Contribution au développement analytique et bioanalytique d'une substance active utilisée dans le traitement d'une maladie rare (application au développement de la 3,4-Diaminopyridine)

PARIS-BIUP (751062107) / SudocSudocFranceF

Mise au point du dosage de la 3,4-diaminopyridine dans le plasma sanguin (application à des études cinétiques chez l'animal)

PARIS-BIUP (751062107) / SudocSudocFranceF

La REMED ou Revue des erreurs liées aux médicaments et dispositifs médicaux associés : illustration à partir d’un exemple

Résumé Objectif : Illustrer, à l’aide d’un exemple, la méthodologie de la Revue des erreurs liées aux médicaments et aux dispositifs médicaux associés. Description de la problématique : Des erreurs médicamenteuses se produisent régulièrement dans les établissements de santé. Les professionnels de la santé sont invités à étudier ces erreurs de façon exhaustive et multidisciplinaire. L’erreur étudiée a eu lieu à l’Unité de soins de longue durée, où une infirmière a donné des médicaments à un autre patient que celui auquel ils étaient destinés. Au cours des 15 étapes de la Revue des erreurs liées aux médicaments et aux dispositifs médicaux, 9 causes et 7 mesures d’amélioration ont été relevées. Discussion : Une fois la phase d’appropriation de l’outil passée, les utilisateurs ont été unanimes à souligner son intérêt. L’outil structure la démarche et assure que l’essentiel des questions ont été posées. Il participe également à sensibiliser les professionnels à la problématique étudiée. Conclusion : La Revue des erreurs liées aux médicaments et aux dispositifs médicaux permet d’analyser les erreurs médicamenteuses de façon structurée et approfondie. Sa conduite dans le service où a eu lieu l’erreur renforce l’efficience des mesures correctives et leur acceptation par le personnel. Abstract Objective: Using an example, to show the methods involved in a review of medication-related errors and associated medical devices. Problem description: Medication errors occur regularly in healthcare establishments. Healthcare professionals are asked to study these errors in an exhaustive and multidisciplinary way. The error analyzed was one that occurred in a long-term care unit, where a nurse administered medication to the wrong patient. During the 15 steps involved in the review of medication errors and medical devices, 9 causes and 7 measures for improvement were identified. Discussion: Once the conversion period for the tool was finished, users were unanimous in its support. The tool provides a structured approach and ensures that the essential questions have been asked. It also serves to educate professionals in the problem at hand. Conclusion: The review of medication errors and medical devices allows a structured and in-depth analysis of medication errors. Its use within the context where the error occurred reinforces effective corrective measures and their acceptance by workers. Key words: medication error, risk management, preventable drug-related morbidity, patient misidentification, professional practice evaluatio

La REMED ou Revue des erreurs liées aux médicaments et aux dispositifs associés : une méthode d’amélioration de la qualité des soins

Résumé Objectif : Décrire la méthodologie de la Revue des erreurs liées aux médicaments et aux dispositifs médicaux associés. Il s’agit d’une revue de morbidité et mortalité appliquée au circuit du médicament. Elle a été élaborée dans le cadre d’une collaboration entre la Société française de pharmacie clinique en partenariat avec la Société française de gériatrie et gérontologie et la Société française de gestion des risques en établissement de santé. Mise en contexte : Les professionnels de la santé sont de plus en plus conscients de la nécessité de gérer les risques sanitaires et notamment les risques liés aux erreurs. Afin de poursuivre la lutte contre l’iatrogénie médicamenteuse évitable, nous avons participé à la formalisation d’une nouvelle méthode d’évaluation des pratiques professionnelles, qui cible en particulier les erreurs médicamenteuses. Elle est dénommée Revue des erreurs liées aux médica­ments et aux dispositifs associés. Celle-ci permet un traitement structuré et approfondi des erreurs médi­camenteuses survenues dans un établissement de santé. Nous proposerons une liste des questions in­troductives à la conduite de la Revue des erreurs liées aux médicaments et aux dispositifs médicaux associés, puis nous décrirons succinctement les ou­tils qui la composent, enfin nous aborderons les avantages attendus. Conclusion : Toute activité humaine est suscep­tible de générer des erreurs. Utiliser l’erreur comme outil pédagogique est un défi culturel. Ainsi, la mise en oeuvre et le développement par les professionnels d’une revue des erreurs liées aux médicaments et aux dispositifs associés, en milieu hospitalier ou li­béral, contribueront à la promotion de la qualité des soins. Abstract Purpose: To describe the methodology of reviewing errors related to medications and associa­ted medical devices. What is involved is a review of morbidity and mortality applied to the drug distribu­tion process. It was developed by the Société fran­çaise de pharmacie clinique in partnership with the Société française de gériatrie et gérontologie and with the Société française de gestion des risques en établissement de santé. Context: Healthcare professionals are increasin­gly aware of the necessity of managing health risks and especially error-related risk. In order to conti­nue the battle against preventable healthcare related medication errors, we participated in formalizing a new method of evaluating professional practices that specifically targets medication errors. The method is called review of errors related to medica­tions and medical devices. It is an in-depth and struc­tured assessment of medication errors occurring in a health care establishment. We first suggest a list of questions introductory to conducting the review of errors related to medications and associated medi­cal devices, and then we briefly describe the tools of which it is composed and its expected benefits. Conclusion: All human activity is subject to error. Using errors as a teaching tool is a cultural challenge. Hence, the implementation and develop­ment by professionals of a review of errors related to medications and associated medical devices in a hospital or other environment will help to promote the quality of health care. Key words: medication error; evaluation of pro­fessional practices; risk management; preventable healthcare related medication errors

