Remedies - Winter 2023

BUILDING COMMUNITIES BENEFITS US ALL

I’ve been with the School of Pharmacy and Pharmaceutical Sciences since it was established; in fact, as founding chair of the Department of Pharmaceutical Sciences, I was here before our first class of PharmD students began its studies in 2017. During my time here, not only have we opened a building that provides the best environment possible for our students to learn and thrive, but we have grown to become part of the local community. And we are continuing to grow. This past fall we enrolled our first students in new master’s (MS) and PhD programs in pharmaceutical sciences. Eight MS and seven PhD students are now gaining hands-on experience in our labs to prepare them for careers in the pharmaceutical and biotechnology sectors.

We’ll also see the opening later this year of our $15 million research and development building adjacent to our main building. The R&D facility will expand our drug development and drug discovery research initiatives, and help us build relationships with pharmaceutical companies.

As we work to ensure that the School of Pharmacy and Pharmaceutical Sciences remains a strong part of the fabric of our community, I encourage you to read about our people and initiatives. I hope you enjoy this issue of Remedies

Thank you.

Kanneboyina Nagaraju Dean

SCHOOL OF PHARMACY AND PHARMACEUTICAL SCIENCES

DEAN

Kanneboyina Nagaraju, DVM, PhD

ASSOCIATE DEAN FOR RESEARCH

Eric Hoffman, PhD

INTERIM ASSOCIATE DEAN FOR EDUCATION AND ENGAGEMENT

KarenBeth Bohan, PharmD, BCPS

ASSISTANT DEAN FOR ACADEMIC AFFAIRS AND CLINICAL ASSISTANT PROFESSOR OF PHARMACY PRACTICE

Erin Pauling, PharmD, BCACP

ASSISTANT DEAN FOR ADMINISTRATION, FINANCE AND OPERATIONS

Laura McDuffee

ASSISTANT DEAN OF EXPERIENTIAL EDUCATION AND CLINICAL ASSOCIATE PROFESSOR

Nicholas Schwier, PharmD

CHAIR, DEPARTMENT OF PHARMACEUTICAL SCIENCES

Aaron Beedle, PhD

CO-CHAIR, DEPARTMENT OF PHARMACY PRACTICE

Kenneth McCall, PharmD, FAPhA

CO-CHAIR, DEPARTMENT OF PHARMACY PRACTICE

Sarah Spinler, PharmD, FCCP, FAHA, FASHP, AACC, BCPS, AQ Cardiology

REMEDIES

EDITOR

Katie Ellis

ART DIRECTOR

Katie Honas ’14

PHOTOGRAPHER

Jonathan Cohen

CONTRIBUTING WRITERS

Anthony Borrelli John Brhel, Eric Coker, Jennifer Micale

VICE PRESIDENT FOR COMMUNICATIONS AND MARKETING

Greg Delviscio

DIRECTOR OF CREATIVE SERVICES

Gerald Hovancik Jr.

COPY EDITORS

Natalie Blando-George, John Brhel, Eric Coker

ON THE COVER Assistant Professor of Pharmaceutical Sciences

Katie Edwards is studying the impact on fish of pharmaceuticals found downstream from wastewater treatment plants.

Binghamton University School of Pharmacy and Pharmaceutical Sciences holds accreditation from the Accreditation Council for Pharmacy Education (ACPE), 190 South LaSalle Street, Suite 2850, Chicago, IL 60603, 312-664-3575; Fax 866-228-2631, www.acpeaccredit.org

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What happens when fish are exposed to pharmaceutical residue?

10 Raising up a community Supporting downtown Johnson City merchants spurs revitalization

16 Building castles in the air

Karen Williams pays it forward to help residents achieve their dreams

Bettering lives by listening Building a pharmacy program for Uganda

By Anthony Borrelli

AFTER A DECADE helping pharmacists at clinics and hospitals in Uganda improve healthcare and cultivate a new generation of pharmaceutical care experts, KarenBeth Bohan has learned to value a very simple lesson: Let your patient tell you what’s wrong.

Basics like these are what Bohan, professor and interim associate dean for education and engagement in Binghamton University’s School of Pharmacy and Pharmaceutical Sciences, hopes her students take from classrooms to clinical work and into whatever careers they pursue in a rapidly evolving medical field.

Bohan’s mantra is further explored in her blog, “Out of the Pharmacy Classroom and Into Africa,” which delves into her work developing a learning and serving experience for pharmacy students in Uganda.

Working in Uganda, Bohan has helped craft and refine research advancing pharmacy education to improve safe use of medication and overall patient health. With obstacles ranging from limited availability or lack of some of the latest medications to accessibility of clean water, Bohan says colleagues there have learned how to accomplish more with fewer resources.

“Listening to the patient is one of the primary things you need to do and today, it’s very easy to just do all sorts of medical tests like MRIs or lab work and let those results tell you what’s wrong

with the patient, but in Uganda they don’t have access to all those things,” Bohan says. “They’ve learned how to really pay attention to the symptoms and listen to what the patient is saying. You can really do a lot with that information, and that’s something I’ve taken back to my American pharmacy students.”

