Pharmacy and Pharmaceutical Sciences Commons^™

Plasmodium Para-Aminobenzoate Synthesis And Salvage Resolve Avoidance Of Folate Competition And Adaptation To Host Diet, Joachim Michael Matz, Mutsumi Watanabe, Mofolusho Falade, Takayuki Tohge, Rainer Hoefgen, Kai Matuschewski

Pharmaceutical Sciences Faculty Publications

Folate metabolism is essential for DNA synthesis and a validated drug target in fast-growing cell populations, including tumors and malaria parasites. Genome data suggest that Plasmodium has retained its capacity to generate folates de novo. However, the metabolic plasticity of folate uptake and biosynthesis by the malaria parasite remains unresolved. Here, we demonstrate that Plasmodium uses an aminodeoxychorismate synthase and an aminodeoxychorismate lyase to promote the biogenesis of the central folate precursor para-aminobenzoate (pABA) in the cytoplasm. We show that the parasite depends on de novo folate synthesis only when dietary intake of pABA by …

Choline Is An Intracellular Messenger Linking Extracellular Stimuli To Ip3-Evoked Ca2+ Signals Through Sigma-1 Receptors, Eugen Brailoiu, Sumita Chakraborty, G. Cristina Brailoiu, Pingwei Zhao, Jeffrey L. Barr, Marc A. Ilies, Ellen M. Unterwald, Mary E. Abood, Colin W. Taylor

College of Pharmacy Faculty Papers

Sigma-1 receptors (Sig-1Rs) are integral ER membrane proteins. They bind diverse ligands, including psychoactive drugs, and regulate many signaling proteins, including the inositol 1,4,5-trisphosphate receptors (IP₃Rs) that release Ca²⁺ from the ER. The endogenous ligands of Sig-1Rs are unknown. Phospholipase D (PLD) cleaves phosphatidylcholine to choline and phosphatidic acid (PA), with PA assumed to mediate all downstream signaling. We show that choline is also an intracellular messenger. Choline binds to Sig-1Rs, it mimics other Sig-1R agonists by potentiating Ca²⁺ signals evoked by IP₃Rs, and it is deactivated by metabolism. Receptors, by stimulating PLC and …

Comparison Of Treatment Regimens In Organophosphate And Carbamate Poisoning In A Tertiary Care Hospital-A Retrospective Analysis, Girish P. Thunga Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Introduction Organophosphate consumption is a most common form of poisoning in Asian countries such as India and Srilanka. These compounds being highly lipid soluble they can easily distribute in the tissues and can cross the blood brain barrier and result in various complications. There is an increased rate of morbidity and mortality associated with these compounds. Eventhough, ATR is the most widely used antidote, treatment with PAM and GPR are also noteworthy. However, there are no clear studies stating benefits of individual or combination of regimens with respect to the outcomes. This study is carried out to compare the efficacy …

Role Of N-Acetylcysteine In Management Of Rodenticide Poisoning: A Retrospective Analysis, Girish P. Thunga Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

INTRODUCTION: Rodenticide consumption is a very common form of poisoning, either accidental or intentional, and is mainly reported in the rural parts of India. Rodenticides generally comprise of Superwarfarins, Thallium, Barium Carbonate, Aluminium phosphide (AIP) and Zinc phosphide. They are quite inexpensive and highly toxic chemicals. Annually, around 50,000 cases are reported [1]. The agents present in rodenticides are hepatotoxic in nature and the outcome is often fatal. Therefore, it has always been a concern in major public health, especially in Asian countries. Absence of a definite antidote often results in high mortality rate among the patients. Recent studies suggest …

Dipeptidyl Peptidase-4 Inhibitors Induced Inflammatory Bowel Disease In Type 2 Diabetes Patients: A Case Control Study In A South-Indian Tertiary Care Hospital, Sonal M. Sekhar Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Over the past few years, the use of dipeptidyl peptidase-4 (DPP-4) inhibitors in management of type 2 diabetes have increased as second to third line treatment. A recent study reported that the use of DPP-4 inhibitors may be associated with an increased risk of Inflammatory bowel disease (IBD). However, a meta-analysis showed conflicting results. Objectives:  To find association between DPP-4 inhibitors use and development of IBD in type 2 diabetic patients.  To find association between duration of DPP-4 inhibitors and development of IBD in type 2 diabetic patients.  To find association between duration of type 2 …

