Pharmaceutical Press Research Articles

Sevoflurane analysis in forensic cases using headspace-gas chromatography-mass spectrometry: A case study

The objective is to present a case study related to forensic analysis of Sevoflurane Using Head Space (HS)-GCMS. For qualitative detection of volatile substances, this methodology might be helpful in conducting forensic analysis of such substances. Sevoflurane is an ether inhalation general anaesthetic agent. Sevoflurane is a volatile nonflammable fluorinated methyl isopropyl ether inhaled anaesthetic, chemically related to desflurane and isoflurane (C. M. Rosales, J. Forensic Sci., 2007, 52, 1408–1410). The low solubility and the absence of pungency facilitate rapid mask induction. It has been used as an inhaled anaesthetic since 1985. Its major distribution is initially to areas of high blood flow (brain, heart, liver and kidney) and later to less perfused organs. Sevoflurane can cause cardio-respiratory depression, hypotension, and malignant hyperthermia (M. Adachi, J. Anaesth., 1992, 68, 214–215). Seizures (convulsions) can occur during anaesthesia with Sevoflurane but Sevoflurane related deaths are rare. Various studies have been conducted for detection and quantification of Sevoflurane in postmortem and toxicological studies. The case was submitted at PFSA (Punjab Forensic Science Agency) for analysis consisting of bottle of suspected narcotics. The bottle was recovered from accused committing offence of criminal intimidation, life threat and physically assaulting his ex-wife and children. He trespassed into house and sprayed her with some bottle in order to molest her. He also threatened her children and his father in-law with pistol. The suspected bottle of spray was analyzed qualitatively using HS-GC-MS with slight modification in already validated method. About 1–2 mL of liquid was taken in headspace vial and heated up to 50–60oC (for vaporization) and about 1–2 μL of headspace sample was injected manually in GC. A gas chromatographic system 7890B series (Agilent Technologies, Palo Alto, CA, USA) coupled to MS detector. Agilent HP-5MS Ultra Inert column (30 m length, 250 μm ID, with film thickness of 0.25 μm) (D. Bourdeaux, J. Chromatogr. B. Analyt. Technol. Biomed. Life Sci., 2010, 878, 45–50). was used for the separation of constituents. Injection volume of 1 μL was used in split mode in 20:1 ratio at 250 °C. Helium gas was used as carrier gas with 1 mL/min flow rate with inlet pressure 12.051 psi. Oven temperature for GC column at 50 °C upheld for 2 min and then gradually increased to 150 °C at 50 °C/min for 1 minute. The total run time was set up for 5 min. The temperature for MS source and MS Quad were 230 °C and 150 °C respectively. Scan mode for m/z from 43–220 was done. Agilent GC Chemstation was used for data analysis. Results were compared with reference book (C. Maffat, Clark's Analysis of Drug and Poisons. 3rd. London-Chicago: Pharmaceutical Press, 2004, 2, 1558–1559). This exceptional crime case of using sevoflurane bottle for threatening and attacking received in our lab was evaluated for the presence of suspected drug. The sample analyzed using HS-GCMS showed a single peak on chromatogram at 1.282 + 0.01 minutes and the MS ions were matched with reference MS spectrum showing Sevoflurane which is being used as inhalation anaesthetic. Various studies suggested that Sevoflurane could possible cause irreversible circulatory depression and hypoxia and may cause death. It is the new case of decapitation with sevoflurane. The reported method is quite short and efficient in detection of Sevoflurane using HS-GCMS.

Donepezil overdose secondary to use of a smart home device for medication reminders.

