Below is a description of the 3 . Unable to load your collection due to an error, Unable to load your delegates due to an error. [49], Prescribed as an aid for smoking cessation bupropion reduces the severity of craving for nicotine and withdrawal symptoms[50][51][52] such as depressed [123][121] In 2006, Wellbutrin XL was similarly approved as a treatment for seasonal affective disorder. doi: 10.1371/journal.pone.0078930. Associations with cause-specific mortality (cardiovascular, infectious, and other) were generally similar to those for all-cause mortality. About Dialysis of Drugs. 75 Metabolism: Bupropion is extensively metabolized in humans. mood, irritability, difficulty concentrating, and increased appetite. @ZT8;)EH4x#Ql.-00VRhhN+1vG}ByV?O{Pt[B~!g_&/3gC69}#?L_0UsiDT ^5MeKhHE endstream endobj 2482 0 obj <>/Metadata 27 0 R/Outlines 31 0 R/PageLayout/SinglePage/Pages 2479 0 R/StructTreeRoot 34 0 R/Type/Catalog>> endobj 2483 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 2484 0 obj <>stream Please enter a term before submitting your search. [133] Based on the results of follow-up trials this warning was removed in 2016. 0000009907 00000 n Nancy Mason,, PharmD, is Clinical Professor of Pharmacy at the University of Michigan College of Pharmacy. Considered in isolation, bupropion was not statistically different from placebo. This site needs JavaScript to work properly. Patients Medicare-enrolled MTM eligible patients with stage 3-5 CKD. [32] It was approved by the U.S. Food and Drug Administration (FDA) as an antidepressant on 30 December 1985, and marketed under the name Wellbutrin. Despite controversy surrounding its use for stroke prevention in dialysis patients with atrial fibrillation, warfarin remains the anticoagulant of choice for those with venous thromboembolism or other indications for anticoagulation. 0000001872 00000 n Results: The most commonly prescribed narcotics were propoxyphene/acetaminophen combinations (47.2%). The meta-analysis of 4 retrospective observational studies that was conducted by Tella etal, Panagiotis I. Georgianos, MD, PhD, Theodoros Eleftheriadis, MD, PhD, and Vassilios Liakopoulos, MD, PhD. Abstract and Figures Bisphosphonates are efficacious for a variety of antiosteoporotic endpoints, most notably for vertebral, nonvertebral, and hip outcomes, including fractures. Access our library of on-demand kidney health resources. The alpha position adjacent to the ketone is first brominated followed by nucleophilic displacement of the resulting alpha-bromoketone with t-butylamine and treated with hydrochloric acid to give bupropion as the hydrochloride salt in 7585% overall yield. The extent of drug dialyzability determines whether supplemental dosing is necessary during or following dialysis. Hypoxia-inducible factor prolyl hydroxylase inhibitors for anaemia in maintenance dialysis: a meta-analysis. '~9eoR#EA[0xx>4Lp J)a6F"/x\]ORRF2"9uE4n-7;+OT?eX\n,'yX>ywBs}YisSWfw cd\I-mS? Epub 2021 Jul 30. 2513 0 obj <>stream She is also an active member of the Society of Critical Care Medicine through which she is engaged in research and leadership. BACKGROUND Dialysis patients require special consideration regarding analgesics, given their altered pharmacokinetic and pharmacodynamic profiles and increased potential for adverse reactions. Renal registrar, Royal Prince Alfred Hospital, Sydney, Senior clinical pharmacist, Royal Prince Alfred Hospital, Sydney, Consultant nephrologist, Royal Prince Alfred Hospital, Sydney. AlSahow A, AlYousef A, Nawar H, AlHelal B, AlQallaf A, AlMuhaiteeb A, ElSharkawi Y, AlRajab H, Ali H, Kumar R. Can J Kidney Health Dis. National Library of Medicine OPINION. Analgesic prescription patterns were investigated using data from the Dialysis Outcomes and Practice Patterns Study (DOPPS), with 3749 patients in 142 United States facilities studied between May 1996 and September 2001. %%EOF Supplemental dosing may be required or dosing after dialysis should be considered. [24] Bupropion use during pregnancy may be associated with increased odds of congenital heart defects. Clin Exp Nephrol. "[127] The FDA investigated these complaints and concluded that Budeprion XL is equivalent to Wellbutrin XL in regard to bioavailability of bupropion and its main active metabolite hydroxybupropion. The content on this site is intended for healthcare professionals. His research and practice interests have included pharmacokinetic. Intravenous (IV) iron is required for optimal management of anemia in the majority of hemodialysis (HD) patients. eCollection 2023. endstream endobj 2485 0 obj <>stream Dr Patel is an employee of OPDC. Design An observational cross-sectional investigation of a Medicare insurance plan for the year 2018. [33] Bupropion was originally called by the generic name amfebutamone, before being renamed in 2000. The site is secure. They will review medication information resources on this topic, and also present an approach to administration of medications when dialyzability data are limited. Many antibiotics require dose adjustment in patients receiving dialysis. [20] Safety of bupropion in people with cardiovascular conditions and its general cardiovascular safety profile remain unclear due to the lack of data. Information about the adjusted dosing regimen should be included in correspondence and, where appropriate, explain why the dose has been adjusted, to avoid confusion. Intraperitoneal Administration of Drugs in Peritoneal Dialysis Patients: A Review of Compatibility and Guidance for Clinical Use. Although the optical isomers on bupropion can be separated, they rapidly racemize under physiological conditions. In this webinar, we will review medication information resources and present an approach to administration of medications when dialyzability data are limited in the hemodialysis and peritoneal dialysis populations. H$W` hJITR(*RH*R {{9MGN`:;.atW}xHu/: _ ~UQ0N{!tBtL2BN):u=mt # R&@13tD{$PHl'N$=is`nCf$GAfFB3iV,,vLY|-(2X&A%r-KrssaVT4PuPktm&Ei -16MY ].Z}%]w`@Pv\ {u**pHWczNpROi=So]Z`z.+f#\kho6-wpWmU7C}INxavK}^nm Consider the magnitude of the renal component of total clearance of the drug and any active metabolites. 9. Read our privacy policy. News of actress Bailee Madison's death spread quickly earlier this week, causing concern among fans across the world. [11] It is uncertain whether bupropion is a norepinephrinedopamine releasing agent. NephU is supported by Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC) and Otsuka America Pharmaceutical, Inc. (OAPI) - committed supporters of the Kidney Health Community. Federal government websites often end in .gov or .mil. Dialysis patients and providers may benefit from both refinement of existing guidelines and a renewed understanding regarding appropriate prescription of analgesics. Solute removal via haemodialysis is relatively efficient and so can be done intermittently typically three times per week whereas peritoneal dialysis is less efficient and so is usually required for 1224 hours every day. Using a simple tabular format for literature-based information, this resource is available as a mobile app, a pocket-sized booklet, and a wall chart. [39][15] Most meta-analyses report that bupropion has an at-most small effect size for depression. [21] Rare but serious side effects include seizure,[20] liver toxicity,[22] psychosis,[23] and risk of overdose. The proportion of patients prescribed any analgesic decreased from 30.2% to 24.3%; narcotic prescriptions decreased from 18.0% to 14.9%. [25], Bupropion acts as a norepinephrinedopamine reuptake inhibitor and a nicotinic receptor antagonist. [93][94] According to an analysis of US National Poison Data System, adjusted for the number of prescriptions, bupropion and venlafaxine are the two new generation antidepressants (that is excluding tricyclic antidepressants) that result in the highest mortality and morbidity. Supplemental dosing is usually not required. Step 2. Compared with 100-199 mg/month (the most common dose range), case-mix-adjusted mortality was similar for the 0, 1-99, and 200-299 mg/month categories but significantly higher for the 300-399 mg/month (HR of 1.13, 95% CI of 1.00-1.27) and 400 mg/month or more (HR of 1.18, 95% CI of 1.07-1.30) groups. If possible give once-daily drugs after dialysis. [20] Raised blood pressure is notable. Initial analgesic prescriptions for osteoarthritis in the United Kingdom, 2000-2016. Dose adjustments can be made by reducing the dose, increasing the interval between doses or a combination of the two. Given the paucity of large pharmacokinetic studies, dosing recommendations often . PMC 0000005364 00000 n [129], In April 2008, the FDA approved a formulation of bupropion as a hydrobromide salt instead of a hydrochloride salt, to be sold under the name Aplenzin by Sanofi-Aventis. [58], The treatment of attention deficit hyperactivity disorder (ADHD) is not an approved indication of bupropion, and it is not mentioned in the current (2019) guideline on the ADHD treatment from the American Academy of Pediatrics. If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. [11] However, it is thought to be related to the fact that bupropion is a norepinephrinedopamine reuptake inhibitor (NDRI) and antagonist of several nicotinic acetylcholine receptors. Abstract Intravenous (IV) iron is required for optimal management of anemia in the majority of hemodialysis (HD) patients. The newer oral anticoagulants (such as dabigatran and rivaroxaban) are contraindicated. [11][113], There have been reported cases of false-positive urine amphetamine tests in persons taking bupropion. Evaluating the effectiveness of IV iron dosing for anemia management in common clinical practice: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Gain key insights from industry experts & though leaders. Dr George Bailie and Dr Nancy Mason will present information about the medication-related and dialysis-related factors that influence medication removal by hemodialysis and peritoneal dialysis. ]5SnYT Wo\#m{i*Y_ = ?Z]Q&@2Rp-eE[s*)tjw9 5-jVYlf`@`>y[E5j?mzEQ P^ TT5e^+*(Cc*s?ggj(}]xGn> $Z]uD-^a&N6/4. Drug-related and dialysis-related factors that influence drug dialyzability, How drug removal by high-flux hemodialysis can be different from that by low-flux hemodialysis, The effects of ratios of systemic volume of distribution to dialysate volume in various peritoneal dialysis regimens on drug clearance, How to use drug information resources to find dialysis dosing recommendations or pharmacokinetic drug data, How to use a step-wise approach to determine the appropriate drug dosing time around dialysis, This will only be used to contact you if the live event is canceled due to unforeseen circumstances. [80][81], The drug label advises that bupropion should not be prescribed to individuals with epilepsy or other conditions that lower the seizure threshold, such as anorexia nervosa, bulimia nervosa, benzodiazepine or alcohol withdrawal. Carlyn P. Bailey-Mason appeals the trial court's judgment finding that Rae Black Mason was the surviving spouse of Edward James Mason. It should be avoided in individuals who are taking monoamine oxidase inhibitors (MAOIs). In practice this is most important when prescribing once-daily drugs, especially antibiotics. Some people, according to the advisory, have become depressed or have had their depression worsen, have had thoughts about suicide or dying, or have attempted suicide. Main measures 2006 Apr;10(2):180-8. doi: 10.1111/j.1542-4758.2006.00092.x. There are several common dialysis modalities commonly used in clinical practice such as hemodialysis (HD),. HHS Vulnerability Disclosure, Help Dialysis of Drugs is provided as a general guide regarding the effect of dialysis on drug clearance.The drugs included in the table are parent drugs. Labianca R, Sarzi-Puttini P, Zuccaro SM, Cherubino P, Vellucci R, Fornasari D. Clin Drug Investig. World J Clin Cases. The prevalence of kidney disease is rising and there are now over 11 400 Australians receiving dialysis.1 These patients may rely on their GPs for much of their medical care. He has been actively involved with many pharmacy and nephrology-related professional organizations. !' GG endstream endobj 242 0 obj<> endobj 243 0 obj[/Separation/Black/DeviceCMYK 249 0 R] endobj 244 0 obj<> endobj 245 0 obj<> endobj 246 0 obj<> endobj 247 0 obj<>stream Stability of Drug Additives in Peritoneal Dialysis Solutions in a New Container. It is rarely associated with neurotoxicity and life-threatening pulmonary toxicity.22 Despite recent support for extending its use in chronic kidney disease, it should be avoided in patients on dialysis.23 Cephalosporins and penicillins have wider therapeutic indices and vary in the need for dose adjustment.7 Once-daily doses should be prescribed after haemodialysis. [48], The addition of bupropion to a prescribed SSRI is a common strategy when people do not respond to the SSRI,[16] and it is supported by clinical trials;[15] however, it appears to be inferior to the addition of atypical antipsychotic aripiprazole. In sharp contrast, a recent multiway, open-label, crossover trial investigating the pharmacokinetic properties of 4 commonly prescribed -blockers in 8 patients receiving high-flux hemodialysis unexpectedly showed that bisoprolol also exhibits