Dose Packaging Research Articles

経口糖尿病薬の服薬状況とその改善への試み

The compliance of 60 year old or older diabetic patients taking oral antidiabetic agents was investigated. As a result, the compliance for oral antidiabetic agents with different dosing times declined according to the frequency that such medicine had to be taken.It is suggested that this case occurs when the complexity of medicines increases by using a heat seal and when patient's concern to oral antidiabetic agents declines since packaging forms of medicines are the same. A good compliance was obtained regardless of the dosing time if the total number of medications were 4 or less, if all the medicines could be included in one dose package and if the dosing time for all medicines was the same.

Compliance and medication knowledge among elderly Japanese home-care recipients.

To investigate the risk factors for noncompliance in elderly home-care recipients; and to evaluate to what extent regular home visits and drug counseling by a pharmacist contribute to compliance. One hundred and sixty-three elderly home-care recipients aged 62 years and over took part in this study. All subjects were cognitively normal, and taking a regimen of one or more prescribed drugs. Medication use was observed by pharmacist-conducted interviews during home visits. Compliance was estimated by comparing prescribed regimens with medications actually being taken at home. The mean age with (SD) of the subjects was 78.7 (8.3) years. Eighteen per cent were regularly counseled by a pharmacist about medication. Poor compliance with prescribed medications was associated with subjects aged 80 years and over, who were administering their own medication, consuming less than three meals a day, did not have one dose packages, and who were not receiving pharmacist counseling. In multiple logistic regression analyses, frequency of meals (OR 5.99; 95% CI 1.25-28.79), pharmacist counseling (OR 5.32; 95% CI 2.00-14.20), and age (OR 0.96; 95% CI 0.92-1.00) were independent predictors of good compliance for home-care recipients with physical disabilities. Compliance correlated inversely with knowledge of drug names, and drug purposes in the uncounseled group. Compliance, however, positively correlated with knowledge of drug purposes in the counseled group. In this study, compliance among elderly Japanese home-care recipients was found to be associated with receiving pharmacist counseling, frequency of meals, and age.

Physicochemical Interaction between Enteric Coated Tablets and Aminophylline Tablet in the Unit Dose Package

Physicochemical Interaction between Enteric Coated Tablets and Aminophylline Tablet in the Unit Dose Package

Inhalation delivery systems with compliance and disease management capabilities

Non-compliance with prescribed medication is a major reason for poor therapeutic outcomes, leading to unnecessary contributions to healthcare costs. Poor technique in self-administration of inhalation therapy is a special type of non-compliance associated with this route of administration. However, pulmonary drug delivery has fundamental advantages for therapy of diseases of the respiratory tract because it is site-directed. The lung is also a promising portal for drug delivery into the systemic circulation. Incorporation of microprocessors into pulmonary drug delivery systems facilitates sophisticated compliance management of chronic diseases such as asthma and diabetes. Microprocessor-assisted systems afford control of patients' administration technique during the therapeutic inhalation event, thus leading to efficient and reproducible regional deposition of the inhaled drug or diagnostic agent. SmartMist™ is a hand-held asthma disease management device that aids patients to use optimally metered dose inhalers. It also measures pulmonary lung function and provides a long term downloadable electronic record of the therapeutic and diagnostic events. The AERx™ pulmonary delivery system utilizes similar microprocessor capabilities; however, it employs a novel means of generating aqueous aerosols from unit dose packages, thus providing a broad inhalation technology base for delivery of a wide variety of therapeutic and diagnostic agents into the respiratory tract, and via the lung into the systemic circulation.

保存剤を含有していない０．１２５％チロキサポール吸入液における一回量包装の有用性

By comparing the usual method of measuring medication dosage in medical cups in our hospital (A packages) with newly developed one dose packages (B, C packages) the stability of the ingredients, the sterility of the material, and the accuracy of the correctness of the measuring the samples, we assessed the usefulness of one dose packages of preservativefree 0.125% tyloxapol solutions for the administration of oral medications. The results were as follows: 1) pH tended to rise in A as the strage temperature increased but was stable in both B and C. No changes in the external appearance were detectable in any of them. 2) No microbial contamination was found in any of the packages, A, B or C. 3) The measuring accuracy was better in B and C than in A. Thus, the one dose packages appeared to be more useful than the usual method of measuring drugs using medical cups as a method by which 0.125% tyloxapol solutions for inhalations can be used safely and conveniently even when supplied to patients.

Supracondylar process syndrome: A case report

A 43-year-old right-hand-dominant female licensed practical nurse presented with a 10-year history of pain and paresthesias involving the left forearm. Her symptoms had become progressively worse and were exacerbated by distributing medicine to patients and repeatedly opening unit dose packages. She reported waking up several times each night because of an inability to find a comfortable position for her left forearm. Examination of the left forearm revealed diffuse tenderness. Light palpation 8 cm proximal to the medial epicondyle produced median and ulnar nerve paresthesias in the distal forearm and hand. Tinel's sign was positive over the carpal tunnel but not over Guyon's canal. Phalen's test was positive. Pinch was weak, as were the intrinsic hand muscles. The pronator teres muscle was tender. Pronation with the elbow flexed produced paresthesias in the median nerve distribution with the sensation that the fingers were cold. Supination and flexion decreased these symptoms, but the patient was most comfortable with the forearm held in a neutral position of rotation. Extension in supination caused pain along the ulnar forearm, whereas extension with pronation caused pain along the radial border of the forearm. Simple pronation and supination produced claudicatory pain in the forearm and hand within a few seconds.

