• 【泊沙康唑用于预防急性髓样白血病患者在转换为片剂之前和之后的侵袭性真菌感染的目标药物水平获得的回顾性分析。】 复制标题 收藏 收藏
    DOI:10.1177/1078155217722405 复制DOI
    作者列表:Liebenstein TK,Widmer KM,Fallon MJ
    BACKGROUND & AIMS: BACKGROUND:Posaconazole is approved for invasive fungal infection prophylaxis in patients with hematologic malignancies. Posaconazole suspension is plagued by poor oral absorption and dietary requirements that are difficult for patients to meet. The delayed-release tablet formulation of posaconazole may be taken without regards to meals and has significantly better oral absorption than posaconazole suspension. OBJECTIVES:We sought to determine if a switch to posaconazole tablets improved steady-state drug level attainment for invasive fungal infection prophylaxis in patients with acute myeloid leukemia. METHODS:All adult inpatients with acute myeloid leukemia undergoing chemotherapy, who received posaconazole for invasive fungal infection prophylaxis between 2012 and 2015, were included. The primary outcome was proportion of patients with first posaconazole level greater than 700 ng/mL. Secondary outcomes included proportion of patients with first posaconazole level greater than 1000 ng/mL, invasive fungal infection within 100 days, and adverse drug events. RESULTS:Forty patients received posaconazole tablets and 34 patients received suspension. Posaconazole levels were significantly higher at first measurement in patients receiving tablet than suspension (1296 ng/mL vs. 788 ng/mL, p < 0.01). Thirty-seven patients receiving tablets had a serum drug level greater than 700 ng/mL on first measurement versus 18 receiving suspension (p < 0.01). Patients receiving tablets were also more likely to have a serum drug level over 1000 ng/mL on first measurement (26 vs. 11, p < 0.01). Rates of invasive fungal infection and adverse events were not statistically different. CONCLUSIONS:Patients receiving posaconazole tablets attained significantly higher serum drug levels than those receiving suspension.
    背景与目标: 背景:泊沙康唑被批准用于血液系统恶性肿瘤患者的侵入性真菌感染预防。泊沙康唑悬浮液的口服吸收不良和饮食需求使患者难以满足。泊沙康唑的缓释片剂可在不考虑进餐的情况下服用,并且口服吸收比泊沙康唑悬浮液要好得多。
    目的:我们试图确定使用泊沙康唑片是否可以改善预防急性髓性白血病患者侵袭性真菌感染的稳态药物水平。
    方法:纳入2012年至2015年期间接受泊沙康唑预防侵入性真菌感染的所有接受化疗的急性髓性白血病成人患者。主要结局是首次泊沙康唑水平高于700μng/ mL的患者比例。次要结果包括首次泊沙康唑水平大于1000µng / mL,100天内侵袭性真菌感染以及药物不良反应的患者比例。
    结果:40例患者接受泊沙康唑片治疗; 34例患者接受悬浮液治疗。首次接受片剂的患者中,泊沙康唑的水平明显高于混悬液(1296 ng / mL vs. 788 ng / mL,p <0.01)。初次测量时有37例接受片剂治疗的患者血清药物水平高于700μng/ mL,而接受悬浮液的有18例患者(p <0.01)。首次服用片剂的患者血清药物水平也更有可能超过1000μng/ mL(26 vs. 11,p <0.01)。侵袭性真菌感染和不良事件的发生率在统计学上没有差异。
    结论:接受泊沙康唑片剂的患者血清药物水平明显高于接受悬浮液治疗的患者。
  • 【强化舌头训练结合平板电脑个人电脑游戏对健康成年人的影响。】 复制标题 收藏 收藏
    DOI:10.1111/joor.12944 复制DOI
    作者列表:Hwang NK,Kim MJ,Lee G,Yoon T,Park JS,Jung Y
    BACKGROUND & AIMS: BACKGROUND:Game-based training has been shown to improve behavioural motor learning in various medical fields including rehabilitation. OBJECTIVES:This study aimed to investigate the effects of a tablet PC (personal computer) game-based tongue training on tongue strength, thickness and compliance in healthy adults. METHODS:This study recruited 30 healthy volunteers. Subjects were randomly assigned to two groups (n = 15/group). Group 1 performed game-based tongue training, and group 2 performed tongue resistance training using the Iowa Oral Performance Instrument. Both groups performed the same tongue exercises as follows: frequency (isotonic = 30 times × 3, isometric = 20 seconds × 3), intensity (70% of 1-repeated maximum contraction) and intervention period (5 days for 6 weeks). The primary outcomes were tongue muscle strength and thickness. Secondary outcomes were assessed using a 0-to-10 numerical rating self-report scale that included motivation, interest/fun, physical effort and muscle fatigue/pain. RESULTS:Both groups showed significant improvement in tongue strength and thickness, but there were no significant differences between the groups after the intervention. The self-report scale numerical rating revealed that group 1 had significantly higher motivation and interest/fun after the exercise than group 2. Group 1 had expended a significantly lower physical effort than group 2. No significant differences were noted between the 2 groups for muscle fatigue/pain. CONCLUSION:This study showed that both exercises had similar effects on tongue strength and thickness increase in healthy adults, but game-based tongue training was more fun and physically less demanding.
