Drug Supply Research Articles

Management of Prescription Medicines in Ukraine: Continuation of the Experimental Study on the Organization of Pharmaceutical Provision

Conducted the experimental study on the organization of pharmaceutical provision, complaints of patients from the position of management of prescription medicines in Ukraine. It has been proven that the level of organization of pharmaceutical supply affects patient complaints. 750 complaints from patients about unsatisfactory on the organization of the pharmaceutical provision were processed. Found that 77% of complaints of patients (women accounted for 70%; men – 30%) were related to late or incomplete on the organization of the pharmaceutical provision of prescription medicines. Violation of the rights of patients to receive medicines on discounted and free prescriptions of doctors was recorded in 88% of complaints. The matrix of complaints based on patient reports of unsatisfactory of prescription medicines of different clinical and pharmacological, classification and legal and nomenclature and legal groups was constructed. In accordance to the ATC classification, the clinical and pharmacological groups were distributed of medicines on 9 clinical and pharmacological groups. According to ATC code A, 5 INN medicines were not available to patients, and more complaints were received. According to ATC code B, 7 INN medicines were not available to patients, and more complaints were received. According to ATC code C, 25 INN medicines were not available to patients, and more complaints were received. According to ATC code D, 1 INN medicines were not available to patients, and more complaints were received. According to ATC code L, 2 INN medicines were not available to patients, and more complaints were received. According to ATC code M, 1 INN medicines were not available to patients, and more complaints were received. According to ATC code N, 13 INN medicines were not available to patients, and more complaints were received. According to ATC code R, 5 INN medicines were not available to patients, and more complaints were received. According to ATC code S, 2 INN medicines were not available to patients, and more complaints were received. The organization of pharmaceutical provision of these drugs was at a low level. It is substantiated that the main feature of pharmaceutical provision of patients is social orientation. It is proved that it is necessary to actively develop the social potential of health care facilities in the format of transparency, completeness, reliability, and efficiency of information about the costs that form the cost of drugs. In the course of the study, a matrix of complaints based on patient reports of unsatisfactory pharmaceutical provision of drugs of different clinical and pharmacological, classification and legal, nomenclature and legal groups was constructed. On the basis of the matrix of complaints, three national lists of drugs were developed with the further development of organizational and legal measures to increase the level of pharmaceutical provision of patients. It is noted that the reference mechanism of drug pricing is aimed at establishing the level of reimbursement at the expense of the state and reducing costs to 50% for pharmaceutical provision of patients.

Pharma Supply Chain Management System Using Blockchain

A drug traceability system's objective is to track or trace a drug's movement along the drug supply chain, which is essential for both public drug security and the operations of pharmaceutical companies. Data integrity, privacy, system resilience, and adaptability expectations have not been met by traditional centralized server-client technology solutions. We have presented a whole new blockchain method for drug traceability. Compared to other solutions now on the market, this one is more secure and scalable. The proposed system can also efficiently prune its storage, producing a reliable and practical blockchain storage solution.

Cripistemologies of Drug Use Against Transinstitutional Carceral Ableism

Across Canada, thousands of drug users are dying from a toxic illicit drug supply resulting from oppressive drug policies and regulations that reinforce the prohibition and criminalization of drug use and the pathologization and rehabilitation of drug users. Bringing together critical drug studies and critical disability studies, the article contributes cripistemologies of drug use to unpack some of the ways transinstitutional carceral ableism conjoins control strategies of punishment-therapy-abandonment to unite both medical and carceral approaches to disability and drug use that have debilitating and deadly consequences. Against transinstitutional carceral ableism, the article mobilizes cripistemologies of drug use to trouble and reject the disposability of non-rehabilitated drug users central to medical and carceral approaches and instead favour consensual and pleasurable drug use via care practices grounded in interdependence, mutual aid, and solidarity.

Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to opioid antagonism

Xylazine is in the unregulated drug supply at increasing rates, usually combined with fentanyl, necessitating understanding of its pharmacology. Despite commentary from politicians, and public health officials, it is unknown how xylazine impacts naloxone efficacy, and. few studies have examined it alone. Here, we examine the impact of xylazine alone and in combination with fentanyl on several behaviors in mice. Surprisingly, naloxone precipitates withdrawal from xylazine and fentanyl/xylazine coadministration, with enhanced sensitivity in females. Further, xylazine is a full agonist at kappa opioid receptors, a potential mechanism for its naloxone sensitivity. Finally, we demonstrate surprising effects of xylazine to kappa opioid antagonism, which are relevant for public health considerations. These data address an ongoing health crisis and will help inform critical policy and healthcare decisions. One-sentence summaryWe present surprising new insights into xylazine and fentanyl pharmacology with immediate implications for clinical practice and frontline public health.

Clinical and economic implications of using daratumubab with lenalidomide in the 1st and 2nd lines of therapy for multiple myeloma patients

Objective: to assess clinical and economic implications of adding daratumumab (Dara) to the “lenalidomide + dexamethasone” (Rd) treatment program in early lines of therapy for patients with multiple myeloma (MM) ineligible for high-dose chemotherapy (HDCT) with subsequent autologous hematopoietic stem cell transplantation (autoHPSCT).Material and methods. Partitioned survival model was developed to compare overall survival in the treatment programs of MM patients in the 1st to 3rd lines of therapy. The following treatment options were included in the analysis: 1st line – Dara+Rd; 2nd line – “carfilzomib + lenalidomide” (K+Rd) or “ixazomib + lenalidomide” (Ixa+Rd) triplets; 3rd line – pomalidomide (Pom+dex) and Rd+(Dara+Rd)+(Pom+dex) versus Rd+(K/Ixa+Rd)+(Pom+dex/Dara). Probabilities of transition between health states (progression-free, progressed disease, and death) were based on published clinical data. Lifetime direct healthcare costs and incremental cost-effectiveness ratios (ICERs) per 1 life year gained were calculated from a Russian health care perspective. The indicator of the difference in costs between current and expected practice was used in budget impact analysis.Results. Dara+Rd combination increased life expectancy by 1.04 years (+16.05%) and 0.95 years (+14.57%) per patient, and in the target population (n=955) by 995.48 and 903.40 years for (Dara+Rd)+(K+Rd)+(Pom+dex) and (Dara+Rd)+(Ixa+Rd)+(Pom+dex) treatment programs, respectively, compared to Rd use in the 1st line. The ICER per 1 life year gained for Dara+Rd in 1st line therapy was 8.95 mln rubles for (Dara+Rd)+(K+Rd)+(Pom+dex) and 8.41 mln rubles for (Dara+Rd)+(Ixa+Rd)+(Pom+dex). It's lower than the median ICER of 13.64 million per 1 life year gained for antitumor drugs used to treat cancer of lymphatic and hematopoietic tissues (reference ICER). Dara+Rd triplet is used in 2nd line therapy after Rd, the number of life years gained in the target population due to greater efficacy is higher by 291.50 years compared with K+Rd and by 203.93 years compared with Ixa+Rd. The ICER per 1 life year gained for Dara+Rd is also lower than the ICER reference value: 9.25 mln rubles versus 13.64 mln rubles. The budget impact analysis showed that using Dara in early stages of MM therapy does not increase drug provision costs in the target population.Conclusion. The obtained results allowed to conclude that it is economically feasible to add Dara to the 1st and 2nd lines of therapy in lenalidomide treatment programs for MM patients who are not candidates for HDCT with autoHPSCT.

[Development of Transdermal Formulation Based on Nanotechnology and Elucidation of Its Drug Delivery Pathways].

Transdermal drug delivery is a formulation in which the drug is absorbed through the skin for systemic action. Its advantages include avoidance of first-pass effects, sustained drug supply, and ease of administration and discontinuation. Drugs administered transdermally transfer into the blood circulation through the stratum corneum, epidermis, and dermis. The stratum corneum on the skin surface plays a barrier function in skin absorption. Therefore, developing of transdermal drug delivery systems requires innovations that overcome the barrier function of the stratum corneum and improve skin permeation. This review examines the usefulness of transdermal formulations based on solid nanoparticles using raloxifene. Milled raloxifene was gelled with (mRal-NPs) or without menthol (Ral-NPs) using Carbopol. The drug release and transdermal penetration were measured using a Franz diffusion cell, and the therapeutic evaluation of osteoporosis was determined in an ovariectomized rat model. Although the raloxifene released from Ral-NPs remained in the nanoparticle state, the skin penetration of raloxifene nanoparticles was prevented by the stratum corneum in rat. The inclusion of menthol in the formulation attenuated the barrier function of the stratum corneum and permitted raloxifene nanoparticles to penetrate through the skin. Moreover, macropinocytosis relates to the formulation's skin penetration, including menthol (mRal-NPs). Applying mRal-NPs attenuated the decreases in calcium level and stiffness of bones of ovariectomized rats. This information can support future studies aimed at designing novel transdermal formulations.

