Formulation, characterization and in vivo evaluation of novel edible dosage form containing nebivolol HCl

O objetivo deste trabalho foi desenvolver um gel comestível para veiculação de cloridrato de nebivolol, com características reológicas adequadas, que podem fornecer meio de administrar o fármaco em casos de disfagia orofaríngea e pacientes geriátricos. Géis comestíveis foram preparados utilizando goma gelana de baixa acetilação e citrato de sódio, em diferentes concentrações. Estudou-se o efeito da concentração da solução no tempo de gelificação, a viscosidade e a liberação do fármaco. A formulação otimizada apresentava consistência de pudim, o que é considerado adequado para pacientes disfágicos como sugerido pela National Dysphagia Diet Task Force. A formulação otimizada contendo 0,4% (m/v) de goma gelana e 0,3% (m/v) de citrato de sódio mostrou que mais de 95% de fármaco foi liberado em 20 minutos. Esta formulação também mostrou, significativamente, melhor perfil farmacocinético, quando comparado com os comprimidos convencionais comercializados administrados a coelhos brancos neozelandeses (n = 3). A formulação otimizada manteve-se estável durante 6 meses, armazenada a 25 oC ± 0,2 °C/60 ± 5% de UR. A partir deste estudo, conclui-se que a nova forma de gel comestível contendo cloridrato de nebivolol pode ser mais eficaz no tratamento de hipertensão em pacientes portadores de disfagia.The objective of this investigation was to develop a novel oral edible gel dosage form for nebivolol hydrochloride, with suitable rheological characteristics that can provide a means of administering the drug to dysphagic and geriatric patients. Edible gels were prepared using low acetylated gellan gum and sodium citrate in different concentrations. The effect of concentration of the solution on gelation time, viscosity, and drug release was studied. Optimized formulation had "spoon thick" consistency that is considered suitable for dysphagic patients as suggested by National Dysphagia Diet Task Force. The optimized formulation containing gellan gum (0.4 % w/v) and sodium citrate (0.3 % w/v) showed more than 95% drug release in 20 minutes. This formulation also showed significantly better pharmacokinetic profile when compared to marketed conventional tablets in New Zealand white rabbits (n = 3). Optimized formulation was found stable for 6 months when stored at 25 °C ± 0.2 °C/60 ± 5% RH. From this study, it can be concluded that the novel edible gel dosage form containing nebivolol hydrochloride may prove to be more efficacious in the treatment of hypertension in dysphagic patients

Maximising health literacy and client recall of clinical information: An exploratory study of clients and speech-language pathologists

Limited research has been carried out in the field of speech-language pathology with regard to ways of maximising health literacy and client recall. However, speech-language pathologists (SLPs) frequently provide vast amounts of information that clients need to understand, apply and review in order to manage their (or their child’s) health. This exploratory study aimed to contribute information about ways in which SLPs can overcome low health literacy and poor client recall so that treatment effectiveness is improved. A case-study design was used with specific focus on four clients receiving treatment for dysphagia, voice disorders (including laryngectomies) and cleft lip and/or palate management in Cape Town. Strategies which may be able to maximise health literacy and client recall of clinical information were trialled and evaluated by clients and their SLPs, using semi-structured interviews. The researchers proposed a combination of high-tech strategies which assisted in all the cases. No single solution or universal tool was found that would be appropriate for all. There is a need to evaluate the long-term effectiveness of the combined strategies across a wider population, at different stages of rehabilitation and in diverse contexts. Implications and suggestions for future related research are presented

Developing an Acute Care Simulation Lab and Practicum

The benefits of simulation-based education have been well-documented in health-related disciplines and are emerging in speech-language pathology. Several clinical training paradigms for acute care speech-language pathology skills have been successful when implemented in high fidelity, nursing simulation labs with price tags that are cost prohibitive for most speech-language pathology programs. Through funding support from a grant and a four-phased simulation development program, the authors developed an acute care simulation lab dedicated to speech-language pathology students for under $9,000 and simultaneously piloted a one-credit, acute care, adult- and geriatric-focused clinical practicum course. The clinical practicum was structured to scaffold student learning using task trainers, computer-based simulations, and live simulations with low fidelity manikins and standardized patients. The authors are hopeful that this article provides speech-language pathology programs a practical framework for structuring a dedicated, simulation space and course, while empowering faculty to more fully integrate simulation-based learning experiences into their curricula in a way that is evidence-based and in keeping with the best practice resources that are currently available in the field of speech-language pathology