    背景与目标: 背景:基于游戏的训练已被证明可以改善包括康复在内的各个医学领域的行为运动学习。
    目的:本研究旨在研究基于平板电脑(个人计算机)游戏的舌头训练对健康成年人舌头力量,厚度和顺应性的影响。
    方法:本研究招募了30名健康志愿者。将受试者随机分为两组(n = 15 /组)。第一组进行基于游戏的舌头训练,第二组使用爱荷华州口腔表演仪进行舌头抵抗训练。两组进行以下相同的舌头练习:频率(等渗= 30次×3,等距= 20秒×3),强度(1次重复最大收缩的70%)和干预期(5天,共6周)。主要结局是舌头肌肉的力量和粗细。次要结局使用0到10的数字自我评估量表进行评估,该量表包括动机,兴趣/乐趣,体力劳动和肌肉疲劳/疼痛。
    结果:两组患者的舌头力量和粗细程度均有显着改善,但干预后两组之间无显着差异。自我报告量表的数字评分显示,锻炼后的第1组的动机和兴趣/乐趣明显高于第2组。第1组的体力消耗明显低于第2组。两组的肌肉无明显差异。疲劳/疼痛。
    结论:这项研究表明,两种锻炼对健康成年人的舌头力量和厚度增加都具有相似的效果,但基于游戏的舌头训练更有趣,对身体的要求也更低。
  • 【包含无定形碱化替米沙坦的聚合物固体分散体的片剂配方。】 复制标题 收藏 收藏
    DOI:10.1208/s12249-018-1124-y 复制DOI
    作者列表:Chae JS,Chae BR,Shin DJ,Goo YT,Lee ES,Yoon HY,Kim CH,Choi YW
    BACKGROUND & AIMS: :To overcome the poor dissolution of telmisartan (TMS) at weak acidic pH, amorphous alkalinized TMS (AAT) was prepared by introducing sodium hydroxide as a selective alkalizer. AAT-containing polymeric solid dispersions were prepared by a solvent evaporation method; these solid dispersions were AAT-PEG, AAT-PVP, AAT-POL, and AAT-SOL for the polymers of PEG 6000, PVP K30, Poloxamer 407, and Soluplus, respectively. The characteristics of the different formulations were observed by differential scanning calorimetry, powder X-ray diffraction, Fourier transform infrared spectroscopy, and scanning electron microscopy. To compare the supersaturation behavior, a dissolution test was performed at 37 ± 0.5 °C either in 900 ml (plain condition) or 500 ml (limited condition) of pH 6.8-simulated intestinal fluid used as a medium. AAT-SOL exhibited enhanced dissolution, indicating the probability of extended supersaturation in the limited condition. AAT-SOL was further formulated into a tablet by introducing other excipients, Vivapur 105 and Croscarmellose, as a binder and superdisintegrant, respectively, using a direct compression method. The selected AAT-SOL tablet was superior to Micardis (the reference product) in the aspect of supersaturation maintenance during dissolution in the limited condition, suggesting that it is a promising candidate for practical development that can replace the commercial product in the future.
    背景与目标: :为克服替米沙坦(TMS)在弱酸性pH下的不良溶解,通过引入氢氧化钠作为选择性碱化剂来制备无定形碱化TMS(AAT)。含AAT的聚合物固体分散体是通过溶剂蒸发法制备的。这些固体分散体分别是PEG 6000,PVP K30,泊洛沙姆407和Soluplus的聚合物的AAT-PEG,AAT-PVP,AAT-POL和AAT-SOL。通过差示扫描量热法,粉末X射线衍射,傅里叶变换红外光谱和扫描电子显微镜观察了不同制剂的特性。为了比较过饱和行为,在37±0.5°C的900毫升(纯条件)或500毫升(有限条件)的pH 6.8模拟肠液作为介质中进行了溶出度测试。 AAT-SOL表现出增强的溶解性,表明在有限条件下扩展过饱和的可能性。通过使用直接压片法分别引入其他赋形剂Vivapur 105和Croscarmellose,分别将AAT-SOL和AVI-SOL分别制成粘合剂和超崩解剂,制成片剂。所选的AAT-SOL片剂在有限条件下溶解过程中的过饱和维持方面优于Micardis(参考产品),这表明它是可以在将来替代商业产品的实际开发中有希望的候选者。
  • 【Simparica Trio™(一种含有sarolaner,moxidectin和pyrantel的新型咀嚼片)对犬中钩虫感染的功效。】 复制标题 收藏 收藏
    DOI:10.1186/s13071-020-3951-4 复制DOI
    作者列表:Becskei C,Thys M,Kryda K,Meyer L,Martorell S,Geurden T,Dreesen L,Fernandes T,Mahabir SP
    BACKGROUND & AIMS: BACKGROUND:Ancylostomatids ('hookworms') are among the most important zoonotic nematode parasites infecting dogs worldwide. Ancylostoma caninum and Uncinaria stenocephala are two of the most common hookworm species that infect dogs. Both immature and adult stages of hookworms are voracious blood feeders and can cause death in young dogs before infection can be detected by routine fecal examination. Hence, treatment of both immature and adult stages of hookworms will decrease the risk of important clinical disease in the dog as well as the environmental contamination caused by egg-laying adults, which should reduce the risk of infection for both dogs and humans. The studies presented here were conducted to evaluate the efficacy of a novel, oral chewable tablet containing sarolaner, moxidectin and pyrantel (Simparica Trio™), against induced larval (L4), immature adult (L5) and adult A. caninum, and adult U. stenocephala infections in dogs. METHODS:Eight negative-controlled, masked, randomized laboratory studies were conducted. Two separate studies were conducted against each of the target parasites and stages. Sixteen or 18 purpose bred dogs, 8 or 9 in each of the two treatment groups, were included in each study. Dogs experimentally infected with the target parasite were dosed once on Day 0 with either placebo tablets or Simparica Trio™ tablets to provide minimum dosages of 1.2 mg/kg sarolaner, 24 µg/kg moxidectin and 5.0 mg/kg pyrantel (as pamoate salt). Timing of dosing relative to parasite inoculation allowed for efficacy to be evaluated primarily against the target parasite stage. Worm counts were conducted 7 or 8 days after treatments during necropsy. Efficacy was based on the number of worms recovered at necropsy compared to placebo control. RESULTS:Based on geometric mean worm counts, efficacy of Simparica Trio™ was ≥ 98.4% against L4 larval stage of A. caninum, ≥ 99.8% against immature adult (L5) A. caninum, and 100% against adult A. caninum and adult U. stenocephala. CONCLUSIONS:These studies confirm the efficacy of a single oral dose of a novel, chewable tablet containing sarolaner, moxidectin and pyrantel (Simparica Trio™) against L4 larval and immature adult (L5) A. caninum, and adult A. caninum and U. stenocephala infections in dogs.
