Perceptions, Barriers, and Knowledge of Inpatient Glycemic Control: A Survey of Health Care Workers.

Objectives: To assess knowledge and perceptions of health care workers regarding optimal care for patients with hyperglycemia and identify commonly perceived barriers for the development of a hospital-wide education program.

Research Design And Methods: A cross-sectional design was utilized to survey health care workers involved in managing hyperglycemia in an urban, community teaching hospital. Each health care worker received a survey specific to their health care role.

Using beta-blockers to treat heart failure.

Bisoprolol, carvedilol, metoprolol, and nebivolol are beta-blocker drugs used to improve survival in patients with systolic heart failure. This article reviews these drugs and how practitioners can initiate and titrate them for maximum patient benefit.

Efficacy and Safety of Prasugrel Compared With Clopidogrel for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

Dual antiplatelet therapy comprising aspirin and a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is essential to prevent thrombotic complications after percutaneous coronary intervention (PCI). The comparative efficacy between clopidogrel at a higher loading dose (600 mg) and prasugrel is uncertain. The aim of this study was to compare efficacy and safety of clopidogrel (higher loading dose) with prasugrel (loading dose of 60 mg) along with their respective maintenance doses in patients with acute coronary syndrome (ACS) undergoing PCI at 1 year.

Development and in-vivo evaluation of ondansetron gels for transdermal delivery.

Nausea and vomiting are some of the major side effects caused by certain drug therapies, e.g. chemotherapy, radiotherapy and general anesthesia.

Rates of febrile neutropenia with pegfilgrastim on same day versus next day of CHOP with or without rituximab.

Febrile neutropenia is a complication of myleotoxic chemotherapy that can markedly decrease quality of life and increase healthcare costs. A granulocyte-colony stimulating factor (G-CSF) is used to increase neutrophil production to reduce the risk of developing febrile neutropenia. However, G-CSF administered on the same day as chemotherapy can worsen and prolong neutropenia.

A quantitative professionalism policy in a community pharmacy introductory pharmacy practice experience.

Objective: To determine whether implementing a quantitative professionalism policy would lead to improved behaviors in an introductory pharmacy practice experience (IPPE) and to evaluate students' attitudes about professionalism expectations in the IPPE.

Design: A policy using quantitative parameters for assessing unprofessional behaviors was developed and implemented in the community pharmacy IPPE after discrepancies were identified in the way professional expectations were assessed.

Assessment: The quantitative professionalism policy reduced the number of assignments submitted post deadline (p<0.

Iontophoresis successfully delivers dexamethasone sodium phosphate to dermis as measured by microdialysis.

Despite its widespread and long term use, the effectiveness of iontophoresis to increase the delivery of dexamethasone sodium phosphate (DSP) remains controversial. The goal of this study was to quantitatively compare the DSP concentrations in dermis' dialysates in two delivery scenarios: with and without iontophoresis. Interstitial fluid concentrations were measured by cutaneous microdialysis.

Feasibility of a pharmacy-based influenza immunization program in an academic emergency department.

Background: From September 2002 to August 2010, 13 patients who were discharged from the emergency department (ED) were immunized against influenza. This correlates with a time when pharmacists were not permitted to vaccinate patients in New York.

Objective: The objectives of this study were to determine the feasibility of a pharmacist-based influenza vaccination program in the ED, assess patients' willingness to be vaccinated by a pharmacist, and identify reasons for declination.

Student preferences regarding teaching methods in a drug-induced diseases and clinical toxicology course.

Objectives: To determine which teaching method in a drug-induced diseases and clinical toxicology course was preferred by students and whether their preference correlated with their learning of drug-induced diseases.

Design: Three teaching methods incorporating active-learning exercises were implemented. A survey instrument was developed to analyze students' perceptions of the active-learning methods used and how they compared to the traditional teaching method (lecture).

Physicochemical characterization, solubilization, and stabilization of 9-nitrocamptothecin using pluronic block copolymers.

Solid-state properties and physicochemical characteristics of 9-nitrocamptothecin (9NC) were investigated with a view of molecular and bulk level understanding of its poor aqueous solubility and hydrolytic instability that prevent efficient drug delivery and pharmacological activity. 9NC bulk drug substance was found to be a nonhygroscopic, yellowish crystalline solid with long rectangular prism-shaped particle morphology and a sharp melting point at 264°C. Hydrolysis of 9NC-lactone occurs above pH 4, whereas complete conversion of lactone to carboxylate was recorded above pH 8.

Development of polyvinylpyrrolidone-based spray-dried solid dispersions using response surface model and ensemble artificial neural network.

A model for spray drying processes was developed using polyvinylpyrrolidone (PVP)-K29/32 as a placebo formulation to predict quality attributes (process yield, outlet temperature, and particle size) for binary solid dispersions (SDs). The experiments were designed to achieve a better understanding of the spray drying process. The obtained powders were analyzed by modulated differential scanning calorimetry, thermogravimetric analysis, X-ray diffraction, polarized light microscopy, and particle size analysis.

Evaluation of colloidal solid dispersions: physiochemical considerations and in vitro release profile.