While Bohan has honed her expertise in infectious disease pharmacology and global pharmacy education over the past 24 years, the past six at Binghamton, an early foray into the medical field almost took her career in a different direction. When she was 16, she volunteered as an emergency medical technician in her native Laurel, Md. She continued as a medic through her first year of college.

“When I started doing bigger ambulance calls and being the lead, this one time there was a really bad accident between a motorcycle and a vehicle, and that was a difficult situation to get through,”

Professor of Pharmacy Practice KarenBeth Bohan, right, with pharmacy students at the Blood Pressure Clinic in Masindi, Uganda.

she says. “After that, I didn’t think I could do that for the rest of my life.”

That’s when a friend casually asked, “What about pharmacy?”

Knowing little beyond what she’d seen in retail drug stores, Bohan spoke with local pharmacists about how they enjoyed their jobs. Their enthusiasm convinced her to enroll in pharmacy school at the University of Maryland, Baltimore. She found a new path.

“Pharmacists can work directly with patients and health providers in the hospital setting,” Bohan says. “They can help monitor drug therapy and recommend lab tests and talk to patients about how to get the best effects from their drugs.”

Bohan’s professional path took another unexpected turn in 2011, when she was working at Wilkes University in Pennsylvania. An anthropologist visited her office and asked, “How’d you like to go to Africa with me?”

He was working on a rural water improvement project in Uganda and an expert like Bohan, with

her knowledge of health and waterborne infections, would be a valuable addition to the research team. Once there, Bohan began a collaboration with a Ugandan pharmacy school and its students as part of her initial work on that water sanitation project.

“What I’m trying to do now is help them build a curriculum in their pharmacy program so that students know how to work with patients at a higher level and how to work on a team with doctors,” Bohan says. “They’re recognizing that clinical pharmacists can be very helpful in a hospital setting, so that’s actually a huge change.”

Bohan says there is plenty more work ahead, and while she regularly keeps in touch from Binghamton, she’s hoping to return there next summer.

“Uganda is in the very beginning of clinical pharmacy. They need pharmacists to step up and go find physicians who want to work with us,” Bohan wrote in her August blog post. “No, they are not going to pay you. Yes, the work is hard and you will not always be appreciated, but there is someone who will: the patients.”

JONATHAN COHEN

KarenBeth Bohan, professor of pharmacy practice, travels to Uganda when she is able. She is helping to build a pharmacy curriculum where there are few resources.

SWIMMING IN METFORMIN

By Jennifer Micale

Katie Edwards, assistant professor of pharmaceutical sciences, stands in the Susquehanna River, which can be impacted by pharmaceutical residue discharged into waterways.

EVERY DRUG HAS BOTH A MINIMUM AND MAXIMUM EFFECTIVE CONCENTRATION, SO WE WANT TO BE IN A ‘SWEET SPOT’ OF THAT RANGE.”

KATIE EDWARDS

Overshadowed by a green branch, Zolgensma placidly wanders through his miniature habitat in Katie Edwards’ office, fins fluttering.

His fancy moniker is an inside joke: A Binghamton University assistant professor of pharmaceutical sciences, Edwards paid a bit too much for the betta fish, so she named him after the market’s most expensive medication, used to treat spinal muscular atrophy. His predecessor, Timolol, another betta fish, had been named after a beta blocker drug.

But Zolgensma is a reminder, too, of sorts. Once medication works its way out of the human body, its chemical residue travels down sewage pipes. Sewage treatment plants aren’t geared to filter for pharmaceuticals, so another set of pipes discharges that waste into waterways — such as the nearby Susquehanna River — where fish live and breed, along with a whole chain of life that relies on those fish. What happens when those fish are exposed to this pharmaceutical residue?

It’s a question that Edwards, also a visiting professor of microbiology at Cornell University, is uniquely positioned to answer.

“My background is a little unusual for a pharmacy department,” she admits.

She worked as a synthetic organic chemist in the pharmaceutical industry, then after earning her doctorate in environmental toxicology from Cornell University, spent more than a decade in biological engineering. After that, she moved on to natural resources, then microbiology and finally a return to pharmaceutical sciences, where she investigates and teaches drug stability, drug delivery and pharmacokinetics, which deals with the timing of movement of drugs through the body.

Her environmental interests began with research into fish and vitamin B1 deficiency; also known as thiamin, it’s one of the primary cofactors

involved in converting glucose to energy and it is critical to neurological and cardiovascular function. It is an essential vitamin, meaning that it must be obtained from the diet since we can’t synthesize it ourselves. Many developed countries add thiamin to breads and rice, along with other vitamins. This supplementation is usually sufficient to prevent thiamin deficiency, although it still occurs in select populations, including people with alcohol use disorders or genetic defects that restrict its uptake. It is also a vitamin that can easily be broken down during food processing. However, dietary thiamin deficiency remains a common problem in developing countries, particularly those that rely on white rice as a staple, since most of rice’s vitamin content is located in the husk, which is removed during processing.