Medication cart-filling time, accuracy, and cost with an automated dispensing system

Medication cart filling with an automated dispensing system was compared with manual cart filling with respect to personnel time, costs, and accuracy. At a 650-bed tertiary-care medical center, technician cart filling and pharmacist cart checking were timed for the existing manual system and for the Baxter ATC-212 automated dispensing system. Subsequently, carts filled with each system were checked for accuracy of dispensing. On the basis of drugs used in the automated system over three months, drug acquisition and dispensing costs were calculated for automated and manual cart filling; the costs of personnel time were also compared. Daily cart filling time for technicians was significantly less with the automated system. The savings of pharmacist time was not significant; pharmacists had to cut the strip-packaged drugs into individual doses as they checked patients' medications. For both systems, errors were found in fewer than 1% of the doses (0.84% for the manual system and 0.65% for the automated system). Drug costs were higher with the automated system; acquisition prices for the bulk drugs purchased for use in the dispensing machine were higher than the prices of the same products in unit dose packaging. Personnel time saved amounted to less than 0.5 full-time equivalent. With the automated system, overall time savings was not great enough to substantially affect pharmacy operations, and drug costs were higher.

Use of Bar Codes in Inpatient Drug Distribution

The development and operation of a prototype inpatient drug distribution system that uses bar codes is described, and the impact of bar coding on the cassette-filling and verification process is summarized. A prototype pharmacy dispensing site was created to function in parallel with an existing satellite dispensing site that served 78 general medical-care beds. Supplemental labels encoded with an 11-digit unique product identification number, a 5-digit expiration date, and a 6-character lot number were generated and affixed to all unit dose packages dispensed from the prototype pharmacy site. The unit doses were labeled with Code 49 symbology; each label measured 0.8 x 1.25 inches. Each patient cassette was labeled using Code 39 symbology. A cost-benefit model was developed, and the two dispensing systems were compared with respect to (1) time to fill patient cassettes, (2) time to verify patient cassettes, (3) time to process patient charges and credits, (4) time to correct dispensing errors, (5) accuracy of the cassette-filling process, and (6) accuracy of the cassette verification process. Bar-code dispensing and verification saved 1.52 seconds per dose. Additionally, the cassette verification function was shifted from pharmacists to technicians. Estimated per-dose cost of the bar-code system was 2.73 cents. A measurable improvement in the accuracy of filling patient cassettes was documented. The feasibility of using bar codes in unit dose dispensing was demonstrated, and the prototype system was shown to produce cost efficiencies and patient-care benefits.

Larger type needed on unit dose packaging

Journal Article Larger type needed on unit dose packaging Get access Henry H. Fowler, JR. Henry H. Fowler, JR. 2302 Thistledawn Road, Louisville, KY 40216 Search for other works by this author on: Oxford Academic Google Scholar American Journal of Hospital Pharmacy, Volume 46, Issue 9, 1 September 1989, Page 1771, https://doi.org/10.1093/ajhp/46.9.1771 Published: 01 September 1989

Accidental poisoning in childhood: a multicentre survey. 2. The role of packaging in accidents involving medications.

To assess the effectiveness of child-resistant closures (CRCs) and unit dose packaging in preventing childhood poisoning with medications, a survey by 14 hospitals of accidental suspected poisoning in children under 5-years-old, was compared with a survey of a representative sample of households with children under 5 living in the catchment areas of the hospitals. Nine hundred and thirty-eight medications thought to have been ingested by 877 children were compared with 5827 medications found in households with children. The relationship between availability of packs or medications in the home and their involvement in accidents was quantified by means of an Accident Association Index (AAI). A low AAI indicated that the involvement of a pack or medication was less than expected from availability and therefore safe. A high AAI indicated that involvement was greater than expected and therefore unsafe. Medications involved in suspected poisoning were most frequently packed in containers without CRCs (63%) or transparent blisters (20%); both had high AAIs. CRCs, strips, sachets and opaque blisters had low AAIs. Analgesics, expectorants and gastrointestinal medications, had low AAIs, while oral contraceptives, hypnotics, sedative/tranquillizers, antidepressants, anticonvulsants, anti-emetics, and anti-infectives had high AAIs. Prescription medications were more frequently involved in accidents than over-the-counter (OTC) medications and had a higher AAI. Comparison of the AAIs of different kinds of medication in each of their various pack types showed that safe packaging reduced the risk from medications which had a high average AAI. Only 40% of medications were in their normal storage place at the time of the accident. Medicine and bathroom cabinets, and kitchen cupboards and drawers were the safest places to store medications. Handbags, fridges, and shelves or ledges in the bathroom were the most unsafe places. No pack had a low AAI when stored on open shelves indicating that safe packaging cannot compensate for unsafe storage. Other factors which influenced the involvement of medications in accidents were the intended user and the duration of storage. The results of the study have important implications for design of packaging for medications and for education of the public.

