By: Joseph Eskandrous, PharmD Candidate c/o 2019 Clostridium difficile (C. difficile) is a gram-positive, anaerobic, sporogenic bacterium that is primarily responsible for antibiotic-associated diarrhea and is a significant nosocomial pathogen.1 Clostridium difficile infection (CDI) is triggered by toxin production from the bacteria. Normal bacterial flora is disrupted when the colon is colonized with C. difficile…

By: Jonathan Mercado (PharmD Candidate c/o 2019), Rebecca Sin (PharmD Candidate c/o 2019) Immuno-oncology is an advanced and rapidly growing area of research focused on utilizing the body’s immune system to help fight cancer. Immunotherapy has demonstrated clinical efficacy and unprecedented rates of response in treating specific cancers, usurping the classical approach to chemotherapy and…

By: Shireen Farzadeh, PharmD Candidate c/o 2019 – Nivolumab (Opdivo®) is a monoclonal antibody that blocks programmed death receptor-1 (PD-1). PD-1 plays an important role in the immune checkpoint cascade. It is indicated for the treatment of melanoma, renal cell carcinoma, non-small cell and small cell lung cancer, squamous cell carcinoma of the head and…

By: Alex Chu & Joseph Eskandrous (PharmD Candidates c/o 2019) – The geriatric population grows older with each passing day and is more likely to experience chronic pain due to shifts in body composition and pathological diseases.1 Chronic geriatric pain may be defined as an unpleasant sensory and emotional experience associated with actual or potential…

By: Natalie Rodriguez, PharmD Candidate 2019 Philadelphia College of Pharmacy, University of the Sciences  and Stacey Gorski, Assistant Professor of Biological Sciences – PRESS SUMMARY The most common cause of hyperthyroidism, or an over-active thyroid, is an autoimmune disease known as Graves’ disease.  In patients with Graves’ disease, the immune system attacks the thyroid gland…

By: Kathleen Horan, PharmD Candidate c/o 2020 – During my institutional Introductory Pharmacy Practice Experiential (IPPE) rotation in the emergency department at NYU Winthrop University Hospital in the spring of 2018, I witnessed a variety of interesting cases while shadowing my preceptor, emergency department pharmacist Megan Czuba, PharmD. Among these emergencies cases, I witnessed a…

By: Jonathan Mercado, PharmD Candidate c/o 2019 – Hydroxyurea is a versatile, multi-functional drug that has been used for decades in the United States. It was originally approved in 1967 as an antineoplastic drug for use in multiple cancers including melanoma, ovarian cancer, and most prominently chronic myeloid leukemia (CML).1 Although approved as a chemotherapeutic…

By: Shireen Farzadeh, PharmD Candidate c/o 2019 – Sofosbuvir/velpatasvir/voxilaprevir (Vosevi®) is the first pangenotypic fixed-dose combination tablet that includes 400 mg of sofosbuvir, a Hepatitis C virus (HCV) nucleotide analog, 100 mg of velpatasvir, an HCV NS5A inhibitor, and 100 mg of voxilaprevir, an HCV NS3/4A protease inhibitors.1,2 In the interest of brevity, sofosbuvir/velpatasvir/voxilaprevir will…

By: Vicky Liu, PharmD Candidate c/o 2018 – Hepatitis is an inflammation of the liver commonly caused by viruses which can lead to self-limitation, fibrosis, cirrhosis, or liver cancer. Viral hepatitis is categorized into five types: A, B, C, D, and E. Of the five types, A, B, and C are the most prevalent in…

By: Anna Chen, PharmD Candidate c/o 2020 – Every day the public faces an onslaught of a new fad diet that promises to prevent boredom and the feelings of restriction that regular diets are famous for. One example is the banana diet that promises to keep one satiated with the high volume and fiber content…

By: Jonathan Mercado, PharmD Candidate c/o 2019 – In April 2016, the FDA approved the first drug specifically indicated for the symptoms of psychosis associated with Parkinson’s disease (PDP).1 Currently, clozapine and quetiapine are used off label to treat symptoms associated with Parkinson disease such as voices in patients’ heads, various hallucinations and delusions. In…

By: Jack (Hongkai) Bao, PharmD Candidate c/o 2018 – Inhalers are one of the most prescribed therapies used to treat respiratory disorders in patients. Anticholinergics, β-agonists, and corticosteroids are all packaged into a miniature device that patients must use correctly every time to ensure delivery of their medication. To complicate matters, a myriad of inhaler…

