scholarly journals EXTENDED-RELEASE DELIVERY SYSTEMS OF OPIOIDS: ANALGESIA AND DEPENDENCE

2021 ◽  
pp. 35-51
Author(s):  
Alexandre Pérez-López ◽  
Laura Gómez-Lázaro ◽  
Cristina Martín-Sabroso ◽  
Juan Aparicio-Blanco
Keyword(s):  
Treatment Success ◽  
Opioid Analgesics ◽  
The United States ◽  
Dosage Forms ◽  
Blood Levels ◽  
Prolonged Release ◽  
Duration Of Action ◽  
Alternative Routes ◽  
Dosing Intervals ◽  
Higher Doses

The consumption of opioid analgesics has increased drastically in the last decades worldwide. This high consumption is linked with a surge in the number of opioid prescriptions for the treatment of chronic pain and a surge in opioid misuse and addiction. Opioid analgesics have a short duration of action, making necessary frequent administrations to provide extended analgesia. The use of prolonged-release formulations enables dosing intervals to be spaced out and drug blood levels to be stabilized, improving therapeutic compliance, and reducing the likelihood of developing addiction. However, these formulations contain higher doses of opioid analgesics which make them more susceptible to be manipulated. Hence, the most recent advances in pharmaceutical technology have been oriented towards the application of abuse deterrent technologies aiming to prevent their administration through alternative routes. Moreover, prolonged- release systems also play an essential role in the treatment of opioid addictions with the development of parenteral dosage forms capable of prolonging opioid release for months that help overcome one of the most important drawbacks in achieving treatment success, namely, patient compliance. We review herein the different prolonged-release opioid dosage forms currently approved in Europe and/or the United States for the treatment of pain and opioid dependence.

Preparation and In Vitro Evaluation of Resealed Erythrocytes as A New Trend in Treatment of Asthma

2016 ◽  
Vol 6 (3) ◽  
Author(s):  
Mohammed Ibrahim ◽  
Alaa Zaky ◽  
Mohsen Afouna ◽  
Ahmed Samy
Keyword(s):  
In Vitro Release ◽  
Human Erythrocytes ◽  
The Body ◽  
Blood Levels ◽  
Time Interval ◽  
Burst Release ◽  
Prolonged Release ◽  
Nocturnal Asthma ◽  
Carrier Erythrocytes

Carrier erythrocytes are emerging as one of the most promising biological drug delivery systems investigated in recent decades. Beside its biocompatibility, biodegradability and ability to circulate throughout the body, it has the ability to perform extended release system of the drug for a long period. The ultimate goal of this study is to introduce a new carrier system for Salbutamol, maintaining suitable blood levels for a long time, as atrial to resolve the problems of nocturnal asthma medication Therefore in this work we study the effect of time, temperature as well as concentration on the loading of salbutamol in human erythrocytes to be used as systemic sustained release delivery system for this drug. After the loading process is performed the carrier erythrocytes were physically and cellulary characterized. Also, the in vitro release of salbutamol from carrier erythrocytes was studied over time interval. From the results it was found that, human erythrocytes have been successfully loaded with salbutamol using endocytosis method either at 25 Co or at 37 Co . The highest loaded amount was 3.5 mg/ml and 6.5 mg/ml respectively. Moreover, the percent of cells recovery is 90.7± 1.64%. Hematological parameters and osmotic fragility behavior of salbutamol loaded erythrocytes were similar that of native erythrocytes. Scanning electron microscopy demonstrated that the salbutamol loaded cells has moderate change in the morphology. Salbutamol releasing from carrier cell was 43% after 36 hours in phosphate buffer saline. The releasing pattern of the drug from loaded erythrocytes showed initial burst release in the first hour followed by a very slow release, obeying zero order kinetics. It concluded that salbutamol is successfully entrapped into erythrocytes with acceptable loading parameters and moderate morphological changes, this suggesting that erythrocytes can be used as prolonged release carrier for salbutamol.

scholarly journals Transmission Potential of Zika Virus by Aedes aegypti (Diptera: Culicidae) and Ae. mediovittatus (Diptera: Culicidae) Populations From Puerto Rico

