Pharmacy and Pharmaceutical Sciences Commons^™

Magnetic Resonance Image-Based Estimates Of Hepatic Blood Flow In Children With And Without Obesity; Implications For Physiologically-Based Pharmacokinetic Models, Yoon Cho, Sherwin S. Chan, Chance S. Friesen, Valentina Shakhnovich

Research Days

Background: Physiologically based pharmacokinetic models for simulating drug pharmacokinetics are useful to guide drug dosing for pediatric patients. Hepatic blood flow could be a useful variable to use in these models.

Objectives/Goal: In this study, we explored 2-D phase contrast non-invasive magnetic resonance imaging (MRI) to measure hepatic blood flow in children with and without obesity.

Methods/Design: In this IRB-approved study, we imaged pediatric patients with abdominal MRI with 2D phase contrast imaging of the descending aorta (AO) at the diaphragm, the inferior vena cava (IVC) at the right atrium, and inferior to hepatic drainage above the renal vein confluence …

Is My Prescription Ready Yet? A Qualitative Examination Of Patients' Understanding Of The Prescription Filling Process In Community Pharmacies, Maria Sallee

Honors Theses

Long lines at the pharmacy can frustrate patients. Consequently, patients becoming frustrated can add stress to an already overworked pharmacy. Without knowing what patients understand about the often complicated prescription filling process at community pharmacies, it can be difficult for pharmacists and pharmacy technicians to communicate the reason behind any delays in patients receiving their medication. To learn what patients understand about the prescription filling process, fifteen interviews were conducted over the phone after mailing recruitment flyers to members of a diabetes research collaborative in North Mississippi. The interviews revealed that while patients have a positive relationship with their pharmacists, …

Oxidative Stress And Micrornas In Endothelial Cells Under Metabolic Disorders, Morgan Minjares, Wendy Wu, Jie-Mei Wang

Pharmaceutical Sciences Faculty Publications

Reactive oxygen species (ROS) are radical oxygen intermediates that serve as important second messengers in signal transduction. However, when the accumulation of these molecules exceeds the buffering capacity of antioxidant enzymes, oxidative stress and endothelial cell (EC) dysfunction occur. EC dysfunction shifts the vascular system into a pro-coagulative, proinflammatory state, thereby increasing the risk of developing cardiovascular (CV) diseases and metabolic disorders. Studies have turned to the investigation of microRNA treatment for CV risk factors, as these post-transcription regulators are known to co-regulate ROS. In this review, we will discuss ROS pathways and generation, normal endothelial cell physiology and ROS-induced …

Isolated Temazepam Overdose: A Unique Case Of An Unresponsive Female, Eric Doane

Stratford Campus Research Day

Cases of acute overdose presenting to the emergency department pose a great challenge given that history can sometimes be limited or at times be inaccurate. While naloxone is routinely given in the field to help reduce opiate’s sedating effects, the routine use of flumazenil has not been routinely adopted in cases of benzodiazepine overdose. This is because, unlike naloxone, there are many medications that act on the GABA receptor, and flumazenil is only specific for binding to the benzodiazepine/GABA receptor. This can lead to an unmasking of other medications that may be co-ingested that also effect the GABA receptor leading …

Case Report And Review: Hawthorne Root Toxicity, James Espinosa, Darren Finn, Alan Lucerna

Stratford Campus Research Day

Here we present the case of a patient who purchased a hawthorn root product, Raiz de Tejocote, for weight loss purposes. The side effect profile seen, including a positive digoxin level, are consistent with hawthorn root. This case reinforces the importance of asking a patient about all medications, including over the internet medications.

An Economic And Regulatory Analysis Of Breast Cancer Drugs Approved By The Us Food And Drug Administration, Abdullah Althomali

Pharmaceutical Sciences (MS) Theses

Introduction

Breast cancer is the most common cancer among women and the leading cause of cancer death among women worldwide. The pharmacological options for breast cancer include chemotherapy, hormone therapy, targeted therapy, and immunotherapy, which are used for the prevention or treatment of breast cancer. This study assessed trends in FDA approvals and prices at the market entry of new drugs indicated for breast cancer in the period 1980-2022. The study also evaluated the factors associated with the price of the new breast cancer drugs at market entry.

