the black apothecary

Volume 10|Issue 3 November 2016

The Black Apothecary Howard University College of Pharmacy

Vaccinating Bison Alexandra Flores | 2017

Immunization outreach is a tenant of almost every retail pharmacy’s business model. If a patient is interested in getting the annual flu shot or wanting to learn more about the vaccination to protect herself against the bacterial strains that can cause cervical cancer, then look no further than to your local pharmacy. For those

who work in a retail setting, there is no need to do any convincing about the power of immunizations. It can be seen every day at the work place when everyone from technicians to pharmacists alike are asked to promote vaccinations in order to meet a goal quota by the end of the year. Continued on Page 3

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New Drug Alert | Sustol® Ginikannwa Ezeude | 2019

In August 2016, the Food and Drug Administration approved a new drug be used in combination with other anti-emetics for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy (MEC). Sustol is a 5-HT3-receptor antagonist.

Let’s go down memory lane and think back to when we were in Pharmaceutical Therapeutics I, where we learned that serotonin receptors are a group of G-protein coupled receptors (GPCRs) and ligand-gated ion channels (LGICs) found in the central and peripheral nervous system. These receptors mediate both excitatory and inhibitory neurotransmission, with the natural ligand of these receptors being obviously serotonin. Receptor 5-HT3 specifically is an LGIC. When it is activated to open its ion channels by agonists, the result is neuronal excitation in the Peripheral Nervous System as well as stimulation of the nausea and vomiting center in the Central Nervous System! Ah-hah! This means that Sustol’s mechanism is consistent with what we know of 5-HT3 receptors. If Sustol binds to the receptors in an antagonistic way, it makes sense that this would cause inhibition of the nausea and

vomiting center in the brain stem and ultimately a reduction/cessation of nausea and vomiting!

A frequent complaint from cancer patients on certain types of cancer treatments is nausea and vomiting; this is specifically seen in acute and delayed chemotherapy. In these cases, emesis occurs within 24 hours of the cancer treatment (acute) and then between 1-5 days of the treatment (delayed). Heron Therapeutics conducted a randomized, multicenter, double blind, parallel group study in which they

compared a single 10 mg subcutaneous dose of Sustol to 0.25 mg IV dose of palonosetron HCl in cancer patients on MEC. The end result of the study demonstrated

that Sustol was non-inferior to palonosetron HCl in acute and delayed phases of MEC. The adverse effects associated with Sustol include irritation at the injection sites, constipation, fatigue, abdominal pain, dyspepsia and headache. Generally, Sustol should not be administered more frequently than once every 7 days. Additionally, it should not be used for more than 6 months of successive emetogenic chemotherapy cycles (CenterWatch, FDA drug approval).

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Volume 10|Issue 3 November 2016Although many in the pharmacy bubble

are well aware of the accessibility of vaccinations in the retail setting, and just how invaluable getting them can be; there still remains a large segment of the population who remain unaware of the many benefits.

The APhA (American Pharmacists Association) Incentive Grant was first initiated in 1993, and has served as APhA’s longest running grant program to date. There are several, categories to The Incentive Grant, one such being, Student Innovation in Immunization Practices. Through this project, students are charged with coming up with a creative way to increase vaccine awareness and promotion not to exceed $1,000. Every year The Foundation receives dozens of applications, but in 2016 Howard University College of Pharmacy had the unique distinction of being named as an award recipient along with just one other pharmacy school in the country. The effort to get Howard University recognition on a nationwide scale, started about one year ago when P2 student at the time, Mr. Justin Foster garnered interest in the Incentive Grant and recruited faculty member, Dr. Maritsa Day to come on board.

Through much planning, they decided to create a proposal focused on the undergraduate student’s knowledge of the flu vaccination in

general as well as their knowledge of pharmacist’s role in administering vaccines. After the grant was successfully accepted several students volunteered to help get the project off the ground. Together with a team of students including, Mr. Amanze Aharanwa, Mr. Derrick Anderson, Ms. Annabelle Dorion, Ms. Alexandra Flores, Mr. Justin Foster, Ms. Nikkina Hankins, alongside Dr. Day were able to work together to execute all tasks related to the project. Safeway Pharmacy gratefully agreed to provide the vaccinations as well as have one of their pharmacists on site to help administer the vaccines, and donate all auxiliary items including band aids, gauze, alcohol swabs etc. The event was a huge success with nearly 50 undergraduate students getting the flu vaccine in just under three hours. It felt great to know that the hard work that had taken months to accomplish had finally paid off. Thank you to everyone who volunteered, no matter what capacity to help this event a success. Your efforts were truly appreciated.

