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Clinical & Experimental Optometry Sep 2017Contact lenses as a means to deliver pharmaceuticals to the eye have seen a significant increase in research interest in the past few years. This review will detail the... (Review)
Review
Contact lenses as a means to deliver pharmaceuticals to the eye have seen a significant increase in research interest in the past few years. This review will detail the in vitro experiments which have investigated use of these contact lenses in the context of the desired pharmacological treatment goals in the management of infectious, inflammatory, allergic and glaucomatous diseases of the eye. The techniques researchers have employed to modify and tailor drug release rates from these materials, including the use of vitamin E diffusion barriers, modified ionicity, molecular imprinting and incorporation of drug reservoirs, will be discussed, as well as their impact on drug release kinetics. Finally, the demonstration of the feasibility of these materials when applied in vivo in animal models as well as in humans with and without disease will be presented and their results discussed relating to their implications for the future of the field.
Topics: Contact Lenses, Hydrophilic; Drug Delivery Systems; Humans; Ophthalmic Solutions; Pharmaceutical Preparations
PubMed: 28940532
DOI: 10.1111/cxo.12592 -
Nutrients Mar 2013Parenteral nutrition (PN) has become an integral part of clinical management of very low birth weight premature neonates. Traditionally different components of PN are... (Review)
Review
Parenteral nutrition (PN) has become an integral part of clinical management of very low birth weight premature neonates. Traditionally different components of PN are prescribed individually considering requirements of an individual neonate (IPN). More recently, standardised PN formulations (SPN) for preterm neonates have been assessed and may have advantages including better provision of nutrients, less prescription and administration errors, decreased risk of infection, and cost savings. The recent introduction of triple-chamber bag that provides total nutrient admixture for neonates may have additional advantage of decreased risk of contamination and ease of administration.
Topics: Chemistry, Pharmaceutical; Cost-Benefit Analysis; Drug Contamination; Drug Costs; Equipment Contamination; Equipment Design; Gestational Age; Humans; Infant Nutrition Disorders; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Parenteral Nutrition; Parenteral Nutrition Solutions; Practice Guidelines as Topic; Treatment Outcome
PubMed: 23538938
DOI: 10.3390/nu5041058 -
American Journal of Physiology. Heart... Apr 2022
Topics: Bicarbonates; Dialysis Solutions
PubMed: 35324335
DOI: 10.1152/ajpheart.00057.2022 -
Seminars in Dialysis 2011Adequate dialysis is difficult to define because we have not identified the toxic solutes that contribute most to uremic illness. Dialysis prescriptions therefore cannot...
Adequate dialysis is difficult to define because we have not identified the toxic solutes that contribute most to uremic illness. Dialysis prescriptions therefore cannot be adjusted to control the levels of these solutes. The current solution to this problem is to define an adequate dose of dialysis on the basis of fraction of urea removed from the body. This has provided a practical guide to treatment as the dialysis population has grown over the past 25 years. Indeed, a lower limit to Kt/V(urea) (or the related urea reduction ratio) is now established as a quality indicator by the Centers for Medicare and Medicaid for chronic hemodialysis patients in the United States. For the present, this urea-based standard provides a useful tool to avoid grossly inadequate dialysis. Dialysis dosing, however, based on measurement of a single, relatively nontoxic solute can provide only a very limited guide toward improved treatment. Prescriptions which have similar effects on the index solute can have widely different effects on other solutes. The dose concept discourages attempts to increase the removal of such solutes independent of the index solute. The dose concept further assumes that important solutes are produced at a constant rate relative to body size, and discourages attempts to augment dialysis treatment by reducing solute production. Identification of toxic solutes would provide a more rational basis for the prescription of dialysis and ultimately for improved treatment of patients with renal failure.
Topics: Blood Proteins; Hemodialysis Solutions; Humans; Renal Dialysis; Urea
PubMed: 21929590
DOI: 10.1111/j.1525-139X.2011.00979.x -
Optometry and Vision Science : Official... Oct 2022The dewetting process of contact lenses (CLs) is a result of material and solution properties as well as environmental factors. This article describes an investigational...
SIGNIFICANCE
The dewetting process of contact lenses (CLs) is a result of material and solution properties as well as environmental factors. This article describes an investigational approach to observe and describe dewetting characteristics of different CL material and solution combinations.
PURPOSE
This study aimed to determine the in vitro dewetting characteristics of various daily disposable CLs that were assessed using a noninvasive keratograph dewetting procedure (noninvasive keratograph dry-up time). In vitro dewetting data of the same CL materials soaked in saline solution and artificial tear solution (ATS) were measured to determine additional dewetting characteristics.
METHODS
Noninvasive keratograph dry-up time was measured for six different soft CL materials and three different test conditions, in their specific blister solution, after exposure to saline and an ATS. Twenty CLs of each solution/material combination were assessed after an 8-hour soaking, during a 180-second dewetting observation, and the results were expressed by area under the curve values.
