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…

By: Nagma Gargi, Pharm D. Candidate 2013 – Traditionally, lipid panels are drawn under fasting conditions. Is there data supporting decreased accuracy in a non-fasting lipid panel? Cholesterol is an essential tool for our body for the synthesis of hormones, vitamin D, and bile acids. However, an excess of cholesterol pose a serious threat to…

By: Kathlynn Ferrer, Pharm.D. Candidate c/o 2013 – Nabiximols (Sativex®) is a buccal spray that has been approved for use in the UK, Spain, Germany, Denmark, New Zealand, and Canada. The active ingredients in this product are Tetrahydrocannabinol and Cannabidiol, two kinds of cannabinoids1. Cannabinoids are chemical compounds that stimulate cannabinoid receptors and are the…

By: Alexandra Alleva, Pharm.D. Candidate c/o 2013 – On February 17, 2012, the US Food and Drug Administration (FDA) approved the first medication indicated specifically for patients with endogenous Cushing’s syndrome, a hormone disorder characterized by elevated blood levels of cortisol.  Mifepristone (Korlym®) is for the treatment of glucose intolerance and Type 2 Diabetes Mellitus…

By: Nagma Gargi, Pharm.D. Candidate c/o 2013 – Smoking cessation programs are extremely important in our society as increasing evidence emerges showing the correlation between smoking and the risk factors for various disease states. Thus as professionals it is our duty to educate ourselves first, then our patients. In this article, I want to discuss…

By: Yufan (Frank) Liu, Pharm.D. Candidate c/o 2013 – Results of numerous epidemiological studies have indicated that having high serum cholesterol can lead to coronary heart disease (CHD). 1 More specifically having high LDL cholesterol puts patients at risk for angina and heart attack.2 To reduce this risk HMG-CoA reductase inhibitors, also known as statins,…

By: Shannon Tellier – Medication related problems can be reduced in older adults if the Beers Criteria were utilized by health care professionals. The criteria serves as a guideline to identify potentially inappropriate medications (PIMs) that should be avoided in the elderly population, but it should not replace clinical judgment. This 2012 update includes a…

By: Marie Huang – The amphitheater at Nassau University Medical Center fills up slowly as Dr. Alan Jay Cohen, a psychiatrist from Oakland, California, makes his way up to the podium to lead a talk about bipolar disorder, specifically differentiating between its presentations in adults versus in developing children. Among nonprofessionals, bipolar disorder is simply…

By: Ebey P. Soman – The FDA recently approved a combination tablet of linagliptin with metformin hydrochloride (Jentadueto®) for the treatment of type 2 diabetes.  Developed by Boehringer Ingelheim and Eli Lilly, the new combination tablet provides a twice-daily treatment option for healthcare providers looking for greater flexibility in treating diabetes. Prescribers may add a…

By: Mohamed Dungersi – On February 28, the U.S. Food and Drug Administration (FDA) approved important safety label changes for the class of cholesterol-lowering drugs known as statins.  Aligned with the FDA’s goal to provide the public with more information for the safe and effective use of statins, the agency made several modifications to the…

By: James Schurr, Pharm.D. Candidate c/o 2014 – Graves’ disease is an autoimmune disorder that results in a state of thyrotoxicosis, or a cause of hyperthyroidism, due to the Immunoglobulin G-mediated agonism of thyroid stimulating hormone (TSH) receptors located on the thyroid.  Stimulation of TSH receptors causes an increase in circulating thyroxine (T4) and triiodothyronine…

By: Ebey P. Soman – Proton pump inhibitors (PPIs) are medications commonly prescribed to treat heartburn, acid reflux disease, and ulcers.  Almost a vast majority of patients in the United States seem to be taking a PPI, either as a prescription or from over-the-counter (OTC).  Researchers recently discovered associations between the long-term use of PPIs…

By: Ronik Saha, Pharm.D. Candidate c/o 2013 – Clopidogrel (Plavix®) is a thienopyridine antiplatelet agent, which exerts its antiplatelet effects via in vivo conversion to an active thiol metabolite that irreversibly blocks the P2Y-12 component of platelet ADP receptors.  This prevents activation of the GP2B/3A complex, thereby preventing platelet aggregation.  Along with aspirin, clopidogrel reduces…

By: Neal Shah – Osteoporosis is a disease of the bone characterized by decreased bone mineral density (BMD), which reduces the ability of bone to provide adequate structural support.  The main cause of this decreased BMD is inadequate calcium intake or absorption.  The decreased BMD can cause diffuse lesions throughout the skeletal system and can…

By: Mohamed Dungersi – On January 27, the FDA approved Bydureon® (exenatide extended-release) for use in Type 2 Diabetes Mellitus (T2DM), as an adjunct to diet and exercise.  Bydureon®, a product of Amylin Pharmaceuticals, is a modified formulation of the twice-daily injection, Byetta® (exenatide).  It is the first once-a-week medication for T2DM in the market.…