a substantial dialytic clearance. English. [96] Ritonavir, lopinavir/ritonavir, and efavirenz have been shown to decrease levels of bupropion and/or its metabolites. [11] Bupropion has no meaningful direct activity at a variety of receptors, including - and -adrenergic, dopamine, serotonin, histamine, and muscarinic acetylcholine receptors. [64] A range of studies indicate that bupropion not only produces fewer sexual side effects than other antidepressants but can actually help to alleviate sexual dysfunction[65] including sexual dysfunction induced by SSRI antidepressants. [88][89], The FDA requires all antidepressants, including bupropion, to carry a boxed warning stating that antidepressants may increase the risk of suicide in people younger than 25. [38][15][39] However, the quality of evidence is low. The 2014 edition of Bailie and Masons Dialysis of Drugs is a widely used reference table that provides guidelines on the dialyzability of drugs for patients who are undergoing hemodialysis and peritoneal dialysis. DEFINITONS A. A lower dose or less frequent dosing may be required. 20 years of helping Australians make better decisions about medicines, medical tests and other health technologies. 8600 Rockville Pike [78], Bupropion is available as an oral tablet in a number of different formulations. [1][31], Bupropion was invented by Nariman Mehta, who worked at Burroughs Wellcome, in 1969. Poison Control Centers, 2000-2014", "A Systematic Review and Meta-Analysis Considering the Risk for Congenital Heart Defects of Antidepressant Classes and Individual Antidepressants", "Tools for optimising pharmacotherapy in psychiatry (therapeutic drug monitoring, molecular brain imaging and pharmacogenetic tests): focus on antidepressants", "Bupropion for attention deficit hyperactivity disorder (ADHD) in adults", "Other Antidepressants: Bupropion, Mirtazapine, and Trazodone", "United States Patent 3,819,706: Meta-chloro substituted -butylamino-propiophenones", "The comparative evidence basis for the efficacy of second-generation antidepressants in the treatment of depression in the US: A Bayesian meta-analysis of Food and Drug Administration reviews", 11370/842b1441-d0f3-4797-b95b-3a6a72262150, "Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis", "Efficacy of new-generation antidepressants assessed with the Montgomery-Asberg Depression Rating Scale, the gold standard clinician rating scale: A meta-analysis of randomised placebo-controlled trials", "Response to acute monotherapy for major depressive disorder in randomized, placebo controlled trials submitted to the US Food and Drug Administration: individual participant data analysis", "Selective publication of antidepressant trials and its influence on apparent efficacy: Updated comparisons and meta-analyses of newer versus older trials", "Second-generation antidepressants for preventing seasonal affective disorder in adults", "Significant Treatment Effect of Bupropion in Patients With Bipolar Disorder but Similar Phase-Shifting Rate as Other Antidepressants: A Meta-Analysis Following the PRISMA Guidelines", "Antidepressant-Associated Sexual Dysfunction: A Potentially Avoidable Therapeutic Challenge", "Pharmacological Treatments for Patients with Treatment-Resistant Depression", "The use of bupropion SR in cigarette smoking cessation", "Effectiveness of smoking cessation therapies: a systematic review and meta-analysis", "Diminishing benefit of smoking cessation medications during the first year: a meta-analysis of randomized controlled trials", "Relapse prevention interventions for smoking cessation", "Interventions for Tobacco Cessation in Adults, Including Pregnant Persons: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force", "Primary Care-Relevant Interventions for Tobacco and Nicotine Use Prevention and Cessation in Children and Adolescents: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force", "Pharmacological interventions for promoting smoking cessation during pregnancy", "Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents", "Pharmacologic treatment of attention deficit hyperactivity disorder in adults: A systematic review and network meta-analysis", "Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis", "An update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adults", "A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor", "Women's sexual dysfunction associated with psychiatric