Pharmaceutical sector: Packaging requirement in serialization

Access to healthcare is a fundamental right for every individual, and it is the responsibility of governments to ensure the provision of quality healthcare services and infrastructure to their citizens. Over the past few decades, both governments and the healthcare industry have been grappling with the challenge of minimizing the adverse effects on public health caused by counterfeit medicines. According to the World Health Organization, approximately four out of ten medicines in developing and impoverished countries are either fake or potentially adulterated, leading to significant economic losses and reducing funds allocated for research and development (R&D) by organizations. Preventing counterfeit medicines from entering the supply chain poses a significant challenge for governments and regulatory authorities. Consequently, there is a concerted effort to establish stringent guidelines aimed at thwarting criminals and counterfeiters from infiltrating markets with fake medications. The healthcare industry recognizes the necessity for strict regulations and secure technologies to ensure the provision of safe and authentic drugs to patients. In the United States, the FDA has outlined a ten-year roadmap to implement drug traceability measures. Additionally, the Healthcare Distribution Alliance (HDA) has mandated the inclusion of multiple barcodes and human-readable data in product packaging hierarchy. Furthermore, the FDA is actively engaged in a pilot project with leading pharmaceutical manufacturers and wholesalers to explore the utilization of blockchain technology within an interoperable digital network for securing the transfer of digital traceability data among authorized trading partners.

Directions of improving management of innovative activities in pharmaceutical companies

The purpose of the work is to substantiate theoretical provisions and practical recommendations for improving the management of innovative activities of pharmaceutical companies (PC) for the implementation of strategic tasks regarding innovative development and increasing competitiveness. Materials and methods. To achieve the goal of the study, scientific sources on innovation management and intellectual property management and the peculiarities of the organization of innovation processes in pharmacy were analyzed. When conducting research, methods of information search, systematization, comparison, and generalization were used, as well as the method of expert evaluations, taxonomic analysis, and a graphic method to increase the clarity of the presentation of the material. The results. The main directions and features of innovative activity in pharmacy have been studied. A generalized algorithm for managing innovative activities in pharmaceutical companies is given. The relevance of evaluating and managing the innovative potential of PC to achieve a synergistic effect from the use of resources involved in innovative activities is substantiated. A structural model of the innovative potential of PC is proposed, which considers the peculiarities of the flow of innovative processes in pharmacy, related to the development and introduction of new pharmaceuticals to the market. A methodical toolkit for quantitative and qualitative evaluation of the innovative potential of PC has been defined. To improve the management of the PC's innovative activity, a methodology for determining the range of management decisions is proposed based on the results obtained in the framework of creating a report on the patent landscape. Conclusions. In order to achieve the provision of effective and safe domestic drugs to the population of Ukraine, it is necessary to intensify research in the direction of the formation of an effective system of management of the innovative activity of pharmaceutical companies (PC), focused on their gradual transition to an innovative development model. The conducted analysis showed that despite a sufficiently large number of publications devoted to the problems of innovation management, issues related to the problem of forming an effective system of managing the innovative activity of PCs, as well as choosing an effective toolkit for evaluating and managing their innovative potential, taking into account the specifics of the flow of innovative processes in pharmacy, remain insufficiently disclosed and require further research. The proposed structural model of the innovative potential of the FC, a justified methodological toolkit for its assessment, as well as the construction of a cognitive map to determine the most appropriate key components and directions for further improvement and development of the innovative potential will contribute to increasing the efficiency of the innovative activities of enterprises and the implementation of the goals of the innovation strategy. The developed algorithm of preventive management of innovative activity of the PC, aimed at improving the quality of decisions made on innovation management thanks to the use of patent landscape tools, will also contribute to the faster entry into the market of domestically produced innovative medicinal products

