Day 1 :
Keynote Forum
Paul C Ho
National University of Singapore, Singapore
Keynote: Prevalence of drug resistant epilepsy (DRE) and the value of therapeutic drug monitoring (TDM) and utilization of dried blood spots for TDM in epilepsy
Time : 10:30-11:15
Biography:
Paul C Ho has completed his PhD from the University of Queensland on the topic of Clinical pharmacokinetics in the elderly. Subsequently, he continued his Post-doctoral studies at the Upjohn Center of Clinical Pharmacology, University of Michigan, where he studied the pharmacokinetics of controlled release dosage forms. Currently, he is the Professor and Deputy Head of the Department of Pharmacy, National University of Singapore. His current research areas include the pharmacokinetics and biopharmaceutics of drugs for neoplastic and neurodegenerative diseases. He has published over 140 scientific research articles, and 4 chapters in books in his field of study. He is currently serving as Editorial Board Member and reviewer for a number of journals.
Abstract:
The objective of study is to determine the proportion of population of adult people with epilepsy (PWE) in Singapore to have drug resistant epilepsy (DRE). 557 adult PWE who have attended the neurology specialist clinic of a tertiary referral hospital in Singapore were profiled for drug responses according to the definition for DRE as specified by the International League against Epilepsy (ILAE) 2010 consensus. This is a retrospective cohort study. Data collected included demographics, characteristics of seizure and epilepsy, blood biochemistry levels, electroencephalogram and brain imaging findings, and medication histories. The types and dosages of antiepileptic drugs (AEDs) used were retrieved from case notes and checked against pharmacy records. Each patient was counselled upon the diagnosis of epilepsy and taught to maintain a seizure diary. The dates and number of seizures were retrieved from these diaries at each visit. Treatment-related adverse effects were routinely assessed and hence, patients were assumed not to have treatment-related adverse effects when no relevant documentation was encountered. The prevalence rate of DRE in this clinic was 21.5%. From multivariate analysis, patients with structural-metabolic etiology, mental retardation, psychiatric illnesses and pre-treatment seizure frequency of more than once monthly were found to be more likely to have DRE (p≤0.05). Although the influence of Indian ethnicity on the risk of DRE was only found in the univariate analysis, it warrants investigation in a larger cohort.
- Track 1: Clinical Pharmacists Track 2: Hospital Pharmacists Track 4: Industrial Pharmacists Track 5: Academic Pharmacists
Location: Quay 1
Chair
Jun Xu
Sun Yat- Sen University, China
Session Introduction
Lisa Hong
Loma Linda University School of Pharmacy, USA
Title: Continuous infusion vs. intermittent Vancomycin in neurosurgical intensive care unit patients
Time : 11:40-12:10
Biography:
Lisa Hong, PharmD, BCPS is an Assistant Professor at Loma Linda University (LLU) School of Pharmacy and practices in the Internal Medicine Unit at LLU Medical Center. She received her Doctor of Pharmacy degree from the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in 2013 and completed her 1st year of residency training at the University of Colorado Hospital. She then completed a PGY2 in Internal Medicine at the University of Utah. She has a strong interest in interdisciplinary education and has conducted research in the area of antimicrobial pharmacokinetics.
Abstract:
Target plasma level achievement has remained a challenge in neurosurgical intensive care unit patients receiving intravenous vancomycin. We evaluated continuous infusion (CI) and intermittent vancomycin dosing strategies in these patients. We conducted a retrospective cohort comparing CI vancomycin (target random levels, 20-30 mg/L) with intermittent vancomycin (target troughs, 15-20mg/L) in regards to achievement of target plasma levels, nephrotoxicity, pharmacodynamic target attainment, and cost savings in 130 patients. We found that continuous infusion resulted in greater achievement of goal plasma concentrations at the first steady state level (40 vs. 21.5%, P=0.02), more rapid achievement of goal plasma concentrations (2.04 vs. 3.76 days, P=0.0001), and increased time within therapeutic range (55% vs. 34%, P=0.0001) but no significant difference in nephrotoxicity (15.4% vs. 21.5%, P=0.5). Continuous infusion improved pharmacodynamic target attainment (92.3% vs. 30.8%, P=0.0001) and also reduced levels drawn (3.8 vs. 5.7, P = 0.0007), dose adjustments (1.4 vs. 2.4, P=0.0006), days of therapy (10.4 vs. 14.1, P=0.01), and mean total daily dose requirements (33 vs. 35.7 mg/kg, P=0.0001) per patient. In summary, continuous infusion appears beneficial for improving attainment of target plasma concentrations, pharmacodynamic goals, and financial burden, without increasing risk of acute kidney injury.