A Study On Identifying And Resolving Problems Associated With Administration Of Drugs Via Nasogastric Tube, Sreedharan Nair Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Administration of drugs via the nasogastric tube (NGT) has become very common in ICU patients. Many drug formulations are administered in the crushed form through the tube and this procedure is increasingly done by the nurses. Although crushing of solid dosage forms permits the ease of administration, there are several dosage forms that should not be broken or crushed as it can result in various problems like decreased or increased bioavailability, drug interactions or interaction with the tube itself. Objectives: To assess the problems encountered when medications are being administered by nasogastric tube in a tertiary care hospital and …

Use Of Statins In Ischemic Stroke Patients With Carotid Artery Stenosis: A Prospective Cohort Study In A Tertiary Healthcare Facility, Sonal M. Sekhar Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Stroke is one of the leading causes of adult disability. Carotid artery stenosis (CAS) is a result of systemic atherosclerotic disease. Therefore, any risk factor predisposing a patient to progressive atherosclerosis can potentially manifest itself as stenosis of the carotid artery with resultant ischemic stroke and/or transient ischemic attack (TIA) like symptoms. An aggressive medical cardiovascular risk reduction approach, centered on the use of a statin when CAS is present, is the current standard of care. Therefore, the purpose of this study was to investigate the effect of statin use in ischemic stroke patients with and without CAS on …

Comparison Of Various Cardiovascular Risk Scores To Assess Cardiovascular Risk In People Living With Hiv On Haart In Kasturba Hospital Manipal, Rajesh Radhakrishnan Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Intoduction: The risk of cardiovascular diseases in people living with HIV is greater than in normal individuals Objectives: 1. To Assess the cardiovascular risks in people living with HIV with HAART using standard cardiovascular risk scores. 2. To compare the pattern of cardiovascular disease risk associated with HIV seropositive patients with HAART. Methodology: Patients diagnosed with HIV with HAART with one or other cardiovascular diseases will be enrolled. The data related to various cardiovascular diseases, the duration of cardiovascular disease with onset of HIV infection with HAART. The enrolled patients will be evaluated by using various validated cardiovascular risk scores …

Use Of Surfactants For The Treatment Of Neonatal Respiratory Distress Syndrome, Rajesh V Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Respiratory Distress Syndrome (RDS) is breathing disorder that affects the newborns especially preterm neonates, extremely low birth weight and very low birth weight neonates. This is due to lack of surfactant production in the lungs of a premature baby. Surfactant therapy and oxygen support improves the condition of the neonate with RDS. Use antenatal steroid prevents the occurrence of RDS/reduces the severity of RDS. This study is necessary to assess which surfactant is better, risk factors associated with RDS and comorbidities of neonates present along with RDS. Objectives: The objectives of the studies are to compare the surfactants used …

Retrospective Study To Evaluate Prescription Pattern And Cost Of Illness In Patients With Rheumatoid Arthritis In A Tertiary Care Hospital Setting, Rajesh V Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Rheumatoid Arthritis (RA) is a chronic disease associated with poor quality of life of patients, lifelong dependency on medications and long-term disease suffering which leads to both physical and financial disability in terms of cost. RA flare and complications lead to hospitalization and demand in-patient care and these costs impose a significant burden on the patients especially those from a poor socioeconomic background in a developing society like India where the country reserves only 1.4% of the income for healthcare. Objective: The objective of this study is to find the cost of illness associated with hospitalized patients suffering from …

Drug Utilization Review Of Anticancer Drugs With Otherdrugs In Breast Cancer Patients, Mahadev Rao Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: To study the prescribing pattern of chemotherapeutic drugs in Breast Cancer patients and to survey the prevalence of exigent drug-drug interactions (DDIs) between chemotherapeutic drugs and non-chemotherapeutic drugs and evaluate the risk factors associated with these drug-drug interactions in India. Methods: All discharged patients’ data in the Department of Oncology were collected from September 2019 to March 2020 with the help of Hospital Information System and inpatient file of the breast cancer patients collected from the Medical Records Department. Drugs were screened for interactions by Micromedex solutions database and Epocrates database. Descriptive statistics were generated and was used to …

