Follow

• 

  Clinical Skills Development in the Virtual Learning Environment: Adapting to a New World

  Erini S. Serag-Bolos, Liza Barbarello Andrews, Jennifer Beall, Kelly A. Lempicki, Aimon C. Miranda, Carol Motycka, Chelsea Phillips Renfro, Brittany L. Riley, Chasity M. Shelton, Deepti Vyas, and Kimberly Won

  The rapid transition to distance learning in response to the unexpected SARS-CoV-2/COVID-19 pandemic led to disruption of clinical skills development, which are typically conducted face-to-face. Consequently, faculty adapted their courses, using a multitude of active learning modalities, to meet student learning objectives in the didactic and experiential settings. Strategies and considerations to implement innovative delivery methods and address potential challenges are elucidated. Furthermore, integration of a layered learning approach may allow for more broad perspectives and allow additional interactions and feedback, which is especially necessary in the virtual environment.

• 

  Equity for All: Providing Accessible Healthcare for Patients Living with Disabilities

  Michelle L. Blakely, Sharon E. Connor, and Jennifer Ko

  At the end of this activity, students will be able to:

  • Identify relevant resources to assist patients living with disabilities
  • Recommend appropriate patient-specific resources to minimize barriers to health
  • Identify strategies to enhance the healthcare experience of patients living with disabilities
  • Describe the policies that currently exist to enhance care for patients living with disabilities

• 

  Let Your Pharmacist Be Your Guide: Navigating Barriers to Pharmaceutical Access

  Jennifer Ko, Miranda Steinkopf, and Sharon E. Connor

  At the end of this case, students will be able to: • Describe policy, organizational, and individual factors that contribute to barriers to accessing medications and pharmaceutical care • Identify resources to improve access to affordable medications for uninsured and underinsured patients • Recommend appropriate resources for obtaining affordable medications

• 

  Digging Deeper: Improving Health Communication with Patients

  Jennifer Ko, Miranda Steinkopf, Abby A. Kahaleh, and Sharon Connor

  At the end of this activity, students will be able to:

  • Identify five theories and models that can be used to facilitate the patient-provider health communication process
  • Describe opportunities to optimize communication with patients in healthcare settings
  • Apply health communication theories within patient care, providing specific approaches and language to utilize

• 

  Functional MOFs as Molecular Imaging Probes and Theranostics

  Rajasekharreddy Pala, Subhaswaraj Pattnaik, Yun Zeng, Siddhardha Busi, Surya M. Nauli, and Gang Liu

  "[T]the indiscriminate and irrational use of antibiotics has led to the emergence of multidrug resistance (MDR) which significantly affected the growth and development of conventional antibiotics. Besides, the increasing gap between the emergence antibiotic resistance and development of new class of antibiotics has further aggravated the health risks to human beings [5]. In this context, it is imperative to search for the alternative therapeutic approaches which critically complement the proper utilization of conventional therapeutic strategies in the post-antibiotic era."

• 

  Interpreting Pharmacoeconomic Findings

  Piyameth Dilokthornsakul, Dixon Thomas, Lawrence M. Brown, and Nathorn Chaiyakunapruk

  "Important questions are 'Is the drug worth paying for?' and 'Is the drug affordable within limited budgets?' To answer these questions, decision-makers need to assess the clinical benefits and costs of newer and existing drugs. It is obvious that clinical benefits and costs of drugs should be assessed in an organized way rather than using an informal assessment, such as 'educated guess' or 'what we did last time.' Pharmacoeconomics provides systematic approaches to assess the clinical benefit and cost of drugs in a comparative manner."

• 

  Membrane Microdomains and cAMP Compartmentation in Cardiac Myocytes

  Shailesh R. Agarwal, Rennolds S. Ostrom, and Robert D. Harvey

  "Signaling through the diffusible second messenger, 3′,5′-cyclic adenosine monophosphate (cAMP) is critical to the regulation of cardiac function. Several different G-protein-coupled receptors, including β-adrenergic receptors, muscarinic receptors, and E-type prostaglandin receptors, elicit distinct responses using this ubiquitous second messenger. One critical paradigm that has emerged to explain this behavior is that cAMP signaling is compartmentalized. Spatially confining specific receptors and their downstream effector proteins to form subcellular signaling complexes has been proposed to allow for the high efficiency and fidelity in producing specific functional responses. In cardiac myocytes, lipid rafts created by cholesterol- and sphingolipid-rich membrane microdomains have been demonstrated to act as one means of sorting appropriate receptors and corresponding effectors to relevant subcellular locations. Caveolae, which represent a specific subset of lipid rafts, can dynamically attract or exclude specific signaling proteins through a variety of mechanisms to create highly localized and self-sufficient multi-molecular signaling complexes. Furthermore, disruption of this organization in disease states such as heart failure has been found to alter cAMP responses. In this review, we summarize the current understanding of the role of membrane domains in cAMP signaling in cardiac myocytes. We also highlight the insights gained from previous studies to offer new avenues of research in this expanding field of study."

