Honors College Thesis
 

Effects of phenytoin and carbamazepine on calcium transport in Caco-2 cells and pilot study to compare the role of the Chilean and United States pharmacist from the patient perspective

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  • Adverse effects of anti-epileptic (AED) medications on bone density have been reported since the 1960s. Phenytoin and carbamazepine, two commonly prescribed AED, are frequently associated with osteomalacia including fractures and reduced bone formation. The mechanism by which AED induces bone loss is not fully explained. We sought to determine the effects of AED on calcium transport using Caco-2 cells. Our hypothesis is that carbamazepine and phenytoin would inhibit calcium transport from the apical to the basolateral side of Caco-2 cells grown on semi-permeable supports. Caco-2 cells, derived from a human colon adenocarcinoma, are a model system for study of the function of the intestinal epithelium. Our data demonstrates that phenytoin and carbamazepine dose-dependently inhibit active calcium transport from the apical to basolateral side of Caco-2 cells under physiologic calcium conditions. Vitamin D ameliorates the AED-induced decrease in calcium permeability. Patient perceptions of the retail pharmacist were studied to identify common themes and differences in Chile and Oregon and propose areas for improving patient care. Our hypothesis is that patient perceptions will depend on population size served by a pharmacy. With better patient care pharmacists can improve medication outcomes for patients and avoid some side effects.
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