Material and Methods

Regulatory data were collected from the FDA website, and …

Application Of Informatics Tools To Facilitate The Practice Of Precision Medicine With Genomic Testing And Clinical Data, Michael Sayer

Pharmaceutical Sciences (PhD) Dissertations

The practice of precision medicine considers a variety of sources of information to optimize patient care. Factors such as patient demographics, clinical history, and lab test values have well understood effects on treatment outcomes and influence decision making. However, effective inclusion of biomolecular data such as protein expression and DNA sequencing data within the practice of precision medicine needs continued study. Informatics tools offer solutions to allow these complex data sources to be effectively embraced. Utilization of informatics tools to visualize data pertaining to the gene selection practices of pharmacogenomic (PGx) tests effectively communicated large amounts of information into concise …

An Analysis Of Trends Of Generic Drugs And Biologic Prices In The U.S., Mohammed Jamjoom

Pharmaceutical Sciences (PhD) Dissertations

Introduction: Drug prices are a significant problem for the US healthcare system. Generic and biosimilar market competition reduces drug and biologic prices, results in substantial savings, and improves patient access and outcomes. As the costs of healthcare and prescription drugs continue to rise, the discussion about drug prices has taken a prominent place at the forefront of national discourse. This study assessed impacting trends in prices of generic, biosimilar, and reference products in the US. We also evaluated the effect of the Affordable Care Act (ACA) of 2010 on biologic prices.

Methods: We extracted a list of the new generic …

Optimizing Collaboration Among Clinical Pharmacy Specialists And Behavioral Health Providers In The Primary Care Setting To Increase Mental Health Access, Ryan Ferris, Christine Doran, Bonnie Jiron, Dara L. Johnson

Providence Pharmacy PGY2 Program at Providence Medical Group 2023

No abstract provided.

The Impact Of Pharmacy Led Education On The Management Of Heart Failure With Preserved Ejection Fraction In The Primary Care Setting, Laura Kays, Ben Rosati, Trevor Laursen, Maurice N. Tran

Providence Pharmacy PGY2 Program at Providence Medical Group 2023

No abstract provided.

Beyond Use Date (Bud) Determination Of Ambroxol Hydrochloride Syrup By High-Performance Liquid Chromatography – Uv/Vis Detector, Catur Jatmika, Raditya Iswandana, Indah Dewi Lestari

Pharmaceutical Sciences and Research

Ambroxol HCl is a mucolytic agent often used to treat respiratory disorders associated with excess mucus secretion. This study aims to determine the beyond-use date (BUD) of ambroxol HCl syrup on the market based on analysis of the decrease in drug content using High-Performance Liquid Chromatography (HPLC) – UV/Vis detector. The HPLC conditions were reversed-phase with a C18 column, mobile phase containing acetonitrile - phosphate buffer 0.05 M pH 4.5 (60:40) at a flow rate of 1.0 ml/min using UV detection at 248 nm. To determine BUD, five syrup preparations (brands) obtained from the Jakarta area were analyzed in triplicate. …

Solid Dispersion Technology For Improving The Solubility Of Antiviral Drugs, Maria Elvina Tresia Butar-Butar, Nasrul Wathoni, Hestiary Ratih, Yoga Windhu Wardhana

Pharmaceutical Sciences and Research

Most drugs, including antiviral drugs, show low solubility in water, which affects dissolution, bioavailability, and therapeutic effectiveness. Therefore, many antiviral drugs are given in very large doses. One of the efforts to overcome these problems is the application of solid dispersions in which polymers and surfactants can trap drug molecules that are in the amorphous phase. Drugs in a hydrophilic carrier will increase wettability, water absorption capacity, and porosity of particles, so that the drug is released better. This review article will discuss the development of technology in solid-state, how solid dispersion overcomes the lack of solubility and the rate …

Synthesis Of Ferrous Fumarate From Indonesian Iron Sand And In Vivo Body Weight Gain Test In Rats, Taufiq Indra Rukmana, Felicia Natalia Kurniadi, Harmita Harmita

Pharmaceutical Sciences and Research

Iron deficiency anemia (IDA) is a health problem in Indonesia. Prevention and treatment of IDA is carried out by giving fortified foods and oral iron therapy. Both can use ferrous fumarate which is made with reacting bivalent iron and disodium fumarate. Bivalent iron can be obtained from iron sand in Indonesia. This study aims to synthesize ferrous fumarate from Indonesian iron sand, which is from Malang, Sukabumi, and Cianjur area, and to determine its absorption through in vivo body weight gain test in male Wistar white rats (Rattus norvegicus). First, ferrous fumarate was synthesized through reaction of ferrous …

Utilization Of Spent Arabica Coffee Grounds As Raw Material For Activated Charcoal In Liquid Bath Soap Formulation, Hilda Maysarah, Lydia Septa Desiyana, Siti Nurzuhra, Didi Nurhadi Illian

Pharmaceutical Sciences and Research

Arabica coffee (Coffea arabica) is one of the most popular coffees among Acehnese, an ethnic group from Aceh, Indonesia. The amount of coffee consumed is directly proportional to the amount of coffee waste produced. Spent coffee grounds are the residue obtained during the brewing process. Spent coffee grounds can be utilized by converting them into active charcoal adsorbents. This study aimed to produce activated charcoal from spent arabica coffee grounds (SACG), to utilize it as an active ingredient in the liquid bath soap formulations, and to determine the best formula. The characterization of activated charcoal was conducted and …

