Exploring pharmacy residency program director preference of pharmacy student organization membership and leadership involvement on residency candidate interview selection.

INTRODUCTION: Pharmacy student professional organization involvement and leadership are important qualifications of a pharmacy residency candidate. It is unknown if membership in specific student pharmacy organizations or types of leadership roles within these organizations are preferred by residency program directors (RPDs). The purpose of the study was to determine preference and importance of specific pharmacy student professional organization membership and leadership involvement when selecting residency candidates for an interview by RPDs. METHODS: A descriptive study was conducted using an online survey. Pharmacy RPDs with involvement in reviewing applicants for interviews were included. RPDs ranked the importance and preference of specific student professional organization membership, breadth versus depth of involvement, and leadership position held on selecting candidates for an interview. RESULTS: The survey was sent to 2084 RPDs. A total of 232 respondents met inclusion criteria and completed the survey. The majority (95.5%) of RPDs reported student membership as important, while 28.6% had preference for a specific organization. A total of 56.3% of RPDs reported student leadership as "very important" and 76.1% preferred depth over breadth of involvement. A total of 55.6% of RPDs preferred applicants with a high-level leadership position. CONCLUSIONS: Pharmacy student professional organization membership is important to RPDs when selecting residency candidates for an interview. The majority of RPDs have no preference for a specific organization, while 28.6% report a preference that affects interview selection. RPDs report leadership as important and place higher importance on depth versus breadth of involvement, with greater preference for a high-level leadership position.

Development of a capstone course to improve student confidence and pharmacotherapy knowledge prior to advanced pharmacy practice experiences.

OBJECTIVE: To describe a capstone course designed to improve student confidence with clinical skills, improve confidence with providing medication therapy, and evaluate student knowledge. DESIGN: A 2-week capstone course was incorporated into the third-year pharmacotherapy course in a Doctor of Pharmacy program. Students evaluated complex patient cases and developed pharmacotherapy care plans. Pre- and post-capstone course survey results were used to assess change in student confidence using clinical skills and providing medication therapy, and quiz and exam results were used to assess student knowledge. RESULTS: Student confidence significantly improved from baseline for clinical skills (p < 0.02 across all clinical skills domains) and providing medication therapy (p < 0.01 across all disease states). Students reported the largest improvement in confidence for the clinical skill of creating a Subjective/Objective/Assessment/Plan (SOAP) note on a patient with multiple disease states (p < 0.001). Students reported the highest confidence increase for acute kidney injury (p < 0.001). The average written exam score was 87.2% (standard deviation ± 8.0) and the average verbal exam score was 79.1% (standard deviation ± 15.7). CONCLUSION: A 2-week capstone course can be valuable to improve confidence and assess student knowledge prior to advanced pharmacy practice experiences (APPEs).

Tedizolid: A New Oxazolidinone Antibiotic for Skin and Soft Tissue Infections.

OBJECTIVE: To review the chemistry, pharmacology, microbiology, pharmacodynamics, pharmacokinetics, clinical efficacy, tolerability, drug interactions, dosing, and administration of tedizolid phosphate (TDZ). DATA SOURCES: A search of PubMed using the terms "tedizolid," "torezolid," "TR-701," "TR-700," "DA-7157," and "DA-7218" was performed. The manufacturer's Web site was also reviewed to further identify relevant information. STUDY SELECTION: All English-language articles from 2006 to November 2014 appearing in these searches were reviewed for relevance to this paper. In addition, their bibliographies were reviewed to identify any articles not uncovered in the searches. DATA SYNTHESIS: TDZ is the second oxazolidinone antibiotic with a spectrum of activity targeted against gram-positive organisms including methicillin-resistant Staphylococcus aureus . It is administered via intravenous infusion or orally without regard to food. The primary route of elimination is fecal excretion. Advanced age, hepatic dysfunction, or renal impairment does not alter its disposition. Phase III clinical trials have demonstrated that TDZ 200 mg daily for 6 days is noninferior to linezolid 600 mg twice daily for 10 days in the treatment of adults with skin and soft tissue infections caused or suspected to be caused by gram-positive organisms. TDZ has a side effect profile similar to that of linezolid and a lower potential for drug interactions. CONCLUSION: TDZ has been shown to be safe and effective for the treatment of adults with skin and soft tissue infections. Further research is needed to refine its role, particularly for the treatment of patients requiring a longer duration of therapy and in those receiving concomitant serotonergic agents.

Pharmacodynamic effects of rosiglitazone in nondiabetic patients with metabolic syndrome.

