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MUSC works to identify, eliminate drug effects by Heather Woolwine Public Relations Allegra. Nexium. Orthotrycyclin. Vioxx. Xanax. Viagra. Vasotec. Prozac. Lipitor. Lithium. The list goes on. Millions of people take prescription drugs for a variety of conditions, diseases, and mental illness.   While physicians and pharmacists undergo rigorous training to prescribe and dispense these medicines, adverse drug effects remain a possibility. Drug interactions, writing errors, and idiosyncratic reactions cause the death of at least 7,000 people annually, according to a recent Post and Courier article.   To address these unintended consequences, the Center for Medication Safety was formed out of the South Carolina College of Pharmacy. It is directed by Rick Schnellmann, Ph.D., Department of Pharmaceutical Sciences chair and professor. “We formed the center a little more than a year ago and we’re not just interested in adverse drug effects related to medication errors,” said Schnellmann. “We are employing a three-armed approach, through epidemiology/economics, basic science, and education/outreach, to identify the incidence and morbidity of adverse drug effects from prescription and nonprescription drugs and supplements, particularly in the pediatric and elderly populations; to identify and decrease the financial impact of adverse drug effects, elucidate the mechanisms of adverse drug effects, particularly the role of pharmacogenomics; and to prevent adverse drug effects by increasing drug safety competency and decreasing medication errors through education of health care professionals and the public.”   According to Schnellmann, “adverse drug events are more likely to occur in the pediatric and elderly populations. Changes that occur as the body ages can cause medications to react differently among different age groups. This, along with the fact that pediatric and elderly patients are often underrepre-sented in clinical trials, can pose particular risk. In addition, children often take unusual doses of medications because of their size and unique biology, and there can be issues getting children to take their medications. Compliance in elderly patients can also be an issue. The number and frequency of medications per day and their cost often cause confusion and inability to take all of their prescribed medications as ordered.”   Also, people react to different medications in different ways even within their own age group, thus making it impossible to determine how a drug will affect every person that takes it. Some people metabolize a certain medication faster than others, some slower or not at all. Still, health care professionals are human and not immune to making medication errors either by prescribing medications that cause a problematic drug interaction or making a simple mistake when reading the prescription. Regardless of the reason, adverse drug effects impose significant social and financial burdens and in turn waste health care dollars.   In terms of the center’s three-armed approach, the Pharmacoepidemiologic and Pharmoeconomic Research unit identifies adverse drug effects, medication errors, and the financial implications that ripple throughout the system of prescription and non-prescription drugs and supplements.   “Most people would be surprised to learn the lack of investigation and testing that nutritional supplements and the like must go through before ending up on store shelves,” Schnellmann said. “There’s a lot of anecdotal evidence out there supporting certain medications and/or supplements, but we want to conduct patient-based studies that will provide us with appropriate evidence.”   In addition, this group also has the goal of finding out which drug therapies are the most cost effective in order to save health care dollars.   The pharmacogenomics research unit identifies mechanisms of adverse drug effects. This unit is responsible for finding out why people react the way they do to certain medications based on their genetic makeup. This group is particularly focused on why someone can take a medication and end up with a toxic reaction, whereas another person can take the same dose of the same medication and have total therapeutic success. This group also is responsible for researching drug interactions.   The education and outreach unit organizes and disseminates current research to prevent adverse drug effects, increase drug safety and competency, and decrease medication errors by educating not only the public, but health care professionals as well.   “It is so important that we educate the parents of our pediatric patients and our elderly patients and empower them to become active in their own health care,” Schnellmann said. “We’ve devised a series of 20 minute PowerPoint presentations that offer a good deal of education about drug safety, proper drug administration, importance of complying with medication therapies, and how to identify adverse drug effects. There are also disease-specific presentations and the information will be easily downloaded from our Web site (currently under construction), thus enabling access to this information across the state.”     When it comes to health care professionals, it’s easy to understand their frustration. So many medications exist. Not only can their effects be complex, but many health care professionals are not always cognizant of the specific medication worries that face pediatric and elderly populations. The center’s answer is to educate the state’s nurse practitioners, family physicians, nurses, physician assistants, and pharmacists through educational presentations such as those provided to patients, through lectures and presentations throughout the state. In order to succeed in its educational outreach, the center looks to the MUSC Center for Aging, the Palmetto Poison Center, and various hospital partners throughout the state to help spread the word.   The center was funded thanks to the South Carolina College of Pharmacy and Schnellmann said he plans to apply for state funds from the lottery-funded Centers for Economic Excellence program. The center also received a boost from Charleston philanthropist Doris Meddin in support of the Doris Levkoff Meddin Medication Safety Education Program. Meddin’s brother, Abner Levkoff, M.D., started the MUSC hospital’s first neonatal intensive care unit in 1967.   The Center for Medication Safety Web site will soon provide further information and outreach. For information now, contact Schnellmann at 792-3117.     Friday, April 14, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island papers at 849-1778, ext. 201.