Pharmacy and Pharmaceutical Sciences Commons^™

Are Elevated Vancomycin Serum Trough Concentrations Achieved Within The First 7 Days Of Therapy Associated With Acute Kidney Injury In Children?, Chad A. Knoderer, Kristen R. Nichols, Kelsey C. Lyon, Megan M. Veverka, Amy C. Wilson

Scholarship and Professional Work – COPHS

Background In 2008, the empiric vancomycin dosing recommendation in children at our institution was changed from 40 to 60 mg/kg per day. Subsequently, an increased incidence of acute kidney injury (AKI) in patients receiving vancomycin was suspected. The objective of this study was to evaluate AKI in children receiving vancomycin and to determine risk factors for AKI development.

Methods Medical records of patients aged 30 days through 17 years who received vancomycin for at least 72 hours between January and December 2007 (40 mg/kg per day) and January and December 2010 (60 mg/kg per day) were reviewed. Patients with cystic …

Correlation Of Treatment Dose Enoxaparin With Anti-Xa Concentrations In Adult Hemodialysis Inpatients, Paul E. Brumley, Miroslav A. Anguelov, Jason P. Hecht, Dane L. Shiltz

Scholarship and Professional Work – COPHS

Enoxaparin, a low-molecular-weight-heparin, is being used in hemodialysis patients despite a lack of guideline or manufacturer dose recommendations. Due to enoxaparin’s renal excretion, the possibility of accumulating anti-Xa concentrations in hemodialysis patients using enoxaparin creates a hemorrhagic risk, calling for more research. The objectives of this study are to determine the correlation between treatment dose enoxaparin use and anti-Xa concentrations within the defined therapeutic range in patients receiving chronic, scheduled hemodialysis to determine the degree of change in anti-Xa concentrations in those cases where a concentration was obtained before and after a specific hemodialysis session, and to determine if there …

A Retrospective Comparison Of Daptomycin Thrice-Weekly Versus Q48h Dosing In Hemodialysis Patients With Vancomycin-Resistant Enterococcus (Vre) Or Methicillin-Resistant Staphylococcus Aureus (Mrsa) Bacteremia, Katie L. Axford, Dane L. Shiltz

Scholarship and Professional Work – COPHS

Background. Multi-drug resistant bacteria are a growing concern in healthcare. Daptomycin is being used with increasing frequency in the treatment of vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) bacteremias in hemodialysis (HD) patients. Thrice-weekly dosing of daptomycin in this population would allow for coordination of dosing with common outpatient HD schedules. The aim of this study is to determine if thrice-weekly dosing of daptomycin is equivalent to dosing every 48 hours in patients receiving chronic intermittent hemodialysis. Equivalence will be assessed with regard to microbiological cure, clinical cure, hospital length of stay, and mortality. Methods. All patients with positive …

Cinacalcet Administration By Gastrostomy Tube In A Child Receiving Peritoneal Dialysis, Kristen R. Nichols, Chad A. Knoderer, Bethanne Johnston, Amy C. Wilson

Scholarship and Professional Work – COPHS

A 2-year-old male with chronic kidney disease with secondary hyperparathyroidism developed hypercalcemia while receiving calcitriol, without achieving a serum parathyroid hormone concentration within the goal range. Cinacalcet 15 mg (1.2 mg/kg), crushed and administered via gastrostomy tube, was added to the patient’s therapy. This therapy was effective in achieving targeted laboratory parameters in our patient despite instructions in the prescribing information that cinacalcet should always be taken whole.

Association Between Applications Scores And Positive Onsite Interviews Of Pharmacy Residency Applicants, Sarah Nisly, Meredith L. Howard, Alex N. Issacs, Tate Trujillo

Scholarship and Professional Work – COPHS

Application to pharmacy residency programs has become increasingly competitive over the past several years. Although successful candidates must excel in the various stages of the application process, preparing written applications and securing onsite interviews are early and arguably the most difficult steps. Residency programs vary in the criteria used for offering onsite interviews. The majority of insight into this topic comes from surveys of residency program directors, but corresponding analyses of interview offers have been minimal...

