Assessment of Volunteer Preceptors at Colleges and Schools of Pharmacy in the United States.

Objective. To identify the way colleges and schools of pharmacy in the United States assess the performance of volunteer preceptors who precept students in advanced pharmacy practice experiences (APPEs).Methods. In the summer and fall semesters of 2018, directors of experiential education were invited to complete an online, self-administered questionnaire that included questions dealing with assessment of APPE volunteer preceptors related to promotion and reappointment procedures, abilities and attributes assessed, methods of assessment, and frequency of conducting such assessments. Several attempts were made via email and phone to encourage participation.Results. Eighty-one of 132 (61.4%) fully accredited programs responded with all but one reporting that they evaluated the performance of APPE volunteer preceptors. Forty-one of these 80 (51.3%) indicated that preceptors cannot be promoted in rank, while 47 (58.8%) had a process for preceptor reappointment. The most commonly assessed preceptor abilities and attributes were accessibility, ability to provide feedback to students, communication skills, and professional demeanor. The most reported assessment strategies were summative student evaluations and on-site evaluation of the preceptor by college or school personnel. The frequency of assessments varied based on the assessment method the institution used.Conclusion. Assessment of APPE volunteer preceptors was an integral component of the quality assurance process at almost all responding US pharmacy colleges and schools. The institutions evaluated various preceptor abilities and attributes and used multiple assessment strategies. Findings from this study may help programs review their existing assessment practices, implement new ones, and help to standardize preceptor assessment.

Use of biological based therapy in patients with cardiovascular diseases in a university-hospital in New York City.

BACKGROUND: The use of complementary and alternative products including Biological Based Therapy (BBT) has increased among patients with various medical illnesses and conditions. The studies assessing the prevalence of BBT use among patients with cardiovascular diseases are limited. Therefore, an evaluation of BBT in this patient population would be beneficial. This was a survey designed to determine the effects of demographics on the use of Biological Based Therapy (BBT) in patients with cardiovascular diseases. The objective of this study was to determine the effect of the education level on the use of BBT in cardiovascular patients. This survey also assessed the perceptions of users regarding the safety/efficacy of BBT, types of BBT used and potential BBT-drug interactions. METHOD: The survey instrument was designed to assess the findings. Patients were interviewed from February 2001 to December 2002. 198 inpatients with cardiovascular diseases (94 BBT users and 104 non-users) in a university hospital were included in the study. RESULTS: Users had a significantly higher level of education than non-users (college graduate: 28 [30%] versus 12 [12%], p = 0.003). Top 10 BBT products used were vitamin E [41(43.6%)], vitamin C [30(31.9%)], multivitamins [24(25.5%)], calcium [19(20.2%)], vitamin B complex [17(18.1%)], fish oil [12(12.8%)], coenzyme Q10 [11(11.7%)], glucosamine [10(10.6%)], magnesium [8(8.5%)] and vitamin D [6(6.4%)]. Sixty percent of users' physicians knew of the BBT use. Compared to non-users, users believed BBT to be safer (p < 0.001) and more effective (p < 0.001) than prescription drugs. Forty-two potential drug-BBT interactions were identified. CONCLUSION: Incidence of use of BBT in cardiovascular patients is high (47.5%), as is the risk of potential drug interaction. Health care providers need to monitor BBT use in patients with cardiovascular diseases.

Caspofungin: an echinocandin antifungal agent.

