Pharmacy practice

More information on the different type of bandages

2011-11-14T09:40:00.001-08:00

I think this website is excellent. It contains useful information on the different products available by urgo.

http://www.urgo.co.uk/293-the-different-types-of-bandages#inelastic-bandage

Anal irrigation system-Peristeen

2011-11-14T09:22:00.001-08:00

http://www.coloplast.com/products/urologyandcontinencecare/peristeen/features_benefits/

Ostomy skills video

2011-11-07T09:39:00.000-08:00

I just watched a very informative video on ostomy and learned more about the different type of appliances existing.

http://www.youtube.com/watch?v=rv88UHnG3nM&feature=related

Information about ileostomy can be found here:

http://www.nhs.uk/Conditions/Ileostomy/Pages/Recovery.aspx

Alcohol-related problems on news once again...

2011-08-03T23:17:00.000-07:00

http://news.bbc.co.uk/panorama/hi/front_page/newsid_9548000/9548887.stm

Obesity article

2011-06-30T12:31:00.000-07:00

http://www.bmj.com/content/337/bmj.a1238.full

GATTACA SUMMARY

2011-05-20T07:42:00.001-07:00

http://www.imdb.com/title/tt0119177/synopsis

Melanoma

2011-05-17T07:35:00.000-07:00

Thyroid Lab Tests

2011-05-10T04:55:00.000-07:00

Sources of Info about Src

2011-05-02T09:58:00.000-07:00

http://books.google.co.uk/books?id=sAW-9AuKhmkC&pg=PA27&lpg=PA27&dq=src+and+metastasis&source=bl&ots=oXmqbXglHv&sig=eSTFYDCLuBsPoClsvUucYIXSbEQ&hl=en&ei=w9q-TfzgCYmq8QOggbHZBQ&sa=X&oi=book_result&ct=result&resnum=10&ved=0CGMQ6AEwCQ#v=onepage&q=src%20and%20metastasis&f=false

http://www.ebi.ac.uk/interpro/potm/2003_2/Page_2.htm
http://herkules.oulu.fi/isbn9514269306/html/x693.html

Metastasis

2011-05-02T08:30:00.001-07:00

No health without mental health

2011-04-11T12:18:00.000-07:00

This video refers to the significance of the talking therapies in mental health and overall health, the importance of cooperation of multiple organisation in achieving good mental health and the need for greater attention in problem prevention rather than just focusing on symptom treatment.

Free EHC service in Welsh pharmacies

2011-04-03T23:36:00.000-07:00

http://www.bbc.co.uk/news/uk-12928485 http://www.pjonline.com/news/national_ehc_service_rollout_across_wales_starts_today http://www.cpwales.org.uk/News/20110330-CPW-Press-Release-@-EHC(AE2)-(2)).aspx

Baby doll-Breastfeeding

2011-04-03T23:35:00.001-07:00

http://www.bbc.co.uk/news/uk-12936613

Communication

2011-04-03T05:21:00.000-07:00

Communication

View more presentations from guestaa6f8c4d.

http://www.education4skills.com/thecom/Contents.html

http://painandpsychology.blogspot.com/

Brief intervention, Cycle of change and Motivational Interviewing

2011-03-31T11:45:00.000-07:00

http://dcc2.bumc.bu.edu/MedicineAndPublicHealthForum/brief_intervention.htm http://her.oxfordjournals.org/content/14/3/399.full.pdf+html

Immune system, Cancer and Autoimmune diseases

2011-03-27T07:47:00.000-07:00

http://www.cancer.gov/cancertopics/factsheet/Therapy/biological

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1782355/
http://www.hindawi.com/journals/jbb/si/rccad/
http://www.immunotherapy-in-oncology.com/content.aspx?sc=1
http://www.immunotherapy-in-oncology.com/contentDirect.aspx?c=5
http://www.benthamscience.com/ccdt/samples/ccdt7-1/0003U.pdf

Interesting Link for Health Psychology

2011-03-23T00:16:00.001-07:00

http://nnlm.gov/evaluation/pub/witte/

2011-03-15T02:09:00.000-07:00

http://www.mtw.nhs.uk/formulary/?cid=170

Cancer and pregnancy

2011-03-08T08:27:00.000-08:00

http://today.msnbc.msn.com/id/41874748?GT1=43001

advice on exercise for diabetics

2011-03-06T10:29:00.001-08:00

http://www.runsweet.com/

Safe use of injectables by NPSA

2011-03-06T10:09:00.001-08:00

http://healthcareea.vctms.co.uk/assets/content/9652/4759/content/injectable.pdf

Injecting insulin with a pen

2011-03-06T07:33:00.000-08:00

http://www.bd.com/uk/diabetes/page.aspx?cat=14152&id=31456

http://www.bd.com/uk/diabetes/page.aspx?cat=14152&id=31457

hospital cleaning

2011-03-03T10:19:00.000-08:00

http://www।unison.org.uk/acrobat/14564.pdf

http://www.library.nhs.uk/healthmanagement/ViewResource.aspx?resID=२७१३६२

IBA-useful information

2011-02-15T02:07:00.000-08:00

http://www.alcohollearningcentre.org.uk/Topics/Browse/BriefAdvice/

Benefits of smoking cessation

2011-02-15T01:18:00.000-08:00

BP measurement

2011-02-08T03:04:00.001-08:00

http://www.abdn.ac.uk/medical/bhs/tutorial/tutorial.htm

http://www.videojug.com/film/how-to-take-your-own-blood-pressure

Sleeping with your pets?

