Clinical Pharmacy Bulletin (A Newsletter from Department of Pharmacy Practice, SRM College of Pharmacy) ADVISORY BOARD Prof. Lt. Col. A. Ravikumar Pro-Vice Chancellor Medical & Health Sciences, SRMIST Dr.V.Chitra Dean SRM College of Pharmacy, SRMIST Dr.A.Sundaram Dean SRM MCH & RC, SRMIST Dr.N.Damodharan Vice-Principal SRM College of Pharmacy, SRMIST EDITORIAL BOARD Dr.Mohammed Sayeed Zaman K Editor in-chief ASSOCIATE EDITORS Dr.S.Sarumathy Associate Professor Dr.M.Jagadeesan Assistant Professor Dr.A.Sriram Assistant Professor Dean’s Desk Edition 5,Vol. 2, December 2022 Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy Greetings from the Dean, SRM College of Pharmacy It is a deep honor and privilege to publish our fifth edition Newsletter (Volume 2) from Department of Pharmacy practice - CliniPharm. I am sure that faculty, staff, students, alumni and the reputation and legacy of this department will reach greater heights. Without question, I believe the department is moving towards excellence in Pharmacy practice. We plan to focus on key strategic areas like academic programs, research, and innovation, faculty cum staff investments, alumni engagement, student success, their experience, and innovations in Pharmacy practice. Advancing in these areas will allow us to fully realize our vision of being bold leaders, moving together to the highest level of excellence in learning, discovery, and providing patient care. I am excited about our future together. We have also incorporated laurels brought by our staff as well as students in various academic and co-curricular activities. We hope you enjoy reading this issue as much as we have dedicated in preparing this newsletter. Prof.K.S.Lakshmi Director, Admissions, SRMIST Dr.V.Chitra Dean SRM College of Pharmacy, SRMIST Dr.N Sai Supra Siddhu Assistant Professor Dr.TM.Vijayakumar Associate Professor & Head

Clinical Pharmacy Bulletin, Edition 5, Volume 2 (December 2022) World Pharmacist Day Celebration - 2022 Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy The event with the theme - Pharmacist united in action for a healthier world - was celebrated to create awareness about the role of pharmacists in the society. Chief Guest of the event Tmt. P.V.Vijayalakshmi, Director, Drugs Control Department, Tamil Nadu Government, in her address said “Dispensing medicines is not just an art but a service to the community. Pharmacists play a vital role in guiding the patients,” to mark the World Pharmacist Day. Lt. Col. (Dr) A. Ravi Kumar, Pro Vice-Chancellor (Medical & Health Sciences), SRM Hospital, Kattankulathur, Dr. A. Sundaram, Dean (Medical), SRM Hospital, Kattankulathur, Dr. K. S. Lakshmi, Director, Admissions, SRMIST, Dr. V. Chitra, Dean, SRM College of Pharmacy and Dr. N. Damodharan, Vice Principal, SRM College of Pharmacy were among the dignitaries present in the celebration.

