5^th Global Pharmacists Annual Meeting July 14-15, 2016 Brisbane, Australia

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.

Chair

Paul C. Ho

National University of Singapore, Singapore

Chair

Paul C. Ho

National University of Singapore, Singapore

Session Introduction

Hyeon-Ho Park

Pukyong National University, Republic of Korea

Title: Characterization and fabrication of Ecklonia cava phlorotannin/PVA blended hydrogel patch

Time : 10:45-11:15

Biography:

Hyeon-Ho Park has studied in Biomedical Engineering and Chemistry Department from Pukyoung National University in Busan, Korea. He applied double majors and holded qualification in it. He also has worked in Marine Biomedical Science lab where he is able to experiment constantly on cells, synthesis, extraction and others and then he applied for a Master’s course in the same university and lab.

Abstract:

When skin wound occur, hydrogel patches have been generally used as wound dressing for wound healing. Poly(vinyl alcohol) (PVA) is one of the commonplace hydrogel patch’s materials which have non-toxicity, non-carcinogenicity, biocompatibility and easy processing and Ecklonia cava (EC) is brown alga which is widely found in Jeju Island in Korea. EC has compounds have been associated with a variety of biological activites. It has various bioactivity including radical scavenging, immunomodulatory, anti-inflammatory, bactericidal activity and potential for skin whitening effect and it stimulates proliferation of normal human dermal fibroblast-neo cells (NHDF-neo). We designed to blend PVA hydrogel patches with EC phlorotannin and fabricated without chemical crosslink by using freezing/thawing method to make more effective PVA hydrogel-patches on wound healing. Then, we evaluated swelling property in water and mechanical property to know hydrogel patch’s mechanical characterization and intermolecular interactions of hydrogel affected by EC phlorotannin were elucidated using FTIR and cell proliferation was measured by staining nuclear with Hoechst. As a result, EC phlorotannin/PVA hydrogel patches had high water absorption than those of pure PVA hydrogel patches. But, mechanical property was decreased, being proportional to EC phlorotannin concentraion and FTIR result demonstated that hydrogel pathches including EC phlorotannin increased hydroxyl group in spite of the fact that EC phlorotannin do not affect PVA hydrogel’s intermolecular interactions. Then, cell proliferation is increased on condition which have with EC phlorotannin hydrogel. Therefore, our results suggest that EC phlorotannin/PVA hydrogel patch will be effective wound dressing than that of pure PVA for wound healing.

Van-Tinh Nguyen

Pukyong National University, Republic of Korea

Title: On the characterization of Fucoidan on Sodium alginate/gelatine scaffolds for anti-inflammation in neuroscience

Time : 11:15-11:45

Biography:

Van-Tinh Nguyen has completed his PhD from the Department of Biomedical Engineering, Pukyong National University, Korea. He has completed his graduation in 2012 from the University of Chosun and his current research interests include: Isolation, safety and bioavailability of bioactive materials and; Development of marine-integrated cells and tissue regenerative biomedical substances.

Abstract:

Microglia, which is the immune cells of the central nervous system (CNS). Overexpression of inflammatory mediators by microglia can induce of several neurological diseases. Thus, bases on the requirement of the key in neural tissue engineering are to develop materials with little or no effect to neuroinflammation. In this study, we have developed a method to create three-dimensional (3D) scaffolds by added fucoidan into porous sodium alginate/gelatin (SaGFu). For mechanical characterization such as in vitro degradation, stress/strain, swelling test, and pore size were measured. Moreover, we studied the neuroinflammatory effects of SaGFus on BV2 microglia cells. The effect of gelatin and fucoidan content on the various properties of the scaffold is investigated and the results showed that mechanical properties increased porosity and swelling ratio to the increase in the gelatin and fucoidan adding, while the in vitro biodegradability decreased. The average SaGFus diameter attained by fabrication of Sa/gelatin/fucoidan main ranged from 60±18 to 100±16 um with high porosity (64.44–78.30 %). Cell culture tests, carried out using gelatin 2.0 % and 4.0%, showed a good cell proliferation more than 60–80 % of sodium alginate alone. Following stimulation with 0.5 μg/mL LPS, microglia cultured in 3D SaGFus decrease their expression of NO. SaG2Fu and SaG4Fu also inhibited the activation and translocation of p65 NF-κB protein levels, resulting in reduction of NO and PGE2 production. These results provide insights into the diverse biological effects and open new opportunity for the applications of SaGFus in neuroscience