By: Zachary Piracha, PharmD Candidate c/o 2017 – BACKGROUND The pharmacy profession is constantly fortified by an ever-evolving process by which students of pharmacy become practicing healthcare providers licensed in their respective states. The National Association of Boards of Pharmacy (NABP) carefully regulates the dissemination of tests as well as the shifting forms of administration…

By: Omar Rahman, PharmD Candidate c/o 2017 – Stevens-Johnson Syndrome is a unique skin disease that may be due to an infection, a response to medication, or other idiopathic causes. It is uncommon, as there are approximately only 20,000 cases worldwide annually. The etiology confirms that about half of the cases are in reaction to…

By: Amy Nguyen, PharmD Candidate c/o 2020 and Alex Chu, PharmD Candidate c/o 2019 – One of the most common problems with aging is the ability to maintain brain function. Dementia is a collective term describing conditions revolving the impairment of various brain functions.  Patients with dementia often experience progressive behavioral and neurological changes that…

By: Nicollette Pacheco, Staff Editor [Graphics-focused] – Brexpiprazole (REXULTI®) is a novel atypical antipsychotic that was approved in July 2015 for the adjunctive treatment of Major Depressive Disorder (MDD) and as monotherapy in schizophrenia.1 Brexpiprazole is a serotonin-dopamine activity modulator with partial agonism at serotonergic 5HT1α and dopaminergic D2 receptors, as well as potent antagonism…

By: Svetlana Akbasheva, Section Editor (Clinical) – Despite the advances in the treatment of human immunodeficiency virus (HIV), the incidence of HIV transmission remains alarmingly high, with about 50,000 new cases arising every year in the United States alone.1 Recently, HIV management has turned its focus on prevention for high-risk, uninfected individuals in addition to…

By: Kevin J. Choi, PharmD Candidate c/o 2016 – “Morning Sickness” – we have all heard of this term being associated with thalidomide, a drug particularly recognized for its antiemetic effect, but also for its notorious teratogenicity. However, it is worth re-familiarizing ourselves with the nature of the drug itself (and the clinical threats that…

By: Dimitrios Savva, PharmD c/o 2016 – Digoxin is a cardiac glycoside used in the treatment of atrial fibrillation (Afib) and heart failure. Digoxin inhibits sodium-potassium ATPase, leading to an increase in intracellular sodium which in turn inhibits sodium-dependent calcium transport out of the cytoplasm and ultimately results in an increase in intracellular calcium.1 The…

By: Nicollette Pacheco, Staff Editor (Graphics-focused) – Acetaminophen, an analgesic and antipyretic, has been widely used to relieve minor aches and pains since the 1950s. The drug exhibits these effects by inhibiting the enzymes COX-1 and COX-2, and acts in both the central and peripheral nervous systems.1 While acetaminophen is currently indicated for the relief…

By: Anthony Vecchione, PharmD Candidate c/o 2016 – Seizures are a well-described complication of acute brain injury and neurosurgery. Antiepileptic drugs (AEDs) are frequently utilized for seizure prophylaxis in neurocritical care patients, but this practice is controversial because of the possible adverse effects of these drugs (which can affect patient outcomes). Practitioners have prescribed AEDs…

By: Cyril Collantes, PharmD Candidate c/o 2016 – Obsessive-Compulsive Disorder (OCD) is characterized by two predominant psychiatric components: obsession and compulsion. Obsession refers to the uncontrolled and recurrent thoughts, impulses, or images that can provoke significant anxiety, whereas compulsions are repetitive behaviors or rituals in response to the obsessive thought(s). OCD is clinically significant if…

By: Azia Tariq, Section Editor – Myocardial infarctions, more commonly known as heart attacks, are prevalent in the United States. Each year, approximately 720,000 Americans suffer a heart attack.1 The approval of vorapaxar by the Food and Drug Administration (FDA) presents an additional treatment option for patients at high risk for myocardial infarction and stroke.1,2…

By: Jacqueline Meaney, PharmD [PGY-1 Resident at Gainesville VAMC in Florida] – Major depressive disorder (MDD) is a psychiatric disorder that is characterized by feelings of worthlessness, helplessness, and an inability to experience pleasure in activities that were enjoyable in the past.1 Major depressive disorder is one of the most prevalent mental disorders among adults…

By: Jacqueline Meaney, PharmD [PGY-1 Resident at Gainesville VAMC in Florida] – Fibromyalgia is a syndrome of chronic pain that affects the musculoskeletal system. Typical symptoms include pain, stiffness, fatigue, insomnia, and tenderness over specific areas. Active depression is seen in one-third of patients with fibromyalgia, and a lifetime history of depression is seen in…

