By: Aleena Cherian, PharmD Candidate c/o 2014 – Although opioid analgesics are among the most effective drugs to treat pain, they are associated with a growing number of public health issues including addiction and severe, often fatal, overdoses. The recent increase in incidences of opioid overdose is directly correlated to rapidly increasing and widespread use…

By: Tamara Yunusova, Senior Staff Editor – Approximately 3.2 million Americans have chronic hepatitis C infection.1 While acute cases are not common, rates of chronic hepatitis C continue to surge due to the recent discovery of the virus in 1989 and consequently, the establishment of a test screening for HCV antibodies in 1992.1 HCV has…

By: Andy Zhang, PharmD Candidate c/o 2015 – On March 28, 2013, the U.S. Food and Drug Administration announced the approval of Tecfidera™ (dimethyl fumarate) for the treatment of relapsing forms of multiple sclerosis (MS) in adults.1 Tecfidera™ (dimethyl fumarate) will be the third oral drug used for the treatment of MS. The manufacturer Biogen…

By: Frances Sousonis, Candidate c/o 2017 – Unfortunately, cancer is a disease about which many are able to share stories. All too often, beloved persons are diagnosed with cancer, or, more regrettably, loses their battle with the beast. Colon cancer is the third most common cancer in the United States and around 150,000 people each…

By: Moisey Rafailov, PharmD Candidate c/o 2015 – It was early in the morning on New York’s Route 684 when a car hit a tractor-trailer and continued driving without regard. Imagine that, when later stopped by a police officer, the driver said that the accident was her pharmacist’s fault. What if I were to tell…

By: Sharon Janak, PharmD Candidate c/o 2013 – How can we distinguish between vascular injury and Purple Glove Syndrome (an adverse effect of phenytoin)?  What are the warning signs and symptoms? Phenytoin is an anticonvulsant used to treat generalized tonic-clonic and partial seizures. It stabilizes neuronal cell membranes of the motor cortex by facilitating the…

By: Ada Seldin – An impending storm is threatening to stagger the health care system and the nation at large. Alzheimer’s disease, which now affects as many as 5.1 million Americans, is projected to triple its toll by 2050, to 13.8 million Americans.1 These sky-rocketing rates can be attributed to aging of the ‘baby boomers.’2…

By: Erica Dimitropoulos, Senior Staff Editor – Rheumatoid arthritis is a painful and often debilitating autoimmune disease characterized by symmetric polyarthritis, most commonly of the proximal interphalangeal and metacarpophalangeal joints, elbows, knees, ankles, and spine.1 Its clinical manifestations vary, from a slowly progressing onset of fatigue and musculoskeletal discomfort to a sudden and worsening destruction…

By: Diana Gritsenko, Pharm D. Candidate c/o 2015 – Every flu season, it is the same story: long lines at doctors’ offices and pharmacy counters as patients scramble to get the year’s vaccine before supplies run out. Year after year, doctors and pharmacists groan while explaining over and over again to patients why they need…

By: Fawad Piracha, Pharm. D Candidate c/o 2016 – The 2012-2013 influenza season has developed into one of the greatest nationwide flu outbreaksof the decade.1 Amid this crisis, many flocked to healthcare providers with flu-like symptoms, while others scoured doctors’ offices, clinics, and pharmacies for the vaccine. With the flu claiming many lives throughout the…

By: Nandini Puranprashad, PharmD Candidate; Sibyl Cherian, PharmD Candidate; Tracey Cannova, PharmD Candidate; and Olga HilasPharmD, MPH, BCPS, CGP  – Adverse drug reactions are estimated to occur in 10-20% of hospitalized patients and in 7% of the general population.1 One-third of these reactions are of an allergic or pseudo-allergic nature. The consequences of these hypersensitivity…

By Nancy Rizkalla, PharmD candidate c/o 2015 –        Percutaneous coronary intervention (PCI) with subsequent stent implantation is a highly effective approach in reducing the risk of death or ischemic complications following a myocardial infarction as well as improving the quality of life in patients with stable angina. PCI is ultimately performed in 60 –…

By: Bhavini Shah, PharmD Candidate c/o 2013  – Fycompa® (perampanel) has received the U.S. Food and Drug Administration (FDA) approval for the adjunctive treatment of partial-onset seizures with or without secondarily generalized seizures in patients with epilepsy aged 12 years and older.1  The drug, manufactured by Eisai Inc., is already approved for use in Iceland,…

