specialized software programs. Methods: The first study used ChatGPT4 to extract and assess the quality of regulatory information for antibiotics indicated for complicated urinary tract infections (cUTI) approved by the FDA in 2014-2023. The second study involved comparing the cost-effectiveness analysis of cefiderocol …

Investigation Of Avaren-Fc's Therapeutic Potential Against Ovarian Cancer., Katarina Lee Mayer

Electronic Theses and Dissertations

This thesis describes the investigation of Avaren-Fc (AvFc), a novel lectin-based therapeutic fusion protein consisting of the recombinant Avaren lectin and the Fc region of human IgG1, against ovarian cancer. AvFc possesses selectivity toward tumor associated N-linked high-mannose-type glycans. The present study demonstrates AvFc’s in vitro activity against OVCA cell lines via antibody-dependent cell-mediated cytotoxicity and its ability to extend the survival of mice challenged with murine ID8 OVCA cells after repeated systemic administration. Furthermore, AvFc treatment in this model was found to increase the presence of peritoneal leukocytes, suggesting a shift toward an improved antitumor immune response. Another key …

Antioxidant Activities And Protective Effects Of Shorea Macrophylla Leaf And Bark Extracts, Salfarina Ramli, Nik Nor Sabrina Sukri, Nur Adhwa’ Faqihah Zulkifli, Donna Maretta Ariestanti, Chee Yan Choo, Hasseri Halim, Nurhuda Manshoor, Richard Johari James

Pharmaceutical Sciences and Research

Shorea macrophylla, also known as the ‘Engkabang’ tree or Light Red Meranti, is renowned for its role in reforestation efforts. Despite lacking records of traditional use, the reported biological activities of other species within the Shorea genus spark curiosity about the potential biological activities of this plant. Therefore, this study aims to explore the antioxidant capabilities of S. macrophylla leaf and bark extracts, along with their protective effects against oxidative stress using a brine shrimp model. In the evaluation of antioxidant potential, 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) assays were employed. Extracts were incubated in …

Non-Alcoholic Fatty Liver Disease: Role Of Pnpla3 And Its Association With Environmental Chemicals, Shakil A. Saghir, Ata Abbas, Saleh Alfuraih, Ajay Sharma, Jean Latimer, Yadollah Omidi, Rais Ansari

Pharmacy Faculty Articles and Research

Globally, non-alcoholic fatty liver disease (NAFLD) is on the rise with 30-32%, 27-33%, 35-48%, 36%, 9-20%, and 36-38% prevalence in Asia, Europe, North America, South America, Africa, and Australia, respectively. Approximately, 5-10% of NAFLD proceeds to hepatitis called non-alcoholic steatohepatitis (NASH). NASH often progresses to liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Precise mechanism(s) for the development of HCC is not fully understood in NAFLD and NASH patients. Higher insulin levels in type 2 diabetes (T2D) can result in lipolysis of adipose tissue activating lipid synthesizing enzymes such as fatty acid synthase and stearoyl-CoA desaturase-1, resulting in lipid accumulation in …

Proteomic Identification Of Hemp (Cannabis Sativa) Seeds By Tandem Mass Spectrometry And Evaluation Of Cytotoxic Activity, Taran Harris

Pharmaceutical Sciences (MS) Theses

Hemp (Cannabis sativa) has a long history of use globally as a source of traditional medicine, spiritual enlightenment, and recreational enjoyment. While it was commonly consumed for both medical and recreational purposes in the United States, it was classified as a Schedule 1 drug in 1937, severely restricting its use and research opportunities. Although hemp itself lacks psychoactive properties, Cannabis sativa flowers contain THC, the compound responsible for its psychotropic effects. This restriction hindered quality research into cannabis and its constituents. The study employed techniques, including top-down proteomics, size exclusion chromatography, affinity chromatography, high-resolution ESI QTOF LC/MS/MS, and …

Mechanistic Study Of Antimicrobial Cyclic Peptide [R4w4] Antibacterial Effectiveness Against Methicillin-Resistant Staphylococcus Aureus (Mrsa), Ajayi Akinwale

Pharmaceutical Sciences (PhD) Dissertations

Antimicrobial peptides (AMPs) are being explored as a potential solution to combat antibiotic resistance, as they have shown promise in reducing susceptibility to antibiotics. This study explores if [R₄W₄] peptide is bacteriostatic or bactericidal using modified two-fold serial dilution and evaluates synergism of gentamicin and [R₄W₄] against Escherichia coli (E. coli) and Methicillin-resistant Staphylococcus aureus (MRSA) by checkered board assay. The MRSA resistant to [R₄W₄] and possibility with other antibiotics was evaluated with serial passage. Moreover, we investigated the mechanism of action of [R₄W_{4 …}