Topic of Choice Blog

A text at 5:00 AM wakes me up.   A friend of mine, a pharmacist at a major hospital going through a bout of anxiety and exhaustion.   We talk the next morning and she tells me of he past few days, what she is going through and what she has seen.   She tells me of the suffering of COVID-19 patients, of the health disparities and of the death toll.   I hang up and take a look at the national news, and what meets my eyes are protests in Lansing.   They shouldn’t do that, I think to myself, even if they think the state has not responded strongly enough to the crisis or if they feel the lack of support to our hospitals and healthcare professional.   But then as I read, I realize its about their inability to buy gardening supplies and traveling to their second home up north. I am not going to judge these people and they have the right to their views.   I disagree with other stipulations that the Governor or President put in place.   The angle I am t...

I think as pharmacy students and future pharmacists, this is a question that has crossed all of our minds at some point: Will pharmacist be able to prescribe? Currently, only clinical pharmacists can prescribe through the use of a collaboration agreement can prescribe prescription medications. This is something that has intrigued me and is part of why I want to become a clinical pharmacist. However, what if all pharmacist had the power to prescribe? How would this change the landscape of healthcare? How much more training would pharmacists require and how much would pharmacy school change as a result? These are all questions I have thought to myself when I think about this topic. Currently, it is without a doubt that pharmacist are the most accessible healthcare professionals in America. It was found that, on average, patients go to their community pharmacy about 35 times per year but only see their primary care physician 4 times. This is a huge difference and part of this is beca...

On February 28 of this year, the FDA approved Advil Dual Action (ibuprofen and acetaminophen) as an over the counter (OTC) medication. There is a fixed dose combination of ibuprofen, which is an NSAID and the active ingredient in Advil. The other portion is acetaminophen, which is the active ingredient in Tylenol. It will be used for the relief of pain. The company that made this medication was GlaxoSmithKline Consumer Healthcare LP. It is the first FDA-approved OTC combination of acetaminophen and ibuprofen. The submission for the drug has data from seven clinical trials with three focusing on efficacy and safety in pain relief. Data shows an indication with pain relief and the combination has higher efficacy than ibuprofen or acetaminophen alone. I found this specific drug to be very interesting because I am so used to seeing patients use either ibuprofen or acetaminophen due to their properties. I have heard cases of patients taking both, which have many beneficial effects. It is ...

With the current stay-at-home order and everyone on the internet scrolling social media for new coronavirus updates, it's very easy to come across conspiracy theories on twitter about coronavirus. At first look, these theories appear to be real because they (for once) have "scientific articles" cited. Further clicking on the articles shows that the article comes from a website, such as bioRxiv or medRxiv. Both of these websites are places for scientists to preliminary share their work with other scientists before being accepted to and published in a peer-reviewed journal. Since December, the site reports a "100-fold" surge of views and downloads.  As pharmacy students, we know the risk of trusting articles that have not been peer-reviewed. We have had classes both in pharmacy school and in undergrad warn us that these articles should be vetted and not be taken as fact until published in a journal. To the general public, many of whom are scientific journal novi...

As we all know COVID-19 has taken a toll on all of our lives by creating restrictions and social distancing. We must stay six feet away from each other and it is crazy to know that there are patients in beds crowded in hallways in hospitals. This is putting healthcare professionals at risk, including nurses, pharmacists, and physicians. Another big issue was the shortage of masks maximizing the risk of exposure to our essential health care professionals. I recall reading the other day that hundreds of workers at a health system in the metro-Detroit area testing positive for the corona virus. It makes me wonder if is there is better plan that can be implemented to minimize risk of exposure. Being that there is such an increasing demand to treat these patients, many physicians and nurses have been pulled from their areas of speciality. For example, one of my cousins is an ophthalmologist, while the other is an orthopedic surgeon. Both are working alongside the COVID-19 patients and hav...

Although this may be a touchy topic, I felt the need to bring it to life since I have had many people surrounding me experience it. Let me paint you a picture. Your grandfather is in a retirement home where currently he is sick but stable. The encapsulating COVID19 strikes and retirement homes have no longer allowed visitors due to the risk. However, you so happen to work at this same retirement home so you get to see him every day that you are there. You get to peek into his room on your breaks and play games and eat lunch together. Time passes slowly, what feels like ages. Until suddenly, gramps falls extremely sick during this time with no one but you by his side. You think to yourself, is this a blessing that I am even able to be here? Or a curse that not even his own daughter could be here to comfort him and get a last hug goodbye. This is not my story, but it is that of a close friend. I think that this virus has struck people in vicious ways, and some more than others. I thin...

