Faculty members from the 91̽��School of Pharmacy and the 91̽��School of Medicine have secured a $4.7 million National Institutes of Health grant to study drug disposition during pregnancy. Disposition refers to how the drugs are absorbed, distributed, metabolized, and excreted.

The principal investigator on this multi-part, five-year grant from the NIH National Institute on Drug Abuse is Jashvant Unadkat, professor of pharmaceutics.

Unadkat’s grant includes researchers from the 91̽��Departments of Pharmaceutics, Pharmacy, and Obstetrics and Gynecology. It will involve three subprojects, each examining different drug types and their disposition in pregnant women and their fetuses: the drug abuse treatment methadone, amphetamines and other illicit drugs, and the antidepressant bupropion.

Researchers will work with the British company Simcyp to synthesize the data from all three projects. Simcyp uses a population-based simulator to conduct physiological pharmacokinetic modeling — a mathematical modeling technique for predicting the disposition of synthetic or natural chemical substances in virtual human populations. The analysis may help predict how pregnant women and their fetuses handle illicit drugs, medications for drug abuse, and antidepressants.

Longterm, researchers would like to improve treatment of pregnant women who need to take medications. They hope to guide prescribers on how to adjust dosages. The researchers also want to provide new tools to predict fetal exposure to drugs during pregnancy and to evaluate risks to the baby.

The Unadkat lab has been studying drug disposition during pregnancy for more than 25 years. Earlier, Unadkat’s goals were to develop therapeutic strategies to prevent transmission of HIV from mother to child before birth. One of his key findings was that HIV drug disposition can be substantially altered in pregnant women, so much so that the usual doses administered to men and non-pregnant women do not have the same therapeutic effect in pregnant women.

“These research findings led us to ask a broader question about how to adjust dosing regimens of drugs taken during pregnancy to maintain efficacy and reduce toxicity,” said Unadkat. “It’s inevitable that pregnant women need to take medicinal drugs, because many women have clinical conditions that need to be treated. Not attending to conditions like hypertension or HIV infection could be harmful for the mother and her fetus.”

Unadkat later broadened his research to study illicit as well as licit drugs. His group recognized that the use of illicit drugs in pregnancy is an important social issue. Research on the effects of these drugs during pregnancy could help in assessing risk to the fetus.

Faculty members throughout the 91̽��School of Pharmacy study the safe and effective use of medications taken during pregnancy. For this new NIH grant, Unadkat will collaborate with several such colleagues. Project leaders from the 91̽��School of Pharmacy are Nina Isoherranen, Qingcheng Mao, Jashvant Unadkat and Joanne Wang; and co-investigators are Gail Anderson, Rodney Ho and Ed Kelly. Co-investigators from the School of Medicine are Justine Chang, Michael Grayett and Alyssa Stephenson-Famy.

“I’m delighted to have the opportunity to collaborate with such a wide range of scientists on this NIH grant,” said Unadkat. “It is my hope that the research we are conducting could one day improve the health and well-being of pregnant women and their babies.”

Tuberculosis is an infectious disease that usually attacks the lungs. When left untreated, it can be fatal. It can spread when people with an active TB infection sneeze or cough or spit, sending respiratory fluids through the air. Although the drug-resistant strain of the disease recently has become a concern, the disease is generally treatable with an antibiotic regimen.

In 2011, the first local case of drug-resistant tuberculosis was identified in King County, according to Public Health – Seattle & King County. That same year, 106 cases of TB were reported in the county (at a rate of 5.5 per 100,000 people). While that rate was the lowest it had been during the past 30 years, local public health officials reports that TB remains an ongoing threat in King County.

In late 2012, the Washington State Department of Health TB Services Program and the Washington State Pharmacy Association teamed up to offer training for pharmacy practitioners to become certified in TB screening. The goal is to increase the number of pharmacies throughout Washington that offer these screenings.

Pharmacy students play an important role in this goal. In May, 91 second-year PharmD students received certification in TB screening. Department of Pharmacy faculty member Skye McKennon worked with the State Department of Health and the Washington State Pharmacy Association to create the training program, which was offered as part of the students’ Applied Therapeutics course. This program is believed to be among the first in the country to offer a certificate in TB screening to students as a part of their PharmD curriculum.

The program included a lecture on TB assessment, a chance to practice the Mantoux tuberculin skin sensitivity test — the standard TB screening tool  —  on one another and a tutorial on checking Mantoux test results. The training occurred shortly after the PharmD students had learned about TB in their class.