Know About Newly Approved Drug - Terlipressin INTRODUCTION Hepatorenal syndrome (HRS) involving rapid reduction in kidney function is an acute and life-threatening condition that occurs in people with advanced liver disease. The U.S. Food and Drug Administration (FDA) granted the approval of Terlivaz (Terlipressin) to Mallinckrodt in September 2022 for the treatment of hepatorenal syndrome. Brand name: Terlivaz Generic name: Terlipressin Molecular formula: C52H74N16O15S2 Molecular weight: 1227.4 g/mol INDICATIONS AND USAGE Terlivaz is a vasopressin receptor agonist indicated to improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function DOSAGE AND ADMINISTRATION · Days 1 to 3 administer Terlivaz 0.85 mg (1 vial) intravenously every 6 hours. · Day 4: Assess serum creatinine (SCr) versus baseline. ü If SCr has decreased by at least 30% from baseline, continue Terlivaz 0.85 mg (1 vial) intravenously every 6 hours. ü If SCr has decreased by less than 30% from baseline, dose may be increased to Terlivaz 1.7 mg (2 vials) intravenously every 6 hours. ü If SCr is at or above baseline value, discontinue Terlivaz. · Continue Terlivaz until 24 hours after two consecutive SCr =1.5 mg/dL values at least 2 hours apart or a maximum of 14 days. MARKETED FORMULATION Injection: TERLIVAZ 0.85 mg (1 vial) as a lyophilized powder in a single-dose vial for reconstitution. CONTRAINDICATIONS · In patients experiencing hypoxia or worsening respiratory symptoms. · In patients with ongoing coronary, peripheral, or mesenteric ischemia. WARNINGS AND PRECAUTIONS · Serious or Fatal Respiratory Failure Monitor patients for changes in respiratory status using pulse oximetry and regular clinical assessments. Actively manage intravascular volume overload and adjust TERLIVAZ therapy as appropriate. · Ineligibility for Liver Transplant TERLIVAZ-related adverse reactions may make a patient ineligible for liver transplantation. · Ischemic Events TERLIVAZ is a vasoconstrictor and can cause ischemic events (cardiac, peripheral, or mesenteric) that may require dose interruption or discontinuation. · Embryo-Fetal Toxicity TERLIVAZ may cause fetal harm when used during pregnancy. Advise females of reproductive potential of the potential hazard to the fetus. ADVERSE REACTIONS The most common adverse reactions (=10%) include Abdominal pain, Nausea, Respiratory failure, Diarrhea, and Dyspnea. USE IN SPECIFIC POPULATION Lactation: There are no data on the presence of terlipressin in human milk, the effects on the breastfed infant, or the effect on milk production. Pregnancy: TERLIVAZ may cause fetal harm when administered to a pregnant woman. Administration of a single intravenous dose of terlipressin to pregnant women during the first trimester induced uterine contractions and endometrial ischemia. Pediatric use: Safety and effectiveness of TERLIVAZ have not been established in pediatric patients. Geriatric Use: Reported clinical experience has not identified differences in responses between the elderly and younger patients. Hepatic Impairment: No dose adjustment is required in patients with hepatic impairment REFERENCE https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/ 022231s000lbl.pdf https://www.fda.gov/drugs/new-drugs-fda-cders-newmolecular-entities-and-new-therapeutic-biologicalproducts/novel-drug-approvals-2022 Clinical Pharmacy Bulletin, Edition 5, Volume 2 (December 2022) Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy

The 2 Million Dollar Injection Clinical Pharmacy Bulletin, Edition 5, Volume 2 (December 2022) Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy Onasemnogene abeparvovec is a gene therapy medication used to treat Spinal Muscular Atrophy (SMA), a serious condition of the nerves that causes muscle wasting and weakness. It is indicated for the treatment of pediatric patients less than 2 years of age. It works by replacing the function of the missing or non-working SMN1 gene with a new, copy of an SMN gene. Onasemnogene abeparvovec is the first and only gene therapy approved by the United States Food & Drug Administration (FDA) for the treatment of SMA, including those who are pre-symptomatic at diagnosis. With a whopping cost of 2.1 million USD (approx. 16.7 crore INR) for a one-dose treatment, onasemnogene abeparvovec is currently the most expensive therapeutic agent in the world. It is important to note that Zolgensma (Onasemnogene abeparvovec) manufactured by Novartis Gene Therapies, Inc. isn't marketed in India, and has to be imported from the United States if prescribed by a medical practitioner. The question arises, is this medication worth its price? The simple answer is, yes. In the initial clinical trial that was conducted with onasemnogene abeparvovec, all children were alive at the conclusion of the study and many were able to sit, roll, crawl, play and some could even walk! A main study showed that it reduces the need for artificial ventilation in babies with spinal muscular atrophy. In a study conducted, 20 out of the 22 babies given onasemnogene abeparvovec were alive and breathing without a permanent ventilator after 14 months, when normally only a quarter of untreated patients would survive without needing a ventilator. The study also showed that onasemnogene abeparvovec can help babies sit unaided for at least 30 seconds, a milestone that is never achieved in untreated babies with severe forms of SMA. This level of effectiveness, delivered as a single, one-time therapy, is revolutionary and provides exceptional hope for amilies battling SMA. References https://www.fda.gov/vaccines-blood-biologics/zolgensma https://www.zolgensma.com https://www.zolgensma.com/clinical-studies