As I go further along in my pharmacy curriculum, I can't help but wonder why pharmacists are not utilized more or given more power in their practices. Slowly but surely, it is clear the value and impact of pharmacists are showing. However, I still think we can do more. We are more than what the world and even our healthcare perceives of us. And I think COVID-19 could have been the platform pharmacists needed to showcase their qualities to its maximal effect. With few exceptions, prestigious colleges with renown pharmacy programs prepare prospective students with exceptional clinical knowledge. With the current issue of job market saturation, there needs to be a way to sell our rigorous academic credentials as reason to better utilize pharmacist beyond dispensing, and verifying patient medications. Currently, the clinical expectation of today's pharmacist consist of residency programs that cover a wide range of various sub-department of medicine. The second year of residenc...

Months ago, if someone had told me that I would be wrapping up the last month of P2 year taking exams and attending lectures from my bedroom at home, 40 minutes away from the COP, I would have thought that they were absolutely crazy. While the changes that I have experienced in the last month are nothing compared to others who have faced the effects from the COVID-19 pandemic directly, these past few weeks have taught me just how fast and abruptly life can change. The changes that have occurred worldwide in response to the pandemic have altered the lives of millions, but they have also taught us many lessons: one of which is shedding light on how vital the pharmacy profession is to the healthcare field. But, why is it that it took a time of crisis for this to occur? Pharmacists hold a special role in the healthcare field in the sense that they are one of which, if not the, most accessible healthcare professionals.  They are the medication experts that provide education, c...

One of the topics I have been passionate about throughout pharmacy school has been educating patients on the importance of being up to date on their vaccines. I was a kid when the “anti-vax” started and there were celebrities promoting how dangerous vaccines were for children. With the current COVID-19 pandemic it has given me time to ponder when this is all over, and things finally go back to normal, will the anti-vaccine movement finally be over? Will the general public have a different view on herd immunity and the importance of vaccines? I have often thought that the reason the anti-vaccine movement has survived and been perpetuated this long is a relative sense of security we experience here in the US. For the most part communicable diseases are a thing of the past. Smallpox was eradicated in the 1980’s, pertussis and diphtheria both can be treated with antibiotics, and the influenza virus isn’t really that bad. For most people you get the flu for a couple of days and then you...

If the racial health inequalities that exist in the United States were not clear enough before, the COVID-19 pandemic has certainly highlighted the structural racism that has been embedded in our nation from the start. Recent data has shown an alarming trend in the disproportionate number of African Americans contracting and dying from the virus. In Michigan, African Americans make up a third of all COVID-19 cases and 40% of deaths, yet they make up only 14% of the state's population. As of April 6th, 70% of the people who died from the virus in Louisiana were African American, yet African Americans make up less than ⅓ of the state’s population. In New York, the highest concentrations of infected individuals come from the poorest neighborhoods with large immigrant populations. While the federal government has not released much information regarding the racial dimensions of the illness, less than a dozen states have begun collecting and publicly sharing this staggering data.  A...

So many companies are underway on medications for the prevention and treatment of COVID-19. BenevolentAI, a technology company headquartered in London, England, aims to use data and technology for medicines. From the name, it is clear this company uses artificial intelligence to help advance health. More specifically, in February, they set up a “specialist scientific team” to use their technology in drug discovery. Although possibly unconventional, AI evaluates the best possible medication to treat a disease based on the body of knowledge regarding a disease. In three days, the specialist scientific team input all the known characteristics surrounding the COVID-19 virus. Once all the known and relevant information is added, the AI platform seems to run a scan of all currently approved medications for its potential relevance in treating COVID-19. This scan took about one and a half hours to come up with the drug most compatible. The drug result was baricitinib sold under brand name Ol...

