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Treatment of the most common respiratory infections in children 治疗儿童最常见的呼吸道感染
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2022-01-01 DOI: 10.5937/arhfarm72-37857
M. Baša, A. Sovtić
Acute respiratory infections are the most common group of infective diseases in the pediatric population. Although the improvement of health care and vaccination program has led to a significant reduction in the incidence of certain respiratory infections, the combination of a high prevalence in vulnerable pediatric categories and uncritical prescription of antibiotics, due to the inability to adequately distinguish between viruses and bacterial etiology, still represents a significant challenge for the public health system. In order to promote rational antibiotic therapy with an overall improvement of both diagnostic and therapeutic principles, acute respiratory diseases have been the subject of consideration in numerous publications and national guidelines. Nonspecific clinical manifestations with pathogen heterogeneity and both anatomical and physiological characteristics of the child's respiratory system during growth and development have created the need for individualized therapy. Since the guidelines emphasize the undoubtful and crucial benefits of symptomatic therapy (e.g. analgesics in acute otitis media, supplemental oxygen in lower respiratory tract infections with hypoxemia), the use of antibiotics and corticosteroids is indicated in selected cases with a severe clinical picture. The choice of antibiotic depends on the clinical condition, presumed causative agent, and local epidemiologic circumstances. Respiratory support (oxygen therapy and/or artificial ventilation) is reserved for inpatient treatment of cases with a particularly severe clinical picture and associated complications.
急性呼吸道感染是儿科人群中最常见的传染病。尽管卫生保健和疫苗接种计划的改善已经导致某些呼吸道感染的发病率显著降低,但由于无法充分区分病毒和细菌病因,易受感染的儿科类别的高患病率和抗生素处方不加鉴别,仍然是公共卫生系统面临的重大挑战。为了促进合理的抗生素治疗,全面改进诊断和治疗原则,急性呼吸道疾病已成为许多出版物和国家指南考虑的主题。具有病原体异质性的非特异性临床表现,以及儿童生长发育过程中呼吸系统的解剖和生理特征,都需要个体化治疗。由于指南强调对症治疗(如急性中耳炎的镇痛药,低氧血症下呼吸道感染的补充氧)无疑和至关重要的益处,因此在有严重临床症状的选定病例中应使用抗生素和皮质类固醇。抗生素的选择取决于临床情况、推定的病原体和当地的流行病学情况。呼吸支持(氧气治疗和/或人工通气)用于有特别严重临床症状和相关并发症的住院治疗病例。
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引用次数: 1
Functional thyroid disorders in the pharmacy setting: How can we help our patients? 在药房设置功能性甲状腺疾病:我们如何帮助我们的病人?
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2022-01-01 DOI: 10.5937/arhfarm72-39858
Uroš Pecikoza
Functional thyroid disorders (hypothyroidism and hyperthyroidism) are amongst the most common endocrine disorders pharmacists encounter on a daily basis. They are highly prevalent in iodine-replete areas, and affect women about 10 times more often than man. Hypothyroidism (thyroid hormone deficiency) is usually caused by Hashimoto's thyroiditis, an autoimmune disorder that leads to gradual thyroid destruction. The drug-of-choice for treating hypothyroidism is levothyroxine, a synthetic form of thyroxine. Key points which need to be discussed with patients who are prescribed levothyroxine for the first time are when/how to administer this drug, how its effects are monitored, what drugs may affect its efficacy, and the importance of properly treating hypothyroidism during pregnancy. Hyperthyroidism (increased production of thyroid hormones) is most often caused by Graves' disease, another thyroid autoimmune disorder in which stimulatory autoantibodies against the TSH receptor lead to increased thyroid function. Graves' disease is most commonly treated with thionamide drugs (thiamazole, carbimazole or propylthiouracil) and patients using these drugs should be advised on the monitoring requirements, duration of treatment, and how to recognize possible serious adverse effects (agranulocytosis and hepatotoxicity), and informed that these drugs must be used during pregnancy in order to reduce the risk of adverse outcomes for the mother and baby.
