Oral Administration Of Drug Research Articles

The Effect of Polymer-Solvent Interaction on the Swelling of Polymer Matrix Tablets: A Magnetic Resonance Microscopy Study Complemented by Bond Fluctuation Model Simulations.

Polymer matrix tablets are an important drug-delivery system widely used for oral drug administration. Understanding the tablet hydration process, both experimentally and theoretically, is, thus, very important for the development of drug delivery systems that exhibit high drug loading capacity and controlled release potential. In this study, we used magnetic resonance microscopy (MRM) to nondestructively and dynamically analyze the water hydration process of xanthan-based tablets. The swelling process was characterized by well-resolved fronts of erosion, swelling, and penetration. The experimental results were complemented by numerical simulations of the polymer matrix hydration process. In the simulations, the polymer tablet matrix was modeled as an assembly of interacting chains with embedded drug particles, while its hydration process was mediated by interaction with solvent particles. The swelling dynamics were modeled within a Monte Carlo-based bond fluctuation model (BFM) that elegantly accounted for steric and nearest-neighbor interactions. This study provides an efficient experimental-theoretical approach for the study of polymer matrix swelling processes.

Oral delivery of posaconazole-loaded phospholipid-based nanoformulation: Preparation and optimization using design of experiments, machine learning, and TOPSIS

Phospholipid-based nanosystems show promising potentials for oral administration of hydrophobic drugs. The study introduced a novel approach to optimize posaconazole-loaded phospholipid-based nanoformulation using the design of experiments, machine learning, and Technique for Order of Preference by Similarity to the Ideal Solution. These approaches were used to investigate the impact of various variables on the encapsulation efficiency (EE), particle size, and polydispersity index (PDI). The optimized formulation, with %EE of ∼ 74 %, demonstrated a particle size and PDI of 107.7 nm and 0.174, respectively. The oral pharmacokinetic profiles of the posaconazole suspension, empty nanoformulation + drug suspension, and drug-loaded nanoformulation were evaluated. The nanoformulation significantly increased maximum plasma concentration and the area under the drug plasma concentration–time curve (∼3.9- and 6.2-fold, respectively) and could be administered without regard to meals. MTT and histopathological examinations were carried out to evaluate the safety of the nanoformulation and results exhibited no significant toxicity. Lymphatic transport was found to be the main mechanism of oral delivery. Caco-2 cell studies demonstrated that the mechanism of delivery was not based on an increase in cellular uptake. Our study represents a promising strategy for the development of phospholipid-based nanoformulations as efficient and safe oral delivery systems.

Observing the clinical efficacy of combined serum microneedle therapy for moderate to severe androgenetic alopecia in scalp repair.

In this study, the safety and efficacy of scalp repair serum microneedles combined with oral drug administration and topical medication were investigated for the treatment of moderate to severe androgenetic alopecia. Twenty patients, consisting of 4 males and 16 females, who sought treatment for moderate to severe androgenetic alopecia at our hair medicine research center alopecia specialty clinic between August and December 2022 were randomly selected for the study. Male patients underwent oral administration of finasteride topical application of 5% minoxidil, and biweekly scalp repair serum microneedle therapy. Female patients were administered spironolactone or Diane-35 orally and applied 2% minoxidil topically, paired with biweekly scalp repair serum microneedle therapy sessions. After seven treatments, the scalp repair serum microneedle was discontinued, but oral administration and topical applications were continued, followed by a 1-month follow-up. Using a hair dermoscopy, hair follicles in a fixed region on the top of the head were manually counted per unit area to evaluate the hair restoration status of the patients quantitatively. All 20 patients completed 3 months of combined therapy and a 1-month follow-up. On average, the patients experienced an increase of 42.6 hairs, with an efficiency rate of 100%. Significant differences were observed in hair count between any two of the first seven treatments (p<0.001). A significant negative correlation was discovered between the initial pre-treatment hair count and the total improvement of hair (p<0.001), indicating that the greater the degree of hair loss before treatment, the more pronounced the improvement. Scalp repair serum microneedle combined therapy in moderate to severe androgenetic alopecia significantly reduces the number of microneedle treatments required, enhances treatment efficacy, and improves therapeutic outcomes.