Stephen Gunadi
Providence St. Peter Hospital, USA
Title: Development of a collaborative transitions-of-care program for heart failure patients
Time : 12:10-12:40
Biography:
Stephen Gunadi has completed his PharmD from Pacific University in Portland Oregon and Post-graduate residency training from Providence St. Peter Hospital in Olympia Washington. He is the lead Pharmacist for Transitions of Care, as well as the Co-chair of the Transitions of Care Pharmacy Pillar for Providence Health & Services System. He is also a peer reviewer for Transitions of Care Publications for the American Journal of Health System Pharmacy. He has 7 contributed papers on the topic of Transitions of Care that have been presented at the American Society of Health-System Pharmacists Midyear Conference.
Abstract:
A transitions-of-care committee was established at Providence St. Peter Hospital, a 390-bed community teaching facility in Olympia, Washington, and focused on implementing standardized workflow processes for conducting admission medication review and discharge medication review and providing discharge counseling for patients with HF. All HF patients were to have admission medication reconciliation performed within 48 hours of admission. All HF patients were assigned a readmission risk complexity score after being admitted to the medical floor. The pharmacist, resident, and student performed daily patient medication profile reviews on all HF patients to ensure the use of optimal doses of appropriate HF medication regimens. The pharmacist proactively monitored for patient discharges using reports available in the electronic medical record. The pharmacist, resident, student, or HF nurse navigator counseled each patient on the discharge medications and answered any questions or addressed concerns regarding medications. Input from the quality-improvement specialist and data abstracter was used to ensure compliance with HF CMS core measures. The program has resulted in an increase in core measure compliance and a reduction of HF, 30-day, and all-cause readmissions, and patient satisfaction scores have improved. For each avoided readmission, there was an associated decrease of $5652 in variable costs.
Krystyna Mojsiewicz- Pieńkowska
Medical University of Gdańsk, Poland
Title: What are the consequences of impact of the polysiloxanes (silicones) on the skin barrier?
Time : 12:40-13:10
Biography:
Krystyna Mojsiewicz-Pieńkowska PhD, DSc is an Assistant Professor in the Department of Physical Chemistry at the Medical University of Gdansk, Faculty of Pharmacy with Subfaculty of Laboratory Medicine, Gdańsk, Poland. She is also an expert in the National Centre for Research and Development. She has published more than 40 papers in reputed journals. She is an active reviewer for the scientific pharmaceutical and chemical journals. Currently, her scientific and research activity is related with: studies of the penetration and permeation of silicones and drugs through the human skin; development of analytical methods for drug analysis; silicones application in pharmacy, medicine and cosmetic products; pharmaceutical technology and; studies of a phenomenon of dissolution of poorly soluble drugs.
Abstract:
Overcoming the barrier of the skin is dangerous especially in case of substances which are: toxic, potent or which have the ability to accumulate. An object of interest are polysiloxanes (silicones) with a linear and cyclic structure due to widespread of their use in medicinal products (e.g. Rozex Metronidazolum) and cosmetics (e.g. Penaten Baby Cream or Body Lotion Garnier), which are intended not only for adults and children, but also for infants. Justification for taking this research is no information in the literature that if these compounds have ability to overcome the skin barrier. Based on the results, it was found that human skin shows no barrier to low molecular weight polysiloxanes with cyclic and linear structure. All tested polysiloxanes have been identified in the stratum corneum due to the possibility of the penetration of this layer, and demonstrated the ability to penetrate into epidermis and dermis, in which are the blood and lymphatic vessels. Also there were found evidence of the presence of interactions of polysiloxane with components building blocks of all layers of the skin: silicone-stratum corneum, silicon-epidermis and silicon-dermis. We also found the cause of overcoming, contrary to the Lipiński rule, the skin barrier by low molecular weight polysiloxane (PDMS having a viscosity of 10 cSt), which has a molecular weight of 1250 Da. It was concluded that overcoming the barrier of the skin by this compound can be due to conformational relaxation of structure of the lipid bilayer of the stratum corneum, which could result in increased permeability of such modified lipid membranes. Also contemplated destruction of the skin barrier occurs due to the extraction of lipid matrix of the stratum corneum by the lipophilic polysiloxanes. To accomplish the objective of the research, Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR) and fluorescence microscope were used. Acknowledgens: This project was supported by Polish Ministry of Science (The National Centre for Research and Development NCN, grant 2013/11/B/NZ7/02076)
Enaase A.M.E. Barakat
Mansoura University, Egypt
Title: Measuring the rate of therapeutic adherence among outpatients with T2DM in Egypt
Time : 14:15-14:45
Biography:
Inas Abdalla Mohamed has completed her PhD from Mansoura University and Post-doctoral studies from Mansoura University Faculty of Medicine. She is an Associate Professor of internal medicine and active member in Mansoura Faculty of Medicine, endocrinology and diabetes department. He has published more than 12 papers in reputed journals and supervised many theses in post-graduate studies.
