Current Issue : July - September Volume : 2017 Issue Number : 3 Articles : 5 Articles
Most anticancer agents exhibit a narrow therapeutic index, i.e., a small change in plasma\nconcentrations can lead to a less efficacious treatment or an unacceptable degree of toxicity. This study\naimed at providing health professionals with a feasible and time-saving tool to adapt the dose of\nanticancer agents for patients with renal or hepatic dysfunction. A guideline for anticancer agents\nwas developed based on a literature search. An algorithm was generated to enhance the efficiency\nof the dose adaptation process. Finally, the dosing guideline was converted into an easy-to-use\nExcelTM tool. The concept was applied to a total of 105 adult patients at the Centre for Integrated\nOncology, Bonn, Germany. In total, 392 recommendations for dose adaptation were made and\n320 (81.6%) recommendations were responded to by the oncologists. 98.4% of the recommendations\nwere accepted. The algorithm simplifies the decision and screening process for high-risk patients.\nMoreover, it provides the possibility to quickly decide which laboratory tests are required and\nwhether a dose adjustment for a particular anticancer drug is needed. The ExcelTM tool provides\na recommended individual dose for patients with renal or hepatic dysfunction. The effectiveness\nof this strategy to reduce toxicity should be investigated in further studies before being adopted for\nroutine use....
Among inhaled asthma therapies, the present study aimed to identify factors for selecting the type of inhalation therapy for asthma.\nThree methods are used to deliver inhaled cromoglycate, and the airway deposition rate was evaluated using a cascade impactorwith\n3 dosage forms: dry powder (DP), pressurized metered dose inhaler (pMDI), and solution (jet- andmesh-types). The percentage of\nparticles with diameters of 2ââ?¬â??6 ...
Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain andmorphine consumption after laparoscopic\nsurgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and\ndose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods.\nPatients were randomized to receive 50, 100, or 150mg of ropivacaine 1% by peritoneal nebulization through a nebulizer.Morphine\nconsumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse\neffects were collected during the first 48 hours after surgery. The pharmacokinetics of ropivacaine was evaluated using high\nperformance liquid chromatography. Results. Nebulization of 50 mg of ropivacaine had the same effect of 100 or 150 mg in terms\nof postoperative morphine consumption, shoulder pain, postoperative nausea and vomiting, activity resumption, and hospital\ndischarge timing (>0.05). Plasma concentrations did not reach toxic levels in any patient, and no significant differences were\nobserved between groups (...
With the combination of micropumps and flow sensors, highly accurate and secure\nclosed-loop controlled micro dosing systems for liquids are possible. Implementing a single stroke\nbased control mode with piezoelectrically driven micro diaphragm pumps can provide a solution for\ndosing of volumes down to nanoliters or variable average flow rates in the range of nL/min to Ã?¼L/min.\nHowever, sensor technologies feature a yet undetermined accuracy for measuring highly pulsatile\nmicropump flow. Two miniaturizable in-line sensor types providing electrical readoutââ?¬â?differential\npressure based flow sensors and thermal calorimetric flow sensorsââ?¬â?are evaluated for their suitability\nof combining them with mircopumps. Single stroke based calibration of the sensors was carried\nout with a new method, comparing displacement volumes and sensor flow volumes. Limitations of\naccuracy and performance for single stroke based flow control are described. Results showed that\nbesides particle robustness of sensors, controlling resistive and capacitive damping are key aspects for\nsetting up reproducible and reliable liquid dosing systems. Depending on the required average flow\nor defined volume, dosing systems with an accuracy of better than 5% for the differential pressure\nbased sensor and better than 6.5% for the thermal calorimeter were achieved....
This open-label study aimed to compare once-daily and twice-daily pramipexole extended release (PER) treatment in Parkinson�s\ndisease (PD). PD patients on dopamine agonist therapy, but with unsatisfactory control, were enrolled. Existing agonist doses were\nswitched into equivalent PER doses. Subjects were consecutively enrolled into either once-daily-first or twice-daily-first groups\nand received the prescribed amount in one or two, respectively, daily doses for 8 weeks. For the second period, subjects switched\nregimens in a crossover manner. The forty-four patients completed a questionnaire requesting preference during their last visit.\nWe measured the UPDRS-III, Hoehn and Yahr stages (H&Y) in medication-on state, Parkinson�s disease sleep scale (PDSS), and\nEpworth Sleepiness Scale. Eighteen patients preferred a twice-daily regimen, 12 preferred a once-daily regimen, and 14 had no\npreference. After the trial, 14 subjects wanted to be on a once-daily regimen, 25 chose a twice-daily regimen, and 5 wanted to\nmaintain the prestudy regimen. Main reasons for choosing the twice-daily regimen were decreased off-duration, more tolerable\noff-symptoms, and psychological stability. The mean UPDRS-III, H&Y, and PDSS were not different. Daytime sleepiness was\nsignificantly high in the once-daily regimen, whereas nocturnal hallucinations were more common in the twice-daily. Multiple\ndosing should be considered if once-daily dosing is unsatisfactory. This study is registered as NCT01515774 at ClinicalTrials.gov....
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