Assuntos
Anafilaxia/diagnóstico , Anafilaxia/etiologia , Teste de Degranulação de Basófilos , Basófilos/imunologia , Excipientes Farmacêuticos/efeitos adversos , Povidona/efeitos adversos , Anafilaxia/metabolismo , Teste de Degranulação de Basófilos/métodos , Basófilos/metabolismo , Feminino , Humanos , Imunoglobulina E/imunologia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Diseases of the bowel are not always displayed on conventional abdominal computed tomography (CT). The studied oral contrast agent aims to improve this. PURPOSE: To investigate whether the use of a novel oral contrast for abdominal CT enables the same diagnostic advantages as seen in magnetic resonance imaging (MRI). MATERIAL AND METHODS: Twenty-five consented volunteers drank up to 1400 mL of a stable, drinkable foam. Comments on acceptance and side effects were noted immediately and 24 h later. Foam palatability was documented through interviews, and distribution in the small bowel by Hounsfield units from the CT software. The CT results were compared with age- and sex-matched controls, pretreated according to routine. A non-enhanced abdominal CT protocol of lowest possible radiation dose was used. External referees evaluated all data obtained. RESULTS: Foam was considered odd to swallow, and fullness was reported by all volunteers after 950 mL. Five had difficulties in drinking the last 320 mL and two abstained from it. All adverse symptoms were mild. The distribution in the small bowel was on par with standard agents. Foam density revealed stability with intraluminal values of around -550 HU from stomach to terminal ileum, satisfying the requirement of a great bowel lumen-to-wall contrast. External reviewers re-evaluated all our data, and one predicted the foam to offer a potential for improved diagnostics. CONCLUSION: A CT true-negative bowel filling agent was formulated, with high acceptance, few side effects, and a potential to mimic T1-weighted MRI images.
Assuntos
Meios de Contraste/administração & dosagem , Aditivos Alimentares/administração & dosagem , Intestino Delgado/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Abdome/diagnóstico por imagem , Administração Oral , Idoso , Albuminas , Meios de Contraste/efeitos adversos , Meios de Contraste/química , Ovos , Feminino , Aromatizantes , Aditivos Alimentares/efeitos adversos , Aditivos Alimentares/química , Voluntários Saudáveis , Humanos , Íleo/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Excipientes Farmacêuticos/administração & dosagem , Excipientes Farmacêuticos/efeitos adversos , Excipientes Farmacêuticos/química , Fosfatos , Polissacarídeos Bacterianos , Compostos de Potássio , Doses de Radiação , Estômago/diagnóstico por imagem , ÁguaRESUMO
PURPOSE: A multitude of different versions of the same medication with different inactive ingredients are currently available. It has not been quantified how this has evolved historically. Furthermore, it is unknown whether healthcare professionals consider the inactive ingredient portion when prescribing medications to patients. METHODS: We used data mining to track the number of available formulations for the same medication over time and correlate the number of available versions in 2019 to the number of manufacturers, the years since first approval, and the number of prescriptions. A focused survey among healthcare professionals was conducted to query their consideration of the inactive ingredient portion of a medication when writing prescriptions. RESULTS: The number of available versions of a single medication have dramatically increased in the last 40 years. The number of available, different versions of medications are largely determined by the number of manufacturers producing this medication. Healthcare providers commonly do not consider the inactive ingredient portion when prescribing a medication. CONCLUSIONS: A multitude of available versions of the same medications provides a potentially under-recognized opportunity to prescribe the most suitable formulation to a patient as a step towards personalized medicine and mitigate potential adverse events from inactive ingredients.