By: Ebey P. Soman – Since its discovery in Tanganyika (modern day Mozambique and Tanzania in Africa) in 1952, Chikungunya virus outbreaks have been documented in Africa, South Asia, and Southeast Asia.  Due to recent globalization and increased travel, infection has also spread outside of tropical regions and even into western nations (such as the…

By: Neal Shah – Anticlotting agents are staples in the prevention and treatment of thrombotic disorders, such as deep vein thrombosis, stroke, pulmonary embolism, myocardial infarction, and atrial fibrillation.1  Intravenous medications, such as unfractionated heparin (UFH), low molecular weight heparin (LMWH), and direct thrombin inhibitors (DTI), are commonly used in, both, inpatient and outpatient settings.…

By Lunbao (Jerry) Huang, Pharm.D. Candidate c/o 2013 – Over the last two decades, there has been an increasing focus on hepatocellular carcinoma (HCC, most commonly known as liver cancer).  In the United States, as of 2011, there have been an estimated 26,190 new cases and 19,590 deaths from both hepatic and intrahepatic bile duct cancer.  Defined by the…

By: Gokul Kalla, Pharm.D. Candidate c/o 2013 – Hypertension is a chronic disease that affects one out of every three Americans.  Leaving the condition untreated could increase the risk of serious health consequences such as a stroke or a heart attack.  On December 21, the FDA approved Takeda Pharmaceuticals’ Edarbyclor® (azilsartan medoxomil and chlorthalidone) for…

By: Neal Shah – Defined by the Joint National Committee, hypertension (HTN) is a systolic blood pressure (SBP) greater than or equal to 140 mmHg and a diastolic blood pressure (DBP) greater than or equal to 90 mmHg.  Patients with Stage 1 HTN have a SBP between 140 and 159 mmHg and DBP between 90…

By: Bibin Thomas, Long Island University, PharmD Candidate – Earlier in 2011, it was reported that that young and middle-aged HIV positive patients did not need to receive routine Bone Mineral Density (BMD) tests.  BMD helps to identify patients who are at a high risk for bone fractures or weakened bone structures (and eventually need…

By: Khilna Patel, Pharm.D. Candidate c/o 2012 – On October 25 of this year, Eli Lilly and Company announced a worldwide market withdrawal of Xigris (drotrecogin alfa), a drug previously indicated to treat severe sepsis in high-risk patients.  Drotrecogin alfa is a recombinant form of human activated protein C.  The efficacy of drotrecogin alfa was…

By Ebey P. Soman – Many living organisms occupy our intestines to aid us with metabolism, recycling of hormones, and, most importantly, protection against foreign pathogens.  When this normal flora of bacteria is altered or eliminated via antibiotic use, there is an opportunity for Clostridium difficile to infect us.  Stool transplant, or fecal bacteriotherapy, is…

By: Neal Shah – There are two major classifications of drug-receptor activity: agonism and antagonism. Agonism occurs when a molecule binds to a receptor, causes an exertion of normal receptor operation, and eventually causes a response. Antagonism of a receptor occurs when a molecule binds to the receptor and does not allow activity to occur.1…

By: Neal Shah – Part I:              Preface. Part II:             Brief review of cardiac electrophysiology. Part III:           Ivabradine as a novel If blocker for the use of stable angina. Part IV:           On the horizon: trimetazidine. – PREFACE When viewed anatomically, the heart may seem like a simple organ.  However, the electrophysiological aspects of the heart are…

By: Alisha Kumar, PharmD Candidate c/o 2012 – HIV transmission via organ transplantation is rare in the United States. However, after a public health investigation in 2010, a case of HIV transmission via kidney transplantation was confirmed. The kidney recipient had no history of sexually transmitted infections (STIs), injection drug use, sex with injection drug…

By: Neal Shah – The focus of pharmacy is rapidly shifting from simple filling and dispensing of prescriptions to preventative medicine and efficient clinical practice. The field of genetics has been incorporated in many defining therapies and will continue to shape how we treat our patients. Examples discussed here are the roles of human leukocyte…

By; Nikunj Vyas, PharmD Candidate c/o 2012 – Seasonal flu vaccines protect us against the three influenza viruses that researchers predict will be the most common viral strains during the flu season. The viruses in the vaccine change each year based on international surveillance and scientists‘ estimations about the types and strains of viruses that…

By: Ebey P. Soman – Current research demonstrates a strong correlation between the length of time a child watches television and decreased long-term attention deficiency disorders. A new study by Lillard and Peterson at the Department of Psychology at the University of Virginia suggests that the popular children‘s television show, SpongeBob SquarePants, might be harmful.…

By: Mahdieh Danesh Yazdi – Heart failure is a condition in which the heart cannot pump blood efficiently to adequately perfuse tissues. It is often associated with serious consequences, such as kidney failure, liver dam-age, heart attack, and stroke. Patient care is focused on preventing these complications. Recently, attention has turned to other concerns: studies…