Adherence Versus Compliance, Tasaduq H. Mir

HCA Healthcare Journal of Medicine

Adherence and compliance are 2 words that are used interchangeably by medical professionals. When we come across a patient who is not taking their medication as advised, we say the patient is non-compliant when the truth is that the patient is non-adherent. Although the terms are used as if they mean the same thing, the 2 words are different in so many ways. In order to understand the difference, it is important to understand the true meaning of these words. According to the literature, “adherence is an active choice of patients to follow through with the prescribed treatment while taking …

Metformin-Associated Lactic Acidosis: A Case Report, Joshua Santoli, Jamie Lee Aldakkour, Hossein Tohidi, Yizhi Lin

HCA Healthcare Journal of Medicine

Introduction

Metformin is considered a first-line therapy for patients with diabetes secondary to its cost efficiency, minimal side effects, and marked improvement in one’s hemoglobin A1c; however, metformin is avoided in patients with renal insufficiency out of concern for drug accumulation and lactic acidosis. In fact, there is a black box warning for metformin, identifying lactic acidosis as the inciting trigger for fatal arrhythmias and death.

Case Presentation

A 62-year-old male presented with multiple episodes of nausea, vomiting, abdominal pain, and decreased urine output for 3 days after working on a roof, all day in the summer heat. He did …

Complete Clearance Of Pustular Psoriasis After A Single Dose Of Risankizumab, Ashleigh E. Hermann, Stephen E. Weis

HCA Healthcare Journal of Medicine

Introduction

Psoriasis is a chronic, multifactorial, inflammatory skin disease with several subtypes, including pustular psoriasis. Pustular psoriasis is characterized by pustules forming lakes of pus on the skin. Pro-inflammatory pathways, such as the interleukin (IL)-17/IL-23 axis, have been shown to play a significant role in the pathogenesis of psoriasis. Biologic therapies directed towards these pro-inflammatory pathways have effectively treated plaque psoriasis, but fewer treatments have shown similar efficacy for pustular psoriasis.

Case Presentation

We present a 45-year-old Black female who presented to the dermatology clinic with generalized pustular psoriasis affecting approximately 70% of her body surface area. She also noted …

Rapid Hepatomegaly From Ruxolitinib Discontinuation Syndrome, Ryan Jansen Van Rensburg, Shayna Hale, Anna Calara, Kulveer Dabb, Uday Dandamudi, Parth Desai

HCA Healthcare Journal of Medicine

Introduction

Ruxolitinib (RUX) is a Food and Drug Administration-approved Janus Kinase (JAK) inhibitor shown to be effective in improving hypercatabolic symptoms and splenomegaly in patients with myelofibrosis (MF). RUX therapy provides symptomatic benefits for MF patients but is often discontinued for various reasons including worsening cytopenias. Ruxolitinib Discontinuation Syndrome (RDS) involves an acute cytokine-storm rebound phenomenon that can manifest as an acute relapse of symptoms, worsening splenomegaly, respiratory distress, systemic inflammatory response syndrome, or disseminated intravascular coagulopathy.

Case Presentation

We present the case of a patient with JAK2-positive post-polycythemia vera MF, whose RUX therapy was discontinued due to an active …

Death Due To Drug Reaction With Eosinophilia And Systemic Symptoms (Dress) Syndrome: A Case Report, Samantha P. Sternad, Jane Pangburn, Chad Johnston, David Rowe

HCA Healthcare Journal of Medicine

Background

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening, multi-organ adverse drug reaction with an incidence of 1 in 1000 to 1 in 10 000 highrisk drug exposures.

Case Presentation

An elderly female presented to the hospital with progressive weakness and a diffuse erythematous macular rash covering most of her body that started 3 days prior. Over the next 3 days, the patient quickly deteriorated, developing disorientation with acute onset left-sided weakness, leukocytosis, thrombocytopenia, eosinophilia, liver and kidney failure, and hypoxia. Clinical and histological changes supported the diagnosis of DRESS syndrome caused by intravenous (IV) ampicillin …

Demonstration Of The Managing For Daily Improvement Quality Improvement Methodology In An Alcohol Withdrawal Protocol Audit, Alex Stephens, Diana Hoot, Amy Cain

HCA Healthcare Journal of Medicine

Background

The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) is an assessment tool designed to standardize care and minimize the risk of complications in patients experiencing alcohol withdrawal. After discovering an increase in medication errors and late assessments under this protocol, pharmacists at a 218-bed community hospital performed an audit of protocol compliance using a performance improvement methodology known as Managing for Daily Improvement (MDI).

Methods

A daily audit of CIWA-Ar protocol compliance was performed across all hospital units, followed by discussions with frontline nurses regarding barriers to compliance. The daily audit included assessments of appropriate monitoring frequency, medication …