Burgunda Sweet - Academia.edu (original) (raw)

Papers by Burgunda Sweet

Research paper thumbnail of Lutein and zeaxanthin for macular degeneration

American Journal of Health System Pharmacy Ajhp Official Journal of the American Society of Health System Pharmacists, Jul 1, 2008

The effects of increasing lutein and zeaxanthin dosages in people with age-related macular degene... more The effects of increasing lutein and zeaxanthin dosages in people with age-related macular degeneration (AMD) are discussed. AMD is a disorder of the macula, the area associated with the sharpest visual acuity. AMD is classified as dry (nonneovascular) or wet (neovascular) and is associated with several risk factors, the biggest being age. The pathogenesis of AMD is unknown. Like many chronic illnesses, prevention is a key factor for managing AMD. Lutein and zeaxanthin, natural xanthophylls not synthesized by the human body, have been investigated for their use in promoting visual health. Lutein and zeaxanthin are dietary carotenoids that are components of a normal diet. The mechanism of protection that they confer is unknown, but two mechanisms have been hypothesized. Several studies have been conducted to assess the relationship between plasma levels of lutein and zeaxanthin and the risk of developing AMD and have yielded conflicting results. Increased dietary intake of or supplementation with lutein and zeaxanthin was found to result in increased plasma levels, which were positively and significantly associated with macular pigment optical density. Limited data have suggested that supplementation may also improve visual function. The optimal dose of lutein and zeaxanthin for the prevention or treatment of AMD has not yet been defined. A definite association between lutein and zeaxanthin supplementation and clinical benefit has yet to be shown; however, it may still be an appropriate cautionary measure for patients at high risk for developing AMD.

Research paper thumbnail of Career Placement of Doctor of Pharmacy Graduates at Eight U.S. Midwestern Schools

American Journal of Pharmaceutical Education, 2015

Objective. To characterize postgraduation placement plans of 2013 doctor of pharmacy (PharmD) gra... more Objective. To characterize postgraduation placement plans of 2013 doctor of pharmacy (PharmD) graduates. Methods. A cross-sectional survey of PharmD graduates from 8 midwestern colleges of pharmacy was designed to capture a comprehensive picture of graduating students' experiences and outcomes of their job search. Results. At graduation, 81% of 2013 respondents had postgraduate plans, with approximately 40% accepting jobs and 40% accepting residencies or fellowships. Eighty-four percent of graduates reported being pleased with offers received, and 86% received placement in their preferred practice setting. Students perceived that securing residencies was more difficult than securing jobs. Students who participated in key activities had a nearly sevenfold increase in successful residency placement. Conclusion. While the demand for pharmacists decreased in recent years, responses indicated successful placement by the majority of 2013 graduates at the time of graduation.

Research paper thumbnail of Pharmacy costs associated with nonformulary drug requests

American Journal of Health System Pharmacy, Sep 1, 2001

Pharmacy costs associated with handling nonformulary drug requests were studied. Data for all non... more Pharmacy costs associated with handling nonformulary drug requests were studied. Data for all nonformulary drug orders received at a university hospital between August 1 and October 31, 1999, were evaluated to determine their outcome and the cost differential between the nonformulary drug and formulary alternative. Two sets of data were used to analyze medication costs: data from nonformulary medication request forms, which allowed the cost of nonformulary drugs and their formulary alternatives to be calculated, and data from the pharmacy computer system, which enabled actual nonformulary drug use to be captured. Labor costs associated with processing these requests were determined through time analysis, which included the potential for orders to be received at different times of the day and with different levels of technician and pharmacist support. Economic analysis revealed that the greatest cost saving occurred when converting nonformulary injectable products to formulary alternatives. Interventions were least costly during normal business hours, when all the satellite pharmacies were open and fully staffed. Pharmacists' interventions in oral product orders resulted in a net increase in expenditures. Incremental pharmacy costs associated with processing nonformulary medication requests in an inpatient setting are greater than the drug acquisition cost saving for most agents, particularly oral medications.