功能性甲状腺疾病(甲状腺功能减退和甲状腺功能亢进)是药剂师每天遇到的最常见的内分泌疾病之一。它们在碘含量高的地区非常普遍,对女性的影响大约是男性的10倍。甲状腺功能减退症(甲状腺激素缺乏)通常由桥本甲状腺炎引起,桥本甲状腺炎是一种导致甲状腺逐渐破坏的自身免疫性疾病。治疗甲状腺功能减退症的首选药物是左甲状腺素,一种甲状腺素的合成形式。首次使用左甲状腺素的患者需要讨论的重点是何时/如何给药,如何监测其效果,哪些药物可能影响其疗效,以及妊娠期间正确治疗甲状腺功能减退的重要性。甲状腺功能亢进(甲状腺激素分泌增加)最常由Graves病引起,Graves病是另一种甲状腺自身免疫性疾病,其中针对TSH受体的刺激性自身抗体导致甲状腺功能增加。Graves病最常用硫酰胺类药物(噻马唑、咔咪唑或丙硫脲嘧啶)治疗,应告知使用这些药物的患者监测要求、治疗持续时间,以及如何识别可能的严重不良反应(粒细胞缺陷症和肝毒性),并告知这些药物必须在妊娠期间使用,以减少母亲和婴儿不良结局的风险。
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引用次数: 0
Role of pharmacists in management of patients with thyroid disorders 药师在甲状腺疾病患者管理中的作用
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2022-01-01 DOI: 10.5937/arhfarm72-39948
A. Homšek, M. Roganović, Milena Kovačević, Marija Jovanović
Thyroid dysfunction is one of the most prevalent endocrine disorders, especially common in female patients. If patients are not diagnosed in time or adequately treated, the patients' quality of life can be significantly impaired and additional health problems may occur, considering the key roles of thyroid hormones in the body. Therefore, it is necessary to raise awareness about the importance of recognition of symptoms that may indicate a potential problem with the thyroid gland and help to identify possible causes. For patients who are already being treated with levothyroxine (hypothyroidism), or thiamazole, carbimazole or propylthiouracil (hyperthyroidism), it is necessary to point out the necessity of proper, regular use of the drugs and implementation of accompanying nonpharmacological measures, as well as the potential for the occurrence of adverse reactions and interactions with other drugs or food. A significant role in the mentioned activities should be played by the pharmacist, as the most accessible member of the health team, who can, if necessary, refer the patient to a doctor for diagnosis, monitor the effectiveness and safety of the therapy, and provide appropriate patient counseling.
甲状腺功能障碍是最常见的内分泌疾病之一,尤其常见于女性患者。考虑到甲状腺激素在体内的关键作用,如果患者没有得到及时的诊断或充分的治疗,患者的生活质量可能会严重受损,并可能出现额外的健康问题。因此,有必要提高认识,认识到识别可能表明甲状腺潜在问题的症状的重要性,并帮助确定可能的原因。对于已经接受左甲状腺素(甲状腺功能减退)或噻马唑、咔咪唑或丙硫脲嘧啶(甲状腺功能亢进)治疗的患者,有必要指出正确、定期使用药物和实施伴随的非药物措施的必要性,以及发生不良反应和与其他药物或食物相互作用的可能性。药剂师应在上述活动中发挥重要作用,因为药剂师是卫生团队中最容易接触的成员,必要时可以将患者转介给医生进行诊断,监测治疗的有效性和安全性,并提供适当的患者咨询。
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引用次数: 0
Compliance of the POCT method with the fully automated method for HbA1c determination POCT方法与全自动HbA1c测定方法的一致性
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2022-01-01 DOI: 10.5937/arhfarm72-35905
N. Milinković, M. Sarić-Matutinović, Gordana Dmitrašinović, S. Ignjatović