White rice-based diets sometimes also go handin-hand with raw fish-based diets. The problem: Aside from insufficient amounts of thiamin in the diet, some fish are known to contain the enzyme thiaminase I, which breaks down vitamin B1. This is not only a problem for people, but the issue of thiamin deficiency in aquatic organisms has surfaced in various bodies of water, from Cayuga Lake to the Pacific coast to the Baltic Sea.

Using her bioengineering and chemistry background, Edwards developed bioanalytical assays to better understand B1 deficiency, which can be complex to detect. Through a collaboration with scientists from the University of Western Ontario, fish currently in question in her lab are lake trout from Lake Ontario. Thiamin deficiency in predator fish is usually attributed to a shift in diet to prey fish containing high levels of thiaminase. This enzyme degrades the dietarily available thiamine in the predator fish, which become thiamin deficient, a condition that reduces their reproductive success and ability to withstand disease and pollution challenges.

In this stream of research, Edwards looks at the larger picture of how thiaminase I works

and how it could be inhibited. Her lab also has a project on how fishery processing steps affect thiaminase activity in Asian carp, an invasive species throughout the United States that can hopefully be increasingly harnessed by fisheries for ecological and economic benefit.

Her lab, in collaboration with colleagues at Cornell, has also been researching a purified version of this enzyme at the molecular level, recently finding what can activate and inhibit it. Thiaminase I enzymes are produced by certain bacteria pathogenic to humans and animals, including Clostridium botulinum and Paenibacillus thiaminolyticus, and can be found in certain plants, including bracken fern and horsetail. Edwards notes that “it is conceivable that thiamine depletion exacerbates the impact of C. botulinum, a bacteria yielding neurotoxic effects, on the host. Our results on its activation and inhibition at the molecular level by common dietary constituents may provide a better understanding that may benefit both human and veterinary populations.”

“I’ve been fortunate to be able to approach research challenges from different perspectives because I have applied experience in several

fields, ranging from the environmental realm to engineering to pharmaceutical synthesis,” Edwards says.

FROM INGESTION TO ENVIRONMENTAL RELEASE

Edwards’ interest in fish ultimately led to a broader question: What are the side effects of our everyday medications on the environment that surrounds us?

This began with a pilot study with her collaborators in microbiology and natural resources and the environment at Cornell University, focusing on the impact of metformin at environmental levels on microbial growth. Later, partnering with Jessica Hua, a former assistant professor of biological sciences at Binghamton, Edwards has looked at the impact of metformin on the survival and growth rates of amphibians who are often vulnerable to environmental contaminants. Hua has since left for the University of Wisconsin and Edwards has expanded her focus to fish and humans, working with external fishery partners and Nannette Cowen, a clinical associate professor of nursing at Binghamton.

Assistant Professor Katie Edwards, right, in her lab with research technician Patricia Wolfe, in blue, and undergraduate Sarah Matesic, a chemistry student in Harpur College of Arts and Sciences.

First introduced in 1958, metformin is the most widely prescribed medication for Type 2 diabetes in the United States and is used by approximately 150 million people worldwide every year.

“What’s interesting about metformin is that it is prescribed in very high doses,” Edwards says. “Normally, when we take medications, they’re in the microgram or milligram range: for example, for a common over-the-counter medication you’ll take, say, 325 milligrams of Tylenol to relieve an occasional headache. For metformin, a medication that is taken long-term for a chronic condition, it is common for people to take 2,000 milligrams a day.”

To have a therapeutic effect, a drug needs to reach a certain concentration in the blood plasma, called the minimum effective concentration. Often, there is a lag time between swallowing a pill and achieving that concentration, as the tablet dissolves in the GI tract. The concentration rises and then falls again as your body’s metabolic and excretion processes perform their necessary functions.

“Every drug has both a minimum and maximum effective concentration, so we want to be in a ‘sweet spot’ of that range,” Edwards says.

For many drugs, that range is narrow; take some blood thinners, for instance,

in which there is a fine line between therapeutic effect and toxicity. Metformin, however, has a far larger safety window, and its dosage is measured in grams rather than micrograms or milligrams. Most patients take two large pills a day; any side effects — a sour stomach, cough and diarrhea, for example — are typically mild.

When drugs are metabolized, they typically break down into other constituent substances, often to make the drug more hydrophilic, or dissolvable in water. Metformin, however, is largely hydrophilic by nature and thus not metabolized; it exits through the urine largely intact.

“When considering the dosage, number of prescriptions and lack of metabolism, it is no surprise that various reports have found it at moderately high concentrations in water downstream of wastewater treatment plants, sometimes as much as the microgram per liter range, which is the parts per billion range. Relative to concentrations in blood used therapeutically, this is a low concentration, but as far as drugs go in environmental water, it’s comparatively high. It becomes diluted, of course, but it and other commonly used drugs remain detectable significant distances in environmental water from the point of discharge,” Edwards says of wastewater.

Concentrations are small, much lower than they would be for therapeutic effect, but they can be pervasive for creatures who literally

Zolgensma, a betta fish, in his home in Assistant Professor Katie Edwards’ office.

