Phenoconversion: Drug-Drug-Gene Interactions,
2019
Ohio Northern University
Phenoconversion: Drug-Drug-Gene Interactions, Molly Kulp, Emily Limberg, Brooke Marlowe, Taylor Roberson, David F. Kisor
Pharmacy and Wellness Review
Based on the extensive, poor, intermediate and ultrarapid phenotypes of patients, inferences may be made relative to drug metabolism, ultimately leading to changes in therapeutic drug choice or dosing. Phenoconversion is a phenomenon that occurs when an individual's drug metabolizing capacity is altered due to the combination of a drug-drug interaction and a drug-gene interaction. Phenoconversion can affect pharmacokinetics as well as pharmacodynamics. Some examples of phenoconversions include amiodarone-warfarin, duloxetine-codeine, rifampin-clopidogrel, and rifampinwarfarin. Pharmacists must consider phenoconversion in cases of multi-drug therapy.
A Review Of The Guidelines And Treatment Options For Major Depressive Disorder In Adolescents,
2019
Ohio Northern University
A Review Of The Guidelines And Treatment Options For Major Depressive Disorder In Adolescents, Stacy Henthorne, Joy Hoffman, Albert Bui, Sarah Kradel, Suzanne M. Lifer, Mary Ellen Hethcox
Pharmacy and Wellness Review
Major depressive disorder (MOD) is a disease often underdiagnosed in adolescents. For adolescents in particular, MOD can have far-reaching implications on developmental, social and emotional functioning. Unfortunately, few guidelines detail consistent means by which to evaluate and treat these patients; significantly more information exists that solely pertains to the adult population. Governing bodies such as the American Academy of Child and Adolescent Psychiatry (AACAP) and Resource for Advancing Children's Health (REACH) recommend that primary care physicians be diligent in their psychiatric analyses and follow-ups with young patients who may be experiencing MOD. Both psychotherapy and medications, either as monotherapy or …
The Safety Of Artificial Sweeteners And Their Use In Pharmaceuticals,
2019
Ohio Northern University
The Safety Of Artificial Sweeteners And Their Use In Pharmaceuticals, Kaila Bollinger, Maureen Moynihan, Adam Smith, Alison Steinbrunner, Karen Kier
Pharmacy and Wellness Review
Artificial sweeteners are sugar substitutes that add sweetness to foods and beverages without the extra calories found in sugar. These additives are used to help patients with diabetes avoid hyperglycemia and assist people in losing weight or avoiding weight gain by providing a replacement to higher calorie sugar-sweetened foods. Artificial sweeteners can be found in many sugar-free beverages, candies and gum, as well as pharmaceutical products. Although artificial sweeteners are often recommended over the sugar-sweetened alternatives in weight loss and diabetes prevention, the use of such products are not without risk. Studies have been conducted to assess artificial sweeteners involvement …
Overview Of Kalydeco® (Ivacaftor) For Treatment Of Cystic Fibrosis,
2019
Ohio Northern University
Overview Of Kalydeco® (Ivacaftor) For Treatment Of Cystic Fibrosis, Andrew Skouby, Kayti Kintner, Kimberly Loughlin, Emily Blum, Michael Rush
Pharmacy and Wellness Review
Cystic fibrosis (CF) is a genetic disease associated with specific gene mutations that presents with pulmonary inflammation and frequent lung infections, exocrine pancreatic insufficiency, altered sweat composition and declining lung function. Ivacaftor (Kalydeco®) was approved for treatment of cystic fibrosis in patients 6 years of age and older with a G551D mutation on the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Ivacaftor is a CFTR potentiator and does not work in patients with a mutation of the F508del. Efficacy has been demonstrated in several trials with a primary outcome of improved FEV1, improvements in pulmonary exacerbations, patient-reported decrease in respiratory …
Emergency Contraception: A Comparison Of Levonorgestrel And Ulipristal Acetate,
2019
Ohio Northern University
Emergency Contraception: A Comparison Of Levonorgestrel And Ulipristal Acetate, Tara Tokar, Rachel Muhlenkamp, Kelsey Lindsley, Alison Steinbrunner, Michelle Musser
Pharmacy and Wellness Review
Emergency contraceptives (EC) are a birth control method that is available to minimize unintended pregnancies that might result from unprotected intercourse. Several products are on the market and largely contain levonorgestrel as the active component, including Plan B One-Step®, Next Choice®, Next Choice One Dose™ and My Way®. These are labeled as effective up to 72 hours after intercourse and are available without a prescription. Another product, Ella™, contains ulipristal acetate and can be effective up to 120 hours after intercourse, but does require a prescription. Legislative issues have surrounded these products. At this point in time only Plan B …
Celiac Disease: Current And Investigational Therapies And The Role Of The Pharmacist,
2019
Ohio Northern University
Celiac Disease: Current And Investigational Therapies And The Role Of The Pharmacist, Sarah Turley, Gabriella Gegenheimer, Emily Blum, Erin Petersen
Pharmacy and Wellness Review