The training facilitators were nurses Julie Tomaro and Temple Parsons from the Department of Health, pharmacist Jenny Arnold from the Washington State Pharmacy Association and the School of Pharmacy’s Applied Therapeutics instructors — faculty members Colleen Catalano, Skye McKennon and Elyse Tung.

“It was a pleasure to see students gain confidence in their skills and their scope of practice,” said McKennon. “At the beginning of the training, two students were apprehensive about practicing intradermal injections on one another. After practicing and receiving guidance on their technique, they could accurately perform the injections. By the end, they were happily taking pictures of each other and the marks on their arms.”

Student evaluations for the program were overwhelmingly positive. One student wrote: “I cannot wait to offer this at my work site. I am in the process of working with my company to start doing this in our pharmacy.”

In the future, the 91̽��School of Pharmacy, the Department of Health, and the Washington State Pharmacy Association hope to collaborate again on a TB screening program for students. In the meantime, the state Pharmacy Association is continuing to offer certification programs for practicing pharmacists.

In light of budget cuts to publicly funded TB screening programs in the state, public health agencies are increasingly relying on pharmacists and other healthcare providers to screen for TB.

Pharmacists, as one of the most accessible healthcare providers, are well-positioned to reach out to populations at high risk for acquiring and developing complications from TB. These groups include people with HIV, people with other health problems that make it hard for the body to fight bacteria, recent immigrants, Native Americans, and people who abuse alcohol or use illicit drugs. See the Centers for Disease Control and Prevention full list of risk factors.

Not only are pharmacists important to helping screen for TB; they can also help provide medication management for infected patients to help them adhere correctly to the antibiotic regimen. People with TB must take the drugs exactly as prescribed over a six- to nine-month period. If they don’t, they can relapse or develop drug-resistant TB.

McKennon is excited to think about how this training program inspired the pharmacy students who participated.

“In the big picture, the students learned the importance of the pharmacist in public health matters,” said McKennon. “They also saw how the Department of Health, nurses, the state pharmacy association, the School of Pharmacy, pharmacy practitioners and pharmacy students can collaborate for the benefit of the public.”

Giving heroin users kits with the overdose antidote naloxone is a cost-effective way to prevent overdose deaths and save lives, according to a study released this week in The Annals of Internal Medicine.

Dr. Phillip Coffin, director of Substance Use Research at the San Francisco Department of Public Health and assistant clinical professor at the University of California, San Francisco, and Sean Sullivan, professor and director of the Pharmaceutical Outcomes Research and Policy Program at the 91̽�� in Seattle, co-authored the study

Drug overdose is now the leading cause of injury death in the United States.  Opioids, such as heroin, account for about 80 percent of those deaths. Naloxone is a safe and effective antidote that works by temporarily blocking opioid receptors. As of 2010, 183 public health programs around the country, including those supported by the San Francisco Department of Public Health, had trained more than 53,000 individuals in how to use naloxone. These programs had documented more than 10,000 cases of successful overdose reversals.

The authors of this study developed a mathematical model to estimate the impact of distributing naloxone in this way. Their model was based on conservative estimates of the number of overdoses that occur each year. It accounted for people who overdose repeatedly. It also acknowledged that most people who overdose will survive whether or not they get naloxone.

In their basic model, Coffin and Sullivan estimated that reaching 20 percent of a million heroin users with naloxone would prevent about 9,000 overdose deaths over their lifetime. One life would be saved for every 164 naloxone kits given out. Based on more optimistic assumptions, naloxone could prevent as many as 43,000 deaths – one life for every 36 kits given out.

Naloxone distribution would cost about $400 for every quality-adjusted year of life gained. This value is well below the customary $50,000 cutoff for medical interventions. It is also cheaper than most well-accepted prevention programs in medicine and is most similar to the cost-effectiveness of smoking cessation or checking blood pressure. All reasonable assumptions produced costs that were well within traditional guidelines for cost-effectiveness.

“Naloxone is a highly cost-effective way to prevent overdose deaths,” said Coffin. “And, as a researcher at the Department of Public Health, my priority is maximizing our resources to help improve the health of the community.”