Gun-Woo Oh

Pukyong National University, Republic of Korea

Title: Fabrication, characterization and determination of biological activities of poly (ε-Caprolactone)/chitosan-caffeic acid composite nano/microfiber mat for wound dressing application

Time : 11:45-12:15

Biography:

Gun-Woo Oh has studied in Interdisciplinary Program of Biomedical, Mechanical & Electrical Engineering from Pukyoung National University in Busan, Korea. He also has worked in Marine Biomedical Science lab where he is able to experiment constantly on cells, synthesis, extraction and others, and the adviser is Won-Kyo Jung and then he applied for Doctoral course in the same University and lab.

Abstract:

Electrospinning In the present study, we designed composite nano/microfiber mats consisting of poly (ε-caprolactone) (PCL), chitosan (CH), or chitosan-caffeic acid conjugate (CCA) fabricated by an electrospinning technique for wound dressing application. The average diameters of PCL, PCL/CH, and PCL/CCA composite nano/microfiber mats are 1.30±1.07, 1.20±1.22, and 0.94±0.68 μm, respectively. Based on UTM analysis, the PCL/CCA composite significantly increases tensile properties compared with the PCL and PCL/CH composites. Additionally, initial cell attachment and cell proliferation of the composites using neonatal human dermal fibroblast (NHDF-neo cells), as well as the anti-microbial effect against Staphylococcus aureus, was investigated. The PCL/CCA composite shows significantly higher initial cell attachment and cell proliferation than the PCL and PCL/CH composites, and a high anti-microbial effect was observed compared to the PCL and PCL/CH composites. Based on these results, the CCA is demonstrated to be good supplemental bioactive agent for wound dressing applications and skin tissue engineering.

Hadeer Akram Abdul Razzaq

University Sains Malaysia (USM), Malaysia

Title: The hazards of multiple pharmaceutical excipients…the unnoted polypharmacy

Biography:

Hadeer Akram AbdulRazzaq has completed his PhD at 2013 in School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM). He conducted many researches in fields of clinical pharmacy and pharmacy practice. He is Assistant Professor in University Sains Malaysia (USM). He published more than 70 papers and abstracts in reputed journals and has been served as Editorial Board Member and active reviewer in several journals. He is member in American College of Clinical Pharmacy (ACCP), American Heart Association (AHA), International Society of Pharmacovigilance (ISOP), and Asian Pacific Society of Respirology (APSR).

Abstract:

In spite of the availability of polypharmacy guidelines for the cardiac pharmacotherapy, there has yet to be a guideline for the polypharmacy of pharmaceutical excipients. This study aims to determine whether there is an impact on the multiple uses of pharmaceutical excipients and to detect the polypharmacy of pharmaceutical excipients according to the severity of the adverse drug reactions (ADRs). There were 504 cardiac patients involved and attended at the cardiac clinic of Penang General Hospital, Malaysia. A validated self-reporting questionnaire used to collect 56 symptoms, while serious ADRs were collected from their progress file. All information about the pharmaceutical excipients was collected either from medications’ leaflets or directly from the manufacturers. The result of the study showed that polypharmacy and severity of excipients' ADRs depended on the number of the same type of excipient. The number of ADRs reported by patients was 22, 54, 42, 38, and 42 for those who received 5, 10, 15, 20, and 22 excipients respectively. Moderate and severe complaints of ADRs were significantly increased if the number of active and excipients was higher than 11 and 15 respectively. Current study predicted the polypharmacy of excipient to be 10 (alone) and 15 (with active ingredients). Pharmacists’ awareness needs to be improved by implementing education interventional programs. Beside this, the prescriptions are needed to be checked especially the pharmaceutical excipients to avoid the polypharmacy of pharmaceutical excipients in those use chronic multiple therapies to minimize the incidence of ADRs.