Research Roundup

Researchers: Drs. Abdulwhab Shremo Msdi (our former ID fellow), Alireza FakhriRavari, Jacinda C. Abdul-Mutakabbir, and Karen K. Tan

Are All Pharmacokinetic Equations Created Equal? A Comparative Analysis of Trapezoidal and Non-Trapezoidal Methods for Estimating Day 1 AUC in Adult Hospitalized Patients with Staphylococcus aureus Bacteremia

Infectious Diseases and Therapy

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Summary: The findings from this study highlight key differences between trapezoidal and non-trapezoidal methods, with implications for optimizing vancomycin dosing and therapeutic drug monitoring.

Researcher: Dr. Caroline Sierra

Incorporating Pediatrics in Clinical Education: A Call to Action in Inpatient Pharmacy Practice

The Journal of Pediatric Pharmacology and Therapeutics

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Summary: This important work, co-authored with several pediatric pharmacy faculty members, highlights the need for enhanced pediatric exposure in clinical pharmacy education. The authors discuss strategies to integrate pediatric pharmacotherapy training into inpatient practice to better prepare future pharmacists in managing pediatric patients.

Researcher: Dr. Paul Gavaza

Pharmacists' perception of artificial intelligence: A national survey

American Pharmacists Association

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Summary: The purpose of this study is to describe the perceptions and awareness of artificial intelligence technologies in a population of practicing pharmacists across the United States. Artificial intelligence (AI) is a rapidly growing and evolving field impacting pharmacy research, education, and professional practice. The development and adaptation of AI technologies have the potential to radically shape the future of the pharmacy profession. However, it remains unclear how aware pharmacists are of these technologies or their perceptions regarding current and future utilization.

Researchers: Dr. Lisa Hong, in collaboration with former resident, Dr. Paul Phan

Comparison of Direct Oral Anticoagulants for Treatment of Cerebral Venous Thrombosis – A Retrospective Cohort Study

Clinical and Applied Thrombosis/Hemostasis

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Summary: This small retrospective study evaluated the efficacy and safety of direct oral anticoagulants (DOACs) (apixaban, rivaroxaban, and dabigatran) for treating cerebral venous thrombosis (CVT). The findings suggest no significant differences in outcomes such as recanalization rates, recurrent VTE, or bleeding events among the DOACs, highlighting their potential as effective treatment options for CVT.

Researchers: Drs. Winnie Tran, Farnoosh Zough, Khaled Bahjri, Christopher Hauschild, Mikael Habtezion, and our talented LLUSP Class of 2025 students Asya Bookal, Ahmed Bahjri, and Darren Kang

Evaluation of Sodium-Glucose Cotransporter-2 Inhibitors on Euglycemic Diabetic Ketoacidosis in Patients Admitted to an Academic Medical Center

EC Pharmacology and Toxicology

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Summary: This retrospective cohort study analyzed 1,604 patients admitted to LLUH Medical Center and prescribed SGLT2 inhibitors. While no cases of euglycemic diabetic ketoacidosis (euDKA) were identified, the study highlights a significant gap in diagnostic protocols, emphasizing the need for hospital-wide strategies to improve detection and outcomes.

Researcher: Dr. Lisa Hong

Current state of APPE-readiness assessments in schools or colleges of pharmacy

Currents in Pharmacy Teaching and Learning

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Summary: This study surveyed U.S. PharmD programs to explore the components of Advanced Pharmacy Practice Experience (APPE)-readiness plans. It highlights the widespread use of skills and knowledge assessments such as communication, patient history collection, medication reconciliation, and more. The majority of assessments were incorporated into skills laboratory courses and were remediable. The findings underscore the importance of structured readiness plans and provide valuable insights for enhancing pharmacy education.

Researchers: Dr. Tomona Iso and Dr. Lisa Hong, along with Dr. Christopher Hauschild (LLU Medical Center) and Dr. Tommy Thai (former PGY-1 Pharmacy Resident; current LLUMC pharmacist)

Comparison of sodium zirconium cyclosilicate and sodium polystyrene sulfonate in the treatment of acute hyperkalaemia

European Journal of Hospital Pharmacy

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Summary: This retrospective cohort study of 46 patients evaluated the efficacy of sodium zirconium cyclosilicate (SZC) and sodium polystyrene sulfonate (SPS) in treating acute hyperkalemia (serum potassium ≥5.5 mmol/L) among hospitalized adults. Results showed high rates of potassium normalization in both groups (94% for SZC and 93% for SPS). While no statistically significant difference in efficacy was observed, SZC's quicker onset may offer a meaningful clinical advantage in the acute setting.