Naloxone has been distributed in San Francisco since the late 1990s and with San Francisco Department of Public Health support since 2004. During that time, heroin overdose fatalities slowly decreased from a peak of 155 in 1995 to 10 in 2010. Opioid analgesic deaths (such as those from the prescription pain medications oxycodone, methadone, or hydrocodone) remain elevated, with 121 deaths in 2010. Efforts are under way to expand access to naloxone for patients receiving prescription opioids as well.

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Eileen Shields, San Francisco Department of Public Health, contributed to this report.

The Washington State Pharmacy Association recently announced its 2012 award winners. Several School of Pharmacy alumni were honored for their contributions to the pharmacy profession, patients and the community. In addition, the late School of Pharmacy Dean Emeritus and Professor of Medicinal Chemistry Sid Nelson posthumously received the Washington State Pharmacy Association Distinguished Leadership Award. Nelson, an alumnus and beloved member of the 91̽��School of Pharmacy community, died in December 2011.

The Distinguished Leadership Award goes to individuals who have been instrumental in developing and growing the pharmacy profession and who demonstrate significant influence and direction in the community.

“While Sid was known internationally during his life as an award-winning scientist and mentor to young scientists, he also helped shape pharmacy practice and pharmacy education in our state in his work as a professor and administrator,” said Nanci Murphy, associate dean of academic and student programs at the School of Pharmacy and a long-time colleague and friend of Nelson.

As dean from 1994 to 2008, Nelson helped the School convert from a Bachelor of Science to a Doctor of Pharmacy degree program. He expanded the School’s faculty by recruiting a group of educators who strengthened an already stellar program and who are building on the School’s efforts to improve the practice of pharmacy and to advocate for patients. He supported the development of new innovations in the Doctor of Pharmacy degree curriculum, and he helped expand the School’s many community partnerships and outreach efforts.

But his impact on pharmacy students is arguably his greatest legacy on the pharmacy profession in Washington state.

Nelson, who joined the School of Pharmacy faculty in 1977, taught throughout his tenure as dean and continued to teach after he stepped down. In his popular medicinal chemistry course for second-year students, he made a challenging, complex subject interesting and fun. His students consistently reported that he inspired them to work harder. When students did poorly on an exam, he would seek them out individually to ask how they were doing and offer encouragement.

He held course finals at conferences that he and pharmacy students attended so the students could participate in the conferences without sacrificing their studies. As a teacher, he twice won a 91̽��School of Pharmacy Gibaldi Excellence in Teaching Award.

As a dean, he was devoted to helping students excel academically and grow professionally. He provided Dean’s Fund monies to help students conduct research, create outreach projects and go on international rotations. His open-door policy made him highly accessible. Nelson and his wife, Joan, also made a special point of attending and supporting student events. In 2007, he won the American Pharmacists Association-Academy of Student Pharmacists Dean of the Year Award.

“Sid was one of those unique individuals who transcended the traditional profile of a professor,” said 91̽��School of Pharmacy alumnus Collin Conway, ’05, a pharmacist and co-chair of the 91̽��School of Pharmacy’s Pharmacy Practice Board. “He was always one of my favorites in the classroom, but what really struck me was a rare, unquestionable and sincere interest in my future and well-being. This inspired me not only to get involved in the profession, but also to be a better person. For this, I am forever grateful.”

Today, in hospitals, clinics, community pharmacies, nonprofit organizations, government organizations and elsewhere in this state, 91̽��alumni like Conway are making a positive impact, in part, because Sid encouraged them and believed in them.

Nelson’s wife, Joan, accepted his award during an emotional presentation Nov. 2 at the Washington State Pharmacy Association Annual Meeting awards ceremony in Grand Mound, Wash. (Read more about Sid Nelson’s life and legacy at .)

Also at the awards ceremony, School of Pharmacy alumna Beverly Schaefer, ’70, was named Pharmacist of the Year. Schaefer is co-owner of Katterman’s Sand Point Pharmacy and is currently working on a project to increase prescriptive authority for pharmacists.

Ryan Oftebro, ’03, received the Pharmacist Mutual Distinguished Young Pharmacist of the Year Award. Oftebro, a co-owner at Kelley-Ross Pharmacy, oversees community and clinical services at Kelley-Ross and is noted for his work mentoring student pharmacists.

Jennifer Kreidler-Moss, ’01, received the Innovative Pharmacy Practice Award. She is director of pharmacy services at  Peninsula Community Health Services, which is a Bremerton clinic providing primary care services to a predominantly underserved population.

