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: Benedette Cuffari, BS Toxicology Candidate c/o 2015 – Hemophilia B is an inherited bleeding disorder that is caused by a substantially reduced or complete lack of blood clotting factor IX. Therefore, people suffering from hemophilia B experience bleeding episodes that cause pain, irreversible joint damage, and life threatening hemorrhages. Approximately 28,000 people are currently…

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: Valentina DiGangi,PharmD Candidate c/o 2017, Brandon Hu, PharmD Candidate c/o 2018, Sang Hyo Kim, Staff Editor, Samantha Lau, PharmD Candidate c/o 2018, and Seowoo Yoon, PharmD Candidate c/o 2018 – What does a clinician do when there is limited access to a particular drug, such as morphine? Should they treat a patient who is…

By: Sherin Pathickal, PharmD Candidate c/o 2016 – In 2006, the Institute of Medicine reported that over 1.5 million people in the US suffered from a medication error, errors that not only cost the economy billions of dollars, but endangered countless lives.1 Each year, approximately 7,000 deaths occur to due to preventable medication related errors.2…

By: Davidta Brown, Senior Staff Editor – A new therapeutic device has seemingly leapt from the pages of a science fiction novel and into the hands of migraine sufferers around the world. Worn over the forehead and sending electromagnetic stimulation directly into the supraorbital trigeminal nerves, the cranial nerve stimulator offered by Belgian biotechnology company…

By: Sherin Pathickal, PharmD Candidate c/o 2016 – The mandatory receipt of vaccinations as a preventive public health measure has long been a controversial issue in our society.1 Despite the popular use of immunizations, many reservations about vaccine constituents and their safety have prevailed, leading to increasing numbers of unvaccinated people.1 Opponents of vaccinations have…

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: Erica Dimitropoulos Co-Copy Editor [Content- Focused]  – On February 14, 2014, elosulfase alfa (Vimizim™) became an FDA-approved enzyme replacement therapy for Morquio A Syndrome, a type of mucopolysaccharidosis (MPS IVA).1 Elosulfase alfa was granted priority review and was also the first drug to receive the Rare Pediatric Disease Priority Review Voucher that motivates the development…

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: Daniel Mathan, PharmD Candidate c/o 2016, Anita Kachappilly, PharmD Candidate c/o 2016, & Amrita Singh, PharmD Candidate c/o 2015 – Systemic lupus erythematosus (SLE) is a debilitating autoimmune disease that affects multiple organs in the body and can potentially become life threatening.1 The incidence of SLE is about 50 cases for every 100,000 people; it…

By: Sabrina Ahmed, PharmD Candidate c/o 2017 – One recent stride towards combating worldwide infectious disease has been in the improved surveillance of Japanese encephalitis in Asia, predominantly in South and South-East Asia. This potentially deadly virus is transmitted to humans via mosquito bites. The Japanese encephalitis (JE) virus is the leading cause of encephalitis…

By: Amrita Singh, PharmD Candidate c/o 2015 – Last November, the American College of Cardiology and the American Heart Association released new lipid guidelines, which will transform the way we manage our patients with hyperlipidemia. Earlier, lipid management was based on the ATP-III guidelines, which emphasized the use of several lipid-lowering medications to reach target…

By: Sherin Pathickal, PharmD Candidate c/o 2016 – Dengue Fever, widely known as “break-bone fever,” is an illness that causes pain in the joints and muscles, and is often described by those infected as comparable to the feeling of breaking a bone.1 It is spread by mosquitoes and has a painful array of symptomology such…

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: 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: 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…

Samad Tirmizi, Pharm. D. Candidate c/o 2014 – Deep vein thrombosis (DVT) is a clot formation that occurs within deep veins, generally in the legs. This can cause swelling and pain due to the engorged vessels, and can eventually result in further complications such as a pulmonary embolism. Patients at high risk for DVT are…

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 Davidta Brown, Staff Editor – For post-operative pain treatment, few drugs are as trustworthy, as tried-and-true, as codeine. Prescriptive confidence in the analgesic has promoted its use in children recovering from uncomplicated surgeries, but the spate of injuries and deaths of young children who had been given codeine after undergoing adenotonsillectomies has provoked a…