Assuntos
Competência Clínica/estatística & dados numéricos , Composição de Medicamentos/história , Excipientes Farmacêuticos/efeitos adversos , Medicamentos sob Prescrição/química , Prescrições de Medicamentos , História do Século XX , História do Século XXI , Humanos , Excipientes Farmacêuticos/química , Excipientes Farmacêuticos/história , Medicamentos sob Prescrição/efeitos adversos , Medicamentos sob Prescrição/história , Inquéritos e Questionários/estatística & dados numéricosRESUMO
Crospovidone is an insoluble pharmaceutical disintegrant that has been implicated in a rare foreign body reaction in injection drug users, classically associated with pulmonary angiothrombosis. We recently reported the first known cases of cutaneous crospovidone deposition. We herein report two additional cases with unique clinicopathologic manifestations, both in the setting of suspected injection drug abuse. Additionally, we provide a comprehensive overview of the distinct histomorphology and reproducible histochemistry of crospovidone.
Assuntos
Corpos Estranhos/induzido quimicamente , Excipientes Farmacêuticos/efeitos adversos , Povidona/efeitos adversos , Pele/patologia , Adulto , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Buprenorfina/administração & dosagem , Buprenorfina/efeitos adversos , Feminino , Corpos Estranhos/diagnóstico , Humanos , Injeções Subcutâneas , Masculino , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnósticoAssuntos
Anafilaxia/induzido quimicamente , Carboximetilcelulose Sódica/efeitos adversos , Excipientes Farmacêuticos/efeitos adversos , Dor de Ombro/tratamento farmacológico , Idoso , Anafilaxia/diagnóstico , Carboximetilcelulose Sódica/administração & dosagem , Feminino , Glucocorticoides/administração & dosagem , Humanos , Injeções Intra-Articulares/efeitos adversos , Excipientes Farmacêuticos/administração & dosagem , Testes Cutâneos , Triancinolona Acetonida/administração & dosagemRESUMO
Crospovidone, a polymer of poly N-vinyl-2-pyrrolidone, is an inert insoluble disintegrant found in pharmaceutical tablets. This material has been encountered in the lungs of intravenous drug users and embolized with other components such as talc and microcrystalline cellulose. More recently, crospovidone has also been described in the gastrointestinal tract. We present 2 cases of cutaneous crospovidone deposition resulting from subcutaneous injection of crushed tablets, commonly known as "skin popping." Clinical presentation includes painful, inflamed papules, nodules, or ulcers with overlying eschar. Crospovidone has a distinct and reproducible histochemical staining profile. Histologic recognition of this material is important because it can guide clinicians in their diagnosis and management decisions.
Assuntos
Analgésicos Opioides/efeitos adversos , Corpos Estranhos/etiologia , Transtornos Relacionados ao Uso de Opioides/complicações , Excipientes Farmacêuticos/efeitos adversos , Povidona/efeitos adversos , Pele/química , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Analgésicos Opioides/análise , Composição de Medicamentos , Feminino , Corpos Estranhos/patologia , Humanos , Injeções Subcutâneas , Excipientes Farmacêuticos/análise , Povidona/análise , Pele/patologia , ComprimidosAssuntos
Lactase/uso terapêutico , Intolerância à Lactose/prevenção & controle , Fenobarbital/uso terapêutico , Suplementos Nutricionais , Humanos , Lactente , Lactase/administração & dosagem , Lactose/efeitos adversos , Lactose/química , Excipientes Farmacêuticos/efeitos adversos , Excipientes Farmacêuticos/química , Fenobarbital/administração & dosagem , Fenobarbital/química , Estado Epiléptico/tratamento farmacológicoAssuntos
Catéteres/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Excipientes Farmacêuticos/efeitos adversos , Sulfitos/efeitos adversos , Idoso , Cateterismo/instrumentação , Dermatite Alérgica de Contato/diagnóstico , Feminino , Humanos , Testes do Emplastro , Excipientes Farmacêuticos/administração & dosagem , Sulfitos/administração & dosagemAssuntos