British Journal of Hospital MedicineVol. 83, No. 1 Case ReportDonepezil overdose secondary to use of a smart home device for medication remindersGautam Sen, Tim WellsGautam SenCorrespondence to: Gautam Sen; E-mail Address: [email protected]Department of Cardiology, King's College Hospital NHS Foundation Trust, London, UKSearch for more papers by this author, Tim WellsDepartment of Cardiology, Salisbury District Hospital, Salisbury, UKSearch for more papers by this authorGautam Sen; Tim WellsPublished Online:26 Jan 2022https://doi.org/10.12968/hmed.2021.0243AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Assiri GA, Shebl NA, Mahmoud MA et al. What is the epidemiology of medication errors, error-related adverse events and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature. BMJ Open. 2018;8(5):e019101. https://doi.org/10.1136/bmjopen-2017-019101 Crossref, Medline, Google ScholarAtri A. The Alzheimer's disease clinical spectrum: diagnosis and management. Med Clin North Am. 2019;103(2):263–293. https://doi.org/10.1016/j.mcna.2018.10.009 Crossref, Medline, Google ScholarBirks JS, Harvey RJ. Donepezil for dementia due to Alzheimer's disease. Cochrane Database Syst Rev. 2018;6(6):CD001190. https://doi.org/10.1002/14651858.CD001190.pub3 Medline, Google ScholarChoi Y, Demiris G, Thompson H. Feasibility of smart speaker use to support aging in place. Innov Aging. 2018;2(suppl_1):560–560. https://doi.org/10.1093/geroni/igy023.2073 Crossref, Google ScholarHernandez RK, Farwell W, Cantor MD, Lawler EV. Cholinesterase inhibitors and incidence of bradycardia in patients with dementia in the veterans affairs new England healthcare system. J Am Geriatr Soc. 2009;57(11):1997–2003. https://doi.org/10.1111/j.1532-5415.2009.02488.x Crossref, Medline, Google ScholarJoint Formulary Committee. British National Formulary. London: BMJ Group and Pharmaceutical Press; 2018 Google ScholarNational Institute for Health and Care Excellence. Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease. 2018. https://www.nice.org.uk/guidance/ta217/resources/donepezil-galantamine-rivastigmine-and-memantine-for-the-treatment-of-alzheimers-disease-pdf-82600254699973 (accessed 25 November 2021) Google ScholarO'Brien K, Liggett A, Ramirez-Zohfeld V, Sunkara P, Lindquist LA. Voice-controlled intelligent personal assistants to support aging in place. J Am Geriatr Soc. 2020;68(1):176–179. https://doi.org/10.1111/jgs.16217 Crossref, Medline, Google ScholarShepherd G, Klein-Schwartz W, Edwards R. Donepezil overdose: a tenfold dosing error. Ann Pharmacother. 1999;33(7-8):812–815. https://doi.org/10.1345/aph.18273 Crossref, Medline, Google ScholarSmith E, Sumner P, Hedge C, Powell G. Smart-speaker technology and intellectual disabilities: agency and wellbeing. Disabil Rehabil Assist Technol. 2020;1–11. https://doi.org/10.1080/17483107.2020.1864670 Google Scholar FiguresReferencesRelatedDetailsCited byDonepezil overdose9 April 2022 | Reactions Weekly, Vol. 1901, No. 1 2 January 2022Volume 83Issue 1ISSN (print): 1750-8460ISSN (online): 1759-7390 Metrics History Published online 26 January 2022 Published in print 2 January 2022 Information© MA Healthcare LimitedPDF download

COVID-19 Pandemic and Trends in Clinical Trials: A Multi-Region and Global Perspective.

To evaluate the effect of the COVID-19 pandemic on clinical development, the number of newly started clinical trials in each geographical region between January 2018 and December 2020 were calculated based on data from the ClinicalTrials.gov database. Data regarding new drug applications were obtained from European Medicines Agency monthly reports, pharmaceutical company press releases, and the archives of the Drugs.com database. The mean percentage change in newly started clinical trials for diseases other than COVID-19 between each month in 2019 and the corresponding month in 2020 was −7.5%, with the maximum of −57.3% observed between April 2019 and April 2020. Similarly, the mean percentage change of reported results for each month in 2019 and 2020 was −5.1%, with the maximum of −27.4% observed in July 2020. The activity of clinical trials was decreased as the number of COVID-19 patients was increased, and a statistically negative correlation was observed between the prevalence of COVID-19 and the percentage decrease in the number of clinical trials stared or reported results. As for new drug submissions, decreases were observed in the latter half of 2020 compared with the same period during the previous year, for each indicator. A considerable decline in non-COVID-19 activity for all indicators regarding clinical developments was suggested during the first wave of the COVID-19 pandemic. It is important to recognize the situation and continue to make efforts to conduct clinical trials for both COVID-19 and no-COVID-19 for new medical developments in the future.