2011-01-24T05:14:00.000-08:00

Read the following article to find out more about the health issues related to sleeping with pets.
http://www.aolnews.com/2011/01/20/letting-sleeping-dogs-lie-in-your-bed-can-kill-you/

Increased alcohol price

2011-01-11T00:04:00.000-08:00

http://www.bbc.co.uk/news/health-12094800

The solution to obesity!

2011-01-09T09:54:00.000-08:00

Fruits ah ah save the universe! Fruits ah ah save the universe!

2011-01-07T03:11:00.000-08:00

http://www.famyouth.org.uk/pdfs/DDU.pdf
http://women.timesonline.co.uk/tol/life_and_style/women/the_way_we_live/article5208865.ece
http://news.bbc.co.uk/2/hi/europe/662403.stm

Alfalfa

2011-01-06T23:35:00.001-08:00

http://www.nlm.nih.gov/medlineplus/druginfo/natural/19.html

Dangers of recreating and giving to human drugs only tested on rats

2011-01-06T23:16:00.000-08:00

Drugs tested only on rats in laboratories are recreated for human use. These drugs are not yet defined as illegal, hence they are made up. However, they mighthave severe side effects to humans and they might even be fatal.
http://blogs.discovermagazine.com/80beats/2011/01/05/drug-users-are-mining-the-scientific-literature-for-legal-highs/

Labels

2011-01-05T23:52:00.001-08:00

http://boards.medscape.com/forums?128@@.2a05e9c6!comment=1

Detox food

2011-01-03T08:57:00.000-08:00

http://women.gr.msn.com/fitness/gallerymsn.aspx?cp-documentid=155215679

Dangers of CAMs

2011-01-03T06:08:00.001-08:00

http://www.bbc.co.uk/news/health-12060507

Rise in flu cases and flu related deaths

2011-01-03T06:03:00.000-08:00

http://www.bbc.co.uk/news/health-12094135

Mobile Healthcare

2011-01-03T05:58:00.000-08:00

http://www.bbc.co.uk/news/business-12068755

Insulin-diabetes

2010-12-30T07:33:00.001-08:00

http://www.diabetes.nhs.uk/safe_use_of_insulin/

http://www.mims.co.uk/Tables/882439/Insulin-Preparations/

Haberman feeding teat

2010-12-30T00:35:00.000-08:00

http://www.poshmums.com/breastfeeding/medela-haberman-feeder.htm

Plaster cast and Splint

2010-12-29T11:10:00.000-08:00

splint

http://www.plantar-fasciitistreatment.com/plantar-fasciitis-night-splint

plaster cast

http://boneandspine.com/plaster-techniques/a-clinical-photograph-of-above-knee-plaster-cast/

Lorenzo's oil

2010-12-29T10:10:00.000-08:00

http://www.myelin.org/LorenzosOil/

Spasm and Spasticity

2010-12-29T07:32:00.000-08:00

Spasm: muscles to contracting tightly and painfully
Spasticity: muscles are stiff and resistant to movement

http://www.nhs.uk/Conditions/Multiple-sclerosis/Pages/Symptoms.aspx

difference between mobility and motility

2010-12-29T07:29:00.000-08:00

http://uk.answers.yahoo.com/question/index?qid=20080421150704AAFUcjL

Pes cavus=high arched feet

2010-12-29T06:26:00.001-08:00

http://shoedaydreams.blogspot.com/2008/01/pes-cavus.html

http://www.comfortshoe.com/footcondicitions/cmt.html

Keloid

2010-12-29T00:45:00.000-08:00

http://dupreedermatology.com/keloids.htm

http://emedicine.medscape.com/article/876214-overview

For more info: http://www.skinsight.com/adult/keloid-whosAtRisk.htm

Talipes-Clubfoot

2010-12-29T00:34:00.000-08:00

I was reading about Bethlem myopathy and I came across the term talipes.
I am uploading a picture I found online as "a picture is worth a thousand words".

http://www.eorthopod.com/content/clubfoot

http://www.muscular-dystrophy.org/about_muscular_dystrophy/conditions/663_bethlem_myopathy

Unresectable Meaning

2010-12-22T07:53:00.001-08:00

Unresectable: Unable to be removed (resected) by surgery

Lennox-Gastaut syndrome

2010-12-17T03:15:00.001-08:00

http://www.epilepsy.org.uk/info/lennox.html

http://www.ninds.nih.gov/disorders/lennoxgastautsyndrome/lennoxgastautsyndrome.htm

Alpha-Fetoprotein

2010-12-15T05:32:00.000-08:00

BNF states:

"In view of the increased risk of neural tube and other defects associated, in particular, with carbamazepine, lamotrigine, oxcarbazepine, phenytoin, and valproate, women taking antiepileptic drugs who may become pregnant should be informed of the possible consequences. Those who wish to become pregnant should be referred to an appropriate specialist for advice. Women who become pregnant should be counselled and offered antenatal screening (alpha-fetoprotein measurement and a second trimester ultrasound scan)."

