[Criteria for good prescribing practice in children]. / Inhaltliche Kriterien für eine gute Verordnung bei Kindern.

Paediatric prescribing is complex. A whole range of aspects needs to be considered to achieve an efficacious and safe drug therapy for children. Legal requirements for prescribing are clearly insufficient for this purpose. Children are immature individuals under constant growth and development. Consequently, based on age and cognitive abilities of the child individual drugs and dosing regimens have to be chosen. Frequent off-label use and a lack of age-appropriate formulation worsen the situation. Additionally, not all dosage forms are similarly adequate in different age groups. Taste significantly influences patient adherence. Dose calculations based on body weight are prone to errors, putting a point on the wrong place or mixing up measuring units easily result in ten-fold dosing errors. Computer-based tools to enhance prescribing are promising but, however, not yet widely implemented in paediatrics because of missing evidence-based data sources and the hugely complex process. Communication between clinicians and pharmacists as well as with the patient remains very important.

[Study on dosage form design for improving oral bioavailability of traditional Chinese medicines].

Both chemical drugs and traditional Chinese medicines have the problem of low bioavailability. However, as traditional Chinese medicines are a multi-component complex, their dosage forms are required to be designed in line with their characteristics, in order to improve the bioavailability of traditional Chinese medicines. Traditional Chinese medicines are mostly prepared into pill, powder, paste, elixir and decoction, but with such drawbacks as high administration dose and poor efficacy. With the process of modernization of traditional Chinese medicines, new-type preparations have be developed and made outstanding achievements. However, they fail to make an organic integration between traditional Chinese medicine theories and modern preparation theories. Characteristics of traditional Chinese medicines are required to be taken into account during the development of traditional Chinese medicines. In the article, multi-component preparation technology was adopted to establish a multi-component drug release system of traditional Chinese medicines on the basis of multiple components of traditional Chinese medicines.

Knowledge of folic acid and counseling practices among Ohio community pharmacists / Conocimiento sobre el ácido fólico y práctica de consejo entre los farmacéuticos comunitarios de Ohio

Objective: To determine knowledge of folic acid use for neural tube defect (NTD) prevention and counseling practices among community pharmacists registered in Ohio. Methods: A cross-sectional study was performed on a random sample (n=500) of community pharmacists registered with the Ohio Board of Pharmacy and practicing in Ohio. A survey previously used by researchers to assess folic acid knowledge and practices among samples of other healthcare provider groups in the United States was adapted with permission for this study. The final tool consisted of 28 questions evaluating the knowledge, counseling practices, and demographics of respondents. The cover letter did not reveal the emphasis on folic acid, and surveys were completed anonymously. The university institutional review board deemed the study exempt. Results: Of the 122 pharmacists who completed the survey, 116 (95.1%) knew that folic acid prevents some birth defects. Twenty-eight (22.9%) responded that they «always» or «usually» discuss multivitamins with women of childbearing potential, and 19 (15.6%) responded that they «always» or «usually» discuss folic acid supplements. Some gaps in knowledge specific to folic acid were revealed. While 63.1% of pharmacists selected the recommended dose of folic acid intake for most women of childbearing potential, 13.1% could identify the dose recommended for women who have had a previous NTD-affected pregnancy. Respondents identified continuing education programs, pharmacy journals/magazines, and the Internet as preferred avenues to obtain additional information about folic acid and NTD. Conclusion: This study represents the first systematic evaluation of folic acid knowledge and counseling practices among a sample of pharmacists in the United States. As highly accessible healthcare professionals, community pharmacists can fulfill a vital public health role by counseling women of childbearing potential about folic acid intake. Educational materials may be beneficial in augmenting knowledge of folic acid and facilitating patient education (AU)