During the annual meeting, Brian Beach, ’00, was installed as president of the Washington State Pharmacy Association Board of Directors. Beach is a co-owner of Kelley-Ross Pharmacy and has long been an active member of the Association and an advisory board member of multiple pharmacy and health care organizations.

Learn about the .

Professor of Pharmaceutics Jashvant Unadkat has started a new venture at the 91̽��School of Pharmacy.The 91̽��Research Affiliates Program on Transporters is a cooperative effort between the school  and pharmaceutical research companies AstraZeneca, Genentech and Merck. Researchers across the four institutions are collaborating on research that will facilitate drug development.

The goals of the 91̽��Research Affiliates Program on Transporters are twofold. First, it will provide quantitative information on drug transporters. The data  would help better predict the fate of new drugs early in development and thereby expedite the movement of promising drugs into clinical trials. Second, the findings would enhance the collective knowledge about personalized medicine by better predicting the potential for drug-drug interactions and by showing how an individual’s genetics might influence the processing of  certain drugs.

The program’s researchers hope to achieve these aims by studying and measuring the drug transporters produced in various human tissues and cells. Transporters are membrane proteins in tissues. They help the body absorb, distribute, metabolize and excrete drugs. Such transporters exist throughout the body, including in the liver, kidney, red blood cells and the brain.

For more than a decade, Unadkat’s lab has studied drug transporters in the disposition, efficacy and toxicity of drugs such as those used in the treatment of hepatitis C and HIV infection. Before translating findings from this in-vitro research (done in the test tube) to in-vivo studies (those conducted in the body), Unadkat realized additional research was required. He wanted to know more about the amount and type of transporters present in human tissues.

“Recognizing this gap in knowledge, our lab embarked on setting up a program a few years ago to quantify the level of expression of transporters in human tissues,” said Unadkat.

To do so, he set up a collaboration with Yurong Lai, a Pfizer scientist and a former postdoctoral fellow of the Unadkat Lab.Their novel approach links mass spectrometry (an analytical technique that identifies chemicals by their mass and charge) with liquid chromatography (an analytical technique for separating ions or molecules that are dissolved in a solvent). Seed funding for this work came from Pfizer.

Over time, Unadkat wanted to find a way to share collective expertise and resources with others in the industry who were conducting similar research. He began discussions with scientists from across the pharmaceutical research industry. With the help of two 91̽��offices that help facilitate academia-industry partnerships and help secure support for sponsored collaborations — the 91̽��Center for Commercialization and the 91̽��Office of Sponsored Programs — 91̽��Research Affiliates Program on Transporters came into being late last year with the three major research companies on board. Additional discussions are under way with other companies that have expressed interest in joining the initiative.

Through the initiative, Unadkat, lead scientist Bhagwat Prasad and other scientists and graduate students in the Unadkat Lab are measuring expression of transporters in human tissues and in other kinds of cells and tissues sent from pharmaceutical companies. Members of the program will communicate their results and next steps through regular online and in-person meetings and through online access to the data generated by the Unadkat Lab. This kind of collaboration will mark a first for the companies..

“Such multi-company collaboration is rare because pharmaceutical companies are competitors,” said Unadkat. “Astrazeneca, Genentech and Merck were willing to collaborate and fund UWRAPT because the research is not proprietary.”

In fact, the information that comes from the program’s research will benefit the School of Pharmacy and all the companies involved in drug-development research. All data generated by the program will be shared with all three companies and eventually be published.

What’s more, the 91̽��Research Affiliates Program on Transporters partnership will help the School of Pharmacy train future scientists in pharmaceutical research. The program is intended to be a multi-year, public-private collaborative research venture.

Ultimately, Unadkat and his colleagues hope that by improving understanding about the quantity and types of transporters expressed in human tissues, they will advance the collective knowledge about how medicines are processed by the body. In turn, this will help health care providers prevent drug interactions and understand how genetics affects the way individuals process medications.

The Pharmaceutical Research and Manufacturers of America Foundation recently announced that the 91̽�� and Johns Hopkins University will each receive a $250,000 grant to establish a three-year graduate certificate program. This program is formally known as the PhRMA Foundation Center of Excellence for a Comparative Effectiveness Research  Educational Program.

The PhRMA Foundation’s goal is to encourage the creation of  graduate-level curricular programs in U.S. colleges to  hone students’ knowledge and skills in comparative effectiveness research.

