Script Your Future: COPD & Medication Adherence

Script Your Future

Chronic obstructive pulmonary disease (COPD) is a chronic, progressive disease that is often caused by long-term exposure to lung irritants. This disease is a result of decreased air flow in and out of the lungs due to one or more of the following: airways lose their elasticity, the walls between the air sacs are destroyed, the airways thicken and become inflamed, and/or the airways have increased production of mucus which can clog them. COPD usually causes coughing along with the production of large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms.

The causes of COPD have been extensively studied, and it is no surprise that smoking is at the top of the list. Smoking, frequent exposure to air pollutants, secondhand smoke, and chemical fumes have all been linked to causing COPD.

With that being said, smoking cessation and avoiding harmful fumes are some of the best steps you can take to slowing the progression of this disease and improve your breathing. Because COPD is a progressive disease, it is especially important for patients to take their medications as they are prescribed by a doctor. The medications used to control/treat COPD are usually inhaled bronchodilators and corticosteroids. It is important for these medications to be used regularly, not just when a “flare up” occurs in order to get the best outcomes possible.

Not only does COPD directly affect one’s ability to breathe, it also puts these patients at higher risk for other respiratory conditions. Influenza and pneumonia, especially, are two of the most common co-conditions seen in patients with COPD. Fortunately, there are vaccinations to help prevent you from ever getting the flu or pneumonia! It is recommended for all persons with COPD to get their flu shot each year, and get their pneumonia vaccine as recommended by their health care provider. Managing chronic conditions like COPD can be challenging, but it is important to stay educated about the disease and how to manage it appropriately.

Visit www.scriptyourfuture.org & Take the Pledge to Take Your Meds today!

The Dark History of Research: The Monster Experiment

Contributed by Grandee Dang, Class of 2019

Throughout the course of history, great strides in medicinal discoveries have led to longer life spans and disease prevention. From Jonas Salk who developed the polio vaccine that nearly eradicated the crippling polio disease, to the varicella vaccine still used to day, such monumental discoveries will continue to leave a beacon of hope within the field of health and science (1). However, on the borders that lie beyond that bright beacon of hope are dark patches in medicinal history that so many have either forgotten or have yet unearth. One dark patch is an Iowa study that was also known as the “Monster Experiment” in which several orphan children with speech impediments underwent a social experiment in hopes of correcting their stuttering behavior (2).  The outcome of such experimentation brought forth the ethical issues regarding case studies and the subject matter being observed. Furthermore, the fact that children were the primary participants, the controversy of long term or irreversible psychological damages became the forefront of debate and conversation.

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The Soldiers and Sailors Orphanage (4)

In 1938 at the University of Iowa, American psychologist Wendell Johnson and his subordinate Mary Tudor conducted an experiment to observe how different approaches in social therapy would affect a child’s outcome within their speech (2). The pools of twenty-two participants were selected from Iowa’s “Sailors and Soldiers Orphanage,” in which the children were led to believe that they would undergo a form of “speech therapy” (2). Five of Mary Tudor’s colleagues agreed to act as judges in encouraging any positive behaviors or isolating any negative speech patterns (2). Ten children from the pool of twenty-two that were deemed as “stutterers” from the orphanage were subdivided into two subgroups, group 1A and group 1B. Those who have fallen under group 1A were told that “they were not stutterers” and those under group 1B were “endorsed the label” as “stutterers” by the judges (2). The remaining twelve children had no history of speech impediments, but were subdivided into two groups (2A and 2B) that underwent the same labeling and behavioral encouragement from the judges. The study was designed to observe how direct encouragement and “labeling” would affect a child’s speech patterns (2).  Essentially Tudor wanted to see if labeling a child as a “stutterer” or “non-stutter” would have any changes to those who had a speech impediment versus those who had normal speech behaviors (2). The judges would encourage positive reinforcement among the 1A and 2B sub groups while the 1B and 2A sub groups were often isolated or directly projected as having “a great deal of trouble” in speech regardless whether or not they had a speech impediment (2).