Researchers: Dr. Winnie Tran (DPP) and Dr. Allyson Chan (PGY-2 Cardiology Resident), in collaboration with Dr. Khaled Bahjri (DPAS) and Dr. Chris Hauschild (Medical Center)

Acetazolamide Versus Thiazides with Loop Diuretics in Acute Decompensated Heart Failure

EC Pharmacology and Toxicology

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Summary: Compared three diuretic strategies in ADHF (N=340): acetazolamide + loop, thiazide + loop, and all three combined. No significant differences found in net daily urine output, length of stay, or mortality across groups after adjustments. Calls for further research into the optimal timing and doses of diuretics for ADHF

Researchers: Dr. Winnie Tran, Dr. Paul Gavaza, and our incredible alumni Drs. Kirsten Vyhmeister, Murphy Nguyen, and Grace Kang

Evaluation of Long-term Antithrombotic Management for Atrial Fibrillation Patients with a History of Coronary Stent Implantation

Annals of Clinical Hypertension

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Summary: This groundbreaking research delves into real-world practices, revealing that 67% (44 of 66) of patients with atrial fibrillation on anticoagulants continued antiplatelet therapy beyond 12 months post-PCI, often despite increased bleeding risks. Key predictors for antiplatelet discontinuation included bare metal stents and lower HASBLED scores. The study calls for enhanced teamwork and greater adherence to guidelines to improve patient care.

Researchers: Dr. Lisa Hong, along with two of our distinguished former students, Drs. Divine Grewal and Laurensia Urip

Evaluation of Monotherapy Sodium Zirconium Cyclosilicate Versus Sodium Polystyrene Sulfonate for Acute Hyperkalemia: A Cohort Study

Hospital Pharmacy

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Summary: This retrospective cohort study compared the effectiveness of sodium zirconium cyclosilicate (SZC) and sodium polystyrene sulfonate (SPS) for acute potassium lowering in hospitalized patients with hyperkalemia. The study found that SZC may lower serum potassium more quickly and to a greater degree than SPS, particularly at 8 hours post-treatment, highlighting its potential advantages in managing mild hyperkalemia.

Researchers: Dr. Lisa Hong, Dr. Caroline Sierra

Impact of a Revised Teaching Certificate Program on Pharmacy Resident Precepting Skills

Pharmacy Practice

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Summary: This study found that after revising the TCP to balance experiential and didactic education, more residents felt that the program significantly contributed to their growth as preceptors. The most notable improvement was in the timely and actionable feedback residents provided to students, which increased considerably.

Researchers: Dr. Lisa Hong, Dr. Alireza FakhriRavari

Meta-analysis on safety of standard vs prolonged infusion of beta-lactams

International Journal of Antimicrobial Agents

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Summary: This meta-analysis explored the safety profiles of standard (30-60 mins) versus prolonged (≥3 hours) infusion protocols for beta-lactams, focusing on adverse drug reactions (ADRs). The study analyzed data from 12 studies, encompassing 4,163 patients, and found no significant difference in nephrotoxicity or diarrhea rates between the two infusion strategies. The findings highlight the need for future research with standardized definitions of ADRs, particularly in neurotoxicity and cytopenias.

Researcher: Dr. Christopher Jacobson

A Randomized Comparison of Postprandial Glucose Excursion Using Inhaled Insulin Versus Rapid-Acting Analog Insulin in Adults With Type 1 Diabetes Using Multiple Daily Injections of Insulin or Automated Insulin Delivery

Diabetes Care

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Summary: The study aimed to compare postprandial glucose excursions following a bolus with inhaled technosphere insulin (TI) versus subcutaneous rapid-acting analog (RAA) insulin in adults with type 1 diabetes. A meal challenge was completed by 122 participants, and the results showed that TI resulted in a smaller glucose excursion, lower peak glucose, and a shorter time to peak glucose compared to RAA insulin. The findings highlight the potential of TI to provide better postmeal glucose control.

Researcher: Dr. Justin Kinney

Multicenter Retrospective Review of Ketamine Use in Pediatric Intensive Care Units (Ketamine-PICU Study)

Critical Care Research and Practice

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Summary: This study examined continuous infusion (CI) ketamine practices in pediatric intensive care units (PICUs) and its impact on pain/sedation scores, analgesic/sedative exposure, and adverse effects. The research involved 24 patients across 4 PICUs and found significant improvements in time spent within goal pain score range and a notable reduction in morphine milligram equivalents (MME) during the first 24 hours. However, this reduction was not sustained beyond 48 hours. Common adverse effects included tachycardia, hypotension, increased secretions/suctioning, and emergence reactions. The study highlights the need for larger prospective studies in this population.