• 

  Psychobiology and Psychopharmacology

  Mary Gutierrez and Jerika Lam

  "Before looking at specific drugs, this chapter begins with an overview of normal functions of the brain and how these functions are carried out. Theories of the psychobiological basis of various types of emotional and physiological dysfunctions are presented next. Finally, the chapter reviews the major classification of drugs used to treat mental disorders, explains how they work, and identifies both the beneficial and the problematic effects of psychiatric drugs. Additionally, detailed information regarding adverse and toxic effects, nursing implications, and teaching tools are presented[.]"

• 

  Mechanosensory and Chemosensory Primary Cilia in Ciliopathy and Ciliotherapy

  Surya M. Nauli, Rinzhin T. Sherpa, Caretta J. Reese, and Andromeda M. Nauli

  "Over the past few decades, we have been able to integrate mechanobiology into the molecular basis of disease. Mechanical forces in the cellular microenvironment have been recognized as critical regulators of molecular responses, biochemical reactions, gene expression, and tissue development. Recent insights into cellular mechanotransduction point to the primary cilium as an important cellular organelle responsible for sensing mechanical fluid-shear stress and eliciting downstream effects."

• 

  Cardiovascular Conditions

  Laura V. Tsu

  Based on the chapter by Angela R. Mitchell and Tekoa L. King in the first edition of Pharmacology for Women's Health.

• 

  The Anti-vaccine Movement – A Pharmacist’s View

  Jeffery A. Goad and Melissa Durham

  Goad and Durham discuss the anti-vaccine movement from a pharmacist's perspective, and explore the pharmacist's role in immunizations and the impact of pharmacist-patient communication on vaccinations.

• 

  Biological Basis for Understanding Psychiatric Disorders and Treatments

  Mary Gutierrez, Jerika Lam, and Mary Ann Schaepper

  "The overall purpose of this chapter is to relate psychiatric disturbances and the psychotropic drugs used to treat them to normal brain structure and function. First, this chapter looks at the normal functions of the brain and how these functions are carried out from an anatomical and physiological perspective. Then, it reviews current theories of the psychobiological basis of various types of emotional and physiological dysfunctions. Finally, the chapter reviews the major drugs used to treat mental disorders, explains how they work, and identifies how both the beneficial and the problematic effects of psychiatric drugs relate to their interaction with various neurotransmitter-receptor systems."

• 

  Biomineralization and Biomimicry of Tooth Enamel

  Vuk Uskoković

  This critical review summarizes the basics of biomineralization of tooth enamel and scrutinizes attempts to replicate this intricate biological process in vitro. Special emphasis is given to the author's results, obtained during studies on the formation of enamel by biomimetic means. Fundamental insights found regarding the latter process are presented. Some paradigmatically accepted aspects of the mechanism of amelogenesis, that is, biomineralization of enamel, are challenged. Amelogenin, the major protein of the developing enamel matrix, is thus claimed to be a mineralization inductor, rather than an inhibitor, presumably acting as a channel between the ionic growth units in the protein matrix and the uniaxially growing crystals of apatite. The role of water and other minor constituents of enamel is questioned, as well as the biologically active morphology of amelogenin aggregates and the reliability of recombinant proteins in studying amelogenesis in vitro. Appropriate crystal growth rates, the Ostwald-Lussac law, Tomes' process and mineralization of dentin present other aspects of amelogenesis discussed here. It is also claimed that three fundamental facets of amelogenesis ought to be coordinated in parallel for successful biomimetic replication of the given process in the laboratory: protein assembly, protoeolytic digestion and crystal growth.

• 

  Application of Pharmacokinetics/Pharmacodynamics (PK/PD) in Designing Effective Antibiotic Treatment Regimens

  Ghada F. Ahmed and Ayman Noreddin

  "Designing antibiotic dosing regimens is often not optimal and the dose-response relationship for most antibiotics is not well-known1. Both Pharmacokinetics (PK) and Pharmacodynamics (PD) are characteristics of antimicrobial agents that should be considered in the development of effective antibiotic therapy. By linking the concentration time profile at the site of action to the drug effect (PK/PD), the effect of varying dosage regimens against pathogens could be simulated enabling the identification of effective dosage strategies. It is known that inadequate antibiotic dosing could not only lead to a therapeutic failure, but also to the development of bacterial resistance. Importantly, the evolution of resistance in pathogenic bacteria combined with the decreasing interest from the pharmaceutical industry in developing new antibiotics has created a major public health problem3. Therefore, the activities to maintain the effects of existing antibiotics and prolong their useful life span have a high priority."