THE STATE OF THE PHARMACEUTICAL INDUSTRY IN THE KINGDOM OF MOROCCO

Abstract. IThe purpose of the article was to study the main characteristics of the pharmaceutical industry in Morocco. As materials were studied the official websites of pharmaceutical manufacturers in Morocco, policy documents of industrial pharmaceutical associations, specialized pharmaceutical press of Morocco, educational resources of Morocco and France. As a result, it was found that the pharmaceutical industries of Morocco and Russia are already interacting with each other: BIOCAD supplies high-tech drugs and production technologies to Morocco, Morocco has placed an order with R-Pharm for the purchase of a vaccine against COVID-19, produced under the license of AstraZeneca, and also ordered a million doses of Sputnik V vaccine. Morocco is one of the fastest growing countries in the Middle East and Africa with an economy of $119 billion, a population of 37 million,andtotalhealthspendingof5.5%ofGDP.Expendituresforhealthcarearequitehigh-53.6%oftotalfamilyexpenditures. 31.7% of total health care expenditure is spent on drug purchases. The pharmaceutical industry in Morocco began to develop in 1960 after the end of the French protector and the introduction of the obligation to localize drugs sold in Morocco by foreign pharmaceutical companies. The pharmaceutical industry in Morocco is represented by 51 factories, which cover 2/3 of the country’s drug needs. Mostly generics are produced, 10% of production is exported. The volume of the issue is $1.68 billion (2nd place in Africa). The products are of high quality and certified according to European standards. Morocco is endeavoring to transform its pharmaceutical industry into a strategic asset for influencing African countries through the creation of an «African House of Medicines» based in Morocco, which is the manufacturing and logistics center for medicines in Africa. The main documents regulating the pharmaceutical industry are: Law No. 17-04 of 2006. “Code of Medicines and Pharmacy” and Order of the Minister of Health No. 902-08 5654 of 2008. “Requirements for the premises of pharmaceutical organizations.” Thus, we conclude that the Kingdom is a regional leader with ambitious plans and a large backlog that needs new technologies, markets for pharmaceutical products, a large number of qualified personnel, high-tech drugs at affordable prices. The intensification of cooperation between Russia and Morocco will help both countries to gain a foothold in the rapidly growing pharmaceutical market in Africa.

Variation in UK guidelines for the first-line antimicrobial management of paediatric orbital cellulitis-time for national recommendations.