            Community pharmacy has long been the backbone of pharmacy practice and has been what the average person thinks of when they are asked the question “What is a pharmacist?”. Over the years the practice has undergone quite a few changes but one of the many consistencies are the local, independently owned pharmacies. However, that is beginning to change. According to the NCPA digest, in 2011 there were 23,106 independent pharmacies while in 2017 21,909 which is a relatively significant decrease. This begs the question of why the amount of independent pharmacies is decreasing instead of increasing, or at least staying relatively level. I believe there are a few big reasons for this decline.              First, in general the reimbursement rates for pharmacies, even chains, have decreased over time. This mainly stems from the fact that there are three (CVS Health, OptumRx and Express ...

The COVID-19 pandemic has shaken the world as many of us know it and life in quarantine may not be the only change that we will experience moving forward. The chaos that the virus has created has touched every aspect of life and life may not be the same even after everything is back under control. Individuals, the economy and the ways that things have been done for years have been affected and only time will tell how the world rebounds from this disaster. For years, there have been many vaccine skeptics with worries of getting sick and there being lasting effects on children. At this point in time, the development of a vaccine is our greatest hope of controlling the virus to a degree that life may be able to return to normal. COVID-19 has taken a huge toll on all of humanity and I wonder if vaccine opposers feel differently now or will think differently about vaccines in the future. The pandemic may have a lasting on individual behavior, in both positive and negative ways. Preve...

As I’ve progressed through pharmacy school I have also progressed as a mother of a ferocious little golden retriever puppy. Many of you know he’s all I talk about. As a part of raising him, has come many veterinary visits, medications, and learning the “dog lingo” of treatment. Let’s start from the beginning, we had the Heartgard, Nextgard, and treatment for explosive diarrhea as just a 12 week old pup. Ironically, I had to do my research on these before we learned them in MC610. Before getting a test back for giardia, which costs at least $45 and takes 2-3 business days, they are sending me home with metronidazole, Proviable (dog probiotic), and pro-pectalin (giant horse sized pills that even a 20 lb dog has to take at least 4 of daily. I thought it was very interesting that they were so dead set on sending me home with an antibiotic for my pup before they even knew what he had. It also seemed like a common routine for them to do that, although I trust their judgement as veterinar...

Seal Finger is the hilarious name for a not-so hilarious disease in which people bitten by seals (or really anything in the pinniped family) often contract strange infections from the bite. Historically these infections have resulted in amputation, but even though the incidence of these bites is at all time lows new developments and case studies have lead to effective treatment of Seal Finger. In 2014 an Alaskan man returned from a seal hunt and displayed swollen, red fingers with stiffness and leakage. After the symptoms failed to go away in time he was seen at a hospital in Anchorage where he was treated with a number of cell wall inhibitors (Ceftriaxone, followed by Piperacillin/Tazobactam) with no success. After signs of the infection spread through-out his body (patient had symptoms of the groin and legs) DNA analysis was done on biological samples and confirmed the presence of mycoplasma bacterial DNA. The patient was then promptly treated with Doxycycline, to great effect. Chara...

In this class we have discussed the COVID-19 pandemic on a number of occasions. I recently came across the “Work for America” plan created by the CDC and FEMA, which outlines their plan to end the shelter in place order. The plan consist of three phases, the first of which is expected to last through May 1 st . Phase 1 consists of a national communication campaign to inform the public about social distancing, proper testing, general re-opening plans, and job programs. In addition to the national communication campaign, this time will also be used to determine the appropriate thresholds for restricting or loosening re-opening measures, and coordination between the federal, state, and local authorities will begin. The second phase will focus first on prompt manufacturing of testing kits and PPE. Manufacturing capacity will be repurposed to this end, and programs will be implemented to train local staff in order to strengthen the nation’s health system. This phase is also focused on...

Cancer treatment is always one of the most highly discussed medical therapies. Currently, many treatments for cancer are not only toxic to the cancerous cells, but also to the person who is receiving the treatment. There is a need for new therapy for cancer treatment, with the ideal one targeting only cancerous cells and leaving normal cells (relatively) unaffected. It has been noted for around 20 years that nitric oxide (NO) may have a role in cancer treatment, as it has been shown to cause tumor cell death at high doses. This leads to the question, what levels of NO are needed to cause tumor cell death and how do you deliver the nitric oxide? During my senior year of undergrad, I worked in a biomedical engineering lab that focused on these questions. Using a novel delivery method developed in by the lab, we were able to direct gaseous NO directly to a designated spot on a culture of MDA-MB-231, which is an isolate of breast cancer tissue. Through these experiments, we were able to ...