I decided to search for the term AFP and I found the following definition:

"Alpha-Fetoprotein (AFP), a member of the albuminoid superfamily, is a fetal/tumor-associated protein that is a marker for certain cancers and congenital defects. Like other members of the albuminoid family, AFP can act as a carrier protein, binding several types of molecules including steroids, bilirubin, fatty acids, retinoids, and flavanoids. Some studies suggest that AFP may also act as a regulator of cell growth and survival."

http://www.rndsystems.com/molecule_detail.aspx?m=1049&gclid=CLrI69Ou7qUCFQkf4QodUhXUog

Patient Consent

2010-10-20T10:52:00.000-07:00

http://www.bma.org.uk/images/consenttoolkitdec2009_tcm41-193139.pdf

http://www.gmc-uk.org/guidance/ethical_guidance/children_guidance_index.asp

PGDs

2010-10-20T09:24:00.001-07:00

http://www.mhra.gov.uk/Howweregulate/Medicines/Availabilityprescribingsellingandsupplyingofmedicines/ExemptionsfromMedicinesActrestrictions/PatientGroupDirectionsintheNHS/index.htm

http://www.nelm.nhs.uk/en/Communities/NeLM/PGDs/

Interesting point

2010-10-08T04:56:00.000-07:00

Emergency Contraception can be also offered in Brook centres. http://www.brook.org.uk/find-a-centre.

MYTH: CAN NITROGLYCERIN HEART PATCHES, WORN BY PATIENTS WITH ANGINA, EVER EXPLODE?

2010-09-19T05:11:00.001-07:00

http://dsc.discovery.com/fansites/mythbusters/db/technology/nitroglycerine-heart-patches-explode.html

Epigenetics

2010-09-12T02:57:00.001-07:00

I came across the term epigenetics during Roche-Continents Workshops.
This is a link with information of what it is:
http://learn.genetics.utah.edu/content/epigenetics/
http://learn.genetics.utah.edu/content/epigenetics/inheritance/

GABA-A receptor

2010-09-12T02:33:00.000-07:00

http://www.google.com/imgres?imgurl=http://media.wiley.com/CurrentProtocols/NS/ns0706/ns0706-fig-0001-1-full.gif&imgrefurl=http://www.currentprotocols.com/protocol/ns0706&usg=__Rv4x2ttXFQH_rVZ0t6P0ZifMMFw=&h=255&w=363&sz=5&hl=el&start=39&zoom=1&tbnid=udPgYmqRsn2AXM:&tbnh=140&tbnw=200&prev=/images%3Fq%3Ddiazepam%2Bbinding%2Bsite%26um%3D1%26hl%3Del%26rls%3Dcom.microsoft:el:IE-SearchBox%26rlz%3D1I7GGLL_el%26biw%3D1259%26bih%3D573%26tbs%3Disch:10%2C942&um=1&itbs=1&iact=hc&vpx=900&vpy=225&dur=5553&hovh=188&hovw=268&tx=103&ty=111&ei=Ip6MTJGUDs2Vswaq5PG1Ag&oei=GJ6MTPSoFoaBswbUlPDlAQ&esq=3&page=3&ndsp=20&ved=1t:429,r:12,s:39&biw=1259&bih=573

http://www.currentprotocols.com/protocol/ns0706

Porphyria

2010-09-12T00:31:00.000-07:00

I was reading about the skeletal muscle relaxants and I came across with the term porphyria.
According to BNF54 acute porphyria is a hereditary disorder of haem biosynthesis. Subdivisions include: Acute intermittent porphyria (AIP), Variegate porphyria (VP), Hereditary coproporphyria (HCP), or ALA dehydratase deficiency porphyria.

There are drugs can cause acute porphyrias and their use must be avoided. If that is not possible urinary porphobilinogen excretion should be measured regularly.

A list of drugs safe to use in acute porphyrias can be found here:
http://www.wmic.wales.nhs.uk/pdfs/porphyria/Porphyria_Safe_List_2010_with_letter_August%202010.pdf

In acute porphyria crises, haema arginate (normosang) is given as an IV infusion.

More information can be found here:
http://www.wmic.wales.nhs.uk/porphyria_info.php

http://www.porphyria-europe.com/01-for-patients/EN/for-patients.asp

Angelman syndrome

2010-09-12T00:29:00.000-07:00

http://www.angelman.org/

http://ghr.nlm.nih.gov/condition/angelman-syndrome

http://en.wikipedia.org/wiki/Angelman_Syndrome

Antispasticity Drugs

2010-09-11T03:17:00.000-07:00

http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=spinalcord&part=A3650&rendertype=figure&id=A3651

http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=spinalcord&part=A3650

Tetanus

2010-09-11T01:48:00.000-07:00

Tetanus is an serious, acute infection caused by the bacterium Clostridium tetani, which is found in the soil, dust and manure. The bacterium usually enters the skin through grazes, wounds and burns.
After entering the body, it needs up to 21 days to incubate and usually symptoms appear after the 10 days. Symptoms include muscle spasm which is particularly apparent on the face, fever, sweating, tachycardia and hypertension. If it is not treated it can lead to fatal complications which include septicaemia, asphyxia, heart attack and kideny failure.
To prevent infection wound must be cleaned and antiseptics must be used or if severe the wound should be treated appropriately by a healthcare professional. Vaccination might also need to follow.
Antibiotics may also be given to limit the bacteria growth and the neurotoxin tetanospasmin spreading. Penicillin or metronidazole are usually given and tetracycline is given to those allergic to the aforementioned antibiotics.
Muscle spasms are treated by anticonvulsants (phenobarbital), muscle relaxants (diazepam, baclofen, dantrolene) and neuromuscular blocking agents (vecuronium).
A high calorie and protein-rich diet might be also necessary due to increased muscle activity and energy consumption.