Celiac disease is a genetically-linked autoimmune disease which affects the gastrointestinal tract. It is an inflammatory reaction to ingested gluten-containing substances that produces the most frequent symptoms of abdominal pain, bloating and intermittent or chronic diarrhea. Diagnosis can be made by blood testing for specific IgA autoantibodies and a confirmation duodenal biopsy to look for the characteristic scalloping and villous atrophy that occurs in response to the inflammation. A gluten-free diet, until recently, was the only treatment available and continues to be the mainstay of treatment. Newer adjunct therapies to dietary management include larazotide acetate, peptidases, the use of parasite …
A Comparison Of Mipomersen (Kynamro®) And Lomitapide (Juxtapid®): Medications For The Treatment Of Homozygous Familial Hypercholesterolemia,
2019
Ohio Northern University
A Comparison Of Mipomersen (Kynamro®) And Lomitapide (Juxtapid®): Medications For The Treatment Of Homozygous Familial Hypercholesterolemia, Ann Marie Ruhe, Austin Brown, Ginny Daniels, Kelsey Fink, David Bright
Pharmacy and Wellness Review
Homozygous familial hypercholesterolemia (HoFH) is a rare disease that involves mutations in the genes coding for low density lipoprotein (LDL) receptors, preventing the uptake of LDL cholesterol from the serum and resulting in extremely high cholesterol levels.1 Between December 2012, and January 2013, two orphan drugs were approved by the U.S. Food and Drug Administration (FDA) for the treatment of HoFH. Mipomersen (Kynamro®) is a subcutaneous injection that functions as an antisense oligonucleotide inhibitor and ultimately prevents the translation of mRNA coding for apolipoprotein B (apoB)-100 which binds to LDL and very low density lipoprotein (vLDL) cholesterol.7 Lomitapide (Juxtapid®) is …
Signifor® Receives Fda Approvalfor The Management Of Cushing's Disease,
2019
Ohio Northern University
Signifor® Receives Fda Approvalfor The Management Of Cushing's Disease, Justin Steele, Ann Marie Ruhe, Andrew Skouby, Eric Stack, Sandra L. Hrometz
Pharmacy and Wellness Review
Cushing's disease is a disorder characterized by supraphysiologic levels of circulating cortisol due to excessive adrenocorticotropic hormone (ACTH) secretion. Most often hypersecretion of ACTH is due to a pituitary adenoma, where surgical resection of the tumor is considered first-line treatment for the disease. Alternatively, the FDA has recently approved the somatostatin analogue, Signifor® (pasireotide), for the management of Cushing's disease in patients for whom surgery is not an option. In clinical trials, pasireotide has shown a statistically significant reduction in urinary free cortisol levels, as well as significant improvements in quality of life. Based on current data, pasireotide appears to …
Ado-Trastuzumab Emtansine For Her2 Positive Breast Cancer,
2019
Ohio Northern University
Ado-Trastuzumab Emtansine For Her2 Positive Breast Cancer, Kimberly Baucher, Taylor Beale, Maria Laikos, Eric Stack, Mary Ellen Hethcox
Pharmacy and Wellness Review
No abstract provided.
Novel Oral Anticoagulants: A Comparative Study Of The Clinical Potential For Dabigatran, Rivaroxaban, And Apixaban Versus Warfarin,
2019
Ohio Northern University
Novel Oral Anticoagulants: A Comparative Study Of The Clinical Potential For Dabigatran, Rivaroxaban, And Apixaban Versus Warfarin, Lindsay Mark, Joanne Tran, Zachary Jones, Jessica Beck, David Bright
Pharmacy and Wellness Review
Although Coumadin® (warfarin) has been the standard outpatient anticoagulant for long-term prevention of thrombosis for many decades, it presents with significant challenges for both patients and health care providers in optimizing standards of care including dietary and drug restrictions, regular monitoring of the patient's International Normalized Ratio (INR), and difficulty maintaining therapeutic levels. Despite its unmistakable effectiveness, there has been an interest from the medical community in developing potential alternative drug therapies. As a result, within the past three years the U.S. Food and Drug Administration (FDA) has approved the use of three new oral anticoagulant drugs (dabigatran, rivaroxaban, and …
Antidepressant Therapy: A Review Of Current Treatment Options And A Glance At The Future,
2019
Ohio Northern University
Antidepressant Therapy: A Review Of Current Treatment Options And A Glance At The Future, Brittany Dye, Stacy Henthorne, Molly Kulp, Tristan Maiers, Zachary Crawford, Erin Petersen
Pharmacy and Wellness Review
Depression and anxiety disorders are two of the most common mental illnesses experienced by people within the United States, affecting 6.7 percent of the adult population per year. This article will focus on one specific type of depression, major depressive disorder (MDD), characterized by two or more weeks of depressed mood and/or decreased interest in normally enjoyed activities. Depression complicates treatment of other disease state(s), making successful treatment of depression essential in the management of a patient's overall health. This review will evaluate the pathophysiology, antidepressant treatment, and new approaches to treatment, specifically vortioxetine, for MDD.