Previous research suggests that point-of-care (POCT) determination of glycated hemoglobin (HbA1c) is a diagnostic test that can be an adequate alternative to measuring HbA1c in the laboratory. The main goal of this study was to examine the analytical characteristics of the novel INCLIX POCT method for HbA1c determination in order to test its performance before introducing this method into routine use. HbA1c is measured in a duplicate in 44 EDTA blood samples parallel on INCLIX POCT device (Sugitech, Inc.) and using automated turbidimetric immunoinhibition test on Olympus AU400 (Beckman Coulter). The within run imprecision was 7.58%, between runs imprecision was 6.63% and 6.22%, and day-to-day imprecision was 8.80% and 7.51%. Total laboratory imprecision was in agreement with those stated by the manufacturer. A statistically significant Pearson correlation coefficient was calculated (r = 0.871, P < 0.01; linear R2 = 0.757). Using Deming regression analysis, the following equation was obtained: y = - 1.80 + 1.304x. Our results indicate statistically significant correlation, linear relationship, and a significant degree of compatibility between the two analyzed methods. However, the negative bias of the HbA1c values determined on the POCT analyzer compared to the Olympus AU400 was confirmed, highlighting the need to standardize the INCLIX method.
先前的研究表明,即时检测(POCT)糖化血红蛋白(HbA1c)是一种诊断测试,可以作为实验室测量HbA1c的适当替代方法。本研究的主要目的是研究新型的INCLIX POCT HbA1c检测方法的分析特点,以便在将该方法引入常规使用之前测试其性能。在INCLIX POCT设备(Sugitech, Inc.)上平行测量44份EDTA血样中的HbA1c,并使用Olympus AU400 (Beckman Coulter)上的自动浊度免疫抑制试验。运行内不精度为7.58%,运行间不精度为6.63%和6.22%,日常不精度为8.80%和7.51%。实验室总不精确度与制造商所述一致。Pearson相关系数有统计学意义(r = 0.871, P < 0.01;线性R2 = 0.757)。采用Deming回归分析得到:y = - 1.80 + 1.304x。我们的结果表明,两种分析方法之间存在统计学上显著的相关性、线性关系和显著程度的相容性。然而,与Olympus AU400相比,POCT分析仪测定的HbA1c值存在负偏倚,这凸显了对INCLIX方法进行标准化的必要性。
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引用次数: 0
The potential of natural products use in fused deposition modeling 3D printing of pharmaceutical dosage forms 天然产品在药物剂型的熔融沉积建模3D打印中的应用潜力
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2022-01-01 DOI: 10.5937/arhfarm72-40155
J. Čanji-Panić, N. Todorović, Ana Stjepanović, M. Lalic-Popovic
In recent years, the interest in 3D printing of medicines has increased due to many advantages of this technology, such as flexibility of the dose and dosage form of the printed product. Fused deposition modeling (FDM) is one of the most popular 3D printing technologies in the pharmaceutical field, due to its low cost and simplicity. The subject of this review is the potential use of natural products as biodegradable and biocompatible materials with good safety profiles in FDM 3D printing of pharmaceuticals. Natural products such as alginate, chitosan and starch have already been employed as excipients in FDM 3D printed pharmaceutical dosage forms, while others like shellac and zein show the potential, but haven't yet been part of 3D printed pharmaceutical formulations. These excipients have different roles in the formulation of filaments for FDM 3D printing, for example as fillers, matrix carriers or drug-release modifiers. In addition, the possibility of incorporating active pharmaceutical ingredients of natural origin in filaments for FDM 3D printing was reviewed. High printing temperatures limit the use of natural products in FDM 3D printing. However, adequate selection of thermoplastic material and printing parameters can widen the use of natural products in FDM 3D printing of pharmaceutical dosage forms.
