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Modelling in economic evaluations of medicines 药物经济评价中的建模
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-32404
D. Lakic, I. Stević, M. Odalović, I. Tadić
Economic evaluation in health (also known as pharmacoeconomic in case of medicines) identifies, measures, and values costs and outcomes of alternative healthcare technologies, and can be performed alongside controlled clinical trials, but analytical modelling is usually used. Decision trees and Markov models are the two most common approaches used in economic evaluation. The biggest advantages of a decision tree are clarity, simplicity, and straightforwardness. On the other hand, the main advantage of the Markov model is its ability to incorporate complex events into the simulation, which is practically impossible to do with a decision tree. Reimbursement policy in Serbia mandatorily incorporates economic evaluations to promote availability and accessibility of the prescription medicines. To show current pharmacoeconomic value of a medicine, budget impact analysis and the cost-effectiveness analysis should be included. The latter should be conducted using appropriate modelling techniques. However, since no official methodological guidelines about the modelling and economic analysis exist, the submissions by marketing authorization holders vary greatly. The future of pharmacoeconomic modelling depends on the research area of interest, with new frameworks and approaches being developed.
健康经济评估(在药物的情况下也称为药物经济学)确定、衡量和评估替代医疗保健技术的成本和结果,可以与对照临床试验一起进行,但通常使用分析模型。决策树和马尔可夫模型是经济评估中最常用的两种方法。决策树的最大优点是清晰、简单和直接。另一方面,马尔可夫模型的主要优点是它能够将复杂事件合并到模拟中,这在决策树中实际上是不可能做到的。塞尔维亚的报销政策强制纳入经济评估,以促进处方药的可得性和可及性。为了显示药物的当前药物经济价值,预算影响分析和成本效益分析应该包括在内。后者应使用适当的建模技术进行。然而,由于没有关于建模和经济分析的官方方法指导方针,上市许可持有人提交的材料差异很大。药物经济学模型的未来取决于感兴趣的研究领域,正在开发新的框架和方法。
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引用次数: 0
Engineering cocrystals of Paliperidone with enhanced solubility and dissolution characteristics 具有增强溶解度和溶解特性的帕利哌酮工程共晶
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-32997
Earle Radha-Rani, Gadela Venkata-Radha
In the present study, co-crystals (CCs) of Paliperidone (PPD) with coformers like benzoic acid (BA) and P-amino benzoic acid (PABA) were synthesized and characterized to improve the physicochemical properties and dissolution rate. CCs were prepared by the solvent evaporation (SE) technique and were compared with the products formed by neat grinding (NG) and liquid assisted grinding (LAG) in their enhancement of solubility. The formation of CCs was confirmed by the IR spectroscopy, powder X-ray diffraction and thermal analysis methods. The saturation solubility studies indicate that the aqueous solubility of PPD-BA and PPD-PABA CCs was significantly improved to 1.343±0.162mg/ml and 1.964±0.452mg/ml, respectively, in comparison with the PPD solubility of 0.473mg/ml. This increase in solubility is 2.83-and 3.09-fold, respectively. PPD exhibited a poor dissolution of 37.8% in 60min, while the dissolution of the CCs improved tremendously to 96.07% and 89.65% in 60min. CCs of PPD with BA and PABA present a novel approach to overcome the solubility challenges of poorly water-soluble drug PPD.
本研究合成并表征了与苯甲酸(BA)和对氨基苯甲酸(PABA)共构象的帕利哌酮(PPD)共晶(CCs),以改善其理化性质和溶出速率。采用溶剂蒸发(SE)法制备了CCs,并与纯研磨(NG)和液体辅助研磨(LAG)法制备的CCs提高溶解度的效果进行了比较。通过红外光谱、粉末x射线衍射和热分析等方法证实了CCs的形成。饱和溶解度研究表明,PPD- ba和PPD- paba cc的水溶性分别为1.343±0.162mg/ml和1.964±0.452mg/ml,而PPD的溶解度为0.473mg/ml。溶解度分别增加了2.83倍和3.09倍。PPD在60min内溶出率为37.8%,而CCs在60min内溶出率显著提高,分别为96.07%和89.65%。含BA和PABA的PPD的CCs为克服水溶性差的PPD药物的溶解度挑战提供了新的途径。
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引用次数: 4
Current computer-aided drug design methodologies in discovery of novel drug candidates for neuropsychiatric and inflammatory diseases 当前的计算机辅助药物设计方法在发现新的候选药物神经精神和炎症疾病
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-32523
Mila Radan, J. Bošković, V. Dobričić, O. Čudina, K. Nikolić
Drug discovery and development is a very challenging, expensive and time-consuming process. Impressive technological advances in computer sciences and molecular biology have made it possible to use computer-aided drug design (CADD) methods in various stages of the drug discovery and development pipeline. Nowadays, CADD presents an efficacious and indispensable tool, widely used in medicinal chemistry, to lead rational drug design and synthesis of novel compounds. In this article, an overview of commonly used CADD approaches from hit identification to lead optimization was presented. Moreover, different aspects of design of multitarget ligands for neuropsychiatric and anti-inflammatory diseases were summarized. Apparently, designing multi-target directed ligands for treatment of various complex diseases may offer better efficacy, and fewer side effects. Antipsychotics that act through aminergic G protein-coupled receptors (GPCRs), especially Dopamine D2 and serotonin 5-HT2A receptors, are the best option for treatment of various symptoms associated with neuropsychiatric disorders. Furthermore, multi-target directed cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) inhibitors are also a successful approach to aid the discovery of new anti-inflammatory drugs with fewer side effects. Overall, employing CADD approaches in the process of rational drug design provides a great opportunity for future development, allowing rapid identification of compounds with the optimal polypharmacological profile.