By: Sang Hyo Kim, Staff Editor – This year, on July 23rd, FDA advisers voted 7 to 6, with one abstention, in favor of approving the drug certolizumab (Cimzia®) for the indication of axial spondyloarthritis (axSpA). axSpA is a chronic imflammatory condition that includes ankylosing spondylitis (AS) and non-radiographic axial spndyloarthristis (nr-axSpA).1,2 axSpA, AS and…

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: Ada Seldin PharmD Candidate c/o 2015 – On April 16th, 2013, the FDA approved the labeling change for the reformulated OxyContin® (oxycodone hydrochloride controlled-release) tablets, made by Pharma L.P. This change reflects the abuse-deterrent properties of the reformulated OxyContin®, which were not present in the original formulation approved by the FDA in 1995. OxyContin®…

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: Hayeon Na, Co-Copy Editor [Content-Focused] – On March 22, 2013, Public Broadcasting Service (PBS) aired an episode of “Need to Know” on the safety of low to moderate risk medical devices. The episode closely followed the lawsuit of patient Linda Gross who has pelvic organ prolapse and was advised by her doctor to undergo…

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: Bansri Patel – As of May 1st 2013, Plan B®, the brand name emergency contraception pill will now be available to women aged fifteen and older. It will also be sold in the drug store aisles, as opposed to its current location behind the pharmacy counter. When levonorgestrel (Plan B®) first entered the market,…

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: Tamara Yunusova, Staff Editor – On December 3, 2012, the U.S. Second Circuit Court of Appeals became the first court in the nation to authorize off-label drug promotion under the First Amendment.  The heavily-disputed ruling, which is headed for further appeal, will have far-reaching implications for pharmaceutical companies and drug regulation policy. In a…

By:  Monica Correia, PharmD Candidate c/o 2013 – This past year of advanced pharmacy rotations, has been a tremendous learning experience for me; I was exposed to the day to day functions and roles of pharmacists in a multitude of environments.  While each experience allowed me to focus on a different aspect of pharmacy, the…

By: Tamara Yunusova – On Wednesday, July 25th a petition signed by the reform group Physicians for Responsible Opioid Prescribing (PROP) called on the FDA to implement opioid label changes that would restrict Chronic Non-Cancer (CNCP) opioid treatment for patients with severe pain only.  It wasn’t too long before another petition signed by PROP’s adversary,…

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 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: Addolorata Ciccone, Student Copy Editor – As a fifth-year pharmacy student researching and ranking advanced pharmacy practice experience (APPE) sites, I felt excited at the prospect of taking the knowledge and skills I obtained in the classroom and applying it to real world patients and scenarios.  My years of work in community pharmacies were…

By: Nandini Puranprashad, Pharm D. Candidate c/o 2013 – I’m sitting in a quaint coffee shop in Cherokee, North Carolina, sipping a dirty chai tea with some of my roommates with 1970s music chiming in the background as I write this article and words cannot describe my experiences at this rotation.  The most surprising aspect…

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 Nandini Puranprashad, Pharm D. Candidate c/o 2013 – Felipe Camacho is a 6th year student at the University of Florida College of Pharmacy.  He received his Bachelors of Arts in Music Composition from Rollins College, Winter Park, FL.  After graduation, Mr. Camacho plans to pursue a residency at the Veterans Affairs (V.A.), Lee Memorial…

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 Mohamed Dungersi, Associate Student Editor – Match the following herbal products with their natural source and reason for use: A. This product is a source of omega-3 fatty acids, primarily docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).  It is used to lower triglyceride levels, to lower high blood pressure, and for a variety of…

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: 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: 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: Stanley Saji, Pharm.D. Candidate c/o 2013 – I had a preconceived notion that advanced pharmacy practice experiences (APPEs) were just an application of concepts and therapies learned in pharmacy school.  Little did I know how real APPEs became… During my third rotation, I worked with Dr. Maha Saad, Assistant Clinical Professor in the Department…

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: 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: 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…