2021 ◽  
Author(s):  
Rebecca A Zimler ◽  
Donald A Yee ◽  
Barry W Alto
Keyword(s):  
Puerto Rico ◽  
Aedes Aegypti ◽  
Zika Virus ◽  
Mosquito Species ◽  
The United States ◽  
Infection Rates ◽  
Transmission Potential ◽  
Transmission Rates ◽  
Higher Doses ◽  
Local Transmission

Abstract Recurrence of local transmission of Zika virus in Puerto Rico is a major public health risk to the United States, where mosquitoes Aedes aegypti (Linnaeus) and Aedes mediovittatus (Coquillett) are abundant. To determine the extent to which Ae. mediovittatus are capable of transmitting Zika virus and the influence of viremia, we evaluated infection and transmission in Ae. mediovittatus and Ae. aegypti from Puerto Rico using serial dilutions of infectious blood. Higher doses of infectious blood resulted in greater infection rates in both mosquitoes. Aedes aegypti females were up to twice as susceptible to infection than Ae. mediovittatus, indicating a more effective midgut infection barrier in the latter mosquito species. Aedes aegypti exhibited higher disseminated infection (40–95%) than Ae. mediovittatus (<5%), suggesting a substantial midgut escape barrier in Ae. mediovittatus. For Ae. aegypti, transmission rates were low over a range of doses of Zika virus ingested, suggesting substantial salivary gland barriers.

Competitive position of the expanded Panama Canal in the shipment of liquefied natural gas

2018 ◽  
Vol 233 (4) ◽  
pp. 1154-1176 ◽  
Author(s):  
Luis Carral ◽  
Javier Tarrío-Saavedra ◽  
Diego Crespo-Pereira ◽  
Marina Fernández-Campoamor ◽  
Rodolfo Sabonge
Keyword(s):  
Natural Gas ◽  
Gulf Of Mexico ◽  
Gas Injection ◽  
The United States ◽  
Liquefied Natural Gas ◽  
Panama Canal ◽  
Order Book ◽  
Propulsion Systems ◽  
Competitive Position ◽  
Alternative Routes

The appearance of new gas extraction technologies has led to surplus production in the United States (Gulf of Mexico). At the same time, energy consumption in Asia has increased significantly and Japan has introduced important changes to its post-Fukushima energy policies. Taken together, these factors have resulted in an imbalance in production and consumption between the Atlantic and Pacific Maritime Areas. Over the same period of time, the Panama Canal expansion opened, permitting transit by liquefied natural gas vessels for the first time. These developments are reflected in the current order book for liquefied natural gas carriers, which is composed entirely of ships in the new Neopanamax category. The canal transit fees and new propulsion systems for these ships—dual fuel diesel electric and electronically controlled gas injection—significantly impact the price of cargo at the destination. This study conducts a sensitivity analysis of the variables for transportation costs in order to determine the expanded Canal’s competitive position. In addition, the study uses a Monte Carlo simulation to obtain the most representative values for total cost based on factors such as the type of propulsion and fuel as well as the distance traveled. The analysis clearly demonstrates the competitiveness of exporting liquefied natural gas via the Panama Canal from terminals in the Gulf of Mexico and the Caribbean to consumers in Asia, as well as the competitiveness of the canal itself versus alternative routes. With respect to propulsion systems, the study demonstrates the greater competitive advantage of electronically controlled gas injection propulsion.

scholarly journals Migraine Headache : An Overview

2010 ◽  
Vol 23 (1) ◽  
pp. 114-119
Author(s):  
ASM Hasan ◽  
Iftekhar Mahmood ◽  
MR Islam ◽  
MSI Khan ◽  
SM Ali ◽  
...  
Keyword(s):  
Migraine Headache ◽  
Botulinum Toxin Type A ◽  
Antihypertensive Agents ◽  
Opioid Analgesics ◽  
The Elderly ◽  
Botulinum Toxin Type ◽  
The United States ◽  
Treatment Modalities ◽  
Migraine Treatment ◽  
History Of