MgO Nanoparticle Synthesis, Chemical Delivery in Rat Model Induced Lung Injury

Acute lung injury is a disorder of acute inflammation that causes disruption of the lung endothelial and epithelial barriers. Acute Respiratory Distress Syndrome or ARDS is a diffuse inflammatory lung process that frequently manifests in critically ill patients, with an estimated incidence of 3 million people a year. Clinically, ARDS is manifested by bilateral or diffuse radiographic infiltrates, hypoxemia, decreased lung compliance, and increased ventilatory dead space. The histological manifestation of ARDS is diffuse alveolar damage as defined by epithelial injury, hyaline membrane formation and alveolar flooding with proteinaceous fluid, increase alveolar surface area and frequently neutrophilic inflammation. The animal model correlate to ARDS as an acute lung injury (ALI). Models were employed to test potential new therapeutic interventions and to investigate under-lying mechanistic pathways that lead to diffuse lung injury. In this study cage cigarette smoke model was used for an acute lung injury. For that purpose, thirty (30) young albino healthy rats were used, and their duration of trial was 21 days. Each group was given an oral drug administration containing MgO-150mg/kg, MgO-300mg/kg BW for treatment and diet schedule in young albino rats of male sex for the experimental procedure of 0 to 21 days. Mean body weight, BALF, lipid profile, liver profile and lung histology were assessed. Results revealed that MgO nanoparticles exhibited antioxidant capacity at dosages of 300mg/kg, and 150mg/kg. This formulation of selected nanoparticles at high dose exhibited an acute lung injury and antioxidant effects as compared to low dose extract. Additionally, transcriptional factors revealed up-regulation at high dose in contrast to the low dose extract in lung injury treated groups.

Development of a New Jelly Coating Technology (Oral Jelly Coating) to Improve Prescribed Medication Adherence.

Tablets are the most commonly prescribed dosage form for oral drug administration. Historically, improvement of medication adherence of tablets has been facilitated through, for example, the use of smaller tablets, distinctive shaped tablets and sugar-coated tablets. In addition, new formulation technologies such as orally disintegrating tablets (OD tablets), micro tablet-type granules, jellies, and film formulations are making it possible to create more easily ingested dosage forms. We have developed a new oral jelly coating formulation that can be applied to any sized tablet without reducing the size of the formulation. It was found that this new jelly layer formed on the tablet surface improved the tablet's slipperiness with an appropriate amount of water, while ensuring no change in the dissolution profile. In addition, the jelly layer was ensured storage stability over time without affecting the dissolution profile. Although further studies are needed, this coating technology can quickly change the tablet surface to a jelly-like state after the tablet is taken, giving the tablet the same slipperiness as if it were taken in jelly, making it easier to pass through the pharynx, and thus improving medication adherence.

Exploring the diversityof uncommon oral yeast species andassociated risk factorsamong substance abusers insouthwestern Iran.

Yeast species are a group of coexistent microorganisms in the oral cavity that can cause opportunistic infections in vulnerable individuals, including addicts. This study aimed to identify the yeast species profile responsible for oral yeast colonization (OYC) and the associated risk factors in patients with substance use disorder (SUD) in Ahvaz, Iran. Oral samples were collected from drug users hospitalized in 12 addiction treatment centers, and the related clinical information was mined. Oral yeast species were identified using 21-plex PCR and sequencing of the internal transcribed spacer region (ITS1-5.8S-ITS2). A total of 244 yeast strains were identified from 245 individuals with substance abuse. Candida albicans was the most common species (37.7%) and non-albicans Candida was responsible for 57.7% of OYC, primarily C. dubliniensis (33.2%) and C. glabrata (11.9%). Moreover, uncommon oral yeasts constituted 5.3% of species, including Saccharomyces cerevisiae, Clavispora lusitaniae, Pichia kluyveri, Geotrichum candidum, Magnusiomyces capitatus, Hanseniospora opuntiae, Wickerhamomyces subpelliculosus, Trichosporon asahii, and Aureobasidium pullulans. Importantly, OYC exhibited associations with such factors as duration of drug use, daily drug consumption rate, opioid utilization, oral drug administration, and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) score. The present study is the pioneering investigation revealing the prevalence and diversity of oral yeast species, along with associated risk factors, in individuals with SUD in southwestern Iran. Furthermore, it underscores the importance of developing efficient and cost-effective diagnostic methods tailored for resource-constrained settings.

