Class of 2010 Abstract / OBJECTIVES: The purpose of this study is to determine the effects of professional pharmacy educational training and occupational student pharmacist training towards the quantity of medication errors attributed to not investigating drug-drug interactions and/or not acknowledging contraindications for medications and treatment. METHODS: The design was a cross-sectional, analytical study of student pharmacists in their first, second, or third year of a four-year Doctor of Pharmacy program. A questionnaire of patient drug interaction scenarios along with student work experience and demographic survey questions was administered to a class of students to complete and return at the time it was administered. It was a prospective study. RESULTS: Questionnaires were completed by 180 students. None of the classes surveyed scored significantly higher than another class. Students with retail experience did not score significantly higher survey scores than those with hospital experience. Finally, when comparing the scores of students with experience in multiple fields, in comparison to those with experience in only one field of pharmacy, it was noted that there was no statistical significance. CONCLUSIONS: The amount of professional pharmacy education training and occupational student pharmacist experience was not found to have an affect on a student pharmacist’s ability to prevent medication error that was attributed to either not investigating a drug-drug interaction and/or not acknowledging contraindications for medications and treatment.

Class of 2009 Abstract / OBJECTIVES: The purpose of this study is to evaluate and compare the DDI knowledge of pharmacy, medical, and nurse practitioner students who are beginning clinical clerkships. METHODS: This study utilized a prospective evaluation of DDI knowledge among healthcare professional students who were currently enrolled in their final didactic year at the University of Arizona College of Medicine, College of Pharmacy, or College of Nursing’s nurse practitioner course. Students were provided with 15 possible DDI pairs, and asked to select an appropriate management strategy for each pair. Management options included: “Avoid Combination,” “Usually Avoid Combination,” “Take Precaution,” “No Special Precaution,” and “Not Sure.” The primary outcome measure was the ability to correctly categorize each DDI pair into one of the five management responses. The secondary outcome measure was the number of clinically significant DDIs recognized. Analysis of variance was used to evaluate differences between groups. An alpha of 0.05 was set a-priori. RESULTS: Response rates were 61% for medical students (72 of 119), 82% for pharmacy students (64 of 78) and 100% for nurse practitioner students (29 of 29). The mean number correct for management strategies was comparable in the medical students (2.5, SD= 1.9) and nurse practitioner students (3.0, SD= 1.9), while the pharmacy students had a mean score of 6.1 (SD= 2.2) correct answers. There was a significant difference between the groups in correct responses (p< 0.001). In regards to student ability to identify interactions, the mean number correct was 10.1 (SD= 2.6), 5.0 (SD= 3.3), and 4.4 (SD= 3.0) for pharmacy, medicine, and nursing respectively (F= 60.6; p< 0.001). Post hoc analysis demonstrated that pharmacy students performed significantly better than medical and nurse practitioner students in regards to their ability to: 1) select management strategies for DDI pairs; and 2) identify a DDI interaction. No significant differences were found between the medical and nurse practitioner students. CONCLUSIONS: Pharmacy students demonstrated better knowledge than medical and nurse practitioner students with respect to identifying and selecting management strategies for possible DDIs. However, there is much room for improvement for all groups.

Numerous studies have demonstrated the impact of organic cation (OCTs; SLC22 family) and anion transporters (OATs; SLC22 family) on the efficacy and safety of clinically important therapeutics. To be specific, OCTs and OATs have been identified as determinants for uptake into and secretion from enterocytes, hepatocytes and renal proximal tubular cells, and are frequent sites of drug-drug interaction (DDI). In addition, OCTs expressed in brain are components of the low-affinity, high capacity clearance pathway (uptake-2) for biogenic monoamine neurotransmitters. As a result, OCTs may represent novel targets for mood disorders. The inhibitory effects of several therapeutic agents, designed drugs and novel compounds were assessed on the function of OCTs/Octs and OATs/Oats. Among these compounds, the anthraquinone rhein showed significant inhibition on hOATs. While the antituberculosis drug ethambutol, the herbal products matrine and oxymatrine, synthetic cathinones, and all quinazoline and guanidine compounds produced significant inhibition on hOCT activity with most IC50 values in the micro- and even nanomolar ranges. Considering the clinically relevant unbound concentrations in biofluids, significant DDI potentials were found for rhein, ethambutol, matrine, oxymatrine and several synthetic cathinones affecting enterocytes, hepatocytes and/or proximal tubules. As hOCT2 and hOCT3 may participate in modulating neurotransmitter homeostasis in the CNS, these findings also suggested that the CNS pharmacological effects of synthetic cathinones, quinazoline and guanidine compounds might be due to their inhibitory effects on OCTs; although their impact may be limited solely to clearance of these compounds. Based upon their in vitro OCT/Oct inhibition profiles, three lead quinazoline and guanidine compounds were chosen for in vivo studies. Potent antidepressant-like effects of one lead hOCT-interacting compound (KEO-099) were re-confirmed in the tail suspension test. While in vivo results of the two newly identified hOCT-interacting lead compounds were somewhat less clear. Finally, homology modeling and docking studies for hOCT3 identified key amino acid residues that might be involved in interaction between hOCT3 and small molecules. Subsequent experiments confirmed a competitive mode of interaction between MPP+ and lead compounds on hOCT3. Thus, preliminary analysis indicates our hOCT3 homology model can be used to support rational drug design and high-throughput screening of novel hOCT substrates/inhibitors.