http://www.nhs.uk/Conditions/Tetanus/Pages/Introduction.aspx

Bad Bugs Slideshow: Identifying Bugs and Their Bites

2010-08-30T22:22:00.000-07:00

Bad Bugs Slideshow: Identifying Bugs and Their Bites

Urea Cycle Disorders

2010-08-22T05:35:00.000-07:00

http://www.nucdf.org/about.htm
http://www.nucdf.org/ucd.htm
http://www.nucdf.org/UCD_Clinical_Trials.html
http://www.medschool.lsuhsc.edu/genetics_center/louisiana/article_metabolic_dietary.htm
http://www.hyperiontx.com/clinical_trials
http://www.helpucd.com/HTML%20pages/Main.htm

West Nile Virus

2010-08-19T02:24:00.001-07:00

Insects carrying the West Nile Virus have infected people in North Greece. So I have decided to find more information about the trasmission of the virus and the symptoms it causes. The virus is trasmitted from infected birds to insects and then to humans and other animals. The virus is trasmitted through blood and not through touching infected animals and people.

http://www.cdc.gov/ncidod/dvbid/westnile/cycle.htm

Once infected, the symptoms can develop 2-15days after the infection. 4 out of 5 humans infected have no symptoms but do develop natural immunity which might fade over the years, 20% have West Nile fever with flu-like symptoms and rash in their body and 1 in 150 infected people might develop symptoms of encephalitis (brain inflammation), meningitis (inflammation in the membrane surrounding the brain and spinal cord), meningoencephalitis (inflammation of the brain and the membrane surrounding it) or polymyelitis ( inflammation of the spinal cord). The symptoms are severe including severe headaches, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis.

Sometimes patients might develop milder symptoms for a couple of days and then have severe symptoms and sometimes patients with severe West Nile disease might have permanent effects. Patients suffering from the West Nile fever have symptoms lasting from a few days to a few weeks and they are gone on their own. Although there are not available medicines to cure this infection, patients have to seek medical advice. People at higher risk are those over 50 years and immunocompromised patients.

As we do not know whether we are going to be infected or not, some preventative measures are:
applying insect repellent, such as Deet 50% to exposed skin, spraying clothes, shoes, bed nets with repellents containing permethrin, using bed nets, wearing long-sleeved shirts and trousers, keeping doors and windows closed, staying indoors at dawn, dusk and night if possible, changing the water in the plant pots and animal bowls quite regurarly.

More information can be found here:
http://www.cdc.gov/ncidod/dvbid/westnile/wnv_factsheet.htm

More information on insect repellents can be found here:
http://www.cdc.gov/ncidod/dvbid/westnile/RepellentUpdates.htm
http://www.cdc.gov/ncidod/dvbid/westnile/qa/prevention.htm

And frequently asked questions here:
http://www.cdc.gov/ncidod/dvbid/westnile/q&a.htm

Info for prevention in Greek:
http://www.travelforall.gr/faq.asp?facid=34

2010-08-11T09:40:00.001-07:00

Somnabulism=Sleepwalking

Dantrolene-Dantrium

2010-08-11T07:59:00.000-07:00

Oral dantrolene is used as a muscle relaxant at a dose of 75mg tds.

It acts peripherally and is better than other muscle relaxants which act on the CNS.

It also used intravenously to treat malignant hyperthermia cause by volatile anaesthetics and suxamethomium.Its chemical synthesis is as follows:

http://basic-clinical-pharmacology.net/chapter%2027_%20skeletal%20muscle%20relaxants_files/image021.gif
http://www.spepharm.com/admin/PageImages/1693.jpg
http://www.chemdrug.com/databases/SYNTHESIS/SYN/11/11245903a.gif

Prescriptions-Colours in England, Ireland, Wales, Isle of Man

2010-07-16T15:20:00.000-07:00

http://www.psnc.org.uk/pages/valid_prescription_forms.html

http://www.psnc.org.uk/pages/methadone_instalment_dispensing.html

http://www.psnc.org.uk/data/files/fp10mda_guidancepublished_version24012007.pdf

NHS FRAUD AWARENESS

2010-07-03T22:50:00.000-07:00

http://www.nhsbsa.nhs.uk/CounterFraud.aspx

Cutaneous Fungal infections

2010-06-03T07:11:00.001-07:00

http://www.medscape.com/features/slideshow/cfi?src=mp&spon=30&uac=129142EJ

ANTIFUNGALS

2010-05-27T06:20:00.001-07:00

http://basic-clinical-pharmacology.net/chapter%2048_%20antifungal%20agents_files/image011.gif

Mouse Party- How drugs of abuse work?