药物发现和开发是一个非常具有挑战性、昂贵和耗时的过程。计算机科学和分子生物学令人印象深刻的技术进步使得在药物发现和开发管道的各个阶段使用计算机辅助药物设计(CADD)方法成为可能。目前,CADD是一种有效的、不可缺少的工具,广泛应用于药物化学,指导药物的合理设计和新化合物的合成。在本文中,概述了常用的CADD方法,从命中识别到潜在客户优化。此外,综述了神经精神疾病和抗炎疾病的多靶点配体设计的不同方面。显然,设计多靶点定向配体治疗各种复杂疾病可能具有更好的疗效和更少的副作用。通过胺能G蛋白偶联受体(gpcr)起作用的抗精神病药物,特别是多巴胺D2和5-羟色胺5-HT2A受体,是治疗与神经精神疾病相关的各种症状的最佳选择。此外,多靶点定向环氧合酶-2 (COX-2)和5-脂氧合酶(5-LOX)抑制剂也是一种成功的方法,有助于发现副作用更小的新型抗炎药物。总之,在合理的药物设计过程中使用CADD方法为未来的发展提供了很大的机会,可以快速识别具有最佳多药理特征的化合物。
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引用次数: 0
Endocrine disrupting mechanisms and effects of pesticides 农药对内分泌的干扰机制和影响
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-34291
H. Anlar, M. Bacanlı, N. Başaran
Pesticides are important agents that are intentionally introduced into the environment to control various pests and disease carriers, often by killing them. Although pesticides have many important objectives, including protection against crop loss and vector-borne diseases, there are significant concerns over the potential toxicity of pesticides on various organisms, including humans. The frequent use of pesticides in agriculture has led to the long-term exposure of humans to different pesticide residues. Exposure to pesticides has been linked to disturbances in the endocrine system of animals and humans. There are increasing data on the relation between lipophilic pesticides with low biodegradability and changes in reproductive functions and parameters of male and female animals. But more epidemiological and detailed information is necessary on the probability and strength of pesticide exposure-outcome relations regarding endocrine-disrupting effects.
农药是一种重要的药剂,被有意地引入环境中,以控制各种害虫和疾病载体,通常是通过杀死它们。尽管农药有许多重要的目的,包括防止作物损失和防止病媒传播的疾病,但人们对农药对包括人类在内的各种生物的潜在毒性表示严重关切。农业中农药的频繁使用导致人类长期暴露于不同的农药残留中。接触杀虫剂与动物和人类内分泌系统紊乱有关。越来越多的资料表明,低可生物降解性的亲脂性农药与雌雄动物生殖功能和参数变化之间的关系。但是,需要更多的流行病学和详细的信息来了解农药暴露与内分泌干扰效应的结果关系的概率和强度。
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引用次数: 4
Review of machine learning algorithms' application in pharmaceutical technology 机器学习算法在制药技术中的应用综述
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-32499
Jelena Đuriš, Ivana Kurćubić, S. Ibrić
Machine learning algorithms, and artificial intelligence in general, have a wide range of applications in the field of pharmaceutical technology. Starting from the formulation development, through a great potential for integration within the Quality by design framework, these data science tools provide a better understanding of the pharmaceutical formulations and respective processing. Machine learning algorithms can be especially helpful with the analysis of the large volume of data generated by the Process analytical technologies. This paper provides a brief explanation of the artificial neural networks, as one of the most frequently used machine learning algorithms. The process of the network training and testing is described and accompanied with illustrative examples of machine learning tools applied in the context of pharmaceutical formulation development and related technologies, as well as an overview of the future trends. Recently published studies on more sophisticated methods, such as deep neural networks and light gradient boosting machine algorithm, have been described. The interested reader is also referred to several official documents (guidelines) that pave the way for a more structured representation of the machine learning models in their prospective submissions to the regulatory bodies.