• 

  Palliative Care and Quality of Life

  David M. Chase, Siu Fun Wong, Lari Wenzel, and Bradley J. Monk

  "Once viewed as limited and focused care during the final days of life, the scope of palliative medical care and quality of life (QOL) research has evolved since the 1990s."

• 

  Psychopharmacology (TCAs, SSRIs, SNRIs) and Pain

  Glenn T. Clark, Mary Gutierrez, Jacqueline S. Venturin, and Steven H. Richeimer

  "This chapter focuses on these [psychopharmalogical] agents as they have been used in the comanagement of chronic pain and orofacial pain, in particular. The linkage between these drugs and their use in pain is beyond the fact that, frequently, pain patients have co-morbid depression as well as other psychosocial disorders that impact pain."

• 

  Pharmacokinetic/Pharmacodynamic (PK/PD) Modeling of Anti-Neoplastic Agents

  Daniel Lexcen, Ahmed H. Salem, Walid F. Elkhatib, Virginia Haynes, and Ayman Noreddin

  "Development of tumor resistance to chemotherapeutics is related to inherent tumor variations regarding sensitivity to chemotherapeutics and to sub-optimal dosing regimens, including variation in patient pharmacokinetics that result in suboptimal exposure of tumor cells to anti-neoplastic drugs [1, 2]. The rate and extent of drug efficacy depends on the extent of drug exposure at the tumor site and the time above the effective concentration [3]. In vitro models that incorporate these pharmacokinetic and pharmacodynamic (PK/PD) principles to optimize therapeutic response may be considered the method of choice for optimizing dosing schedules before translating data from static assays to animals and clinical trials [4, 5]. The hollow fiber bioreactor was recently used to evaluate pharmacokinetic/pharmacodynamic (PK/PD) effects of gemcitibine in lung and breast cancers and to model HIV treatments [4-6]."

• 

  Inhibition of Adhesion and Invasion of Pseudomonas aeruginosa to Lung Epithelial Cells: A Model of Cystic Fibrosis Infection

  Ayman Noreddin, Ghada Sawy, Walid Elkhatib, Ehab Noreddin, and Atef Shibl

  "Over their life time, CF patients experience multiple infections by various pneumoniacausing bacteria [6]. With more patients surviving to adulthood, chronic infections with Pseudomonas aeruginosa are coming to the forefront as a leading cause of death [7]. Problems presented by infected CF lung are multi-dimensional; the electrolyte balance and pH of the fluids are abnormal. The mucus is thick and of an alternative composition compared to normal lung and may contribute to colonization with Pseudomonas aeruginosa [2, 3, 5]. As such, research is multi-pronged and includes gene therapy to correct the defective protein, amelioration of inflammatory response and thinning of alveolar surface fluids [8, 9]. Significantly, Pseudomonas bacteria colonize the CF lung far easier than normal lung. Normal lung tissue has several naturally occurring defenses that work in concert with commonly prescribed antibiotics for recovery from lung infections [4, 10]. The CF patient appears to lack these natural defenses [1, 7]."

• 

  Thinking About the Role (Largely Ignored) of Heavy Metals in Cancer Prevention: Hexavalent Chromium and Melanoma as a Case in Point

  Frank L. Meyskens and Sun Yang

  Ultraviolet (UV) light exposure accounts for only 40-50% of the attributable risk for cutaneous melanoma (CM); also classical UV-induced lesions are rare in melanomas (especially among CM with NRAS or BRAF mutations). It is therefore likely that an additional environmental factor exists as familial and genetic factors play a role in less than 5%. A large amount of (largely forgotten) epidemiologic data indicates that heavy metal exposure is strongly associated with the development of CM. Also, epidemiologic studies of patients with joint replacement indicate a marked subsequent time-related increase in melanoma in patients with metal-on-metal hip arthroplasties. In these patients chromium and cobalt levels rise to 10x normal and stay elevated at levels two- to threefold normal for at least 10 years. Chromium is widely used in industry for its anticorrosive and steel-strengthening properties and is widespread in everyday materials. Our hypothesis is therefore that chromium, alone or in conjunction with UV, plays a major role in the pathogenesis of CM. We have incubated human neonatal melanocytes for more than 10 weeks in the presence of a wide range and concentrations of metals without effect except by hexavalent chromium Cr(VI)and to a lesser degree Co²(+). After prolonged culture, chromium-incubated cells produced foci and when replated secondary colonies formed. We have just begun to study this phenomenon in more detail and studies without and with different wavelengths of UV will be explored. Of interest is that aneuploidy (a universal chromosomal change in cutaneous melanoma) in lymphocytes in patients with hip-on-hip metal prostheses has been demonstrated by others.