By: Bethsy Jacob, PharmD Candidate 2014 – On January 18, 2013, the U.S. Food and Drug Administration (FDA) announced a new approval for Botox, generically known as OnabotulinumtoxinA. Patients diagnosed with urinary incontinence due to an overactive bladder can be prescribed Botox, if they are unable to take or are unresponsive to anticholinergic medications.  This…

By:  Lila Ahmed, PharmD Candidate c/o 2013 – In the past, numerous research efforts have attempted to prove the benefits and risks of calcium and multivitamin supplements with little success. Most of the studies performed were inconclusive and did not provide us with significant data; while some studies have found that calcium is beneficial for…

By:  Miriam Maltz, PharmD Candidate c/o 2013, AMSCOP, Long Island University – Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by hyperglycemia that is pursuant to insulin resistance, defects in insulin secretion, or both1. Chronic hyperglycemia is associated with detrimental effects on various organ systems that can increase mortality and impact the patient’s…

By:  Maria Sorbera, PharmD Candidate c/o 2013, AMSCOP, LIU – Hepatitis C is the leading cause of chronic liver disease and cirrhosis, presenting a global health challenge.  Approximately 170 million people worldwide, 3% of the population, are infected with the Hepatitis C Virus (HCV), roughly 3.2 million of whom reside in the United States.  The…

By: Alexandra Alleva, PharmD candidate c/o 2013 – As of December 28th, Bristol-Myers Squibb and Pfizer’s brand name oral anticoagulant, Eliquis® (apixaban), attained FDA approval.1  This occurred one month after its approval in  Europe and Canada, following longer than expected waits in the US due to further investigation requests by the FDA.2 The much-anticipated anticoagulant is…

By: Tamara Yunusova, PharmD Candidate c/o 2017 – Gene therapy? You scoff in disbelief as thoughts of designer babies, liberal eugenics, clones, and ruthless dystopian societies begin to reel in the back of your mind. Perhaps you may even stop to recall a scene or two from Jurassic Park or Star Trek. Undoubtedly, gene therapy…

By: Mahdieh Danesh Yazdi, Associate Student Editor – Many of us have prepared for influenza season by receiving the flu vaccine.  (If you have not, please speak to your doctor or pharmacist soon!  Remember: even if you do not need it for your protection, get it for your patients’ well-being).  However, for the youngest members…

By: Elsa Thomas, PharmD Candidate c/o 2013 – Atropine is an anticholinergic used to treat various conditions, such as bradycardia, neuromuscular blockade, mydriasis, nerve agent poisoning, and salivary hypersecretion.1,2  Pharmacologically, it inhibits smooth muscle and glands innervated by postganglionic cholinergic nerves.1,2  It also has functions in the central nervous system (CNS); it could stimulate or…

By: Jessica Lee, PharmD Candidate c/o 2013 – Rheumatoid arthritis (RA) is an autoimmune disease in which the immune system attacks healthy tissue, causing inflammation of the joints and potential harm to other organs.1  It affects 0.5-1% of the adult population and is more prevalent in the seventh decade of life.1  These patients tend to…

By: James W.  Schurr & Stephen Argiro, PharmD Candidates c/o 2014 – Patients frequently utilize non-steroidal anti-inflammatory drugs (NSAIDs) for a wide variety of conditions, including but not limited to arthritis, headaches, and generalized pain.  Despite an excellent safety profile, NSAIDs are associated with certain toxicities, including renal complications (particularly among at risk populations).1  Acute…

By: Shannon Tellier, PharmD Candidate c/o 2013 – Antidepressant discontinuation syndrome has been reported in all categories of antidepressants after an abrupt interruption of therapy.1  Symptoms usually occur within a few days of stopping or reducing the dosage of the antidepressant, and rarely occur with therapy of less than five weeks.1  If left untreated, most…

By: Eugene Kolomiyets, PharmD Candidate c/o 2013, AMSCOP at LIU – Cystic fibrosis (CF) is an autosomal recessive disease caused by a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene located on chromosome 7.1  The disease has been linked to thousands of possible mutations, but only as many as 25-30 are tested for…

By Sunhae Chang, PharmD Candidate c/o 2013 – When patients complain of heartburn, the blame usually shifts to gastroesophageal reflux disease (GERD).  Therefore, patients receive the “standard therapies for GERD”: antacids, histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), or prokinetics.1,2  Luckily, most patients respond well to these agents.1,2  Unfortunately, the not-as-lucky ones, despite PPI…