Research paper thumbnail of Nattokinase for prevention of thrombosis

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2006

Research paper thumbnail of Oral acetylcysteine for neuropsychiatric disorders

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2015

Research paper thumbnail of Using personal digital assistants to access drug information

American Journal of Health-System Pharmacy

The use of personal digital assistants (PDAs) to access drug information in a health system is de... more The use of personal digital assistants (PDAs) to access drug information in a health system is described. Given the widespread use of PDAs at an 872-bed university health system, an opportunity existed to provide current drug information to physicians via these devices. As part of the health system's intranet, extensive online content had been made available through a browser; extension to PDAs was a natural next step. There were two primary requirements: the ability to synchronize information with the database server when a PDA was used and the development of content and applications by using existing staff. Mobile enterprise software was chosen that supports multiple PDA platforms, is easy to use, and does not require programming skills. The software works through customized "channels," or collections of information from a content provider. The customized channel service works over the Internet. Two channels of content were created, an ambulatory care channel and an inpatient care channel. The ambulatory care channel contains a list of preferred ambulatory care agents, poison control information, the locations of outpatient pharmacies, drug information, and safety tips for prescribing. The inpatient channel contains the inpatient formulary, current news and events, information on currrent drug shortages and recalls, pharmacy contact information, and medication safety tips. When a user synchronizes his or her PDA, the software contacts the department's intranet servers and processes the request. The data are compressed and downloaded to the user's PDA. A university health system successfully used PDAs to access drug and other information.

Research paper thumbnail of Review of the processes for FDA oversight of drugs, medical devices, and combination products

Journal of managed care pharmacy : JMCP

Research paper thumbnail of Managed care perspective on three new agents for type 2 diabetes

Journal of managed care pharmacy : JMCP, 2008

Despite effective monotherapy for diabetes, approximately 50% of patients require additional medi... more Despite effective monotherapy for diabetes, approximately 50% of patients require additional medications after 3 years to achieve target glycosylated hemoglobin (A1C) < 7%. Three new agents, each the first in its therapeutic class with a unique mechanism of action, have been approved for the treatment of type 2 diabetes by the U.S. Food and Drug Administration: pramlintide in March 2005, exenatide in April 2005, and sitagliptin in October 2006. To review the efficacy and safety of 3 new agents for type 2 diabetes (exenatide and pramlintide by subcutaneous injection and sitagliptin by oral administration) and to define their place in therapy given their relatively high cost and unknown long-term safety and efficacy. A MEDLINE search (1950 to June 2007) for English-language articles of studies in human subjects was conducted using these search terms: type 2 diabetes, exenatide, pramlintide, and sitagliptin. This database was supplemented by systematic reviews and meta-analyses thro...

Research paper thumbnail of Abatacept

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2006

The pharmacology, pharmacokinetics, indications, clinical efficacy, adverse effects, drug interac... more The pharmacology, pharmacokinetics, indications, clinical efficacy, adverse effects, drug interactions, dosing, and administration of abatacept are discussed. Abatacept is the first drug in a new class of agents known as selective costimulator modulators. Abatacept has been shown to decrease tumor necrosis factor (TNF)-alpha, which is important to the inflammatory response. Abatacept inhibits T-cell function but does not deplete T cells. Activated T cells are important in the inflammatory cascade, ultimately leading to joint inflammation and irreversible structural damage. In patients with rheumatoid arthritis, there is chronic inflammation of the synovial tissue lining the joint capsule. Abatacept is indicated for reducing the signs and symptoms of moderate to severe rheumatoid arthritis in adult patients who have had an inadequate response to at least one disease-modifying antirheumatic drug. Studies in adult patients with rheumatoid arthritis have evaluated abatacept in patients ...

Research paper thumbnail of Pharmacology and therapeutic uses of theanine

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2006

Research paper thumbnail of Alternative therapies. Wormwood

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2004

Research paper thumbnail of Cidofovir for the Treatment of Recurrent Respiratory Papillomatosis: A Review of the Literature