• 

  Antibacterial Therapy in the Elderly

  Ayman Noreddin and Walid Elkhatib

  As our aged population increases, the unique spectrum of infections presented by this elderly population, particularly those residing in long term care facilities will challenge our ability to maintain an effective battery of antibiotics. The inability to clear drug from the body due to declining lung, kidney/bladder, gastrointestinal and circulatory efficiency can cause accumulation of standard antibiotic doses in the body. Accordingly, there is a heightened risk of reaching toxic drug levels as well as an increased chance of unfavorable interactions with other medications. On the other hand, we can predict problems that arise in treating elderly patients who may have a history of previous antibiotic treatment and exposure to resistant organisms from multiple hospitalizations. Furthermore, the elderly often acquire infections in tandem with other common disease states such as diabetes and heart disease. Thus, it is essential that optimized dosing strategies be designed specifically for this population using pharmacodynamic (PD) principles that take the unique circumstances of the elderly into account. Rational and effective dosing strategies based on pharmacodynamic breakpoints and detailed understanding of the pharmacokinetics of antibiotics in the elderly further the goal of achieving complete eradication of an infection in a timely manner. Specific PD information on isolates and drug susceptibility profiles as well as patient pharmacokinetic (PK) information along with a history of prior antibiotic treatment is imperative for the rational design of specific treatment for an infection in the elderly. Attention must be paid to the PK/PD of the chosen drug in order to ensure maximum bacterial eradication. In addition, this strategy also seeks to prevent the selection of drug resistant bacteria as well as the minimization of toxic effects in the elderly patient. For elderly patients, antibacterial agents with high tissue penetration, lack of interaction with many drugs commonly prescribed to the elderly and whose clearance is not affected by decline of kidney function, may be a preferred choice for the elderly population.

• 

  Protein-Protein Interactions

  Kamaljit Kaur, Dipankar Das, and Mavanur R. Suresh

  "Living organisms are almost exclusively comprised of four classes of molecules, namely, proteins, nucleic acids, polysaccharides, and lipids. Of these, barring lipids, all other classes can be regarded as macromolecules that are built from a limited number of building blocks or monomers. In the case of proteins, such building blocks are amino acids. Proteins are formed by polymerization of essentially twenty 'standard' amino acids. Yet, the myriad of proteins and their diverse functions, ranging from basic metabolism to structural and reproductive functions, can be astounding and constitute the very basis of life on Earth. For instance, an Escherichia coli bacterium contains over 4000 different proteins participating in virtually every life sustaining function of the cell."

• 

  New Perspectives on Melanoma Pathogenesis and Chemoprevention

  Frank L. Meyskens Jr., Patrick J. Farmer, Sun Yang, and Hoda Anton-Culver

  Epidemiologic studies implicate ultraviolet radiation (sunlight) as an etiologic agent for the pathogenesis of melanoma. However, the experimental evidence is less convincing. We present information from recent experimental findings that elevation of reactive oxygen species follows from melanin serving as a redox generator, and that this may play an important role in the etiology and pathogenesis of cutaneous melanoma. These observations offer a new paradigm for the development of preventive (and therapeutic) approaches to this disease.

• 

  Questions and Challenges for the Upcoming Trends in Practical Colloid Science

  Vuk Uskoković

  Practical scope of modern-day colloid science may be presented through a set of achievements and actual aims in preparation of novel materials and construction of novel technologies based on the foundation of knowledge of colloid systems. Yet many uncertainties pervade such field, ranging from the true potential of self-organizing and self-assembling systems in the design of advanced material structures to numerous encounters over the question of practical viability between the tendencies to invest in knowledge on small-scale, molecular recognition processes an on spontaneous, large-scale mesoscopic formation phenomena. Albeit the existence of belief in advancement of knowledge on stereoscopic molecular recognition and molecular assembly recognition that would eventually lead to perfect control inherent in the design of macroscopic structures, trial-and-error phenomena seem to permeate all relevant levels of organization within practical colloid science approaches, from enzymatic, biomolecular recognition processes to the macroscopic design of novel functional outcomes. As genetic evolution teaches us, the major point of any design conductance is not elimination of inherent mistakes, but their productive acceptance, that is mutual coupling with development of improved and more richly organized contexts of knowledge. Within this perspective, inter-disciplinarity, that is constructive crossing of separate scientific areas of investigation, presents a necessary approach immanent in advancement of practical colloid science achievements in the coming area.

• 

  Mood Disorders

  Mary Gutierrez and Glen L. Stimmel

  Details the definition, treatment goals, epidemiology, pathophysiology, clinical presentation and diagnosis, therapeutic plan, treatment, alternative therapies, pharmacoeconomics, and future therapies for mood disorders, including bipolar disorders.

• 

  Schizophrenia

  Mary Gutierrez and Glen L. Stimmel

  Details the definition, treatment goals, epidemiology, clinical presentation and diagnosis, therapeutic plan, treatment, pharmacoeconomics, alternative therapies, and future therapies for schizophrenia.