Comparison of Combined Parenteral and Oral Hormonal Contraceptives: A Systematic Review and Meta-Analysis of Randomized Trials.

Delivering contraceptive hormones through a transdermal patch or a vaginal ring might have advantages over the traditional oral route. To compare the effectiveness, compliance, and side effect profile of oral and parenteral drug administration methods. We performed a systematic literature search in four medical databases-MEDLINE (via PubMed), Cochrane Library (CENTRAL), Embase, and Scopus-from inception to 20 November 2022. Randomized controlled trials assessing the efficacy, compliance, and adverse event profile of combined parenteral and oral hormonal contraceptives were included. Our systematic search provided 3952 records; after duplicate removal, we screened 2707 duplicate-free records. A total of 13 eligible studies were identified after title, abstract, and full-text selection. We observed no significant difference in contraceptive efficacy (Pearl Index) between oral and parenteral drug administration (MD = -0.06, CI: -0.66-0.53; I2 = 0%). We found significant subgroup differences between parenteral methods in terms of compliance (χ2 = 4.32, p =0.038, I2 = 80%) and certain adverse events: breast discomfort (χ2 = 19.04, p =0.001, I2 = 80%), nausea (χ2 = 8.04, p =0.005, I2 = 75%), and vomiting (χ2 = 9.30, p =0.002; I2 = 72%). Both parenteral and oral contraceptives can be used as an effective contraceptive method, and the route of administration should be tailored to patient needs and adverse event occurrence.

Abstract A103: Developing small molecules to disrupt IL-17RB and MLK4 interaction for pancreatic cancer treatment

Abstract Nearly 40% of pancreatic cancer overexpressed pro-inflammatory Interleukin-17 receptor B (IL-17RB), and this signal pathway plays an essential role in promoting tumorigenesis and metastasis. Targeting the initial event of IL-17B/IL-17RB oncogenic signaling by disrupting IL-17RB-MLK4 interaction represents an excellent strategy for treating pancreatic cancer. To develop specific and effective small molecule disruptors, we have established a high-throughput screening (HTS) method using pY447 IL-17RB signal-based assay to identify blockers inhibiting IL-17B/IL-17RB oncogenic signaling. Three FDA-approved drugs were found to inhibit IL-17B-induced pY447 of IL-17RB signaling after screening 2560 FDA-approved drugs and 11000 TKI-related compounds. These drugs are more effective than the original loop peptide in inhibiting soft agar colony formation and spheroid formation of pancreatic tumor cells. Furthermore, we identified Drug H, which was not an anticancer drug before, could efficiently and specifically disrupt the interaction between IL-17RB and MLK4. Oral administration of Drug H can significantly suppress pancreatic tumor growth and metastasis and extend the life of mice with pancreatic tumors. Combining Drug H with gemcitabine treatment also showed synergistic effects in suppressing pancreatic tumor growth and metastasis. These data suggest Drug H may be a promising lead compound for disrupting IL-17RB/MLK4 and treating pancreatic cancer. Citation Format: I-Chih Chen, Yi-Ling Ko, Ching-Hsuan Huang, Jiin-Horng Lee, Yung-Cheng Lo, Chun-Mei Hu. Developing small molecules to disrupt IL-17RB and MLK4 interaction for pancreatic cancer treatment [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr A103.

Pain-free oral delivery of biologic drugs using intestinal peristalsis-actuated microneedle robots.