Stimes GT, Girotto JE. Applying pharmacodynamics and antimicrobial stewardship to pediatric preseptal and orbital cellulitis. Paediatr Drugs. 2019;21:427–38. Article Google Scholar Georgakopoulos CD, Eliopoulou MI, Stasinos S, Exarchou A, Pharmakakis N, Varvarigou A. Periorbital and orbital cellulitis: a 10-year review of hospitalised children. Eur J Ophthalmol. 2010;20:1066–72. Article Google Scholar Tsirouki T, Dastiridou AI, Ibanez Flores N, Castellar Cerpa J, Moschos MM, Brazitikos P, et al. Orbital cellulitis. Surv Ophthalmol. 2018;63:543–53. Article Google Scholar Amin N, Syed I, Osborne S. Assessment and management of orbital cellulitis. Br J Hosp Med. 2016;77:216–20. Article Google Scholar Wong SJ, Levi J. Management of pediatric orbital cellulitis: a systematic review. Int J Pediatr Otorhinolaryngol. 2018;110:123–9. Article Google Scholar Markham JL, Hall M, Bettenhausen JL, Myers AL, Puls HT, McCulloh RJ. Variation in care and clinical outcomes in children hospitalized with orbital cellulitis. Hosp Pediatr. 2018;8:28–35. Article Google Scholar European Centre for Disease Prevention and Control. Surveillance Atlas of Infectious Diseases. European Centre for Disease Prevention and Control; 2020. http://atlas.ecdc.europa.eu/public/index.aspx. Accessed 28 Jun 2020. Paediatric Formulary Committee. BNF for children 2016–2017. London, UK: BMJ Group, Pharmaceutical Press, and RCPCH Publications; 2016. Mathur S, Jackson C, Urus H, Ziarko I, Goodbun M, Hsia Y, et al. A comparison of five paediatric dosing guidelines for antibiotics. Bull World Health Organ. 2020;98:406–12F. Article Google Scholar McMullan BJ, Andresen D, Blyth CC, Avent ML, Bowen AC, Britton PN, et al. Antibiotic duration and timing of the switch from intravenous to oral route for bacterial infections in children: a systematic review and guidelines. Lancet Infect Dis. 2016;16:e139–52. Article Google Scholar World Health Organization. Global action plan on antimicrobial resistance. World Health Organization; 2015. https://www.who.int/antimicrobial-resistance/publications/global-action-plan/en/. Accessed 28 Jun 2020. Sharland M, Butler K, Cant A, Dagan R, Davies G, de Groot R, et al. editors. Manual of childhood infections: the blue book. 4th ed. Oxford, UK: Oxford University Press; 2016. The Royal Children’s Hospital Melbourne. Clinical Practice Guidelines: periorbital and orbital cellulitis. The Royal Children’s Hospital Melbourne; 2019. https://www.rch.org.au/clinicalguide/guideline_index/Periorbital_and_orbital_cellulitis/. Accessed 28 Jun 2020. National Centre for Disease Control. National treatment guidelines for antimicrobial use in infectious diseases. Version 1.0. National Centre for Disease Control; 2016. http://pbhealth.gov.in/AMR_guideline7001495889.pdf. Accessed 28 Jun 2020. Jackson TL, editor. Moorfields manual of ophthalmology. 2nd ed. London, UK: JP Medical Ltd; 2016. ENT UK. Orbital cellulitis management guidelines—for adults & paeds. ENT UK; 2017. https://www.entuk.org/sites/default/files/files/ENT%20UK%20Revised%20Orbital%20Cellulitis%20Flow%20Chart%202017.pdf. Accessed 28 Jun 2020. Horizon Strategic Partners. MicroGuide. Horizon Strategic Partners; 2020. http://www.microguide.eu. Accessed 28 Jun 2020. Brighton and Sussex University Hospitals NHS Trust. Management of pre-septal and orbital cellulitis. Brighton and Sussex University Hospitals NHS Trust; 2014. https://www.bsuh.nhs.uk/library/wp-content/uploads/sites/8/2019/03/Paediatric-Guidelines-Pre-septal-and-orbital-cellulitis-2014.pdf. Accessed 28 Jun 2020. Gloucestershire Hospitals NHS Foundation Trust. Orbital cellulitis/peri-orbital cellulitis (paediatric). Gloucestershire Hospitals NHS Foundation Trust; 2017. https://www.gloshospitals.nhs.uk/gps/antimicrobial-resources/paediatric-antibiotic-treatment-guidelines-site-infection/orbital-peri-orbital-cellulitis-paediatric/. Accessed 28 Jun 2020. Northern Care Alliance NHS Group. Antibiotics guidelines: paediatric prescribing guidelines. Northern Care Alliance NHS Group; 2018. https://www.srft.nhs.uk/EasysiteWeb/getresource.axd?AssetID=21914t 2018. https://www.networks.nhs.uk/nhs-networks/north-west-paediatric-allergy-immunology-infection/documents/antimicrobial-paediatric-guidelines-15-11-2018/view. Accessed 28 Jun 2020. University Hospitals of Leicester NHS Trust. Management of children with preseptal and orbital cellulitis. University Hospitals of Leicester NHS Trust; 2017. https://secure.library.leicestershospitals.nhs.uk/PAGL/Shared%20Documents/Preseptal%20and%20Orbital%20Cellulitis%20UHL%20Childrens%20Hospital%20Guideline.pdf. Accessed 28 Jun 2020. Brady MT, Jackson MA, Kimberlin DW, Long SS, editors. Red book: 2018–2021 report of the committee on infectious diseases. 31st ed. Itasca, USA: American Academy of Pediatrics; 2018. World Health Organization. Pocket book of hospital care for children: guidelines for the management of common childhood illnesses. 2nd ed. World Health Organization; 2013. https://www.who.int/maternal_child_adolescent/documents/child_hospital_care/en/. Accessed 28 Jun 2020. Download references University of Nottingham School of Medicine, Nottingham, UK David McMaster University Hospital Southampton NHS Foundation Trust, Southampton, UK Sanjay Patel The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK Catherine Marsh You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar Correspondence to David McMaster. The authors declare that they have no conflict of interest. Publisher’s note Springer...

P10 An audit to assess the prescribing of analgesia in children who present with pain crisis due to Sickle Cell Disease (SCD)

