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: 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: Mahdieh Danesh Yazdi – The views expressed in this article are solely those of the author and do not reflect the views of the Rho Chi Post, Rho Chi Beta Delta Chapter, or St. John’s University College of Pharmacy and Health Sciences.   For the past few months, I have been on rotation at…

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, 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: 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: James W. Schurr, PharmD Candidate c/o 2014 – Nutrition Support Pharmacy is a specialized practice pertaining to the needs of patients receiving Parenteral (PN) or Enteral Nutrition (EN).  Nutrition Support Pharmacists (NSPs) are integral members of the nutritional support team and bring valuable skills and knowledge to the clinical practice setting.  The Board of…

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: 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: 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: 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: 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: 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: Maria A. Sorbera, Pharm.D. Candidate c/o 2013 –   Maria Sorbera was the 2011-2012 President of the Rho Chi Beta Theta Chapter at the Arnold & Marie Schwartz College of Pharmacy at Long Island University (LIU). She is a strong advocate of networking with fellow pharmacists regardless of their area of expertise, as well…

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: 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: 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: Mahdieh Danesh Yazdi – In previous issues, we discussed prescription drug abuse and several bills currently on the floor of the NYS Legislature, sponsored by Sen. Hannon which addressed the issue. On February 7th, I sat down with Sen. Hannon’s director of communications, Mr. Phil Hecken, and his legislative aide, Mr. Timothy Broschardt to…

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: Shannon Tellier – In December 2011, a report written to the United States (U.S.) Surgeon General, Dr. Regina Benjamin, discussed the importance of pharmacists in the healthcare system.  The objective of the report was to obtain support for expanding the roles of pharmacists in patient care, primary care, and public health services.  This evidence-based…

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: 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: 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: 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: Sandra Leal Pharm.D., CDE –  Sandra Leal, PharmD, CDE is the Director of Clinical Pharmacy at El Rio Health Center in Tucson, Arizona. Dr. Leal is the first pharmacist in Arizona to receive prescriptive authority under collaborative practice. She is currently the Co-Chair of HRSA’s Patient Safety and Clinical Pharmacy Services Collaborative, a national…

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: Jim Fitzgerald, RPh – James Fitzgerald is a SUNY Buffalo School of Pharmacy graduate from the class of 1980. He is currently the supervising pharmacist at Pathmark Pharmacy of Baldwin in Long Island, New York. Mr. Fitzgerald is also a community pharmacy preceptor with St. John’s University and a longtime member of the Rho…