机器学习算法和一般的人工智能在制药技术领域有着广泛的应用。从配方开发开始,通过在质量设计框架内集成的巨大潜力,这些数据科学工具提供了对药物配方和各自处理的更好理解。机器学习算法在分析过程分析技术生成的大量数据时尤其有用。本文简要介绍了人工神经网络作为最常用的机器学习算法之一。描述了网络训练和测试的过程,并附有在药物配方开发和相关技术背景下应用的机器学习工具的说明性示例,以及对未来趋势的概述。最近发表的关于更复杂的方法的研究,如深度神经网络和光梯度增强机算法,已经被描述。有兴趣的读者还可以参考一些官方文件(指导方针),这些文件为机器学习模型在提交给监管机构的预期文件中更结构化的表示铺平了道路。
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引用次数: 5
Developmental toxicity of endocrine-disrupting chemicals: Challenges and future directions 内分泌干扰物的发育毒性:挑战与未来方向
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2021-01-01 DOI: 10.5937/arhfarm71-34457
A. Pizent
Maternal exposure to a mixture of various endocrine disruptors (EDCs) may have a substantial impact on postnatal health of her offspring(s) and increase the risk for health disorders and diseases in adulthood. Research efforts to better understand the health risk associated with endocrine disruptor exposures in early life have increased in recent decades. This paper provides a short overview of the current challenges that researchers continue to face in selecting appropriate epidemiologic methods and study designs to identify endocrine disruptors and evaluate their adverse health effects during this critical developmental window. Major challenges involve the selection of a representative biomarker that reflects the foetal internal dose of the biologically active chemical or its metabolite(s) that may be associated with adverse health effects with regard to variable level and duration of exposure and the latency between exposure and disorder/disease manifestation. Future studies should pay more attention to identifying factors that contribute to interindividual variability in susceptibility to various EDCs and other toxicants.
产妇接触各种内分泌干扰物的混合物可能对其后代的产后健康产生重大影响,并增加成年后健康失调和疾病的风险。近几十年来,为了更好地了解生命早期接触内分泌干扰物所带来的健康风险,研究工作有所增加。本文简要概述了目前研究人员在选择适当的流行病学方法和研究设计以识别内分泌干扰物并评估其在这一关键发育窗口期对健康的不利影响方面继续面临的挑战。主要的挑战涉及选择一种具有代表性的生物标志物,该生物标志物应反映生物活性化学品或其代谢物的胎儿内部剂量,这些物质可能与暴露的不同水平和持续时间以及暴露与失调/疾病表现之间的潜伏期有关,对健康产生不利影响。未来的研究应更多地关注确定导致对各种EDCs和其他毒物易感性的个体间差异的因素。
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引用次数: 1
Non-vitamin K oral anticoagulants (NOACs) in patients with stroke and atrial fibrillation 非维生素K口服抗凝剂(NOACs)在卒中和房颤患者中的应用
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2020-01-01 DOI: 10.5937/arhfarm2005269j
D. Jovanović
Patients with atrial fibrillation who had a previous transient ischemic attack or ischemic stroke had a significantly high risk of stroke recurrence and the introduction of oral anticoagulants should be mandatory. However, the long-term use of oral anticoagulants increases the risk of developing all types of intracranial hemorrhages. The advantages of non-vitamin K oral anticoagulants (NOACs) compared to warfarin are that they have a significantly lower risk for hemorrhagic stroke. They are preferred in elderly patients, those with small vessel disease, or those with previous intracerebral hemorrhage. The time of NOACs introduction after an ischemic stroke depends on its severity and the rule "1-3-6-12" days should be applied. The reintroduction of NOACs in patients with atrial fibrillation and previous intracerebral hemorrhage depends on its etiology and should be after about 4-8 weeks if the cardioembolic risk is high and the risk for intracranial hemorrhage small.
房颤患者既往有过短暂性脑缺血发作或缺血性脑卒中,卒中复发风险显著增高,口服抗凝剂应是强制性的。然而,长期使用口服抗凝剂会增加发生各种类型颅内出血的风险。与华法林相比,非维生素K口服抗凝剂(NOACs)的优点是其出血性中风的风险显著降低。适用于老年患者、小血管病变患者或既往脑出血患者。缺血性卒中后引入noac的时间取决于其严重程度,应采用“1-3-6-12”天的规则。房颤合并既往脑出血患者再次应用NOACs取决于其病因,如果心栓塞风险高,颅内出血风险小,应在4-8周后再次应用NOACs。
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引用次数: 0
Pharmaceutical care in Alzheimer's disease 阿尔茨海默病的药物治疗
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2020-01-01 DOI: 10.5937/arhfarm2002069v
Sandra Vezmar-Kovačević
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive memory and cognitive function impairment as well as behavioural and psychiatric disturbances. Pharmaceutical care involves the process of identifying, resolving, and preventing drug-related problems, and it is aimed at improving the patient’s quality of life. AD is usually diagnosed in elderly patients with comorbidities and, consequently, a variety of drug-related problems may occur. Pharmacists should focus on adverse reactions, drug-drug interactions, and adherence in patients with AD. The introduction of acetylcholinesterase inhibitors in treatment may be associated with adverse effects, such as diarrhoea, muscle cramps, fatigue, nausea, vomiting, insomnia, anorexia, headache, and dizziness, which may be transient or require an alternative medication. Use of anticholinergic medications, bradycardia causing medications, antipsychotics and other medications should be assessed carefully because of potential drug-drug interactions with acetylcholinesterase inhibitors, especially rivastigmine. Adherence may be a major drugrelated problem in patients with AD because of the nature of illness and appropriate communication between pharmacists and patients or carers requiring adequate skills and knowledge. Although AD is increasing in prevalence there is a lack of evidence about the impact of pharmaceutical care on the treatment outcomes and quality of life of patients and more research is needed in this area.