For more information about APhA, check out their website www.pharmacist.com. There are many ways to get involved as a student pharmacist and pharmacist.

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http://www.pharmacist.com


HUCOP All Over the World | India Annabelle Dorian | 2017

One of the main reasons I chose to attend Howard University College of Pharmacy was the its International Rotation Experiential program. In 2015, I was fortunate to be selected to go to Africa, specifically Zambia and South Africa, where I focused on HIV and pharmacovigilance. This past summer the program landed me on the continent of Asia in Mysore, India! My classmate, Beatrice Efamba, and I spent five weeks in Mysore, which is a city in the state of Karnataka in southern India. We resided at JSS College of Pharmacy in one of the guestrooms and rotated at JSS Hospital, the teaching affiliated with the College of Pharmacy, College of Medicine and other health science majors. We also spent some time at the Asha Kirana ARV Center and Bharat Cancer Hospital. JSS recently added the Doctor of Pharmacy degree to the college. It still offers Bachelor’s and Master’s degree in Pharmacy, with an opportunity to matriculate into the Pharm.D. program. The Pharm.D. degree is relatively new, and it was apparent during rounds when pharmacists and pharmacy students spend most of the time observing. Although the degree is new, the faculty is making great strides to improve the program, such as visits from US pharmacists and sending their own students on international rotations. This rotation is considered a clinical rotation with special focus in infectious diseases (brush up on your Integrative Therapeutics 2A and 2B!). Beatrice and I each spent a week rounding in the general medicine ward and pediatric ward at JSS Hospital, which is an 1,800-bed hospital. In the afternoons, we spent about an hour visiting and learning about the other wards such as TB clinic, surgery, orthopedics, and emergency department. We also visited the outpatient pharmacy, the satellite pharmacies located on each floor, the inventory store room, and the drug information center.

Afternoons were also spent participating in journal club and listening to presentations. As one of our assignments, we each presented on diseases that are common in India but foreign to the U.S. – severe dengue fever and leptospirosis.

One the challenges with the health care system is the access to resources. Medical records are still handwritten with limited online access. Because in the U.S. almost everything is electronic, I forgot how time-consuming writing medical notes can be, not to mention the high risk of errors. Due to the costs, laboratory tests are also not routinely done. The language barrier was also a challenge. Every state in India has its own dialect, and the majority of students are not native to Karnataka. So, not only was there a

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India Fast Facts Population: 1,103,596,000

Capital: New Delhi Area: 1,269,221 square miles

Language: Hindi, English, 14 other official languages

Religion: Hindu, Muslim, Christian, Sikh, Buddhist,

Jain, Parsi

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Volume 10|Issue 3 November 2016language barrier for us, as English-speaking students, there was also a language barrier between the students and the patients because they do not know the state language. In spite of the language barrier, I managed to review cases pre and post rounds to gain a better understanding of the disease states and treatment options for the patients.

Even though the rotation required us to work Monday through Saturday, Beatrice and I managed to have some fun immersing ourselves in India’s beautiful culture. We visited the famous Mysore Palace. We spent an entire day with our new friends visiting Kesava Temple, Chamundi Hills, and Botanical Gardens. We tried all the foods and snacks, vegetarian and non-veg. And of course, we couldn’t leave the City of Silk without purchasing some silk for ourselves and our family and friends! We enjoyed exchanging ideas and experiences with the students, who we are so grateful to call them friends. We also appreciated all the support and

guidance we received from our preceptors and

the faculty and staff at JSS. One of the major goals of the Experiential International Program is cultural competency. I owe much of the newfound perspectives to the classmates who have accompanied me on my international experiences, the people who I met on these journeys, and the faculty and staff who

gave me the opportunity to represent Howard University globally. I will leave Howard extremely grateful for these experiences.

