Drug Management Reviews in District Drug Management Unit and General Hospital

Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following the decentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had not been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years

A systematic approach to the formulation of anti-onychomycotic nail patches

Nail patches have a potential role as drug carriers for the topical treatment of nail diseases such as onychomycosis, a common condition. O ur aim was therefore to develop a systematic and novel appr oach to the formulat ion of a simple drug -in-adhesive ungual patch. Twelve pressure -sensitive adhesives (PSAs), four backing membranes, two release liners and three drugs were screened for pharmaceutical and mechanical properties . From this initial screeni ng, two PSAs, two drugs, one backing membrane and one release liner were selected for further investigation. Patches were prepared by solvent -casting and characterised. The patches had good uniformity of thickness and of drug content, and showed minimal drug crystallisation during six month s of storage. Meanwhile, the d rug stability in the patch upon storage and patch adhesion to the nail was influenced by the nature of the drug, the PSA and the backing membrane . The reported methodology paves the way for a systematic formulation of ungual nail patches to add to the armamentarium of nail medicines . Further , from this work, the best patch formulation has been identified

Design of a wireless patient diagnosis system

Medical administrative and diagnosis procedures require the retrieval of patient diagnosis history before treatments and drug administration. This involves careful checking of the patient past record which might be stored electronically or in paper files. This process is tedious, time consuming and often prone to error. The need to reduce error in patient administrative and diagnosis process has result in wide-ranging research work to integrate latest technology into health care system. Hence, the need for an automated system, that can display patient diagnosis record from a storage location to a care giver without any human intervention. This paper describes the design of a wireless patient diagnosis system (WPDS) for retrieving patient medical diagnosis history. A DLP-RFID1 Read/Writer with ISO 15960 tags were linked together in a novel way using LabVIEW solution that integrates MS Access database for storage and retrieval of information

The Development of Motion Graphic as Education Material for Promoting Adequate Home Drug Storage

Inappropriate drug storage at home is a common health problem in the community. Improper storage of drugs may affect the quality of the drug. Pharmacist, as a drug informer, plays an important role in providing education about how to store medicines. This study aims to develop educational media in the form of motion graphics and analyze the effect of media to improve the knowledge of drug storage in housewives. The research was conducted in three stages; media development, content revision, and media testing. The media was developed with drug storage material compiled by two experts. Then the content, appearance, and duration are evaluated. To find out the influence of the media in increasing knowledge about drug storage, quasi-experimental was applied with a one-group pretest-posttest design in October 2019 for 28 housewives. From the results of snowball sampling, it is known that the average age of respondents was 43 years, with a range of 18-58 years and the majority were high school graduates (67.9%). Knowledge of respondents was assessed using a knowledge questionnaire. The motion graphic media has a significant influence on increasing the knowledge of housewives regarding the correct storage of drugs. This is indicated by a significant difference in the pretest (67.85) and posttest scores (83.67) after watching 3-minute motion graphic shows (p = 0.001, Cl 95%)

Drug delivery in overcoming the blood-brain barrier: role of nasal mucosal grafting

The blood–brain barrier (BBB) plays a fundamental role in protecting and maintaining the homeostasis of the brain. For this reason, drug delivery to the brain is much more difficult than that to other compartments of the body. In order to bypass or cross the BBB, many strategies have been developed: invasive techniques, such as temporary disruption of the BBB or direct intraventricular and intracerebral administration of the drug, as well as noninvasive techniques. Preliminary results, reported in the large number of studies on the potential strategies for brain delivery, are encouraging, but it is far too early to draw any conclusion about the actual use of these therapeutic approaches. Among the most recent, but still pioneering, approaches related to the nasal mucosa properties, the permeabilization of the BBB via nasal mucosal engrafting can offer new potential opportunities. It should be emphasized that this surgical procedure is quite invasive, but the implication for patient outcome needs to be compared to the gold standard of direct intracranial injection, and evaluated whilst keeping in mind that central nervous system diseases and lysosomal storage diseases are chronic and severely debilitating and that up to now no therapy seems to be completely successful

DNA-coated microcrystals

Coprecipitation leads to self-assembly of bioactive DNA on the surface of salt, sugar or amino-acid crystals and provides a rapid inexpensive immobilization method suitable for preparing dry-powder formulations of nucleic acids, useful for storage, imaging and drug delivery

Soluplus solutions as thermothickening materials for topical drug delivery.