阿尔茨海默病(AD)是一种以进行性记忆和认知功能障碍以及行为和精神障碍为特征的神经退行性疾病。药学护理包括识别、解决和预防药物相关问题的过程,其目的是提高患者的生活质量。阿尔茨海默病通常在有合并症的老年患者中诊断出来,因此可能会出现各种与药物相关的问题。药师应关注AD患者的不良反应、药物相互作用和依从性。在治疗中引入乙酰胆碱酯酶抑制剂可能与不良反应有关,如腹泻、肌肉痉挛、疲劳、恶心、呕吐、失眠、厌食、头痛和头晕,这些不良反应可能是短暂的或需要替代药物。抗胆碱能药物、引起心动过缓的药物、抗精神病药物和其他药物的使用应仔细评估,因为它们可能与乙酰胆碱酯酶抑制剂(尤其是利瓦斯汀)相互作用。由于疾病的性质以及药剂师与患者或护理人员之间需要足够的技能和知识的适当沟通,依从性可能是AD患者的主要药物相关问题。尽管阿尔茨海默病的患病率正在增加,但缺乏关于药学服务对患者治疗结果和生活质量影响的证据,需要在这一领域进行更多的研究。
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引用次数: 3
Degradation kinetics and characterization of degradation products of losartan potassium by LC-MS/MS method 氯沙坦钾的降解动力学及降解产物的LC-MS/MS表征
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2019-01-01 DOI: 10.5937/arhfarm1902080x
V. Dobričić, B. Marković
This paper presents study of losartan potassium stability evaluation by liquid chromatography with UV/VIS and MS-MS detection and its degradation profile. A solution of losartan potassium was exposed to the following stress agents: 0.1 M HCl, 0.1 M NaOH, and 3% (v/v) H2O2. The analyses of losartan potassium solutions were carried out in a gradient elution mode with acetonitrile and 0.1% (v/v) CF3COOH aqueous solution and constant flow rate of 0.5 mL min within 22 min run time. After 7 days of losartan potassium solutions exposure to the stress agents at room temperature, it was found that the degree of degradation in the presence of 0.1 M HCl and 0.1 M NaOH was less than 1%, while in the presence of 3% H2O2 degradation was significantly higher (about 10%). Chemical structure elucidation of the major degradation products of losartan potassium was performed using LC-MS/MS method. The concentration versus time plot indicated that in 3% (v/v) H2O2 solution losartan potassium was degraded according to the pseudo zero-order reaction kinetics with 1.48ꞏ10 mol L day rate constant.
本文研究了氯沙坦钾稳定性的液相色谱-紫外/可见和质谱联用检测及其降解谱。将氯沙坦钾溶液暴露于以下应激剂中:0.1 M HCl, 0.1 M NaOH和3% (v/v) H2O2。氯沙坦钾溶液以乙腈和0.1% (v/v) CF3COOH水溶液梯度洗脱,恒流量0.5 mL min,运行时间22 min。氯沙坦钾溶液在室温下暴露于胁迫剂7天后,发现0.1 M HCl和0.1 M NaOH存在时降解程度小于1%,而3% H2O2存在时降解程度明显较高(约为10%)。采用LC-MS/MS法对氯沙坦钾的主要降解产物进行了化学结构分析。浓度-时间曲线表明,在3% (v/v) H2O2溶液中,氯沙坦钾的降解符合伪零级反应动力学,日速率常数为1.48ꞏ10 mol L。
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引用次数: 1
Dyslipidemia in type 2 diabetes mellitus 2型糖尿病的血脂异常
Q4 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2019-01-01 DOI: 10.5937/arhfarm1905338s
A. Stefanović, A. Zeljković, J. Vekić, V. Spasojević-Kalimanovska, Z. Jelić-Ivanović, S. Spasić
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引用次数: 1
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