Objetivo: Determinar el conocimiento del uso de ácido fólico para prevención de defectos del tubo neural (NTD) y las prácticas de consejo entre los farmacéuticos comunitarios registrados en Ohio. Métodos: Se realizó un estudio transversal en una muestra aleatoria (n=500) farmacéuticos comunitarios registrados en la Junta de Farmacia de Ohio y que ejercían en Ohio. Se adaptó para este estudio con permiso, una encuesta previamente utilizada por investigadores para evaluar el conocimiento y las prácticas con ácido fólico entre muestras de otros profesionales de la salud en los Estados Unidos. El instrumento final comprendía 28 preguntas que evaluaban el conocimiento, las prácticas de consejo, y la demografía de los respondientes. La carta de presentación no revelaba el énfasis en el ácido fólico y los cuestionarios fueron completados anónimamente. La comisión de investigación institucional consideró el estudio exento de requisitos. Resultados: De los 122 farmacéuticos que completaron el estudio, 116 (95,1%) sabía que el ácido fólico prevenía algunos defectos congénitos. 28 (22,9%) respondió que «siempre» o «normalmente» hablaba de los multivitamínicos con las mujeres con posibilidad de embarazo, y 19 (16,6%) respondió que «siempre» o «normalmente» hablaban de los suplementos de ácido fólico. Se revelaron algunas lagunas en conocimientos específicos sobre el ácido fólico. Mientras que el 63,1% de los farmacéuticos seleccionó la dosis recomendada para la ingesta de ácido fólico en una mujer con posibilidad de embarazo, el 13,1% pudo identificar la dosis recomendada para mujeres que habían tenido un embarazo previo afectado por NTD. Los respondientes identificaron los programas de formación continua, las revistas y periódicos farmacéuticos, e Internet como los medios preferidos para obtener información adicional sobre el ácido fólico y los NTD. Concusión: Este estudio representa la primera evaluación sistemática de los conocimientos y prácticas de consejo sobre ácido fólico en una muestra de farmacéuticos en los Estados Unidos. Como profesionales altamente accesibles, los farmacéuticos comunitarios pueden tener un papel vital en la salud pública aconsejando a las mujeres con posibilidades de embarazo sobre la ingesta de ácido fólico. Los materiales educativos pueden ser benéficos para aumentar el conocimiento del ácido fólico y facilitar la educación de los pacientes (AU)

[Brief history of pharmaceutical standard system in China].

Pharmaceutical standard system which belongs to an important part of national drug policies is an inevitable result of the development of pharmacy. There was a long standing of pharmaceutical standard system in China whose germination could be traced back to Qin and Han dynasties, and it had laid a solid foundation for the establishment and improvement of modern pharmaceutical standard system by continual accumulation from the past dynasties. Since the founding of new China, distinguished achievements had been obtained on pharmaceutical standardization working,and currently it is in a new developing stage. There was a brief description in this paper on the development history of pharmaceutical standard system in China.

[Studies and reports of Chinese cut crude drugs dosage in clinical prescription of traditional Chinese medicine (section of surgery)].

OBJECTIVE: Study the actual dosage of clinical prescription in surgery of traditional Chinese medicine (TCM), and offer the consummate data for formulating the dosage standard of Chinese cut crude drug. METHOD: We made use of the methods of stratified sampling and random sampling to investigate 84,759 broth prescriptions of surgery of TCM in 21 various hospitals, 18 provinces, and constructed the database, then applied Weka KDD software to analyze. RESULT: We identified the frequency and clinical dosage intervals of 300 drugs, and the practical dosage of 155 drugs which dose has difference between in the actuality and in the pharmacopoeia. Most of drug's dosage centralized the four intervals: (3-6], (9-12], (12-15], (18-21], and the concrete dosage were 3, 6, 10, 12, 15, 20 g, etc. CONCLUSION: The dosages in the pharmacopoeia are not coincided with the practical dosages in surgery, and demand to revise. This paper will offer the consummate data for formulating the new dosage standard.

The paradox of natural products as pharmaceuticals. Experimental evidences of a mango stem bark extract.

Recent findings regarding basic, pre-clinical and clinical studies on a mango stem bark extract (MSBE) developed in Cuba (Vimang) on an industrial scale are summarized. Ethnomedical studies, extract reproducibility, biological effects and clinical evaluations in terms of patient quality of life are described as experimental evidences to support the statement that natural products, even being a mixture of compounds, could be as effective as "monoceuticals" for medical uses. Discussion about the use of "monoceuticals" versus "natureceuticals" in health care and medicine is based on effectiveness and availability, taking Vimang as an example of a natural product with supported scientific evidence to be used as antioxidant, analgesic, anti-inflammatory and immunomodulator.

[Study on index for formulation optimization of sustained or controlled released dosage forms].

Release in vitro is one of the indexes for quality control of solid dosage forms. It is not only the important indexes for evaluation of bioequivalence, also the important parameter of formulation optimization, study of the stability and quality control within producing of sustained or controlled release dosage forms. The review is the study on index for formulation optimization of sustained or controlled released dosege forms in China since 1999, including the application of similarity factor and deviation.

[Progress on the updated methods and sophisticated technics used in research of Chinese traditional medicinal compound recipes].

This article reviewed the updated methods and sophisticated technics used in research of traditional Chinese medicinal compound recipes, including mainly biochip technic, computer technic, metabonomics, ADME/Tox technic, fuzzy mathematics, molecular imprinting technic, biotransformation and metabolization in intestinal bacterium and so on.

Intrinsically long-acting agents compared with long-acting chronoformulations.