The experiment ultimately left several of the children with detrimental psychological effects. Norma Jean Pugh was a six-year-old participant with no speech impediment prior to the experiment, however after the studies were conducted, she “could barely speak” (3).  Nine year-old Elizabeth Ostert among other children noticed a “plummet” in academic performance and became recluse due to “fear of speaking” (3). The monster experiment showed when issues of ethics are not navigated thoroughly, the ending results can fall off course into inhumane consequences. The foundation of new therapies and medicinal advances is rooted in cases studies and experimentation. However, when the progress of medicine overshadows human ethics, the field of health and sciences becomes the very monsters they wish to eradicate.

References:

  1. “About Jonas Salks – Salk Institute for Biological Studies”. Salk Institute for Biological Studies. Retrieved 2016-10-25. <http://www.salk.edu/about/history-of-salk/jonas-salk/&gt;
  1. Tudor, Mary (1939).An Experimental Study of the Effect of Evaluative Labeling of Speech Fluency. University of Iowa. Retrieved 2016-10-25. <http://ir.uiowa.edu/cgi/viewcontent.cgi?article=6264&context=etd&gt;
  1. Dyer, Jim.”Ethic and Orphans: ‘The Monster Study'”. Mercury News. Mercury News. Retrieved 25 September  http://wwwpsych.stanford.edu/~bigopp/stutter2.html
  1. “Iowa Soldiers’ Orphans’ Home”. Wikimedia Commons. Free Media Historic Repository. <https://en.wikipedia.org/wiki/Iowa_Soldiers%27_Orphans%27_Home#/media/File:Iowa_Soldiers%27_Orphans%27_Home_Administration_Building_01.JPG&gt;

Past, Present and Future of HIV Vaccine Development

Contributed by Allison Adams, Class of 2019

Since 1984, the Human Immunodeficiency Virus (HIV) has been identified to be the cause of AIDS. At that time, Margaret Heckler, the U.S. HHS Secretary, was confident that there would be an effective vaccine ready for testing within the upcoming years. By 1987, the National Institute of Health (NIH) held the first HIV vaccine clinical trial testing the protein called gp160. The trials were quickly diminished however, due to the lack of scientific advancements at the time. The following year, the National Institute of Allergy and Infectious Diseases started enrollment in Phase I clinical trials and was able to launch Phase II in 1992 that included patients with a high-risk behavioral past who were not yet infected.  By 1993, NIAID combined forces with HIVNET and began striving to start Phase III trials (2).

aidsWhile the progress on this front continued, in 1998, VaxGen Inc. began conducting the world’s first Phase III clinical trials with their product, AIDSVAX. Unfortunately, the results gathered in 2004 were dismal; no efficacy for prevention was detected. By 2009, there were promising results from a Phase III trial on a combination vaccine being conducted in Thailand known as the RV144 using gp120. In those results, four out of ten HIV infections were prevented that would have otherwise happened. While this just 31% efficacious, it left scientists under the impression that there were further opportunities for this vaccine (2).

Continuous studies were made and by 2012, scientists were beginning to use samples from RV144 to try and get a better understanding on what type of immune response that might be needed for an effective vaccine. Building upon these analyses, a Phase I/II study began in 2015 on the vaccine called HVTN 100 (1). This study is to continue on until January 2017 and has already been approved for Phase III efficacy trials (HVTN 702 modified from HVTN 100) based on the interim results from July of 2016.

The latest modification in the vaccine, an adjuvant called MF59, has been added in order to increase the vaccine’s strength as well as the protein involved to match the most common strain of HIV located in South Africa, where the efficacy trials will be taking place (3). HVTN 702 is also known as ALVAC-HIV and is scheduled to start in November 2016.

If these trials can produce results at least 50% efficacious, HVTN 702 will become a licensed preventative HIV vaccine. With the technological advancements that have been made in the past fifty years, the world is teetering on the verge of success in creating a vaccine that will have the capability to prevent a multitude of HIV infections each year (3).