“WHAT’S INTERESTING ABOUT METFORMIN IS THAT IT IS PRESCRIBED IN VERY HIGH DOSES ... IT IS COMMON FOR PEOPLE TO TAKE 2,000 MG/DAY.”

swim in them. Additionally, the supply from human populations and veterinary use in agriculture is continually introduced into waterways so there is constant exposure. The concern isn’t just limited to metformin, of course. Virtually any pharmaceutical can pass from the human body into wastewater and ultimately into the environment, from multivitamins to antibiotics, antidepressants and cholesterol-lowering drugs. This raises questions ranging from developing antibiotic resistance by microbes to the extent to which such compounds are reintroduced into the drinking water supply. But as wide-ranging as it is, the phenomenon is difficult to research, largely because it involves so many pharmaceuticals, from prescription drugs to over-thecounter medications.

Edwards and her collaborators at Cornell University and Saint Louis University in Missouri are looking at the concentration of vitamins in wastewater, such as the multivitamins many people take every day, and she plans to look at pharmaceutical levels in the same samples.

METFORMIN AND VITAMINS

Metformin has been touted in some circles for its potential to increase human longevity, but mysteries remain, even with a drug that’s more than 60 years old; researchers still don’t fully understand its mechanism of action, or what the drug is potentially doing at less than therapeutic doses, Edwards points out.

“It has been a widely successful drug, and understanding its mechanism of action more thoroughly may benefit future drug development,” she says.

To that end, she recently received a seed grant from Binghamton University’s Health Sciences Transdisciplinary Area of Excellence with nursing colleague Cowen to look at the impact of metformin on the metabolism of B

vitamins, and will soon be recruiting patients for a study. Edwards’ hypothesis is that metformin’s beneficial effects, including those on diabetes management and cognitive function, may partly come from increased utilization of B1. She has seen changes in gene expression and thiamin utilization at environmentally relevant concentrations in nonhuman models and cultured cells, and this collaborative study will allow translation to effects at therapeutic concentrations in human populations.

PharmD and PhD students are also aiding this research, investigating the impact of metformin on folic acid, vitamin B12 and vitamin B6 levels, and the relationship to cognitive function in their capstone and thesis research projects using data available in the Centers for Disease Control and Prevention (CDC) National Health and Nutrition Examination Survey.

Edwards’ research on metformin began in the concentration regime that was likely to be present in aquatic environments but has led to a better understanding of its mechanism at concentrations present therapeutically.

“From a pharmacy standpoint, students learn the importance of disposing of unused drugs through community drug-take-back events or drop boxes to limit unintended ingestion and potential misuse,” Edwards says. But these practices also aid in limiting environmental contamination from flushing them down the drain. We don’t yet know the full impact of sewered medications on the environment, and while the concentrations are much lower than what we know to cause toxicity, it remains possible to modulate other properties of the aquatic environment.

RAISING UP COMMUNITY

By Katie Ellis

JUST WHAT does it take to revitalize a community that has fallen on hard times?

Ask anyone on Main Street in Johnson City, N.Y., and you’ll learn that it takes commitment, hard work, like-minded partners, time — and the influx of more people.

In Johnson City, Binghamton University’s Health Sciences Campus, which includes the School of Pharmacy and Pharmaceutical Sciences, and Decker College of Nursing and Health Sciences, is part of an ongoing transformation that is bringing life back to Main Street.

The vision for the Health Sciences Campus arose from President Harvey Stenger’s Road Map to Premier strategic planning initiative in 2013, which proposed establishment of a new college or school in the life sciences. That proposal became the School of Pharmacy and Pharmaceutical Sciences — which moved into its brand-new building in Johnson City in 2018. As the campus continues to grow, with Decker College of Nursing and Health Sciences now located there, and the new pharmacy R&D building and the Ford Family Wellness Center for Seniors both nearing completion, the

...FIVE YEARS FROM NOW WE WILL BE LIKE A LITTLE SOHO AND IT WILL ALL BE WALKABLE.”

JOHNSON CITY MAYOR MARTIN MEANEY

School of Pharmacy and Pharmaceutical Sciences students

Heeral Naik and Corey Graziade, both in their first year of the PharmD program, enjoy a cup of coffee at Sole City Coffee in downtown Johnson City.

time is ripe for a resurgence and groundwork has already been laid.

Stenger has continued to build relationships and make connections between the Health Sciences Campus and Johnson City, and has introduced Kanneboyina Nagaraju, dean of the pharmacy school, to a number of merchants on Main Street.

Nagaraju says he has seen an upswing in Main Street traffic, which he considers a key to the success of the Health Sciences Campus. “The inte gration of the school into the community needs to happen at multiple levels and it’s a symbiotic relationship,” he says. “I’ve been working with some of the merchants to build relationships between our school and downtown Johnson City.

“I want to see the students walking to Main Street and I love the proximity of Main Street businesses,” Nagaraju adds. “You don’t have to drive, and people actually say ‘Hey, Raju! How are you today?’”

But Nagaraju’s not the only one who sees community building as vital for everyone.

“We’re working to increase foot traffic from the Health Sciences Campus to Main Street,” Stenger says. “That’s the outcome we want to have, with students and others walking to Main Street in between classes and at lunchtime to get a sandwich or a coffee.”