Pharmacotherapy, 2005

Recurrent respiratory papillomatosis (RRP) is a rare but potentially severe disease caused by pap... more Recurrent respiratory papillomatosis (RRP) is a rare but potentially severe disease caused by papillomavirus, most often types 6 and 11. The disease, which occurs in both juvenile and adult forms, is characterized by benign epithelial tumors of the airway that most frequently affect the larynx but can also spread along the entire aerodigestive tract. Recurrent respiratory papillomatosis is the most common benign neoplasm of the larynx in children and the second most frequent cause of childhood hoarseness. Standard treatment, which is palliative only, consists of surgical excision of papillomata to maintain airway patency and improve voice quality. Recurrence despite repeated surgical procedures is the rule. To date, incorporation of adjuvant treatments has not been reliably beneficial in altering the disease course. Several case series have described promising results with cidofovir, a cytosine nucleoside analog with antiviral activity. To evaluate the data available on the safety and efficacy of cidofovir for the treatment of RRP, we conducted a MEDLINE search for all case reports or series from January 1966-August 2004 describing cidofovir therapy in either adults or children with RRP. The bibliographies of qualifying articles were also searched for relevant references. In both adults and children with mild-to-severe RRP, intralesional administration of cidofovir directly into the site of papillomata was associated with partial-to-complete regression of papillomata, improvement in voice quality and airway status, and decreased need for surgery. Wide variation in intralesional cidofovir dose (2-57 mg), frequency (every 2-8 wks), and duration (4 mo-4 yrs) was found. Successful outcomes have also been reported with intravenous cidofovir, but data are limited to three case reports. Rash, headache, and precordialgia were the only adverse effects reported with intralesional cidofovir. Nephrotoxicity and neutropenia secondary to either intralesional or intravenous cidofovir were not observed. Long-term risks associated with intralesional administration remain to be seen. Further studies are necessary to determine the most appropriate dose, frequency, and duration of therapy, and to fully characterize the safety profile of cidofovir when given intralesionally.

Research paper thumbnail of Compounding pharmaceuticals for investigational use

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2002

Research paper thumbnail of Hawthorn: pharmacology and therapeutic uses

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2002

The uses, pharmacology, clinical efficacy, dosage and administration, adverse effects, and drug i... more The uses, pharmacology, clinical efficacy, dosage and administration, adverse effects, and drug interactions of hawthorn are discussed. Hawthorn (Crataegus oxyacantha) is a fruit-bearing shrub with a long history as a medicinal substance. Uses have included the treatment of digestive ailments, dyspnea, kidney stones, and cardiovascular disorders. Today, hawthorn is used primarily for various cardiovascular conditions. The cardiovascular effects are believed to be the result of positive inotropic activity, ability to increase the integrity of the blood vessel wall and improve coronary blood flow, and positive effects on oxygen utilization. Flavonoids are postulated to account for these effects. Hawthorn has shown promise in the treatment of New York Heart Association (NYHA) functional class II congestive heart failure (CHF) in both uncontrolled and controlled clinical trials. There are also suggestions of a beneficial effect on blood lipids. Trials to establish an antiarrhythmic effe...

Research paper thumbnail of Drug Absorption with Food

Handbook of Drug-Nutrient Interactions, 2009

... Amoxicillin/ clavulanate Augmentin Food increases absorption and decreases GI upsetCarbamazep... more ... Amoxicillin/ clavulanate Augmentin Food increases absorption and decreases GI upsetCarbamazepine Tegretol Food increases absorption Carvedilol Coreg Food decreases risk for orthostatic hypotension ... verapamil II Low High Carbamazepine, ciprofloxacin, warfarin # Rate ...

Research paper thumbnail of Retisert: is the new advance in treatment of uveitis a good one?

The Annals of pharmacotherapy, 2007

To review the use of corticosteroids for the treatment of uveitis, with a focus on the pharmacolo... more To review the use of corticosteroids for the treatment of uveitis, with a focus on the pharmacology, efficacy, and safety of a newer delivery device, Retisert. A PubMed/MEDLINE search from 1950 through February 2007 was conducted, and manufacturer-provided data were reviewed. Animal studies and Phase II and III clinical trials evaluating the safety and efficacy of Retisert for the treatment of uveitis were considered. The data were extracted from PubMed/MEDLINE using the search terms fluocinolone acetonide, corticosteroids, intravitreal implant, uveitis, ocular steroids, and Retisert. The findings of the clinical studies showed, with use of Retisert, a reduction in the recurrence of uveitis, improvement in visual acuity, and a decreased need for adjunctive therapy with corticosteroids and immunosuppressant agents. There are currently no studies directly comparing Retisert with other treatment options. The most commonly reported adverse events (ADEs) in clinical trials included catar...