Researchers: Dr. Jody Gonzalez and Dr. Khaled Bahjri, along with contributions from our alumni Drs. Shasta Erickson, Clarissa Garcia, and Montinee Santhavachart, alongside colleagues from LLUSM's Family Medicine Department and LLU's School of Allied Health Professions.

Analyzing Potential Interactions Between Complementary and Alternative Therapies, Over-the-Counter, and Prescription Medications in the Older Population

The Permanente Journal

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Summary: The study focused on evaluating clinically significant interactions between complementary and alternative medicine (CAM), over-the-counter (OTC) medications, and prescription drugs in a geriatric clinic. Over a 2-year period, 420 participants aged 65 and older were enrolled. The findings revealed a 15.6% rate of potential drug interactions, with common contributors including supplements like Gingko biloba, garlic, and calcium, as well as OTC medications like ibuprofen. This research highlights the importance of awareness and investigation of CAM use among healthcare professionals to enhance patient safety.

Researcher: Dr. Christopher Jacobson 

Inhaled Technosphere Insulin for Individualized Diabetes Management: 3 Case Reports of CGM Outcomes

Association of Diabetes Care & Education Specialists in Practice

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Summary: This insightful article explores the use of inhaled Technosphere insulin, a fast-acting insulin administered via inhalation, in managing diabetes. Through three compelling case studies, Dr. Jacobson and his co-authors illustrate how this innovative approach can significantly improve glycemic control, reduce the risk of hypoglycemia, and enhance the quality of life for people with diabetes. The study highlights the benefits of continuous glucose monitoring (CGM) metrics, such as Time in Range (TIR) and Time above Range (TAR), in providing a comprehensive understanding of glucose management beyond the traditional A1C levels.

Researcher: Dr. Lisa Hong

Integrating learners into research and quality improvement projects: A joint opinion of the Adult Medicine and Education and Training Practice Research Networks of the American College of Clinical Pharmacy

Association of Diabetes Care & Education Specialists in Practice

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Summary: This manuscript dives into overcoming barriers and shares strategies for success, emphasizing communication, planning, and mentorship. An invaluable guide for anyone involved in research projects.

Researcher: Dr. Caroline Sierra, in collaboration with pediatric experts

Updates in the treatment of asthma in pediatrics: A review for pharmacists

AJHP

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Summary: This review offers a deep dive into current asthma guidelines, focusing on personalized treatments, including corticosteroids and biologic agents. It navigates through the nuances of pediatric asthma care, highlighting new strategies for difficult-to-treat cases. Guidelines for the diagnosis and treatment of asthma in pediatric patients have recently been updated by the National Asthma Education and Prevention Program (NAEPP) and the Global Initiative for Asthma (GINA). Both the NAEPP and GINA guidelines provide a stepwise approach for treatment of pediatric asthma, although there are notable differences between the 2 reports. Newer treatment strategies such as single maintenance and reliever therapy, long-acting muscarinic antagonists, and biologics are covered within both guidelines, but recommendations for younger age groups are lacking.

Researchers: Dr. Caroline Sierra, our alumnus and former PGY-1 resident Dr. Shawn Idnani, and Dr. Timothy Lee, a physician at LLUMC and LLUCH

Urinary Tract Infections in Patients Younger than 60 Days Old

The Pediatric Infectious Disease Journal

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Summary: This collaborative effort investigates the treatment of urinary tract infections (UTIs) in infants under 60 days of age. It focuses on the transition from intravenous to oral antibiotics, aiming to reduce hospitalization while ensuring effective care. Patients shifting to oral treatment had a shorter mean hospital stay, with no major difference in UTI symptoms within 30 days. 

Researcher: Dr. Lisa Hong

Nationwide evaluation of the clinical impact of acute care adult medicine pharmacists

Journal of the American College of Clinical Pharmacy

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Summary: This manuscript provides groundbreaking insights into the critical role of inpatient adult medicine (AMED) clinical pharmacists. The research, a multicenter, prospective, observational study, involved a 65-item survey distributed to AMED pharmacists. These professionals spend over 50% of their time in acute care settings.

Researcher: Dr. Caroline Sierra, in collaboration with researchers at the University of Tennessee HSC

Impact of Intravenous Fat Emulsion Choice on Candida Biofilm, Hyphal Growth, and Catheter-Related Bloodstream Infections in Pediatric Patients

The Journal of Infectious Diseases

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Summary: This manuscript offers groundbreaking findings. The study investigates how different intravenous fat emulsions (IFEs) impact Candida albicans' biofilm formation and the rate of catheter-related bloodstream infections (CR-BSIs) in pediatric patients.