State measures to ensure the availability of penicillin in the USSR over the second half of the 1940s

Based on the analysis of declassified documents of the State Archive of the Russian Federation and the Russian State Archive of Economics, the article considers the issue of measures taken by the USSR government in the second half of the 1940s to ensure economic and physical accessibility for the population of the country of a new drug — penicillin. The author provides information on the number of enterprises that produced antibiotics in the USSR during this period, the total volume of their production. It is shown that the capacity of domestic enterprises for a long time did not allow covering the calculated healthcare need for the drug, which determined its acute shortage. The article considers the process of pricing and government regulation of the price of a domestic drug. Based on a comparison of the cost of penicillin therapy and the income level of the population, it was concluded that the drug was affordable for the country’s residents by the end of the 1940s — beginning of the 1950s. In the conditions of an acute shortage of penicillin in the USSR in 1947, a system of centralized distribution of an antibiotic, paid for from the state budget, was introduced in medical institutions of the country. The Ministry of Health of the USSR developed a special distribution coefficient that determined the share of a particular republic in the total volume of drug supplies. The same principle was also translated to subsequent levels of distribution: by regions and cities. The article reflects the problems that accompanied the process of managing drug turnover within the country. The author showed that the introduction of penicillin into wide clinical practice, accompanied by state support measures, even despite the continued shortage of the drug, quickly and positively affected the health of the population of the USSR.

Implementation opportunities and challenges to piloting a community-based drug-checking intervention for sexual and gender minority men in Vancouver, Canada: a qualitative study

BackgroundIn response to the overdose crisis, a collaborative group of two community-based organizations, a health authority and a research institute in Vancouver, Canada, implemented a pilot community-based drug checking (CBDC) intervention for sexual and gender minority (SGM) men. This study identified key factors that influenced the implementation of the CBDC intervention, including opportunities and challenges.MethodsWe conducted semi-structured interviews with seven pertinent parties involved in the CBDC, including policymakers, researchers and representatives from community-based organizations. These interviews were coded and analyzed using domains and constructs of the Consolidated Framework for Implementation Research.ResultsWhile drug-related stigma was identified as a challenge to deliver drug checking services, participants described the context of the overdose crisis as a key facilitator to engage collaboration between relevant organizations (e.g., health authorities, medical health officers, community organizations) to design, resource and implement the CBDC intervention. The implementation of the CBDC intervention was also influenced by SGM-specific needs and resources (e.g., lack of information about the drug supply). The high level of interest of SGM organizations in providing harm reduction services combined with the need to expand drug checking into community spaces represented two key opportunities for the CBDC intervention. Here, SGM organizations were recognized as valued partners that fostered a broader culture of harm reduction. Participants’ emphasis that knowing the composition of one’s drugs is a “right to know”, particularly in the context of a highly contaminated illicit drug market, emerged as a key implementation factor. Lastly, participants emphasized the importance of involving SGM community groups at all stages of the implementation process to ensure that the CBDC intervention is appropriately tailored to SGM men.ConclusionsThe context of the overdose crisis and the involvement of SGM organizations were key facilitators to the implementation of a drug checking intervention in SGM community spaces. This study offers contextualized understandings about how SGM knowledge and experiences can contribute to implement tailored drug checking interventions.

Factors Affecting the Pharmaceutical Supply Chain: A Systematic Review

Background: Medicine plays a crucial role in societal health, and even minor disruptions in the supply chain can lead to crises. An organized supply chain ensures that patients receive their medications in the best possible conditions. Objectives: This study aims to identify and categorize key variables associated with the pharmaceutical supply chain. Methods: We conducted a systematic review of all studies on drug supply chain management, adhering to the PRISMA guidelines. The search was carried out in both international and national databases from January 30, 2000, to March 30, 2023. We used specific keywords related to the drug supply chain for this search. We excluded articles, letters to the editor, and editorials from the review and ultimately qualitatively examined 34 studies. The quality of these articles was assessed using the CASP checklist. Results: We identified key variables and classified them into five categories: monitoring and control (16 variables), information technology and intelligence (4 variables), human capital (10 variables), physical and financial resources (16 variables), and suppliers (4 variables). Conclusions: It is imperative for health policymakers to develop effective strategies in monitoring and control, information technology and intelligence, human capital, physical and financial resources, and management of drug suppliers. These strategies are essential for the efficient supply and distribution of drugs within the supply chain.

