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Student Clinical Digest 2014-2015 STUDENT CLINICAL DIGEST Presented by the Student College of Clinical Pharmacy— the official UGA chapter of American College of Clinical Pharmacy Volume 1, Issue 4 Clinical Pharmacist Focus ences and humble advice to our tered. I wanted to be a generalist students. and didn’t want to specialize out of fear of being too narrowly Why did you decide to pursue a focused and lacking variety. I residency? liked being able to dip my feet in other fields, and this has really I decided to pursue a residency helped me in the positions I’ve because of the opportunities held. available to me as a 4th year stu- dent on rotation at Emory Uni- What made you switch from versity Medical Center. During hospital to academia? this APPE, it was the 1st time I Michael Neville, Pharm. D., saw pharmacist working with the Someone told me many years ago BCPS, FASHP surgery team, internal medicine, they thought I would be a really intensive care unit, and transplant. great teacher and other people INSIDE THIS By Khushbu Tejani, Pharm D. Candi- What really impressed me was pointed it out a few more times ISSUE: date seeing the pharmacists being during my career. Both my par- proactive and contributing to ents come from an educational In this issue, we meet Dr. Michael patient care in a way that I never background and wanted me to Neville, a clinical pharmacist as saw before. While there, they got follow. I initially did not want to Clinical 1 well as former Clinical Associate to know me and asked me to pursue academia but it runs in my Pharmacist Focus Professor at the College of Phar- consider applying for their resi- blood. I enjoy teaching because I macy. Dr. Neville completed his dency program. At that time, it struggled a lot while a student Pharmacist’s Po- 1 PGY1 residency at Emory Hospi- was a great opportunity that I myself so I can relate to students tential Role in the tal and worked there as a clinical knew I didn’t want to pass up. who struggle. I enjoy seeing those Ebola Outbreak pharmacist in the following years. people learn things, see the light Prior to leaving the College in Why did you choose not to spe- bulb come on, and for them to December to assume responsibili- cialize and do a PGY2? realize they can really learn the Denying Immuniza- 3 ties as the Assistant Dean of stuff and do well with it in the tion: An Epidemic Student Affairs at Wingate School At the end of my PGY1, I was future. of Pharmacy, he was able to share more of an internal medicine with us his many clinical experi- clinical pharmacist and like the Continues on Page 2 Dyslipidemia Man- 4 variety of disease states encoun- agement Guide- lines: A Battle Field Pharmacist’s Potential Role in the Ebola Outbreak Brincidofovir: The 5 Potential New Drug for the Treatment Ebola By Brittany Chambers and most widespread Ebola out- vided as needed and can signifi- With the emergence of the Ebola break since the virus was first cantly increase the chance of virus outbreak spreading to the discovered in 1976, according to survival (1). There are currently United States in the fall of 2014, the World Health Organization. two experimental vaccines, cAd3- Drug digest in side- widespread panic has set in There are 5 species of the Ebola ZEBOV and VSV-EBOV, which bar! among the population. The out- virus and the most recent out- are undergoing Phase I trials that By Marisa Fortunato break began in Guinea in March break in 2014 was caused by the began in September and October of 2014 and with no therapies or Zaire species. Ebola virus disease of 2014 (2). If Phase I trials are vaccines against this deadly dis- (EVD) is a severe illness that can successful, it is thought that these ease, it spread to at least seven be fatal, especially if untreated. vaccines will be put on the fast- other countries by October of Currently, there are no FDA- track to FDA approval for use in 2014, including the United States. approved antiviral treatments for the current Ebola outbreak; The current outbreak is the largest EVD but supportive care is pro- Continued on Page 2 STUDENT CLINICAL DIGEST Page 2 Clinical Pharmacist Focus Continued from front page smaller projects for each rotation. those who are willing to take con- How would you describe your typical The day-to-day activities are really structive criticism and able to be time workday as a resident and even the varied depending on the rotation. On managers. We try to figure out all of few years after residency? some services, the team rounds twice these characteristics and skills during a day, such as the ICU rotation, but the interview process. By using multi- Emory residency was very intense. I others may only do once