Novel in situ gelling ophthalmic drug delivery system based on gellan gum and hydroxyethylcellulose: Innovative rheological characterization, in vitro and in vivo evidence of a sustained precorneal retention time

International audienceAchieving drug delivery at the ocular level encounters many challenges and obstacles. In situ gelling delivery systems are now widely used for topical ocular administration and recognized as a promising strategy to improve the treatment of a wide range of ocular diseases. The present work describes the formulation and evaluation of a mucoadhesive and ion-activated in situ gelling delivery system based on gellan gum and hydroxyethylcellulose for the delivery of phenylephrine and tropicamide. First, physico-chemical characteristics were assessed to ensure suitable properties regarding ocular administration. Then, rheological properties such as viscosity and gelation capacity were determined. Gelation capacity of the formulations and the effect of hydroxyethylcellulose on viscosity were demonstrated. A new rheological method was developed to assess the gel resistance under simulated eye blinking. Afterward, mucoadhesion was evaluated using tensile strength test and rheological synergism method in both rotational and oscillatory mode allowing mucoadhesive properties of hydroxyethylcellulose to be point out. Finally, residence time on the ocular surface was investigated in vivo, using cyanine 5.5 dye as a fluorescent marker entrapped in the in situ gelling delivery systems. Residence performance was studied by non-invasive optical imaging on vigilant rabbits, allowing eye blinking and nasolacrimal drainage to occur physiologically. Fluorescence intensity profiles pointed out a prolonged residence time on the ocular surface region for the developed formulations compared to conventional eye drops, suggesting in vitro/in vivo correlations between rheological properties and in vivo residence performances

Mucoadhesive Poloxamer-Based Hydrogels for the Release of HP-beta-CD-Complexed Dexamethasone in the Treatment of Buccal Diseases

International audienceOral lichen planus (OLP) is an ongoing and chronic inflammatory disease affecting the mucous membrane of the oral cavity. Currently, the treatment of choice consists in the direct application into the buccal cavity of semisolid formulations containing a corticosteroid molecule to decrease inflammatory signs and symptoms. However, this administration route has shown various disadvantages limiting its clinical use and efficacy. Indeed, the frequency of application and the incorrect use of the preparation may lead to a poor efficacy and limit the treatment compliance. Furthermore, the saliva clearance and the mechanical stress present in the buccal cavity also involve a decrease in the mucosal exposure to the drug. In this context, the design of a new pharmaceutical formulation, containing a steroidal anti-inflammatory, mucoadhesive, sprayable and exhibiting a sustained and controlled release seems to be suitable to overcome the main limitations of the existing pharmaceutical dosage forms. The present work reports the formulation, optimization and evaluation of the mucoadhesive and release properties of a poloxamer 407 thermosensitive hydrogel containing a poorly water-soluble corticosteroid, dexamethasone acetate (DMA), threaded into hydroxypropyl-beta-cyclodextrin (HP-beta-CD) molecules. Firstly, physicochemical properties were assessed to ensure suitable complexation of DMA into HP-beta-CD cavities. Then, rheological properties, in the presence and absence of various mucoadhesive agents, were determined and optimized. The hydration ratio (0.218-0.191), the poloxamer 407 (15-17 wt%) percentage and liquid-cyclodextrin state were optimized as a function of the gelation transition temperature, viscoelastic behavior and dynamic flow viscosity. Deformation and resistance properties were evaluated in the presence of various mucoadhesive compounds, being the sodium alginate and xanthan gum the most suitable to improve adhesion and mucoadhesion properties. Xanthan gum was shown as the best agent prolonging the hydrogel retention time up to 45 min. Furthermore, xanthan gum has been found as a relevant polymer matrix controlling drug release by diffusion and swelling processes in order to achieve therapeutic concentration for prolonged periods of time

On the Nanoscale Mapping of the Mechanical and Piezoelectric Properties of Poly (L-Lactic Acid) Electrospun Nanofibers

International audienceThe effect of the post-annealing process on different properties of poly (L-lactic acid) (PLLA) nanofibers has been investigated in view of their use in energy-harvesting devices. Polymeric PLLA nanofibers were prepared by using electrospinning and then were thermally treated above their glass transition. A detailed comparison between as-spun (amorphous) and annealed (semi-crystalline) samples was performed in terms of the crystallinity, morphology and mechanical as well as piezoelectric properties using a multi-technique approach combining DSC, XRD, FTIR, and AFM measurements. A significant increase in the crystallinity of PLLA nanofibers has been observed after the post-annealing process, together with a major improvement of the mechanical and piezoelectric properties

Disorder-to-Order Markers of a Cyclic Hexapeptide Inspired from the Binding Site of Fertilin β Involved in Fertilization Process

International audienc

Development and multi-centre evaluation of a method for assessing the severity of potential harm of medication reconciliation errors at hospital admission in elderly

International audienc