But, Stenger says, it will take three things to be successful:

• a well-lit, safe walk

• interesting things to see while walking

• entrepreneurs and business owners willing to take a chance on locating on Main Street

REVIVING THE ECONOMY

There are already positive signs according to Martin Meaney, Johnson City mayor and lifelong village resident.

Admittedly a little apprehensive when the

Meaney has walked the downtown with Stenger, Broome County Executive Jason Garnar and others. “It’s got to be visual, and we identified places that really need help and we all shared our vision,” he says. “With everyone working together — and we all have the same goal — I want to see Johnson City move forward and look nicer. It’s a common goal and it’s going to happen.”

The University has been a strong partner for the village as the Health Sciences Campus continues to grow, Meaney says. “The R&D building at the School of Pharmacy might spur a pharmaceutical company to come here. The potential is there,” he says.

But in addition to having a common goal, funding is vital. There’s hope for $10 million from the village’s Downtown Revitalization Initiative (DRI) proposal that was submitted in late September, Meaney says. Winners were not yet

JONATHAN COHEN/PEXELS

announced as of mid-January. If selected, the funds would be used for a myriad of projects.

“I think we’re ready to put on the full-court press and the DRI could push us to the finish line,” he says.

One part of that full-court press is working with building owners to see storefronts built and introducing people to possible business and dining opportunities, Meaney adds. “Once they start filling in, it will be a domino effect and a collaborative effort.”

BUILDING COMMUNITY

Others who believe in Johnson City are also putting in the work.

Rita Moelder owns The Grapevine Café at 220 Main St., which she opened about six years ago. Her Johnson City roots run deep — her mother has owned Health Beat Natural Foods a couple of doors down for years.

“I always planned on opening something like this, and then this building came up for sale after I learned that the pharmacy school was opening,” Moelder says. “That’s mostly why I chose to open

up in Johnson City rather than in Binghamton where they have so many restaurants. It was a good opportunity.”

The restaurant offers a diverse, ever-changing, healthy menu, including plenty of vegetarian, vegan and gluten-free foods; an assortment of teas; a bar; and live music on the weekends.

“I love to cook and this gives me an opportunity to make what I want,” Moelder adds. “I can get as creative as I like.”

With a good customer base to start, she’s seen more students coming in lately, she says. “We do tend to get more faculty, but we have free Wi-Fi and students come in here to do work and have coffee and lunch.”

Just down the street from The Grapevine Café, Sole City Coffee at 250 Main St. attracts patrons from the Health Sciences Campus, but also from off the highway and the greater Binghamton region, though owners Tom and Kathryn Sheredy say most of their customers are long-time Johnson City residents.

Once a cigar store among its other incarnations, Sole City was brought back to life by the Sheredys, who completely renovated the building, including removing and rebuilding the entire storefront.

They’ve paid homage to Johnson City’s roots throughout the shop, highlighting Endicott Johnson Shoes and its local history in the décor as well as the name.

And, after a great deal of research, they found a source for their house blend, someone who also roasts their beans for them.

“I don’t know how many coffees we went through before we settled on what we thought was our perfect blend,” says Kathryn Sheredy. “A lot was based on our palate.”

According to customers, they settled on a winner. “We’re pleasantly overwhelmed,” says Tom Sheredy. “Everything came together and we’ve had so much support. Members of the community come in every day and say ‘Thank you so much.’”

Rita Moelder, owner of The Grapevine Café in downtown Johnson City, explains the day’s menu to School of Pharmacy and Pharmaceutical Sciences PharmD students Arshad Ali, center, and Erin Wong.

LOOKING AHEAD

Both Moelder and the Sheredys hope to establish a stronger flow of Health Sciences Campus customers. In support of that goal, Nagaraju spearheaded an initiative to offer savings vouchers to students to entice them to patronize The Grapevine Café and Sole City Coffee.

Binghamton University and its Health Sciences Campus are an extension of the community, says Kathryn Sheredy. “People are thankful they are here and we care about the students. If it wasn’t

for Binghamton University and United Health Services, downtown Johnson City would be a ghost town.

“Once we started rebuilding Main Street and have people walking outside and seeing the parking spots filled, it has created energy,” she says. “We’re filling the empty spaces, putting the lights on and it’s no longer stagnant.”

For the merchants on Main Street, the mayor, residents and the Health Sciences Campus, rebuilding downtown Johnson City is a labor of love that is beginning to pay off.

JONATHAN COHEN

The Grapevine Café owner Rita Moelder serves School of Pharmacy and Pharmaceutical Sciences secondyear PharmD student Arshad Ali, left, and fourth-year PharmD student Erin Wong as they catch up on coursework.

PRECEPTOR

Building castles in the air

Residency program director emphasizes lifelong learning

By John Brhel

If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them.”

It’s been decades since she uttered these famous words by Henry David Thoreau in her valedictory speech at Bainbridge-Guilford High School, but they still hold true for Karen Williams. As program director of the PGY1 (postgraduate year one) pharmacy residency program at Guthrie Robert Packer Hospital in Sayre, Pa., she believes in making big dreams a reality for the early-career pharmacists under her charge.