BACKGROUND: The mainstays of treatment for nosocomial fungal infections have been amphotericin B and azole derivatives. Caspofungin acetate is a new echinocandin antifungal agent with a mechanism of action that targets a structural component of the fungal cell wall. OBJECTIVE: This article describes the pharmacologic properties and potential clinical usefulness of caspofungin. METHODS: Relevant information was identified through searches of MEDLINE (1966-September 2001). Iowa Drug Information Service (1966-September 2001), and International Pharmaceutical Abstracts (1970-September 2001), as well as meeting abstracts of the Infectious Diseases Society of America and the Interscience Conference on Antimicrobial Agents and Chemotherapy (1996-2001), using the terms caspofungin, MK-0991, pneumocandin, echinocandin, candin, and beta-(1,3)-glucan inhibitor. RESULTS: In vitro, caspofungin exhibits antifungal activity against an array of clinically important yeasts and molds, including Candida and Aspergillus spp. The proposed susceptibility breakpoint for caspofungin against Candida spp, the most common cause of nosocomial fungal infections, is a minimum inhibitory concentration of < or =1 microg/mL. In humans, caspofungin has a volume of distribution of 9.67 L, is extensively bound to albumin (97%), has a plasma elimination half-life of 9 to 11 hours, and is metabolized to inactive metabolites in the liver. Dose adjustment based on age, sex, race, or renal function does not appear to be necessary, although patients with moderate hepatic insufficiency (Child-Pugh score 7-9) should receive a lower maintenance dose. The results of clinical trials, although somewhat preliminary, suggest that caspofungin is effective in the treatment of esophageal and oropharyngeal candidiasis and invasive aspergillosis. When combined with other antifungal agents, caspofungin produces a synergistic or additive effect against a variety of clinically important fungi. The most commonly reported adverse events with caspofungin have included fever, infusion-related reactions, headache, nausea, elevations in liver transaminase levels, and histamine-type reactions. The recommended dosage in adults is 70 mg IV on day 1 followed by 50 mg/d, with the duration of treatment depending on the severity of the patient's underlying condition and the clinical response. CONCLUSION: Although additional studies are needed, caspofungin appears to be a promising agent for the treatment of patients with difficult-to-treat or life-threatening fungal infections.

A novel HPLC assay for pentamidine: comparative effects of creatinine and inulin on GFR estimation and pentamidine renal excretion in the isolated perfused rat kidney.

PURPOSE: 1. To develop and validate an analytical method for pentamidine (PTM) by reversed-phase HPLC. 2. To compare the effects of creatinine and inulin on PTM excretion in the isolated perfused rat kidney. METHODS: The HPLC method utilized a base deactivated, 5 micro, C18 column and a mobile phase containing acetonitrile (24%) and 0.025 M monobasic phosphate buffer, pH 3.2 (76%). Mobile phase flow rate and UV detection wavelength were 1 mL/min and 270 nm, respectively. Sulfadiazine (SDZ) was used as the internal standard. The method was used to measure pentamidine in perfusate and urine samples generated from studies with the isolated perfused rat kidney (IPK) model. Perfusion experiments were conducted in the presence of two different GFR markers: creatinine and inulin (PTM dose 800 micro g). Both creatinine and inulin were assayed using colorimetric methods. RESULTS: The HPLC assay is rapid, sensitive and reproducible. The method was validated over two standard concentration ranges: 0.1 to 1 micro g/mL, and 1 to 10 micro g/mL. In control (drug-naïve) IPK perfusions, creatinine clearance was approximately 15% greater than inulin clearance (0.80+/- 0.21 mL/min vs. 0.69+/-0.17 mL/min, p > 0.05). In the presence of PTM, however, creatinine clearance was reduced to 0.56+/-0.27 (p < 0.05 compared to control). Inulin clearance was not altered by PTM administration (0.76+/-0.26 mL/min). Cumulative urinary excretion of PTM (% dose) was 3.0+/-0.47% and 9.6+/-4.2% in the presence of creatinine and inulin, respectively. PTM clearance was significantly reduced (0.06+/-0.01 mL/min vs. 0.13+/-0.01 mL/min, p < 0.05) and % kidney accumulation significantly enhanced (66+/-4.7% vs. 37+/-9.7%, p < 0.05) by creatinine. CONCLUSIONS: Creatinine overestimated GFR in the IPK. The altered renal excretion of PTM by creatinine is consistent with inhibition of PTM tubular secretion. Because of increased kidney accumulation, detrimental effects of PTM on renal function were observed. Based on these findings, creatinine should be used cautiously as an indicator of GFR in IPK experimentation.

Assessment of full-time faculty preceptors by colleges and schools of pharmacy in the United States and Puerto Rico.