    背景与目标: 背景技术:钩虫(钩虫)是全世界感染犬的最重要的人畜共患线虫寄生虫。犬十二指肠瘤和钩头畸形犬是感染狗的两种最常见的钩虫。钩虫的未成熟阶段和成年阶段都是贪食者,它们可以使幼犬死亡,然后才能通过常规粪便检查发现感染。因此,对钩虫的未成熟阶段和成年阶段的治疗都将降低犬中发生重要临床疾病的风险以及成虫产卵所造成的环境污染,这将降低犬和人的感染风险。此处进行的研究旨在评估含有sarolaner,moxidectin和pyrantel(Simparica Trio™)的新型口服咀嚼片对诱导幼虫(L4),成年幼虫(L5)和成年犬链霉菌以及成年U的功效。狗的头颅感染。
    方法:进行了八项阴性对照,隐蔽,随机实验室研究。针对每个目标寄生虫和阶段进行了两个单独的研究。每项研究均包括16只或18只目的犬,两个治疗组分别为8只或9只。实验上感染目标寄生虫的狗在第0天用安慰剂片剂或Simparica Trio™片剂给药一次,以提供最低剂量1.2毫克/千克sarolaner,24微克/千克莫昔克丁和5.0毫克/千克吡喃酮(作为pamoate盐)。相对于寄生虫接种的给药时间允许主要针对目标寄生虫阶段评估功效。尸检后7或8天进行蠕虫计数。功效是基于尸检时与安慰剂对照相比发现的蠕虫数量。
    结果:基于蠕虫的几何平均数,Simparica Trio™对抗犬链球菌L4幼虫期的效率≥98.4%,针对未成年犬(L5)犬链球菌的≥99.8%,对成年犬链球菌和成虫的功效为100%头颅单胞菌。
    结论:这些研究证实了单次口服的含有sarolaner,moxidectin和pyrantel(Simparica Trio™)的新型可咀嚼片剂对L4幼虫和未成年成年犬L. A. caninum以及成年成年犬A. caninum和U的功效。狗的头颅感染。
  • 【病人报告的地拉莫司薄膜衣片对输血依赖性贫血患者的随机II期研究结果。】 复制标题 收藏 收藏
    DOI:10.1186/s12955-018-1041-5 复制DOI
    作者列表:Taher AT,Origa R,Perrotta S,Kouraklis A,Ruffo GB,Kattamis A,Goh AS,Huang V,Zia A,Herranz RM,Porter JB
    BACKGROUND & AIMS: BACKGROUND:Adherence to long-term chelation therapy in transfusion-dependent patients is critical to prevent iron overload-related complications. Once-daily deferasirox dispersible tablets (DT) have proven long-term efficacy and safety in patients ≥2 years old with chronic transfusional iron overload. However, barriers to optimal adherence remain, including palatability, preparation time, and requirements for fasting state. A new film-coated tablet (FCT) formulation was developed, swallowed once daily (whole/crushed) with/without a light meal. METHODS:The open-label, Phase II ECLIPSE study evaluated patient-reported outcomes (PROs) in transfusion-dependent thalassemia or lower-risk myelodysplastic syndromes patients randomized 1:1 to receive deferasirox DT or FCT over 24 weeks as a secondary outcome of the study. Three PRO questionnaires were developed to evaluate both deferasirox formulations: 1) Modified Satisfaction with Iron Chelation Therapy Questionnaire; 2) Palatability Questionnaire; 3) Gastrointestinal (GI) Symptom Diary. RESULTS:One hundred seventy three patients were enrolled; 87 received the FCT and 86 the DT formulation. FCT recipients consistently reported better adherence (easier to take medication, less bothered by time to prepare medication and waiting time before eating), greater satisfaction/preference (general satisfaction and with administration of medicine), and fewer concerns (less worry about not swallowing enough medication, fewer limitations in daily activities, less concern about side effects). FCT recipients reported no taste or aftertaste and could swallow all their medicine with an acceptable amount of liquid. GI summary scores were low for both formulations. CONCLUSIONS:These findings suggest a preference in favor of the deferasirox FCT formulation regardless of underlying disease or age group. Better patient satisfaction and adherence to chelation therapy may reduce iron overload-related complications. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT02125877; registered April 26, 2014.