“I have this vision of the castle in the air, the thing that we’re trying to reach, where they are an advanced practice practitioner who can function well at a very high level, taking care of patients,” says Williams. “I think most of my professional work is spent putting the foundation under that and making that something that everybody can achieve.”

When Williams found out that Binghamton University would be opening the School of Pharmacy and Pharmaceutical Sciences (SOPPS), she believed that the school would elevate the level of practice in the community.

“We were starting our residency program

at the same time Binghamton matriculated its first class,” says Williams. “So it was a unique relationship that we developed, because we very early realized that we could help each other and support each other in our goals.

“We really wanted to advance the level of our practice,” she adds. “We wanted to explore innovative ways to layer students and learners into our practice. And, of course, the school really needed a place to train its students. Obviously, it’s a win-win if you’re able to have great practice sites and great care happening in those places.”

Williams and her team help SOPPS students learn the skills and progress through the levels of learning so that they can demonstrate and perform the tasks of a pharmacist.

“They come in not really understanding or not knowing necessarily how to put those pieces together and provide that care,” says Williams. “But we teach them how to efficiently collect data, look for drug-related problems, find solutions for those problems, and then communicate the problems and the solutions to the care team and, together with the care team, come up with the best next steps for patients.”

Students in their last year of pharmacy school do a series of back-to-back, five- to six-week rotations throughout the year. For example, on Friday, they may go to one site and Monday

morning show up at a different site and start a new rotation.

“Maybe you’re inpatient for a couple of rotations, maybe you’re in retail pharmacies for a couple of rotations,” says Williams. “Maybe you do something virtual where you’re working with a pharmacy benefit manager and developing protocols or policies for the insurance company. So really, this year of experience is sampling.”

While doing a residency is not a professional requirement for pharmacists, Williams considers it a professional necessity.

“We’ve realized that students are coming out without the level of expertise to be able to practice high-level care without that year of residency,” says Williams. “To get a lot of those higher-level, direct patient-care jobs, more and more, students really need that extra year of training.”

Rachel Klosko, a clinical assistant professor at SOPPS, is a preceptor at Guthrie. She calls her colleague a role model for fellow pharmacists, residents, students and other medical staff at her institution.

“She is able to show students that no pharmacist knows everything, and we need to continually cultivate that passion for lifelong learning to provide the best patient care,” Klosko says.

Williams might do a lot, but she’d never admit to knowing it all. Every day is an opportunity to learn something new, she says.

“You never know everything and most of the time you don’t know what you don’t know,” Williams says. “It’s really important to keep your brain open and be accepting of those things that are going to make you better. And that is sort of where professional development comes in. Because I think you have to actively work at ensuring you are improving.”

Karen Williams, center, director of the PGY1 pharmacy residency program at Guthrie Robert Packer Hospital, meets with students and residents, from left, Dominick Patafio, Oluwateniayo “Teni” Sopitan, Brian Kam PharmD ’22, Keith Hughes and Kayode Medugbon.

Research Rewards

Capstone projects prove beneficial to PharmD students

By Eric Coker

THE SCHOOL of Pharmacy and Pharmaceutical Sciences’ research emphasis appealed to Nicole Ink, PharmD ’22, before she ever set foot on campus.

But being a pharmacy student took on added appeal when she learned at orientation about the school’s graduation requirement: a capstone research project.

“I’ve always loved science and have been a curious person,” Ink says. “The thought of doing research was exciting. The capstone project and its research track jumped out to me. I said to myself: ‘I want to try that.’”

Ink did more than “try.” Her project was honored at the school’s 2022 capstone poster presentation, and she is now putting her research skills to use in a clinical-pharmacy residency at Guthrie Robert Packer Hospital in Sayre, Pa.

The Candor (N.Y.) High School graduate is just one of the PharmD students who has conducted pharmacy-related research with faculty and preceptor mentors.

A fluorescence microscope image of cells treated with DNA damage agents.

Mohammad Ali directs the capstone program.

CAPSTONE TESTIMONIALS

 GRADUATES AND CURRENT PharmD candidates from the School of Pharmacy and Pharmaceutical Sciences offer some capstone tips to prospective students:

Nicole Ink: “Ask questions and push yourself. With the capstone project, you can put in extra effort and get something really valuable out of it. It’s a fantastic talking point, especially for jobs and residency applications. It’s more than just something you need to graduate. It’s a unique and valuable opportunity from Binghamton University that should be embraced.”

Joe D’Antonio: “Anyone who has independent motivation, surrounds themselves with a group of people they can rely on and chooses a project they feel strongly about will not only succeed at their capstone project, but will have a wonderful time actually doing it.”

Juhi Gurtata: “The capstone requirement is an excellent opportunity for students to learn more about a topic of their interest, work alongside faculty and learn more about what research entails. If it wasn’t for this experience, I would have never gotten out of my comfort zone to participate in such a hands-on project.”

“This is beneficial to students because it broadens their CVs, broadens their opportunities and opens their eyes about what other career paths pharmacists can take,” says Mohammad Ali, assistant professor of pharmaceutical sciences and director of the capstone program. “Pharmacists can be involved in clinical research, scientific research and even in post-doctoral fellowships with industry. The capstone program gives them a head start in those directions.”