Research paper thumbnail of Using personal digital assistants to access drug information

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2002

The use of personal digital assistants (PDAs) to access drug information in a health system is de... more The use of personal digital assistants (PDAs) to access drug information in a health system is described. Given the widespread use of PDAs at an 872-bed university health system, an opportunity existed to provide current drug information to physicians via these devices. As part of the health system's intranet, extensive online content had been made available through a browser; extension to PDAs was a natural next step. There were two primary requirements: the ability to synchronize information with the database server when a PDA was used and the development of content and applications by using existing staff. Mobile enterprise software was chosen that supports multiple PDA platforms, is easy to use, and does not require programming skills. The software works through customized "channels," or collections of information from a content provider. The customized channel service works over the Internet. Two channels of content were created, an ambulatory care channel and an ...

Research paper thumbnail of Outcomes of an Erythropoietic Growth Factor Interchange Program in Hospitalized Chronic Hemodialysis Patients

Research paper thumbnail of Drug Absorption With Food

Handbook of Drug-Nutrient Interactions, 2004

... Amoxicillin/ clavulanate Augmentin Food increases absorption and decreases GI upsetCarbamazep... more ... Amoxicillin/ clavulanate Augmentin Food increases absorption and decreases GI upsetCarbamazepine Tegretol Food increases absorption Carvedilol Coreg Food decreases risk for orthostatic hypotension ... verapamil II Low High Carbamazepine, ciprofloxacin, warfarin # Rate ...

Research paper thumbnail of Risk assessment of NSAID-induced gastrointestinal toxicity in ambulatory care patients

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2004

The risk of gastrointestinal (GI) toxicity associated with the use of a traditional nonsteroidal ... more The risk of gastrointestinal (GI) toxicity associated with the use of a traditional nonsteroidal antiinflammatory drug (NSAID) versus a cyclooxygenase-2 (COX-2) inhibitor was compared among patients in a managed care organization. Patients over 18 years old who received a prescription for ibuprofen, naproxen, celecoxib, or rofecoxib between March 2001 and June 2001 were included in this study. All subjects were followed for 12 months for GI complications, medication use, and changes in physical conditions from baseline. A simplified risk-scoring scale was used to measure patients' risk of GI complications. A total of 172 patients were randomly selected: 86 receiving traditional NSAIDs and 86 receiving COX-2 inhibitors. Patients receiving COX-2 inhibitors were older and more likely to be receiving treatment for osteoarthritis (OA) or rheumatoid arthritis (RA), while patients taking traditional NSAIDs were more likely to be receiving treatment for acute pain. The average risk scor...

Research paper thumbnail of Lutein and zeaxanthin for macular degeneration

American Journal of Health System Pharmacy Ajhp Official Journal of the American Society of Health System Pharmacists, Jul 1, 2008

The effects of increasing lutein and zeaxanthin dosages in people with age-related macular degene... more The effects of increasing lutein and zeaxanthin dosages in people with age-related macular degeneration (AMD) are discussed. AMD is a disorder of the macula, the area associated with the sharpest visual acuity. AMD is classified as dry (nonneovascular) or wet (neovascular) and is associated with several risk factors, the biggest being age. The pathogenesis of AMD is unknown. Like many chronic illnesses, prevention is a key factor for managing AMD. Lutein and zeaxanthin, natural xanthophylls not synthesized by the human body, have been investigated for their use in promoting visual health. Lutein and zeaxanthin are dietary carotenoids that are components of a normal diet. The mechanism of protection that they confer is unknown, but two mechanisms have been hypothesized. Several studies have been conducted to assess the relationship between plasma levels of lutein and zeaxanthin and the risk of developing AMD and have yielded conflicting results. Increased dietary intake of or supplementation with lutein and zeaxanthin was found to result in increased plasma levels, which were positively and significantly associated with macular pigment optical density. Limited data have suggested that supplementation may also improve visual function. The optimal dose of lutein and zeaxanthin for the prevention or treatment of AMD has not yet been defined. A definite association between lutein and zeaxanthin supplementation and clinical benefit has yet to be shown; however, it may still be an appropriate cautionary measure for patients at high risk for developing AMD.

Research paper thumbnail of Career Placement of Doctor of Pharmacy Graduates at Eight U.S. Midwestern Schools

American Journal of Pharmaceutical Education, 2015

Objective. To characterize postgraduation placement plans of 2013 doctor of pharmacy (PharmD) gra... more Objective. To characterize postgraduation placement plans of 2013 doctor of pharmacy (PharmD) graduates. Methods. A cross-sectional survey of PharmD graduates from 8 midwestern colleges of pharmacy was designed to capture a comprehensive picture of graduating students' experiences and outcomes of their job search. Results. At graduation, 81% of 2013 respondents had postgraduate plans, with approximately 40% accepting jobs and 40% accepting residencies or fellowships. Eighty-four percent of graduates reported being pleased with offers received, and 86% received placement in their preferred practice setting. Students perceived that securing residencies was more difficult than securing jobs. Students who participated in key activities had a nearly sevenfold increase in successful residency placement. Conclusion. While the demand for pharmacists decreased in recent years, responses indicated successful placement by the majority of 2013 graduates at the time of graduation.