AimTo assess the prescribing of analgesia to manage pain crises in children with SCD. This was to establish whether the Trust was meeting national and local standards. Prompt pain control is essential to reduce length of stay and further complications.1Standards100% of admissions will be prescribed regular paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) at the recommended frequency unless contraindicated in accordance with national guidance.2 3100% of admissions will be prescribed appropriate doses of analgesia with consideration to weight and age in accordance with local policy.4MethodThe audit was registered with the Trust’s audit committee. A list of paediatric patients with the diagnosis of SCD was sought from paediatricians with an interest in haematology. A data collection form was created. Data was collected retrospectively over a one-year period. A total of 60 admissions were reviewed to check whether analgesia was prescribed regularly at the recommended frequency, and at the correct dose. Results were analysed using descriptive statistical analysis. Exclusion criteria included patients with hospital admissions under 24 hours.ResultsA total of 55 admissions were included in the final sample. The audit showed the Trust was non-adherent to both standards assessed. A total of 45% (95% CI [31.9%, 58.1%]) of admissions were prescribed regular analgesia. A total of 78% (95% CI [67.9%, 88.9%] of admissions were prescribed appropriate doses of analgesia. Two main reasons were found as to why analgesia was prescribed at the incorrect dose. This was due to incorrect weights recorded on the electronic system (n=4) and doses based on age only (n=8).ConclusionThe results show prescribers are familiar with the correct doses of analgesia but fail to prescribe analgesia regularly. This highlights an opportunity for education and training in the management of pain crisis in SCD. One recommendation includes development of an integrated care pathway booklet for paediatric patients presenting with pain crisis due to SCD. Integrated care pathway booklets have been implemented for other conditions such as cystic fibrosis yielding positive outcomes. The results have highlighted key issues surrounding the electronic prescribing system such as out-of-date weights remaining on the system unless updated, and default treatment protocols. The electronic prescribing system requires refinement for use within paediatrics. One suggestion includes compulsory weight field on admission. Limitations of this audit included small sample size. There was a lack of data to make suggestions based on different ages.ReferencesRees D, Olujohungbe A, Parker N, et al. Guidelines for the management of the acute painful crises in sickle cell disease. Br J Haemato 2003;120:744–752.National Institute for Health and Care Excellence (2012) Sickle cell disease: managing acute painful episodes in hospital. NICE Guideline (CG143).Paediatric Formulary Committee. BNF for Children (2018–2019). London: BMJ Group, Pharmaceutical Press, and RCPCH Publications; (2018).General Hospital (2015) Management of sickle cell disease in paediatric patients (CG377).

The Impact of COVID-19 on the Conduct of Clinical Trials for Medical Products in Korea.

BackgroundThe number of clinical trials conducted in Korea continues to increase and an increasing proportion focus on severe and rare incurable diseases. After the start of the severe acute respiratory syndrome, coronavirus disease 2019 (COVID-19), Korea Centers for Disease Control and Prevention (KCDC) developed guidelines to prevent the spread of infection. This study evaluated the impact of COVID-19 and the KCDC guideline on the conduct of clinical research in Korea. The purpose was to develop recommendations on how to minimize the risk of infection while enabling subjects to take part in the trials if no better alternative treatment options were available.MethodsThe impact on subject's scheduled visits and major milestones of clinical trials in Korea were measured by conducting a survey among clinical project manager (CPMs) working at global clinical research organization. The policy on monitor's access to hospital and site initiation meetings was investigated through correspondence with clinical trial center of 39 hospitals. The Top 25 pharmaceutical companies' official press and public clinical trial registry database were used to analyze companies' trial strategy during the pandemic and COVID-19 clinical research status, respectively.ResultsOf 85 CPMs, 12% reported that trial subjects' scheduled visits had been affected in their project. Monitors' access to hospital for source data verification was restricted at all sites in February 2020. Accordingly, 43% of 105 CPMs reported that the COVID-19 epidemic had an effect on study major milestones and data cleaning and database lock accounted for > 60% of milestones affected. In addition, 87% sites advised not to have site initiation meetings and 52% pharmaceutical companies suspended recruitment or new study start-up due to the pandemic. On the other hands, the number of COVID-19 related clinical trials increased rapidly in Korea and worldwide, with investigator-initiated trials accounting for 47% and 63% of all trials locally and globally, respectively. Most trials were phase 2 and were in the recruitment stage.ConclusionThe COVID-19 and the KCDC guideline influenced all parties involved in clinical trials in Korea. In order to ensure the safety and well-being of trial subjects during the pandemic, new approaches are required for clinical trials to respond to the impact actively. Method of non-contact is developed to replace and supplement the face-to-face contact and alternatives to reduce the travel is introduced to decrease the risk of infection for all trial participants in whole trial process. The relevant regulations should be developed and the guidelines for foreign countries need to be adopted in accordance with the situation in Korea. COVID-19 trial is rapidly increasing worldwide and continuous support of health authorities, regulation, and facilities is required for developing the treatments with protecting all trial participants.