RESULTS
Fastest dewetting occurred for all materials when measured out of saline, indicated by the highest averaged area under the curve value of 9243.3 ± 38.3 over all lens materials. Slower dewetting was detected for all materials when measured out of their specific blister solution (7755.9 ± 37.1) and out of ATS (7988.8 ± 40.0). Intragroup results were statistically significantly different for all solutions showing the smallest differences within the ATS group ( P < .001, Kruskal-Wallis test).
CONCLUSIONS
A pure saline thin film is not an ideal representation of a complex tear film layer of a healthy human because it lacks any evaporative protection by a lipid layer. The use of an ATS, which more likely mimics the natural tear film, allowed in this experimental in vitro project to decrease the gap to the in vivo field. In vitro dewetting information in connection with the blister solution allows only a theoretical conclusion about the initial lens wear after lens insertion.
Topics: Blister; Contact Lenses, Hydrophilic; Humans; Lipids; Lubricant Eye Drops; Saline Solution; Tears
PubMed: 36095059
DOI: 10.1097/OPX.0000000000001939 -
BMC Ophthalmology Nov 2023Dry eye disease (DED) is a disorder characterized by loss of tear film homeostasis that causes ocular surface inflammation and damage. The incidence of DED increases...
Real-world treatment patterns of OTX-101 ophthalmic solution, cyclosporine ophthalmic emulsion, and lifitegrast ophthalmic solution in patients with dry eye disease: a retrospective analysis.
BACKGROUND
Dry eye disease (DED) is a disorder characterized by loss of tear film homeostasis that causes ocular surface inflammation and damage. The incidence of DED increases with age. Cyclosporine ophthalmic solution 0.09% (CEQUA; OTX-101), cyclosporine ophthalmic emulsion 0.05% (Restasis; CsA), and lifitegrast ophthalmic solution 5% (Xiidra; LFT) are anti-inflammatory agents indicated for DED. This analysis compared treatment patterns in patients with DED receiving OTX-101, CsA, or LFT.
METHODS
This real-world, retrospective, longitudinal cohort study utilized Symphony Health Integrated Dataverse claims from July 2019 to June 2021. The dataset included all patients with OTX-101 claims and patients with CsA or LFT claims randomly selected 2:1 to OTX-101. Patients were sorted into 3 cohorts based on index treatment. Index date was that of first treatment claim, and follow-up period was from index date to end of clinical activity or data availability. Time to treatment discontinuation (TTD), probability of discontinuation, and treatment persistence were assessed for OTX-101 vs. CsA, then OTX-101 vs. LFT. Subgroup analysis was performed based on age and prior DED treatment. Kaplan-Meier analysis and log-rank test were used to examine TTD. A logistic model evaluated association between index treatment and discontinuation. Unadjusted and adjusted odds ratios, 95% confidence intervals, and P-values were reported, with statistically significant associations based on P-values < 0.05.
RESULTS
Overall, 7102 patients (OTX-101 n = 1846; CsA n = 2248; LFT n = 3008) were eligible. Median TTD was 354 days for patients receiving OTX-101 vs. 241 days for CsA and 269 days for LFT. Log-rank test indicated TTD was significantly longer for patients on OTX-101 vs. CsA (P = 0.033). Patients on CsA were 35% more likely to discontinue treatment than patients on OTX-101; OTX-101 and LFT groups had similar discontinuation rates. After 360 days, 49.8% of patients receiving OTX-101 remained on treatment vs. 39.4% of patients on CsA (P = 0.036) and 44.0% of patients on LFT (P = 0.854).
CONCLUSIONS
Patients receiving OTX-101 remained on treatment significantly longer and were significantly less likely to discontinue treatment than patients on CsA. Older patients remained on OTX-101 significantly longer than CsA. These findings highlight treatment pattern differences in patients with DED receiving these anti-inflammatory agents.
Topics: Humans; Ophthalmic Solutions; Emulsions; Retrospective Studies; Longitudinal Studies; Dry Eye Syndromes; Cyclosporine; Anti-Inflammatory Agents
PubMed: 37919692
DOI: 10.1186/s12886-023-03174-y -
European Journal of Pharmaceutics and... Jun 2023Both stability and compatibility of parenteral nutrition solutions (PNS) with drug products are major concerns for clinicians and clinical pharmacists, especially when... (Review)
Review
Both stability and compatibility of parenteral nutrition solutions (PNS) with drug products are major concerns for clinicians and clinical pharmacists, especially when concurrent administration of PNS with intravenous medications (IVM) is unavoidable. Since the same physicochemical principles apply to both adult's and paediatrics' PNS, concerns about stability and compatibility may still apply to both. However, these concerns are relatively more common in paediatrics and neonatal clinical settings, where limited vascular access can be problematic and the coadministration of PNS and drugs is more common. In neonatal and paediatric populations, there have been few experimental studies and comprehensive evaluations looking at medication compatibility with frequently used PNS. This work is part of a larger research project concerned for compatibility of PNS with commonly used intravenous medication in paediatric and neonates. This paper captures and reviews published data on factors influencing stability and compatibility of parenteral nutrition solutions. This information will help clinicians and clinical pharmacists to understand the principals of the stability and compatibility of PNS, furthermore, it will inform better design of future compatibility studies, as it highlights the complexity of PNS and the multiple factors influencing the stability of PNS, and hence its compatibility with IVM. When preparing, prescribing, and administering the PNS, especially when co-administration with IVM is unavoidable, it is important to take into account the physicochemical properties of the PNS components and IVM as well as administration conditions and environmental factors. These factors should also be considered in the design of the compatibility studies of the PNS with the IVM.