Assessment Of Pattern, Risk Factors And Treatment Of Iron Deficiency And Megaloblastic Anemia In Adult And Pediatric Population In A Tertiary Care Hospital In South India, Leelavathi D. Acharya Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

IntroductionIron Deficiency Anemia (IDA) is a major nutritional problem globally which is especially true in developing countries like India. IDA is associated with worsened quality of life, impaired physical & cognitive performance. Even though treatment patterns are simple & effective, there is a high prevalence of IDA. The reason for this is partly due to non-compliance of the patients & partly due to ineffective/incomplete treatment by physicians.[4] Due to the risks associated with blood transfusions, alternative treatments of anemia in the critically ill are being explored.[5]ObjectivesTo assess the pattern, risk factors and treatment of IDA in adult and pediatric population …

The Study Of Prevalence Of Diabetes Mellitus And Its Complications In Hiv Patients In, Leelavathi D. Acharya Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background –Diabetes is a chronic, metabolic disorder that is characterized by resulting from defects in insulin secretion, insulin action or both which will affect the patient Quality of life. Pharmaceutical Care is the responsible provision of drug therapy for of achieving definite therapeutic outcomes that improve the patient‘s quality of life.It contributes to the resolution of medical conditions and can help avoid undesirable outcomes about patient‘s drug therapy problems, resulting in benefits to patients.Objectives –To study the impact of Pharmaceutical care in type 2 diabetic patients in a tertiarycare hospital.Methodology –A prospective interventional study was conducted for a period of …

Cardiovascular Safety Of Febuxostat And Allopurinol In Gout/Hyperuricemia Patients: A Retrospective Cohort Event Reporting In A Tertiary Healthcare Facility, Sonal M. Sekhar Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: On February 21st 2019, FDA added a boxed warning for increased risk of death with febuxostat compared to allopurinol. Purpose: To compare the incidence of cardiovascular events and efficacy between febuxostat and allopurinol use. Methods: A retrospective cohort study was conducted in hyperuricemic/gout patients admitted between 2013 to 2017. Study cohort (febuxostat/allopurinol/both) and control cohort (drugs other than febuxostat/allopurinol) were selected based on inclusion and exclusion criteria. The primary outcomes were various cardiovascular events which were compared and analysed using IBM SPSS version 20 and p<0.05 was considered statistically significant. Results: Mean reduction in level of serum urate after febuxostat and allopurinol use was 2.754 mg/dl [p=0.000; CI (95%) 2.209-3.299] and 1.137 mg/dl [p=0.000; CI (95%) 0.792-1.482], respectively. However, there was no statistically significant difference between the groups. The mean survival time for febuxostat was 37 months [CI (95%) 24-51], whereas for allopurinol was 107 months [CI (95%) 52-162] and for both users was 38 months [CI (95%) 20-56]. However, there was no significant difference among the groups (p=0.762). Cardiovascular events occurred in 4 (5.63%) patients in febuxostat group (n=71), 6 (6.45%) patients in allopurinol group (n=93) and 3 (30%) patients in group with both drugs (n=10). The number needed to harm (NNH) for febuxostat, allopurinol and with both drugs were 22, 19 and 3, respectively. Conclusion: Both febuxostat and allopurinol are significantly efficacious in reducing serum urate levels. Lesser mean survival time in febuxostat group indicates faster occurrence of cardiovascular events. On the other hand, incidence of cardiovascular events was more with allopurinol than febuxostat without statistical significance. We observed these cardiovascular adverse events of allopurinol and febuxostat are duration depended.