Fda Approves New Tuberculosis Drug: Bedaquiline (Sirturo®),
2019
Ohio Northern University
Fda Approves New Tuberculosis Drug: Bedaquiline (Sirturo®), Megan Ruffner, Kent Wilin, Charles Hay, Zachary Crawford, Andrew Roecker
Pharmacy and Wellness Review
Tuberculosis (TB), caused by the acid-fast bacilli (AFB) Mycobacterium tuberculosis, is an infectious disease that continues to greatly impact morbidity and mortality worldwide; in 2011 it caused 1.4 million deaths. Some strains of the bacteria have become resistant to current treatment regimens, resulting in multidrug-resistant (MOR) and extensively drugresistant (XOR) TB. The emergence of these resistant strains of bacteria calls for new treatment regimens that can quickly and effectively eradicate the organism. The U.S. Food and Drug Administration (FDA) recently approved Sirturo® (bedaquiline) with the indication of MDR pulmonary TB. Bedaquiline introduces a novel mechanism of action via the inhibition …
Truvada® Recommended By Fda Committee For Pre-Exposure Prophylaxis In High-Risk Hiv-Negative Individuals,
2019
Ohio Northern University
Truvada® Recommended By Fda Committee For Pre-Exposure Prophylaxis In High-Risk Hiv-Negative Individuals, Justin Steele, Emily Blum, Alison Steinbrunner, Lara Long, Andrew M. Roecker
Pharmacy and Wellness Review
Once-daily combination tenofofovir disoproxil fumarate (TDF) and emtricitabine (FTC) has received Food and Drug Administration (FDA) approval for use in pre-exposure prophylaxis (PrEP) against Human Immunodeficiency Virus (HIV) infection in high-risk individuals. In clinical trials, FTC/TDF has been shown to reduce the risk of HIV acquisition by 62 percent in sexually active heterosexual men and women. Similarly, use of FTC/TDF demonstrated a 44 percent reduction in HIV infection within the men who have sex with men population.7 When used compliantly and in conjunction with safe sex practices, it appears that FTC/TDF can play an important role in reducing the …
Comparing The Glp-1 Receptor Agonists: Byetta®, Victoza® And Once-Weekly Bydureon™,
2019
Ohio Northern University
Comparing The Glp-1 Receptor Agonists: Byetta®, Victoza® And Once-Weekly Bydureon™, Todd A. Tucker Jr., Sarah Turley, Kaila Bollinger, Jessica Beck, Sandra L. Hrometz
Pharmacy and Wellness Review
Type 2 diabetes mellitus (T2DM) has traditionally been managed with oral medications. However, in the last few years, subcutaneous glucagon-like peptide-1 (GLP-1) receptor agonists have risen to fame. These agents serve as a reliable addition to current monotherapy. GLP-1 receptor agonists offer a significant reduction in hemoglobin AlC (HbAlc), fasting plasma glucose, and have the added benefit of weight loss. They work primarily by enhancing glucose-dependent insulin secretion while inhibiting glucagon secretion. The available GLP-1 agonists are Byetta® (exenatide), Victoza® (liraglutide), and Bydureon™ (exenatide extended-release). Studies suggest that they are similar in safety and efficacy, with the longer acting GLP-1 …
Sildenafil As An Appropriate Monotherapy Option In The Treatment Of Pulmonary Arterial Hypertension (Pah),
2019
Ohio Northern University
Sildenafil As An Appropriate Monotherapy Option In The Treatment Of Pulmonary Arterial Hypertension (Pah), Kaitlin Horton, Kent Wilin, Sarah Ginty, Lara Long, David Bright
Pharmacy and Wellness Review
Pulmonary arterial hypertension (PAH) is a debilitating disease characterized by constriction in the diameter of the pulmonary arterial lumen.1,2 This leads to increased pressure and stress on the right ventricle of the heart, which may lead to heart failure and death.2,3 Currently there are only a few treatment options for patients with PAH. Sildenafil, a phosphodiesterase type 5 (PDE-5) inhibitor, can be used to treat PAH. Sildenafil inhibits the degradation of cyclic guanosine monophosphate (cGMP). Increased cGMP concentration results in pulmonary vasculature relaxation. Current clinical trials have indicated that sildenafil can significantly improve many of the symptoms of PAH. The …
Overview Of Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis,
2019
Ohio Northern University
Overview Of Stevens-Johnson Syndrome And Toxic Epidermal Necrolysis, Christina Spinaris, Sarah Kradel, Tara Tokar, Zachary Crawford, Michael M. Milks
Pharmacy and Wellness Review
