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International Journal of Environmental... Apr 2021The multiplicity of dosing frequencies that are attached to medication orders poses a challenge to patients regarding adhering to their medication regimens and...
The multiplicity of dosing frequencies that are attached to medication orders poses a challenge to patients regarding adhering to their medication regimens and healthcare professionals in maximizing the efficiencies of health care service delivery. A multidisciplinary team project was performed to simplify medication regimens to improve the computerized physician order entry (CPOE) system to reduce the dosing frequencies for patients who were discharged from the hospital. A 36-month pre-test-post-test study was performed, including 12-month pre-intervention, 12-month intervention, and 12-month post-intervention periods. Two-pronged strategies, including regimen standardization and prioritization, were devised to evaluate the dosing frequencies and prescribing efficiency. The results showed that the standardized menu reduced the dosing frequencies from 4.3 ± 2.2 per day in the pre-intervention period to 3.5 ± 1.8 per day in the post-intervention period ( < 0.001). In addition, the proportion of patients taking medications five or more times per day decreased from 40.8% to 20.7% ( < 0.001). After prioritizing the CPOE dosing regimen, the number of pull-down options that were available reflected an improvement in the prescribing efficiency. Our findings indicate that concerted efforts in improving even a simple change on the CPOE screen via standardization and prioritization simplified the dosing frequencies for patients and improved the physicians' prescribing process.
Topics: Hospitals; Humans; Medical Order Entry Systems; Medication Errors; Pharmaceutical Preparations; Republic of Korea
PubMed: 33924431
DOI: 10.3390/ijerph18084086 -
Drug Development and Industrial Pharmacy Jun 2015Identification of lead compounds with higher molecular weight and lower aqueous solubility has become increasingly prevalent with the advent of high throughput...
Identification of lead compounds with higher molecular weight and lower aqueous solubility has become increasingly prevalent with the advent of high throughput screening. Poor aqueous solubility of these lipophilic compounds can drastically affect the dissolution rate and subsequently the drug absorbed in the systemic circulation, imposing a significant burden of time and money during drug development process. Various pre-formulation and formulation strategies have been applied in the past that can improve the aqueous solubility of lipophilic compounds by manipulating either the crystal lattice properties or the activity coefficient of a solute in solution or both, if possible. However, despite various strategies available in the armor of formulation scientist, solubility issue still remains an overriding problem in the drug development process. It is perhaps due to the insufficient conceptual understanding of solubility and dissolution phenomenon that hinders the judgment in selecting suitable strategy for improving aqueous solubility and/or dissolution rate. This article, therefore, focuses on (i) revisiting the theoretical and mathematical concepts associated with solubility and dissolution, (ii) their application in making rationale decision for selecting suitable pre-formulation and formulation strategies and (iii) the relevant research performed in this field in past decade.
Topics: Animals; Chemistry, Pharmaceutical; Drug Design; High-Throughput Screening Assays; Humans; Models, Theoretical; Molecular Weight; Pharmaceutical Preparations; Solubility
PubMed: 25342479
DOI: 10.3109/03639045.2014.971027 -
Home Health Care Services Quarterly 2021In Japan, the mean time spent on preparing and administering medications each day for everyone in care facilities has been reported to be 163 min. Most caregivers that...
In Japan, the mean time spent on preparing and administering medications each day for everyone in care facilities has been reported to be 163 min. Most caregivers that administer medications to the elderly in care facilities have reported that this responsibility is a burden. We developed a drug distribution support device (DDSD) for caregivers, which was then installed in a group home and a 3-month monitoring experiment was conducted. Caregivers then answered a questionnaire survey on medication management burden pre- and post-DDSD use. The caregivers reported no difficulties associated with medication distribution using DDSD. The DDSD reduced the daily dispensing duration by an average of 3.5 min. The questionnaire survey showed no differences in items related to the reduction of errors, and the Family Caregiver Medication Administration Hassles Scale showed no reduction of burden on caregivers. However, whether the DDSD reduces medication management burden remains undetermined.