Research paper thumbnail of Pharmacy costs associated with nonformulary drug requests

American Journal of Health System Pharmacy, Sep 1, 2001

Pharmacy costs associated with handling nonformulary drug requests were studied. Data for all non... more Pharmacy costs associated with handling nonformulary drug requests were studied. Data for all nonformulary drug orders received at a university hospital between August 1 and October 31, 1999, were evaluated to determine their outcome and the cost differential between the nonformulary drug and formulary alternative. Two sets of data were used to analyze medication costs: data from nonformulary medication request forms, which allowed the cost of nonformulary drugs and their formulary alternatives to be calculated, and data from the pharmacy computer system, which enabled actual nonformulary drug use to be captured. Labor costs associated with processing these requests were determined through time analysis, which included the potential for orders to be received at different times of the day and with different levels of technician and pharmacist support. Economic analysis revealed that the greatest cost saving occurred when converting nonformulary injectable products to formulary alternatives. Interventions were least costly during normal business hours, when all the satellite pharmacies were open and fully staffed. Pharmacists&#39; interventions in oral product orders resulted in a net increase in expenditures. Incremental pharmacy costs associated with processing nonformulary medication requests in an inpatient setting are greater than the drug acquisition cost saving for most agents, particularly oral medications.

Research paper thumbnail of Nattokinase for prevention of thrombosis

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2006

Research paper thumbnail of Oral acetylcysteine for neuropsychiatric disorders

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2015

Research paper thumbnail of Using personal digital assistants to access drug information

American Journal of Health-System Pharmacy

The use of personal digital assistants (PDAs) to access drug information in a health system is de... more The use of personal digital assistants (PDAs) to access drug information in a health system is described. Given the widespread use of PDAs at an 872-bed university health system, an opportunity existed to provide current drug information to physicians via these devices. As part of the health system&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s intranet, extensive online content had been made available through a browser; extension to PDAs was a natural next step. There were two primary requirements: the ability to synchronize information with the database server when a PDA was used and the development of content and applications by using existing staff. Mobile enterprise software was chosen that supports multiple PDA platforms, is easy to use, and does not require programming skills. The software works through customized &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;channels,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; or collections of information from a content provider. The customized channel service works over the Internet. Two channels of content were created, an ambulatory care channel and an inpatient care channel. The ambulatory care channel contains a list of preferred ambulatory care agents, poison control information, the locations of outpatient pharmacies, drug information, and safety tips for prescribing. The inpatient channel contains the inpatient formulary, current news and events, information on currrent drug shortages and recalls, pharmacy contact information, and medication safety tips. When a user synchronizes his or her PDA, the software contacts the department&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s intranet servers and processes the request. The data are compressed and downloaded to the user&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s PDA. A university health system successfully used PDAs to access drug and other information.

Research paper thumbnail of Review of the processes for FDA oversight of drugs, medical devices, and combination products

Journal of managed care pharmacy : JMCP

Research paper thumbnail of Managed care perspective on three new agents for type 2 diabetes

Journal of managed care pharmacy : JMCP, 2008

Despite effective monotherapy for diabetes, approximately 50% of patients require additional medi... more Despite effective monotherapy for diabetes, approximately 50% of patients require additional medications after 3 years to achieve target glycosylated hemoglobin (A1C) < 7%. Three new agents, each the first in its therapeutic class with a unique mechanism of action, have been approved for the treatment of type 2 diabetes by the U.S. Food and Drug Administration: pramlintide in March 2005, exenatide in April 2005, and sitagliptin in October 2006. To review the efficacy and safety of 3 new agents for type 2 diabetes (exenatide and pramlintide by subcutaneous injection and sitagliptin by oral administration) and to define their place in therapy given their relatively high cost and unknown long-term safety and efficacy. A MEDLINE search (1950 to June 2007) for English-language articles of studies in human subjects was conducted using these search terms: type 2 diabetes, exenatide, pramlintide, and sitagliptin. This database was supplemented by systematic reviews and meta-analyses thro...