Optimized Antimicrobial Dosing Strategies: A Survey Of Pediatric Hospitals, Chad A. Knoderer, Kristen R. Nichols, Elaine G. Cox

Scholarship and Professional Work – COPHS

Background

Extended-interval aminoglycoside (EIAG) and extended- and continuous-infusion β-lactam (EIBL and CIBL) dosing strategies are increasingly used in adults, but pediatric literature is limited.

Objective

The objective of this study was to describe the use of EIAG, EIBL, and CIBL dosing in pediatric hospitals in the USA.

Study Design, Setting, and Participants

A national survey of children’s hospitals was conducted. A single practitioner from each target hospital was identified through the Children’s Hospital Association. Practice-based survey questions identified whether hospitals utilize EIAG, EIBL, and CIBL dosing.

Main Outcome Measure

The main outcome measure was the percentage utilization of the dosing …

Ceftriaxone Potentiates Warfarin Activity Greater Than Other Antibiotics In The Treatment Of Urinary Tract Infections, Lindsay M. Saum, Ryan P. Balmat

Scholarship and Professional Work – COPHS

Background: The cephalosporin class has been associated with an increased risk of bleeding among elderly patients receiving warfarin. Urinary tract infections (UTI) are the most prevalent infection in elderly patients.

Objective: To determine the extent of interaction between antibiotics used in the treatment of UTI, particularly specific cephalosporins and warfarin.

Methods: A retrospective chart review was conducted on chronic warfarin patients with a diagnosis of UTI treated with ceftriaxone, a first-generation cephalosporin, penicillin, or ciprofloxacin. The primary outcome was the comparison of the extent of international normalized ratio (INR) change from baseline between each antibiotic group.

Results: The ceftriaxone group …

Promoting Interprofessional Education Through A Student Led Community Health Screening Event, Carrie Maffeo, Eileen Carroll, Alexandra Foster, Kelly Daneri, Isabel Hagedorn, Mary Graham, Jane Gervasio

Scholarship and Professional Work – COPHS

Published abstract from the 115th Annual Meeting of the American Association of Colleges of Pharmacy, Grapevine, TX, July 26-30.

A.S.P.E.N. Parenteral Nutrition Safety Consensus Recommendations: Translation Into Practice, Phil Ayers, Stephen Adams, Joseph Boullata, Jane Gervasio, Beverly Holcomb, Michael D. Kraft, Neil Marshall, Antoinette Neal, Gordon Sacks, David S. Seres, Patricia Worthington, Peggi Guenter

Scholarship and Professional Work – COPHS

Parenteral nutrition (PN) serves as an important therapeutic modality that is used in adults, children, and infants for a variety of indications. The appropriate use of this complex therapy aims to maximize clinical benefit while minimizing the potential risk for adverse events. Despite being classified and acknowledged as a high-alert medication,¹ only 58% of organizations have precautions in place to prevent errors and patient harm associated with PN.² Complications can occur as a result of the therapy and as the result of the PN process. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Parenteral Nutrition Safety Consensus …

Drug-Drug Interaction Between Methotrexate And Levetiracetam Resulting In Delayed Methotrexate Elimination, Emily Bain, Ruemu E. Birhiray, David J. Reeves

Scholarship and Professional Work – COPHS

Objective: To report a case of delayed methotrexate (MTX) elimination while receiving concomitant levetiracetam. Case Report: A 46-year-old man with relapsed osteosarcoma of the base of the skull receiving high-dose MTX tolerated his first cycle of MTX with elimination to nontoxic MTX levels (≤0.1 µmol/L) within 90 hours. After hospital discharge, the patient experienced seizures secondary to brain metastasis and started on levetiracetam, which was continued as maintenance therapy. The patient experienced delayed MTX elimination during cycles 2, 3, and 4 while receiving levetiracetam. On average, elimination to nontoxic MTX levels took 130 hours (106-144 hours). Before the fifth cycle …

Correlation Of Adherence To The 2012 Infectious Diseases Society Of America Practice Guidelines With Patient Outcomes In The Treatment Of Diabetic Foot Infections In An Outpatient Parenteral Antimicrobial Programme, L. M. Pence, C. M. Mock, M. B. Kays, Kendra M. Damer, E. W. Muloma, S. M. Erdman

Scholarship and Professional Work – COPHS

Aim

To evaluate adherence to the 2012 Infectious Diseases Society of America practice guidelines for the management of patients with diabetic foot infections and to determine an association between adherence and clinical outcome.