    背景与目标: 背景:输血依赖型患者坚持长期螯合治疗对预防铁超载相关并发症至关重要。已证明每日一次地拉罗司分散片(DT)对于≥2岁的慢性输血铁超负荷患者具有长期疗效和安全性。但是,仍然存在妨碍最佳依从性的障碍,包括适口性,准备时间和对禁食状态的要求。开发了一种新的薄膜包衣片剂(FCT)制剂,每天(整顿或压碎)吞咽一次(含/不含便餐)。
    方法:开放标签的II期ECLIPSE研究评估了输血依赖性地中海贫血或低危骨髓增生异常综合症患者的患者报告结局(PRO),这些患者在24周内按1:1的比例接受了Deferasirox DT或FCT作为继发性转归学习。开发了三份PRO问卷以评估两种Deferasirox制剂:1)对铁螯合疗法问卷的改良满意度; 2)可口性问卷; 3)胃肠道(GI)症状日记。
    结果:173例患者入选。 87架接受了FCT,86架采用了DT配方。 FCT接受者持续报告出更好的依从性(更容易服药,更少的时间来准备药物和就餐前的等待时间),更高的满意度/偏好(总体满意度和药物管理)以及更少的担忧(更少担心没吞下足够的东西)药物治疗,日常活动限制较少,对副作用的担忧较少)。 FCT接收者报告没有味道或余味,可以用可接受量的液体吞服所有药物。两种配方的胃肠道摘要分数均较低。
    结论:这些发现表明,无论基础疾病或年龄组如何,都倾向于使用地拉罗司FCT制剂。更好的患者满意度和对螯合疗法的依从性可以减少铁过载相关的并发症。
    试用注册:ClinicalTrials.gov标识符:NCT02125877;于2014年4月26日注册。
  • 【在数字平板电脑上阅读时的认知参与:来自同时记录的姿势和眼球运动的证据。】 复制标题 收藏 收藏
    DOI:10.1177/1747021820931830 复制DOI
    作者列表:Ballenghein U,Kaakinen JK,Tissier G,Baccino T
    BACKGROUND & AIMS: :The present study utilised a novel combination of eye movement and motion capture recordings to examine cognitive engagement during reading on a hand-held tablet computer. Participants read a multiple-page text with a specific task in mind and after reading recalled the main contents of text from memory. The results showed that head distance from screen was slightly shorter, and readers spent longer time reading task-relevant than irrelevant segments of text and had better memory for task-relevant than irrelevant text information, indicating that there are task-induced momentary changes in engagement during reading. Moreover, head motion and individual fixation durations decreased during the course of reading of relevant segments, and even though there was an overall increase in table motion during reading, the slope of this increase was steeper for irrelevant than relevant text segments. These results suggest that readers become more engaged with relevant and less engaged with irrelevant text segments across the text. The novel methodological combination of eye and postural movements seems to provide valuable information about cognitive engagement during reading in digital environments. The cumulation of evidence from this and previous studies suggests that reading on a tablet affords different interactions between the reader and the text than reading on a computer screen. Reading on a tablet might be more similar to reading on paper, and this may impact the attentional processes during reading.
    背景与目标: :本研究利用眼睛运动和动作捕捉记录的新颖组合来检查在手持平板电脑上阅读时的认知参与度。参与者阅读多页文本时要牢记特定的任务,阅读后会从内存中调出文本的主要内容。结果显示,距屏幕的头部距离略短,并且与无关的文本段相比,读者花更长的时间阅读与任务相关的内容,并且与无关的文本信息相比,与任务相关的内容的记忆性更好,表明存在因任务而引起的瞬时变化在阅读过程中。而且,在阅读相关节段的过程中头部运动和个人注视的持续时间减少了,即使在阅读过程中桌子运动总体上有所增加,但与相关的文本节段相比,无关紧要的这种增加的斜率也更陡峭。这些结果表明,读者对文本的相关性越来越高,而对文本中无关紧要的文本则越不感兴趣。眼睛和姿势运动的新颖方法组合似乎为数字环境下阅读过程中的认知参与提供了有价值的信息。来自本研究和先前研究的证据表明,在平板电脑上阅读与在计算机屏幕上阅读相比,在阅读器和文本之间提供了不同的交互。在平板电脑上阅读可能与在纸上阅读更相似,并且这可能会影响阅读过程中的注意力过程。
  • 【压片对多药耐药结核病治疗中药物暴露的影响。】 复制标题 收藏 收藏
    DOI:10.5588/ijtld.18.0775 复制DOI
    作者列表:Court R,Chirehwa MT,Wiesner L,de Vries N,Harding J,Gumbo T,Maartens G,McIlleron H
    BACKGROUND & AIMS: :SETTING: Treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) are poor. Due to drug toxicity and a long treatment duration, approximately half of patients are treated successfully. Medication is often crushed for patients who have difficulty swallowing whole tablets. Whether crushing tablets affects drug exposure in MDR-TB treatment is not known.OBJECTIVE AND DESIGN: We performed a sequential pharmacokinetic study in patients aged >18 years on MDR-TB treatment at two hospitals in Cape Town, South Africa. We compared the bioavailability of pyrazinamide, moxifloxacin, isoniazid (INH), ethambutol and terizidone when the tablets were crushed and mixed with water before administration vs. swallowed whole. We sampled blood at six time points over 10 h under each condition separated by 2 weeks. Non-compartmental analysis was used to derive the key pharmacokinetic measurements.RESULTS: Twenty participants completed the study: 15 were men, and the median age was 31.5 years. There was a 42% reduction in the area under the curve AUC0-10 of INH when the tablets were crushed compared with whole tablets (geometric mean ratio 58%; 90%CI 47-73). Crushing tablets of pyrazinamide, moxifloxacin, ethambutol and terizidone did not affect the bioavailability significantly.CONCLUSION: We recommend that crushing of INH tablets in the MDR-TB treatment regimen be avoided. Paediatric INH formulations may be a viable alternative if the crushing of INH tablets is indicated.
