Pharmacy and Pharmaceutical Sciences Commons^™

The Effects Of A Glp-1 Receptor Agonist On Hba1c And Weight In Comparison To Standard Therapy In A Veteran Population, Isaac Warshawsky

Undergraduate Honors Thesis Collection

Glucagon-Like Peptide 1 Receptor Agonists (GLP-1 RAs) present a novel therapy for use in Type 2 Diabetes Mellitus (T2DM) patients to reduce Hemoglobin A1c (HbA1c) and weight. GLP-1 RAs are costly medications and are not currently on the national formulary for Veterans Affairs medical centers. This study looks to explore the efficacy data in a veteran population.

Evaluation Of Attendance, Patient Satisfaction, Knowledge, And Clinical Outcomes Following Participation In A Group Diabetes Self-Management Education And Support Program In A Primary Care Clinic Setting, Jordan Rauh

Undergraduate Honors Thesis Collection

Introduction: Although group Diabetes Self-Management Education and Support (DSMES) programs have been attempted throughout Community Health Network, no evaluation of the programs had been conducted.

Objectives: The primary objectives of this study were to evaluate attendance, patient satisfaction and change in disease state knowledge following participation in six sessions of a group DSMES program led by a multidisciplinary team. The secondary objective was to evaluate clinical outcomes.

Methods: This retrospective, observational study focused on process improvement evaluating a standardized approach to a group DSMES program beginning in August 2017 within Community Health Network. Eleven courses ran six sessions lasting approximately …

Counseling On Exercise: The Pharmacist's Role, Katelyn Hettinger

Undergraduate Honors Thesis Collection

Only one in three adults in the United States meets the weekly physical activity recommendations, and only 5% of adults are active for at least 30 minutes a day.¹ Exercise is a key component of health and wellness, especially for patients already experiencing comorbid conditions. Exercise has been proven to help alleviate pain in patients experiencing anything from low back pain to fibromyalgia and has been a helpful adjunct in diabetes management.² Pharmacists are in an exciting position to advocate for changes in patients’ lifestyles daily and are in an incredibly accessible position to do so. However, exercise …

The Impact Of Nurse Stress, Job Distress, Job Satisfaction And Mood On Patient Outcomes, Madelynne Wright

Undergraduate Honors Thesis Collection

This study examined the intercorrelations among nursing home healthcare providers’ stress, job distress, job satisfaction, and mood, as well as the relationships between these factors and patient outcomes. Additionally, this study investigated the impact Butler University’s Music First! program had on nurse job perceptions. A total of 63 nurses from 9 long-term care facilities completed questionnaires asking about stress, job distress, and global job satisfaction. Nurses’ depression, anxiety and hostility were also assessed with a 15-item Profile of Mood States questionnaire. Of these 63 nurses, 20 completed the questionnaires at three different time points during the implementation of the Music …

Impact Of In-House Specialty Pharmacy On Access To Novel Androgen Axis Inhibitors In Men With Advanced Prostate Cancer, Anna Driscoll, Nathan Handley, Md, Mba, Adam Binder, Siobhan Henry, W. Kevin Kelly, Do

Phase 1

Introduction: Novel androgen axis inhibitors are standard of care treatments in advanced prostate cancer. The billed amounts for these medications are often very high, which may create significant financial toxicity for patients and lead to delays in treatment. Our institution implemented an in-house specialty pharmacy in 2014, that provides these medications and evaluates copay assistance options for all patients. We evaluated the program’s impact on out of pocket cost (OOP) and turnaround time (TAT).

Methods: We reviewed available internal specialty pharmacy records to identify prescriptions for abiraterone or enzalutamide filled between 1/1/17 and 12/31/18. Payments were stratified by primary payment …

Targeting The Rage Signaling Pathway To Ameliorate The Complications Of Diabetes, Stephen James Dansereau

Legacy Theses & Dissertations (2009 - 2024)

Diabetes is a global health epidemic that can be devastating to those afflicted,

Reflections On The Effects Of Federalism On Opioid Policy, Matthew B. Lawrence

Faculty Articles

One thing we have seen today that we talk about in health law all the time is how the policy, the laws and institutions up at the 10,000 foot level, can so dramatically influence the personal, people’s lived experiences. Our speakers today have done a really great job of drawing out abstract institutional questions and also showing us how those questions have influenced the lives of real people in often tragic ways. Another thing we have seen that we talk about in administrative law all the time is the importance of expertise, especially given how hard it is to trace …