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Public Health is Pharmacy’s Secret Derrick Anderson | 2018

For many years, pharmacy in the U.S. Public Health Service has been known as “Pharmacy’s Best Kept Secret”. Well the cat is out of the bag and we are going to give you the run down on this amazing opportunity. The U.S. Public Health Service (PHS) is the major health arm of the Federal Government and the world’s foremost health service. Composed of over 6,600 Commissioned Corps officers and 45,000 Civil Service employees, they are a principal component of the Department of Health and Human Services. A unique arm of the uniform services, their mission includes but are not limited to; promoting public heath nationwide, expanding knowledge on research leading to prevention and treatment of disease, and respond to natural disasters and biological and chemical terrorism. PHS officers are throughout the nation in areas both urban and rural, working with agencies like the Indian Health Service, FDA, Bureau of Prisons, and many more.

HUCOP’s presence within PHS is on the rise and current officers like Captain Postelle Birch-Smith, would like to see more of us join them in the corps. To lend a helping hand, she came back to speak with a group of students about the benefits of joining the PHS and how we can get a head start on applying to become a member of the PHS. During the meeting, Derrick Anderson, a P3 and JRCOSTEP intern, gave a reflection on his personal experience on his internship at the Centers for Medicare and Medicaid (CMS) this past summer and gave valuable information on CMS and PHS as a

whole. The duo then went on to discuss the benefits including, lowered student loan and credit card interest rates, tax-free housing allowances, 30 days leave annually, access to free healthcare, low-cost military flights and retail discounts nationwide. Captain Birch-Smith also spoke for the network of HUCOP alum who was banding together to work to provide a support network for us in the near future as well.

Each year the application for JRCOSTEP and SRCOSTEP is release each year in the fall. To stay up to date on the great things of PHS, follow their social media pages on Facebook, Twitter and Instagram!

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New Drug Alert | Zepatier® Shazma Aftab | 2018

Approved in January 2016, Zepatier is a fixed-dose once daily, oral combination therapy indicated for the treatment of chronic hepatitis-C virus (HCV) genotypes 1 or 4. Zepatier is composed of elbasvir, an HCV NS5A inhibitor, and grazoprevir, an HCV NS3/4A protease inhibitor and is specifically indicated with or without ribavirin for the treatment of chronic HCV genotypes 1 or 4 infection in adults with or without cirrhosis. The FDA approval of Zepatier was based on six studies that assessed the rate of sustained virologic response 12 weeks after the completion of treatment with Zepatier in patients with chronic HCV GT1 or GT4 infections.1 The clinical development program enrolled 1,373 patients selected from diverse groups of individuals which included patients that failed prior therapy with PegIFN and RBVs as well as patients with impactful comorbidities and health complications such as renal impairment, compensated cirrhosis, or HIV-1 co-infection. A sustained virologic response is defined as HCV RNA levels measuring less than the lower limit of quantification at 12 weeks after the cessation of treatment (indicating that patient’s HCV infection has been cured); across the studies, subjects achieved high rates of sustained virologic response that ranged from 94-97% amongst patients with GT-1 infections and 97-100% amongst patients with GT-4 infections.4 Although its still early days into Merck’s release of Zepatier, the drug seems to be the

frontrunner in terms of safety when compared to Gilead Science’s HCV combo treatments Harvoni and Sovaldi.5 Clinical trial data compared by Advera Health Analytics suggests that although Harvoni was most effective in patients who hadn’t previously been treated, Zepatier and Harvoni were almost equally effective in treating individuals who had already undergone treatment.2 A significant difference between the drugs is the side effect profile amongst patients; whereas Harvoni and Solvadi labels include dangerous side effects such as cardiac arrect and suicidal idealation, Zepatier demonstrates itself to

be less risky yet on par in terms of efficacy with Harvoni.5 Merck has set the price for a 12-week regimen of Zepatier at $54,600, whereas Harvoni runs at about $94,600 (both prices without accounting for discounts or

rebates offered to payers). Merck’s price setting move has definitely captured the attention the leading PBM Express Scripts, which set off a pricing war last year along upon selecting AbbVie’s Viekira Pak as its preferred HCV treatment ($83,319).5 With the approval of Zepatier, there is a projected shift in the contentious sphere of hepatitis C drugs on the drug of choice for treatment of HCV patients.