    背景与目标: 地点:耐多药结核病(MDR-TB)的治疗效果不佳。由于药物毒性和较长的治疗持续时间,约有一半的患者得到了成功的治疗。对于吞咽整片药物有困难的患者,通常会压服药物。目的:我们在南非开普敦的两家医院对年龄> 18岁的患者进行了耐多药结核病治疗的序贯药代动力学研究。我们比较了将吡嗪酰胺,莫西沙星,异烟肼(INH),乙胺丁醇和特立西酮在给药前压碎并与水混合后的生物利用度与吞咽的整体生物利用度。在间隔2周的每种情况下,我们在10小时内的六个时间点对血液进行了采样。结果:二十名参与者完成了这项研究:15名男性,中位年龄为31.5岁。与整粒片剂相比,当将片剂压碎时,INH曲线AUC0-10下的面积减少了42%(几何平均比率58%; 90%CI 47-73)。吡嗪酰胺,莫西沙星,乙胺丁醇和特立西酮的压片对生物利用度没有显着影响。结论:我们建议避免在耐多药结核病治疗方案中压碎INH片。如果需要将INH片剂压碎,则小儿INH制剂可能是可行的选择。
  • 【通过压制包衣制备延迟释放片剂剂型:包衣材料对茶碱释放的影响。】 复制标题 收藏 收藏
    DOI:10.3109/10837450903188519 复制DOI
    作者列表:El-Malah Y,Nazzal S
    BACKGROUND & AIMS: :In this study, compression-coated tablets were prepared and examined by real-time swelling/erosion analysis and dissolution studies. Of the coating materials, PVP showed no swelling behavior and had no impact on theophylline release. Polyox(®) exhibited swelling behavior of an entangled polymer, which was reflected in its > 14-hour delayed-release profile. Hydroxypropyl methylcellulose (HPMC), which revealed the characteristics of a disentangled polymer, caused a 2-h delay in theophylline release. Based on preliminary texture analysis data, Polyox(®)/PVP blends were used as coating materials to manipulate the onset of drug release from the compression-coated tablets. Of the blends, at a 1:1 ratio, for example, resulted in a burst release after 10 h, which demonstrated the feasibility of preparing delayed release dosage forms by compression coating. Furthermore, it was feasible to predict the dissolution behavior of polymers from their swelling/erosion data, which were generated from texture analysis.
    背景与目标: :在这项研究中,制备了压缩包衣片剂,并通过实时溶胀/侵蚀分析和溶出度研究进行了检查。在包衣材料中,PVP没有显示溶胀行为,对茶碱的释放没有影响。 Polyox®表现出缠结聚合物的溶胀行为,这反映在其> 14小时的延迟释放曲线中。羟丙基甲基纤维素(HPMC)揭示了缠结聚合物的特性,导致茶碱释放延迟了2小时。基于初步的质地分析数据,将Polyox®/ PVP掺合物用作包衣材料,以控制药物从压制包衣片中释放的开始。在这些混合物中,例如以1:1的比例导致10小时后爆发释放,这证明了通过压制包衣制备延迟释放剂型的可行性。此外,从由结构分析产生的溶胀/侵蚀数据预测聚合物的溶解行为是可行的。
  • 【从肠溶性硫酸亚铁片剂中吸收的部分铁。】 复制标题 收藏 收藏
    DOI:10.4103/ijmr.IJMR_1464_18 复制DOI
    作者列表:Thankachan P,Bose B,Subramanian R,Koneri R,Kurpad AV
    BACKGROUND & AIMS: Background & objectives:Iron supplementation is widely used public health measure to manage iron deficiency anaemia. In India, enteric-coated iron tablets are administered to adolescent boys and girls to avoid adverse effects such as gastritis, which reduces compliance, but this may result in poor iron absorption. Data on the absorption of iron from enteric-coated ferrous sulphate tablets are lacking. The present study using stable isotopic approach was aimed to measure iron absorption in iron deficient women. Methods:Iron absorption was measured from stable isotope-labelled enteric-coated ferrous sulphate ([57]Fe, ECFS) and uncoated ferrous sulphate ([58]Fe, UCFS) tablets in iron-deficient (n=9) women, aged 18-40 yr with no infection or inflammation. The two types of tablets (ECFS and UCFS) were administered on consecutive days, 60 min after breakfast, and the sequence being random. Blood samples were collected before dosing, and on day 15, to measure iron absorption from the shift in iron isotopic ratios in haemoglobin. Results:Eight women completed the iron absorption study. Iron absorption was found to be significantly lower in ECFS compared to UCFS (3.5 vs. 12%, P <0.05) consumption. Interpretation & conclusions:Our study showed poor iron bioavailability from ECFS, and supplementation programmes may consider UCFS tablets for better haematological outcomes.
    背景与目标: 背景与目的:补铁被广泛用于控制缺铁性贫血的公共卫生措施。在印度,对青少年男孩和女孩服用肠溶铁片可避免诸如胃炎等不良反应,这会降低依从性,但这可能会导致铁吸收不良。缺乏从肠溶性硫酸亚铁片剂中吸收铁的数据。目前使用稳定同位素方法的研究旨在测量缺铁妇女的铁吸收。
    方法:在年龄为18岁的缺铁女性中,采用稳定同位素标记的肠溶性硫酸亚铁([57] Fe,ECFS)和未涂覆的硫酸亚铁([58] Fe,UCFS)片剂测量铁的吸收。 -40年,无感染或发炎。早餐后60分钟连续两天服用两种类型的片剂(ECFS和UCFS),顺序是随机的。在给药前和第15天收集血样,以从血红蛋白中铁同位素比的变化来测量铁吸收。
    结果:八名妇女完成了铁吸收研究。与UCFS消耗量相比,ECFS中的铁吸收量显着降低(3.5%vs. 12%,P <0.05)。
    解释与结论:我们的研究表明ECFS的铁生物利用度较差,补充计划可能会考虑使用UCFS片剂来获得更好的血液学结果。
  • 【通过高压均质原纤化纤维素:易分散膜的分析和应用。】 复制标题 收藏 收藏
    DOI:10.1208/s12249-019-1593-7 复制DOI
    作者列表:Lenhart V,Quodbach J,Kleinebudde P
    BACKGROUND & AIMS: :Powdered cellulose (PC) and microcrystalline cellulose (MCC) are common excipients in pharmaceuticals. Recent investigations imply that particle size is the most critical parameter for the different performance in many processes. High-pressure homogenization (HPH) was used to reduce fiber size of both grades. The effect of the homogenization parameters on suspension viscosity, particle size, and mechanical properties of casted films was investigated. PC suspensions showed higher apparent viscosities and yield stresses under the same process conditions than MCC. SLS reduced shear viscosity and thixotropic behavior of both cellulose grades probably due to increased electrostatic repulsion. Homogenization reduced cellulose particle sizes, but re-agglomeration was too strong to analyze the particle size correctly. MCC films showed a tensile strength of up to 16.0 MPa and PC films up to 4.1 MPa. PC films disintegrated within 30 s whereas MCC films did not. Mixtures of MCC and PC led to more stable films than PC alone, but these films did not disintegrate anymore. Diclofenac sodium was incorporated in therapeutic dose with drug load of 47% into orodispersible PC films. The content uniformity of these films fulfilled requirements of Ph.Eur and the films disintegrated in 12 s. In summary, PC and MCC showed comparable results after HPH and most differences could be explained by the smaller particle size of MCC suspensions. These results confirm the hypothesis that mainly the fiber size during processing is responsible for the existing differences of MCC and PC in pharmaceutical process, e.g., wet-extrusion/spheronization.