Methods

A retrospective chart review was performed to evaluate the management and clinical outcomes of patients with diabetic foot infections treated with outpatient parenteral antimicrobial therapy between 1 January 2011 and 30 June 2012 at Wishard Health Services/Eskenazi Health. Adherence to individual Infectious Diseases Society of America diabetic foot infection treatment guideline recommendations was measured, and then assessed in relation to clinical outcome.

Results

A total of …

Waveguide Evanescent Field Scattering Microscopy: Bacterial Biofilms And Their Sterilization Response Via Uv Irradiation, Qamrun Nahar, Frederik Fleiβner, Jeremiah Shuster, Michael Morawitz, Christopher Halfpap, Mihaela Stefan, Uwe Langbein, Gordon Southam, Silvia Mittler

Physiology and Pharmacology Publications

Waveguide Evanescent Field Scattering (WEFS) microscopy is introduced as a new and simple tool for label-free, high contrast imaging of bacteria and bacteria sensors. Bacterial microcolonies and single bacteria were discriminated both by their bright field images and by their evanescent scattering intensity. By comparing bright field images with WEFS images, the proportion of planktonic: sessile (i.e., ‘floating’: attached) bacteria were measured. Bacteria were irradiated with UV light, which limited their biofilm forming capability. A quantitative decrease in attachment of individual, sessile bacteria and in attached, microcolony occupied areas was easily determined within the apparent biofilms with increasing UV dose. …

Distribution Of Non-At1, Non-At2 Binding Of 125i-Sarcosine1, Isoleucine8 Angiotensin Ii In Neurolysin Knockout Mouse Brains, Robert C. Speth, Eduardo J. Carrera, Catalina Bretón, Andrea Linares, Luz Gonzalez-Reiley, Jamala D. Swindle, Kira L. Santos, Ines Schadock, Michael Bader, Vardan T. Karamyan

HPD Articles

The recent identification of a novel binding site for angiotensin (Ang) II as the peptidase neurolysin (E.C. 3.4.24.16) has implications for the renin-angiotensin system (RAS). This report describes the distribution of specific binding of 125I-Sarcosine1, Isoleucine8 Ang II (125I-SI Ang II) in neurolysin knockout mouse brains compared to wild-type mouse brains using quantitative receptor autoradiography. In the presence of p-chloromercuribenzoic acid (PCMB), which unmasks the novel binding site, widespread distribution of specific (3 µM Ang II displaceable) 125I-SI Ang II binding in 32 mouse brain regions was observed. Highest levels of binding >700 fmol/g initial wet weight were seen in …

Electrostatic Charge Effects On Pharmaceutical Aerosol Deposition In Human Nasal-Laryngeal Airways, Jinxiang Xi, Xiuhua Si, Worth Longest

University Faculty Publications and Creative Works

Electrostatic charging occurs in most aerosol generation processes and can significantly influence subsequent particle deposition rates and patterns in the respiratory tract through the image and space forces. The behavior of inhaled aerosols with charge is expected to be most affected in the upper airways, where particles come in close proximity to the narrow turbinate surface, and before charge dissipation occurs as a result of high humidity. The objective of this study was to quantitatively evaluate the deposition of charged aerosols in an MRI-based nasal-laryngeal airway model. Particle sizes of 5 nm-30 μm and charge levels ranging from neutralized to …

Female Rats Are More Susceptible To Central Nervous System Oxygen Toxicity Than Male Rats, Heather E. Held, Raffaele Pilla, Geoffrey E. Ciarlone, Carol S. Landon, Jay B. Dean