Intrinsically long-acting antihypertensive drugs may be characterized by long elimination half-lives with high trough: peak ratios for decreasing blood pressure. These agents are usually administered once daily in the morning, and at steady-state they provide 24 h blood pressure control, attenuate the early-morning surge in blood pressure, and maintain a normal circadian blood pressure pattern. In comparison, chronoformulations incorporate shorter-acting antihypertensive drugs into a delivery system that is delayed-onset or extended-release, or both. These agents, which are often designed to be given once daily at bedtime, deliver peak drug concentrations that coincide with the early-morning surge in blood pressure. Chronoformulations also provide 24 h blood pressure control. In highly compliant patients, both intrinsically long-acting drugs and chronoformulations are likely to provide comparable blood pressure control. However, in poorly compliant patients who miss doses of medication, intrinsically long-acting drugs are likely to be superior, because they sustain blood pressure control beyond the dosing interval.

The effect of formulation on the antimicrobial activity of cetylpyridinium chloride in candy based lozenges.

PURPOSE: The purpose of this investigation was to determine the influence on the antimicrobial activity of cetylpyridinium chloride of the various components of the formulation of each of six candy based lozenges. METHODS: In vivo activity was investigated using six volunteers by determining the reduction in colony forming units recoverable from the oropharynx after sucking each lozenge separately on different days. In vitro determinations investigated the relative activity of aqueous solutions of the lozenges, the effect on activity of additional active ingredients, pH and lozenge base ingredients against separate inocula of each of the test organisms Staphylococcus aureus, Streptococcus pyogenes and Candida albicans. RESULTS: Both in vivo and in vitro results showed that the pH of the dissolved lozenge solution was the single most influential readily adjustable formulation parameter which significantly influenced the activity of cetylpyridinium chloride activity in candy based lozenges. CONCLUSIONS: Lozenges containing cetylpyridinium chloride as the active ingredient should be formulated at a pH greater than 5.5.

WHO Expert Committee on specifications for pharmaceutical preparations.

This report presents the recommendations of an international group of experts convened by the World Health Organization to consider matters concerning the quality assurance of pharmaceuticals and specifications for drug substances and dosage forms. Of particular relevance to drug regulatory authorities, the report discusses activities related to the further development of The international pharmacopoeia, as well as simple test methodology, the stability of dosage forms, good manufacturing practices, legal and administrative aspects of the functioning of national drug regulatory authorities, and quality assurance in the supply system. The report is complemented by numerous annexes, including guidelines for the graphic representation of chemical formulae, lists of available International Chemical Reference Substances and International Infrared Reference Spectra, general recommendations for the preparation and use of infrared spectra in pharmaceutical analysis, and guidelines on stability testing of pharmaceutical products. In the context of good manufacturing practices, guidance is provided on the validation of manufacturing processes and for the manufacture both of investigational products for clinical trials and of herbal medicinal products. The final annexes contain guidelines adopted or endorsed by the Committee on registration requirements to establish the interchangeability of multisource pharmaceutical products, implementation of the WHO Certification Scheme on the Quality of Pharmaceutical Products Moving in International Commerce, the assessment of herbal medicines, and import procedures for pharmaceutical products.

Normas sobre doses de vitaminas, sais minerais e oligoelementos em medicamentos e suplementos nutricionais / Rules for vitamins, minerals and trace elements in medicines and nutritional supplements

No presente estudo säo discutidas, inicialmente, a importância das vitaminas e sais minerais dentro de uma dieta alimentar normal, assim como questöes de suplementaçäo dessas substâncias, tanto en estado carenciais como em casos näo clínicos. Chama-se atençäo para a tendência atual, abservada praticamente em todos os países que se situa na vanguarda no campo médico quanto `a utilizaçäo profilática de polivitaminas com sais minerais e oligoelementos, para manter a saúde e o bem-estar e, sobretudo, para retardar ou amenizar os sintomas de envelhecimento. como existem poucos dados nacionais atualizados sobre este assunto, o autor efetuou uma análise com base em documentaçäo internacional, ficando evidenciado que há quase um consenso sobre a matéria. As diversas publicaçöes, tanto dos Estados Unidos da America do Norte como de alguns países europeus, fornecem elementos importantes sobre doses de vitaminas, sais minerais e oligoelementos, assim como sobre suplementaçäo polivitamínica em geral. Recomenda-se, pois, a utilizaçäo destas informaçöes na revisäo dos dados brasileiros, acentuando que elas se aplicam bem à classe média da nossa populaçäo. Entretanto adaptaçöes poderäo ser necessárias segundo as condiçöes regionais do país, na sua variaçäo alimentar. O estudo que ora se publica pretende ser tomado como base para discussöes entre médicos, especialmente os nutrólogos e nutricionistas