Biologic drugs hold immense promise for medical treatments, but their oral delivery remains a daunting challenge due to the harsh digestive environment and restricted gastrointestinal absorption. Here, inspired by the porcupinefish's ability to inflate itself and deploy its spines for defense, we proposed an intestinal microneedle robot designed to absorb intestinal fluids for rapid inflation and inject drug-loaded microneedles into the insensate intestinal wall for drug delivery. Upon reaching the equilibrium volume, the microneedle robot leverages rhythmic peristaltic contraction for mucosa penetration. The robot's barbed microneedles can then detach from its body during peristaltic relaxation and retain in the mucosa for drug releasing. Extensive in vivo experiments involving 14 minipigs confirmed the effectiveness of the intestinal peristalsis for microrobot actuation and demonstrated comparable insulin delivery efficacy to subcutaneous injection. The ingestible peristalsis-actuated microneedle robots may transform the oral administration of biologic drugs that primary relies on parenteral injection currently.

ЭФФЕКТИВНОСТЬ ЛЕЧЕНИЯ БОЛЬНЫХ ТУБЕРКУЛЕЗОМ ЛЕГКИХ С ПРЕ-ШЛУ И ШЛУ M. tuberculosis C ИСПОЛЬЗОВАНИЕМ РАЗЛИЧНЫХ СПОСОБОВ ВВЕДЕНИЯ ПРОТИВОТУБЕРКУЛЕЗНЫХ ПРЕПАРАТОВ

Aim: to evaluate effectiveness of treatment of patients with extensively drug resistant (XDR) or pre-extensively drug resistant (pre-XDR) pulmonary TB using parenteral administration of TB drugs. Materials and methods. We carried out a prospective open cohort study of 143 patients with pulmonary TB hospitalized in 2022. The patients were divided into two groups according to the route of drug administration. The main group consisted of 74 patients, who received parenteral TB drugs before sputum conversion followed by oral drug administration. Parenteral drug administration was indicated to patients with severe intoxication syndrome, advanced TB process, or concomitant gastrointestinal diseases. The control group consisted of 69 patients, who received all TB drugs orally. Oral drug administration was also indicated to patients with difficult venous access. Results. Sputum conversion was observed by the third month of treatment much faster in the main group than in the control group. Treatment effectiveness by cavity closure did not differ between the groups. Conclusion. Intravenous administration of TB drugs contributes to rapid sputum conversion, which allows earlier patient discharge from hospital or surgical treatment.

Revealing Changes in Celecoxib Nanostructured Lipid Carrier's Bioavailability Using Hyaluronic Acid as an Enhancer by HPLC-MS/MS.

Oral drug administration is the most common and convenient route, offering good patient compliance but drug solubility limits oral applications. Celecoxib, an insoluble drug, requires continuous high-dose oral administration, which may increase cardiovascular risk. The nanostructured lipid carriers prepared from drugs and lipid excipients can effectively improve drug bioavailability, reduce drug dosage, and lower the risk of adverse reactions. In this study, we prepared hyaluronic acid-modified celecoxib nanostructured lipid carriers (HA-NLCs) to improve the bioavailability of celecoxib and reduce or prevent adverse drug reactions. Meanwhile, we successfully constructed a set of FDA-compliant biological sample test methods to investigate the pharmacokinetics of HA-NLCs in rats. The pharmacokinetic analysis confirmed that HA-NLCs significantly enhanced drug absorption, resulting in an AUC0-t 1.54 times higher than the reference formulation (Celebrex®). Moreover, compared with unmodified nanostructured lipid carriers (CXB-NLCs), HA-NLCs enhance the retention time and improve the drug's half-life in vivo. HA-NLCs significantly increased the bioavailability of celecoxib. The addition of hyaluronic acid prolonged the drug's in vivo duration of action and reduced the risk of cardiovascular adverse effects associated with the frequent administration of oral celecoxib.

A stimulus responsive microneedle-based drug delivery system for cancer therapy.

The intricate nature of the tumor microenvironment (TME) results in the inefficient delivery of anticancer drugs within tumor tissues, significantly compromising the therapeutic effect of cancer treatment. To address this issue, transdermal drug delivery microneedles (MNs) with high mechanical strength have emerged. Such MNs penetrate the skin barrier, enabling efficient drug delivery to tumor tissues. This approach enhances drug bioavailability, while also mitigating concerns such as liver and kidney toxicity associated with intravenous and oral drug administration. Notably, stimulus responsive MNs designed for drug delivery have the capacity to respond to various biological signals and pathological changes. This adaptability enables them to exert therapeutic effects within the TME, exploiting biochemical variations and tailoring treatment strategies to suit tumor characteristics. The present review surveys recent advancements in responsive MN systems. This comprehensive analysis serves as a valuable reference for the prospective application of smart MN drug delivery systems in cancer therapy.