References

  1. (2016). Avac.org. Retrieved 26 September 2016, from http://www.avac.org/trial/hvtn-100
  2. History of HIV Vaccine Research | NIH: National Institute of Allergy and Infectious Diseases. (2016). Niaid.nih.gov. Retrieved 26 September 2016, from https://www.niaid.nih.gov/diseases-conditions/hiv-vaccine-research-history
  3. HVTN 702 is a “Go” Uhambo continues. (2016). Hvtn.org. Retrieved 26 September 2016, from http://www.hvtn.org/en/community/community-compass/current-issue/cc-current-article2.html

 

10 Days Left! American Pharmacists Month 2016

Our UCSOP faculty, staff, and students are busy with activities that emphasize the role of the pharmacist in providing optimum patient care during the month of October 2016. This month is American Pharmacists Month, a time dedicated to celebrate all the contributions pharmacists make to health care. But, it’s also a time to provide community outreach and education about medication safety, medication adherence, and disease management.

P1070579This month, our students have organized health fairs, immunization clinics, and other outreach projects throughout the Kanawha County. Whether delivering Generation Rx curriculum to area elementary schools to help teach children about prescription abuse and medication safety or filling prescriptions at the Kanawha Charleston Humane Association, our students and faculty are dedicated to utilizing their skills and knowledge in ways that benefit our community.

With 10 days left in American Pharmacists Month, our students are busy planning and preparing for several events including:

  • Saturday, October 22 –  Providing health services at the RAMS Clinic in Elkview
  • Monday, October 24 – Friday October 28 SNPhA Power-To-End-Stroke Tweet-a-Thon #SNPhANoBarriers • @SNPhARegion2 • @UCSOP • #UCSOP
  • Thursday, October 27 Health Fair from 4-7pm at the YMCA
  • Saturday, October 29 CPFI & ACCP Trunk or Treat—Promoting Poison Control at the South Charleston Kroger
  • Monday, October 31 SNPhA’s Say Boo to the Flu! Immunization Clinic at Family Care, (West Side near Patrick Street)

Our students serve over 10,000 patients throughout the Kanawha Valley each year through their activities and health fairs. We are proud of the work they do and their focus on community and public health.

 

 

 

Pharmacy Students Help Prepare Medicines at Animal Shelter

Contributed by Amanda Miller, Class of 2019

When an area experiences any form of natural disaster our first instinct is to try and help the people affected by the disaster. However, humans are not the only ones in need of help. Natural disasters can also displace animals. After the floods that happened in West Virginia in June 2016, there were many animals that lost their homes or owners, and many became extremely ill. Luckily, the Kanawha Charleston Humane Association (KCHA) stepped up to help as many of these animals as possible.

kcha1Since June, KCHA has experienced a huge influx of animals coming into the shelter—many are extremely young and very ill puppies and kittens. In these cases these animals have to be separated from the general population of the shelter and require more intense care from the veterinarian and the staff that assists them. This increased need for medical attention has made it difficult for the veterinarian technicians at KCHA to maintain a supply of prepared medications.

In order to host kittens at the shelter, most need at least 4 different medications when they first arrive. This does not include the animals who are extremely sick and will need this care for multiple days or possibly weeks of care. That means if the shelter takes in 20 kittens who require this extra care, which may require as many as three doses a day, these kittens will need 420 doses of each medication for one week. That is a lot of medication to both prepare and give to these kittens. This is where student pharmacists have stepped in to help.

kcha2As pharmacy students we have experience with preparing medications. From our first year of pharmacy school we are taught how to compound medications and how to draw medicine appropriately into syringes. So, although we do not have the know-how on how to give these medications to the sick animals, we do know the medications they are being treated with. For American Pharmacists’ Month we at the University of Charleston School of Pharmacy (UCSOP) are volunteering our time to try and help KCHA prepare medications. By taking this extra workload off the veterinary staff, we are enabling them to spend more time actually treating these animals instead of having to spend their time preparing the medications. The veterinarian and veterinarian technicians have all been extremely thankful for our help because we have been able to help when they are in such direr need of help. Because we are training to become medication experts, pharmacy students are able to offer assistance for this specific area of need.

Our hope is to continue our relationship with KCHA and volunteer not only in October for American Pharmacists Month but year-round as well. Volunteering at the shelter not only helps the community but it allows pharmacy students to put their skills and knowledge into practice while helping our furry friends!