    背景与目标: :粉状纤维素(PC)和微晶纤维素(MCC)是药物中的常见赋形剂。最近的研究表明,粒径是许多工艺中不同性能的最关键参数。高压均质化(HPH)用于减小两种等级的纤维尺寸。研究了均质化参数对流延膜的悬浮液粘度,粒度和机械性能的影响。与MCC相比,在相同的工艺条件下,PC悬浮液表现出更高的表观粘度和屈服应力。 SLS降低了两种纤维素等级的剪切粘度和触变性,这可能是由于静电排斥力增加所致。均质化降低了纤维素的粒径,但是再聚结太强而无法正确分析粒径。 MCC膜的拉伸强度高达16.0 MPa,PC膜的拉伸强度高达4.1 MPa。 PC薄膜在30秒钟内崩解,而MCC薄膜则没有。 MCC和PC的混合物比单独的PC产生更稳定的薄膜,但这些薄膜不再崩解。将双氯芬酸钠以治疗剂量并以47%的载药量掺入可口分散的PC膜中。这些薄膜的含量均匀性满足Ph.Eur的要求,并且薄膜在12秒内崩解。总之,PCH和MCC在HPH后显示出可比的结果,并且大多数差异可以通过MCC悬浮液的较小粒径来解释。这些结果证实了以下假设:在加工过程中,主要的纤维尺寸是造成制药过程中MCC和PC存在差异的原因,例如湿法挤出/滚圆。
  • 【不同类型食物对头孢克洛缓释片生物利用度的比较作用。】 复制标题 收藏 收藏
    DOI:10.1007/BF03190587 复制DOI
    作者列表:Khan BA,Ahmed T,Karim S,Monif T,Saha N,Sharma PL
    BACKGROUND & AIMS: :This randomized, six-treatment, six-period, six sequence, single dose, crossover pharmacokinetic study assessed the effect of different types of food on the bioavailability of 500-mg cefaclor extended release tablet in 23 healthy male volunteers. A single dose of cefaclor extended release 500-mg tablet was administered at six occasions: after overnight fasting, after two vegetarian (high-fat and low-fat), two non-vegetarian (high-fat and low-fat) and rice diets. Serial blood samples were collected up to 12 h after dose. Serum cefaclor concentrations were determined by a validated HPLC method. An almost equivalent increase in both Cmax and AUC was observed with both high-fat non-vegetarian and low-fat vegetarian breakfasts. However, when MIC90 values, a pharmacodynamic end-point were compared, the low-fat vegetarian diet fared better than the high-fat non-vegetarian diet. The results obtained favor low-fat vegetarian diet (breakfast) to be taken with cefaclor extended release tablet to achieve maximum benefit in terms of clinical efficacy.
    背景与目标: :这项随机,六次治疗,六次治疗,六次治疗,六次治疗,单次剂量,交叉药代动力学研究评估了23种健康男性志愿者中不同类型食物对500 mg头孢克洛缓释片生物利用度的影响。单剂量头孢克洛500毫克头孢克洛缓释片分六次服用:禁食过夜后,两次素食(高脂和低脂),两次非素食(高脂和低脂)和大米饮食后。给药后直至12 h收集系列血样。血清头孢克洛浓度通过有效的HPLC方法测定。高脂非素食早餐和低脂素食早餐的Cmax和AUC均几乎增加。但是,当比较MIC90值(药效学终点)时,低脂素食饮食的表现要好于高脂非素食饮食。获得的结果有利于低脂素食饮食(早餐),与头孢克洛缓释片一起服用可在临床疗效方面获得最大收益。
  • 【屈比特尔缬沙坦钠片治疗慢性心力衰竭的功效:随机对照试验的系统评价方案。】 复制标题 收藏 收藏
    DOI:10.1097/MD.0000000000018050 复制DOI
    作者列表:Liu Z,Wang J,Li Y
    BACKGROUND & AIMS: BACKGROUND:This study aims to systematically explore the efficacy of sacubitril valsartan sodium tablet (SVST) for the treatment of chronic heart failure (CHF). METHODS:Nine electronic databases, including PUBMED, Cochrane Library, EMBASE, PsycINFO, Web of Science, Allied and Complementary Medicine Database, WANGFANG, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure will be searched. Randomized controlled trials on SVST in the treatment of CHF will be collected. The search time limit will be from the establishment of each electronic database until June 1, 2019. Two authors will independently select the literature, carry out the data, and assess the methodological quality. RESULTS:This study will systematically investigate the efficacy and safety of SVST for CHF. The outcomes consist of all-cause mortality, change in body weight, urine output, change in serum sodium; and incidence of any expected and unexpected adverse events. CONCLUSION:The findings of this study will summarize from evidence-based medicine and a scientific basis for the efficacy and safety of SVST in the clinical treatment of CHF. PROSPERO REGISTRATION NUMBER:PROSPERO CRD42019138882.