近年来,由于3D打印技术的许多优点,例如打印产品的剂量和剂型的灵活性,人们对药物3D打印的兴趣越来越大。熔融沉积建模(FDM)是制药领域最流行的3D打印技术之一,由于其低成本和简单。本综述的主题是天然产物作为具有良好安全性的生物可降解和生物相容性材料在药物FDM 3D打印中的潜在应用。海藻酸盐、壳聚糖和淀粉等天然产品已经被用作FDM 3D打印药物剂型的辅料,而虫胶和玉米蛋白等其他产品则显示出潜力,但尚未成为3D打印药物配方的一部分。这些赋形剂在FDM 3D打印长丝的配方中具有不同的作用,例如作为填料、基质载体或药物释放调节剂。此外,综述了在FDM 3D打印长丝中加入天然活性药物成分的可能性。高打印温度限制了天然产品在FDM 3D打印中的使用。然而,充分选择热塑性材料和打印参数可以扩大天然产品在药物剂型FDM 3D打印中的使用。
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引用次数: 1
Usage of compaction simulators for the powder compression characterization: Advantages and limitations 粉末压缩特性的压实模拟器的使用:优点和局限性
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2022-01-01 DOI: 10.5937/arhfarm72-41301
Nenad Nikolić, Tijana Miletić, J. Kovacevic, Đorđe Medarević, S. Ibrić
Compaction simulators are designed as machines which can provide an in-depth analysis of the powder compaction process. Characterization of the powder compression and compaction process, as well as material characterization, play an important role in the formulation and manufacturing process design and development, as well as in creating a strong knowledge basis for the scale-up of the tablet compression and troubleshooting in further stages of the product lifecycle. Although compaction simulators are designed to simulate the compression process on high-speed tablet-presses, with the advantages of a small quantity of material needed and highly sophisticated instrumentation, there are certain limitations in the extrapolation of the process parameters from these machines to high-speed rotary tablet presses. However, the advantage of the use of compaction simulators for studying basic compression and compaction mechanisms, identification of critical material attributes and critical process parameters ranges, and their relations with tablet characteristics and critical quality attributes of pharmaceutical products is clear, compared to the use of small excentre tablet presses, and complementary to the use of small rotary tablet presses. This scientific paper provides an overview and examples of the different advantages provided by the instrumentation of compaction simulators, including certain limitations in their exploitation.
压实模拟器被设计成可以提供粉末压实过程深入分析的机器。粉末压缩和压实过程的表征,以及材料表征,在配方和制造工艺设计和开发中发挥着重要作用,同时也为扩大片剂压缩和在产品生命周期的其他阶段进行故障排除创造了强大的知识基础。虽然压实模拟器是为了模拟高速压片机的压实过程而设计的,具有所需材料量少、仪器高度精密的优点,但将这些机器的工艺参数外推到高速旋转压片机上,存在一定的局限性。然而,与使用小型立式压片机相比,与使用小型旋转压片机相辅相成,使用压实模拟器研究基本的压缩和压实机制,识别关键材料属性和关键工艺参数范围,以及它们与片剂特性和药品关键质量属性的关系,优势是显而易见的。这篇科学论文概述了压实模拟器仪器提供的不同优势,并举例说明了它们在开发中的某些局限性。
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引用次数: 0
Preparation and characterization of 3D printed bone scaffold for ibuprofen delivery 3D打印布洛芬骨支架的制备与表征
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2022-01-01 DOI: 10.5937/arhfarm72-40262
M. Jovanović, M. Petrović, D. Stojanović, S. Ibrić, P. Uskoković
In this work, a blend of gelatin A (GA) and polyvinylpyrrolidone (PVP K30) was used for semi-solid 3D printing of bone scaffold for ibuprofen (IBU) delivery. The cross-linking of the obtained scaffold was performed with a 1% glutaraldehyde (GTA) solution, followed by lyophilization. The thermal and mechanical properties, as well as drug release profiles, and drug kinetics of prepared scaffolds were investigated. The cross-linked and lyophilized scaffold has shown good thermal stability, mechanical properties, and prolonged release of IBU following the Fickian diffusion process.