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Midyear Do’s and Dont’s Samantha Green | 2018

It is that time of year again where fourth year pharmacy students are stressing over midyear and second year and third year students are trying to figure out if they should even attend. Let me help answer a few questions and talk about some key points to remember if you plan to go. Attending midyear is no small financial task. When you take into account the cost of flights, hotel stays, dining, transportation, and the fee for the conference, it can dry your pockets out very quickly. So for the P2’s and P3’s considering going to midyear, if you have the monetary

means to go, then it definitely will not hurt to attend. It gives you an opportunity to survey the atmosphere you will be stepping into during your fourth year if you are considering applying for a residency program. However, if you do not attend during your second or third year, that is perfectly fine as well. There are many people who never go to midyear prior to their fourth year and they turn out just fine.

For the fourth year students who are going, below you will find a list of Do’s and Dont’s to remember during this hectic time

Most importantly, bring a positive attitude! 8

Do Bring multiple copies of your CV

Use resume paper Place in presentation folders

Business Cards Multiple pens

Make notes to remember introductions

Scrap paper Shoulder bag

Free up your arms and hands Make a path for yourself

Map out what booths you need to make sure you go to Check the schedule

Reach out to residents prior to the meeting Show that you are serious about their program

Bring “Thank You” cards Hand written is better than email

Don’t Ask questions that can be found on the programs’ website Stay in line for one booth too long

You may miss out on other programs Procrastinate asking people to write strong letters of recommendations for you Chew gum

Bring breath mints to avoid dry mouth from nervousness

Wear wrinkled clothing See if your hotel has an iron and if not, bring your own

Miss the poster presentations A perfect opportunity to meet residents in a more intimate setting Shows you care about the research being done

Bash any other institution Comparing programs to others may not be a good thing

Pharmacy is a small world


Are You Ready for the Winter? Nikkina Hankins | 2018

The most exciting thing about November is that Winter Break is not far away. We have been working hard in the classroom as well as in the Washington, DC Metropolitan community. Each year with the entry of new students creates friendships that will last beyond the four years of pharmacy school and walls of Chauncey Cooper Hall. Many of us are surprised by how much information our brains could consume, digest and retain in the 16 weeks that create a semester. As we being to make the final touches on notes and assignments, it is also imperative to begin the transition into DC Winter. For some of us it is our first winter with snow and below 0º degree weather. I remember my first real snowfall was in January 2015. We had all just returned from our winter breaks. Some of my classmates were excited for their first snow. Some of my classmates were not concerned about the possible blizzard. I was stuck in between. When the first few flakes fell, I began to realize how I was not prepared for a true blizzard emergency. After my first few snow experiences as well as Dr. McCants’ Emergency Preparedness Course, I know the importance of being prepared for what weather may bring not day or weeks, but at least a month ahead of time. A winter emergency preparedness list should be drafted and constructed in the fall. This is the best time to purchase your items when they are in a surplus. Each person may have different items on her list, but there are some core items that should never be forgotten. Winter Preparedness goes beyond the item one may keep in the car or home. As a

pharmacy student, your winter preparedness includes preparing for the Spring Semester. For may of us the spring brings many transitions into the classroom, study room and workplace. First year students will begin Pharmaceutical Therapeutics (PT) and Chemistry (PC). These two classes are the core of your understanding of medication. If you would like to get a step ahead, review your drug cards. You can learn the mechanism of action and common side effects of the top 300 prescribed drugs, as well as the chemical structures. For second year students, the big bang is

hitting your universe. Welcome to Integrated Therapeutics (IT)! You thought you knew a few things about medicine, but IT will be your wide awakening. Tegrity is a vital friend during the semester, but for now to help your mindset for the spring semester you should review your lectures from PC and PT. Also do not forget to review your Biostatistics

notes. Understanding the different tests as well as how to read statistical results will help when you read articles and research about various therapeutic plans. Organization is key to success as well. Make sure your old notes for previous semesters are in order so that you can review old topics quickly. As third years, you are in your final stretch in the classroom. You are thinking about your APPEs and the IT 3 series. This is the time to reevaluate your career plan. Do your research on possible career possibilities as well as fellowships and residencies. This will help make any final decisions on your APPE rotations. Also review your notes to help with the PCOA. This