ฤทธิ์การต้านมะเร็งของสารไบแซนโทนจากไลเคน Usnea Aciculifera ต่อเซลล์มะเร็งลำไส้ใหญ่และทวารหนักของมนุษย์, ณัฏธิดา เมฆสุกใส

Chulalongkorn University Theses and Dissertations (Chula ETD)

ไบแซนโทน (Bixanthones) เป็นกลุ่มสารชีวสังเคราะห์ที่มีโครงสร้างทางเคมีหลักเป็น xanthone ซึ่งเกิดจาก xanthone monomer สองโมเลกุลมาเชื่อมต่อกันด้วยพันธะแบบต่างๆแล้วเกิดเป็นสารไบแซนโทนขึ้นหลากหลายชนิดและสามารถพบได้ในแหล่งธรรมชาติ ได้แก่ พืช เชื้อรา และไลเคน ฤทธิ์ทางเภสัชวิทยาหลักของสารกลุ่มนี้ที่พบ ได้แก่ ฤทธิ์ต้านจุลชีพ ฤทธิ์ต้านอนุมูลอิสระ และฤทธิ์ต้านมะเร็ง จากการศึกษาที่ผ่านมาพบว่า สารไบแซนโทนที่สกัดได้จากพืชและเชื้อราหลายชนิดมีฤทธิ์ในการต้านเซลล์มะเร็งต่างๆ ได้ เช่น เซลล์มะเร็งเม็ดเลือดขาว (P388) เซลล์มะเร็งปอด (LL2 และ H520) เซลล์มะเร็งเต้านม (MCF-7) เซลล์มะเร็งหลอดอาหาร (TE1 และ KYSE-150) และเซลล์มะเร็งต่อมลูกหมาก (DU-145) เป็นต้น แต่อย่างไรก็ตามยังไม่เคยมีรายงานการศึกษาฤทธิ์ต้านมะเร็งและกลไกการออกฤทธิ์ของสารไบแซนโทนที่สกัดได้จากไลเคนในเซลล์มะเร็งลำไส้ใหญ่และทวารหนักมาก่อน ในงานวิจัยนี้จึงสนใจที่จะศึกษาฤทธิ์ต้านมะเร็งของสารไบแซนโทนทั้ง 8 ชนิดที่สกัดได้จากไลเคน Usnea aciculifera ในเซลล์มะเร็งลำไส้ใหญ่และทวารหนัก ได้แก่ เซลล์ HT-29 ผลการศึกษาพบว่า สารไบแซนโทนสองชนิด ได้แก่ TT-03 และ TT-08 สามารถยับยั้งการรอดชีวิตและมีความเป็นพิษต่อเซลล์มะเร็ง HT-29 มากที่สุด โดยพบว่า สารไบแซนโทน TT-08 มีความเป็นพิษต่อเซลล์ปกติ PCS201-010 น้อยกว่าสารไบแซนโทน TT-03 และมีค่าดัชนีความจำเพาะ (selectivity index) ของเซลล์ลำไส้ปกติ CRL-1790 ต่อเซลล์มะเร็ง HT-29 เท่ากับ 1.95 ดังนั้นผู้วิจัยจึงเลือกสารไบแซนโทน TT-08 มาทำการศึกษาต่อไป จากการศึกษาต่อในระดับเซลล์และโมเลกุล พบว่า สารไบแซนโทน TT-08 มีความเป็นพิษต่อเซลล์มะเร็ง HT-29 แปรผันตามความเข้มข้นและระยะเวลาที่ใช้ทดสอบโดยมีค่าความเข้มข้นที่ทำให้เซลล์ตายร้อยละ 50 เท่ากับ 3.87± 0.13, 2.05 ± 0.06 และ 1.51± 0.11 ไมโครโมลาร์ หลังจากได้รับสารนาน 24, 48 และ 72 ชั่วโมง และสามารถยับยั้งการเจริญเติบโตของเซลล์มะเร็งผ่านการชักนำให้เกิดการหยุดของวัฏจักรเซลล์ที่ระยะ S …

Formulation Strategies To Enhance Solubility And Permeability Of Small Molecules For Drug Delivery Applications, Pradeep Kumar Bolla