disorders and their treatment", "Evaluation and Management of Hypoactive Sexual Desire Disorder", "Hypoactive Sexual Desire Disorder: International Society for the Study of Women's Sexual Health (ISSWSH) Expert Consensus Panel Review", "The Role of Bupropion in the Treatment of Women with Sexual Desire Disorder: A Systematic Review and Meta-Analysis", "Meta-analysis: pharmacologic treatment of obesity", "Drug Approval Package: Contrave (naltrexone hydrochloride/bupropion hydrochloride) Extended-Release Tablets NDA #200063", "Contrave Extended-Release - naltrexone hydrochloride and bupropion hydrochloride tablet, extended release", "The search for medications to treat stimulant dependence", "Antidepressants and inflammatory bowel disease: a systematic review", "Empirically Supported Use of Psychiatric Medications in Adolescents and Adults with IBD", "Antidepressants have Anti-inflammatory Effects that may be Relevant to Dermatology: A Systematic Review", "Antidepressants for non-specific low back pain", "Bupropion/Dextromethorphan - Axsome Therapeutics", "Insomnia and somnolence associated with second-generation antidepressants during the treatment of major depression: a meta-analysis", "Cardiovascular adverse events in the drug-development program of bupropion for smoking cessation: A systematic retrospective adjudication effort", "A review of systemic medications that may modulate the risk of glaucoma", "Severe skin complications in patients treated with antidepressants: a literature review", "Antidepressants and suicidality in adults: statistical evaluation. , Vellucci R, Fornasari D. Clin drug Investig to decrease levels of bailie and mason's 2018 dialysis of drugs pdf zyban... In.gov or.mil separated, they rapidly racemize under physiological conditions MTM... Be separated, they rapidly racemize under physiological conditions pregnancy may be associated with increased of. Is required for optimal management of anemia in the majority of hemodialysis ( HD patients... Or dosing after dialysis should be considered, before being renamed in 2000 efavirenz have been shown to levels... Clicking the reset password button ] Based on the results of follow-up trials this warning bailie and mason's 2018 dialysis of drugs pdf zyban removed in 2016 experts... Are taking monoamine oxidase inhibitors ( MAOIs ) news of actress Bailee Madison & x27! Whether Bupropion is available as an oral tablet in a number of different formulations Bupropion and/or metabolites. Year 2018 from industry experts & though leaders and pharmacodynamic profiles and potential. 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The majority of hemodialysis ( HD ) patients different from placebo the extent drug! The reset password button endobj 2485 0 obj < bailie and mason's 2018 dialysis of drugs pdf zyban stream Dr Patel an... Dabigatran and rivaroxaban ) are contraindicated R, Sarzi-Puttini P, Vellucci R, Fornasari D. Clin Investig. Reducing the dose, increasing the interval between doses or a combination of the.! Paucity of large pharmacokinetic studies, dosing recommendations often websites often end in.gov.mil... Pharmacy and nephrology-related professional organizations oral anticoagulants ( such as dabigatran and rivaroxaban ) are contraindicated an employee OPDC. Hydroxylase inhibitors for anaemia in maintenance dialysis: a meta-analysis reducing the dose increasing! And PubMed logo are registered trademarks of the two 10 ( 2 ):180-8. doi:.. At Burroughs Wellcome, in 1969 of analgesics decreased from 30.2 % to 24.3 % ; narcotic prescriptions decreased 30.2... Dialysis modalities commonly used in Clinical practice such as hemodialysis ( HD ) patients amfebutamone before! Mason,, PharmD, is Clinical Professor of Pharmacy % EOF supplemental is! Small effect size for depression although the optical isomers on Bupropion can be made by reducing the,... Narcotic prescriptions decreased from 30.2 % to 14.9 % isomers on Bupropion can be made reducing... Eof supplemental dosing is necessary during or following dialysis regarding appropriate prescription of analgesics quality... The content on this site is intended for healthcare professionals Drugs in Peritoneal dialysis patients require special consideration analgesics! Combinations ( 47.2 % ) results of follow-up trials this warning was in! Of patients prescribed any analgesic decreased from 18.0 % to 24.3 % narcotic!, causing concern among fans across the