Reflections: UCSOP Summer Internship Experience

As an undergraduate looking to one day attend pharmacy school I was looking for any chance I could get to gain experience in the field of pharmacy. When the opportunity to become an intern at the University of Charleston School of Pharmacy came up I had to take it. I quickly began the application process and soon was asked to interview for the position. After two rounds of interviews I received a phone call offering me the internship, which I quickly accepted.

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Beautiful view of the WV State Capitol building from UC’s campus.

I moved into East Apartments in the beginning of June to begin the internship. On the first day I received a very warm welcome from the faculty and staff of the School of Pharmacy. We toured Charleston, visited the Capitol building and Cultural Center, and became oriented with our new home for the next 8 weeks.

While we received many tasks to work on for the duration of the internship, our biggest project for the month of June was to serve as Head Counselors of the ExRx: Experience Pharmacy Summer Bootcamp. The camp was a week-long experience for high schoolers and undergraduates who were interested in pharmacy school. We spent the weeks leading up to the camp planning events, setting up activities, and preparing for the arrival of the students to the dorms. While we were leading the activities, we also got to immerse ourselves into the curriculum and learn about pharmacy school as well. After the camp ended we were invited to attend two School of Pharmacy alumni events; Blues Brews and BBQ, and Wine and all that Jazz. While the week of camp was long, we learned so much about UCSOP as well as meeting current students and alumni of UCSOP.

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Killian Rodgers, summer intern, and I volunteered at the animal shelter giving medication to dogs.

Throughout the month of July we got to work very closely with a P4 student who was on rotation with UCSOP administration. We also got the opportunity to work in the research lab under Dr. Linger. We spent the week assisting her running diagnostic tests, purifying proteins, and preparing a poster presentation. Also in the month of July we were able to shadow Dr. Juengel from UCSOP at WV Health Right. Both experiences allowed us to see different sides of pharmacy, and different paths we could take with a PharmD. Throughout the month we also volunteered at the local animal shelter and the health department. Both volunteer experiences served to broaden our horizons on what can be done with a PharmD, as well as giving us a sense of community and communication skills that are often used in pharmacy school.
Overall the experience allowed me to become even more excited about one day obtaining my PharmD. I got to experience several different paths of pharmacy that I didn’t know existed and I made connections with pharmacists and administrators that are invaluable. The eight weeks flew by as I grew to love Charleston more every day. To anyone who is currently and undergraduate and looking to attend pharmacy school this internship is a great way to further develop skills and experience that will be so useful when it comes time to apply!

KCHD’s Harm Reduction Program

Beginning in December 2015 the Kanawha-Charleston Health Department opened its Harm Reduction Clinic with Syringe Exchange Program. The program is designed to reduce the number of shared and re-used needles in order to control the spread of Hepatitis. Through confidentiality the patients receive the assistance they need through the needle exchange, counseling, and the various testing options available.

The Kanawha-Charleston program does not run off of any state funding or grants and relies completely on donations and volunteers to keep up with its increasing number of weekly patients. Volunteers can assist nurses in preparing patient bags containing clean syringes, a container for used syringes, as well as other products used to administer safe injections, such as alcohol pads and cotton balls. Several UCSOP students and faculty volunteer each week and gain experience with patient interactions.

The Harm Reduction Clinic takes place every Wednesday from 10:00am until 3:00pm. Patients, who remain anonymous throughout the process, have the opportunity to consult with a rehabilitation and addiction counselors while in the waiting area. Each patient is given the opportunity to safely exchange used syringes for new ones, with the promise that the patient will return the next week for the same purpose. While at the health department patients have access to free testing for Hepatitis B, Hepatitis C, and HIV. Patients can also request to have a doctor access any injections sites for signs of infection. The program also offers contraceptives to women patients.

In addition to the screening and testing options available, patients are also encouraged to complete a short Naloxone training course. With the increased drug use also comes increased risk of overdose, and this training helps patients to better identify the signs of an overdose. Naloxone can be injected into someone who is experiencing an overdose in order to reverse the effects and potentially safe a life. The training takes place during the hours of the clinic an lasts approximately 30 minutes.  Patients walk away with a sample of Naloxone and the proper training to handle an overdose situation.