a day. ple preceptors to ask different ques- wasn’t really a great student in phar- tions, we were able to know more macy and really only began to under- about these skills and the candidate’s stand and focus on my work at the When you were the director of the personality, motivation, and needs. end of my degree. I knew the resi- residency program, what factors did We may even give a short exam and dency was intense but still decided to you look at in your applicants? afterwards, we would get together do it. The program is laid out with an and rank each individual candidate orientation session at the beginning We looked for applicants who were and choose the ones who would do followed by month-long experiences well rounded. Because our program well and fit well into our program. indifferent specialties such as surgery had several residents (4 or 5), we or oncology, precepted by different needed them to work well together How flexible were the rotations? clinical pharmacist. The resident is and looked for these characteristics also assigned a clinical pharmacist to during the interview. We also looked There are some rotations that their be the overall mentor/advisor as a for those who weren’t too “needy” as program considered to be essential or consistent presence and guide. This well and whether our program was a required, but also reserved a few Hysingla ER (hydrocodone): clinical pharmacist is helpful when good match for what they were months where the residents were able you do your grand round presenta- looking for in a residency. Some to choose certain rotations in which Hysingla ER is a long-acting tion and research project. The re- applicants may have had multiple they showed more interested such as hydrocodone product that was approved search project is intense for those degrees whose needs were more than bone marrow transplant. by the FDA in November 2014. It has who haven’t completed a research what we could offer. Those who are Continues on Page 3 been approved for use in patients who project. In addition to that, there are self-directed and motivated really require chronic management of severe also several longitudinal projects and stood out for us. We also sought pain and who have failed previous thera- pies. It is available in strengths of 20 mg -120 mg hydrocodone and is designed to be taken once every 24 hours. Given the high potency of this product and the already widespread problem of abuse of opioid painkillers, a high potential for misuse exists. In an attempt to solve this problem, Hysingla ER has been Pharmacist’s Potential Role in the Ebola Outbreak formulated with unique physical and Continued from front page chemical properties designed to deter its abuse. The tablet itself is difficult to break and crush, which will make alter- by Brittany Chambers response against the Ebola virus (2). nate routes of ingestion more challeng- this is where a potential role for Pharmacists have gained a large and ing. Additionally, it does not dissolve pharmacists could come into play. vital role in providing immunizations easily, forming a viscous gel instead of a cAd3-ZEBOV is derived from a and with the panic and fear of the solution, making injection difficult. It is chimpanzee adenovirus and is genet- current Ebola outbreak, administer- the hope of the manufacturer, Purdue ically engineered to express glycopro- ing vaccinations against the Ebola Pharma L.P., that Hysingla will provide teins from both the Sudan and Zaire virus may become a primary duty of an effective therapeutic option for pa- species of the Ebola virus to generate pharmacists, if and when they are tients who need chronic pain manage- an immune response (2). VSV- approved. ment, while simultaneously cutting EBOV is a recombinant vesicular down on the potential for its abuse. stomatitis virus-based vaccine that References: References: encodes for the Ebola virus (EBOV) WHO: Ebola Virus Disease update, FDA News Release. “FDA approves glycoprotein in place of the of the 1 Sept. 2014. Web. 24 Nov. 2014. extended-release, single-entity hydroco- vesicular stomatitis virus (VSV) <http://www.who.int/mediacentre/ done product with abuse-deterrent glycoprotein to provoke an immune factsheets/fs103/en/>. properties”. November 20, 2014. Gao J, Yin L. "Drug Development http://www.fda.gov/newsevents/ for Controlling Ebola Epidemic - A newsroom/pressannouncements/ Race against Time." Drug Discoveries ucm423977.htm & Therapeutics 8.5 (2014): 229-31. Web. 24 Nov. 2014. <https:// www.jstage.jst.go.jp/article/ ddt/8/5/8_2014.01040/_article>. Volume 1, Issue 4 Page 3 Clinical Pharmacist Focus Continued from page 2 “Students can What educational steps did you take competitive.
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