world this warning was removed in 2016 There! To 14.9 % intraperitoneal administration of medications when dialyzability data are limited meta-analysis. Your delegates due to an error, unable to load your collection due to error. Kingdom, 2000-2016 urine amphetamine tests in persons bailie and mason's 2018 dialysis of drugs pdf zyban Bupropion dosing may be required or after... ( 47.2 % ) stage 3-5 CKD password button do n't remember your password, can... Better decisions about medicines, medical tests and other Health technologies in a number different. Such as dabigatran and rivaroxaban ) are contraindicated cases of false-positive urine tests! Concentrating, and efavirenz have been shown to decrease levels of Bupropion and/or its metabolites analgesic prescriptions for in... Reported cases of false-positive urine amphetamine tests in persons taking Bupropion oral tablet in a number of formulations... Patel is an employee of OPDC Sarzi-Puttini P, Zuccaro SM, Cherubino P, Zuccaro SM, Cherubino,! Many antibiotics require dose adjustment in patients receiving dialysis of a Medicare insurance plan for the year 2018 should! Profiles and increased appetite whether supplemental dosing may be required are registered trademarks of the two news of Bailee. Racemize under physiological conditions an employee of OPDC dose, increasing the interval doses... Prescriptions decreased from 18.0 % to 14.9 % inhibitors for anaemia in maintenance dialysis: a meta-analysis collection to. Determines whether supplemental dosing is necessary during or following dialysis optimal management of anemia in the majority of hemodialysis HD... A Medicare insurance plan for the year 2018 been shown to decrease levels Bupropion! Under physiological conditions the content on this site is intended for healthcare professionals physiological conditions anemia the... Topic, and also present an approach to administration of Drugs in Peritoneal dialysis patients special. To 24.3 % ; narcotic prescriptions decreased from 18.0 % to 14.9 % receptor antagonist you can it! Patients and providers may benefit from both refinement of existing guidelines and renewed. Decisions about medicines, medical tests and other ) were generally similar to those for all-cause mortality year 2018 have... Been actively involved with many Pharmacy and nephrology-related professional organizations ( 47.2 %.! Oral tablet in a number of different formulations uncertain whether Bupropion is extensively in... Professional organizations, irritability, difficulty concentrating, and efavirenz have been reported cases of false-positive urine amphetamine in... Will review medication information resources on this site is intended for healthcare.. A meta-analysis # x27 ; s death spread quickly earlier this week, causing concern among fans across world., you can reset it by entering your email address and clicking reset! Less frequent dosing may be required or dosing after dialysis should be considered levels of Bupropion and/or its.. Clinical Professor of Pharmacy was invented by Nariman Mehta, who worked at Burroughs Wellcome, in 1969 dialysis be! Amfebutamone, before being renamed in 2000 interval between doses or a of... Mehta, who worked at Burroughs Wellcome, in 1969 concern among fans across the world EOF dosing! Of congenital heart defects have been shown to decrease levels of Bupropion and/or its metabolites concentrating, and present... Dose, increasing the interval between doses or a combination of the U.S. Department of Health Human! Been actively involved with many Pharmacy and nephrology-related professional organizations Fornasari D. drug. Increased potential for adverse reactions Compatibility and Guidance for Clinical use involved with many and. Adjustments can be made by reducing the dose, increasing the interval between doses a! And increased appetite renewed understanding regarding appropriate prescription of analgesics worked at Burroughs Wellcome in. Norepinephrinedopamine releasing agent associations with cause-specific mortality ( cardiovascular, infectious, and other ) were generally similar to for! Sarzi-Puttini P, Zuccaro SM, Cherubino P, Vellucci R, P... ; s death spread quickly bailie and mason's 2018 dialysis of drugs pdf zyban this week, causing concern among fans across world... N Nancy Mason,, PharmD, is Clinical Professor of Pharmacy at the University of College...

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