Comparative effectiveness research is a growing field that aims to generate evidence to improve health care decisions for patients and providers. It examines the benefits and risks of different medical or healthcare interventions, including drugs and medical technology. The results of these comparison studies are used by medical professionals to make better  informed healthcare decisions and thereby improve patient care.

“While there were several excellent candidates that applied for the grant, this years recipients were chosen because they displayed strong track records conducting comparative effectiveness research and demonstrated a commitment to advancing the field through related activities,” said Jean Paul Gagnon, chair of the PhRMA Foundation comparative effectiveness research advisory committee.

The 91̽��is home to an interdisciplinary comparative effectiveness research program — the 91̽��Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance — composed of several world-renowned research centers and programs from the region. They include centers at the 91̽��Schools of Pharmacy, Public Health, Medicine and Nursing as well as at Fred Hutchinson Cancer Research Center, Seattle Children’s and the Puget Sound Veteran’s Administration.

With this PhRMA Foundation grant, the Schools of Pharmacy and Public Health are implementing an interdisciplinary certificate program for 91̽��graduate students. Faculty members from the participating centers of the CHASE Alliance will contribute. Interested 91̽��graduate students can apply starting in April.

“My colleagues and I are excited to be launching a graduate certificate program in comparative effectiveness research with the support of the PhRMA Foundation,” said Lou Garrison, professor and associate director of the Pharmaceutical Outcomes Research & Policy Program in the School of Pharmacy. “As we move into this new era of patient-centered, real-world outcomes research with active stakeholder engagement, there is a tremendous need for newly trained researchers to take advantage of these new opportunities and to address critical information needs.”

Garrison is the principal investigator of this new grant. Co-investigators are Anirban Basu, associate professor of health services in the School of Public Health, and Beth Devine, associate professor of pharmaceutical outcomes research and policy.

Moving forward, the 91̽��and Johns Hopkins faculty members who received the PhRMA Foundation grant will collaborate to train high-caliber comparative effectiveness researchers and practitioners.

91̽��graduate students interested in finding out more about the comparative-effectiveness research certificate can email the School of Pharmacy at rxalumni@uw.edu

Hong Kong has a strong healthcare system, but as one of the most densely populated regions in the world, it continues to be challenged by an ever-expanding populace. The typical teaching hospital in Hong Kong has between 1,200 and 1,900 beds with only 20 to 30 pharmacists on staff. The pharmacists and physicians in Hong Kong’s hospital system are increasingly overwhelmed by heavy workloads. Whats more, the region’s health care system has been tested by a few public health crises in the past decade — most notably the 2003 SARS outbreak and the 2009 H1N1 epidemic.

The Hong Kong Hospital Authority (HKHA) is seeking to expand the clinical services that pharmacist’s in Hong Kong offer, with a stronger emphasis on direct patient care rather than on dispensing.

Expanding the pharmacists role and increasing the number of pharmacists in hospitals will ease the burden on physicians and allow healthcare providers to more easily respond to public health crises. It will also make better use of the pharmacist’s expertise.

This past October, three 91̽��School of Pharmacy professors traveled to Hong Kong to provide geriatric pharmacotherapy training. Associate Professor of Pharmacy Lingtak-Neander Chan, Professor of Pharmacy Al Ellsworth and Clinical Associate Professor of Pharmacy Annie Lam, all practicing pharmacists, were invited by the Chinese University of Hong Kong (CUHK) to lead a two-week certificate program and clinical skills workshop for 24 Hong Kong pharmacists. The Hong Kong Hospital Authority commissioned this program as part of its larger effort to restructure the region’s pharmacy practice model.

“The knowledge base of pharmacists in Hong Kong is excellent — from basic pharmacology to general practice guidelines,” said Lingtak-Neander Chan. “But pharmacists there haven’t been given the opportunity to directly apply their knowledge and refine their skills on the bedside or in the clinic.”

The training program led by Chan and his colleagues taught how to provide clinical pharmacy services to older adults and to evaluate their disease states to create patient-specific management plans. It covered a range of geriatric pharmacy topics, including common medication-related problems and geriatric- and drug-induced diseases. Chan and Lam, both from Hong Kong, tailored the curriculum to meet the regions cultural needs.