Research paper thumbnail of Abatacept

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2006

The pharmacology, pharmacokinetics, indications, clinical efficacy, adverse effects, drug interac... more The pharmacology, pharmacokinetics, indications, clinical efficacy, adverse effects, drug interactions, dosing, and administration of abatacept are discussed. Abatacept is the first drug in a new class of agents known as selective costimulator modulators. Abatacept has been shown to decrease tumor necrosis factor (TNF)-alpha, which is important to the inflammatory response. Abatacept inhibits T-cell function but does not deplete T cells. Activated T cells are important in the inflammatory cascade, ultimately leading to joint inflammation and irreversible structural damage. In patients with rheumatoid arthritis, there is chronic inflammation of the synovial tissue lining the joint capsule. Abatacept is indicated for reducing the signs and symptoms of moderate to severe rheumatoid arthritis in adult patients who have had an inadequate response to at least one disease-modifying antirheumatic drug. Studies in adult patients with rheumatoid arthritis have evaluated abatacept in patients ...

Research paper thumbnail of Pharmacology and therapeutic uses of theanine

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2006

Research paper thumbnail of Alternative therapies. Wormwood

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2004

Research paper thumbnail of Cidofovir for the Treatment of Recurrent Respiratory Papillomatosis: A Review of the Literature

Pharmacotherapy, 2005

Recurrent respiratory papillomatosis (RRP) is a rare but potentially severe disease caused by pap... more Recurrent respiratory papillomatosis (RRP) is a rare but potentially severe disease caused by papillomavirus, most often types 6 and 11. The disease, which occurs in both juvenile and adult forms, is characterized by benign epithelial tumors of the airway that most frequently affect the larynx but can also spread along the entire aerodigestive tract. Recurrent respiratory papillomatosis is the most common benign neoplasm of the larynx in children and the second most frequent cause of childhood hoarseness. Standard treatment, which is palliative only, consists of surgical excision of papillomata to maintain airway patency and improve voice quality. Recurrence despite repeated surgical procedures is the rule. To date, incorporation of adjuvant treatments has not been reliably beneficial in altering the disease course. Several case series have described promising results with cidofovir, a cytosine nucleoside analog with antiviral activity. To evaluate the data available on the safety and efficacy of cidofovir for the treatment of RRP, we conducted a MEDLINE search for all case reports or series from January 1966-August 2004 describing cidofovir therapy in either adults or children with RRP. The bibliographies of qualifying articles were also searched for relevant references. In both adults and children with mild-to-severe RRP, intralesional administration of cidofovir directly into the site of papillomata was associated with partial-to-complete regression of papillomata, improvement in voice quality and airway status, and decreased need for surgery. Wide variation in intralesional cidofovir dose (2-57 mg), frequency (every 2-8 wks), and duration (4 mo-4 yrs) was found. Successful outcomes have also been reported with intravenous cidofovir, but data are limited to three case reports. Rash, headache, and precordialgia were the only adverse effects reported with intralesional cidofovir. Nephrotoxicity and neutropenia secondary to either intralesional or intravenous cidofovir were not observed. Long-term risks associated with intralesional administration remain to be seen. Further studies are necessary to determine the most appropriate dose, frequency, and duration of therapy, and to fully characterize the safety profile of cidofovir when given intralesionally.

Research paper thumbnail of Compounding pharmaceuticals for investigational use

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2002

Research paper thumbnail of Hawthorn: pharmacology and therapeutic uses

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2002

The uses, pharmacology, clinical efficacy, dosage and administration, adverse effects, and drug i... more The uses, pharmacology, clinical efficacy, dosage and administration, adverse effects, and drug interactions of hawthorn are discussed. Hawthorn (Crataegus oxyacantha) is a fruit-bearing shrub with a long history as a medicinal substance. Uses have included the treatment of digestive ailments, dyspnea, kidney stones, and cardiovascular disorders. Today, hawthorn is used primarily for various cardiovascular conditions. The cardiovascular effects are believed to be the result of positive inotropic activity, ability to increase the integrity of the blood vessel wall and improve coronary blood flow, and positive effects on oxygen utilization. Flavonoids are postulated to account for these effects. Hawthorn has shown promise in the treatment of New York Heart Association (NYHA) functional class II congestive heart failure (CHF) in both uncontrolled and controlled clinical trials. There are also suggestions of a beneficial effect on blood lipids. Trials to establish an antiarrhythmic effe...