By: Neal Shah, Co-Editor-in-Chief – Duloxetine is a serotonin (5HT) and norepinephrine (NE) reuptake inhibitor (SNRI) introduced to the US market in 2004, indicated for the treatment of diabetic neuropathic pain.1 A chemical figure of duloxetine is shown [in the PDF].2 It was developed in an effort to mimic tricyclic antidepressant mitigation of neuropathic pain…

By: Neal Shah, Co-Editor-in-Chief – Electroconvulsive therapy (ECT) is a last-line procedure in the treatment of refractory depression, among other neuropsychological disorders.1 By inducing a seizure, neurotransmitters are released and the disease state may feature a modest mitigation in symptoms.1 Seizure medications such as benzodiazepines and barbiturates are prescribed to increase or heighten the seizure…

By: Elsa Thomas, Pharm.D. c/o 2013 – Human body uses various complex mechanisms to maintain its body temperature within a narrow range despite extreme environmental temperature changes as well as physiological changes. Several factors can affect body temperature such as disease states, growth, exercise, hormonal changes, and medications. Hypothermia can occurs as a result of…

By: Joo Hee Kwon, Pharm.D. Candidate c/o 2013 – There are 3 antigenic types of influenza: A, B, and C. Influenza C causes mild illness and therefore does not cause epidemics.  In contrast, influenza A and B are capable of causing mild to severe flu and in some cases death.  An epidemic can occur depending…

By: Steve Soman, Pharm.D. Candidate c/o 2013 – Bisphosphonates are proven to enhance bone density and reduce fracture incidence in post-menopausal women but recent data suggests they may have adverse effects with regards to bone quality.  The drugs in this class can be differentiated as non-nitrogen containing (older generation) and nitrogen containing (newer generation) medications.…

By: Addolorata Ciccone, Co-Copy Editor – Acute Coronary Syndromes Acute coronary syndrome (ACS) is a myocardial ischemia caused by obstruction of coronary arteries.  ACS is stratified into three types, based on electrocardiogram (EKG) changes and the presence of cardiac biomarkers (e.g. troponin, creatinine phosphokinase, and myoglobin).  To guide treatment plans, it is important to identify…

By: Marina Yermolayeva, PharmD Candidate c/o 2013 – “I’m allergic to the generic; I need the brand name medication,” is a common claim heard by many health care providers.  Managed care organizations get numerous calls from doctors and patients requesting prior authorizations to approve brand name medications whilst there are generic alternatives available on formulary.…

By: Neal Shah, Co-Editor-In-Chief – Migraines can be “classic” or “common.”  While all migraines feature unilateral, pulsating headaches, classic migraines feature an “aura” upon onset (whereas common migraines do not).  Pharmacologic treatment of migraines generally includes serotonin agonists (triptans).1 Triptans are selective agonists of the 5-hydroxytryptamine 1B and 1D (5HT1B/1D) subtypes.  By activating these receptors,…

By: Neal Shah, Co-Editor-in-Chief –  Dialysis is the removal of substances from intravascular circulation by filtration.1  Typically, dialysis is ordered when kidney function declines to 10–15% of normal function.2  The National Kidney Foundation’s Kidney Disease Outcome Quality Initiative (K/DOQI) recommends that planning for dialysis begin when patients reach chronic kidney disease stage 4, which is…

By: Steve P. Soman – Mirabegron (Mybetriq®), known also by the brand name Betanis®in Japan, is a new once daily oral drug.   First in its class, it is a selective β(3)-adrenoceptor agonist that improves symptoms associated with over active bladder (OAB) such as urinary incontinence, urgency, and urinary frequency by enhancing storage function and relaxing…

By: Neal Shah, Co-Editor-In-Chief – Contrast dyes enhance imaging for computer tomography (CT), magnetic resonance (MR), and X-rays.1  Dyes usually consist of barium, iodine, or gadolinium, depending on the procedure.2  CT and X-ray scans often use iodine for systemic imaging and barium sulfate for GI imaging, whereas MR imaging primarily uses gadolinium.2  Gadolinium and iodine…

By: Lunbao (Jerry) Huang, Pharm.D. Candidate c/o 2013 – Donepezil, brand name Aricept®, is an acetylcholinesterase inhibitor indicated as monotherapy for Alzheimer’s disease, the most common form of dementia.  Cholinergic deficiency in the cortex and basal forebrain contributes to cognitive deficits in these patients.  Donepezil reversibly, noncompetitively inhibits centrally active acetylcholinesterase, the enzyme responsible for…

