Even though school is out, plenty of research happens in the summer. You may spend your time researching which beach has the softest sand, what combination of ingredients make the best burger or maybe researching where the pool floaties ended up after last summer. The College of Pharmacy faculty at the University of Findlay have been spending their time performing research that will expand the knowledge in the field of pharmaceutical practice. Over the course of May and June, several professors at Findlay have been published in a variety of pharmaceutical journals covering topics ranging from pharmacy practice challenges in India to essential knowledge pharmacists should have on Parkinson’s disease.
Parkinson’s Disease Continuing Education
Approximately 1 million Americans currently live with Parkinson’s disease with 60,000 new cases diagnosed each year. Common symptoms of resting tremors, slowness of movement and rigidity appear in geriatric patients for a variety of reasons and as there is no definitive diagnostic test, the misdiagnosis rate of Parkinson’s is strikingly high at 25 percent. To assist pharmacists in accurately diagnosing patients with Parkinson’s, Richard Dudley, Ph.D., and Charles Mosler, Pharm.D. co-authored a continuing education piece, “A Review of Parkinson’s Disease: Essentials for Pharmacists”, for the Ohio Pharmacist Association Journal, Volume 67, No. 6, June 2018. This paper reviewed the pathological basis of Parkinson’s disease (PD) and the resulting motor and non-motor symptoms in order to increase pharmacists’ ability to identify symptoms and appropriate care for patients.
Mosler, a professor at Findlay since 2010, was chosen to be one of four participants to attend a four-day seminar at the Northwestern University Parkinson’s Disease and Movement Disorder Clinic last summer. He has created courses at Findlay that delve into the nuances of the disease, such as the accompanying sleep disorders and patient self-care, providing more information than general coursework does.
Monte Carlo Simulation in Practice
Monte Carlo simulations are used when trying to solve issues of optimization when there is not a large data set to pull from. The simulations substitute a range of values—a probability distribution—for any factor that has inherent uncertainty. It then calculates results over and over, each time using a different set of random values from the probability functions. By using probability distributions, variables can have different probabilities of different outcomes occurring. Once the calculations are complete the data will show the outcome with the highest occurrence, which indicates range of highest optimization.
Susan Lewis, Pharm.D. utilized the Monte Carlo simulation technique during research into kidney failure treatments, an area of research that traditionally has small amounts of data due to available patients. The first paper, titled “Development of a vancomycin dosing approach for critically ill patients receiving hybrid hemodialysis using Monte Carlo simulation,” was published May 11 in SAGE Open Medicine Journal. Her second paper, published in the June 2018 edition of the American College of Clinical Pharmacology’s (ACCP) Journal of Clinical Pharmacology, was titled “A Monte Carlo Simulation Approach for Beta-Lactam Dosing in Critically Ill Patients Receiving Prolonged Intermittent Renal Replacement Therapy.”
Ebola Disease in Education
Ebola Virus Disease (EVD) is a severe, often fatal illness. Studies have shown that healthcare professionals lack an in-depth knowledge of EVD. Europe, Asia and Africa are beginning to emphasize the need to train healthcare professionals about EVD, but the United States still lacks formal training for healthcare students. Jason Guy, Pharm.D., with several other authors, published the paper “Effects of Ebola Virus Disease education on student health professionals” in Elsevier’s Currents in Pharmacy Teaching and Learning Journal. In order to enhance EVD training, there needs to be evidence that the training does help improve knowledge of participants. The research found a type of educational intervention that is a useful tool to help enhance or augment knowledge for healthcare workers. This may help in providing better care for patients and enhanced education available in the United States.
Medicinal Herbs in Education
Although the use of herbs as medicine dates back to the origins of pharmacy itself, it is having a bit of an identity crisis in relation to medicine in America. While the worldwide herbal medicine industry is estimated at $83 million, it is not regulated like conventional drug therapies are. Additionally, with a rise in the geriatric community using herbal medicine in conjunction with complicated conventional drug treatments, there is an increasing risk of conflicting reactions that can cause harm to the patient.
Chandra Sekar, Ph.D., and Findlay student Taylor Allen are making the case that in order to truly be experts in the field, pharmacists should have Medicinal Herbs as a required course in school. In their paper, fittingly titled “Should ‘Medicinal Herbs’ be a Mandatory Course for Pharmacy Students?,” published in Crimson Publishers Modern Applications in Pharmacy & Pharmacology Journal, they cite studies that show patients rarely inform their doctors about self-medication using herbal medication due to fear the doctor will mock them. This in addition to evidence that University of Findlay students who have taken the college’s “Medicinal Herbs” course make safer recommendations using their knowledge of herbal and clinical drug interaction makes a strong case that both pharmacists and patients would benefit greatly from a wider knowledge of how medicinal herbs interact with conventional drugs.
Pharmacy Practice Challenge in India
In addition to challenging pharmaceutical practices in America, Sekar has also been busy researching the effectiveness of pharmacy practice on an international scale. In a commentary paper “Major Pharmacy Practice Challenge for India: Irrational Fixed Dose Combination” published in the Indian Journal of Pharmacy Practice, Vol 10, Issue 2, Sekar along with two Findlay students, Kunjal Patel and Prachie Patel, show that the current practice of fixed doses in India is unsustainable.
Fixed doses combinations (FDCs) is a term for a pill that consists of two or more active ingredients. It is beneficial for patients who need to take multiple pills to treat a disease. By combining two medicines into one, it reduces the number of pills to keep track of, thus making it easier for the patient to remember and reducing the likelihood that they will fall into relapse. When used appropriately, FDCs can lead to better outcome of case managements including greater patient compliance, easier dosing schedule, lower risk for side effects and lower cost.
While there are many benefits to FDCs, if used inappropriately the risks far outweigh the benefits. In India there are currently over 6000 FDC products in the market with most being considered ‘irrational.’ This means that there is no scientific rationale for the combinations and they only lead to harm for the patient. These drugs are often created for pure profit as the cost of an FDC is higher than the cost of a single ingredient drug. These drugs are not approved by the central regulator in India, but due to a large loophole in the law, are still able to receive manufacturing and distribution licenses. Sekar, Patel and Patel argue that if the practice of pharmacy is going to continue to grow in India, the practice of irrational FDCs must stop.
If you have any questions about the research done or about the University of Findlay’s College of Pharmacy, contact the pharmacy office at 419-434-5646.