Artificial intelligence in the field of pharmacy practice: A literature review.

Artificial intelligence (AI) is a transformative technology used in various industrial sectors including healthcare. In pharmacy practice, AI has the potential to significantly improve medication management and patient care. This review explores various AI applications in the field of pharmacy practice. The incorporation of AI technologies provides pharmacists with tools and systems that help them make accurate and evidence-based clinical decisions. By using AI algorithms and Machine Learning, pharmacists can analyze a large volume of patient data, including medical records, laboratory results, and medication profiles, aiding them in identifying potential drug-drug interactions, assessing the safety and efficacy of medicines, and making informed recommendations tailored to individual patient requirements. Various AI models have been developed to predict and detect adverse drug events, assist clinical decision support systems with medication-related decisions, automate dispensing processes in community pharmacies, optimize medication dosages, detect drug-drug interactions, improve adherence through smart technologies, detect and prevent medication errors, provide medication therapy management services, and support telemedicine initiatives. By incorporating AI into clinical practice, health care professionals can augment their decision-making processes and provide patients with personalized care. AI allows for greater collaboration between different healthcare services provided to a single patient. For patients, AI may be a useful tool for providing guidance on how and when to take a medication, aiding in patient education, and promoting medication adherence and AI may be used to know how and where to obtain the most cost-effective healthcare and how best to communicate with healthcare professionals, optimize the health monitoring using wearables devices, provide everyday lifestyle and health guidance, and integrate diet and exercise.

Assessment of mitral valve commissural morphology by transoesophageal echocardiography predicts outcome after balloon mitral valvotomy.

BACKGROUND: Balloon mitral valvotomy (BMV) is a safe and an effective treatment in patients with symptomatic rheumatic mitral stenosis. This study was conducted to validate the importance of assessing the morphology of mitral valve commissures by transoesophageal echocardiography and thereby predicting the outcome after balloon mitral valvotomy [BMV]. MATERIALS AND METHODS: Study consisted of 100 patients with symptomatic mitral stenosis undergoing BMV. The Commissural Morphology and Wilkins score were assessed by transoesophageal echocardiography. Both the commissures (anterolateral and posteromedial) were scored individually according to whether non-calcified fusion was absent (0), partial (1), or extensive (2) and calcification (score 0) and combined giving an overall commissural score of 0-4. Outcome of BMV was correlated with commissural score and Wilkins score. RESULTS: The commissural score and outcome after BMV correlated significantly. 66 of 70 patients (94%) with a commissural score of 3-4 obtained a good outcome compared with only six (20%) patients of 30 with a commissural score of 0-2 (positive and negative predictive accuracy 94% and 80%, respectively, p < 0.001). Increase in 2DMVA post BMV was more in patients with higher commissural score (score of 3-4). Wilkins score <8 usually predicts a good outcome but even in patients with Wilkins score >8 a commissural score >2 predicts a 50% chance of a good result. CONCLUSIONS: A higher commissural score predicts a good outcome after BMV hence it can be concluded that along with Wilkins score, commissural morphology and score should be assessed with TOE in patients undergoing BMV.

Regulations of Medical Devices in Regulated Countries: A Comparative Review.

The term "medical device" covers a vast range of equipment, from simple tongue depressors to hemodialysis machines. Like medicines and other health technologies, they are essential for patient care. With the increased use of medical devices, stringent regulatory standards are required to ensure that the devices are well studied, safe, and well tolerated. Recently, introduced guidelines and amendments in the laws of the US, Europe, and Canada provide adequate guidance for both manufacturers and competent authorities to prevent defects and performance failures efficiently and appropriately. A defective device may result in inaccurate patient results, leading to misdiagnosis, delays in treatment, adverse events, injuries, or even death. Therefore, a thorough review of the medical device before being released for use by the public and effective monitoring of the medical device once placed on the market are crucial.

Preparation of fluconazole buccal tablet and influence of formulation expedients on its properties.

The aim of present study was to prepare buccal tablets of fluconazole for oral candidiasis. The dosage forms were designed to release the drug above the minimum inhibitory concentration for prolonged period of time so as to reduce the frequency of administration and to overcome the side effects of systemic treatment. The buccal tablets were prepared by using Carbopol 71G and Noveon AA-1 by direct compression method. Microcrystalline cellulose was used as the filler and its effect was also studied. The prepared dosage forms were evaluated for physicochemical properties, in vitro release studies and mucoadhesive properties using sheep buccal mucosa as a model tissue. Tablets containing 50% of polymers (Carbopol & Noveon) were found to be the best with moderate swelling along with favorable bioadhesion force, residence time and in vitro drug release. The in vitro drug release studies revealed that drug released for 8 h, which in turn may reduce dosing frequency and improved patient compliance in oral candidiasis patients.