DEVELOPMENT OPTIMIZATION AND EVALUATION OF EFFERVESCENT TABLETS OF CHLORPHENIRAMINE MALEATE USING BOX BEHNKEN DESIGN

Objective: The objective of present study was to develop effervescent tablets of Chlorpheniramine maleate (CPM) for the treatment of dysphasia.Methods: Effervescent tablets were prepared by direct compression method and were optimized using box behnken design. Amount to sodium bicarbonate (X1), amount of tartaric acid (X2) and amount of fumaric acid (X3) were selected as independent variables, whereas disintegration time (Y1), amount of carbon dioxide (Y2) and drug release in 5 minutes (Y3) were selected as dependent variables. All the batches were also evaluated for general post compression evaluation of tablet such as-weight variation, thickness, friability and hardness. From the results of design batches, best batch was selected and evaluated for in vivo pharmacokinetic study in rabbit model.Results: The disintegration time ranged from 103.33 ± 0.24 sec to 157.00 ± 0.75 sec while amount of carbon dioxide ranged from 0.26±0.014 g to 2.03±0.056 g in all the design batches. From the results of design batches, batch B4 was selected as optimized batch due to higher amount of released carbon dioxide and faster drug release as compared to other batches. Batch B4 was showing higher AUC and Cmax while lower tmax as compared to drug suspension while performing in vivo study of optimized batch in rabbit model.Conclusion: The study concluded that the combination of sodium bicarbonate, tartaric acid and fumaric acid approach for development of effervescent tablet aids to achieve faster disintegration and faster drug release property for CPM.Â

Allied health video consultation services

Many Australians have limited access to health care services due to a range of barriers including living a considerable distance from health services. Furthermore, there are significant shortages of healthcare workers in many rural and remote areas. Traditionally, many people have had to either travel long distances to access healthcare, or go without. Telehealth is an alternative approach, using telecommunications and information technology to supplement face-to-face delivery of healthcare services

A mobile application based on machine learning and music therapy principles for post-stroke upper-limb motor recovery

A stroke is a medical condition caused by a disruption in blood flow to the brain. This can lead to difficulties with everyday activities and movement. Music therapy is a promising new alternative to traditional rehabilitation methods. This therapy uses sound’s natural properties to enhance stroke recovery, improve motor skills and stimulate neural plasticity. This approach motivates people on both a physical and emotional level. Software tools developed to date to aid in motor recovery after stroke rely mainly on external mechanisms and specific hardware components. This limitation restricts the potential scope of these tools. This study aims to examine the effectiveness and mechanisms of using a mobile application with machine learning algorithms and music therapy principles as a complementary intervention for post-stroke motor recovery. This research project has resulted in the development of a mobile app, based on the widely used Fugl Meyer Assessment. The application uses Vision Framework from Apple and a custom Activity Classification CoreML machine learning model to detect an individual's position in a seated posture. It has also been integrated with XCode. The application generates an audio cue when a user successfully completes one of the Fugl-Meyer Assessment activities. To train the model, 340 clips of a variety of exercises have been created. The research sheds light on how this technology can be used to transform neurorehabilitation while also helping to develop accessible and convenient tools that promote stroke motor recovery

Design and evaluation of fast dispersible tablets of lamivudine using selected natural superdisintegrants

Magister Pharmaceuticae - MPharmFast dispersible tablets (FDTs) are solid single-unit dosage forms that are placed in the mouth and allowed to disperse or dissolve in the saliva without the need of water. The basic approach to formulating FDTs consists of adding a superdisintegrant to a tablet formulation. These tablets offer both the advantages of conventional tablets and liquid dosage forms along with distinctive properties which include accurate dosing, ease of administration, quick onset of action, enhanced bioavailability, and increased patient adherence. FDTs have been found to be effective in remedying therapeutic in-adherence caused by dysphagia (swallowing difficulties) particularly in paediatric and geriatric subjects. There is a strong correlation between therapeutic success and patient adherence especially with HIV/AIDS treatment regimens, consequently the dosage form should be patient friendly and devoid of unappealing characteristics. This study aimed at developing a cost effective fast dispersible tablet of lamivudine using alternative excipients and conventional techniques. Only conventional tablets and oral liquid dosage forms of lamivudine are available on the South African market. Two natural polymers reported to have superdisintegrating properties were selected to serve as multipurpose excipients in this study. The polymers were identified, characterised and compared using thermal, spectroscopic and micromeritic analytical tools. The polymer that displayed the best characteristics in terms of micromeritic, tableting and disintegrating properties was retained and used for the optimum formulation. The optimum formulation was composed of 150 mg of lamivudine, 23% w/w unripe banana powder and 2% w/w magnesium stearate. FDTs of lamivudine were obtained using the compression technique with and without wet granulation. The tablets were assessed as per the United States Pharmacopoeia (USP) guidelines and other evaluation procedures pertaining to FDTs. The wet granulated tablets were found to be less friable and thus more resilient than the directly compressed tablets. In-vitro disintegration of the wet granulated tablets occurred within 50±3 sec in deionised water (pH 7) and 35±2 sec in a phosphate buffer solution (pH 6.8). Consequently, the innovative tablets fulfilled the core requirement of FDTs i.e. rapid disintegration. Drug release studies were carried out by analysing dissolution aliquots of the innovative tablets using a validated High Performance Liquid Chromatography (HPLC) method, and comparing them to Aspen Lamivudine®, a conventional tablet of lamivudine presently on the South African market. Complete dissolution in deionised water (pH 7) was attained within 10 minutes and 30 minutes for the innovative tablets and Aspen Lamivudine® respectively