The Role of a Simulation-Based Activity on Student Perceptions of Parenteral Nutrition Education.

Introduction: Parenteral nutrition (PN) education in pharmacy schools and postgraduate programs may not sufficiently prepare future pharmacists for clinical practice. Limited data exist regarding innovative teaching strategies in the area of PN. The purpose of this study was to identify students' perceptions of a simulated PN activity in a pharmacotherapeutics course. Methods: Second-year Doctor of Pharmacy (PharmD) students from two cohorts (N = 84 for both cohorts) completed a PN assignment using simulated PN materials, which resembled those seen in clinical practice. Before and after the activity, students completed identical surveys about their perceived competence and interest in PN, which were analyzed using Wilcoxon signed-rank tests. Results: Following the simulation, the percentage of students affirming their perceived competence (selecting strongly agree or agree in the survey) in their ability to describe the process of combining ingredients to make a PN admixture (45.2% vs. 83.3%, p < 0.001) and calculate PN-related problems (58.3% vs. 83.3%, p < 0.001) improved. The proportion of students expressing interest in PN increased after the simulation (78.6% vs. 86.9%, p < 0.001). Conclusion: A simulated practicum experience in PN was viewed positively by PharmD students at this university, and may be a valuable active learning experience to incorporate in a PharmD curriculum.

An HPLC tandem mass spectrometry for quantification of ET-26-HCl and its major metabolite in plasma and application to a pharmacokinetic study in rats.

ET-26-HCl is a new analog of etomidate, a short-acting anesthetic drug, with less adrenal cortex inhibition. The pharmacokinetics of ET-26-HCl in rats needs to be determined for future clinical trials in human subjects. In order to facilitate the pharmacokinetic study, a liquid chromatography based tandem mass spectrometric (HPLC-MS/MS) method was developed and validated for quantification of ET-26-HCl and its major metabolite, ET-26-acid. These two compounds and gabapentin (internal standard) were extracted using a protein precipitation method with methanol and detected by Multiple Reaction Monitoring of m/z transition of 275.6-170.9, 217.7-113.1, and 172.5-154.3 for ET-26-HCl, ET-26-acid, and gabapentin respectively. This method was validated in terms of sensitivity, linearity, reproducibility, and stability. The HPLC-MS/MS method was found linear over the concentration ranges of 21.76-4352ng/mL, and 18.62-3724ng/mL with LLOQ of 21.76 and 18.62ng/mL for ET-26-HCl and ET-26-acid respectively. The mean intra-day and inter-day accuracy was between 94.11-107.78%, while the precision was within the limit of 15.0% for all the quality control samples. A pharmacokinetic study was then conducted in rats following intravenous injection of 2.1, 4.2, and 8.4mg/kg. The linear pharmacokinetics of ET-26-HCl was observed over the dose range of 2.1-8.4mg/kg. The average terminal phase elimination half-lives were 0.87 and 1.03h for ET-26-HCl and ET-26-acid respectively. In summary, an HPLC-MS/MS method for quantification of ET-26-HCl in rat plasma has been developed and successfully applied to a pharmacokinetic study.

A Novel Approach of Daunorubicin Application on Formation of Proliferative Retinopathy Using a Porous Silicon Controlled Delivery System: Pharmacodynamics.

PURPOSE: Proliferative vitreoretinopathy (PVR) is the most common cause of poor visual outcomes in association with retinal detachment surgeries and ocular trauma. Daunorubicin (DNR) has shown the strongest efficacy in proliferation inhibition in vitro. However, clinical studies have shown only mild effect owing to limitations of narrow therapeutic window and short vitreous half-life. METHODS: Three milligrams of DNR-loaded particles were intravitreally injected into 18 pigmented rabbits, and vitreous samples were collected up to 84 days for analysis. Thirty-seven rabbits were used for a dose-escalation (1, 3, 6 mg) safety and efficacy study in a rabbit PVR model using a pretreatment design. RESULTS: Loading efficiency of DNR was 108.55 ± 12 µg per 1 mg particles. Eighty-four days of follow-up did not reveal any adverse reaction. Pharmacokinetic analysis demonstrated a vitreous half-life of 29 days with a maximum DNR concentration of 178 ng/mL and a minimum concentration of 29 ng/mL at day 84. Daunorubicin-loaded porous silicon (pSi) particles were dosed 8 to 9 weeks before PVR induction, and PVR severity score was dose dependent (Spearman ρ = -0.25, P = 0.0005). Proliferative vitreoretinopathy with tractional retinal detachment was 88% in the control group, 63% in the low-dose group, 14% in the medium-dose group, and 0% in the high-dose group (Cochran-Armitage Trend Test, Z = 8.99, ρ = -0.67, P < 0.0001). CONCLUSIONS: Daunorubicin-loaded pSi particles can safely reside in the vitreous for at least 3 months. The pSi-based delivery expanded the therapeutic window of DNR by a factor of 862 and drove down the minimum effective concentration by a factor of 175.

Caracterización agroecológica y uso de la tierra en el proceso de autodesarrollo y organización productiva de la comunidad de K'aralahuani (prov. Tapacari)

La presente investigación se realizo en la comunidad de K'aralahuani (prov.Tapacari del Dpto. de Cochabamba) abarcando la caracterización agroecológica, las estrategias campesinas de uso de la tierra en la organización de la producción, tenencia y acceso y los criterios de caracterización local del suelo en función al uso de la tierra. La metodología de investigación se sustenta en el enfoque metodológico histórico cultural lógico, desarrollado en base a la investigación participativa revalorizadora y los estudios de caso familiares. Como resultado de la investigación se ha encontrado que K'aralahuani es una comunidad típica de cabecera de valle en el cual se tiene un alto porcentaje de cultivos a secano. Presenta dos zonas agroecológicas: Pre-Puna y Cabecera de Valle, tres zonas de producción: alta, media, baja. Donde la intensidad de uso agrícola en las zonas de producción ya sea en forma rotativa o asociativa dependen de las condiciones ecológicas de cada zona de producción (condiciones de riego y humedad, topografía, un territorio, basado en los diferentes recursos (cultivos, insumos, mano de obra, agua, suelo y otros) y ecosistemas a lo largo del proceso productivo, en función de los objetivos de reproducción biológica y social de la familia. La utilización de varias estrategias sociales de transformación del espacio físico-natural en un espacio socio económico, son posibles a través de la ocupación simultánea y complementaria de varios pisos altitudinales y zonas agroecológicas de producción. Don entidades regulan el uso del espacio agrícola: La familia cuyas parcelas se encuentran en diversos sectores de la comunidad y el sindicato para las tierras comunales, empleando las rotaciones y asociaciones, haciendo un manejo sostenible de sus tierras. En la comunidad existen dos formas de redistribución de la tierra: la yapa y el ariendo. Las formas de acceso que encontramos en la comunidad son: el saqey, en compañía o al partido, la yapa y el arriendo que puede ser a nivel familiar o comunal. Las formas de tenencia más comunes en la comunidad son: la dotación, la herencia, el arrimante y la compra.