Open Access Theses & Dissertations

All the new chemical entities/drug molecules intended for therapeutic use must be administered using an appropriate delivery system/dosage form to achieve maximum bioavailability. However, designing a drug delivery system is complex as several factors such as lipophilicity, molecular mass, crystallinity, ionic charge, polymorphic forms and hydrogen bonding) affect the solubility and permeability of these molecules. Biopharmaceutics drug classification system (BCS) categorizes the existing drugs into four classes based on the aqueous solubility and membrane permeability and it is reported that >70% of the drugs are poorly soluble and belong to BCS class II and BCS class IV. Several physical, chemical …

Timely Follow Up Care After Initiation Of Adhd Medication In Children: A Quality Improvement Project, Rebecca Haas

DNP Scholarly Projects

Background: Enhancing medication safety, strengthening compliance and mitigating side effects requires close monitoring. A child, defined by Centers for Medicare and Medicaid Services, as being between the ages of 6 years and 12 years of ages, with Attention Deficit Hyperactivity Disorder (ADHD) must have an initial medication visit within 30 days of a first-time trial of ADHD medication. Increasing staff awareness of organizational policy of expected timeframe for medication checks and annotating appointment slots as initial medication checks will decrease the number of days between the first-time trial of ADHD medication and a child’s medication assessment. Methods: The Model for …

Measuring The Effects Of Lobinaline-N-Bioxide (419) On Alcohol Consumption, Nicotine Locomotor Sensitization, And Conditioned Place Preference In Mice And Rats, Cocanut M. Suhail

Theses and Dissertations--Medical Sciences

Objective: Novel drug 419 was examined to see the effect it has in vivo mice and rats on alcohol consumption, nicotine locomotor sensitization, and conditioned place preference (CPP) models regarding behavioral tests on dopamine transporter activity.

Methods: Mice and rats were used to see how they react to the drug 419 and control vehicle, in each of the models. The animals were assessed to pre- and post- drug administration of novel drug 419. We examined each model to see the association between how drug 419 will help with treating drug abuse.

Results: We found that in alcohol consumption model the …

Meaningful Measurement Matters: Defining Potentially Inappropriate Medication Use To Target Cognitive Outcomes, Ashley I. Martinez

Theses and Dissertations--Pharmacy

Preventable and unintended consequences of medication use occur in more than 25% of ambulatory and hospitalized patients, and nearly half of long-term care patients. Unfortunately, many medications used to treat common health conditions in older adults (such as anxiety, behavioral disturbances, incontinence, insomnia, depression, and pain) have also been linked to cognitive impairment and decline. Recently, substantial efforts to investigate medications and medication classes that may be associated with cognitive impairment and decline in older adults have been undertaken. Unfortunately, studies have used a wide variety of different tools to define “potentially inappropriate medication” (PIM) use, and no published literature …

Relationship Between Initial Prescription Opioid Exposure Length And Future Opioid Use Disorder Diagnosis In Opioid Naive Adolescents, Eric Lindahl

Theses and Dissertations--Pharmacy

Objectives: The long-term risks associated with the use of short-term prescription opioids in opioid naïve adolescents in not well characterized. The purpose of this study was to explore the potential association between the days’ supply of the initial prescription opioid exposure and the rates of diagnosed OUD in the subsequent 3-year period. Methods: We conducted a retrospective cohort study using a nationwide database of commercially-insured adolescents aged 12-17 at the time of the index opioid fill. A multivariable Cox Proportional Hazard regression model was developed to analyze the association of interest while accounting for known risk factors for the development …

The Impact Of Bone Marrow Transplantion On Patients With Psychiatric Diagnoses: Medication Adherence Assessment, Brittany Galop

Theses and Dissertations--Pharmacy

Objectives: We investigated whether there is a measurable difference in medication utilization for psychiatric conditions before and after bone marrow transplantation (BMT). Previous studies have identified a potential association between psychiatric conditions and immune function. We hypothesized that medication utilization for psychiatric diagnoses would be impacted by BMT.

Methods: This study was a retrospective, quasi-experimental cohort design. De-identified data was compiled from the Truven database for patients ranging from January 2009 through December 2016. Two measurements of medication utilization, proportion of days covered (PDC) and medication possession ratio (MPR) were calculated for each included Medispan-defined class of medications before analyzing …

Population Pharmacokinetic Modeling And Genetic Association Analysis In Infants With Neonatal Abstinence Syndrome Receiving Morphine Or Clonidine, Fei Tang

