Class of 2009 Abstract / OBJECTIVES: The objectives of this study were 1) to review the University of Arizona College of Pharmacy’s curriculum to assess if courses cover pertinent topics in the use of prescription and over-the-counter (OTC) medications by pregnant and lactating women based on The American Association of Colleges of Pharmacy (AACP) Gender and Sex-Related Health Care Pharmacy Curriculum Guide and 2) to assess pharmacy students’ knowledge and abilities to counsel women during pregnancy and breastfeeding. METHODS: The curriculum review was a retrospective, descriptive analysis to assess how well the required curriculum addressed eight pertinent topics in the use of prescription and OTC medications by pregnant and lactating women. The self-assessment questionnaire was a cross-sectional, descriptive analysis that measured student pharmacists’ comfort level with counseling pregnant and lactating women, their perception of how well pharmacy school has prepared them for this role, and their familiarity with and use of available resources. RESULTS: The College of Pharmacy was not in compliance with AACP’s Pharmacy Curriculum Guide. This was reinforced by the questionnaire, which showed that the majority of students, regardless of year in school, did not feel they had been adequately prepared to counsel or to make recommendations to this population. CONCLUSIONS: It is recommended that the curriculum be amended by adding a lecture on teratogenicity. A list of gender and sex- related topics should be provided as well as a handout with available resources. In addition, case studies in each course should be revised to include critical decision-making, recommendations, and counseling if the patient were pregnant or breastfeeding.

Beyond the expected DBP exposure from drinking water, dermal from bathing, and inhalation, occurrence in food and beverage items can provide an additional occurrence pathway. Synthetic dyes are often added to beverages for aesthetic purposes and many are in the form of a reactive azo (-N=N-) dye or triarylmethane dye, both with a characteristic aromatic ring. The presence of dyes in beverages that are reconstituted with disinfected tap water pose the risk of reactions with the residual chlorine in the drinking water resulting in decolorization, and of greater concern, disinfection byproduct formation. Additionally, oral over-the-counter (OTC) medications contain chemical constituents that when reconstituted with tap water present a risk of DBP formation. Several studies were performed to evaluate the kinetic decay rates of the dyes and drugs in disinfectants, and the effects of water quality conditions on DBP formation. Commercial beverage products and OTC medications were evaluated for the DBPs that were detected in the free chlorine-treated precursor samples. The dye and drugs precursors followed second order kinetics, with the fastest rates for brilliant blue and phenylephrine in chlorinated water. The effects of water properties on precursor degradation and DBP formation was complex due to the influence of characteristics of precursor molecules. The cytotoxic and anti-estrogenic responses were measured in the dye and drug precursors and their respective beverages and OTC medications, to determine potential links. Mio Energy showed estrogenic character and Alka Seltzer induced an anti-estrogenic and cytotoxic response, however there were no clear linkages between the beverage/ medication and their respective dye and drug precursors.