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Volume 10|Issue 3 November 2016test is vital to your progression. Use this time to brush up on your study habits and time management. Even though you are taking less classes, never take advantage of the free time. Keep up the motivation and stamina to finish IT with strong grades and retention. Last but importantly not least, to the fourth years, stay motivated, strong and encouraged, but most importantly stay saved up in the bank that is. As you are approaching the end of your journey at the College of Pharmacy, you are quickly approaching your professional career. If you have not completed your research already, make sure to record the cost of your board and law exams as well as your state license. It will help to relieve any last minute stress or worries in the summer and fall. Also

stay steadfast in your NAPLEX studies. A few questions day will help you more than you think. Don’t forget to look over your CV and add updates from your rotations. The details on a CV can change you from a good applicant to a great applicant. An extra set of eyes to review your CV is also a plus. Take advantage of the free time; enjoy your break and make sure to rest. A healthy and rested brain is a great machine once it is put into work. It may seem a lot to be be prepared at the moment but future you will greatly appreciate the extra studying and time management. New beginnings do not start on January 1 or the beginning of the semester. The new beginnings start now!

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Home and Car List Blankets Candles

Matches or Lighter First Aid Kit Bottled Water

Crackers Canned Food

Batteries Flashlight

Extra Phone Charger Hat, Gloves and Scarf

Shovel Windshield Scraper

Study List Top 300 Prescribed Drug Cards

Flash Cards Highlighters Colored Pens PT/PC Notes

IT Notes External Hard Drive

Goodman and Gilman’s The Pharmacological Approach to Therapeutics

Foye’s Principles of Medicinal Chemistry Pharmacotherapy: A Pathophysiocological

Approach Handbook of Nonprescription Drugs

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The Black Apothecary Staff

Editor in Chief Nikkina Hankins

Columnists Derrick Anderson

Shazma Aftab Annabelle Dorian

Ginikannwa Ezeude Alexandra Flores Samantha Green

Faculty Advisor Dr. Monika Daftary

1 "Sustol." Sustol for Healthcare Professionals. Heron Therapeutics, n.d. Web. 20 Nov. 2016. 2 Society, National Geographic. "India Facts, India Flag -- National Geographic." National Geographic. National Geographic Society, n.d. Web. 20 Nov. 2016. 3 "Commissioned Corps of TheU.S. Public Health Service." U.S. Public Health Service Home. Unites States Public Health Service, 3 Nov. 2015. Web. 20 Nov. 2016. 4"Zepatier (elbasvir and Grazoprevir)." Zepatier New FDA Drug Approval. CenterWatch, n.d. Web. 10 Oct. 2016. 5 Wasserman, Emily. "UPDATED: Zepatier Beats Harvoni, Sovaldi in Hep C Clinical-data Safety Showdown: Advera Health Analytics." Pharma News. Questex, 24 Feb. 2016. Web. 10 Oct. 2016 6 Ross, Matt. "Winter Outlook 2013-14 for Washington, D.C.: Volatile, Leaning Warm, with below Normal Snow." Washington Post. The Washington Post, 13 Nov. 2013. Web. 20 Nov. 2016. 7 "How to Make a Winter Survival Kit." How to Make a Winter Survival Kit. Wisconsin Emergency Management, n.d. Web. 20 Nov. 2016. 8 Bosman, Katie. "Lesson 1: Studying." Blog post. Confessions of a Student Pharmacists. N.p., 27 Jan. 2013. Web. 20 Nov. 2016.

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Need a break from studying? Want to win a gif t card (e.g. Starbucks, Chipotle)? This year, The Black Apothecary will raffle off gift cards with each issue!

How to enter the raffle: 1. Complete the Sudoku puzzle in the current issue of The Black Apothecary . 2. Fill out the entry form below and submit your completed puzzle pages to the Editor-in-Chief or Faculty Advisor by the deadline. One entry per person. 3. After verification of answers by the Staff, you will be entered to win a gift card!

Good Luck! Deadline for Fall Raffle: 12/16/2016

Raffle Entry Name: ___________________________

E-mail: ___________________________

Phone: ___________________________

Date Submitted: __________________

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