Estimating changes in overdose death rates from increasing methamphetamine supply in Ohio: Evidence from crime lab data

BackgroundWe investigate the relationship between the supply of methamphetamine and overdose death risk in Ohio. Ohio and the overall US have experienced a marked increase in overdose deaths from methamphetamine combined with fentanyl over the last decade. The increasing use of methamphetamine may be increasing the risk of overdose death. However, if people are using it to substitute away from more dangerous synthetic opioids, it may reduce the overall risk of overdose death. MethodsOhio’s Bureau of Criminal Investigation’s crime lab data include a detailed list of the content of drug samples from law enforcement seizures, which are used as a proxy for drug supply. We use linear regressions to estimate the relationship between the proportion of methamphetamine in lab samples and unintentional drug overdose death rates from January 2015 through September 2021. ResultsRelatively more methamphetamine in crime lab data in a county-month has either no statistically significant relationship with overdose death rates (in small and medium population counties) or a negative and statistically significant relationship with overdose death rates (in large population counties). Past overdose death rates do not predict future increases in methamphetamine in crime lab data. ConclusionsThe results are consistent with a relatively higher supply of methamphetamine reducing the general risk of overdose death, possibly due to substitution away from more dangerous synthetic opioids. However, the supply of methamphetamine appears unrelated to the past illicit drug risk environment. The non-lethal and yet serious health effects of MA use were not explored and, thus, even if the presence of MA reduces the population-level overdose mortality rate, the rise of other adverse health effects may counteract any public health benefits of fewer deaths.

Changes in injecting versus smoking heroin, fentanyl, and methamphetamine among people who inject drugs in San Diego, California, 2020–2023

BackgroundAmidst an increasingly toxic drug supply in North America, people who inject drugs may be transitioning to smoking them. We aimed to assess changes in injecting and smoking opioids and methamphetamine among a cohort of people who inject drugs from San Diego, California. MethodsOver five six-month periods spanning October 2020–April 2023, we assessed prevalence of injecting and smoking opioids or methamphetamine and whether participants used these drugs more frequently by smoking than injecting. Multivariable Poisson regression via generalized estimating equations was used to examine time trends. ResultsOf 362 participants, median age was 40 years; a minority were female (29%), Hispanic/Latinx/Mexican (45%), and housed (33%). Among this cohort, of whom 100% injected (and 84% injected and smoked) in period one (October 2020-April 2021), by period five (November 2022-April 2023), 34% only smoked, 59% injected and smoked, and 7% only injected. By period five, the adjusted relative risk (aRR) of injecting opioids was 0.41 (95% Confidence Interval [CI]: 0.33, 0.51) and the aRR for injecting methamphetamine was 0.50 (95% CI: 0.39, 0.63) compared to period one. Risks for smoking fentanyl rose significantly during period three (aRR=1.44, 95% CI: 1.06, 1.94), four (aRR=1.65, 95% CI: 1.24, 2.20) and five (aRR=1.90, 95% CI: 1.43, 2.53) compared to period one. Risks for smoking heroin and methamphetamine more frequently than injecting these drugs increased across all periods. ConclusionsOpioid and methamphetamine injection declined precipitously, with notable increases in smoking these drugs. Research is needed to understand the health consequences of these trends.

Blockchain integration in healthcare: a comprehensive investigation of use cases, performance issues, and mitigation strategies.

Healthcare is a critical area where blockchain technology (BT) is being heralded as a potential game-changer for facilitating secure and efficient data sharing. The purpose of this review is to examine BT applications, performance challenges, and solutions in healthcare. To begin, This review paper explores popular blockchain networks for data exchange, encompassing both public and permissioned platforms, such as Ethereum and Hyperledger Fabric. This paper analyzes the potential applications of BT's decentralized, immutable, and smart contract capabilities in healthcare settings, including secure and interoperable health data exchange, patient consent management, drug supply chain oversight, and clinical trial management. The healthcare industry might greatly benefit from the increased privacy, transparency, and accessibility that these technologies provide. Despite BT's promising medical uses, the technology is not without its drawbacks. High energy consumption, throughput, and scalability are all concerns. We wrapped up by discussing the solutions that have been implemented, including consensus processes, scalability measures like sharding, and off-chain transactions that are designed to mitigate the drawbacks.