Synthesis, in silico, in vitro evaluation of furanyl- and thiophenyl-3-phenyl-1H-indole-2-carbohydrazide derivatives as tubulin inhibitors and anticancer agents.

Twenty-one new indole derivatives comprising of seven furanyl-3-phenyl-1H-indole-carbohydrazide derivatives and fourteen thiophenyl-3-phenyl-1H-indole-carbohydrazide derivatives were synthesised and biologically evaluated for their microtubule-destabilising effects, and antiproliferative activities against the National Cancer Institute 60 (NCI60) human cancer cell line panel. Among the derivatives, 6i showed the best cytotoxic activity exhibiting selectivity for COLO 205 colon cancer (LC50 = 71 nM), SK-MEL-5 melanoma cells (LC50 = 75 nM), and MDA-MB-435 (LC50 = 259 nM). Derivative 6j showed the strongest microtubule-destabilising effect. Both 6i and 6j were able to induce G2/M cell cycle arrest and apoptosis in MDA-MB-231 triple-negative breast cancer cells. Molecular docking simulation results suggested that these derivatives inhibit tubulin by binding at the colchicine site. The calculated molecular descriptors showed that the most potent derivatives have acceptable pharmacokinetic profiles and are favourable for oral drug administration.

A Review on: Formulation and Evaluation of Herbal Medicated Chewing Gum

One portable method of medicine delivery is chewing gum. It may be used to provide medications orally, either systemically or locally. In recent years, significant progress has been made in research and technology related to the oral medication administration route. Medicated chewing gum has gained international attention throughout the year due to its ability to promote patient compliance in both pediatric and geriatric patients as well as the general population. The Mayan Indians used to clean their teeth and refresh their breath by chewing tree resin from the sapodilla tree a thousand years ago. Over the course of the year, herbal chewing gum has been more widely accepted as a medication delivery method. Herbal chewing gum today contains a number of substances. A variety of characteristics, including color, stickiness, hardness, and in vitro drug release, are assessed for the prepared product. Chewing gum can be utilized as a portable medication delivery mechanism for oral drug administration, both systemic and local. The majority of people find chewing gum to be enjoyable. Medicated gum preparations frequently require organic solvents to solubilize the active ingredients, and it can be challenging to remove these organic solvents from the finished product.

Data-driven development of an oral lipid-based nanoparticle formulation of a hydrophobic drug.

Due to its cost-effectiveness, convenience, and high patient adherence, oral drug administration normally remains the preferred approach. Yet, the effective delivery of hydrophobic drugs via the oral route is often hindered by their limited water solubility and first-pass metabolism. To mitigate these challenges, advanced delivery systems such as solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) have been developed to encapsulate hydrophobic drugs and enhance their bioavailability. However, traditional design methodologies for these complex formulations often present intricate challenges because they are restricted to a relatively narrow design space. Here, we present a data-driven approach for the accelerated design of SLNs/NLCs encapsulating a model hydrophobic drug, cannabidiol, that combines experimental automation and machine learning. A small subset of formulations, comprising 10% of all formulations in the design space, was prepared in-house, leveraging miniaturized experimental automation to improve throughput and decrease the quantity of drug and materials required. Machine learning models were then trained on the data generated from these formulations and used to predict properties of all SLNs/NLCs within this design space (i.e., 1215 formulations). Notably, formulations predicted to be high-performers via this approach were confirmed to significantly enhance the solubility of the drug by up to 3000-fold and prevented degradation of drug. Moreover, the high-performance formulations significantly enhanced the oral bioavailability of the drug compared to both its free form and an over-the-counter version. Furthermore, this bioavailability matched that of a formulation equivalent in composition to the FDA-approved product, Epidiolex®.