Excipientes Farmacêuticos/efeitos adversos , Povidona/efeitos adversos , Adulto , Anemia/induzido quimicamente , Feminino , Humanos , Metadona/administração & dosagem , Dor Musculoesquelética/induzido quimicamente , Tratamento de Substituição de Opiáceos/efeitos adversos , Abuso de Substâncias por Via Intravenosa/complicaçõesAssuntos
Informação de Saúde ao Consumidor , Conhecimentos, Atitudes e Prática em Saúde , Excipientes Farmacêuticos/normas , Carboidratos/análise , Humanos , Medicamentos sem Prescrição/normas , Excipientes Farmacêuticos/efeitos adversos , Excipientes Farmacêuticos/química , Medicamentos sob Prescrição/normas , Cloreto de SódioAssuntos
Estimulantes do Sistema Nervoso Central/efeitos adversos , Fentermina/efeitos adversos , Adulto , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Transtornos da Coagulação Sanguínea/induzido quimicamente , Transtornos da Coagulação Sanguínea/tratamento farmacológico , Celulite (Flegmão)/tratamento farmacológico , Celulite (Flegmão)/microbiologia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Edema/induzido quimicamente , Edema/terapia , Feminino , Humanos , Injeções , Testes de Função Hepática , Excipientes Farmacêuticos/efeitos adversos , Fentermina/administração & dosagem , Sepse/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/complicações , Comprimidos , Talco/efeitos adversosRESUMO
AIM: This study aimed to investigate the in vitro effects of three paediatric liquid oral medicines on bovine dental enamel subsurfaces under pH cycling conditions. METHODS: Bovine enamel blocks were evaluated for surface hardness at baseline for sample selection. 52 intact bovine enamel blocks (16mm(2)) were randomly divided into four groups (n=13) according to the immersion treatments: G1: antibiotic (Klaricid®), G2: antihistamine (Claritin®), G3: antihistamine (Dimetapp®) and G4: control (de-ionised water). The blocks were submitted to pH cycling treatments twice a day for 12 days. The medicines were evaluated for pH, viscosity, and concentration of calcium, phosphate and fluoride. After the treatment period, cross-sectional microhardness (CSMH) measurements of the enamel blocks were taken and the data, expressed in Knoop hardness number (kg/mm(2)) was used to calculate the ΔS. STATISTICS: ANOVA followed by the Tukey test were used for statistical analyses (p<0.05). RESULTS: The antibiotic Klaricid® showed the highest concentration of fluoride, calcium and phosphate. Considering pH and viscosity, the following pattern was observed according to the treatment group: G4>G1>G2>G3 and G1>G2>G3>G4 respectively. Regarding the demineralisation pattern, the following results were observed: G4>G3>G2>G1. Compared to the control, the antibiotic and both the antihistamines provoked less demineralisation of the enamel blocks (p<0.05). CONCLUSIONS: Antibiotic G1 (Klaricid®) presented an in vitro protective effect against acid attacks probably due to its mineral content and viscosity.
Assuntos
Esmalte Dentário/efeitos dos fármacos , Excipientes Farmacêuticos/efeitos adversos , Anatomia Transversal , Animais , Antibacterianos/efeitos adversos , Antibacterianos/química , Bromofeniramina/efeitos adversos , Bromofeniramina/química , Cálcio/análise , Bovinos , Claritromicina/efeitos adversos , Claritromicina/química , Solubilidade do Esmalte Dentário/efeitos dos fármacos , Combinação de Medicamentos , Fluoretos/análise , Dureza , Antagonistas não Sedativos dos Receptores H1 da Histamina/efeitos adversos , Antagonistas não Sedativos dos Receptores H1 da Histamina/química , Concentração de Íons de Hidrogênio , Loratadina/efeitos adversos , Loratadina/química , Descongestionantes Nasais/efeitos adversos , Descongestionantes Nasais/química , Excipientes Farmacêuticos/química , Fosfatos/análise , Pseudoefedrina/efeitos adversos , Pseudoefedrina/química , Distribuição Aleatória , Soluções , Desmineralização do Dente/induzido quimicamente , ViscosidadeRESUMO
We report on a patient with an iodine allergy. He developed a delayed cutaneous reaction after receiving an iodinated radiographic contrast media and at the same time topical disinfection with povidone-iodine. In the patch- and intradermal tests he showed positive results with various radiographic contrast media, povidone- iodine and iodine, but not with povidone.