Topics: Aged; Caregivers; Group Homes; Humans; Medication Therapy Management; Pharmaceutical Preparations; Surveys and Questionnaires
PubMed: 34292134
DOI: 10.1080/01621424.2021.1947927 -
Current Drug Metabolism 2017While establishing efficacy in translational models and humans through clinically-relevant endpoints for disease is of great interest, assessing the potential toxicity... (Review)
Review
BACKGROUND
While establishing efficacy in translational models and humans through clinically-relevant endpoints for disease is of great interest, assessing the potential toxicity of a putative therapeutic drug is critical. Toxicological assessments in the pre-clinical discovery phase help to avoid future failure in the clinical phases of drug development. Many in vitro assays exist to aid in modular toxicological assessment, such as hepatotoxicity and genotoxicity. While these methods have provided tremendous insight into human toxicity by investigational new drugs, they are expensive, require substantial resources, and do not account for pharmacogenomics as well as critical ADME properties. Computational tools can fill this niche in toxicology if in silico models are accurate in relating drug molecular properties to toxicological endpoints as well as reliable in predicting important drug-target interactions that mediate known adverse events or adverse outcome pathways (AOPs).
METHODS
We undertook an unstructured search of multiple bibliographic databases for peer-reviewed literature regarding computational methods in predictive toxicology for in silico drug discovery. As this review paper is meant to serve as a survey of available methods for the interested reader, no focused criteria were applied. Literature chosen was based on the writers' expertise and intent in communicating important aspects of in silico toxicology to the interested reader.
CONCLUSION
This review provides a purview of computational methods of pre-clinical toxicologic assessments for novel small molecule drugs that may be of use for novice and experienced investigators as well as academic and commercial drug discovery entities.
Topics: Animals; Drug Discovery; Humans; Models, Molecular; Pharmaceutical Preparations; Toxicology
PubMed: 28302026
DOI: 10.2174/1389200218666170316093301 -
Yakugaku Zasshi : Journal of the... 202170-90% of recently developed new drug candidates are poorly soluble in water, which creates a series of thorny challenges in developing its oral dosage forms, resulting... (Review)
Review
70-90% of recently developed new drug candidates are poorly soluble in water, which creates a series of thorny challenges in developing its oral dosage forms, resulting in low bioavailability. In pre-formulation study, various specialized formulations have been developed to improve drug solubility. Intermolecular interactions between drug and excipients in the formulations can modify the drug state and achieve the improvement of drug solubility. Therefore, the understanding of intermolecular interaction is essential to design formulations with higher quality and to assure the quality as a pharmaceutical product. Solid-state NMR has attracted much attention as a promising method to evaluate the molecular state of a drug and the interaction between a drug and excipient in its formulation. I have applied solid-state NMR and its characteristic technique, namely magic-angle spinning (MAS), for various specialized formulations including amorphous solid dispersion, supersaturated solution, drug-loaded organic nanotube, and drug nanosuspension. The intermolecular interactions of drug and excipient in amorphous solid dispersion have been identified by C and N solid-state NMR. High-resolution MAS determined the interaction modes of drug and excipient in a supersaturated solution. The two-step dissolution profile of drug from organic nanotube was understood, based on the molecular states revealed by the combination of various solid-state NMR techniques. A suspended-state NMR clarified the nanostructure of drug nanoparticles dispersed in water. It is expected that more qualified pharmaceutical formulations with improved drug solubility can be designed based on the remarkable development of recent solid-state NMR technology.