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immunologic reactions that typically present due to drug hypersensitivity. These reactions present with serious mucocutaneous manifestations that can lead to significant morbidity and mortality. The pathogeneses of SJS and TEN have yet to be clearly elucidated, but three potential immunologic mechanisms have been defined in literature: granulysin, Fas-FasL, and perforin and granzyme B. Medications have been immunologically linked as the primary causative agents of SJS/TEN. Corticosteroids, intravenous immunoglobulin administration (IVIG) and cyclosporine have been employed as treatments; however, none have resulted in consistent positive outcomes. Pharmacists have a significant role in …
The Impact Of Pharmacogenomics On Chemotherapeutic Drug Development And Use,
2019
Ohio Northern University
The Impact Of Pharmacogenomics On Chemotherapeutic Drug Development And Use, Lara Long, Amy Pasternak, Ellen Hazelet, David Kisor
Pharmacy and Wellness Review
Cancer therapy is largely dependent on general treatment guidelines, and patients undergoing chemotherapy often experience treatment failure with standard drugs. The development of individualized drug therapy through pharmacogenomics has the potential to enhance chemotherapy regimen selection and improve patient outcomes. Antineoplastic agents such as cetuximab and trastuzumab are effective in treating cancers possessing specific genetic biomarker characteristics. Patients need to undergo genetic testing before these agents are administered to ensure appropriate use. Cetuximab has been shown to improve outcomes in metastatic colorectal cancers and head and neck squamous cell carcinomas positive for EGFR. Trastuzumab has shown benefit in human epidermal …
Improving Maternal And Fetal Health: A Look At Thyroid Function During Pregnancy,
2019
Ohio Northern University
Improving Maternal And Fetal Health: A Look At Thyroid Function During Pregnancy, Sarah Ginty, Jessica Beck, Taylor Gauthier, Amanda Meyer, Michelle R. Musser
Pharmacy and Wellness Review
Maintenance of thyroid function during pregnancy is critical for both maternal and fetal health and development; therefore, knowledge regarding the relationship between thyroid hormones and pregnancy is essential. The American Thyroid Association task force has developed clinical guidelines on the diagnosis and treatment of thyroid disease during pregnancy. Gestational thyroid diseases are divided into two classifications, hypothyroidism and hyperthyroidism, which are further divided into more specific classifications based on clinical presentation. Differentiation, diagnosis, and monitoring of thyroid diseases throughout pregnancy require assessing symptoms, as well as obtaining levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) concentration by a simple …
Dronedarone: An Update To A Controversial Therapy For Atrial Fibrillation,
2019
Ohio Northern University
Dronedarone: An Update To A Controversial Therapy For Atrial Fibrillation, Zachary Crawford, Sara Mcallister, Amanda Hoersten, Jennifer Bauer, Megan Keller, David Bright
Pharmacy and Wellness Review
As of 2004, it was estimated that 2.2 million Americans were diagnosed with paroxysmal or persistent atrial fibrillation (AF) resulting in one out of every six strokes in the United States. AF leads to a reduction in pumping efficiency of the heart increasing the risk of several serious sequelae such as thromboembolic stroke and congestive heart failure (CHF). It also results in a reduced quality of life for the patients suffering from the disease. Patients with AF require appropriate antiarrhythmic therapy to control symptoms and prevent adverse effects of the condition. Multaq® (dronedarone), an antiarrhythmic drug approved for AF in …
Lysteda® For Heavy Menstrual Bleeding,
2019
Ohio Northern University
Lysteda® For Heavy Menstrual Bleeding, Erica B. Schoenberger, Todd A. Tucker Jr., Justin W. Steele, Amanda Meyer, Sandra L. Hrometz
Pharmacy and Wellness Review
Lysteda®, a novel formulation of tranexamic acid, is an antifibrinolytic medication recently approved by the Food and Drug Administration (FDA) for the treatment of heavy menstrual bleeding. Tranexamic acid has been shown to significantly reduce menstrual blood loss while simultaneously allowing a woman to safely become pregnant. The major advantage of Lysteda® (an oral modified-release formulation of tranexamic acid) compared to oral immediate-release tranexamic acid, is the decreased occurrence of gastrointestinal side effects. As there are no therapeutic equivalents to Lysteda® for heavy menstrual bleeding, it is important for pharmacists to be able to counsel patients appropriately on the specific …