STUDY OBJECTIVES: To determine the effects of the thiazolidinedione rosiglitazone on the adipocyte-derived cytokines adiponectin (an antiinflammatory and insulin-sensitizing cytokine; low levels have been associated with metabolic syndrome) and resistin (an inflammation mediator; high levels have been associated with metabolic syndrome) in nondiabetic patients with metabolic syndrome, and to characterize the effects of rosiglitazone on other components of the metabolic syndrome phenotype in this population. DESIGN: Prospective, randomized, double-blind, placebo-controlled study. SETTING: Outpatient general clinical research center. PATIENTS: Thirty-two nondiabetic men and women with a clinical diagnosis of metabolic syndrome (as defined in the American Heart Association-National Heart, Lung, and Blood Institute scientific statement). INTERVENTION: Patients were randomly assigned to receive either oral rosiglitazone 4 mg/day or matching placebo for 12 weeks. MEASUREMENTS AND MAIN RESULTS: The primary end point was change in serum adiponectin concentrations from baseline to week 12. Secondary end points were changes in serum resistin concentrations, insulin resistance, fasting glucose level, fasting insulin level, body weight, lipid levels, systolic and diastolic blood pressure, and waist circumference from baseline to week 12. Also, changes from baseline in adiponectin and resistin concentrations and insulin resistance were assessed over time at weeks 2, 4, 8, and 12. Rosiglitazone was associated with a significant increase in serum adiponectin concentration after 12 weeks compared with placebo (45.8% vs 2.6%, p=0.002). The increase in adiponectin concentration occurred quickly, with a significant difference observed after 2 weeks of therapy. Compared with placebo, rosiglitazone was not associated with significant 12-week changes in serum resistin concentrations, insulin resistance, fasting glucose level, fasting insulin level, body weight, lipid levels, systolic or diastolic blood pressure, or waist circumference. CONCLUSION: Rosiglitazone had beneficial effects on adiponectin concentrations without significantly affecting other components of the metabolic syndrome phenotype. Additional studies that further elucidate the time course of thiazolidinedione pharmacodynamic effects, along with their effects on cardiovascular end points, are warranted in nondiabetic patients with metabolic syndrome.

Relationship between plasma resistin concentrations, inflammatory chemokines, and components of the metabolic syndrome in adults.

Recent data suggest that resistin, an adipocyte-derived cytokine, has a putative role in inflammatory processes and metabolic derangements. In vitro data suggest that resistin stimulates the production of inflammatory chemokines, yet the relationship in vivo is largely unknown. The purpose of this study was to determine if a relationship exists between plasma resistin concentrations, plasma inflammatory chemokine aged concentrations (ie, monocyte chemoattractant protein 1 [MCP-1] and epithelial neutrophil activator 78 [ENA-78]), and components of the metabolic syndrome in nondiabetic subjects without known cardiovascular disease (CVD). Plasma samples were obtained from nondiabetic subjects (N = 123) aged 18 to 55 years without known CVD or CVD risk equivalents. The presence of the metabolic syndrome was assessed using consensus guidelines. Fasting plasma resistin, MCP-1, ENA-78, and high-sensitivity C-reactive protein (hs-CRP) concentrations were analyzed. The study population consisted of 67.5% women and 68.3% Caucasians (mean age = 44 +/- 7 years and mean body mass index = 33.3 +/- 6 kg/m(2)). The metabolic syndrome was present in 46.3% of study participants. Resistin concentrations were significantly correlated with white blood cell count (r = 0.326, P < .001), hs-CRP concentrations (r = 0.293, P = .005), MCP-1 concentrations (r = 0.251, P = .005), body mass index (r = 0.193, P = .033), and high-density lipoprotein cholesterol (r = -0.182, P = .044). Resistin concentrations were 1.21 times higher in subjects with the metabolic syndrome compared with those without the metabolic syndrome (P = .003). In stepwise regression analysis, white blood cell count (P < .001) and MCP-1 concentrations (P = .002) were significantly associated with resistin concentrations, independent of hs-CRP, sex, body mass index, presence of the metabolic syndrome, and high-density lipoprotein cholesterol. Data from our cross-sectional study demonstrate that plasma resistin concentrations are associated with circulating chemokine markers of inflammation, namely, MCP-1, and white blood cell count in nondiabetic adults without CVD. Future studies examining the causal relationship between plasma resistin concentrations, chemokine markers of inflammation, CVD, and diabetes are warranted.

Influence of SLCO1B1 and CYP2C8 gene polymorphisms on rosiglitazone pharmacokinetics in healthy volunteers.

Polymorphisms in drug transporter genes and/or drug-metabolising enzyme genes may contribute to inter-individual variability in rosiglitazone pharmacokinetics in humans. We sought to determine the joint effects of polymorphisms in the SLCO1B1 drug transporter gene and the cytochrome P450 ( CYP ) 2C8-metabolising enzyme gene on rosiglitazone pharmacokinetics in healthy volunteers. Healthy Caucasian subjects were prospectively enrolled on the basis of SLCO1B1 521 T > C genotype. Additionally, subjects were genotyped for SLCO1B1 -11187 G > A, -10499 A > C and 388 A > G polymorphisms, and the CYP2C8*3 polymorphism. SLCO1B1 haplotypes and diplotypes were computationally assigned. Rosiglitazone plasma concentrations were determined by high-performance liquid chromatography and analysed using non-compartmental methods. The study population consisted of 26 subjects, with a mean age of 33 +/- 9 years, and a mean weight of 66.6 +/- 11.7 kg. There were no significant differences in rosiglitazone pharmacokinetic parameters between SLCO1B1 diplotype groups. Subjects with the CYP2C8*1/*3 genotype ( n = 7), however, had significantly lower rosiglitazone area under the plasma concentration-time curve (AUC) and significantly higher rosiglitazone oral clearance, compared with CYP2C8 wild-type homozygotes ( n = 19). Stepwise linear regression analysis revealed that CYP2C8 genotype ( p = 0.006) and weight ( p = 0.022) were significant predictors of rosiglitazone AUC (overall p = 0.002; R 2 = 41.6 per cent). We concluded that polymorphisms in the CYP2C8 drug-metabolising enzyme gene, but not the SLCO1B1 drug transporter gene, significantly influence rosiglitazone disposition in humans. Future studies examining the influence of CYP2C8 genotypes and haplotypes on thiazolidinedione disposition and response in patients with type 2 diabetes are warranted.