Topics: Biological Availability; Dosage Forms; Drug Compounding; Drug Liberation; Excipients; Nanoparticles; Nanostructures; Nanotubes; Nuclear Magnetic Resonance, Biomolecular; Pharmaceutical Preparations; Solubility; Solutions; Water
PubMed: 34471007
DOI: 10.1248/yakushi.21-00124 -
Talanta Jan 2016Screen-printed electrodes (SPEs) have gone through significant improvements over the past few decades with respect to both their format and their printing materials.... (Review)
Review
Screen-printed electrodes (SPEs) have gone through significant improvements over the past few decades with respect to both their format and their printing materials. Thus, SPEs have been successfully applied for the in situ detection of a plethora of analytes in a wide range of sample matrixes due to their advantageous material properties, such as disposability, simplicity, and rapid responses. In particular, the development of electrochemical sensors based on SPEs for pharmaceutical analysis has received massive consideration since they enable the rapid screening of the pharmaceutical compounds in complex matrixes, requiring small volumes of samples and no pre-treatment steps. This review summarizes the design and the working principles of electrochemical sensors based on SPEs applied to the quantification of pharmaceutical and biological compounds.
Topics: Biosensing Techniques; Electrochemistry; Electrodes; Humans; Pharmaceutical Preparations; Printing
PubMed: 26695333
DOI: 10.1016/j.talanta.2015.06.011 -
Physical Review. E Oct 2022Traditionally, acoustic streaming is assumed to be a steady-state, relatively slow fluid response to passing acoustic waves. This assumption, the so-called slow...
Traditionally, acoustic streaming is assumed to be a steady-state, relatively slow fluid response to passing acoustic waves. This assumption, the so-called slow streaming assumption, was made over a century ago by Lord Rayleigh. It produces a tractable asymptotic perturbation analysis from the nonlinear governing equations, separating the acoustic field from the acoustic streaming that it generates. Unfortunately, this assumption is often invalid in the modern microacoustofluidics context, where the fluid flow and acoustic particle velocities are comparable. Despite this issue, the assumption is still widely used today, as there is no suitable alternative. We describe a mathematical method to supplant the classic approach and properly treat the spatiotemporal scale disparities present between the acoustics and remaining fluid dynamics. The method is applied in this work to well-known problems of semi-infinite extent defined by the Navier-Stokes equations, and preserves unsteady fluid behavior driven by the acoustic wave. The separation of the governing equations between the fast (acoustic) and slow (hydrodynamic) spatiotemporal scales are shown to naturally arise from the intrinsic properties of the fluid under forcing, not by arbitrary assumption beforehand. Solution of the unsteady streaming field equations provides physical insight into observed temporal evolution of bulk streaming flows that, to date, have not been modeled. A Burgers equation is derived from our method to represent unsteady flow. By then assuming steady flow, a Riccati equation is found to represent it. Solving these equations produces direct, concise insight into the nonlinearity of the acoustic streaming phenomenon alongside an absolute, universal upper bound of 50% for the energy efficiency in transducing acoustic energy input to the acoustic streaming energy output. Rigorous validation with respect to experimental and theoretical results from the classic literature is presented to connect this work to past efforts by many authors.
PubMed: 36397528
DOI: 10.1103/PhysRevE.106.045101 -
Physical Review. E Jun 2022Chirality can endow nonequilibrium active matter with unique features and functions. Here, we explore the chiral dynamics in biphasic active nematics composed of...
Chirality can endow nonequilibrium active matter with unique features and functions. Here, we explore the chiral dynamics in biphasic active nematics composed of self-rotating units that continuously inject energy and angular momentum at the microscale. We show that the self-rotation of units can regularize the boundaries between two phases, rendering sinusoidal-like interfaces, which allow lateral wave propagation and are characterized by chains of ordered antiferromagnetic cross-interface flow vortices. Through the spontaneous coordination of counter-rotating units across the interfaces, topological defects excited by activity are sorted spatiotemporally, where positive defects are locally trapped at the interfaces but, unexpectedly, are transported laterally in a unidirectional rather than wavy mode, whereas inertial negative defects remain spinning in the bulks. Our findings reveal that individual chirality could be harnessed to modulate interfacial morphodynamics in active systems and suggest a potential approach toward controlling topological defects for programmable microfluidics and logic operations.