By: Tamara Yunusova, Senior Staff Editor – Diabetic peripheral neuropathy (DPN) is a common complication of diabetes, burdening almost 50% of the diabetic population.1 While diabetic neuropathy is a broad term that may refer to a spectrum of autonomic, focal, proximal and peripheral neuropathies, it is generally characterized by poor gait and abnormal cold/heat sensations.…

By: Syed Arafath, PharmD Candidate c/o 2015, AMSCOP at LIU – Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States, behind heart disease and cancer.1 Many patients with COPD often present with multiple-organ dysfunction, especially cardiovascular disease.2,3 COPD and heart failure frequently coexist in approximately 30% of cases…

By: Jacqueline Meaney, PharmD Candidate c/o 2015, University at Buffalo: School of Pharmacy and Pharmaceutical Sciences – Chronic alcohol consumption may lead to a deficiency in thiamine (Vitamin B1), which can lead to alcohol-induced brain damage. Since thiamine is a cofactor for essential pathways in the brain, decreased levels of thiamine in the body can…

By: Nancy Rizkalla, PharmD Candidate c/o 2015 – NSAIDs are effective agents used in the management of several types of pain. They mitigate the negative effects of inflammation by inhibiting two key enzymes called cyclooxygenase (COX)—COX-1 and COX-2—and their subsequent products. However, the inhibition of these enzymes’ other beneficial functions is associated with negative side…

By: Luxi Wang, PharmD Candidate c/o 2015, Lev Gurevich, PharmD Candidate c/o 2015, and Gladys El-Chaar, PharmD, Clinical Professor, Department of Clinical Pharmacy Practice, St. John’s University College of Pharmacy and Health Sciences – Case Presentation A 17-year-old female presented to the ED after experiencing a tonic-clonic seizure with loss of consciousness lasting 5 minutes…

By: Katharine Cimmino, Editor-in-Chief – Attention-deficit/hyperactivity disorder (ADHD) is the most common pediatric psychiatric disorder, and it affects the education, social interactions, and over-all wellbeing of both children and adolescents.1 Symptoms of ADHD can persist into adulthood, and those with this disorder are more likely to suffer from other mental health co-morbidities.2 According to guidelines…

By: Jacqueline Meaney, PharmD Candidate c/o 2015, University at Buffalo: School of Pharmacy and Pharmaceutical Sciences — Psychotropic medications are typically used in conjunction with cognitive behavioral therapy to treat behavioral problems that affect children with autism spectrum disorder (ASD). Symptoms of ASD typically include a need for routines (change intolerance), difficulty with verbal and…

By: Diana Gritsenko, PharmD Candidate 2015 – Multiple complications can arise during pregnancy. While venous thromboembolism (VTE) has a prevalence rate of just 0.06% it is one of the leading causes of maternal mortality. It is recommended that at-risk pregnant women receive anticoagulation therapy for a minimum of 3 months and VTE prophylaxis for the…

By: Elissa Tam PharmD Candidate c/o 2015 – HIV/AIDS continues to be a persistent problem in the United States and in various countries around the world. In 2010 alone, there were around 47,500 new HIV infections in the United States with about 1.1 million Americans living with HIV at the end of 2010.1 When left…

By Davidta Brown, Senior Staff Editor – The pain, nausea, and light or sound sensitivity that comprise a migraine attack afflict more than 10% of individuals around the world, easily making migraines one of the most globally debilitating diseases of the present day.1 According to the International Headache Society (IHS), migraines are defined by both…

By: Anthony Botte and Tyler Valente, PharmD Candidates c/o 2016 – Diseases which are prevalent within the pediatric population require distinct protocols for treatment accompanied by the utmost care and precision. Pediatric hypertension (HTN) is one disease state in particular that has come to the forefront of medical practice in the United States over the…

By: Jenny Park PharmD Candidate c/o 2015 – A series of broad HIV specific monoclonal antibodies (mAb) have been isolated and been shown to bind to CD4 binding sites, V1/V2 loops, V3/V4 loops, glycans, and proximal external regions. It has been shown that administration of a “cocktail” of HIV-1 specific monoclonal antibodies along with single…

By: Ada Seldin, Staff Editor – The overuse of antipsychotics in the nursing home population for off-label indications continues to impact patient safety. In 2005, the FDA issued a black box warning that stated, “The treatment of behavioral disorders in elderly patients with dementia with atypical antipsychotic medications is associated with increased mortality.” The evidence…