Research paper thumbnail of Drug Absorption with Food

Handbook of Drug-Nutrient Interactions, 2009

... Amoxicillin/ clavulanate Augmentin Food increases absorption and decreases GI upsetCarbamazep... more ... Amoxicillin/ clavulanate Augmentin Food increases absorption and decreases GI upsetCarbamazepine Tegretol Food increases absorption Carvedilol Coreg Food decreases risk for orthostatic hypotension ... verapamil II Low High Carbamazepine, ciprofloxacin, warfarin # Rate ...

Research paper thumbnail of Retisert: is the new advance in treatment of uveitis a good one?

The Annals of pharmacotherapy, 2007

To review the use of corticosteroids for the treatment of uveitis, with a focus on the pharmacolo... more To review the use of corticosteroids for the treatment of uveitis, with a focus on the pharmacology, efficacy, and safety of a newer delivery device, Retisert. A PubMed/MEDLINE search from 1950 through February 2007 was conducted, and manufacturer-provided data were reviewed. Animal studies and Phase II and III clinical trials evaluating the safety and efficacy of Retisert for the treatment of uveitis were considered. The data were extracted from PubMed/MEDLINE using the search terms fluocinolone acetonide, corticosteroids, intravitreal implant, uveitis, ocular steroids, and Retisert. The findings of the clinical studies showed, with use of Retisert, a reduction in the recurrence of uveitis, improvement in visual acuity, and a decreased need for adjunctive therapy with corticosteroids and immunosuppressant agents. There are currently no studies directly comparing Retisert with other treatment options. The most commonly reported adverse events (ADEs) in clinical trials included catar...

Research paper thumbnail of Using personal digital assistants to access drug information

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2002

The use of personal digital assistants (PDAs) to access drug information in a health system is de... more The use of personal digital assistants (PDAs) to access drug information in a health system is described. Given the widespread use of PDAs at an 872-bed university health system, an opportunity existed to provide current drug information to physicians via these devices. As part of the health system's intranet, extensive online content had been made available through a browser; extension to PDAs was a natural next step. There were two primary requirements: the ability to synchronize information with the database server when a PDA was used and the development of content and applications by using existing staff. Mobile enterprise software was chosen that supports multiple PDA platforms, is easy to use, and does not require programming skills. The software works through customized "channels," or collections of information from a content provider. The customized channel service works over the Internet. Two channels of content were created, an ambulatory care channel and an ...

Research paper thumbnail of Outcomes of an Erythropoietic Growth Factor Interchange Program in Hospitalized Chronic Hemodialysis Patients

Research paper thumbnail of Drug Absorption With Food

Handbook of Drug-Nutrient Interactions, 2004

... Amoxicillin/ clavulanate Augmentin Food increases absorption and decreases GI upsetCarbamazep... more ... Amoxicillin/ clavulanate Augmentin Food increases absorption and decreases GI upsetCarbamazepine Tegretol Food increases absorption Carvedilol Coreg Food decreases risk for orthostatic hypotension ... verapamil II Low High Carbamazepine, ciprofloxacin, warfarin # Rate ...

Research paper thumbnail of Risk assessment of NSAID-induced gastrointestinal toxicity in ambulatory care patients

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 15, 2004

The risk of gastrointestinal (GI) toxicity associated with the use of a traditional nonsteroidal ... more The risk of gastrointestinal (GI) toxicity associated with the use of a traditional nonsteroidal antiinflammatory drug (NSAID) versus a cyclooxygenase-2 (COX-2) inhibitor was compared among patients in a managed care organization. Patients over 18 years old who received a prescription for ibuprofen, naproxen, celecoxib, or rofecoxib between March 2001 and June 2001 were included in this study. All subjects were followed for 12 months for GI complications, medication use, and changes in physical conditions from baseline. A simplified risk-scoring scale was used to measure patients' risk of GI complications. A total of 172 patients were randomly selected: 86 receiving traditional NSAIDs and 86 receiving COX-2 inhibitors. Patients receiving COX-2 inhibitors were older and more likely to be receiving treatment for osteoarthritis (OA) or rheumatoid arthritis (RA), while patients taking traditional NSAIDs were more likely to be receiving treatment for acute pain. The average risk scor...