Microencapsulation: an acclaimed novel drug-delivery system for NSAIDs in arthritis.

Arthritis refers to different medical conditions associated with disorders of the primary structures that determine joint functioning, such as bones, cartilage, and synovial membranes. Drug discovery and delivery to retard the degeneration of joint tissues are challenging. Current treatment of different types of arthritis such as osteoarthritis, rheumatoid arthritis, septic arthritis, juvenile idiopathic arthritis, and ankylosing spondylitis involves the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, diclofenac, aceclofenac, ibuprofen, flurbiprofen, indomethacin piroxicam, dexibuprofen, ketoprofen, nabumetone, nimesulide, and naproxen, mainly by the oral, parenteral, or topical route. However, the frequent dosing that is required with NSAIDs often leads to patient noncompliance, so drug-delivery technologies should be developed to reduce the frequency of dosing and to allow sustained release of medications. Microencapsulation is one of the novel drug-delivery technologies employed to sustain drug release. This method reduces dosing and eliminates gastrointestinal irritation, thus ultimately improving patient compliance in the pharmacotherapy of arthritis. We provide a comprehensive overview of several microencapsulation technologies used in the treatment of arthritis that may reduce the dose-related adverse effects caused by NSAIDs.

Calcium alginate cross-linked polymeric microbeads for oral sustained drug delivery in arthritis.

After the successful optimization and development of a drug entity, design of dosage form then plays an important role. Hence, research continuously keeps on searching for ways to deliver drugs over an extended period of time. With aceclofenac, a novel NSAID used in the treatment of rheumatoid arthritis, frequency of administration may cause certain GI-adverse effects. The objective of the present research work was to develop a microparticulate oral sustained release dosage form, to reduce dosing frequency, to eliminate the dose related adverse effects and to ultimately improve compliance in the pharmacotherapy of arthritis. The microbeads were prepared by an ionotropic external gelation technique, by using sodium alginate as the hydrophilic carrier and calcium chloride as the cross-linking agent. The shape and surface characteristics were determined by scanning electron microscopy (SEM). Particle size distribution was determined by an optical microscope. The physical state of the drug in the formulation was determined by differential scanning calorimetry (DSC). While increasing the concentration of sodium alginate dispersion increased flow properties, mean particle size, swelling ratio and drug entrapment efficiency. The mean particle sizes of drug-loaded microbeads were found to be in the range 596.45 ± 1.04 to 880.10 ± 0.13 µm. The drug entrapment efficiency was obtained in the range of 63.24-98.90% (w/v). The release of drug from the microbeads at pH 1.2 is negligible. Under neutral conditions, the beads will swell and the drug release depends on swelling and the erosion process resulting in an optimum level of drug released in a sustained manner which exhibits zero-order kinetics.

Influence of natural polymer coating on novel colon targeting drug delivery system.

A novel colon targeted tablet formulation was developed using natural polysaccharides such as chitosan and guar gum as carriers and diltiazem hydrochloride as model drug. The prepared blend of polymer-drug tablets were coated with two layers, inulin as an inner coat followed by shellac as outer coat and were evaluated for properties such as average weight, hardness and coat thickness. In vitro release studies of prepared tablets were carried out for 2 h in pH 1.2 HCl buffer, 3 h in pH 7.4 phosphate buffer and 6 h in simulated colonic fluid (SCF) in order to mimic the conditions from mouth to colon. It was observed that 4% w/v of rat cecal contents in saline phosphate buffer (SCF) incubated for 24 h provides suitable conditions for in vitro evaluation of the formulations prepared. The drug release from the coated system was monitored using UV/ Visible spectroscopy. In vitro studies revealed that the tablets coated with inulin and shellac have controlled the drug release in stomach and small intestinal environment and released maximum amount of drug in the colonic environment. Among the polymers used, chitosan was found to be the suitable polymer for colon targeting. The study revealed that polysaccharides as carriers and inulin and shellac as coating materials can be used effectively for colon targeting of drugs for treating local as well as systemic disorders.

Novel colon targeted drug delivery system using natural polymers.

A novel colon targeted tablet formulation was developed using pectin as carrier and diltiazem HCl and indomethacin as model drugs. The tablets were coated with inulin followed by shellac and were evaluated for average weight, hardness and coat thickness. In vitro release studies for prepared tablets were carried out for 2 h in pH 1.2 HCl buffer, 3 h in pH 7.4 phosphate buffer and 6 h in simulated colonic fluid. The drug release from the coated systems was monitored using UV/Vis spectroscopy. In vitro studies revealed that the tablets coated with inulin and shellac have limited the drug release in stomach and small intestinal environment and released maximum amount of drug in the colonic environment. The study revealed that polysaccharides as carriers and inulin and shellac as a coating material can be used effectively for colon targeting of both water soluble and insoluble drugs.