By: Ada Seldin, Staff Editor – Intrathecal baclofen (ITB) is indicated for the treatment of intractable spasticity caused by spinal cord injury, multiple sclerosis, spinal ischemia or tumor, transverse myelitis, cervical spondylosis, cerebral palsy, and degenerative myelopathy.1 Baclofen inhibits both monosynaptic and polysynaptic reflexes at the spinal cord level by decreasing excitatory neurotransmitter release from…

By: Katharine Cimmino, Editor-in-Chief – Pressure ulcers can be a painful condition decreasing the quality of life of patients and prolonging hospital stays.1 About 10% of hospital inpatients and 26% of hospice admissions have pressure sores.2 Pressure ulcers are injuries that occur when pressure is applied for prolonged periods of time over bony prominences.1 There…

By: Hayeon Na, Co-Copy Editor [Content-Focused] – On October 8th of 2013, Bayer’s new drug riociguat (Adempas®) was approved for the treatment of patients whose pulmonary hypertension (PH) belongs in WHO groups 1 and 4.1 Riociguat (Adempas®) is a soluble guanylate cyclase (sGC) stimulator, and currently the only one of its kind on the market.…

By: Davidta Brown, Senior Staff Editor – In August 2013, the results of a yearlong safety study were published in the Journal of American Medical Association (JAMA) Psychiatry.1 The study, which followed the health status of about 43,000 youths aged 6 to 24, confirmed and built upon a previously noted trend in adults: that the…

By: Tamara Yunusova, Senior Staff Editor – Proton Pump Inhibitors (PPIs) are acid-reducing agents that have multiple uses in the treatment and prophylaxis of conditions such as peptic ulcer diseases, H. Pylori infection, Zollinger-Ellison syndrome, GERD, and NSAID gastroduodenal ulcers. Their versatility in treating a wide range of conditions, unparalleled efficacy over their Histamine-2-receptor antagonist…

By: Richard Chung, PharmD Candidate c/o 2017 – Malignant peripheral nerve sheath tumor, otherwise known commonly as MPNST, is an aggressive sarcoma that can randomly form around peripheral nerves. Approximately 1 in 100,000 of the population is diagnosed with MPNST, with only 20-50% surviving five years after initial diagnosis.1 In addition, approximately half of the…

By: Ada Seldin, Staff Editor – On November 22, 2013, simeprevir (Olysio®), a new agent to treat chronic hepatitis C, received approval under the FDA’s priority review program. Simeprevir is an NS3/4A protease inhibitor that blocks the replication of the hepatitis C virus. Two other drugs from the same class, boceprevir and telaprevir, which were…

By: Neal Shah, PharmD, MD/PhD Student c/o 2021, West Virginia University School of Medicine – Methadone is a powerful long-acting mu-opioid agonist that has been traditionally used in the management of chronic pain, treatment of pain refractory to certain opioid agents, and maintenance of opioid addiction.1-5 While neuropathic pain is not traditionally linked to mu-opioid…

By: Rebecca Gilene, PharmD Candidate c/o 2014, St. Louis College of Pharmacy – The FDA approved macitentan (Opsumit®) on October 18, 2013 for the treatment of pulmonary arterial hypertension.1 Pulmonary arterial hypertension, often referred to as PAH, is a disease characterized by high blood pressure in the arteries between the heart and lungs. An increase…

By: Arya Mathew, PharmD Candidate c/o 2014 –  About twelve percent of the U.S. population suffers from migraines, affecting adult women three times more than adult men.  Migraines are returning attacks of moderate to severe, throbbing or pulsing pain, usually on one side of the head.  Along with the severe pain, migraine sufferers also experience…

By: Samad Tirmizi, PharmD Candidate c/o 2014 – Hemolytic anemia (HA) is a type of anemia that occurs due to the breakdown of red blood cells. It is classified as intrinsic and extrinsic according to causative factors. Medication induced hemolytic anemia is an example of extrinsic, while genetic predisposition is an intrinsic factor. Drug induced…

By: Nathan Trustman, PharmD Candidate c/o 2014, AMSCOP at LIU – The antibiotic class known as the fluoroquinolones is widely used in both outpatient and inpatient settings. They provide bactericidal effects by inhibiting DNA gyrase and topoisomerase IV enzymes in bacteria. The systemic agents that are most commonly used in clinical practice include ciprofloxacin, levofloxacin,…