Mr. U. Poli Reddy of M.Pharm Pharmacy Practice II Year, won third prize for the Best M.Pharm Project in G.Rangachari Memorial (PG Pharmacy Fellowship) Award for the year 2022-2023 conducted as a st part of the 61 National Pharmacy Week celebrations. The event was conducted by the Tamil Nadu Pharmaceutical Sciences Welfare Trust, Chennai. The student received a certificate of appreciation and a cash award of Rs.8000. Mr. S. Manikandan of M.Pharm Pharmacy Practice II Year, won second prize for the Best M.Pharm Project in G.Rangachari Memorial (PG Pharmacy Fellowship) Award for the year 2022-2023 st conducted as a part of the 61 National Pharmacy Week celebrations. The event was conducted by the Tamil Nadu Pharmaceutical Sciences Welfare Trust, Chennai. The student received a certificate of appreciation and a cash award of Rs.10,000. Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy Clinical Pharmacy Bulletin, Edition 5, Volume 2 (December 2022) Awards and Honours

Awards and Honours Clinical Pharmacy Bulletin, Edition 5, Volume 2 (December 2022) Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy Mr. Mohammed Ismail of M.Pharm Pharmacy Practice First Year, has participated in the Red Ribbon Club (RRC) State level online quiz competition conducted on November 21, 2022 and awarded as winner at the District level. The student received a certificate of appreciation and a cash award of Rs.5000. Ms. A. Adhisaya of Pharm.D Fifth Year, has won second Prize in the Best st E Poster Presentation in the scientific session conducted on 21 November, 2022 as a part of National Pharmacy Week celebrations. The event was conducted by B.S. Abdur Rahman Crescent Institute of Science and Technology. The student received a medal and a certificate of appreciation. Fun Health Facts Drink something hot to cool down If you are tired, exercise will help Bananas can help improve your mood Optimism may help you live longer Chewing gum makes you more alert

Did You Know? Clinical Pharmacy Bulletin, Edition 5, Volume 2 (December 2022) Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy Dietary Research Researchers at Baylor College of Medicine discovered the 3-D structure and mode of action of diacylglycerol O-acyltransferase-1 (DGAT1), the enzyme that synthesizes triglycerides and also is required for human dietary fat absorption and storage. DGAT1 is a known target to treat obesity and other metabolic diseases, so having a detailed understanding of what DGAT1 looks like and how it works opens opportunities for designing novel strategies for managing these conditions. The findings are published in the journal Nature. "DGAT1 is a particularly interesting enzyme because it synthesizes triglycerides, which are the main component of hard fat, the type of fat usually found in the belly or midsection in our body. Triglycerides also are part of the particles that transport cholesterol-high-density lipoproteins (HDL, or 'good cholesterol'), and low-density and very-low-density lipoproteins (LDL and VLDL, or 'bad cholesterols'),” DGAT1 is located in the membrane of the endoplasmic reticulum, a cellular structure engaged in the synthesis of proteins and lipids. This study not only reveals the structure and mode of action of a human enzyme that is essential for proper human metabolism, but it also enables researchers to explore the effects of molecules that interact with DGAT1 and potentially regulate its activity How the body makes triglycerides ? Source: https://www.sciencedaily.com/releases/2020/05/200513111423.htm One quarter of your bones are in your feet. The small intestine is roughly 23 feet long. When listening to music, your heartbeat will sync with the rhythm Your brain can survive for five to 10 minutes without oxygen Between birth and death, the human body goes from having 300 bones, to just 206 Hearts can beat outside of their bodies The cornea is the only part of the body with no blood supply – it gets its oxygen directly from the air