Investigation of powder flow within a pharmaceutical tablet press force feeder – A DEM approach

Powder flow in rotary tablet presses, constituting one of the key machines in the tablet production chain, is today still considered as a black box. In this study, a discrete element approach is presented to assess the powder flow in a lab-scale rotary tablet press with a force feeder consisting of three paddle wheels of different shapes. Process conditions are chosen same as in reality and a model direct compression formulation with a poly-disperse particle size distribution is considered. Different means of process insights, e.g. tablet mass and API content, mass holdup in the different paddle wheel zones, particles' velocity, particle's segregation and mixing within the feeder, and residence time analysis, are presented. A direct link between the powder flow in the force feeder and the tablet quality attributes is established. Over the production time the particles filled into the dies have traveled different distances in the force feeder during which their particle properties might change. Thus over the die height differences in terms of particle size and particle properties due to particle attrition and over lubrication are identified. This intra-die variability is a direct consequence of the de-mixing in the force feeder and the shear forces exerted by the different paddle wheels. Modifications in terms of force feeder design, e.g. paddle wheel arrangement and blade shapes, are suggested as they could decrease the de-mixing side effect and enhance product quality. Finally, process understanding could be improved which helps in pharmaceutical development and increases the patient's safety.

Karen Baxter confirmed as managing director of Pharmaceutical Press

Karen Baxter confirmed as managing director of Pharmaceutical Press

Editorial: New Generation Therapeutic Modalities the importance of pharmacy and pharmaceutical science

I spend quite a bit of time collating information from pharmaceutical company press releases and news feeds to compile review articles describing the latest advances in therapeutic approaches (novel targets, growth in options for treatment of rare diseases, emerging modalities such as CAR-T, new drug delivery technologies, etc.). Based on what I have seen over the last few years, looking at the evolution in this space, I sense there may be potential impacts for pharmacy we ought to consider, if we are not already doing so, for the profession and the science of pharmacy and in the education and training of future pharmacists and pharmaceutical scientists. My most recent review of information showed that a significant amount of new research collaborations involving pharmaceutical companies and of early phase clinical research highlighted gene delivery, oligonucleotide therapeutics, CAR-T therapeutics, and novel treatments for rare diseases.

Tablet Compression Force as a Process Analytical Technology (PAT): 100% Inspection and Control of Tablet Weight Uniformity

The modern rotary pharmaceutical tablet press is capable of accepting or rejecting individual tablets based on the measured compression force of the tablet. Because during steady operation, each tablet is compressed to the same thickness, a larger compression force implies a heavier tablet. Tablets that are too heavy likely contain more than the desired content of drug substance. The measured compression force thus becomes an important input to the overall control strategy, and variability in the compression force from one tablet to the next corresponds directly with the uniformity of dosage units. This provides an extraordinary opportunity to use the instantaneous compression force signal as a process analytical technology to make product collection decisions on every individual tablet. Only 1 question requires investigation: how to set the main compression force limits to achieve the desired tablet weights? In this work, a small-scale characterization method and associated mathematical model are developed to answer this question.

Numerical Analysis of the Die Filling Process Within a Pharmaceutical Tableting Machine

AbstractOne of the main benefits of numerical simulations is the ability to shed light on the underlying physics in unit operations. This advantage was exploited in this work to study the die filling process in a lab‐scale pharmaceutical rotary tablet press. The die filling process with emphasis on mass holdup, mass flow rate, tablet mass, and API content in the dies is described in detail. Eventually a design of experiments provides a clear picture on the influence of process conditions and material properties on the tablet mass to improve the process understanding.

Alina Lourie, departing director of Pharmaceutical Press, on taking RPS publishing into the digital age

Alina Lourie, departing director of Pharmaceutical Press, on taking RPS publishing into the digital age

“Under the regulation radar”: PR strategies of pharmaceutical companies in countries where direct advertising of prescription drugs is banned—The Israeli case

In most Western countries, where direct advertising of prescription drugs (DTCA) is banned, the pharma industry relies primarily on PR activities to promote its products. Despite the pharma industry's ever-increasing share in framing media coverage of health issues, the strategies used in its press materials have not yet been systematically examined. This study uses framing theory to explore the PR strategies and tactics employed by pharmaceutical companies to promote their products in Israel, where DTCA is banned. Using a combination of qualitative and quantitative content analysis, we examined 1548 pharmaceutical press releases. The Israeli example can serve as a case study for understanding how the pharma industry operates in many countries around the world where DTCA is banned. Our findings show that strategies and tactics dubbed as “disease mongering” dominate the pharma industry’s press releases. The four main strategies identified in this study are third party technique, disease branding, drug branding and Astroturfing. Some of the common PR strategies and tactics we found are not only unethical, but also opposed to the regulatory bodies in Israel, and would never receive approval, even in countries where DTCA is allowed.