Development And Evaluation Of A Cancer Registry For Shirdi Sai Baba Cancer Hospital And Research Centre, Kanav Khera Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: There exists a National Cancer Registry Programme (NCRP) aimed at collecting cancer patient data at the hospital and population level. 33 population-based cancer registries (PBCRs) and 100+ hospital-based registries (HBCRs) are present. Continuous training of professionals and monitoring of data completeness are a requisite to ensure generation of reliable databases. Advances in information technology allow for proper planning and development in all active registries. However, due to lack of time and personnel, systematic filling in of data takes a back-seat in India. Objectives: To develop a cancer registry for Shirdi Sai Baba Cancer Hospital and Research Centre. Methods: After …

Assessing Risk Factors For Esophageal Cancer, Mahadev Rao Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Esophageal cancer (EC) stands the 6th most frequent cause of death due to cancer worldwide.It is mainly classified into mainly Esophageal squamous cell carcinoma (ESCC) and Esophageal adenocarcinoma (EAC). The incidence extends from Eastern to Central Asia. Although there are advances in the management and treatment of EC patients, the generaloutcome is very poor. It is mainly because of the diagnosis during its advanced stages and due to the absence of early clinical symptoms. Therefore, it is an important health challenge .A clear picture regarding the risk factors and other patient demographics may help to improve the management of …

Providers’ Perception Of Alert Fatigue After Implementation Of User-Filtered Warnings, Hina Afaq, Sahaana Mukundan, Sadaf Zia, Alisa K. Escano Dr., Rebecca Lear Dr., Casey Washington Dr.

Pharmacotherapy and Outcomes Science Publications

Alert fatigue is a complex problem that many health institutions face when using an electronic health record (EHR). The addition of user-filtered warnings (UFW) is a physicians’ proposed intervention at Inova Health System (IHS), a large 5-hospital health system in Northern Virginia, that allows prescribers to filter out specific drug-drug interactions and pregnancy and lactation medication alerts for a 30-day period. This study aims to determine the impact of UFW on physicians’ perception of alert fatigue and to calculate the reduction of medication alerts. It was hypothesized that the reduction in alerts will significantly impact physicians’ perception of alert fatigue …

Assessing The Use Of Pre-Treatment Medications In The Management Of Infusion-Related Reactions In An Outpatient Infusion Center, Alyssa Boesche, Alyssa Augst, Bill Kuhlman

Pharmacy Posters

Introduction

• Infusion-related reactions (IRRs) are well-known adverse drug reactions of many biological agents and antineoplastic medications
• While typically mild-to-moderate in intensity, IRRs can be severe, with potentially life-threatening consequences requiring urgent interventions
• Appropriate use of pre-treatment medications, such as corticosteroids, antihistamines, intravenous fluids, and antiemetics reduces the incidence and severity of IRRs

Purpose

• Evaluate the use of pre-treatment medications in patients with experienced IRRs at an outpatient infusion center
• Identify opportunities to improve treatment plans and reduce the occurrence of IRRs

Evaluating The Effect Of Sodium Zirconium Cyclosilicate In Acute Hyperkalemia Management, Austin Brandes, Hannah Thompson, Paul Huiras

Pharmacy Posters

Introduction

• Sodium zirconium cyclosilicate (ZS-9) can acutely decrease serum potassium (K) levels after one dose and may have favorable side effects compared to sodium polystyrene sulfate (SPS).
• ZS-9 replaced oral SPS in the Hyperkalemia Order Set at St. Cloud Hospital in April 2019

Purpose

• To characterize the acute potassium-lowering effects of one 10-gram dose of sodium zirconium cyclosilicate in conjunction with other potassium-lowering medications

A Bird's-Eye View Of The Multiple Biochemical Mechanisms That Propel Pathology Of Alzheimer's Disease: Recent Advances And Mechanistic Perspectives On How To Halt The Disease Progression Targeting Multiple Pathways., Caleb Vegh, Kyle Stokes, Dennis Ma, Darcy Wear, Jerome Cohen, Sidhartha D. Ray, Siyaram Pandey

Touro College of Pharmacy (New York) Publications and Research

Neurons consume the highest amount of oxygen, depend on oxidative metabolism for energy, and survive for the lifetime of an individual. Therefore, neurons are vulnerable to death caused by oxidative-stress, accumulation of damaged and dysfunctional proteins and organelles. There is an exponential increase in the number of patients diagnosed with neurodegenerative diseases such as Alzheimer’s (AD) as the number of elderly increases exponentially. Development of AD pathology is a complex phenomenon characterized by neuronal death, accumulation of extracellular amyloid-β plaques and neurofibrillary tangles, and most importantly loss of memory and cognition. These pathologies are most likely caused by mechanisms including …