Soluplus is a pharmaceutical excipient used primarily in the manufacture of solid dispersions. The polymer also exhibits interesting rheology in aqueous solution, increasing in viscosity as the solution is warmed. This material could have application topical drug delivery to sites including the skin, vagina, rectum or nasal mucosa, where the increase in viscosity allows for improved retention. However, there exists very little information surrounding this “thermothickening” phenomenon and the effect of solution composition on temperature-dependent rheology. In this study, the effect of soluplus concentration, salt inclusion, ethanol addition, and pH on temperature-dependent rheology was measured. The rheology of the solutions was unaffected by pH over the range tolerated by the skin (pH 4–7), but the inclusion of ethanol rapidly negated the thermothickening effect. “Salting out” of the solutions resulted in a depression of gelation temperatures, and an increase in both storage and loss moduli of the solutions. 30% (w/v) soluplus in 1 M NaCl or KCl was identified as a potential thermothickening agent for topical drug delivery.Peer reviewe

The transcriptional response of Caenorhabditis elegans to ivermectin exposure identifies novel genes involved in the response to reduced food intake

We have examined the transcriptional response of Caenorhabditis elegans following exposure to the anthelmintic drug ivermectin (IVM) using whole genome microarrays and real-time QPCR. Our original aim was to identify candidate molecules involved in IVM metabolism and/or excretion. For this reason the IVM tolerant strain, DA1316, was used to minimise transcriptomic changes related to the phenotype of drug exposure. However, unlike equivalent work with benzimidazole drugs, very few of the induced genes were members of xenobiotic metabolising enzyme families. Instead, the transcriptional response was dominated by genes associated with fat mobilization and fatty acid metabolism including catalase, esterase, and fatty acid CoA synthetase genes. This is consistent with the reduction in pharyngeal pumping, and consequential reduction in food intake, upon exposure of DA1316 worms to IVM. Genes with the highest fold change in response to IVM exposure, cyp-37B1, mtl-1 and scl-2, were comparably up-regulated in response to short–term food withdrawal (4 hr) independent of IVM exposure, and GFP reporter constructs confirm their expression in tissues associated with fat storage (intestine and hypodermis). These experiments have serendipitously identified novel genes involved in an early response of C. elegans to reduced food intake and may provide insight into similar processes in higher organisms

Drosophila modifier screens to identify novel neuropsychiatric drugs including aminergic agents for the possible treatment of Parkinson's disease and depression.

Small molecules that increase the presynaptic function of aminergic cells may provide neuroprotection in Parkinson's disease (PD) as well as treatments for attention deficit hyperactivity disorder (ADHD) and depression. Model genetic organisms such as Drosophila melanogaster may enhance the detection of new drugs via modifier or 'enhancer/suppressor' screens, but this technique has not been applied to processes relevant to psychiatry. To identify new aminergic drugs in vivo, we used a mutation in the Drosophila vesicular monoamine transporter (dVMAT) as a sensitized genetic background and performed a suppressor screen. We fed dVMAT mutant larvae ∼ 1000 known drugs and quantitated rescue (suppression) of an amine-dependent locomotor deficit in the larva. To determine which drugs might specifically potentiate neurotransmitter release, we performed an additional secondary screen for drugs that require presynaptic amine storage to rescue larval locomotion. Using additional larval locomotion and adult fertility assays, we validated that at least one compound previously used clinically as an antineoplastic agent potentiates the presynaptic function of aminergic circuits. We suggest that structurally similar agents might be used to development treatments for PD, depression and ADHD, and that modifier screens in Drosophila provide a new strategy to screen for neuropsychiatric drugs. More generally, our findings demonstrate the power of physiologically based screens for identifying bioactive agents for select neurotransmitter systems

Evaluation of the implementation of the alert issued by the UK National Patient Safety Agency on the storage and handling of potassium chloride concentrate solution

Objectives: To assess the effectiveness of the response of NHS hospital trusts to an alert issued by the National Patient Safety Agency designed to limit the availability of concentrated potassium chloride in hospitals in England and Wales, and to determine the nature of any unintended consequences. Design: Multi-method study involving interviews and a physical inspection of clinical areas. Setting: 207 clinical areas in 20 randomly selected acute NHS trusts in England and Wales between 31 October 2002 and 31 January 2003. Participants: Senior managers and ward based medical and nursing staff. Main outcome measures: Degree of staff awareness of and compliance with the requirements of the national alert, withdrawal of concentrated potassium chloride solutions from non-critical areas, provision of pre-diluted alternatives, storage and recording in accordance with controlled drug legislation. Results: All trusts required that potassium chloride concentrate be stored in a separate locked cupboard from common injectable diluents (100% compliance). Unauthorised stocks of potassium chloride were found in five clinical areas not authorised by the trust (98% compliance). All trusts required documentation control of potassium chloride concentrate in clinical areas, but errors were recorded in 20 of the 207 clinical areas visited (90% compliance). Of those interviewed, 78% of nurses and 30% of junior doctors were aware of the alert. Conclusions: The NPSA alert was effective and resulted in rapid development and implementation of local policies to reduce the availability of concentrated potassium chloride solutions. The success is likely to be partly due to the nature of the proposed changes and it cannot be assumed that future alerts will be equally effective. Continued vigilance will be necessary to help sustain the changes