By: Davidta Brown, Copy Editor [Content-Focused] – It’s difficult to have a discussion about antibiotics without mentioning the developing crisis of antibiotic-resistance. Pathogens like MRSA (methicillin-resistant Staphylococcus aureus) have become a part of the general public’s consciousness – a household name and a community-acquired “superbug.” With the last new class of antibiotics developed in the…

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 – Patients with Type 1 or Type 2 diabetes who cannot control their glucose levels simply by taking oral medications have to inject insulin daily. They also have to measure their glucose levels by using strips and lancets on a regular basis. For patients, especially elderly ones, the…

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: Sabrina Ahmed, PharmD Candidate c/o 2017 – Over the decades, one of the biggest mysteries encountered by researchers has been why so many CD4 T-cells die when one is infected with Human Immunodeficiency Virus (HIV).1 CD4 T-cells are an integral part of the immune system as they locate pathogens and signal other immune cells…

By: Ada Seldin, Staff Editor – Since the first release of the Surgeon General’s Report on smoking 50 years ago, it has become clear that smoking results in premature death and a myriad of diseases, affecting almost every organ system. Public health initiatives to increase awareness, prevent initiation, and promote smoking cessation have been marginally…

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: 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: Frances Trosa PharmD Candidate c/o 2015 – After much anticipation, the report from the Eighth Joint National Committee (JNC 8) has arrived! Panel members appointed to the committee have created evidence – based recommendations to assist physicians in managing hypertensive patients. A major difference between the JNC 7 report and the JNC 8 report…

By: Katharine Cimmino, Editor-in-Chief – Marijuana, also known as “grass,” “pot,” “joint,” “weed,” “reefer,” “hashish,” and “Mary Jane,” is a very popular illicit drug.1 According to the National Survey on Drug Use and Health, “In 2012, 5.4 million persons aged 12 or older used marijuana on a daily or almost daily basis in the past 12…

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: Hamid Razaki, PharmD – Drug shortages seen across pharmacies in the United States continue to be an issue in patient care. A drug product shortage is defined as a supply issue that affects how the pharmacy prepares or dispenses a drug product, or that influences patient care when prescribers must use an alternative agent.1…

By: Ramya Mathew, PharmD Candidate c/o 2015 – Vertex Pharmaceuticals, an American biotechnology company based in Cambridge, Massachusetts, has been researching a new “nuke” for the treatment of Hepatitis C called VX-135. This nucleotide polymerase inhibitor is currently undergoing clinical trials, but the FDA has put the research on a partial hold due to findings…

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,…

By: Ada Seldin, Staff Editor – On August 12,2013, a new weapon against HIV-1 infection was added to the existing armada. Dolutegravir, the third integrase strand transfer inhibitor to attain FDA approval, targets a protein essential to HIV replication. HIV-1 is the predominant type of HIV virus, the other being HIV-2, which is endogenous to…

By: Andy Zhang, PharmD Candidate c/o 2015 – On August 1st, 2013, the U.S. Food and Drug Administration (FDA) released a new warning of serious acetaminophen associated skin reactions, including Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN) and acute generalized exanthematous pustulosis (AGEP).1 Acetaminophen is one of the most widely used over-the-counter (OTC) medication, and…

By: David Ong, PharmD Candidate c/o 2014 – Manipulating the renin-angiotensin system is one of the many ways drugs are used to treat hypertension. By blocking key steps in the renin-angiotensin cascade, blood pressure decrease may be achieved. Angiotensin II receptor blockers (ARBs) represent one of the drug classes that utilize the aforementioned mechanism. ARBs…

By: Aleena Cherian, Co-Copy Editor [Graphics-Focused] – Attention deficit/hyperactivity disorder (ADHD) is a chronic neurological behavior characterized by persistent patterns of inattention and/or hyperactive behavior, resulting in a wide range of emotional, functional, and neurocognitive impairments.1,2 First line therapy for ADHD consists of stimulant medications together with non-pharmacologic interventions, and has been shown to improve…

By Omar Khalid Pharm.D. Candidate c/o 2014 – The outpour of a multitude of new oral anticoagulants in recent years has health care professionals questioning whether they should switch the patients over, and what new agents should be used. With the recent addition of dabigatran (Pradaxa®) in October 2010, rivaroxaban (Xarelto®) in November 2011, and…

By: Nathan Trustman, PharmD Candidate c/o 2013, AMSCOP at LIU – Obesity is defined as having a body mass index (BMI) of 30 kg/m2 or greater. It is thought to be the result of an imbalance between energy intake and energy expenditure, possibly due to a number of genetic and environmental factors.1 It is estimated…

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: Erica Dimitropoulos, Senior Staff Editor – Lupus is highly unpredictable and occurs without warning; there is no known cause and no known cure. It affects over 1.5 million Americans, 90% of whom are women between the ages of 15 – 44.1 No two cases of lupus are alike, making it a very difficult disease…

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: 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 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: 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:  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: 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: 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 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 – 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: 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: 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 – 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: 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: Addolorata Ciccone, Pharm.D. Candidate c/o 2013 – The following medications are easily confused.  Try to match each one with its corresponding fun fact.  This capsule should be swallowed whole; if chewed or dissolved orally, oropharyngeal anesthesia may occur, which poses a choking hazard.  Drinking a glass of water can help bypass this potential adverse…

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: Lunbao (Jerry) Huang, Pharm.D. Candidate c/o 2013 – Counterfeit prescription medications are becoming a great concern for us. They have increased worldwide costs and endangered our public safety. Activities related to counterfeit drugs cost our healthcare system an estimated $75 billion in 2010. Many patients were seriously injured and died due to counterfeit medications.…

By: Mahdieh Danesh Yazdi – As previously reported, there is currently great concern in the medical community because of the growing number of drug shortages.  Many of these are drugs that are critical to patient care, such as chemotherapy agents and antibiotics.  Last October, President Obama issued an executive order in an attempt to curb…

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: 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: 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: Jimmy Johnson, PharmD Candidate c/o 2012 – Drug shortages have become more and more of an issue in the health care industry. There are over 200 drugs on the Food and Drug Administration’s (FDA) drug shortage list – a number that has tripled in the last five years.1 The largest impact has been on anesthesia…