    背景与目标: 背景:本研究旨在系统地研究沙比特比缬沙坦钠片(SVST)在治疗慢性心力衰竭(CHF)中的疗效。
    方法:将检索9个电子数据库,包括PUBMED,Cochrane图书馆,EMBASE,PsycINFO,Web of Science,联合和补充医学数据库,WANGFANG,中国生物医学文献数据库以及中国国家知识基础设施。将收集关于SVST治疗CHF的随机对照试验。搜索时间限制是从每个电子数据库的建立到2019年6月1日。两位作者将独立选择文献,进行数据研究并评估方法学质量。
    结果:本研究将系统地研究SVST治疗CHF的有效性和安全性。结果包括全因死亡率,体重变化,尿量变化,血清钠变化;以及任何预期和意外的不良事件的发生率。
    结论:本研究的结果将从循证医学和SVST在CHF临床治疗中的有效性和安全性的科学基础中总结。
    PROSPERO注册号:PROSPERO CRD42019138882。
  • 【羟丙基甲基纤维素的特性会影响可压实性,并通过红外光谱预测颗粒和片剂的性能。】 复制标题 收藏 收藏
    DOI:10.1002/jps.10323 复制DOI
    作者列表:Gustafsson C,Nyström C,Lennholm H,Bonferoni MC,Caramella CM
    BACKGROUND & AIMS: :Particle characteristics, chemical substitution, compaction behavior, and tablet properties of hydroxypropyl methylcellulose powders from two different suppliers were related using multivariate data analysis. By Principal Component Analysis it was shown that the the degree of substitution of the HPMC powders did not correlate to the particle and compaction properties as strongly as anticipated. Particle shape and powder surface area seem to be more important for the compaction behaviour of the powders than the degree of substitution. In addition, particle and tablet properties were predicted from infrared spectral data. Fourier transform infrared (FTIR) and near infrared (NIR) spectral data of the powders were combined with measured values of the particle characteristics, compaction behavior, and tablet properties using the multivariate data analysis program SIMCA 7.1. Properties like density, particle shape, tablet tensile strength, and drug release characteristics of the HPMC powders and corresponding tablets in this study could be predicted using Partial Least Squares models. In conclusion, the particle shape and powder surface area of HPMC powders seem to be important factors for the quality of tablet attained. Further, this study confirms that NIR and FTIR analysis used in combination with multivariate analysis are powerful tools for predicting the properties of materials and the quality of the end product.
    背景与目标: :使用多变量数据分析,对来自两个不同供应商的羟丙基甲基纤维素粉的颗粒特征,化学取代,压实行为和片剂性质进行了关联。通过主成分分析表明,HPMC粉末的取代度与预期的强烈颗粒与压实度不相关。颗粒形状和粉末表面积对于粉末的压实行为似乎比取代度更为重要。另外,根据红外光谱数据预测了颗粒和片剂的性质。使用多元数据分析程序SIMCA 7.1,将粉末的傅立叶变换红外(FTIR)和近红外(NIR)光谱数据与颗粒特性,压实行为和片剂特性的测量值结合在一起。可以使用偏最小二乘模型预测本研究中HPMC粉末和相应片剂的密度,颗粒形状,片剂拉伸强度和药物释放特性等特性。总之,HPMC粉末的颗粒形状和粉末表面积似乎是获得片剂质量的重要因素。此外,这项研究还证实,将近红外和FTIR分析与多变量分析结合使用是预测材料性能和最终产品质量的有力工具。
  • 【拉可酰胺在血浆,唾液和尿液中的片剂和糖浆制剂的耐受性,药代动力学和生物等效性:唾液可替代中隔室中的药代动力学。】 复制标题 收藏 收藏
    DOI:10.1111/j.1528-1167.2012.03725.x 复制DOI
    作者列表:Cawello W,Bökens H,Nickel B,Andreas JO,Halabi A
    BACKGROUND & AIMS: PURPOSE:To test for bioequivalence of 200 mg lacosamide oral tablet and syrup formulations. Additional objectives were to compare the pharmacokinetic profile of lacosamide in saliva and plasma, and to evaluate its tolerability. METHODS:This open-label, randomized, two-way crossover trial was conducted in 16 healthy Caucasian male participants in Germany. The bioequivalence of 200 mg lacosamide tablet and syrup was evaluated using plasma to determine maximum measured concentration (C(max)) and area under the curve from zero to the last time point (AUC)(0-tz). Plasma and saliva samples for evaluation of pharmacokinetic parameters of lacosamide and the major metabolite O-desmethyl lacosamide (SPM 12809) were taken over 15 time points (0.5-72 h) and used to statistically compare bioavailability of the two. Urine samples were collected predose and over five time points (0-48 h) to evaluate the cumulative amount of unchanged drug and metabolite. KEY FINDINGS:Lacosamide median time to reach C(max) (t(max)) was 1 h for tablet and 0.5 h for syrup in plasma and saliva. Mean terminal half life (t(½)) for tablet and syrup was 12.5 and 12.4 h in plasma, and 13.1 and 13.3 h in saliva, respectively. Tablet and syrup mean plasma AUC(0-tz) was 84.5 and 83.3 μg/mL*h, respectively. Mean AUC(0-tz) in saliva was 93.2 μg/mL*h for tablet and syrup. Mean C(max) for tablet was 5.26 μg/mL in plasma and 5.63 μg/mL in saliva. Syrup mean C(max) was 5.14 and 8.32 μg/mL in plasma and saliva, respectively. Within 2 h of syrup administration, elevated lacosamide concentration in saliva compared to plasma was observed. The ratio of lacosamide syrup to tablet was 0.98 for C(max) and 0.99 for AUC(0-tz) in plasma, and 1.00 for AUC((0-tz)) in saliva; the 90% confidence intervals (CIs) for these parameters were within the range of 0.80-1.25, which meets accepted bioequivalence criteria. The syrup-to-tablet ratio for C(max) in saliva was 1.48, and the 90% CIs exceeded the accepted upper boundary for bioequivalence (1.32-1.66). Both formulations were well tolerated. Metabolite concentration versus time profiles for saliva were similar to plasma following tablet and syrup administration. SIGNIFICANCE:The tablet and syrup formulations of lacosamide 200 mg were bioequivalent and well tolerated. Saliva samples were demonstrated to be a suitable surrogate to evaluate lacosamide tablet pharmacokinetics in the central compartment. Due to residual syrup in the buccal cavity, limitations exist when using saliva to evaluate the pharmacokinetics of lacosamide syrup <2 h after administration.