Topics: Infant, Newborn; Humans; Child; Parenteral Nutrition Solutions; Pharmaceutical Preparations; Drug Stability
PubMed: 37061100
DOI: 10.1016/j.ejpb.2023.04.002 -
Clinical Journal of the American... Aug 2022
Topics: Charcoal; Dialysis Solutions; Humans; Renal Dialysis; Uremia
PubMed: 35835517
DOI: 10.2215/CJN.06860622 -
Scientific Reports Jul 2021Given that nonadherence is related to subject characteristics and drug tolerance and preserved eye drops tend to be more intolerable than preservative-free ones, we... (Comparative Study)
Comparative Study Randomized Controlled Trial
Given that nonadherence is related to subject characteristics and drug tolerance and preserved eye drops tend to be more intolerable than preservative-free ones, we conducted a phase 4, parallel-grouped, investigator-blind, active-control, randomized, multicenter study. A total of 51 patients with intraocular pressure (IOP) ≥ 15 mmHg diagnosed with open-angle glaucoma or ocular hypertension were randomly assigned to the preserved latanoprost group (n = 26) and the preservative-free latanoprost group (n = 25). The efficacy variables were corneal/conjunctival staining grade, Ocular Surface Disease Index (OSDI), adherence at 12 weeks after the first administration; corneal/conjunctival staining grade at 4 weeks; and IOP, tear break-up time (TBUT), and hyperemia score at 4 and 12 weeks. The safety variables included visual acuity and drug tolerance questionnaire results. There was no statistically significant difference in corneal/conjunctival staining grade, OSDI, or TBUT between the groups at 4 and 12 weeks. However, the adherence rate was higher and the hyperemia score was lower in the preservative-free group than in the preserved group. The severity and duration of stinging/burning sensation were lower in the preservative-free group than in the preserved group. Overall, preservative-free latanoprost showed better ocular tolerance assessed by hyperemia scores and stinging/burning symptoms following higher adherence than preserved latanoprost.
Topics: Aged; Drug Administration Schedule; Female; Glaucoma, Open-Angle; Humans; Intention to Treat Analysis; Latanoprost; Male; Middle Aged; Ocular Hypertension; Ophthalmic Solutions; Preservatives, Pharmaceutical; Treatment Adherence and Compliance; Treatment Outcome
PubMed: 34294842
DOI: 10.1038/s41598-021-94574-x -
Wiley Interdisciplinary Reviews.... 2014Many vision threatening ocular diseases such as age-related macular degeneration (AMD), diabetic retinopathy, glaucoma, and proliferative vitreoretinopathy may result in... (Review)
Review
Many vision threatening ocular diseases such as age-related macular degeneration (AMD), diabetic retinopathy, glaucoma, and proliferative vitreoretinopathy may result in blindness. Ocular drug delivery specifically to the intraocular tissues remains a challenging task due to the presence of various physiological barriers. Nonetheless, recent advancements in the field of nanomicelle-based novel drug delivery system could fulfil these unmet needs. Nanomicelles consists of amphiphilic molecules that self-assemble in aqueous media to form organized supramolecular structures. Micelles can be prepared in various sizes (10-1000 nm) and shapes depending on the molecular weights of the core and corona forming blocks. Nanomicelles have been an attractive carrier for their potential to solubilize hydrophobic molecules in aqueous solution. In addition, small size in nanometer range and highly modifiable surface properties have been reported to be advantageous in ocular drug delivery. In this review, various factors influencing rationale design of nanomicelles formulation and disposition are discussed along with case studies. Despite the progress in the field, influence of various properties of nanomicelles such as size, shape, surface charge, rigidity of structure on ocular disposition need to be studied in further details to develop an efficient nanocarrier system.
Topics: Animals; Drug Carriers; Humans; Hydrophobic and Hydrophilic Interactions; Micelles; Nanostructures; Ophthalmic Solutions; Rabbits
PubMed: 24888969
DOI: 10.1002/wnan.1272