The training also included a full-day physical exam workshop, led by Ellsworth, who is also a 91̽��professor of family medicine. Chan, who is also a 91̽��Nutrition Sciences interdisciplinary faculty member, provided nutritional management training. In addition, the 91̽��professors joined the Hong Kong pharmacists and physicians on rounds at a few major teaching hospitals.

“It was a great opportunity for the pharmacists to participate as contributing members of the healthcare team,” said Lam. “The physicians were very welcoming.”

Ultimately, having pharmacists participate in rounds, like they do in many hospitals in the United States, can improve the cost-effectiveness of drug therapy and prevent medication-related adverse events.

Chan — who is passionate about advocating for the role pharmacists can play in improving health outcomes — has been collaborating with the Hong Kong Hospital Authority for ten years. He was previously part of a collaboration between the authority and the University of Illinois at Chicago while he was on faculty there. After he joined the 91̽��School of Pharmacy in 2004, he stayed in contact with colleagues in Hong Kong. He has gone back twice to provide training and resources.

He has also helped arrange for a handful of Hong Kong pharmacists to visit Seattle and shadow area pharmacists. Those visiting pharmacists sought advice from Chan on how to implement innovative programs back in Hong Kong. Several individuals returned to Hong Kong to start successful hospital pharmacy programs in the acute care and critical care setting. These programs have been embraced by the collaborating physicians.

All of the pharmacists Chan has met in Hong Kong, he said, are excited and enthusiastic about the future of their profession.

At present, the Hong Kong Hospital Authority is gearing up to hire more pharmacists. The CUHK School of Pharmacy is increasing its enrollment. And the Hong Kong Academy of Pharmacy recently collaborated with the American Society of Consultant Pharmacists to establish a medication therapy management certification program. In fact, Annie Lam spent another week in Hong Kong to help launch this training program.

“The pharmacists in Hong Kong would like to shift from a role of drug distribution to a role of providing clinical services,” said Chan, citing a recent ‘International Journal of Pharmacy Practice article that reflected this sentiment. “I look forward to seeing that happen for the profession of pharmacy in Hong Kong in the years to come.”

In the Clinical Skills Competition, two-person teams of pharmacy students are given a patient case that reflects actual scenarios that hospital pharmacist’s may encounter. They have two hours to identify acute and chronic medical problems and develop a pharmacists care plan. The teams who make it to the top ten at the national level also give a presentation justifying their therapy recommendations to a panel of judges.

Participants must possess knowledge in clinical pharmacology, therapeutics, medical terminology and basic pharmacokinetics principles, among other things. They can use some reference materials in the competition.

Friedman and Lei, both fourth-year pharmacy students, represented the 91̽��after winning the local ASHP competition this past fall. They competed against seventeen 91̽��teams at the local level.

The case the teams were given at the New Orleans meeting involved a 34-weeks-pregnant woman with prior miscarriage. She had high blood pressure and protein in the urine, a pregnancy complication called preeclampsia. Her blood tests showed she had elevated liver enzymes, low platelet count and a breakdown of red blood cells.

“The only effective treatment in this case would be delivery of the baby,” said Friedman. “But we were asked to manage her condition pending a Cesarean section. The patient also had a number of co-morbidities [other health problems], including asthma and history of depression, which we also managed.”

The care plan the 91̽��team created was five pages long. Among its recommendations: give the patient an infusion of the blood pressure medication labetalol, a magnesium infusion to prevent seizures, and a pain management regimen.

Friedman and Lei received the highest scores for the accuracy, relevance and completeness of their patient care plan as well as for the strength of their presentation.

“We had prepared extensively and were confident in our recommendations,” said Friedman, “but it was still surreal hearing our names called as the national winners.”

The second and third place honors at the ASHP meeting went to a team from Harding University in Arkansas and Thomas Jefferson University in Pennsylvania, respectively. This year’s clinical skills competition was the largest that the ASHP had held in its sixteen years.

For their first place win, Friedman and Lei took home a number of prizes, including $500, an individual trophy and a large trophy for the 91̽��School of Pharmacy to display.

“I think we both learned a tremendous amount in preparation for the competition, helping us further refine our critical thinking skills,” said Lei. “The process of working through a complex clinical case is a very valuable and fun experience.”

When she and Friedman receive their Doctor of Pharmacy degrees this June, they both hope to enter a pharmacy practice residency program. Friedman’s long-term goal is to work in critical care at a teaching hospital; Lei’s is to specialize in critical care or infectious disease.

