Chemometric evaluation of the combined effect of temperature, pressure, and co-solvent fractions on the chiral separation of basic pharmaceuticals using actual vs set operational conditions.

The need to determine the actual operational conditions, instead of merely using the set operational conditions, was investigated for in packed supercritical fluid chromatography (SFC) by design of experiments (DoE) using a most important type of compounds, pharmaceutical basics, as models. The actual values of temperature, pressure, and methanol levels were recorded and calculated from external sensors, while the responses in the DoE were the retention factors and selectivity. A Kromasil CelluCoat column was used as the stationary phase, carbon dioxide containing varying methanol contents as the mobile phase, and the six racemates of alprenolol, atenolol, metoprolol, propranolol, clenbuterol, and mianserin were selected as model solutes.

Asthma/COPD drugs reflecting disease prevalence, patient adherence and persistence.

The aim of this review is to discuss the methodological issues involved in using pharmacy-record databases of drug sales in pharmacoepidemiology and to illustrate the usefulness of such data in estimating disease prevalence, patient adherence and persistence to therapy. Recent studies show that asthma/chronic obstructive pulmonary disease (COPD) prevalence increases with age. The volume of acquired asthma/COPD drugs per patient also increases with age and was approximately 2.

Prevalence and predictors of lipid and glucose monitoring in commercially insured patients treated with second-generation antipsychotic agents.

Objective: The authors sought to quantify plasma lipid and glucose testing rates in patients receiving second-generation antipsychotics before and after guidelines recommending testing were issued in February 2004 by the American Diabetes Association (ADA).

Method: In this retrospective cohort analysis using data from a large managed care database (PharMetrics, 2000-2006), patients under age 65 on second-generation antipsychotics were identified and followed from 40 days before to 130 days after the antipsychotic prescription was written. Baseline and 12-week (40 days) lipid and glucose testing rates were determined for pre- and postguideline cohorts.

Refill adherence to oral antihyperglycaemic drugs in Sweden.

Only 49% of the patients with T2D in Sweden that medicate with oral antihyperglycaemic drugs (AHGD) had good blood glucose control (HbA(1C) < 6.0%). The reason can be low medication adherence.

Dispensed volumes of anti-asthmatic drugs related to the prevalence of asthma and COPD in Sweden.

Purpose: To explore the possibility of using dispensed volumes asthma/COPD drugs as a proxy for the combined prevalence of asthma plus COPD.

Methods: The proportions of the Swedish population with inhalation drugs for asthma/COPD 2004 were obtained using three different databases. A pharmacy record database gave the volumes of dispensed drugs (defined daily doses, DDDs of R03A + R03B drugs) for each patient, 20 years and older.

Medication persistence among patients with asthma/COPD drugs.

Objective: To determine medication possession ratio (MPR) of patients with asthma/COPD drugs.

Method: Individual patient's volumes of asthma/COPD drugs (ATC-code R03) for 2000-2004 were obtained from a pharmacy record database. For each patient the MPR was calculated as the percentage of the treatment time that the patient had drugs available.

Metabolic risks and effects of atypical antipsychotic treatment.

Weight gain and the associated increased risk of diabetes and cardiovascular disease may be problems for individuals who receive long-term treatment with atypical antipsychotics. Atypical antipsychotics differ in their propensity to cause obesity and other metabolic disturbances. If a patient gains substantial weight while taking atypical antipsychotics, the physician should consider switching him or her to a drug with a lower risk of weight gain.

Adiposity and insulin sensitivity derived from intravenous glucose tolerance tests in antipsychotic-treated patients.

Cardiovascular disease is more common in schizophrenia patients than in the general population, with a hypothesized contribution from increases in adiposity produced by antipsychotic medications. We sought to test the relationship between adiposity and insulin resistance using frequently sampled intravenous glucose tolerance tests (FSIVGTTs) to quantify whole-body insulin sensitivity in chronically treated patients with schizophrenia or schizoaffective disorder and untreated healthy controls. FSIVGTTs, body mass index (BMI), and waist circumference were obtained in nondiabetic patients (n=63) receiving olanzapine, risperidone, ziprasidone, or first generation antipsychotics, as well as in healthy controls (n=14).

Perceptions of weight gain and bipolar pharmacotherapy: results of a 2005 survey of physicians in clinical practice.

Objective: To assess the perceptions of clinicians in the psychiatric community about pharmacotherapy and its impact on weight gain and adverse metabolic effects in patients with bipolar disorder.

Methods: In November 2005, self-administered questionnaires were sent to 7000 psychiatrists who treat bipolar disorder in their clinical practice. An additional mailing of these questionnaires was sent in January 2006 to a different group of 7000 psychiatrists who treat bipolar disorder in their clinical practice.

The metabolic effects of antipsychotic medications.

Objectives: To review current evidence for the hypothesis that treatment with antipsychotic medications may be associated with increased risks for weight gain, insulin resistance, hyperglycemia, dyslipidemia, and type 2 diabetes mellitus (T2DM) and to examine the relation of adiposity to medical risk.

Methods: We identified relevant publications through a search of MEDLINE from the years 1975 to 2006, using the following primary search parameters: "diabetes or hyperglycemia or glucose or insulin or lipids" and "antipsychotic." Meeting abstracts and earlier nonindexed articles were also reviewed.

Differential metabolic effects of antipsychotic treatments.

Metabolic abnormalities such as obesity, diabetes and dyslipidaemia increase the risk of cardiovascular disease, as well as a number of other adverse long-term health consequences. There is increasing evidence from case studies, retrospective analyses and clinical trials to suggest that second-generation antipsychotics can increase the risk of metabolic abnormalities in patients with schizophrenia, with indications that the level of risk may vary among antipsychotic medications. Comparison of weight gain data for the second-generation antipsychotics provides strong evidence to indicate differences in the weight gain liability, with clozapine and olanzapine being associated with the greatest weight gain over 1 year.

Reducing the emission of particles from a diesel engine by adding an oxygenate to the fuel.

Particulate and high emissions of NO(x) are the main problems that are associated with diesel engines. Therefore, techniques and fuels that promote a reduction in these emissions currently are attracting great interest. In this paper, a mixture of acetal and regular diesel fuel has been tested in a heavy-duty diesel engine.

Plasma leptin and adiposity during antipsychotic treatment of schizophrenia.

Alterations in plasma leptin have been reported in schizophrenia patients treated with antipsychotics, suggesting the hypothesis that impairments in leptin secretion or signaling might play a role in antipsychotic-induced weight gain. Plasma leptin was measured in 72 schizophrenia patients chronically treated with olanzapine (n=27), risperidone (n=24) or typical antipsychotics (n=21) and 124 healthy adult control subjects. ANCOVA was used to test effects of adiposity (body mass index kg/m2; BMI), subject group (treated patients vs untreated controls), and treatment group (specific medication groups and untreated controls) on plasma leptin concentrations.

Abnormalities in glucose regulation during antipsychotic treatment of schizophrenia.

Background: Hyperglycemia and type 2 diabetes mellitus are more common in schizophrenia than in the general population. Glucoregulatory abnormalities have also been associated with the use of antipsychotic medications themselves. While antipsychotics may increase adiposity, which can decrease insulin sensitivity, disease- and medication-related differences in glucose regulation might also occur independent of differences in adiposity.