Sciatica (lumbar radiculopathy)

Nurse PrescribingVol. 15, No. 1 Calculation SkillsSciatica (lumbar radiculopathy)Dilyse NuttallDilyse NuttallSearch for more papers by this authorDilyse NuttallPublished Online:12 Jan 2017https://doi.org/10.12968/npre.2017.15.1.12AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Joint Formulary Committee (2016) British National Formulary 71. BMJ Group & Pharmaceutical Press, London Google ScholarNICE (2015) CKS Sciatica (lumbar radiculopathy). https://cks.nice.org.uk/sciatica-lumbar-radiculopathy (accessed 6 December 2016) Google Scholar FiguresReferencesRelatedDetails 2 January 2017Volume 15Issue 1ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 12 January 2017 Published in print 2 January 2017 Information© MA Healthcare LimitedPDF download

Numerical simulation of powder flow in a pharmaceutical tablet press lab-scale gravity feeder

The die filling process within a lab-scale rotary tablet press is simulated using the Discrete Element Method (DEM). The particle motion is captured as particles travel from the gravity feeder consisting of a chute connected to the shoe represented by a rectangular box to the dies/cavities of the turret. The particles fill the dies mostly due to gravity. The process conditions such as die table speed, die diameter as well as the material characteristics e.g. cohesion, coefficient of friction, coefficient of restitution, etc. influence the die filling process. The process conditions and material characteristics are systematically investigated by varying one of those parameters at a time while keeping other conditions constant. Eventually process conditions as well as material properties were changed simultaneously to analyze interaction relationships. The results give both qualitative (powder flow pattern from the feeder to the dies) and quantitative (tablet mass variation, mass flow rate etc.) insights into the die filling process. The numerical results indicate that faster die table speeds and smaller die diameters give rise to lower tablet mass with a significantly increased mass variation, which would eventually increase the challenges in meeting the specifications. On the other hand, cohesion between the particles significantly reduces the tablet mass and increases the mass variation. The influence of particle-wall friction coefficient on the particle rearrangement is analyzed both qualitatively and quantitatively, which shows that increasing the particle-wall friction reduces the dead zones within the shoe. The coefficient of restitution does not exhibit any influence on the die filling which may be attributed to the very confined space of the feeding system. Eventually this study emphasizes the importance of tablet blend characterization prior to tableting and provides operators with optimal process parameters and material attributes to ensure a high tableting process performance.

Identifying and treating patients with psoriasis

Practice NursingVol. 26, No. 11 DermatologyIdentifying and treating patients with psoriasisJean WatkinsJean WatkinsSearch for more papers by this authorJean WatkinsPublished Online:9 Nov 2015https://doi.org/10.12968/pnur.2015.26.11.546AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Altman K (2014) Prognosis in guttate psoriasis. http://emedicine.medscape.com/article/1107850 (accessed 30 September 2015) Google ScholarBorton C, Thomas H (2011) Generalised pustular psoriasis. http://patient.info/doctor/generalised-pustular-psoriasis (accessed 30 September 2015) Google ScholarBuckley D (2012) The role of the practice nurse in managing psoriasis in primary care. Nursing in General Practice. lenus.ie/hse/bitstream/10147/308927/1/NOV13Art3.pdf (accessed 30 September 2015) Google ScholarJoint Formulary Committee (2015) British National Formulary (online). London: BMJ Group and Pharmaceutical Press. www.evidence.nhs.uk/formulary/bnf/current/ (accessed 30 September 2015) Google ScholarNHS Choices (2014) Psoriatic arthritis. www.nhs.uk/conditions/psoriatic-arthritis/pages/introduction.aspx (accessed 30 September 2015) Google ScholarNational Institute for Health and Care Excellence Clinical Knowledge Summary (2014) Psoriasis. http://cks.nice.org.uk/psoriasis (accessed 30 September 2015) Google ScholarTetty S, Sahota A (2012) Clinical review of managing psoriasis in primary care. www.gponline.com/clinical-review-managing-psoriasis-primary-care/dermatology/psoriasis/article/1128473 (accessed 30 September 2015) Google ScholarThe Psoriasis and Psoriatic Arthritis Alliance (2015) Psoriasis and phototherapy. http://papaa.org/further-information/psoriasis-and-phototherapy (accessed 30 September 2015) Google ScholarTidy C (2012) Psoriatic nail disease. http://patient.info/health/psoriatic-nail-disease (accessed 30 September 2015) Google Scholar FiguresReferencesRelatedDetails 2 November 2015Volume 26Issue 11ISSN (print): 0964-9271ISSN (online): 2052-2940 Metrics History Published online 9 November 2015 Published in print 2 November 2015 Information© MA Healthcare LimitedKeywordspsoriasispsoriatic arthritisemollientsphototherapyPDF download