    背景与目标: 目的:测试200毫克拉考酰胺口服片剂和糖浆制剂的生物等效性。其他目标是比较拉可酰胺在唾液和血浆中的药代动力学特征,并评估其耐受性。
    方法:这项开放标签,随机,双向交叉试验是在德国的16位健康的白种人男性参与者中进行的。使用血浆评估200 mg拉考酰胺片和糖浆的生物等效性,以确定最大测量浓度(C(max))和从零到最后一个时间点的曲线下面积(AUC)(0-tz)。在15个时间点(0.5-72 h)采集血浆和唾液样品以评估拉可酰胺和主要代谢产物O-去甲基拉可酰胺(SPM 12809)的药代动力学参数,并用于统计学比较两者的生物利用度。在给药前和五个时间点(0-48小时)内收集尿液样品,以评估未改变药物和代谢物的累积量。
    主要发现:血浆和唾液中Lacosamide达到C(max)(t(max))的中位时间为1小时,糖浆为0.5小时。片剂和糖浆的平均终末半衰期(t(1/2))在血浆中分别为12.5和12.4 h,在唾液中分别为13.1和13.3 h。片剂和糖浆的平均血浆AUC(0-tz)分别为84.5和83.3μg/ mL * h。片剂和糖浆中唾液的平均AUC(0-tz)为93.2μg/ mL * h。片剂的平均C(max)在血浆中为5.26μg/ mL,在唾液中为5.63μg/ mL。血浆和唾液中糖浆的平均C(max)分别为5.14和8.32μg/ mL。在给予糖浆的2小时内,观察到唾液中拉考酰胺的浓度与血浆相比有所升高。血浆中拉考酰胺糖浆与片剂的比例在血浆中C(max)为0.98,在AUC(0-tz)中为0.99,在唾液中AUC((0-tz))中为1.00。这些参数的90%置信区间(CIs)在0.80-1.25的范围内,符合公认的生物等效性标准。唾液中C(max)的糖浆与片剂之比为1.48,并且90%的CI超过了生物等效性的可接受上限(1.32-1.66)。两种制剂均具有良好的耐受性。片剂和糖浆给药后,唾液的代谢物浓度与时间的关系与血浆相似。
    重要性:200毫克拉考酰胺的片剂和糖浆制剂具有生物等效性,并具有良好的耐受性。唾液样品被证明是评估中隔室中拉考酰胺片药代动力学的合适替代品。由于颊腔中残留糖浆,使用唾液评估给药后2小时内的拉考酰胺糖浆的药代动力学存在局限性。
  • 【通用氟西汀新片剂配方的生物等效性测试。】 复制标题 收藏 收藏
    DOI:10.1007/BF03190640 复制DOI
    作者列表:Jovanović D,Kilibarda V,Dordević S,Jovanović M,Jovic-Stosić J,Srdić D,Knezević T
    BACKGROUND & AIMS: :The pharmacokinetics and relative bioavailability of fluoxetine capsules (reference) and tablets (test) were compared in 24 healthy subjects of both sexes after a single 20 mg oral dose of fluoxetine (as a hydrochloride salt). A randomized, crossover design with a 2-week wash-out period between each dose was applied. Serum samples, obtained before dosing and at various appropriate time points up to 192 hours, were analyzed for fluoxetine and norfluoxetine content by a simple, accurate and precise HPLC method. ANOVA, power analysis, 90% confidence intervals (CI), and two one-sided tests were used for the statistical analysis of pharmacokinetic parameters. The tolerability of the preparations was good. The respective point estimates of the ratios of the geometric means of log-Cmax and log-AUC(0-infinity) of fluoxetine were 0.912 and 0.935 with 90% of 0.838-0.992 and 0.857-1.020. The corresponding point estimates of norfluoxetine were 0.952 (90% CI = 0.843-1.075) and 0.904 (90% CI = 0.807-1.013), respectively. Since both 90% CI for the AUC(0-infinity). and Cmax geometric mean ratios of fluoxetine and norfluoxetine were included in the 80% to 125% interval proposed by the FDA the test drug (fluoxetine tablets) was considered bioequivalent to the reference one (Prozac capsules) according both to the rate and extent of absorption.
    背景与目标: :在单次口服20 mg氟西汀(作为盐酸盐)后,在24位男女健康受试者中比较了氟西汀胶囊(参考)和片剂(测试)的药代动力学和相对生物利用度。采用随机,交叉设计,每个剂量之间有2周的清除期。通过简单,准确和精确的HPLC方法分析给药前和至多192小时的各个适当时间点获得的血清样品的氟西汀和去甲氟西汀含量。方差分析,功效分析,90%置信区间(CI)和两个单方面试验用于药代动力学参数的统计分析。制剂的耐受性良好。氟西汀的log-Cmax和log-AUC(0-无穷大)的几何平均值之比的点估计分别为0.912和0.935,其中90%为0.838-0.992和0.857-1.020。去甲氟西汀的相应点估计分别为0.952(90%CI = 0.843-1.075)和0.904(90%CI = 0.807-1.013)。因为两个90%CI均为AUC(0-无穷大)。 FDA提议的80%至125%区间中包括氟西汀和去氟西汀的Cmax和Cmax几何平均比值,根据吸收率和吸收程度,认为测试药物(氟西汀片)与参考药(百忧解胶囊)具有生物等效性。

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