Colloidal solid dispersion is an innovative breakthrough in the pharmaceutical industry that overcomes the solubility-related issue of poorly soluble drugs by using an amorphous approach and also the stability-related issue by means of a complex formation phenomenon using different carrier materials. In the present study, a newly developed adsorption method is introduced to incorporate a high-energy sulfathiazole-polyvinylpyrrolidone (Plasdone® K-29/32) solid dispersion on porous silicon dioxide (Syloid® 244FP). Different ternary systems of sulfathiazole-Plasdone® K-29/32-Syloid® 244FP were prepared (1:1:2, 1:1:3, and 1:2:2) and categorized depending on the mechanism by which Syloid® 244FP was incorporated.

Primer on clinical practice guidelines.

Clinical practice guidelines (CPGs) are valuable tools for health care providers and support evidence-based medicine (EBM). Many organizations, including medical associations and government-affiliated agencies, develop and publish guidelines using varying methods. Unfortunately, many guidelines are not appropriately developed and certain recommendations are not based on the best available evidence.

Iontophoresis of amoxicillin and cefuroxime: rapid therapeutic concentrations in skin.

Context: Amoxicillin (AMX) and cefuroxime (CFX) are antibiotics used often to treat skin bacterial infections. Typically, high oral doses are required to achieve minimum inhibitory concentration (MIC) at the site of infection that may affect only a very small area of skin.

Objectives: To lower side effects and increase therapeutic effectiveness, the percutaneous absorption and retention of AMX and CFX administered by iontophoresis was investigated in a rabbit model by measuring dermis concentrations via microdialysis.

To evaluate the change in release from solid dispersion using sodium lauryl sulfate and model drug sulfathiazole.

The solubility of drugs remains one of the most challenging aspects of formulation development. There are numerous ways to improve the solubility of drugs amongst which the most promising strategy is solid dispersion. Different ratios of sulfathiazole: PVP-K29/32: sodium lauryl sulfate (SLS) were prepared (1:1:0.

Optimization of perfusate pH to improve microdialysis recovery of lipophilic compounds.

Introduction: Microdialysis (MD) allows sampling of compounds in-vivo from tissues' interstitial fluid. However, molecules insoluble at physiological pH have usually extremely low recovery. The addition of albumin to the perfusate or the use of isotonic lipoemulsion improves recovery of these molecules although it requires a cleaning step before HPLC analysis.

Efficacy of class III antiarrhythmics and magnesium combination therapy for atrial fibrillation.

Unlabelled: Atrial fibrillation is a common cardiac arrhythmia, and has been a significant financial burden. Class III antiarrhythmics such as dofetilide, ibutilide, and amiodarone are indicated for rhythm control. Magnesium may possess intrinsic antiarrhythmic properties, and may potentially increase the efficacy of class III antiarrhythmics when used concomitantly.

Irreversible atorvastatin-associated hearing loss.

Drug-associated ototoxicity is a potentially irreversible adverse event. Among the several 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) available in the United States, only atorvastatin is associated with tinnitus, but none are associated with any forms of hearing loss. A search of the published literature (1950-August 2011) revealed no published case reports of ototoxicity associated with statins.

Lisdexamfetamine in the treatment of adolescents and children with attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder is one of the most common neurobehavioral disorders defined by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity. Symptoms begin in childhood and may persist into adolescence and adulthood. Currently available pharmacological treatment options for attention-deficit/hyperactivity disorder in children and adolescents include stimulants that are efficacious and well tolerated; however, many of these preparations require multiple daily dosing and have the potential for abuse.

The neuroprotective effect of fisetin in the MPTP model of Parkinson's disease.

Background: Parkinson's disease (PD) is characterized by excessive deposition of neuritic plaques known as Lewy bodies of which α-synuclein is the major contributor to neuronal death. Both oxidative stress and cytokines signaling have been proposed to play an important role in α-synuclein-induced neuronal death in MPTP and PD-related neuronal cell death. Fisetin, a natural polyphenol, possesses antioxidant, anti-inflammatory, and anti-apoptotic properties.

To determine the end point of wet granulation by measuring powder energies and thermal properties.

Wet granulation has been widely used in pharmaceutical industry as a tablet manufacturing process. However, end-point determination of wet granulation process has always remained a challenge. Many traditional methods are available for end-point determination, yet accuracy and reproducibility still remain a challenge.

Ulipristal acetate: review of the efficacy and safety of a newly approved agent for emergency contraception.

Background: Emergency contraception (EC) is used to prevent unintended pregnancies. The current gold standard for oral EC is levonorgestrel (LNG) administered as a single 1.5-mg dose or in 2 doses of 0.

To evaluate the effect of addition of an anionic surfactant on solid dispersion using model drug indomethacin.

Formation of solid dispersion also known as high energy solids is one of the most successful concepts to improve dissolution profile of poorly water-soluble drugs. Use of surfactants in formulation is one of the methods to increase solubility profile. In this research, we have used model drug, a weak acid (indomethacin) together with polymer (PVP) and anionic surfactant (sodium lauryl sulfate (SLS)) in different concentrations to study the effect of incorporation of SLS in solid dispersion.

Skin microdialysis-based estimation of systemic bioavailability fraction.

Systemic bioavailability is usually determined from plasma data. However, when plasma is difficult to access, as in young children, alternative methods would be particularly beneficial. The present study investigates the possibility of calculating systemic bioavailability fraction (F) from skin concentrations measured by two microdialysis (MD) sampling methods: continuous microdialysis and intermittent microdialysis.