Cubosomes: Recent Developments and Applications from a Global Perspective

Liquid crystalline cubosomes are self-assembly of aqueous lipid and surfactant mixture. They are discrete and sub-micron in size. It is an innovative lipid-based nanosystem resembling well-known vesicular systems including niosomes and liposomes. Cubic phases incorporate lipophobic, amphiphilic and hydrophilic, components through the utilization of a rounded bi-continuous lipid bilayer and water channels. Cubosomes contain lipids such as phytantriol (PHYT) and glycerol monooleate (GMO) which are amphiphilic in nature that are diffused in water and structured in 3-D as a “honeycomb” structure with suitable stabilizer (Poloxamer 407). Cubosomes are generated by mostly two techniques i.e., top-down, bottom-up methods. UV spectrophotometer, X-ray scattering, transmission electron microscopy, and photon correlation spectroscopy are used to characterize and evaluate cubosomes. They are commonly used in the administration of oral, ophthalmic, transdermal, and chemotherapeutic drugs. The liquid crystalline phase and bicontinuous cubic form nanoparticles are thoroughly discussed in this paper. In the current review search criterion used parameters affecting cubosomes bi-continuous lipid bilayer by top-down and bottom-up methods mostly. The sources referred from peer-reviewed recognized journals. Keywords used as filters were cubosomes, amphiphilic lipids, top-down, bottom-up, bicontinuous, GMO, and phytantriol (PHYT). For the purpose of a comprehensive update literature review over a range (1976–2023) has been conducted on the recent developments cubosomes system.

Difficulties in decision making on a long standing, complicated case of osteoporosis – a real challenge for functional rehabilitation

We aim was to present a case of severe osteoporosis with concern to an adult female who was under specific medication against the condition while she experienced inexplicable weight loss in association with an incidental fracture inconsistent with DXA changes. Challenges of the case management and decision making are further on explained. Real-life-medicine poses multiple issues that require an individual decision while respecting the standard protocols. That is why a generalized decision is rather impractical. Here we introduce the clinical case of a lady in her late 60s with a known 6-year history of osteoporosis that required several difficult decisions along surveillance: at first, zoledronic acid represented an available solution, yet after one year, BMD decreased and adjustment was done by initiating a second sequence according to the teriparatide protocol. DXA-BMD, as well as the spectrum of bone turnover markers, qualified the patient as responsive and she further continued with oral bisphosphonates while being monitored via telemedicine amid COVID-19 pandemic. After 24 more months, a second decision of zoledronic acid was done, despite prior partial response, but digestive complains restricted the oral administration of anti-osteoporotic drugs. After one more year, denosumab was initiated and consecutive follow-up is essential. At this point, another challenging aspect was revealed: the discordance between DXA – based scores increase and the presence of an incidental fracture. A supplementary investigation was considered useful (Tc- whole body scintigraphy) noting the clinical presentation with local pain, dysfunctionality, and mild weight loss that also required rehabilitation management.

Development and validation of a nomogram for predicting the risk of poor prognosis in patients with cerebral infarction

ObjectiveTo identify factors related to poor prognosis in patients with cerebral infarction (CI) and to construct and validate a personalized prediction model based on these factors. MethodsA retrospective analysis was conducted on the clinical and follow-up data of 857 patients with CI who were diagnosed in the neurology department of a tertiary A hospital in Anhui Province, China from April 2020 to March 2022. Based on follow-up data and the Modified Rankin Scale (mRS) score one year after discharge, patients were divided into a good prognosis group (793 cases, mRS ≤2) and a poor prognosis group (64 cases, mRS >2). Multivariate logistic regression analysis was used to identify independent risk factors, which were then used to establish a nomogram model. The predictive performance of the model was evaluated using the area under the receiver operating characteristic curve (ROC, AUC), and the calibration curve was used to evaluate the calibration of the nomogram. ResultsThere was a statistically significant difference in the distribution of eight variables between the groups, including post-discharge use of biguanide hypoglycemic drugs, insulin, systolic blood pressure, exercise status, alcohol consumption, smoking status, age, and gender (P < 0.05). Multivariate logistic regression analysis suggested that gender, smoking after discharge, alcohol consumption, lack of exercise, and oral administration of biguanide hypoglycemic drugs are independent risk factors for poor prognosis in patients with CI (P < 0.05). The personalized poor prognosis nomogram constructed based on these five predictive factors showed good discriminative ability and predictive stability, with AUCs of 0.768 (95 % CI: 0.712–0.825) and 0.775 (95 % CI: 0.725–0.836) before and after internal validation, respectively. The calibration curve confirmed the accuracy and consistency of the nomogram (P = 0.956). ConclusionFemale gender, smoking, alcohol consumption, lack of exercise, and post-discharge use of biguanide hypoglycemic drugs are independent risk factors for poor prognosis in patients with CI. The constructed nomogram shows good predictive efficiency for post-discharge prognosis and can help in clinical decision-making.

