Clinical Decision Making by Medical Marijuana Physicians in Florida: A Qualitative Assessment.

Medical marijuana (MMJ) was legalized in November 2016 with the passing of Amendment 2 in the state of Florida. Since the legalization, many studies have been conducted to understand the direct effect medical marijuana has on specific medical conditions. Unlike most allopathic drugs, medical marijuana does not target single ailments or specific conditions and does not follow precise recommending guidelines. There is scarce knowledge on how patient characteristics, including medical conditions, affect a physician's direct recommendations and registry limits. To obtain insight on the effect patient characteristics have on the clinical decision-making process, we conducted ten qualitative interviews of medical marijuana physicians who are certified to order medical marijuana for patients in Florida. Interview topics ranged from typical daily practice to specific recommendations for patient histories. Each interview was transcribed and thematically analyzed. Five major patient characteristics that influence a physician's recommendation emerged from the interviews: patient medical history, co-medications, lifestyle, marijuana experience level and counter-indications. Each category was analyzed further to understand how the characteristics influenced the practice of recommending and ordering product. Physicians emphasized the equivalent importance of reviewing a patient's medical history, lifestyle, and past marijuana experiences while also expressing the need to look holistically at the individual patient. Instead of the characteristics determining what the physician recommends for the patient and orders through the registry, the characteristics dictate the education given to the patient so that the patient may lead and determine their own individual care.

Novel hydrogel-based ocular drug delivery system for the treatment of conjunctivitis.

PURPOSE: Conventional dosage form like eye drops showed poor therapeutic response and also require frequent dosing. Therefore, developing the dosage form to deliver the drug to the target site without much loss of drug or without causing any systemic side effects is the challenging job for the researchers in pharmaceutical industries. OBJECTIVE: The main aim of the present work was to formulate and evaluate hydrogel-based drug delivery containing combination of neomycin sulphate and betamethasone sodium phosphate in order to provide prolonged release and also better bioavailability of drugs for the treatment of eye infections. METHODS: In this study, poloxamer 407 and chitosan at different concentrations were used as the gelling agents. The prepared formulations were evaluated for clarity, pH, drug content, gelling capacity, gelling temperature and in vitro drug release study. RESULTS: From the preliminary studies, F5 formulation was selected as an optimized formulation. The optimized formulation was further evaluated for ex vivo permeation study, sterility test, HET-CAM and ocular irritation testing using rabbits. Ocular irritation by HET-CAM assay showed that the formulated gel does not cause any irritation to the blood vessels. Draize irritation test was performed using rabbits and results showed that formulation was non-irritant to the eye. CONCLUSION: The formulated hydrogel formulation can be used as an alternative to conventional ophthalmic eye drop formulation of drugs neomycin and betamethasone for the purpose of providing prolonged therapy for the treatment of conjunctivitis.

Cell line selection combined with jasmonic acid elicitation enhance camptothecin production in cell suspension cultures of Ophiorrhiza mungos L.

Ophiorrhiza mungos is a herbaceous medicinal plant which contains a quinoline alkaloid, camptothecin (CPT), an anticancer compound. A high-yielding cell line, O. mungos cell line-3 (OMC3) was selected from cell suspension cultures of O. mungos using cell aggregate cloning method and established cell suspension culture. OMC3 cell suspension produced significantly high biomass (9.25 ± 1.3 g/flask fresh weight (FW)) and CPT yield (0.095 ± 0.002 mg g-1 dry weight (DW)) compared with the original cell suspension. Inoculum size of OMC3 cell suspension culture was optimised as 14 g L-1. Media optimisation has shown that 5 % (w/v) sucrose and an increased ammonium/nitrate concentration of 40/20 mM favoured CPT production, whereas 3 % (w/v) sucrose, an ammonium/nitrate concentration of 20/40 mM and 1.25 mM of phosphate favoured biomass accumulation. Jasmonic acid, chitin and salicylic acid was used to elicit CPT production in the original cell suspension culture and achieved significantly high CPT production with jasmonic acid (JA) elicitation. Further, OMC3 cell suspension culture was elicited with JA (50 µM) and obtained 1.12 ± 0.08 mg g-1 DW CPT and 9.52 ± 1.4 g/flask FW (190.4 g L-1 FW). The combination of cell line selection and elicitation has produced 18.66-fold increases in CPT production together with significantly high biomass yield. The study is helpful in the scale-up studies of O. mungos cell suspension culture in suitable bioreactor systems for the production of CPT.

Prolonged release of TGF-ß from polyelectrolyte nanoparticle loaded macroporous chitin-poly(caprolactone) scaffold for chondrogenesis.

Cartilage degeneration occurs when the catabolic factors overtakes the anabolic factors. The regeneration capability of damaged cartilage is poor due to its hypovascular and hypocellular tissue. Tissue engineering strategies aims in development of a suitable substrate that provide the required physical, chemical and biological cues to the proliferating cells to direct chondrogenesis. A macroporous polymeric blend scaffold of chitin and poly(caprolactone) (PCL) was fabricated by lyophilisation technique and characterized using Scanning Electron Microscope (SEM), Fourier Transform Infrared Spectroscopy (FTIR) and Thermogravimetric/Differential thermal Analysis (TG/DTA). The effect of prolonged release of Transforming growth factor-ß (TGF-ß) was studied by encapsulating it in chondroitin sulphate nanoparticles (nCS) incorporated in chitin-PCL scaffold. Chondroitin sulphate nanoparticles containing TGF-ß (TGF-ß-nCS) was developed by polyelectrolyte crosslinking using chitosan. Characterization of TGF-ß-nCS by Dynamic Light Scattering particle sizer and SEM showed a 230±20nm sized spherical particles. Swelling and degradation studies of the composite scaffold showed its stability. Protein adsorption was enhanced in nanoparticle containing scaffold. The effect of TGF-ß was well addressed by the increased attachment and proliferation of rabbit adipose derived mesenchymal stem cells (rASCs). The chondrogenic potential of rASCs in the presence of TGF-ß releasing composite scaffold showed an increased proteoglycan deposition. These studies highlight the positive effects of chitin-PCL-TGF-ß-nCS scaffold for cartilage regeneration.