Stability of extemporaneously prepared cinacalcet oral suspensions

Purpose The stability of extemporaneously prepared cinacalcet suspensions over 90 days was evaluated. Methods Cinacalcet 5-mg/mL suspension was prepared by triturating 30-mg cinacalcet tablets. Twelve 30-mL batches were prepared with a 1:1 mixture of Ora-Plus and either Ora-Sweet or Ora-Sweet SF (sugar free). Three suspensions of each kind were stored at both room temperature and refrigerated conditions. A 1-mL sample was taken from each bottle at 0, 7, 18, 32, 64, and 90 days. Each sample was assayed using high-performance liquid chromatography (HPLC). A new HPLC method for evaluating drug peaks of pure cinacalcet was developed. Stability was defined as retention of at least 90% of the initial drug concentration. Results The HPLC method established in this study serves as a novel assay for evaluating cinacalcet oral suspensions. For all suspensions tested at individual conditions, the concentration remained above 90% of the initial concentration for 90 days of storage with the exception of Ora-Plus and Ora-Sweet SF suspensions stored under refrigeration, which were stable for 64 days. Usual sedimentation of the suspensions occurred over time but resolved with agitation; there was no other change in visual appearance of the suspensions over the course of the 90-day study. The color and odor of the suspensions throughout the study remained unchanged with respect to the initial time point. Conclusion Extemporaneously compounded cinacalcet 5-mg/mL oral suspensions prepared with a 1:1 mixture of Ora-Plus and either Ora-Sweet or Ora-Sweet SF and stored in 2-oz amber polypropylene plastic bottles were stable for at least 64 days at room temperature and under refrigeration

Testing the stability of the benefit transfer function for discrete choice contingent valuation data

We examine the stability of the benefit transfer function across 42 recreational forests in the British Isles. A working definition of reliable function transfer is put forward, and a suitable statistical test is provided. The test is based on the sensitivity of the model log-likelihood to removal of individual forest recreation sites. We apply the proposed methodology on discrete choice contingent valuation data and find that a stable function improves our measure of transfer reliability, but not by much. We conclude that, in empirical studies on transferability, function stability considerations are secondary to the availability and quality of site attribute data. Modellers’ can study the advantages of transfer function stability vis-à-vis the value of additional information on recreation site attributes

Developing business developing careers : how and why employers are supporting the career development of their employees

This publication sets out the case for employers to engage with the idea of career development

Stability of Extemporaneously Prepared Rufinamide Oral Suspensions

Background: Rufinamide is an oral antiepileptic drug indicated for adjunctive therapy in treating generalized seizures associated with Lennox-Gastaut syndrome. Currently, rufinanide is available as 200-mg and 400-mg tablets. A liquid dosage form does not exist at the present time. Lack of a suspension formulation may present an administration problem for many children and adults who are unable to swallow tablets. The availability of a liquid dosage form will provide an easy and accurate way to measure and administer the medication. Objective: To determine the stability of both sugar-containing and sugar-free rufinamide suspensions over a 90-day period. Methods: A suspension of rufinamide 40 mg/mL was prepared by grinding twelve 400-mg tablets of rufinamide tablets in a glass mortar. Sixty milliliters of Ora-Plus and 60 mL of either Ora-Sweet or Ora-Sweet SF (sugar free) were mixed and added to the powder to make a final volume of 120 mL. Three identical samples of each formulation were prepared and placed in 60-mL amber plastic bottles and were stored at room temperature. A 1-mL sample was withdrawn from each of the 6 bottles with a micropipette immediately after preparation and at 7, 14, 28, 56, and 90 days. After further dilution to an expected concentration of 0.4 mg/mL, the samples were assayed using high-performance liquid chromatography. Stability was defined as the retention of at least 90% of the initial concentration. Results: At least 90% of the initial rufinamide concentration remained throughout the 90-day study period in both preparations. There were no detectable changes in color, odor, taste, and pH and no visible microbial growth. Conclusions: Extemporaneously compounded suspensions of rufinamide 40 mg/mL in a 1:1 mixture of Ora-Plus and Ora-Sweet or Ora-Sweet SF were stable for at least 90 days when stored in 59-mL amber polypropylene plastic bottles at room temperature

Education in Pediatrics in US Colleges and Schools of Pharmacy

Objective. To determine the extent to which pediatrics is taught at US doctor of pharmacy (PharmD) programs and to characterize what is being taught and how. Methods. A 40-question online survey instrument was sent to accredited and candidate-status US PharmD programs. Results. Of 86 participating programs (67.2% response rate), 81 (94.2%) indicated that pediatric topics were included in their required classroom curricula (mean, 21.9 contact hours). A pediatric elective course was offered by 61.0% of programs (mean, 25.9 contact hours). Advanced pharmacy practice experiences (APPEs) in pediatrics were offered by 97.4% of programs, with an average of 27 students per program completing this practice experience annually. Conclusions. Almost all responding programs incorporated pediatrics in their required curricula. Pediatric elective courses provided an adequate mean number of contact hours, but 39.0% of programs did not offer an elective course. One-fifth of students completed a pediatric APPE prior to graduation. Continued expansion of pediatric-focused classroom and experiential curricula across US PharmD programs is recommended

Methadone and Corrected QT Prolongation in Pain and Palliative Care Patients: A Case–Control Study

Background: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients. Objective: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool. Design: We performed a case–control study of adult inpatients receiving ME for pain management. Settings/Subjects: Adult inpatients receiving ME with a QTc \u3e470 msec (males) and \u3e480 msec (females) were matched 1:2 according to age, history of QTc prolongation, and gender with ME patients who did not have a prolonged QTc interval. QTc prolongation risk factors were collected for both groups. Covariates were analyzed using conditional logistic regression. Classification and regression tree analysis was used to identify the ME dose associated with QTc prolongation. Results: Predictors of QTc prolongation included congestive heart failure (CHF) (OR: 11.9; 95% CI: 3.7–38.2; p \u3c 0.00), peptic ulcer disease (PUD) (odds ratio [OR]: 8.3; 95% confidence interval [95% CI]: 2.4–28.9; p \u3c 0.00), hypokalemia (OR: 6.5; 95% CI: 1.5–28.2; p \u3c 0.01), rheumatologic diseases (OR: 4.7; 95% CI: 1.6–13.9; p \u3c 0.00), taking medications with a known torsades de pointes (TdP) risk (OR: 4.4; 95% CI: 1.8–10.7; p \u3c 0.01), malignancy (OR: 3.3; 95% CI: 1.2–9.3; p \u3c 0.03), hypocalcemia (OR: 2.1; 95% CI: 0.9–4.8; p \u3c 0.07), and ME doses \u3e45 mg per day (OR: 1.9; 95% CI: 0.8–4.8; p \u3c 0.16). Mild liver disease was protective against QTc prolongation (OR: 0.05; 95% CI: 0.0–0.46; p \u3c 0.01). Conclusions: Predictors of QTc prolongation in our multivariate conditional logistic regression model included CHF, PUD, hypokalemia, rheumatologic disorders, use of medications with a known TdP risk, malignancy, hypocalcemia, and ME doses \u3e45 mg per day