The history of headache can be traced almost to the beginning of the history of humankind. Among the many causes of it, migraine headache is a debilitating disorder affecting millions of people in the United States and worldwide. The diagnosis of migraine can significantly affect quality of life, health care costs and daily productivity. Hundreds of trials and many guidelines have documented various approaches to migraine management, whether via acute treatment or chronic migraine prophylaxis. Acute or abortive migraine management encompasses specific and nonspecific migraine therapeutics including non-opioid and opioid analgesics, triptans and ergotamines. Prophylactic migraine management data span the pharmacological spectrum from antiepileptic and antihypertensive agents to botulinum toxin type A. Special considerations for migraine management also must be applied in various populations including children, pregnant women and the elderly. Although hundreds of clinical trials are available regarding migraine treatment modalities, this review serves as an introduction to current accepted therapeutics for migraine treatment and an overview of pharmacological prophylaxis in the modern management of migraine. TAJ 2010; 23(1): 114-119

scholarly journals Clinical efficacy of different dosage forms containing vitamin D: design and study outcomes of a randomized, comparative clinical trial

2020 ◽  
Vol 7 (3) ◽  
pp. 176
Author(s):  
Nidhi Sapkal ◽  
Gaurav Chhaya ◽  
Milan Satya ◽  
Dhara Shah
Keyword(s):  
Vitamin D ◽  
Clinical Efficacy ◽  
Dosage Forms ◽  
Oral Solution ◽  
Blood Levels ◽  
Open Label ◽  
Soft Gelatin Capsules ◽  
25 Hydroxy Vitamin D ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Different dosage forms of vitamin D like tablets, soft gelatin capsules, oral granules, powders, solutions and thin films are available. The objective of the present study was to evaluate and compare the clinical efficacy of three different dosage forms of vitamin D3 namely, orally disintegrating strips, oral granules and oral solution.</p><p class="abstract"><strong>Methods:</strong> An open label, single centre, prospective, randomized, parallel group, comparative study was conducted for a period of 4 months. The study participants were divided into three groups (A, B, C) and received the respective treatments (orally disintegrating strips, n=20; granules, n=20; oral nano solution, n=10) for the study period. The estimation of blood levels of 25-hydroxy vitamin D [25(OH)D<sub>3</sub>] in all the subjects at day 0, 60 and 120 was carried out.</p><p class="abstract"><strong>Results:</strong> The normalization level of 25(OH)D<sub>3 </sub>achieved by the subjects in group A, group B and group C was 100%, 83.3% and 90% respectively after 90 days. Comparison of 25(OH)D<sub>3 </sub>level in all three groups showed significant increase at day 60. The levels were maintained at day 90 and 120 even after drastic reduction in dosage in Group A and group C. On day 120, the dose reduction was in the order of group A&gt;group C&gt;group B.</p><p class="abstract"><strong>Conclusions: </strong>All the three formulations showed increase in the level of 25(OH)D<sub>3. </sub>It can be concluded that oral disintegrating strips of 25(OH)D<sub>3</sub> are clinically more efficient than other conventional dosage forms.</p>

Demographic characteristics, medical and psychiatric history of patients with prescription opioid use disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S300-S301
Author(s):  
S. Herrera ◽  
A. Riquelme ◽  
T. León ◽  
M. Babul
Keyword(s):  
Opioid Analgesics ◽  
The United States ◽  
Opioid Use Disorder ◽  
Demographic Characteristics ◽  
Prescription Opioid ◽  
Psychiatric History ◽  
Opioid Use ◽  
History Of ◽  
Competing Interest ◽  
Prescription Opioid Misuse