Class of 2012 Abstract / Specific Aims: To evaluate the quality of evidence in the literature substantiating major drug-drug interactions of the HMG-CoA reductase inhibitors (statins) atorvastatin, lovastatin, and simvastatin with the azole anti-fungals fluconazole, itraconazole, and ketoconazole. Methods: In this descriptive retrospective analysis, a list of articles reporting on each drug-drug interaction was compiled from the online databases Medline and International Pharmaceutical Abstracts, and the drug compendia Micromedex and Facts & Comparisons. The studies included in this analysis were primary literature reports, written in English, and consisted of human subjects. All studies included were evaluated using a 5-point quality of evidence scale developed to assess drug-drug interactions (van Roon scale). This scale rates the study type from lowest to highest quality, from zero to four. Case reports were additionally analyzed using the Drug Interaction Probability Scale (DIPS). The DIPS tool uses 10 questions to evaluate the probability that an adverse event is caused by a drug-drug interaction. Main Results: Twenty-one studies met the selection criteria. There were three studies involving atorvastatin, four studies involving lovastatin, and fourteen studies involving simvastatin. The mean quality of evidence score on the van Roon scale was 2.0 + 0.77, where atorvastatin studies had a score of 2.3 + 1.15, lovastatin had a score of 2.25 + 0.95 and simvastatin had a score of 1.86 + 0.66. Seventy-one percent of the studies reviewed were case reports. Conclusions: The reports substantiating some drug-drug interactions may be of little and low quality evidence.

Candidate: Kateřina Kukrálová1 Supervisor: prof. RNDr. Jiří Vlček, CSc.1 Consultant: PharmDr. Zuzana Očovská1 1 Department Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Title of the master thesis: The analysis of drug-drug interactions in patients admitted to hospital (I.) The presence of potential drug-drug interactions (DDIs) is common in daily practice and only a small proportion of potential DDIs results in hospitalization of the patients. Nevertheless, DDIs represent a significant cause of hospital admissions. This study aims to identify DDIs in the medication history of the patients admitted to University Hospital Hradec Králové via the emergency department in August-November 2018. The objectives of this study are a) to determine the prevalence of potential DDIs; b) to categorize identified potential DDIs with respect to their mechanism, severity, risk rating, level of documentation and potential outcomes and c) to determine the prevalence of manifest DDIs. This study has a cross-sectional design. The following data were obtained retrospectively from electronic medical records: demographic data, medication history, past medical history, laboratory and clinical findings, and information about hospital admission. The identification of potential DDI was...

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OUŘEDNÍKOVÁ, Veronika. Addicted mothers in relation to pregnancy and motherhood. Praha, 2016. 84 s. Diploma thesis. Charles University, Hussite theological faculty. Supervisor: PhDr. Miloslav Čedík The diploma thesis deals with problems of drug addiction of women during pregnancy and motherhood. The work is divided into theoretical and practical. The theoretical part discusses the basic concepts and generally approaching the issue. An important part of this passage is the chapter that describes care system in the Czech Republic on drug-dependent pregnant women and mothers. The practical part is mainly composed of qualitative research, which was conducted in therapeutic community Karlov with drug addicted mothers. The second part of the thesis is to investigate the influence of pregnancy and motherhood on the life of drug addicted women. In conclusion, the diploma thesis presents the results obtained on the basis of the research, which was conducted through semi-structured interviews with clients in healing the therapeutic community Karlov.

Introduction 1. The drug, an addictive substance, drug addiction and certain further relevant terms 2. Overview of the classification, evolution, characterization and effects of particular illegal drugs 3. Drug scene in the Czech Republic in and the drug phenomenon in the European context 4. Drug-related crime in the light of the offender 5. The legal regulation related to substance abuse 6. Prevention and the drug policy in the Czech Republic Conclusion Abbreviation list Used literature list Appendix list Appendix Summary

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Targeted oral antineoplastic agents (OAs) have become a staple and rapidly growing field in the realm of cancer treatment. As with any chemotherapeutic/narrow spectrum agent, clinicians have to be aware of potential drug interactions that could interfere with therapy. Drug information databases are a common resource utilized to check for interactions between agents and patient's home medications. A major concern with OAs is that they are usually taken at home as well as picked up at a pharmacy by the patient themselves. With this kind of therapy adherence and patient side effect reporting becomes a concern. We wanted to determine the reliability of these databases for picking up potential interactions with patients on OAs. We accessed hospital records to find patients with various malignancies on OAs between the calendar year of 2013-2014, of which we found 876 that were screened for potential use of OAs. The goal was to find patients on OAs specifically and determine the number of drug interactions flagged by either drugs.com and/or Lexicomp®. In addition, the significance of the interaction as well as disagreements between databases were analyzed. A major interaction by Lexicomp® is defined as either a ‘D’ or an ‘X’ level interaction and on drugs.com is labeled ‘major.' Of the 876 screened we found 16 patients (one patient had tried 3 different agents, and another patient had tried two) on OAs. Lexicomp® flagged overall 42 interactions amongst all subjects, of which 17 were major interactions. Drugs.com flagged overall 44 interactions amongst all subjects, of which 11 were major interactions, being the more conservative of the two. Between the 2 databases there were 10 out of 18 major interactions that both were in agreement upon. These discrepancies are of concern in that clinicians hope that resources they utilize are incongruent with one another and allow them to practice in the safest manner in terms of avoided potential serious drug interactions whether it be harm to a patient or decreased effectiveness of the OA. Now that all patients have been screened, future research would be to determine the clinical significance of these interactions and whether or not they had an effect on patient outcomes.