2010-05-27T06:17:00.000-07:00

http://learn.genetics.utah.edu/content/addiction/drugs/mouse.html

Spray drying

2010-05-24T03:23:00.000-07:00

http://www.spraydrysys.com/spray-dryers/spray-dryers.htm

Freeze drying

2010-05-24T03:02:00.000-07:00

http://www.freezedryinginfo.com/

Gene Therapy

2010-05-23T15:18:00.000-07:00

http://learn.genetics.utah.edu/content/tech/genetherapy/gtapproaches/

TNP

2010-05-23T03:17:00.000-07:00

Posseting vs Gastro-oesophageal reflux disease in Babies

2010-05-23T03:02:00.000-07:00

http://www.childhealth.co.uk/common_childhood_complaints/possetting.php

ROSACEA

2010-05-22T00:46:00.000-07:00

http://www.nlm.nih.gov/medlineplus/ency/imagepages/19686.htm

POMPHOLYX

2010-05-22T00:04:00.000-07:00

It is a type of ezcema that usually appears in the hands or feet. Its cause is unknown, but it is thought to be linked to stress, a reaction to neomycin or an irritation from perfumes, chemicals, metals.

http://www.patient.co.uk/health/Pompholyx.htm

ECZEMA SLIDESHOW

2010-05-19T23:50:00.000-07:00

http://www.medscape.com/features/slideshow/eczema?src=mp&spon=30&uac=129142EJ

Chimeric fusion proteins

2010-05-16T01:12:00.001-07:00

They can bind 2mols of TNFα and prevents rec interaction by steric hindrance.

http://mct.aacrjournals.org/content/6/11/2995/F1.large.jpg

http://www.arthritis.co.za/images/enbrel%20img1E.jpg

monoclonal abs

2010-05-16T01:00:00.001-07:00

http://www.pharmainfo.net/files/images/stories/article_images/Engineered%20Monoclonal%20Antibodies.jpg

http://www.nature.com/nrc/journal/v1/n2/images/nrc1101-118a-i1.gif

Dismutation

2010-05-15T10:15:00.000-07:00

A reaction involving a single substance but producing two products; e.g., two molecules of acetaldehyde may react, producing an oxidation product (acetic acid) and a reduction product (ethyl alcohol).

http://www.mondofacto.com/facts/dictionary?query=dismutation

Hyaluronan

2010-05-15T08:24:00.000-07:00

http://www.nature.com/nm/journal/v11/n11/images/nm1105-1161-F1.jpg

One of the chief components of the extracellular matrix, hyaluronan contributes significantly to cell proliferation and migration, and may also be involved in the progression of some malignant tumors. It is secreted by fibroblasts (synovial in RA)

http://en.wikipedia.org/wiki/Hyaluronan

Solutions

2010-05-13T03:38:00.000-07:00

1.Linctuses (Oral Solutions):
liquid oral prep, used as demulcent, expectorants and sedatives to sooth throat and cough, formulated as viscous sugar solutions
2.Mixtures and solutions:
simple oral preps with dissolved drugs
3.Elixir:
liquid oral prep of potent / unpleasantly-tasting drugs. To mask taste: high sugar/sweetening agents (pediatric elixirs: fruit syrup) levels. Non-aqueous solvents/ solubilising agents.
4.Draught (= shot):
liquid prep. formulated as single dose in a larger volume than normal.
5.Pediatric (elderly, animals) drops:
oral liquid formulation of potent drugs in solution. Accuracy when given by nurse.
6. Gargles and Mouthwashes:
concentrated aqueous solutions, diluted before use.
7. Syrup (=flavoring vehicles):
viscous solution of sugar (sucrose).
8. Spirits:
Volatile solutions of 1/more active drugs in ethanol 96%/dilute ethanol.
9.Oils:
vehicles for fat soluble drugs/vitamins.
10.Juices, Aromatic water, water (potable, distilled, purified)
11. Preservatives:
hard to get good preservatives at a safe, efficient and efficacious level. Syrup over 65% and low pH, chloroform (volatile, loss through plastics, carcinogenic): 1:20dilution, ethanol. parabens.
12.Antioxidants:
non-toxic, non-irritant, effective at low []s, odorless, tasteless, soluble in vehicle, stable.
13. Viscosity enhancers:
improve palatability and ease of pouring.
14. Sweetening agents:
glucose, sucrose, syrups, honey
sorbitol, mannitol, xylitol
sodium&calcium saccharin, aspartame, acesulfate potassium, thaumatin
15.Flavoring agents:
juices (raspberry), extracts (liquorice), spirits (lemon), syrups (blackcurrant), tinctures (ginger), aromatic water (cinnamon)
16.Coloring agents:
non-toxic, non-irritant, compatible
mask unpleasant appearance, color-flavor, identification
17.Galenical preps of crude drugs
concentrated products of natural-origin drugs

maceration (soaking in fluid), percolation (filter), decotation (boiling), digestion (by bac), infusion (pouring)

18.Tinctures:

alcoholic liquids containing low [crude drugs]

maceration, percolation

19.Infusions (~Tea bag):

dilute solutions of readily soluble drugs, made by pouring boiling water on drug, then comminutation (filter through sieve) and maceration.