IntroductionOver the past two decades the prescription of opioid analgesics has increased with a subsequent escalating in prescription opioid misuse. It is estimated that 4.5 million (2.5%) of the United States of America population abuse of pain relievers; opioids are among the most commonly.In Chile there are few reports about the prevalence of opioid use disorder.ObjectivesThe aim of this study is to describe the demographic characteristics, medical and psychiatric comorbidity of patients that suffer from opioid addiction.Patients and methodsThis transversal study examined data of 7 patients with opioid use disorder (OUD; DSM-5) that consulted at the addiction unit of “Red de Salud, Pontificia Universidad Católica de Chile”, between November 2013 and October 2015. Data included: demographics, medical and psychiatric history, laboratory and imaging tests.ResultsOf all the patients, 57% were men, 25 to 67 years of age, 43% between 35-40 years; 57% were married; 57% had completed studies at university. 43% had also alcohol use disorder, 28% marijuana, 28% cocaine and 28% benzodiazepines than in most cases began before OUD. In addition; 57% had medical comorbidity among which stand out obesity (17%), osteoarthritis (17%) and chronic low back pain (17%). Eighty-three percent require hospitalization. Twenty-eight percent had abnormal liver tests and one patient had positive hepatitis B core antibody. Opioids used were: morphine(14%), codeine (43%), tramadol (42%).ConclusionThese results emphasize on the misuse of prescription opioids analgesics, the complexity of patients with OUD and the prevalence of other substance use disorder that precedes and accompany OUD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Pelvic Congestion Syndrome: Systematic Review of Treatment Success

2018 ◽  
Vol 35 (01) ◽  
pp. 035-040 ◽  
Author(s):  
Magda Rizer ◽  
Ryan Alexander ◽  
Emerson Sharpe ◽  
Paul Rochon ◽  
Candace Brown
Keyword(s):  
United States ◽  
Systematic Review ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Treatment Success ◽  
Percutaneous Treatment ◽  
The United States ◽  
Pelvic Congestion Syndrome ◽  
Venous Dilatation ◽  
Pelvic Congestion

AbstractPelvic venous insufficiency is now a well-characterized etiology of pelvic congestion syndrome (PCS). The prevalence of CPP is 15% in females aged 18 to 50 years in the United States and up to 43.4% worldwide. In addition to individual physical, emotional, and quality-of-life implications of CPP, there are profound healthcare and socioeconomic expenses with estimated annual direct and indirect costs in the United States in excess of 39 billion dollars. PCS consists of clinical symptoms with concomitant anatomic and physiologic abnormalities originating in venous insufficiency. The etiology of PCS is diverse involving both mechanical and hormonal factors contributing to venous dilatation (>5 mm) and insufficiency. Factors affecting the diagnosis of PCS include variance of causes and clinical presentations of pelvic pain and relatively low sensitivity of noninvasive diagnostic imaging and laparoscopy to identify insufficiency compared with catheter venogram. A systematic review of the literature evaluating patient outcomes following percutaneous treatment of PCS is presented.

Newly Approved Novel Dosage Forms of Glucagon for Management of Severe Hypoglycemia

2020 ◽  
Vol 35 (4) ◽  
pp. 176-181
Author(s):  
Thomas J. Borden ◽  
Danial E. Baker ◽  
Terri L. Levien ◽  
Brian J. Gates
Keyword(s):  
United States ◽  
Older People ◽  
Severe Hypoglycemia ◽  
The United States ◽  
Medical Intervention ◽  
Dosage Forms ◽  
Adverse Outcomes ◽  
Oral Glucose ◽  
Term Care ◽  
Increased Risk

The prevalence and clinical impact of diabetes mellitus (DM) continues to increase in the United States and throughout the world. Older adults are at increased risk for adverse outcomes associated with hypoglycemia, particularly in situations where a lack of awareness may arise because typical symptoms are not necessarily present, serve to prompt medical intervention with oral glucose. Glucagon emergency kits that have been available to date require multiple-step reconstitution that may compromise timely and appropriate administration of lifesaving glucagon treatment during episodes of severe hypoglycemia. In settings such as long-term care facilities, trained medical professionals may not be readily available, meaning that glucagon must be administered by laypersons. Novel dosage forms of glucagon that have recently been approved for marketing in the United States allow glucagon to be delivered more easily, which may positively impact effective treatment of severe hypoglycemia among older people. Nasal glucagon and glucagon autoinjection "pens" are as effective as glucagon kits and increase the likelihood glucagon will be appropriately used by patient caregivers. The safety, efficacy, and convenience of these new devices may improve outcomes and reduce health care costs of older people with diabetes.