Assuntos
Toxidermias/diagnóstico , Toxidermias/etiologia , Povidona-Iodo/efeitos adversos , Idoso , Meios de Contraste , Toxidermias/prevenção & controle , Humanos , Masculino , Testes do Emplastro , Excipientes Farmacêuticos/efeitos adversos , Povidona/efeitos adversosRESUMO
Microwave digestion of hydrogenated cottonseed oil prior to trace nickel determination by electrothermal atomic absorption spectrometry (ETAAS) is proposed here for the first time. Currently, the methods outlined in U.S. Pharmacopeia 28 (USP28) or British Pharmacopeia (BP2003) are recommended as the official methods for analyzing nickel in hydrogenated cottonseed oil. With these methods the samples may be pre-treated by a silica or a platinum crucible. However, the samples were easily tarnished during sample pretreatment when using a silica crucible. In contrast, when using a platinum crucible, hydrogenated cottonseed oil acting as a reducing material may react with the platinum and destroy the crucible. The proposed microwave-assisted digestion avoided tarnishing of sample in the process of sample pretreatment and also reduced the cycle of analysis. The programs of microwave digestion and the parameters of ETAAS were optimized. The accuracy of the proposed method was investigated by analyzing real samples. The results were compared with the ones by pressurized-PTFE-bomb acid digestion and ones obtained by the U.S. Pharmacopeia 28 (USP28) method. The new method involves a relatively rapid matrix destruction technique compared with other present methods for the quantification of metals in oil.
Assuntos
Óleo de Sementes de Algodão/química , Aditivos Alimentares/química , Contaminação de Alimentos , Níquel/análise , Óleo de Sementes de Algodão/efeitos adversos , Óleo de Sementes de Algodão/efeitos da radiação , Contaminação de Medicamentos , Técnicas Eletroquímicas , Aditivos Alimentares/efeitos adversos , Aditivos Alimentares/efeitos da radiação , Manipulação de Alimentos , Temperatura Alta , Peróxido de Hidrogênio/química , Hidrogenação , Hidrólise/efeitos dos fármacos , Hidrólise/efeitos da radiação , Indicadores e Reagentes/química , Micro-Ondas , Ácido Nítrico/química , Excipientes Farmacêuticos/efeitos adversos , Excipientes Farmacêuticos/química , Politetrafluoretileno/química , Reprodutibilidade dos Testes , Espectrofotometria Atômica , Fatores de TempoRESUMO
Paclitaxel (PTX) is a potent anticancer agent whose clinical usefulness is marred by a delivery problem that is caused by its unfavorable pharmacokinetic and physical properties. Paclitaxel is currently formulated in a mixture of Cremophor EL and ethanol, which is diluted 5-20 times with normal saline or 5% dextrose prior to administration via slow infusion to avoid precipitation in plasma. Many adverse reactions to the PTX formulation have been reported because of the presence of Cremophor EL, including hypersensitivity reactions, nephrotoxicity, and neurotoxicity. Cremophor EL also causes vasodilation, labored breathing, lethargy, hypotension, and leaching of plasticizers, such as diethylhexylpthalate, from the polyvinylchloride infusion bags/sets. Significant research efforts have been conducted to develop an alternative formulation approach to increase the aqueous solubility of PTX without using Cremophor, thereby decreasing its toxicity. This article reviews the various investigated formulation approaches including pastes; liposomes; conjugates with antibodies, peptides, and fatty acids; nanospheres and microspheres; cyclodextrin complexes; emulsions; mucoadhesive gel; prodrugs; and nanoparticulate systems. The pros and cons of each approach are also discussed. Finally, this review concludes with a discussion of nanoparticulate delivery, which is the most promising PTX delivery system of the future because it incorporates the benefits of other approaches such as conjugation, complexation, and prodrugs.