Clinical Internship Experience by Pharm.D Student Clinical Pharmacy Bulletin, Edition 5 Volume 2 (December 2022) Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy I have completed my one year internship at SRM Medical College Hospital & Research Centre. It was a great leaning experience during which we got the exposure of working pattern of clinical pharmacist. Being an intern, it was good to attend and participate in the ward round to update knowledge in clinical and therapeutic area. While attending ward rounds at different departments, I came across many new clinical cases and identified many important therapeutically significant interventions. As a part of clinical pharmacy services, I provided patient counselling to improve medication adherence and to reduce Drug Related Problems. Various drug queries from consultant and residents physicians were answered with adequate evidences like details of newer cephalosporin's, immunization schedule, updated information regarding SSSRI and Benzodiazepines, Poison informations etc. In OPD of psychiatry department, it was quite challenging to counsel the psychiatry patients and their relatives. By putting enough efforts, I learnt to deal with these type of patients and approach of counselling for these patients. The most satisfactory thing I felt was the spending of quality time with needy patients to listen them carefully, providing them all necessary information, resolving their doubts thoroughly and most importantly to give them sympathy. Dr. G. Asvitha Medical writer HCL Technologies Pharm.D Intern (2021 - 2022)

Social talk by Research Associate Clinical Pharmacy Bulletin, Edition 5 Volume 2 (December 2022) Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy Having an active social life is one of the strongest predictors of longevity and good health. Human connection is one of the most fundamental and important human drives. But it can also be our most tiring! Quick question: raise your hand if you ever get tired after talking to too many people. Did you raise your hand? Congrats: you're human! I think we tend to overplay our differences, and underestimate just how similar we all really are deep down in our basic needs, strivings, and frustrations. Emerging research shows that even though we each show distinct patterns of thoughts, motivations, and behaviors that make us different from each other, we actually display the whole spectrum of behaviors in our everyday life. Everybody sometimes gets tired from too many social interactions, sometimes acts like a jerk, sometimes is lazy, etc. Just some of us are consistently more so on a regular basis than others. .In a 2016 study, two Finnish researchers looked at one of the most prominent descriptions about introverts: that they need to be alone and recharge after too many social interactions. While this is undoubtedly true, does this really differentiate introverts from extraverts? Incredibly this idea has never actually been tested scientifically until now. Over the course of 12 days, 48 participants filled out measures of their personality, mood, stress, and levels of fatigue. Five times a day, they were asked to describe their behavior, feelings, and situations during the last hour. They also were asked to describe the extent to which they interacted in person with others in the past hour. In addition to looking at the effects of behaving extraverted, they also looked at the effects of behaving conscientiously. They found that the more people were acting extraverted and conscientious, the more they reported being in a positive mood and feeling lower levels of fatigue in the moment, but after 3 hours they reported higher levels of fatigue. The level of fatigue depended on the number of people met during the last hour, the intensity of the social interactions, and how much they had a specific goal in mind when they were studying or working. Interestingly, these effects were found for both introverts and extraverts. While the findings on conscientiousness are not surprising (hard work is hard work!), this was the first direct evidence suggesting that too much socializing is draining for everyone. Indeed, prior research showed that in general, when under stress, tired, or living in crowded circumstances, people often choose to be alone if they can. This research also adds to a growing literature suggesting that in the moment, acting extraverted has the same consequences on mood for both introverts and extraverts. Taken together, all of this research suggests that for most humans on this planet, having a reasonable amount of social interaction and working hard toward goals makes people feel good, but too much of either tends to make people tired after a few hours. Dr. B. Mothishwaran Clinical Research Associate Directorate of Research, SRMIST

Publication- Recent Highlights Clinical Pharmacy Bulletin, Edition 5, Volume 2 (December 2022) Drug Information Centre, Department of Pharmacy Practice, SRM College of Pharmacy Ms. L. Preethi, Ms. Alina M.S, Ms. Lakshmi Chandran and Mr. Asvin S of Pharm D VI Year have published their dissertation work titled “Duration of Seroprotection of the live attenuated SA-14-14-2 Japanese encephalitis vaccine in children in India” in Journal of Travel Medicine The dissertation was done in collaboration with two institutes of Indian Council of Medical Research (ICMR), namely Regional Medical Research Centre, Gorakhpur and National Institute of Virology, Pune. Impact factor: 39.19 The research work was done under the guidance of Dr.T.M.Vijayakumar, Associate Professor & HOD, Department of Pharmacy Practice and Dr.M.Jagadeesan, Assistant Professor, Department of Pharmacy Practice.