By: Neal Shah, Co-Editor-in-Chief – Xerostomia, commonly known as dry mouth, is an anti-muscarinic side effect of numerous medications.  Antidepressants, analgesics, diuretics, and antihistamines have a high propensity to cause xerostomia.1  Xerostomia may also result from Sjogren’s syndrome, Parkinson’s disease, and various chemotherapy agents.2  Traditionally, muscarinic agonists like pilocarpine have been used to reverse xerostomia.…

By: Mohamed Dungersi, Associate Student Editor –  What is diabetic ketoacidosis (DKA)? Diabetic ketoacidosis (DKA) is an acute complication of uncontrolled diabetes or hyperglycemia. It is usually observed in cases of extreme hyperglycemia (usually in excess of 500 mg/dl, though it can occur over 250 mg/dl).1,2  It is usually characterized by the presence of hyperglycemia,…

By: Neal Shah, Co Editor-In-Chief – Dyskinesias are abnormal, involuntary movement disorders.  Subsets of dyskinesias include choreas and atheosis.  Chorea is irregular and sporadic contraction of muscles whereas athetosis involves a twisting and writhing of muscles.  These two dyskinesias often occur together and are thus termed choreathetosis.1  Common conditions which feature choreatheosis are Huntington’s, and…

By: Neal Shah, Co Editor-In-Chief – Pure Red Cell Aplasia (PRCA), also known as erythroblastopenia, is characterized by a suppression of erythrocytes in the bone marrow.  It is a peculiar oddity that the bone marrow’s progenitor cells still differentiate into white blood cells and platelets.1  PRCA has idiopathic, viral, auto-immune, and genetic etiologies.  Diamond-Blackfan syndrome…

By: Lunbao (Jerry) Huang, Pharm.D.  Candidate c/o 2013 – Pain is a very difficult condition to manage, as clinicians have only subjective findings to work with.  Opioid medications are currently the cornerstones for the management of moderate to severe pain; however, it is often problematic to determine a patient’s real ‘need’ for opioids.  Physicians’ clinical…

By: Shannon Tellier, Associate Student Editor – The disease burden in children outweighs the number of pediatric clinical drug trials currently being conducted.  The lack of data in pediatrics leads to drugs being used off-label and without sufficient knowledge of doses, tolerability, and efficacy.  In 1975, only 22% of products in the electronic Physicians’ Desk…

By: Raymond Wu, Pharm.D. Candidate c/o 2013   The 5-hydroxytryptamine type 3 (5HT3) antagonists (e.g. ondansetron [Zofran®]) are commonly used in the prevention and treatment of nausea and vomiting in the inpatient setting.1  Overall, ondansetron is a well-tolerated medication with few side effects.1  Constipation, dizziness, and headache are the most commonly reported side effects associated…

By: Jayoung Park, Pharm.D. Candidate c/o 2013 – Traditionally, human immunodeficiency virus (HIV)-infected patients have generally been excluded from organ transplantation.1  One of the principal concerns was that immunosuppression would accelerate HIV/acquired immune deficiency syndrome (AIDS), resulting in increased mortality and a “waste” of organs.1 A study entitled, “Opportunistic Infections and Neoplasms Following Liver and…

By: Lila Ahmed, Pharm.D. Candidate c/o 2013 – Whether you wish to admit it or not, all of us have watched or at least heard of the Dr. Oz Show.  I am sure that many of us encounter patients in the pharmacy who say, “I saw this on Dr. Oz; where could I find it?”…

By: Mahdieh Danesh Yazdi, Associate Student Editor, with Special Thanks to Dr. Tomasz Jodlowski for his contributions to this article – In the 1990s, major urban and rural areas across the United States grappled with a common problem: drug addiction.  At that time, the drugs of choice were illicit substances (i.e. heroin).  In order to combat…

By: Lauren Kaveski, Pharm.D. Candidate c/o 2013 – We see proton pump inhibitors (PPIs) used in many medication regimens, but it is unknown whether the majority of patients receive these medications for appropriate durations or indications.  For all labeled indications, other than Zollinger-Ellison Syndrome (a rare condition characterized by damaging gastrin hypersecretion and subsequent hydrochloric…

By: Lunbao Huang Pharm D. Candidate c/o 2013 – The seventh report of the Joint National Committee on high blood pressure (JNC-7) states that most classes of antihypertensive drugs such as angiotensin converting enzyme inhibitors (ACEIs), angiotensin-II receptor blockers (ARBs), beta-blockers (BBs), diuretics, and aldosterone-receptor antagonists can be used for hypertensive heart failure patients except…