Chapter 5: Establishing Teacher Allies through Critical Multicultural Coursework

2021 ◽  
Vol 123 (13) ◽  
pp. 1-30
Author(s):  
Lan Kolano ◽  
Leslie Gutierrez ◽  
Anna Sanczyk
Keyword(s):  
United States ◽  
Preservice Teachers ◽  
Undocumented Immigrants ◽  
The United States ◽  
Border Crossing ◽  
Preparation Programs ◽  
Teachers Perceptions ◽  
Immigration Laws ◽  
Alternative Routes ◽  
Policies And Practices

Background Contemporary dominant discourses surrounding (un)documented migration in the United States are commonly divided into two polarized frames: those immigrants who are hard workers seeking a better life, and others who are border-crossing criminals. For teachers in the Southeast, developing an understanding of immigrants becomes critically important as new demographic trends and anti-immigration rhetoric have resulted in the implementation of restrictive laws, policies, and practices. In this article, we move beyond pedagogical strategies that address students’ linguistic needs and explore what teachers know and say about immigration, along with what they know about undocumented and DACAmented students. Purpose The purpose of this study was to explore the ways in which exposure to counternarratives of undocumented or DACAmented youth and families altered the frames in which teachers viewed immigration and undocumented and DACAmented immigrants. Research Design The researchers used qualitative methods to collect a series of narratives in the form of I-essays from 71 preservice teachers over four semesters. The narratives were then used as a tool of communication in exploring two research questions: (1) What were teachers’ perceptions of undocumented immigrants, given the racialized context in the Southeast? (2) How did counternarratives presented in multiple formats challenge the dominant essentialized view of undocumented immigrants? Narrative data from participants were analyzed using an inductive analysis approach. Findings The findings support how the use of critical conversations around immigration and exposure to the lives of youth and families through the use of film and narratives can support the development of teachers as undocumented allies. Conclusions We argue that preservice (ESL) teachers need to be knowledgeable about immigration laws, statuses, policies, and practices in order to be prepared to serve their students’ needs and to aid them in mapping out alternative routes/resources. For our participants, their views were challenged to reflect a deeper understanding of immigration, particularly around what it means to be an undocumented immigrant in an area of the United States that has experienced new immigrant growth. This study has significant implications for teacher preparation programs and further research.

scholarly journals Stability Indicating HPLC-ECD Method for the Analysis of Clarithromycin in Pharmaceutical Dosage Forms: Method Scaling versus Re-Validation

2019 ◽  
Vol 87 (4) ◽  
pp. 31 ◽  
Author(s):  
Makoni ◽  
Chikukwa ◽  
Khamanga ◽  
Walker
Keyword(s):  
High Performance ◽  
The United States ◽  
High Performance Liquid Chromatographic ◽  
Dosage Forms ◽  
Pharmaceutical Dosage Forms ◽  
Analytical Column ◽  
Ich Guidelines ◽  
Relative Standard ◽  
Run Time ◽  
Liquid Chromatographic

An isocratic high-performance liquid chromatographic method using electrochemical detection (HPLC-ECD) for the quantitation of clarithromycin (CLA) was developed using Response Surface Methodology (RSM) based on a Central Composite Design (CCD). The method was validated using International Conference on Harmonization (ICH) guidelines with an analytical run time of 20 min. Method re-validation following a change in analytical column was successful in reducing the analytical run time to 13 min, decreasing solvent consumption thus facilitating environmental and financial sustainability. The applicability of using the United States Pharmacopeia (USP) method scaling approach in place of method re-validation using a column with a different L–designation to the original analytical column, was investigated. The scaled method met all USP system suitability requirements for resolution, tailing factor and % relative standard deviation (RSD). The re-validated and scaled method was successfully used to resolve CLA from manufacturing excipients in commercially available dosage forms. Although USP method scaling is only permitted for columns within the same L-designation, these data suggest that it may also be applicable to columns of different designation.

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