ASHP is a 35,000-member national professional association that represents pharmacists who practice in hospitals, health maintenance organizations, long-term care facilities, home care, and other components of health care systems. ASHP has a long history of improving medication use and enhancing patient safety.

Dr. Shiu-Lok Hu, Gibaldi Endowed Professor of Pharmaceutics at the 91̽��School of Pharmacy, created the “prime-boost” immunization method in the late 1980s while working at Oncogen. This method uses two vaccine components — a relatively harmless virus that delivers HIV proteins and primes the immune system, followed by booster shots of the HIV proteins themselves. This one-two punch approach activates both antibody and cell-mediated immune responses.

Now, as HIV/AIDS researchers worldwide seem to be moving closer to a possible HIV vaccine, Hu has received a vote of confidence from the Bill & Melinda Gates Foundation for his contributions to the field. The foundation awarded Hu a $6.7 million grant that will enable his research team to join the Consortium for AIDS Vaccine Discovery (CAVD), an international network of scientists launched by the Gates Foundation to design novel HIV vaccine candidates and advance the most promising candidates to clinical trials.

Hu’s research project is entitled, “Unmasking conserved epitopes on HIV envelope protein for vaccine design.” Two co-investigators on the project are from the Perelman School of Medicine at the University of Pennsylvania: Dr. Jim Hoxie, professor of medicine and director of the Penn Center for AIDS Research, and Dr. Drew Weissman, associate professor of medicine in the Division of Infectious Diseases. The third co-investigator is Dr. Shan Lu, professor of medicine, biochemistry and molecular pharmacology at the University of Massachusetts Medical School.

The goal of their four-year study is to build upon the success of the prime-boost strategy and to explore vaccine designs that may generate protective antibodies targeting the part of the virus it uses to bind to immune cells — the part widely considered the Achilles’ heel of the virus. Hu’s lab has previously shown that the removal of a specific glycan molecule on the envelope protein used by the virus to enter the host cell resulted in an enhanced ability of the mutant protein to induce neutralizing antibodies. Now Hu and his colleagues seek to uncover ways to further enhance this glycan-modified envelope vaccine design’s ability to provoke an immune response.

In other words, they hope to find a safe, effective vaccine that will help the immune system ward off HIV infection.

HIV infects more than 2 million people globally each year. Throughout the world, an estimated 33 million people are living with HIV/AIDS. While antiretroviral therapy can control progression to AIDS, it cannot cure or stop the spread of the disease.

“The successful development of safe and efficacious vaccines against these diseases represents our best hope for eradicating this pandemic in the long term,” said Hu. “The search for a vaccine is a humbling and daunting task as an individual scientist. But as a member of the CAVD and the AIDS research community, it is tremendously exciting and rewarding.”

Indeed, being part of the Consortium for AIDS Vaccine Discovery will allow Hu’s research team to tap into an international research network of more than 500 HIV/AIDS investigators across 94 institutions in 19 countries.

For his part, Hu has a highly active research program at the 91̽��School of Pharmacy. He is currently part of three, multiyear, multi-institution National Institute of Allergy and Infectious Diseases HIV Vaccine Research and Design grants, for which his contributions total more than $9.5 million.

This new Gates Foundation grant, said Hu, will allow his team to leverage the expertise, resources and infrastructure of the top scientists in the field.

“We all know the challenges we face to develop a safe and effective vaccine against HIV/AIDS,” he said. “However, I believe we can make a difference if we commit ourselves and work together toward this worthwhile goal.”

The 91̽��School of Pharmacy is the fifth ranked pharmacy school in the nation, according to U.S. News & World Report. Ranked No. 9 among pharmacy schools in National Institutes of Health grant funding, its faculty secured more than $15 million in overall research funding in fiscal year 2011. The School of Pharmacy educates professional pharmacists, develops scientific leaders and serves the community through health outreach and education.

Pharmacy student Faaiza Alibhai’s recent trip to Honduras was not only a great opportunity to experience another country and provide health care to a resource-limited population. It was also, she said, a fantastic chance to further prepare for a career working with people from diverse backgrounds.

“My Spanish is limited,” said the second-year student, “but I appreciated that I could communicate with patients by attempting to speak the language and using hand signals and motions. It was amazing how much we could understand each other and overcome barriers just by trying.”