20.Oxymels:

preps of acetic acid+honey vehicles for crufe drugs

21.Powder mixtures:

simple form of preps for reconstitution (ensure drug evenly dispersed in powder mix by uniform particles)

22.Granules for reconstitution:

granulated preps-more elegant appearance than powders, involves heating, contact with solvents, less dense than powders and may require larger containers.

GMP- Definitions

2010-05-12T03:32:00.000-07:00

GMP stands for Good Manufacturing Practice and cGMP for current good manufacturing practice. It is of the Quality Assurance (QA) and ensures that manufacturing mett the standards. More specifically, it ensures that products are consistently produced and controlled to quality standards appropriate to their intended use.

QA is a wide ranging concept, it covers all matters which influence quality of product and it is defined as the sum of organised arrangements with object of ensuring med. products are of quality for intended use (GMP) and factors outside Orange Guide.

Quality control is GMP sampling, specifications, testing, organisation, documentation, release procedures to ensure the necessary and relevant tests are actually carried out and that materials not released to use or products for sale and supply, until their quality judged satisfactory.

Marketing Authorisation (=Product License)
any UK medicinal product--> PL/MA on packaging
2 basic requirements to gain:
1. Dossier (dif. for new chemical entity vs generic) with evidence on safety, efficacy and quality --> MHRA
2. pharmaceutical manufacturer holds:

Manufacturer's Licence (by MHRA) AKA Manufacture's Authorisation
site inspected by MHRA to ensure safety
GMP certificate (UK contract manuf.), letter of certificate (overseas contract manuf.)

In EU alternative ways to obtain MA. A central registration for the whole EU/ rgistration in one member state and a reciprocal arrangement to allow for a simplified MA in other member states.

FDA, PFSB, TGA, EMEA=MHRA

Orange Guide: Rules and Guidance for Pharmaceutical Manufacturers and Distributors

John Sharp

Prostate cancer- Useful video

2010-05-12T00:53:00.000-07:00

http://news.bbc.co.uk/1/hi/health/8665230.stm

Suppositories

2010-05-09T02:11:00.000-07:00

Lecture 3 - Suppositories

http://www.pharmpedia.com/Suppositories#Problems_in_formulation

Inhalers

2010-05-04T10:04:00.000-07:00

http://www.pharmpedia.com/Courses:Pulmonary_Drug_Delivery/Definition
http://www.pharmpedia.com/Courses:Components_of_aerosol
http://en.wikipedia.org/wiki/Dry_Powder_Inhaler

Targeting HIV-1 Cell Entry

2010-05-03T01:25:00.000-07:00

Engineered zinc fingers designed to span a specific site on the CCR5 gene (TM gene). ZFN-nuclease cleaves DNA, a new gene is inserted, editing and making CD4+cells resistant to HIV-1 infections.

Examples of controlled release

2010-04-30T11:46:00.000-07:00

Implantable devices:

Advantages include: Convenience, compliance, control and commercial, disadvantages surgery is need to be inserted/removed, possibility of failure, potency, reactions with body and commercial (time and money).

they can be used for pain, contraception, diabetes, incontinence, systemic infection, ocular and dental purposes. Contraceptives include rods, vaginal rings and IUD coil. Mirena is a diffusion-contolled DDS for local delivery and it is easily reversible. The coil is removed by pulling the strings of the device. Norplant and Jadelle (newer device where drug and matrix combined) rods involve 6 rods being implanted in the arm.

Intraocular delivery is also possible. Drug can be even inserted under sclera in the back of the eye. It is unpleasant to insert an implant in the eye, but is better than injections. RESISERT (diffusion-controlled delivery) was the first CR device for eye delivery and is used to treat chronic noninfectious uveitis lasts for 30months before removed by taking off the sutures and decreases chances of reoccurance of uveitis. The matrix device has a drug core and a polyvinyl membrane. IVATION INTRAVETREAL IMPLANT (diffusion-controlled DSS) is used for AMD, DME and glaucoma. It looks like a screw, but is tiny compared to a coin. It consists up an erodible polymer and it can stay in the sub-conjuctiva of the eye for around 2 years. MEDIDUR is an device which is injected/dropped at the back of the eye and replaced after 36months, but is currently under phase III clinical trials, VITRASERT lasts for 5-8months and OCUSERT is a device used once weekly instead of 28drops squeezed in the eye.

There is also a Pressure-responsive Intraocular implantable delivery device which works by electronically-controlled pump. It is inserted in the conjuctiva and a reservoir contains the drug. When neccesary an injection of drug is being done to refill the reservoir. The advantage is that instead of injecting the eye, the device is being punched. The device then self-heals and release the drug by repsonding to mechanical force.

Drug-eluting stents (diffusion or chemically controlled release) which is an artificial 'tube' inserted into a natural passage/conduit in the body to prevent, or counteract, a disease-induced, localized flow constriction (stenosis of blood vessels). Restenosis (amount of cells reinfiltered after stent loss) limits effectiveniness though. Used to deliver cytotoxic drug such as Paciltaxel.

Examples of osmotic delivery devices include: DUROS, a catheter direct drug specifically to 1 point protected by body all time. The drug is pushed out of the orifices by a semi-permeable membrane.

Examples of degradable devices include: DURIN (chemically-controlled DDS, drug and rate-limiting polymer mixed into fibre, rod or tablet), GLIADEL wafers used in the treatment of malignant gliomas.