The Harm Reduction Clinic and Needle Exchange Program provide a safe place for patients to discuss their concerns and receive counseling. The Health Department also ensures the safety of its patients by keeping the identity of each patient anonymous and maintaining police presence. This program is fairly new it has already seen an increase in the number of weekly patients, and its services have already affected many patients. While the program centers on reducing the prevalence of diseases transmitted by sharing and re-using needles, the program has also aided many patients in drug detoxification and recovery programs.

 

UCSOP Works with National Youth Science Camp

Since its start in 1963 West Virginia’s National Youth Science Camp has been encouraging recent high school graduates to pursue further education in the science field. Two students from each state are chosen to attend the month long camp that is centered at Camp Pocahontas in Bartow, West Virginia. This year the campers kicked off their journey by visiting the University of Charleston School of Pharmacy. Over 100 students arrived on campus the morning of June 16th and were welcomed by Dr. Paul Hill, the chancellor of West Virginia Higher Education Policy Commission. Dr. Hill spoke about the history of the National Youth Science Camp as well as his involvement as the CEO of the U.S Chemical Safety Board. The camp encourages students to take STEM (Science Technology Engineering and Math) classes and become more involved in the science field in their future studies. After the morning lecture the campers toured UCSOP and engaged in interactive sessions in the sterile IV and compounding laboratories.

Following the opening of the camp at UC the students traveled to Camp Pocahontas to begin their month long adventure. Their schedules for a typical day were full, beginning at 7:00am each day and ending around 11:00pm. The students experienced many guest lectures on varying topics from developments in cancer treatments to studies in foreign language in the medical fields. In addition to lectures, students had the opportunity to engage further into the sciences with hands on activities proctored by guest scientists of varying fields. Dr. Rebecca Linger, a professor at UCSOP, and P2 student Rachel Peaytt, traveled to the camp Sunday June 26th to conduct a week-long directed study block for the students. Their program was entitled Assaying Antioxidant Content of Medicinal Plants. Beginning the multi-day process Dr. Linger led the campers on a medicinal plant walk in search of plant samples. The samples were spectrophotmetrically tested for flavonoid content, giving the students an opportunity to see chemical interactions through color changes. The students were given the opportunity to learn about medicinal plants, as well as gain experience in plant material extraction and assay.

While the students developed their interests in science they also developed outdoor leadership through the camp. The campers participated in various outdoor activities including camping, hiking, kayaking, rock climbing, and mountain biking. With several overnight camping adventures, the students got to explore much of the beautiful West Virginia scenery including Canaan Valley and the Cranberry Glades. The students also got to spend time exploring the science behind telescopes and space exploration at the National Radio Astronomy Observatory in Green Bank, West Virginia.

Through the many hands-on activities, guest lectures, and outdoor activities the students developed a sense of what’s going on in the science community. This camp allows students to grow or develop their interest in science, while encouraging them to pursue their careers and continue their education. Dr. Linger and Rachel thoroughly enjoyed their experience with their involvement in the camp, and hope to continue building a relationship between UCSOP and the National Youth Science Camp.

UCSOP ExRx Bootcamp a Success!

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High school students make ointment in the compounding lab

From June 21st through the 24th the halls of UCSOP looked very different with almost 30 high school and undergraduate students here for the 3rd annual ExRx- Experience Pharmacy Summer Bootcamp. These students were formally here to learn about UC and the profession of pharmacy as a whole but also to do what anyone at a camp wants to do- have fun! Favorite activities included compounding camphor-menthol ointment in the compounding lab with Mr. Ramirez, preparing sterile IVs with Dr. Embrey and Ms. Condee, and a photo scavenger hunt around campus which turned into a fierce competition to find as many UC Golden Eagles as possible. (The winning team, The Green Circle Group ultimately found 28!)

Campers came from all over the country. While a majority came from West Virginia we had people come all the way from New York, Florida, and numerous other states to participate. In addition to the hands on experiences, campers also got a feel for the more didactic classroom based portions of the Pharm D. program through sessions on the history of pharmacy, ethics, and the APhA Career Pathways program.