OBJECTIVE: To identify the manner in which colleges and schools of pharmacy in the United States and Puerto Rico assess full-time faculty preceptors. METHODS: Directors of pharmacy practice (or equivalent title) were invited to complete an online, self-administered questionnaire. RESULTS: Seventy of the 75 respondents (93.3%) confirmed that their college or school assessed full-time pharmacy faculty members based on activities related to precepting students at a practice site. The most commonly reported assessment components were summative student evaluations (98.5%), type of professional service provided (92.3%), scholarly accomplishments (86.2%), and community service (72.3%). Approximately 42% of respondents indicated that a letter of evaluation provided by a site-based supervisor was included in their assessment process. Some colleges and schools also conducted onsite assessment of faculty members. CONCLUSIONS: Most colleges and schools of pharmacy assess full-time faculty-member preceptors via summative student assessments, although other strategies are used. Given the important role of preceptors in ensuring students are prepared for pharmacy practice, colleges and schools of pharmacy should review their assessment strategies for full-time faculty preceptors, keeping in mind the methodologies used by other institutions.

Faculty awards at US colleges and schools of pharmacy.

OBJECTIVES: To determine recognition given for outstanding teaching, service, and scholarship at US colleges and schools of pharmacy, the types of awards given, and the process used to select the recipients. METHODS: A self-administered questionnaire was made available online in 2006 to deans at 89 colleges and schools of pharmacy. RESULTS: Sixty-four usable responses (72%) were obtained. An award to acknowledge teaching excellence was most commonly reported (92%), followed by an award for adjunct/volunteer faculty/preceptors (79%). The majority of the institutions (31 out of 58) reported offering 1 teaching award annually. The 2 most common methods for selecting the recipient of the teaching award were by student vote and by college/school committee vote following nominations. Twenty-four of the 63 respondents indicated that their institution provided an award for research/scholarship and 18 offered an award for outstanding service. CONCLUSIONS: Teaching excellence was recognized and rewarded at most US colleges and schools of pharmacy; however, research/scholarship and service were formally recognized less frequently.

Programmatic curricular outcomes assessment at colleges and schools of pharmacy in the United States and Puerto Rico.

OBJECTIVES: To categorize the manner in which programmatic curricular outcomes assessment is accomplished, identify the types of assessment methodologies used, and identify the persons or groups responsible for assessment. METHODS: A self-administered questionnaire was mailed to 89 institutions throughout the United States and Puerto Rico. RESULTS: Sixty-eight of 89 surveys (76%) were returned. Forty-one respondents (60%) had a written and approved plan for programmatic curricular outcomes assessment, 18% assessed the entire curriculum, and 57% had partial activities in place. Various standardized and institution-specific assessment instruments were employed. Institutions differed as to whether an individual or a committee had overall responsibility for assessment. CONCLUSION: To move the assessment process forward, each college and school should identify a person or group to lead the effort. Additional validated assessment instruments might aid programmatic assessment. Future studies should identify the reasons for selecting certain assessment instruments and should attempt to identify the most useful ones.

Stability of sotalol hydrochloride in extemporaneously prepared oral suspension formulations.

The physical, chemical, and microbial stabilities of extemporaneously compounded oral liquid formulations of sotalol hydrochloride were studied. Sotalol hydrochloride oral liquid suspensions (5mg/mL) were prepared from commercially available tablets (Betapace) in a 1:1 mixture of Ora-Plus: Ora-Sweet, a 1:1 mixture of Ora-Plus:Ora-Sweet SF, and a 1:2.4 mixture of simple syrup:methylcellulose vehicle. Six batches of each formulation were prepared; three were stored at refrigerated temperature (2 deg to 8 deg C) and three at room temperature (20 deg to 25 deg C). Samples were collected from each batch weekly for 6 weeks, and again at 12 weeks. Samples were analyzed by means of a high-performance liquid chromatographic method, and the concentrations obtained were compared to the theoretical time zero value. Samples were examined for pH, odor, color, and consistency changes. The suspensions also were evaluated for their microbial stability. Sotalol hydrochloride oral liquid suspensions (5mg/mL) were chemically stable for 12 weeks regardless of storage conditions (room temperature or refrigerated). Bacterial growth was not supported by any of the formulations. Suspensions stored at refrigerated temperature retained better physical quality (e.g., odor, color, and consistency) than suspensions stored at room temperature. Overall, this study demonstrates that oral formulations of sotalol hydrochloride can be readily prepared with commercially available vehicles. The method of preparation is relatively simple, the materials are relatively inexpensive, and the products have a shelf-life of at least 12 weeks.