In vivo and in vitro transdermal availability of Ibuprofen using novel solubility enhancing fluid nanosized carrier systems

The objective of this study was to explore the benefits of transdermal drug delivery systems as an alternative option for patients who are unable to tolerate oral administration of drugs, such as ibuprofen (IB). To achieve this, nonionic surfactants and three cosolvents were employed to develop new microemulsions (MEs) that contained IB as nanocarriers. The aim was to enhance the solubility and bioavailability of the drug after transdermal administration. The MEs were characterised by droplet size, polydispersity index (PDI), and rheological properties. Furthermore, the flux of IB was evaluated by Franz diffusion cells using excised rat skin and in vivo bioavailability using rats. The results showed that the MEs had ideal viscosity and droplet size below 100 nm. Moreover, using the developed MEs, an improvement in the solubility (170 mg/mL) and flux through the rat skin (94.6 ± 8.0 µg/cm2.h) was achieved. In addition, IB demonstrated a maximum plasma level of 0.064 mg/mL after 8 h of transdermal administration in rats using the ME with an increase in the bioavailability of about 1.5 times in comparison to the commercial IB gel. In conclusion, the developed nonionic MEs containing IB can be ideal nanocarriers and promising formulations for the transdermal administration of IB.

A cross sectional survey of nurses’ reasons for medication errors at private multispecialty hospitals in Madurai, India

Abstract Introduction Healthcare services should eliminate errors, but any human-involved tasks are prone to error and healthcare is no exception.1 Medication errors are possible in hospitals though they should be eliminated with utmost care. Such medication errors would lead to an increased fatality rate, the emergence of new diseases, increased mediation costs and extended hospital stays.2,3 Aim This cross-sectional study aimed to classify and to identify the reasons for medication error as reported by the nurses and the impact of the collaborative work of Nurses, Pharmacists and Doctors in reducing medication errors and improving patient safety. Methods An exploratory (cross-sectional) study was conducted to classify and to identify the reasons for medication error among 474 nurses working in private multispecialty hospitals in Madurai between January to May 2023. The data for the study was collected using a questionnaire which included demographic variables and questions on medication errors. The questionnaire was filled through a one-to-one interview method and the data collected were analysed using SPSS 21.0. Results The results of analyses done using SPSS revealed that 58.2% of nurses reported having made medication errors and 88.4% of them said they had reported these immediately on the occurrence of such errors to their nursing superintendents. The most common type of medication errors reported were wrong infusion rates and wrong medicines, especially for medicines with similar sounding names (sound-alike drugs). Lack of awareness of the causes of medication errors was found to be the major reason for the occurrence of such errors in hospitals. The analyses showed that there was a significant relationship between age, years of experience and medication errors. One-way ANOVA analysis revealed that the greater the age and experience, the lesser the occurrence of medication errors. However, there was no significant relationship between working shifts and medication errors. The findings also highlighted that the greater the number of patients in the ward, the higher the error in oral administration of drugs. The finding reveals that teamwork between nurses, pharmacists and doctors was reported to help to drastically reduce the number of errors. Discussion/Conclusion Whilst a small-scale study only and reliant on accurate self-reporting, the findings suggest that not all nurses report medication errors, which could result in adverse outcomes for patients. Hence the nursing managers or nursing superintendents should encourage nurses to report medication errors to ensure patient safety. The findings also suggest that collaborative work between nurses, pharmacists, and doctors can reduce medication errors, hence collaborative work and appointing clinical Pharmacists is important to reducing medication errors.