在这项工作中,使用明胶a (GA)和聚乙烯吡咯烷酮(PVP K30)的混合物进行半固体3D打印布洛芬(IBU)递送骨支架。得到的支架用1%戊二醛(GTA)溶液进行交联,然后冻干。研究了制备的支架的热力学性能、药物释放谱和药物动力学。交联冻干支架具有良好的热稳定性和力学性能,并能在菲克扩散过程中延长IBU的释放时间。
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引用次数: 1
Attitudes of the elderly towards interprofessional cooperation and collaborative pharmacy practices: Questionnaire development 老年人对跨专业合作与协同药学实践的态度:问卷编制
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-32284
Velibor Ilić, L. Tasić, V. Marinković
Population aging is progressing at the highest rate historically, leading to an increased morbidity. Therefore, higher levels of collaborative pharmaceutical practice (CPP) and interprofessional collaboration (IPC) are expected to provide the necessary improvement to the healthcare system performance. For a strong body of literature to be built in the area of CPP and IPC, methodologically sound research studies must be completed, using questionnaires with well-developed psychometric properties. Therefore, the objective was to develop a questionnaire aimed at researching the attitudes of the elderly (65+) towards IPC and CPP. A structured questionnaire was developed using the Delphi method by a team of experts (n=8) within four rounds of meetings. Reliability, question correlation and factor analysis were used for questionnaire validation. Questionnaire validation (n=40) determined the Cronbach's Alpha to be at the high value of 0.774, and reliability analysis of questionnaire's scales on the total sample (n=185) in the five Geriatric Centers confirmed a relatively high value of 0.736. Interclass correlation coefficient values were highly significant (ICC=0.749; p<0.01), which confirmed questionnaire compactness regarding CPP. An exploratory factor analysis highlighted 2 significant factors explaining 53% of the entire model variability. Both questionnaire validation (n=40) and total sample analysis (n=185) confirmed the appropriateness of the developed questionnaire.
人口老龄化正以历史上最高的速度发展,导致发病率上升。因此,更高水平的协同制药实践(CPP)和跨专业协作(IPC)有望为医疗保健系统绩效提供必要的改进。为了在CPP和IPC领域建立强大的文献体系,必须完成方法学上合理的研究,使用具有良好心理测量特性的问卷调查。因此,目的是制定一份调查问卷,旨在研究老年人(65岁以上)对IPC和CPP的态度。一组专家(n=8)在四轮会议中使用德尔菲法制定了结构化问卷。采用信度、问题相关及因子分析进行问卷验证。问卷验证(n=40)确定Cronbach's Alpha值较高,为0.774,对5个老年中心总样本(n=185)的问卷量表进行信度分析,确定其值较高,为0.736。类间相关系数值极显著(ICC=0.749;p<0.01),证实了CPP问卷的紧凑性。探索性因素分析突出了2个重要因素,解释了整个模型变异的53%。问卷验证(n=40)和总样本分析(n=185)均证实了所编制问卷的适宜性。
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引用次数: 0
PDA-CAD method for the determination of magnesium, pyridoxine and thiamine in a dietary supplement supported by analytical quality by design methodology 用PDA-CAD方法测定膳食补充剂中镁、吡哆醇和硫胺素的分析质量
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-32093
Milena Rmandić, Milan Rađenović, J. Stanković, A. Protić, Biljana Otašević, A. Malenović
In this research, Analytical Quality by Design (AQbD) methodology was used to develop the HILIC-PDA-CAD method for the determination of magnesium, pyridoxine and thiamine content in a dietary supplement. Experiments were conducted on the Dionex Ulitimate 3000 HPLC system with PDA and CAD detectors. Separations were performed on the ZIC-HILIC PEEK column (100 × 4.6 mm, 5 mm) with a mixture of acetonitrile, acetone and ammonium acetate/ammonium formate aqueous solution (48:12:40, v/v/v) as the mobile phase. The detection was performed at 220 nm. The optimal settings of CAD were defined with the one-factor-at-a-time approach: evaporation temperature 50°C, filter constant 10 s, pressure gas 60 psi. The influence of qualitative (salt type) and quantitative factors (pH and salt concentration) on the magnesium retention factor, k Mg and the selectivity factor between pyridoxine and chloride anion, a B6/Cl-, was tested using the I-optimal design. The design space was defined by Monte Carlo simulations and model coefficients' errors were propagated with the aim of identifying the conditions that meet the following criteria: k Mg <4 and a B6/Cl->3.5, with the probability p=95%. From the derived 2D-Design Space graph, 95 mM of ammonium formate pH 4.4 was selected as the optimal composition of the aqueous phase. The method was validated and its reliability in routine application was confirmed.