One particularly exciting session was Dr. Radhakrishnan’s lecture “The Travelogue of a Tablet” which covered the journey of tablet from mouth to active site to excretion. Campers enjoyed being in the “facilities and us[ing] resources that current pharmacy students get to use” while getting a lecture from a professor they very well may have if they come to UCSOP.

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Students work with a mannequin in the simulation lab

Ultimately, the success of a program like this is the impact it has on the students. One student even went so far as to say they had “been to few camps and things about pharmacy and [in] the few short days here…learned more then any other place as well had more fun. So [they] would highly recommend this to anyone for the fact of all th [sic] info …[and] how fun it was.” A focus of UCSOP and in turn a focus of the camp was on promoting rural health. Students were exposed to the unique challenges of rural health pharmacists by interacting with some and hearing about their experiences. As a result, 75% indicated after the camp that they are interested in serving rural populations.

While this extended four day ExRx program is only offered once per summer, UCSOP has shorter ExRx open house events on campus throughout the school year. Check out this link for more information.

Each group of campers led by a P2 Fellow created a short video to capture their camp experience. Check them out below to see what each group was up to!

The Silver Star Group led by Kathryn Howerton

The Pink Circle Group led by Rachel Peaytt

Squad Red Stars led by Kyle Theiss

The Gold Star Group led by Blanche Ndifon

The Blue Star Group led by Leila Fleming

The Green Circle Group led by Amber Gross

(Cirlce groups are high school students and star groups are current undergraduate students)

Be sure to look out for information about ExRx 2017 next Spring on the UCSOP website this fall!

UCSOP Flood Relief with the Kanawha-Charleston Humane Association

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A cat at the Kanawha-Charleston Humane Association receives respiratory treatment in a nebulizing chamber

In the wake of the recent floods, countless people around the Kanawha area have needed help and many have volunteered to assist with clean up and medical care. But a group that is often forgotten in crisis situations is pets. On June 29th, a group of UCSOP faculty and students including Dr. Sarah Embrey Dr. Cassie Legari, Dr. MIchelle Knight, Kendra Hall (Class of 2019), and UCSOP interns Killian Rodgers and Dawnna Metcalfe went to the Kanawha-Charleston Humane Association to help out in this time of need.

 

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Intern Dawnna Metcalfe prepares a syringe to help cats with respiratory issues

The Kanawha-Charleston Humane Association (KCHA) operates a shelter and animal hospital just outside of Charleston near Yeager Airport. They have over 100 kennels for dogs and house many cats as well. In addition to providing shelter, food, and medical care for pets in need, they work to fight animal cruelty in Kanawha county and help reduce the pet overpopulation issue through Trap-Neuter-Return programs. As a humane society, they try to save every animal they can and pair them up with a loving family to provide them a forever home.

Since the floods however, they have been inundated with new arrivals. Many are pets who are currently separated from their owners but many are also newly strayed and will need forever homes as well.

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A dog at KCHA awaits her dewormer

The team from UCSOP helped the veterinary staff at KCHA, led by University of Charleston Alumn, Dr. Jamie Totten, prepare medications, administer medications, and get a census of some of the dogs and cats. Many cats at KCHA were in need of respiratory care so Dr. Embrey and the UCSOP summer interns helped prepare dozens of syringes with necessary medications. In addition, the interns and a P2 student helped to deliver deworming medication to over 60 dogs.

Both the people and the pets at KCHA were very happy and grateful for the help, even the dogs that weren’t too happy about taking their medication. But there is still plenty more that needs to be done! Below are some links for how you can help out KCHA and the pets of Kanawha county:

If you are interested in adopting click here to find out about the process of providing a pet with their forever home.

If you are interested in volunteering or fostering an animal click here.

If you would like to donate money click here.

If you are in the area and would like to donate some supplies click here for a list of what they need most.

If you are a medical professional or work in a medical environment- the veterinary staff at KCHA are in desperate need of equipment like syringes, if you have any that you are willing to donate (expired equipment is OK) please click here for contact info on how to get that to the right people.

Contributed by: Killian Rodgers and Dawnna Mecalfe