Molecular Pharmacology & Physiology Faculty Publications

Tonic–clonic seizures typify central nervous system oxygen toxicity (CNS-OT) in humans and animals exposed to high levels of oxygen, as are encountered during scuba diving. We previously demonstrated that high doses of pseudoephedrine (PSE) decrease the latency to seizure (LS) for CNS-OT in young male rats. This study investigated whether female rats respond similarly to PSE and hyperbaric oxygen (HBO). We implanted 60 virgin stock (VS) and 54 former breeder (FB) female rats with radio-telemetry devices that measured brain electrical activity. One week later, rats were gavaged with saline or PSE in saline (40, 80, 120, 160, or 320 mg/kg) …

Facile, Regio-And Diastereoselective Synthesis Of Spiro-Pyrrolidine And Pyrrolizine Derivatives And Evaluation Of Their Antiproliferative Activities, Abdulrahman I. Almansour, Raju Suresh Kumar, Farzana Beevi, Amir Nasrolahi Shirazi, Hasnah Osman, Rusli Ismail, Tan Soo Chen, Brian Sullivan, Kellen Mccaffrey, Alaa Nahhas, Keykavous Parang, Mohamed Ashraf Ali

Pharmacy Faculty Articles and Research

A number of novel spiro-pyrrolidines/pyrrolizines derivatives were synthesized through [3+2]-cycloaddition of azomethine ylides with 3,5-bis[(E)-arylmethylidene] tetrahydro-4(1H)-pyridinones 2a-n. Azomethine ylides were generated in situ from the reaction of 1H-indole-2,3-dione (isatin, 3) with N-methylglycine (sarcosine), phenylglycine, or proline. All compounds (50 M) were evaluated for their antiproliferative activity against human breast carcinoma (MDA-MB-231), leukemia lymphoblastic (CCRF-CEM), and ovarian carcinoma (SK-OV-3) cells. N-alpha-Phenyl substituted spiro-pyrrolidine derivatives (5a-n) showed higher antiproliferative activity in MDA-MB-231 than other cancer cell lines. Among spiro-pyrrolizines 6a-n, a number of derivatives including 6a-c and 6i-m showed a comparable activity with doxorubicin in all three cell lines. Among all compounds …

Bipolar Disorder: A Pharmacotherapy Management Overview, Huong Le, Tina Pham, Laura Tsu

Pharmacy Faculty Articles and Research

This home-study CPE activity has been developed to educate pharmacists on bipolar disorder and its management using non-pharmacologic and pharmacologic therapies.

Non-Raft Ac2 Defines A Camp Signaling Compartment That Selectively Regulates Il-6 Expression In Airway Smooth Muscle Cells, Amy S. Bogard, Anna V. Birg, Rennolds S. Ostrom

Pharmacy Faculty Articles and Research

Adenylyl cyclase (AC) isoforms differ in their tissue distribution, cellular localization, regulation, and protein interactions. Most cell types express multiple AC isoforms. We hypothesized that cAMP produced by different AC isoforms regulates unique cellular responses in human bronchial smooth muscle cells (BSMC). Overexpression of AC2, AC3, or AC6 had distinct effects on forskolin (Fsk)-induced expression of a number of known cAMP-responsive genes. These data show that different AC isoforms can differentially regulate gene expression. Most notable, overexpression and activation of AC2 enhanced interleukin 6 (IL-6) expression, but overexpression of AC3 or AC6 had no effect. IL-6 production by BSMC was …

A Service Learning Experience For Pharmacy Students Involving Unwanted Medication Collection, Patricia L. Darbishire

IMPACT Symposium

This poster outlining a serve learning experience of students in Purdue’s pharmacy program was presented at the IMPACT Symposium 2014.

An Analysis Of The Cause, Effect & Control Of Hyperlipidemia From A Nursing Perspective, Melissa Rodgers

Theses and Dissertations

Two of the top four causes of death worldwide, heart disease and stroke, are related to hyperlipidemia, elevated cholesterol levels; these two illnesses account for approximately seventeen million deaths each year (World Health Organization, 2014). In order to combat the prevalence of these illnesses, the National Cholesterol Educational Panel has issued guidelines regarding cholesterol management. Extensive research has been published concerning cholesterol management. However, a gap remains between evidenced-based practice and community awareness of this phenomenon. This manuscript compiles research from peer reviewed nursing journals and acclaimed government and national organizations to express the cause, effect, and control of hyperlipidemia …