Assessing student perceptions of the Pharm.D. degree at a private tertiary medical university in India

Background: Pharmacy education in India has expanded to include the Doctorate of Pharmacy degree (Pharm.D.). With clinical practice in early development, job opportunities in India are limited. Graduates often consider pharmacy opportunities abroad. Aims: This study compares Indian students’ career aspirations related to the Pharm.D. degree before and after beginning their programmes. Methods: A 5-point Likert scale paper survey with open ended questions was distributed to all Pharm.D. students (Year 1- 6) at a medical university in India. Results: With a response rate of 83% (144/173), over half of the students’ primary goal was to pursue careers abroad post-graduation (54.2% before, 51.4% after). Data from the last three graduating classes indicated that 28.3% travelled abroad for future studies while 62.3% secured positions in India. Conclusions: Opportunities abroad remain challenging for Indian trained Pharm.D.s’; graduates may consider the expanding clinical opportunities in India

Compounded Apixaban Suspensions for Enteral Feeding Tubes

Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of seven days. Methods: Apixaban suspensions were prepared from commercially available 5 mg Eliquis® tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride (PVC), with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A seven-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40-60% Ora-Plus® in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus®:water, was compatible with both tubing types, retaining \u3e 98% drug in post-tube samples. The stability study also confirmed that this formulation was stable physically and chemically over seven days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus®:water. The stability study results supported a beyond-use date of seven days at room temperature

SGLT-2 Inhibitors: A Novel Mechanism in Targeting Glycemic Control in Type 2 Diabetes Mellitus

OBJECTIVE: To review the chemistry, pharmacology, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, dosing, drug interactions, and administration of canagliflozin, dapagliflozin, and empagliflozin, and comparing the benefit and risk aspects of using these agents in the older adult diabetes patient population. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION, AND DATA SYNTHESIS: A search of PubMed using the terms SGLT-2 inhibitors, canagliflozin, dapagliflozin, empagliflozin, efficacy, and tolerability was performed to find relevant primary literature on each of the sodium/glucose cotransporter 2 (SGLT-2) inhibitors currently approved for use in type 2 diabetes. Phase III trials for all agents were included. All English-language articles from 2010 to 2015 appearing in these searches were reviewed for relevance to this paper. In addition, related articles suggested in the PubMed search were also reviewed. The SGLT-2 inhibitors have shown a reduction in hemoglobin A1c values and fasting plasma glucose levels with a low incidence of hypoglycemia. The incidence of mycotic infections is increased in patients taking an SGLT-2 inhibitor. CONCLUSION: SGLT-2 inhibitors may be a viable treatment option for patients not controlled on other oral agents. The risk of hypoglycemia is small. However, the clinical efficacy and tolerability of these agents has not been fully elucidated in older and frail patients

Sertraline and Phenytoin Drug Interaction in a Geriatric Patient

This report presents the case of a 78-year-old man residing in a nursing home who presented with a 2-month history of increasing lethargy and confusion. These symptoms coincided with the initiation of sertraline in the patient. Among other medications, he was also taking phenytoin. The medical team concluded that the cause of the patient’s lethargy and confusion was a drug interaction between sertraline and phenytoin. Phenytoin was held, while the sertraline was slowly tapered to discontinuation. The patient’s symptoms resolved soon thereafter. Future research is needed to better guide clinicians in appropriate selection, dosing, and monitoring of selective serotonin reuptake inhibitors with concomitant phenytoin use.Key words: phenytoin, sertraline, SSRIs, drug interactio

Assessing student perceptions of the Pharm.D. degree at a private tertiary medical university in India

Background: Pharmacy education in India has expanded to include the Doctorate of Pharmacy degree (Pharm.D.). With clinical practice in early development, job opportunities in India are limited. Graduates often consider pharmacy opportunities abroad. Aims: This study compares Indian students’ career aspirations related to the Pharm.D. degree before and after beginning their programmes. Methods: A 5-point Likert scale paper survey with open ended questions was distributed to all Pharm.D. students (Year 1- 6) at a medical university in India. Results: With a response rate of 83% (144/173), over half of the students’ primary goal was to pursue careers abroad post-graduation (54.2% before, 51.4% after). Data from the last three graduating classes indicated that 28.3% travelled abroad for future studies while 62.3% secured positions in India. Conclusions: Opportunities abroad remain challenging for Indian trained Pharm.D.s’; graduates may consider the expanding clinical opportunities in India