本研究采用设计质量分析(AQbD)方法,建立了HILIC-PDA-CAD法测定膳食补充剂中镁、吡哆醇和硫胺素的含量。实验在Dionex ultimate 3000高效液相色谱系统上进行,该系统具有PDA和CAD检测器。采用ZIC-HILIC PEEK色谱柱(100 × 4.6 mm, 5mm),以乙腈、丙酮和乙酸铵/甲酸铵水溶液(48:12:40,v/v/v)为流动相进行分离。检测波长为220 nm。CAD的最佳设置采用单因素-一次方法定义:蒸发温度50°C,过滤常数10 s,压力气体60 psi。采用i -优化设计考察了定性因素(盐型)和定量因素(pH和盐浓度)对镁保留因子k Mg和吡哆醇与氯阴离子a B6/Cl-的选择性因子的影响。通过蒙特卡罗模拟定义设计空间,传播模型系数误差,目的是确定满足以下标准的条件:k Mg 3.5,概率p=95%。从二维设计空间图中,优选pH 4.4的甲酸铵为95 mM的最佳水相组成。对该方法进行了验证,验证了其在日常应用中的可靠性。
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引用次数: 0
Experimental design in HPLC separation of pharmaceuticals 高效液相色谱法分离药物的实验设计
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-32480
Jevrem Stojanović, Jovana Krmar, A. Protić, B. Svrkota, Nevena Đajić, Biljana Otašević
Design of Experiments (DoE) is an indispensable tool in contemporary drug analysis as it simultaneously balances a number of chromatographic parameters to ensure optimal separation in High Pressure Liquid Chromatography (HPLC). This manuscript briefly outlines the theoretical background of the DOE and provides step-by-step instruction for its implementation in HPLC pharmaceutical practice. It particularly discusses the classification of various design types and their possibilities to rationalize the different stages of HPLC method development workflow, such as the selection of the most influential factors, factors optimization and assessment of the method robustness. Additionally, the application of the DOE-based Analytical Quality by Design (AQbD) concept in the LC method development has been summarized. Recent achievements in the use of DOE in the development of stability-indicating LC and hyphenated LC-MS methods have also been briefly reported. Performing of Quantitative structure retention relationship (QSRR) study enhanced with DOE-based data collection was recomended as a future perspective in description of retention in HPLC system.
实验设计(DoE)是当代药物分析中不可缺少的工具,因为它可以同时平衡许多色谱参数,以确保高压液相色谱(HPLC)的最佳分离。本文简要概述了DOE的理论背景,并为其在HPLC制药实践中的实施提供了一步一步的指导。特别讨论了各种设计类型的分类,以及它们在HPLC方法开发流程的不同阶段合理化的可能性,如最具影响因素的选择、因素优化和方法稳健性评估。此外,还总结了基于doe的设计分析质量(AQbD)概念在LC方法开发中的应用。本文还简要介绍了利用DOE开发稳定性指示LC和连字符LC- ms方法的最新成果。建议采用基于do的数据收集技术,加强定量结构保留关系(QSRR)的研究,作为描述HPLC系统中保留的未来研究方向。
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引用次数: 4
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Arhiv za Farmaciju
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