THE ENTERPRISE AND EXPECTATIONS

Including a capstone project in the curriculum was a priority for the School of Pharmacy and Pharmaceutical Sciences when it opened in 2017, says Tracy Brooks, associate professor and vice chair of pharmaceutical sciences.

“From the get-go, the focus here has been a research-intensive pharmacy school,” says Brooks, who works with students on capstone projects. “How do we make students appreciate the value of research? How do we involve them and expose them to some degree so they can understand the research enterprise and its values and difficulties, even if their career goals don’t include research again?”

The capstone program, which Brooks says is offered only at 25%-30% of pharmacy schools nationwide, provides PharmD students the opportunity to work in a solo research track or as part of a group setting.

“I start with them early in their second (P2) year with a series of seminars that introduces them to the capstone idea, the timeline and the expectations,” Ali says.

About five to eight students per year choose the solo track, while the remaining 60-70 take part in group research, Ali and Brooks say. For the group projects, Ali asks faculty members and preceptors to submit project applications, which are then examined and chosen by a capstone committee at the school. In a capstone project

open house, the students meet with faculty members and preceptors to ask questions about projects. The research groups (usually containing four students) are then given a week to rank projects in their order of preference.

“We do our best to give them one of their top three [choices],” says Ali, who adds that there are 16-17 accepted projects per year.

In the solo research track (which has GPA requirements), students are involved in the project idea and work with faculty members or preceptors to propose their project to the capstone committee. Those students then take a

three-credit lab in their third year to prepare for and initiate the research.

“It’s like a mini-thesis,” says Brooks, who coordinates the solo tracks. “In general, the research track students want more depth in their projects.”

But the group projects also offer challenges, she says, particularly for the faculty member or preceptor making the pitch.

“It has to be something that is of interest, but not an imminent requirement,” Brooks says. “They have to come up with a proposal, but wait about a year and a half before students are

Mohammad Ali, assistant professor of pharmaceutical sciences, right, with members of one of his capstone research project teams: left to right, Shirley Xu, Michelle Yeung, Deanna Maybee and Keira Farrell. Not pictured, team member Majda Bouregba.

Assistant Professor of Pharmaceutical Sciences Tony Davis gives direction to Kaiyu Tio, an undergraduate student in Harpur College of Arts and Sciences working in the Davis Lab.

actually with them to do it.”

All students work on projects during their final year and make a poster presentation in the weeks before graduation.

FROM INTIMIDATION TO EXCITEMENT

By the time students present their capstone posters, they are feeling assured and have gained a great deal of research knowledge. For many, it’s a far cry from the initial capstone discussions as P2 students.

Ink says she felt unsure about herself before embarking on a project with Ali examining DNA damage repairs in cancer cells.

“I gained a lot of confidence,” she says of the experience. “I started at Binghamton hesitant and afraid to make a mistake. As I went on, it was exciting to see this novel idea [grow]. I stopped worrying and focused more on what was happening with the project.”

Joseph D’Antonio, a 2023 Doctor of Pharmacy candidate from Hauppauge, N.Y., admits to being nervous when he first learned about the capstone requirement while interviewing at the pharmacy school in early 2019.

“To the uninitiated it can seem like a large and daunting task,” he says. “In our third year, we got to choose our research project and I have been beyond excited ever since. … When you read the school information resources and see ‘capstone — requirement’ listed in the fourth year, it automatically makes it feel intimidating. This feeling was exceptionally misplaced, but caused me to waste quite a bit of time being anxious about it looming on the horizon throughout my pharmacy-school career.”

D’Antonio is now working with fellow PharmD candidates Juhi Gurtata, Mana Halaji Dezfuli and Eric Kelly on a project mentored by Tony Davis, assistant professor of pharmaceutical sciences, on drug molecules that might inhibit a key protein that plays a role in the tuberculosis proteasome pathway.

Gurtata says she was “indifferent” about

EXTERNAL PRECEPTORS

 BESIDES FACULTY MEMBERS, PharmD students get the opportunity to work with external preceptors from Northwell Health, Guthrie Robert Packer Hospital, Bassett Medical Center and even community pharmacies. In 2021, Bassett anesthesiologist Linda Demma and Bassett clinical pharmacy specialist Amanda Winans mentored students in a project that researched pain-management options for patients on opioid or blocker drugs.

Demma and Winans called the experience “mutually beneficial.”

“We share our knowledge and experiences with the students, and in return we learn from the students as well,” Winans says. “It allows for shared experiences on a larger level, affording dissemination of our findings to other regional and national platforms for greater benefit within the healthcare community.”

External preceptors such as clinical staff also bring a perspective that is different from faculty mentors, they say.

“Full-time clinical practice allows for routine encounters with complex patients and clinical conundrums that prompt research-related questions on a regular basis,” Winans says. “The students experience the full depth of research, beginning and ending with actual impacts on patient care.”

JONATHAN COHEN

Brooks

Tony Davis, assistant professor of pharmaceutical sciences, is surrounded by members of his capstone research group, all fourth-year students. Clockwise from left, Mana Halaji Dezfuli, Joseph D’Antonio, Eric Kelly and Juhi Gurtata.

the capstone requirement until examining the research projects proposed by the pharmacy school’s faculty.