Abstract:
Background: Therapeutic adherence is considered as an integral component of patient healthcare. Despite effective methods of treatment, 50% of diabetic patients fail to achieve satisfactory glycemic control. Clinical experience indicates that no improvement of metabolic control is possible without patients’ adherence to medications. This study sought to examine the rate of medication adherence and different factors affecting it among Type 2 diabetic patients in Egypt. Methods: A total of 226 Type 2 diabetic patients who fulfilled the inclusion criteria were recruited in the current study. Adherence to the treatment was evaluated during patients’ hospitalization in the Outpatient Clinics of Internal Medicine Department at University of Mansoura, Egypt. The medication adherence has been assessed during a personal interview with each patient using a multiple-choice graded questionnaire. Results: The adherence rates to medication, dietary/exercise and appointment were observed to be suboptimal. The most important social factors included marital status, family support, and socio-economical level. Other factors include patient knowledge about the disease, patients’ beliefs and motivation about prescribed drugs, and regularity of patients’ self monitoring of blood glucose level. Among drug factors, the number of drugs taken, complexity of drug regimen, and the presence of drug side effects. Economical factor played an important role. Direct and indirect care costs in relation to patients’ income were significantly affecting the rate of adherence to medication. Conclusion: An improvement with the adherence to oral hypoglycemic agent(s) may be achieved through patient education about diabetes, improvement of patients’ economical levels as well as a reduction in the cost of medication.
Anja Täuber
Technische Universität Braunschweig, Germany
Title: Poloxamer 407-based formulations with antimycotic ciclopirox olamine for onychomycosis and skin mycosis therapy
Time : 14:45-15:15
Biography:
Anja Täuber has studied Pharmacy in Braunschweig and finished her qualification for Analytics in 2016. She completed her PhD from TU Braunschweig, Germany. She has published 5 papers.
Abstract:
Fungal infections of nail and skin (onychomycosis and tinea pedis, respectively) are widespread diseases being mostly triggered by the dermatophyte fungus Trichophyton rubrum. Since a tinea pedis infection may cause onychomycosis due to autoinoculation, our objective was the development of formulations targeting simultaneously both diseases. The formulations were 5-component systems consisting of poloxamer 407 (P407), double distilled water, isopropyl alcohol, propylene glycol and medium chain triglycerides in given ratios. Into these vehicles, the broad-spectrum antifungal active ingredient ciclopirox olamine was incorporated. The P407-based formulations were characterised macroscopically, microscopically and rheologically. Moreover, permeation and penetration studies across bovine hoof plates and keratin films as artificial nail plate models as well as across isolated human stratum corneum (SC) were performed with modified Franz diffusion cells. The permeated and penetrated drug amount was determined with high performance liquid chromatography (HPLC). To evaluate the antifungal efficacy against the dermatophyte T. rubrum, in vitro infected nail plate studies with bovine hoof plates and keratin films were carried out according to Lusiana et al., 2013. Moreover, a novel in vitro model of infected SC with a polycarbonate filter as backing was established based on abovementioned model (Täuber and Müller-Goymann, 2014; Täuber and Müller-Goymann, 2015a). Differential scanning calorimetry (DSC) measurements were executed to analyse the interaction between the P407-based formulations and SC. Furthermore, one-year stability studies were performed at 30°C to monitor changes of the P407-based formulations during storage.
Seong-Yeong Heo
Pukyong National University, Republic of Korea
Title: Fabrication and characterization for promoting osteoblast differentiation using bioactive substance from fish frame
Time : 15:15-15:45
Biography:
Seong-Yeong Heo has completed his MSc from Pukyong National University in Korea. He has studied Marine Life Science and Tissue Engineering. Currently, he is doing research on tissue regenerative scaffold fabricated by three axis plotting system and cell signaling investigated by western blot and RT-PCR analysis. Additionally, he has published 3 papers in reputed journals.
Abstract:
In order to utilize fish byproducts in a calcium and phosphate supplement, Johnius belengerii frame composed of flesh and skeleton discarded from industrial processing were degraded by pepsin in acetic acid solution. In current study, we report the osteogenic effect of fish frame extracts (FBE) from Johnius belengerii in MC3T3-E1 pre-osteoblast. We designed composite scaffolds consisting of poly-caprolactone (PCL) and FBE fabricated by three axis plotting system for bone regeneration, The effect of FBE coated scaffolds (1 and 3%) on various mechanical properties and charactertistics including the morphology image, FT-IR analysis, tensile properties and drug releases were investigated. Moreover, the in vitro biocompatibilities of the FBE coated scaffolds were examined using MC3T3-E1 pre-osteoblast. On the scaffold surface, cell attachment, proliferation, mineralization and osteogenic factors were determined. At the results, the PCL/FBE combined scaffolds showed cell attachment, proliferation, mineralization and osteogenic factors than the PCL scaffold. Consequently, the FBE combined scaffold suggents further investigation a potential biomedical engineering field due to enhancement of osteogenesis.