Theses and Dissertations--Pharmacy

Neonatal abstinence syndrome, or NAS, is a postnatal opioid withdrawal syndrome occurring in 55% to 94% of neonates as a result of in utero exposure to opioids. It has emerged as a significant public health issue, as its incidence more than quadrupled in the past decade. There is significant variability in disease severity and treatment outcomes in neonates with NAS due to patient-specific factors and treatment- or site-specific factors. To understand what contributes to variability in length of hospital stay and other outcomes in neonates with NAS, we assessed population pharmacokinetics (PK) of clonidine and morphine, and we investigated potential …

Extensively Drug-Resistant Pseudomonas Aeruginosa In Vitro Susceptibility And Mechanisms Of Resistance, Chanah Gallagher

Theses and Dissertations--Pharmacy

Pseudomonas aeruginosa causes severe healthcare-associated infections. Forty-eight extensively drug-resistant (XDR)-P. aeruginosa isolates were selected from 287 isolates collected for evaluation based on clinical susceptibility data. In vitro activity of commonly utilized antimicrobials (i.e. antipseudomonal beta-lactams, aminoglycosides, fluoroquinolones, and polymyxins) plus ceftolozane-tazobactam, ceftazidime-avibactam, and aztreonam-avibactam against XDR-P. aeruginosa were determined. The mechanism of resistance profile was determined through phenotypic expression analysis. Overall, polymyxin B and colistin were 100% susceptible. Apart from the polymyxins, ceftolozane-tazobactam had the highest susceptibility (94%) followed by ceftazidime-avibactam (90%) and amikacin (83%). Ceftolozane-tazobactam activity was not significantly different from ceftazidime-avibactam (p=0.6831). Only 40% of isolates …

Combination Of Investigational Cell-Based Therapy And Deep Brain Stimulation To Alter The Progression Of Parkinson’S Disease, Nader El Seblani

Theses and Dissertations--Pharmacy

Parkinson’s disease (PD) is the second most common neurodegenerative disorder and the motor symptoms are caused by progressive loss of midbrain dopamine neurons. There is no current treatment that can slow or reverse PD. Our current “DBS-Plus” clinical trial (NCT02369003) features the implantation in vivo of autologous Schwann cells (SCs) derived from a patient’s sural nerve into the substantia nigra pars compacta (SNpc) in combination with Deep Brain Stimulation (DBS) therapy for treating patients with advanced PD.

The central hypothesis of our research is that transdifferentiated SCs within conditioned nerve tissue will deliver pro-regenerative factors to enhance the survival of …

Correlating The Physicochemical Properties Of Magnesium Stearate With Tablet Dissolution And Lubrication, Julie L. Calahan

Theses and Dissertations--Pharmacy

Magnesium stearate (MgSt) is the most commonly used pharmaceutical excipient and is present in over half the tablet formulations on the market. In spite of its popularity as an effective lubricant, it has been repeatedly recognized that there is significant variability between MgSt samples, which can cause inconsistent lubrication between batches of MgSt. The hypothesis of this research is that the batch-to-batch variability in tablet lubrication and dissolution observed in tablet formulations containing different MgSt samples can be correlated with differences in MgSt physicochemical properties (fatty acid salt composition, crystal hydrate form, particle size and surface area). Developing correlations between …

Novel Small Molecule Antifungals For Invasive Fungal Infections, Emily Dennis

Theses and Dissertations--Pharmacy

Human fungal pathogens cause a range of diseases from benign skin conditions (i.e., ringworm) to thrush, mucosal membrane infections, and life-threatening systemic infections including bloodstream infections (i.e., aspergillosis and candidiasis) and Cryptococcal meningitis. These systemic infections occur most often in immunocompromised individuals and have high mortality rates. Current antifungal agents used in the clinic belong to three main classes: the polyenes (e.g., amphotericin B (AmB)), the echinocandins (e.g., caspofungin (CFG)), and the azoles (e.g., fluconazole (FLC)). In addition, the antimetabolite pyrimidine analogue flucytosine is used in combination with AmB. The …

Characterization And Engineering Of Interrupted Adenylation Domains, Taylor A. Lundy

Theses and Dissertations--Pharmacy

Nature has historically served as a prolific source of biologically active molecules produced by plants, fungi, and bacteria termed natural products (NPs). These NPs often serve as therapeutic leads due to their structural diversity and unique mechanisms of action. However, many need modifications to make them more effective or safer for human use. This can be a daunting and complicated task to do via traditional organic chemistry because of their complexity, copious stereocenters, and a multitude of reactive functional groups. For this reason, enzymatic modification of these NP during their biosynthesis is an appealing option. One major class of NPs …