Application of radiotracer method for precise determination of water vapor transmission characteristics of unit dose packaging systems

Application of radiotracer method for precise determination of water vapor transmission characteristics of unit dose packaging systems

The Generic Blister Card -A Versatile Approach to Unit Dose Packaging

AbstractIn an effort to enhance compliance and to allow suitable flexibility in clinical studies, a generic blister card was conceived. The blister was designed with sufficient capacity to adequately hold two #0 size capsules. The configuration of the card is four vertical rows of blisters by eight horizontal rows. By manually filling the blisters and sealing with a small heat press, cards can be cut to size in configurations ranging from 1 to 32 blisters using a simple paper cutter. This card provides a versatile, inexpensive alternative package to accommodate requests for unit dose systems.

ASHP technical assistance bulletin on single unit and unit dose packages of drugs

Journal Article ASHP technical assistance bulletin on single unit and unit dose packages of drugs Get access American Journal of Hospital Pharmacy, Volume 42, Issue 2, 1 February 1985, Pages 378–379, https://doi.org/10.1093/ajhp/42.2.378 Published: 01 February 1985

一回量包装におけるバラ錠の安定性

Non-sealed tablets and capsules are used often in Unit Dose Package (UDP) prepared in hospital pharmacy. Their stability was examined in terms of hardness, weight and friability at 25° and relative humidity of 75%. In most uncoated tablets and film-coated tablets, their hardness decreased largely in several days, and their weight increased. All capsules increased their weight by more than 1%, but sugarcoated tablets showed little change in hardness and weight. Change in hardness showed a significant relation to change in weight and in friability; therefore, in the quality control of non-sealed tablets, hardness may be a simple and important index. Non-sealed tablets and capsules increased their stability when stored in packing paper for UDP, but should be preserved carefully in case of storage for a long time. When exposed to fluorescent light (1, 000 lux), about 10% of samples showed a change in appearance after 8 days. Under the same conditions, phytonadione uncoated tablets (5 mg) decreased their contents to 63% after 4 weeks; decrease was far smaller, to 83%, when the tablets were stored under a light-resistant cover.

Effect on moisture permeability of typewriting on unit dose package surfaces

The effects of typewriting on labels of two unit dose packages with respect to moisture permeability were examined. Using an electric typewriter, a standard label format was imprinted on two different types of class A unit dose packages: (1) a heat-sealed paper-backed foil and cellofilm strip pouch, and (2) a copolyester and polyethylene multiple-cup blister with a heat-sealed paper-backed foil and cellofilm cover. The labels were typed at various typing-element impact settings. The official USP test for water permeation was then performed on typed packages and untyped control packages. The original untyped packages were confirmed to be USP class A quality. The packages for which successively harder impact settings were used showed a corresponding increase in moisture permeability. This resulted in a lowering of USP package ratings from class A to class B and D, some of which would be unsuitable for use in any unit dose system under current FDA repackaging standards. Typing directly onto the label of a unit dose package before it is sealed will most likely damage the package and possibly make it unfit for use. Pharmacists who must type labels for the unit dose packages studied should use the lowest possible typewriter impact setting and test for damage using the USP moisture-permeation test.

Unit dose packaging for ophthalmic ointments

Unit dose packaging for ophthalmic ointments

Premixed Intravenous Admixtures: A Positive Development for Hospital Pharmacy

The development of premixed intravenous admixtures is reviewed in a historical context, and its effects on hospital pharmacy practice are discussed. As pharmaceutical manufacturers introduce more i.v. medications in ready-to-use containers, the same complaints that were voiced by pharmacists about unit dose packaging and ready-to-dispense tablets and capsules are being aired. But premixed i.v. admixtures are a logical extension of the basic unit dose principle of providing a readily identifiable and ready-to-administer dose. The time and cost savings these products offer are needed in hospital pharmacies. Some of the disadvantages of these products--including storage and freezer space and multiplicity of administration systems--are overcome by proper planning and education of personnel. If fewer personnel are now needed to prepare i.v. admixtures, then those personnel should be used to improve patient care in other ways. The use of premixed i.v. admixtures is a positive technological advance in drug packaging. Its advantages outweight its disadvantages, and it will soon be become the universally accepted form of i.v. drug packaging.

ASHP Guidelines for Repackaging Oral Solids and Liquids in Single Unit and Unit Dose Packages

ASHP Guidelines for Repackaging Oral Solids and Liquids in Single Unit and Unit Dose Packages

Stability of uncoated aminophyiiine tablets In unit dose packages

Stability of uncoated aminophyiiine tablets In unit dose packages

ASHP guidelines for repackaging oral solids and liquids in single unit and unit dose packages

ASHP guidelines for repackaging oral solids and liquids in single unit and unit dose packages