“I got to learn more about the professors and their areas of interest, along with learning what interests me to potentially do research in,” says Gurtata, who adds that the capstone project has been one of her best experiences as a pharmacy student.

RESULTS AND CONCLUSIONS

During the capstone process, students often discover that science does not always work as planned, Brooks says. And that’s OK.

“We see failures all the time,” she says. “It’s a normal thing. You have to revise on the fly. In science, you can come up with a great idea and it doesn’t go the exact way you planned. So

you’ve got to go with the flow.”

It’s a lesson that D’Antonio and his group have already learned.

“Research is not straightforward,” he says. “There can be a massive difference between theoretical and practical pharmaceutical science, and in order to succeed in the research field it requires that you maintain a certain level of broad vision. This comes in handy when results of a given experiment end up not being in line with your hypothesis. It allows you the ability to step away from the protocol and question why things turned out how they did. From there you can go back and make small tweaks and adjustments to confirm your initial results and make improvements.

“Our particular research is important because tuberculosis is still one of the leading causes of infectious disease deaths in the world,” D’Antonio says. “Exploring the repurposing of existing therapeutics to perhaps treat this grave disease could perhaps one day save millions of lives.”

For Ink, conducting research in the capstone program led to her interest in oncology. The Guthrie residency has “scratched the itch” for still being involved in research, she says.

“I love working with patients and I love research,” she says. “One thing that made me go to residency is that we also [conduct] research there. It’s clinically based, but it’s also correcting data and determining results. It’s solving a puzzle that can lead to benefits for patient outcomes.”

The capstone program helps students such as Ink because it is a “differentiation,” Brooks says, as the research experience will make their pharmacy education and background stand out.

“It’s also going to help them appreciate science: new ideas, new drugs, the evaluation of one drug over another,” she says. “They can appreciate what comes behind all of those new discoveries, recommendations and guidelines. Even if students never do research, they can at least appreciate its value in the clinical field.”

EXCELERATE: WHAT WILL THE CAMPAIGN DO FOR THE SCHOOL OF PHARMACY AND PHARMACEUTICAL SCIENCES?

Binghamton University publicly launched its $220 million EXCELERATE: Moving at the Speed of Binghamton campaign in April 2022 — its third and largest campaign by far. Remedies sat down with Dean Kanneboyina Nagaraju to talk about his priorities for the campaign and what it will do for the School of Pharmacy and Pharmaceutical Sciences.

Help recruit and retain tenure-track faculty, split between the departments of Pharmacy Practice and Pharmaceutical Sciences, with appropriate startup funds.

Two faculty positions are already approved for fall 2023, and both will be interdisciplinary, with a primary appointment in pharmacy and a joint appointment with Decker College of Nursing and Health Sciences, Nagaraju says. One position, in collaboration with Decker College and its Motion Analysis Research Lab (MARL) will focus on frailty and aging and how we can model and understand the biomarkers of the changes that come with aging.

The second position will focus on investigating exercise mimetics, a class of drugs that mimic or enhance the therapeutic effects of exercise, especially in individuals who are nonambulatory.

“We’re initially focusing on these two positions because we already have expertise in muscle research,” Nagaraju says. “But if we want to build in a new direction and have the ability to develop interdisciplinary research, our foundation needs to be broader and strong.”

Additional faculty will allow Nagaraju to reduce each faculty member’s teaching load so they can focus on research, he adds. “That’s equally true for pharmacy practice faculty, not just pharmaceutical sciences,” he says. “I want tenure-track faculty in practice, but they have to have high-quality clinical research.”

Develop new programs at the master’s and certificate levels that will enhance the learning environment.

• A master’s degree in biopharmaceutical manufacturing: Biologics and immunotherapies are transforming the therapeutic landscape for many diseases, including cancer and autoimmune diseases. “There are not many programs that train scientists for these emerging therapies,” Nagaraju says. “Instead, people just evolve into positions, but with a master’s program, we could give them turnkey people.”

• A pharmacy technician certificate program: “This is a numberone priority for local hospitals,” Nagaraju says. “We could offer a low-cost program that will provide interns to these hospitals while students learn skills that will allow them to begin a career in pharmacy.”

With scholarship support, bring in high-quality students.

“We are not here to simply fill seats,” Nagaraju says. “We are here to develop the next leaders in pharmacy and pharmaceutical sciences.”

Gifts of any amount can also be made to the Binghamton Fund for the School of Pharmacy and Pharmaceutical Sciences, which provides immediate-use dollars that can be used to fund the dean’s priorities and, thereby, the campaign priorities.

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JONATHAN COHEN

SCHOOL OF PHARMACY AND P HARMACE UTI CAL SC IE NCES

Ricky Lam, PharmD ’22, pictured near his computer that displays a microscopic image of a dystrophic tissue that was stained with immunofluorescence, in Associate Professor of Pharmaceutical Sciences Aaron Beedle’s laboratory in the School of Pharmacy and Pharmaceutical Sciences in July 2021.