Drug calculations in intravenous calcium supplementation

Nurse PrescribingVol. 13, No. 9 Calculation SkillsDrug calculations in intravenous calcium supplementationAlison EggletonAlison EggletonSearch for more papers by this authorAlison EggletonPublished Online:12 Sep 2015https://doi.org/10.12968/npre.2015.13.9.430AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Joint Formulary Committee (2015a) British National Formulary (online). London: BMJ Group and Pharmaceutical Press. www.evidence.nhs.uk/formulary/bnf/current (accessed 26 August 2015) Google ScholarJoint Formulary Commitee (2015b) British National Formulary for Children. www.evidence.nhs.uk/formulary/bnfc/current (accessed 26 August 2015) Google ScholarSuneja M et al. (2015) Hypocalcemia. Medscape. http://emedicine.medscape.com/article/241893-overview (accessed 26 August 2015) Google ScholarSociety for Endocrinology (2013) Emergency endocrine guidance: Acute hypocalcaemia. www.endocrinology.org/policy/docs/13-02_EmergencyGuidance-AcuteHypocalcaemia_%28inAdults%29.pdf (accessed 26 August 2015) Google Scholar FiguresReferencesRelatedDetails 2 September 2015Volume 13Issue 9ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 12 September 2015 Published in print 2 September 2015 Information© MA Healthcare LimitedPDF download

Medicines and health visiting: From sceptic to prescriber

Nurse PrescribingVol. 13, No. 9 Student PerspectiveMedicines and health visiting: From sceptic to prescriberTristana RodriguezTristana RodriguezSearch for more papers by this authorTristana RodriguezPublished Online:12 Sep 2015https://doi.org/10.12968/npre.2015.13.9.464AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Bhanbhro S, Drennan VM, Grant R et al. (2011) Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: A systematic review of literature. BMC Health Serv Res 11: 330. doi: https://doi.org/10.1186/1472-6963-11–330. Crossref, Google ScholarBridges JM (1990) Literature review on the images of the nurse and nursing in the media. J Adv Nurs 15(7): 850–4 Crossref, Google ScholarGhaye T, Lillyman S (2010) Reflection: Principles and practices for healthcare professionals. 2nd edn. Quay Books, London Google ScholarJoint Formulary Committee (2013) Nurse Prescribers' Formulary for Community Practitioners. BMJ Group and Pharmaceutical Press. http://tinyurl.com/qzyg7ce (accessed 11 June 2015) Google ScholarKolb DA (1984) Experiential Learning: Experience the Source of Learning and Development. Prentice Hall, New Jersey Google ScholarLangridge P (2004) Extended independent and supplementary prescribing: An update. Paediatr Nurs 16(3): 21–3 Crossref, Google ScholarLewin K (1958) Group decision and social change. In: Swanson GEet al., eds. Readings in Social Psychology. Henry Holt and Co, New York Google ScholarNHS England (2015) NHS Improving Quality. http://www.england.nhs.uk/ourwork/qual-clin-lead/nhsiq/ (accessed 11 June 2015) Google Scholar FiguresReferencesRelatedDetails 2 September 2015Volume 13Issue 9ISSN (print): 1479-9189ISSN (online): 2052-2924 Metrics History Published online 12 September 2015 Published in print 2 September 2015 Information© MA Healthcare LimitedPDF download

Handbook of Drug Administration Via Enteral Feeding Tubes, 3rd Edition

Edited by Rebecca White, B.Sc., M.Sc., MRPharmS, FFRPS, and Vicky Bradnam, B.Pharm., ClinDip, M.B.A, MRPharmS, Published by Pharmaceutical Press, 1573 St. Paul Avenue, Gurnee, IL 60031, 2015. 752 p. Price $74.99 (soft cover) Description: This handbook provides guidelines on the administration of