Mechanical pumps are also available. An example is the one to control insulin release. It monitors glucose, transmits reading to pump and secrete insulin. There is also an implantable pump controlled by the phycisian. It is implanted every 3 months and contains 6000units of insulin. However, if pump fails, it will cause trouble to patients.

There are also mechanical pumps for intrathecal delivery for severe chronic tumour pain management with morphine sulphate.

Lastly, in the future, Micro-scale delivery will be feasible. In a microfibrated osmotic engine, water flow increases and pushes balloon upwards to the hole to be released and delivered to patients. Osmotic agent pushes drug dwon. The size of the device is tiny with V capacity of microL, so drug needs to be potent!

Controlled release microchip: a metal mould with conical holds with sealing top with erodible. Underneath insoluble polymer sealing. Only way drug escape is through top. Each hole can be filled with different polymers to give a pulsatile effect. It works via erosion and PLGA tailors the rate of erosion, by changing the lactic acid, hydrophobicity and MR (methyl groups) is increased, making it harder to degrade as opposed to the hydrophilic glycolic acid.

Controlled delivery devices

2010-04-30T08:46:00.000-07:00

Controlled dlievery systems are preparations designed in such a way that they release rate or location of active drug is controlled. They are needed to reduce fluctuations in [plasma] (imp. For reducing side effects of narrow therapeutic window drugs), reduce dosing frequency (imp. for patient compliance), control delivery site (colon) for optimum activity and timed release the drug (e.g. pulsatile action for hormones or angina).

There are four main mechanisms for controlling Drug Release.

The first one is Diffusion-control DDS. When diffusion takes place through a non-porous or micro-porous membrane and water-insoluble polymers coat the drug core [(s)/(l)], the device is called Reservoir and the drug goes in solution when in aqueous environment. Monolithic devices is the second type of diffusion-control DDS. Diffusion takes place through bulk water-insoluble polymer, when water penetrates, drug in solution diffuses. The drug is dissolved in polymer solution prior to device formation and dispersed throughout the device. This tends to be used for implantable devices.

The second type of CDDS is Chemically-controlled ones, where diffusion is similar to the matrix monolithic device. Drug is dissolved in (natural or synthetic and water-soluble or water degradable) polymer solution prior to device formation and is released as the polymer matrix breaks down. Predominantly for long-term implantation. There are two subtypes: monolithic devices, where either pure polymer erodes (surface erosion, decreasing ph, increases autocatalytic degradation of polymer backbone by acid addition or SAVIT delivery technology where coating is non-erodible and active erodible matrix erodes at both ends) or combination of erosion and diffusion takes place (bulk erosion, PLGA is commonly used and FDA approved). Multiple drug can be delivered at specific times and locations through the CHRONOP delivery technology and alternative pulsative release is also possible, when at fixed time drug will erode from inside. This is particularly useful for prolonged GIT absorption. The second subtype is Pendant systems where hydrolysis pendant group to break it free and be released from the backbone and diffusion of bulk polymer takes place. The rate of release depends on the hydrolysis of ester. Also in the HLB ratio. The more hydrophobic functional groups of polymer, the more slow release rate.

The third type is Water penetration- controlled DSS. The drug is being delivered through osmosis (Water transport through semipermeable membrane to form concentration solution inside, drug is pushed out through the hole) or swelling (water penetration into glossy polymer). Osmosis can be direct or indirect and more controlled, depending on the needs. An example of an osmotic device is OROS which provides CR for 24hrs, can be used for high doses of poorly and highly soluble drugs and improve bioavailability. It has been used to improve PK profile of oxybutin. Swelling controlled devices is affected by polymer structure (physichochemical properties, x-linking), hydrophobicity (polymer and drug contribute) and drug (concentration). The more concentrated, the greater gradient outside and inside. The more hydrophilic (pectin), water enters in rapidly and increases swelling, hydrophobic compounds (HPMC) decrease swelling rate. Mixture of hydroxypropyl and methyl controls swelling rate. There are also devices that can control rate by erosion, swelling and diffusion. Properties of gel can also be tailored by LBG (nice, straight polymer):Xanthan (helical polymer stabilises H-bonding) ratio. When gel formulation is wetted, water ingress allows drug to diffuse out gel. GEMINEX delivery technology combines two drugs together in a bilayer with a unique release profile. By altering polymer properties we can change where and how quickly drug is released. Distance betwee polymer chains is also important when high amylose starch is being used in formulations, such as CONTRAMID. It is safe, compressible, biogegredable, can be chemically x-linked, has a high drug capacity, fexible release profiles and can release multiple drugs. There are more complex systems to, such as GEOMATRIX. It has a hydrophilic HPMC core with drug in it, changing the properties alter parameters of device and tailored released depends on drug barrier. Both layers can expands or it can swell thinly. Water penetration controlled DSS working by swelling are capable of 0 order, quick slow, slow-quick, binary, positioned, acce;erated, delayed and pulsatile release. Burst can also take place in the swelling mechanism and the thicker the membrane, the slower the release. Alginate is an example of a polysaccharide working in this way.