Compounded Apixaban Suspensions for Enteral Feeding Tubes

Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of seven days. Methods: Apixaban suspensions were prepared from commercially available 5 mg Eliquis® tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride (PVC), with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A seven-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40-60% Ora-Plus® in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus®:water, was compatible with both tubing types, retaining \u3e 98% drug in post-tube samples. The stability study also confirmed that this formulation was stable physically and chemically over seven days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus®:water. The stability study results supported a beyond-use date of seven days at room temperature

The Relationship Between Pharmacy Student\u27s Beliefs About Medications and Their Counseling Behaviors

Objectives: Objectives were to assess pharmacy student beliefs about medications and the relationship with grades in a pharmacy counseling course. Method: Third year pharmacy students in a pharmacy counseling course were surveyed using the previously validated Beliefs about Medications Questionnaire-General (BMQ-G). The BMQ-G includes four subscales (overuse, harm, benefit, and sensitivity to medications) rated on a 5-point Likert scale (higher scores represent stronger feelings). Belief profiles were created using two-step cluster analysis to group students with similar beliefs. Students also reported demographics and prior work in a pharmacy setting. Grades from a ‘simulated’ patient counseling session were collected via school records. Student t-test and multivariate linear regression were used to compare beliefs with grades. Results: Among 66 students (84.5% response rate), 54.5% were female, 80.3% white, and 77.3% non-Hispanic. Nearly all students (84.8%) reported working in a pharmacy setting. Overall mean(sd) scores on the beliefs scales were: overuse 3.12(.76), harm 1.83(.53), benefit 3.99(.55), sensitive soma 2.37(.82). Cluster analyses revealed two beliefs profiles: Negative Profile-more feelings of overuse, harm, and sensitivity to medications and less benefit, Positive Profile-less feelings of overuse, harm, and sensitivity to medications and greater benefit. Students with positive belief profiles had higher grades compared to students with negative belief profiles (90.0 vs. 87.2, p=.014). Findings remained in a multivariate linear regression controlling for gender and prior work in a pharmacy. Implications: As counseling becomes primary to a pharmacist’s role, findings from this study demonstrate the need for greater understanding about the relationship between pharmacist’s beliefs about medications and patient counseling

Compounded apixaban suspension for enteral feeding tubes

Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of seven days. Methods: Apixaban suspensions were prepared from commercially available 5 mg Eliquis® tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride (PVC), with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A seven-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40-60% Ora-Plus® in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus®:water, was compatible with both tubing types, retaining \u3e 98% drug in post-tube samples. The stability study also confirmed that this formulation was stable physically and chemically over seven days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus®:water. The stability study results supported a beyond-use date of seven days at room temperature

The Relationship Between Pharmacy Student\u27s Beliefs About Medications and Their Counseling Behaviors

Objectives: Objectives were to assess pharmacy student beliefs about medications and the relationship with grades in a pharmacy counseling course. Method: Third year pharmacy students in a pharmacy counseling course were surveyed using the previously validated Beliefs about Medications Questionnaire-General (BMQ-G). The BMQ-G includes four subscales (overuse, harm, benefit, and sensitivity to medications) rated on a 5-point Likert scale (higher scores represent stronger feelings). Belief profiles were created using two-step cluster analysis to group students with similar beliefs. Students also reported demographics and prior work in a pharmacy setting. Grades from a ‘simulated’ patient counseling session were collected via school records. Student t-test and multivariate linear regression were used to compare beliefs with grades. Results: Among 66 students (84.5% response rate), 54.5% were female, 80.3% white, and 77.3% non-Hispanic. Nearly all students (84.8%) reported working in a pharmacy setting. Overall mean(sd) scores on the beliefs scales were: overuse 3.12(.76), harm 1.83(.53), benefit 3.99(.55), sensitive soma 2.37(.82). Cluster analyses revealed two beliefs profiles: Negative Profile-more feelings of overuse, harm, and sensitivity to medications and less benefit, Positive Profile-less feelings of overuse, harm, and sensitivity to medications and greater benefit. Students with positive belief profiles had higher grades compared to students with negative belief profiles (90.0 vs. 87.2, p=.014). Findings remained in a multivariate linear regression controlling for gender and prior work in a pharmacy. Implications: As counseling becomes primary to a pharmacist’s role, findings from this study demonstrate the need for greater understanding about the relationship between pharmacist’s beliefs about medications and patient counseling