Assuntos
Antineoplásicos Fitogênicos/uso terapêutico , Neoplasias/tratamento farmacológico , Paclitaxel/uso terapêutico , Animais , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/farmacocinética , Química Farmacêutica/métodos , Química Farmacêutica/tendências , Sistemas de Liberação de Medicamentos/métodos , Sistemas de Liberação de Medicamentos/tendências , Humanos , Paclitaxel/química , Paclitaxel/farmacocinética , Excipientes Farmacêuticos/efeitos adversos , Excipientes Farmacêuticos/químicaRESUMO
INTRODUCTION: Since 2007 German health insurance funds may conclude discount contracts with pharmaceutical companies for individual drugs. According to German legislation pharmacies are liable to preferentially dispense these drugs to patients of the respective funds if the prescribed drug is identical regarding active ingredient, strength, package size, and route of administration, and is approved for the same indication. We aimed to assess the number and nature of clinically relevant differences between prescribed drug and its legal alternatives. METHODS: Using databases and expert systems of the drug information system AiD KLINIK we evaluated all 258 412 exchangeable drug pairs of the German market currently regulated by discount contracts. RESULTS: 15,7 % of the drug pairs differed in dosage, in one quarter each colour or shape was significantly different, and in roughly 3 % the size of the substituted drug differed by more than 50 %. In 9,43 % splitting characteristics of solid oral doses differed and in 1,87 % the substituted drug contained additives with allergenic potential not present in the primarily selected drug. On average 0,44 clinically relevant differences could be calculated in each substitution. CONCLUSION: This study has revealed that current legal provision ignore important medical criteria of the substitution process including individual risks (e. g. allergies). Patients will have to change the drug application process and will therefore need appropriate information and training. All these differences between substitutional drug pairs should already be known when prescribing so as to maintain patient safety in the face of this merely cost-saving measure.
Assuntos
Contratos/legislação & jurisprudência , Aprovação de Drogas/legislação & jurisprudência , Custos de Medicamentos/legislação & jurisprudência , Indústria Farmacêutica/legislação & jurisprudência , Medicamentos Genéricos/efeitos adversos , Medicamentos Genéricos/economia , Programas Nacionais de Saúde/legislação & jurisprudência , Redução de Custos/legislação & jurisprudência , Formas de Dosagem , Relação Dose-Resposta a Droga , Contaminação de Medicamentos , Hipersensibilidade a Drogas/etiologia , Serviços de Informação sobre Medicamentos , Embalagem de Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Sistemas Inteligentes , Alemanha , Humanos , Educação de Pacientes como Assunto , Excipientes Farmacêuticos/efeitos adversos , Fatores de Risco , Equivalência TerapêuticaRESUMO
OBJECTIVE: To evaluate pediatricians' perceptions and attitudes about the use of liquid pediatric medicines and their relationship with dental caries and dental erosion. STUDY DESIGN: A cross sectional study was conducted. Data was collected by questionnaires handed out in hospitals, medical clinics and offices. A convenience sample of 104 pediatricians was obtained. RESULTS: Most respondents (80.8%) stated that pediatric medicines could be related with dental disorders. Dental caries (64.70%) and tooth discoloration (43.7%) were the most frequent mentioned alterations, while only 3 (4.2%) respondents pointed out dental erosion. A considerable number of respondents (62.50%) recognized the presence of fermentable carbohydrates as a contributing factor to tooth decay, however not all of them recommended oral hygiene after their consumption (50.80%). Besides, 48 respondents (46.20) also believed that pediatric medicines could cause dental wear. CONCLUSIONS: Pediatricians in this study did not perceive the correct relationship between the presence of acidity in medicines and dental erosion; however, most of them presented a reasonable awareness about the relationship between sugared pediatric medicines and dental caries. Besides, they were unaware about the need of recommending oral hygiene after medicines' use.