Black Americans' Drug Mortality Increases and Local Employment Opportunities, 2010‒2021.

Objectives. To test the associations between local employment opportunities for the Black workforce and drug mortality among Black Americans, while examining the potential moderating effects of fentanyl seizure rates. Methods. We derived data from the National Center for Health Statistics' restricted-access Multiple Cause of Death file, linked with county-level job counts, drug supply, and other characteristics from the US Census Bureau and the Centers for Disease Control and Prevention. After examining the characteristics of counties by the magnitudes of increases in drug mortality from 2010‒2013 to 2018-2021, we conducted a first-differenced regression analysis to test the associations between the job-to-Black workforce ratio and age-adjusted drug mortality rates among Black Americans in US counties and test the moderating effects of state-level fentanyl seizure rates. Results. One more job per 100 Black workers was associated with 0.29 fewer drug overdose deaths per 100 000 Black Americans in the county. This negative association was stronger in the counties of the states with higher increases in fentanyl seizure rates. Conclusions. Increasing employment opportunities can be an important strategy for preventing Black Americans' drug mortality, especially among those living in areas with higher increases in fentanyl seizure rates. (Am J Public Health. Published online ahead of print April 25, 2024:e1-e4. https://doi.org/10.2105/AJPH.2024.307646).

Protocol for the development of a consensus practice guideline To address clinical and regulatory barriers to buprenorphine dispensing in community pharmacy

BackgroundLess than half of community pharmacies in the United States stock buprenorphine products indicated for the treatment of opioid use disorder. This lack of access to buprenorphine in community pharmacies is a significant barrier to care. To address this issue, this protocol outlines a comprehensive approach to develop a practice guideline aimed at improving access to safe and effective opioid use disorder treatment in community pharmacies.MethodsThe guideline development process will proceed in three phases, following a technique closely aligned with the Institute of Medicine’s guidance on guideline development. The first phase will involve conducting qualitative interviews with pharmacists in three states to identify their beliefs toward buprenorphine dispensing. As limitations on buprenorphine supply are related to constraints at all levels of the drug supply and regulatory system, the second phase, we will recruit representatives from regulatory agencies, pharmacy organizations, the Drug Enforcement Administration, pharmaceutical wholesalers as well as addiction medicine physicians and psychiatric pharmacists to develop consensus recommendations through a modified Delphi design. This will be followed by a public comment period and external expert review of the recommendations led by the National Association of Boards of Pharmacy. Finally, in the third phase, a national, mixed media dissemination campaign will be led by the National Community Pharmacists Association (NCPA) to convey recommendations to practicing pharmacists.DiscussionThe guideline development process aims to incorporate the perspectives of multiple stakeholders and emphasize the importance of addressing the regulatory and pharmacy-specific aspects of care in addition to clinical evidence and guidance. The development of this guideline will provide targeted, multidisciplinary guidance for pharmacists, improving access to safe and effective opioid use disorder treatment in the community setting.PreregistrationThis protocol was registered with the Open Science Framework in March of 2023. Registration may be found at: https://doi.org/10.17605/OSF.IO/6S9DY.

Containing an epidemic in the case of running out of treatment: A switched system approach

In this paper, we discuss an epidemic switched system. A susceptible–infected–treated model is considered. The course of an epidemic is profoundly influenced by the allocation of resources. If these resources are limited, then we need to devise an optimal distribution strategy. One significant case to study is when the drug supply is insufficient. We study a control problem that minimizes the total outbreak size of the epidemic and optimizes the rate of vaccination/isolation control by minimizing the suitable functional subject to resource constraints. In the end, simulations are performed for illustrations.