Alibhai spent a week in Honduras this past September with 28 other 91̽��pharmacy students as part of a Global Brigades medical project. Global Brigades is a non-government organization that empowers groups of volunteers (“brigades”) to facilitate sustainable solutions in under-resourced communities while fostering local cultures.

The group of pharmacy students brought with them almost $25,000 worth of donated medicines. The students had procured the medications from area pharmacies, from national pharmacy organizations, and from funds they raised and donated themselves.

They also recruited 11 Puget Sound-area health care providers to join them — including doctors, a nurse, a nurse practitioner, a physical therapist, and, of course, pharmacists. Those pharmacists were School of Pharmacy clinical and affiliate faculty members Jennifer Chang, Don Downing and Holly Gurgle; the Washington State Pharmacy Association’s Jenny Arnold, 06; and recent alumnus Luis Ramos, 10.

The brigade’s goal was to offer a temporary, free clinic in the village of Joya Grande, a town of about 660 people located northwest of Tegucigalpa.

Joya Grande has a good school, a high literacy rate and relatively easy access to safe water, but it is part of a nation with high poverty and unemployment rates. Further, 30 percent of Joya Grande residents don’t have working latrines, and there is no health care facility in the village. Some common illnesses in the region include diarrhea, intestinal parasites and skin fungus. The village leaders have expressed a need for more health education and disease prevention.

So the team of volunteers set out to help fulfill that need.

On the first morning they arrived in Joya Grande, there was already a long line of Honduran villagers waiting for them.

“They didn’t seem to care about having to wait,” said Alibhai. “They were just so happy to see us and were so welcoming.”

The volunteers set up multiple health care stations at the local school. A Honduran dentist, pharmacist and obstetrician/gynecologist  worked with the team. Overall, the brigade offered intake, triage, medical care, dental care, gynecological care, pharmaceutical care and health education programs.

The pharmacy students worked side-by-side with the care providers, sharing their opinions and medication expertise. They also put the skills they had learned at pharmacy school to good use.

“While in Honduras, I improved my ability to formulate, implement, evaluate and review patient care plans through hands-on training in triage, consultation and the pharmacy,” said second-year student Fabienne Chou.

She also witnessed creative problem-solving firsthand.

“One baby we saw had severe burns on its foot that were several days old and infected,” said Chou. “The surgery resident debrided the scab and applied a high dose of antibiotic. Had this not happened, the child could have had its foot amputated.”

The brigade also taught basic health education programs for adults and children. By the last day of the clinic, some of the Honduran children were showing off to the volunteers what they had learned about how to brush their teeth and wash their hands.

Ultimately, more than 800 Hondurans, many of whom had traveled from neighboring villages, received care. People who needed pharmaceutical treatment received medications for free that they otherwise may not have been able to afford or obtain.  All patients were given antiparasitic drugs.

This was only the second time since Global Brigades was founded in 2004 that a pharmacy student group has led a medical brigade. It was one of a small percentage of brigades that has been led by graduate level students.

“Generally brigades have relied heavily on doctor consultations,” said Alibhai. “But in our circumstance we placed a larger focus on collaboration between the various disciplines. Providers spent their time and efforts diagnosing patients, leaving the treatment of the patients entirely up to the pharmacists.”

The volunteers also visited an orphanage and an HIV/AIDS care center while in Honduras.

Alibhai and fellow second-year student Denise Ngo planted the seeds for this trip last fall. Both of them had previously traveled to Honduras through Global Brigades as 91̽��undergraduates. In their first year of pharmacy school, they started talking about how they’d like to return now that they had more hands-on clinical skills.

Once they received the go-ahead from the School of Pharmacy, they got started. After recruiting their fellow participants, and with initial support from the School’s Deans Fund for Excellence, the group of students held an auction that raised $8,000 to help pay for travel costs. They also worked to secure donated medicines. They even created an elective preparatory course featuring guest speakers covering topics ranging from basic Spanish to cultural sensitivity to womens health.

“The brigade was such an amazing experience that many of us hope to go on another one,” said Clinical Professor Downing.

He recounted the day an elderly Honduran woman was waiting near the pharmacy at day’s end. She had already waited more than three hours to get care and had received her medications. She also had a long walk home ahead of her.

“I asked in my broken Spanish if she needed help,” said Downing. “She looked at me and said she hadn’t had a chance to say ‘thank you and that she wasn’t going to leave until she let us know how she felt about what we had done for her.”