PubMed: 35854599
DOI: 10.1103/PhysRevE.105.064607 -
Physical Review. E Apr 2021Double stranded DNA can adopt different forms, the so-called A-, B-, and Z-DNA, which play different biological roles. In this work, the thermodynamic and the kinetic...
Double stranded DNA can adopt different forms, the so-called A-, B-, and Z-DNA, which play different biological roles. In this work, the thermodynamic and the kinetic parameters for the base-pair closing and opening in A-DNA and B-DNA were calculated by all-atom molecular dynamics simulations at different temperatures. The thermodynamic parameters of the base pair in B-DNA were in good agreement with the experimental results. The free energy barrier of breaking a single base stack results from the enthalpy increase ΔH caused by the disruption of hydrogen bonding and base-stacking interactions, as well as water and base interactions. The free energy barrier of base pair closing comes from the unfavorable entropy loss ΔS caused by the restriction of torsional angles and hydration. It was found that the enthalpy change ΔH and the entropy change ΔS for the base pair in A-DNA are much larger than those in B-DNA, and the transition rates between the opening and the closing state for the base pair in A-DNA are much slower than those in B-DNA. The large difference of the enthalpy and entropy change for forming the base pair in A-DNA and B-DNA results from different hydration in A-DNA and B-DNA. The hydration pattern observed around DNA is an accompanying process for forming the base pair, rather than a follow-up of the conformation.
Topics: Base Pairing; DNA, A-Form; DNA, B-Form; Molecular Dynamics Simulation; Thermodynamics
PubMed: 34005973
DOI: 10.1103/PhysRevE.103.042409 -
PloS One 2023In Switzerland, 20,000 people are hospitalized each year as result of drug related problems (DRPs). The sources of DRPs can be related to patients' behavior (i.e., wrong...
BACKGROUND
In Switzerland, 20,000 people are hospitalized each year as result of drug related problems (DRPs). The sources of DRPs can be related to patients' behavior (i.e., wrong administration) or to health processes (i.e., drug-drug interaction). No community pharmacy (CP) service focus on DRPs related to patients' behavior is currently recognized or remunerated in Switzerland. A medication review with follow up (MRF) has been developed to evaluate prescription and non-prescription medication.
OBJECTIVE
To evaluate the impact of MRF service for the identification and management DRPs associated to patients' behavior and to describe pharmaceutical interventions carried out through MRF.
METHODS
A pre-post intervention study with a cluster design and one intervention group will be carried out in CPs in the canton of Vaud (Switzerland) for 15 months. Volunteer pharmacists will be trained on the identification and management of DRPs related to patients' behavior. After training, they will include randomly selected adults taking four or more chronic drugs prescribed for at least three months prior to recruitment. Then, they will conduct three pharmacist-patient face-to-face consultations at 6-month intervals. Tasks will be differentiated by pharmacy technician or pharmacist to triage expired medication or to manage DRPs in a structured manner, respectively. The primary outcome is the identification of DRPs associated to patients' behavior. Secondary outcomes are to assess patients' medication knowledge, number of expired medications, interventions carried out by pharmacists and pharmacists' satisfaction. The study will begin in April 2023 in 19 to 35 pharmacies that will recruit at least 162 patients. A sub analysis will be carried out for patients with 65 years old or over.
CONCLUSIONS
The MRF intervention features a training designed for an enhanced evaluation of patient's behavior towards their medication. The study will allow the assessment and management of DRPs in Swiss CPs with the support of the local health authorities and pharmacist association.
TRIAL REGISTRATION
Clinicaltrials.gov NCT05348538.
Topics: Adult; Aged; Humans; Community Pharmacy Services; Drug-Related Side Effects and Adverse Reactions; Follow-Up Studies; Medication Review; Pharmaceutical Preparations; Pharmacies; Pharmacists; Switzerland
PubMed: 37847695
DOI: 10.1371/journal.pone.0292037