Features of anti-drug work with students of non-medical specialties of higher and secondary professional education in the Kursk region in the conditions of post-pandemic reality

The problem of drug addiction is a problem that affects all spheres of society: economic, political, legal, large-scale, moral. Throughout post-Soviet history, since only the silence of these phenomena was a crisis, drug addiction has been an exclusively youth problem. Works from the 1990s to the early 2000s pointed to a rejuvenation of drug addiction problems: the most progressive drug addiction was in the age group from 15 to 19 years, and in the period from 2000 to 2010, the average age of initiation of drug addiction decreased to 10-14 years [7 ]. From 2012 – 2014 There was a tendency towards a restructuring of the morbidity structure, and it was revealed that the most vulnerable group of the population are people aged 18 to 40 years [6]. The average age of first trial has also shifted towards adulthood [3]. All this indicates that student youth are the most vulnerable to drug addiction risk factors. With the onset of the pandemic and the lockdown, teenagers and young people found themselves in London. Many were forced to be alone for several days due to sudden poisoning, many suffered due to losses at work and their only source of income. At the same time, psychological risk factors associated with drug use have worsened [6]. According to the data obtained by the Russian authorities, due to the reduction in the distribution and availability of narcotic substances in the first two months of the pandemic, there was a rapid decline in the detection of drug-related crimes. However, after some time, the popularity of not only communication on social networks increased, but also the sale of drugs through them among teenagers and students. According to the Ministry of Internal Affairs of the Russian Federation, drug distribution and trafficking have increased in the context of the web, and since the summer of 2020, the volumes of the illegal drug market have recovered and increased to heights [8, 9]. Thus, the period under study is 2022–2023. The youth community approached in the context of the consequences of serious psychological trauma, a shortage of anti-drug information during the covid period and an intensification of the illegal supply of drugs. Prevention 2022 – 2023 – this is largely ―catching up.‖

Numerical study of the distribution of sprayed particle deposition in different human nasal cavity

This article numerically investigates the propagation of nasal sprayer particles to improve drug delivery through the nasal cavity. Topical nasal sprays are among the generally dictated therapeutic agents for sinus disorders in humans. However, the inconsistency of instructions indicates a lack of definitive knowledge of the best methods for nebulizing drugs. This study suggested nasal spray angles that could improve local drug delivery to the affected area compared to common spray methods. In this study, various particle diameters and aerosol flow angles are examined to evaluate the optimal efficiency of drug supply into the nasal cavity. Computational simulation of a particle-laden flow is performed in the nasal cavity of a healthy patient and a patient with rhinitis. The numerical results of this work open up new possibilities for proposing an alternative user-friendly plan that can essentially improve local drug delivery to the human nasal cavity.

Analysis of the Supply Chain in Managing Second-line Anti-TB Drugs at State Drug Stores: An Observational Study

Abstract: Introduction: MDR-TB is a global health threat requiring uninterrupted access to second-line TB drugs for successful treatment. Inefficiencies in the supply chain can disrupt access, prompting this investigation into stockout factors at an SDS in Maharashtra, India. Objectives: Study investigates the drug supply chain at the State Drug Store (SDS). Measure the stock situation for second-line anti-TB drugs at the SDS. By analyzing stakeholder perspectives, the study will explore factors contributing to gaps invloved. Materials and Methods: A cross-sectional study was conducted from October 2023 to January 2024 in one of three State Drug Stores (SDS) located in Maharashtra, India. Maharashtra has 3 SDS and to ensure anonymity, the SDS involved in the study are labeled as SDS1. Five-year retrospective data of the TB drug supply chain from the Central TB Division website (quantitative) and primary data rom stakeholders (interviews, document review, TB program survey) were analyzed using Power Query (quantitative) and thematic analysis (qualitative) to identify trends, challenges, and stakeholder perspectives. Results: The key findings of the study are stockouts of medicines, expiry of drugs and delay in disposal of expired drugs, insufficient fund allotment for local purchases, and inadequate quantities received from the Central TB Division (CTD). Conclusion: State Drugs State in total has been maintained well and it is crucial to recognize the ongoing efforts of the SDS to navigate these difficulties and ensure patient access to vital medications. Moving forward, implementing the proposed solutions like demanding funds from higher authorities to start local purchases can strengthen the SDS's ability to provide uninterrupted access to essential medications.