The fourth and last type of DSS is responsive DSS. Drug release can be controlled by temperature (some polymers undergo a sol-gel transition upon a temp. change), ph (changes in ionisation or cleavage of functional groups due to altered ph can affect sol-gel behaviour, drugs can be loeaded in acidic branched polymers and by repleiing drug can go out), chemicals, enzymes (GIT lots of bac. espesh in colon have enzymes that can be used in delivery systems and an increased drug plasma concentration is being observed as the drug is released by degrading enzymes), ultrasound, magnetism, light, mechanical force (disrupts matrix by compression, sqeezing drug out and allowing it to be released) and IR radiation (insulin released from nanoparticles).

Reflecting on aseptic practical

2010-04-30T08:32:00.000-07:00

I have concluded that maybe it is better and safer for patients and me to work as a community pharmacist. Aseptic practical today was really useful to understand what can go wrong in the preparation of these products and how to handle syringes, which is different learning all these information theoretically or watching a youtube video from being in a lab preparing a injection product. I think that in my practical several things went wrong and I have actually realised how precise and responsible technicians and clinical pharmacists should be when dealing with such preparations. Also, through the practical, I have realised that I am actually needlephobic. :S Lastly, I have reflected on the option of doing a pre-registration in hospital and I have concluded that however interesting hospital pharmacy may be, I would enjoy more dealing with all the community health care cases and the business, management and marketing side of pharmacy. I like business&management anyway. I am finally more orientated on my final goal and the future carrer outcome of my degree.

THE SEVEN PRINCIPLES

2010-04-22T11:14:00.000-07:00

1. MAKE THE CARE OF PATIENTS YOUR FIRST CONCERN
2. EXERCISE YOUR PROFESSIONAL JUDGEMENT IN THE INTERESTS OF
PATIENTS AND THE PUBLIC
3. SHOW RESPECT FOR OTHERS
4. ENCOURAGE PATIENTS TO PARTICIPATE IN DECISIONS ABOUT THEIR CARE
5. DEVELOP YOUR PROFESSIONAL KNOWLEDGE AND COMPETENCE
6. BE HONEST AND TRUSTWORTHY
7. TAKE RESPONSIBILITY FOR YOUR WORKING PRACTICES

Emulsions

2010-04-19T06:44:00.001-07:00

http://www.pharmpedia.com/Emulsions

10 Diet Commandments for Pain Patients

2010-04-18T08:44:00.001-07:00

ttp://health.msn.com/health-topics/pain-management/fibromyalgia/slideshow.aspx?cp-documentid=100246652&imageindex=1

Affinity vs Avidity in Immunology

2010-04-12T07:55:00.001-07:00

http://science.kukuchew.com/2008/05/08/affinity-and-avidity/

Xanthomas

2010-04-12T06:53:00.000-07:00

I was reading through a msn article today on cholesterol. You can find here: http://health.msn.com/health-topics/cholesterol/articlepage.aspx?cp-documentid=100252282&page=1&gt1=31007 and I didn't know what xanthomas are, so I have decided to check the term out.

Xanthomas are fat deposits found under the skin and it looks pretty much like this:

More information and pictures can be found in medline plus link:

http://www.nlm.nih.gov/medlineplus/ency/article/001447.htm

Additional reader

2010-03-31T04:29:00.000-07:00

I have just noticed that this blog has 2 readers and I am quite happy and impressed about it! The texts/ videos in here are not mine, they are just a collection of resources that I find in the process of learning! I think that blogging is a great way of applying CPD cycles and it is a really handy way of tracing what one has learned and remind themselves what they have learned and are supposed to know. At least that is how it works for me. I also hope to write something on my own one day and not just have a collection of links and texts written by others. In any case, I hope you find this blog useful.

Special Containers&Calendar Packs

2010-03-20T08:58:00.000-07:00

http://www.psnc.org.uk/pages/special_container_calendar_pack_database.html

bristol paediatric cardiac surgery unit inquiry

2010-03-19T13:27:00.000-07:00

http://news.bbc.co.uk/1/hi/health/background_briefings/the_bristol_heart_babies/304026.stm

Harold Shipman

2010-03-19T09:34:00.000-07:00

MIchael Neary

2010-03-19T09:13:00.000-07:00

Michael Neary is a retired Irish consultant obstetrician/gynecologist. He gained notoriety when it was discovered that he had performed what was considered an inordinate number of caesarian hysterectomies during his time at Our Lady of Lourdes Hospital in Drogheda, County Louth. He was suspended by the Irish Medical Council in 1999 pending their investigations, and then struck off the Register of Medical Practitioners in 2003. As a result of the Medical Council's investigation, which discovered a number of alarming aspects to the case, an inquiry was set up in April 2004 by the then Minister for Health and Children, Micheál Martin to investigate the matter. Their report was made public by the Tánaiste, and Minister for Health Mary Harney in February 2006. The Lourdes Hospital Inquiry report was written by Judge Maureen Harding-Clarke, a prominent Irish judge. She and her team interviewed Dr Neary himself, most hospital staff in Drogheda and various action groups and patients.

During the inquiry, Judge Harding-Clarke's offices were broken into at least three times, she has said.

Her report repeated many findings of the Medical Council's investigation (which she criticised for taking too long), but delved much deeper into Dr Neary's actions, and those of his colleagues.

http://en.wikipedia.org/wiki/Michael_Neary_(surgeon)

http://www.rte.ie/tv/whistleblower/index.html