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contamination, both high and low water-soluble active pharmaceutical ingredients were reduced (completely and 932-fold, respectively) in the single-step cleaning. The RVC1 automated robotic cleaning device showed the necessary microbiological and chemical efficacy to be used in the cleaning routine of compounding pharmacies, both in a singlestep cleaning (brushing, ultraviolet light, and mopping simultaneously) or in a double-step cleaning (brushing and ultraviolet light first, mopping second). It is then recommended to always use the mopping accessory and the ultraviolet light on. The RVC1 can be a valuable add-on method to standardize cleaning.Bacterial and fungal catheter-related bloodstream infections (CRBSI) cause high fever and blindness due to fungal endophthalmitis. Candidal CRBSI have a particularly high mortality rate and needs attention. In this study, we examined the effect of biotin on the colonization and growth of Candida albicans in the lumen of the catheter used for nutrient infusions. In the current study, nutrient infusion-1 commercially available peripheral parenteral nutrition (PPN) infusion solution with vitamin B1 (control), nutrient infusion-2 biotin added to the PPN infusion, nutrient infusion-3 water-soluble vitamins (B2, B6, B12, C, folic acid, nicotinamide, panthenol) except biotin added to the PPN infusion, and nutrient infusion-4 commercially available PPN infusion with all water soluble vitamins (B1, B2, B6, B12, C, folic acid, nicotinamide, biotin, panthenol) were used. Candida albicans suspension was injected into a Planecta infusion set, which was connected to one of the test solutions, and the infusions flow pass was blocked for approximately 30 minutes. Subsequently, the infusions were resumed, and the test solution was collected at 24 hours, 48 hours, and 72 hours to estimate the Candida albicans colony-forming units in each infusion. We demonstrated that nutrient infusion with biotin promoted colonization and proliferation in the catheter lumen, whereas those without biotin had no effect. These results suggest that biotin may accelerate the colonization and growth of Candida albicans in catheter lumen and using biotin-containing nutrient infusions may increase the risk of CRBSI.Allopurinol is an orally administered inhibitor of xanthine oxidase used primarily in the treatment of hyperuricemia associated with gout. Allopurinol reduces serum and urinary uric acid concentrations. Its use should be individualized for each patient. The dosage of allopurinol to accomplish full control of gout and to lower serum uric acid to normal or near-normal levels varies with the severity of the disease, and needs to be flexible to permit precise, customized dose titration for individual patients. This flexibility is readily achieved using an oral liquid dosage form. However, no commercial liquid dosage form of allopurinol currently exists. Allopurinol is commercially available as 100-mg and 300-mg scored tablets. An extemporaneously compounded suspension from pure drug powder or commercial tablets would provide a convenient option to meet unique patient needs. The purpose of this study was to determine the physicochemical stability of extemporaneously compounded allopurinol suspensions in the PCCA Bobtained in triplicate. A stable extemporaneous product is defined as one that retains at least 90% of the initial drug concentration throughout the sampling period. The study showed that allopurinol concentrations did not go below 93% of the label claim (initial drug concentration) at both temperatures studied. Viscosity and pH values also did not change significantly. Selleckchem BIBO 3304 This study demonstrates that allopurinol is physically and chemically stable in SuspendIt for 180 days in the refrigerator and at room temperature, thus providing a viable, compounded alternative for allopurinol in a liquid dosage form, with an extended beyond-use-date to meet patient needs.There is still an evident need for nonsterile compounded medications for pediatric and elderly patients in cases where patients require dose adjustments or have swallowing difficulties. Pharmacists generally have the choice between compounding capsules or oral liquids. In daily pharmacy practice, extemporaneous capsules are from time to time seen as a better alternative to oral liquid medication, although various published studies indicate that weight variation and/or uniformity of content can be significantly out of specification for compounded capsules. In contrast, analyses with the ready-to-use oral liquid vehicle SyrSpend SF in 104 different formulations with 89 unique active pharmaceutical ingredients showed results that all 6.414 samples analyzed were within specification. It can, therefore, be argued that SyrSpend SF could be a better way to assure content uniformity compared to manually compounded, small-batch extemporaneous capsules.In the formulation of parenteral dosage forms, pH is a critical factor and can be a complicated factor in compounding intravenous admixtures since the additives and the vehicle may have different pH values. This is especially important, as a significant number of parenteral medications require compounding involving dissolution of lyophilized powders; dilution of drug doses for infusion; mixing of dextrose, amino acids, vitamins, and electrolytes for parenteral nutrition; etc. Compounding intravenous admixtures is common practice, but each admixture may present a different set of problems to consider, especially as it relates to pH.Surfactants have many applications in pharmacy. However, they must be used appropriately to prevent poor formulations and difficulties in measuring doses due to foaming, etc. It is not difficult to determine which surfactant is appropriate for different applications, to determine the appropriate hydrophilic lipophilic balance system to be used, to blend surfactants if needed, and to prepare them correctly to minimize any adverse effect on the final preparation. This article discusses several types of substances that have surfactant properties (anionic surfactants, cationic surfactants, nonionic surfactants, poloxamers) and their applications.The Republic of Zambia is a landlocked country in South-Central Africa. According to the United Nations World Population Prospects 2020, a full 60.5% of Zambia's 18.3 million inhabitants live below the international poverty line. The Centers for Disease Control and Prevention, meanwhile, rank malaria seventh among the top 10 causes of death. This article presents an American neurologist's work from a teaching hospital in Zambia to acquire versions of acetaminophen and ibuprofen liquids, and matching placebos for both, in a double-blind study aimed at malaria's infamous mile-high fevers. Success came with the essential help of a compounding pharmacist in Houston, Texas.In the U.S., compounding pharmacies are regulated primarily by state boards of pharmacy, which often collaborate with federal agencies such as the Drug Enforcement Administration or the Department of Health and Human Services. Other organizations, such as the U.S. Food and Drug Administration, the Occupat ional Safety and Health Administration, the Environmental Protection Agency, and state departments of agriculture or labor may also have jurisdiction over compounding pharmacies and their employees. In addition, compounding pharmacies are subject to the requirements of Section 503A of the Federal Food, Drug, and Cosmetic Act. Complying with requirements for training and competency and documenting adherence to various agency regulations may seem daunting, but guidance in doing so is available from independent organizations such as the United States Pharmacopeial Convention, Inc., and the Pharmacy Compounding Accreditation Board. In this second article in a series on safety standards in pharmaceutical compounding, we discuss the roles of several of those influential federal organizations and the benefits that guidance from independent agencies provides for compounding pharmacists. Questions of interest to pharmacists who seek to comply with established agency safety standards are also answered.Congenital ichthyoses are a heterogeneous group of genetic skin disorders characterized by defects in the critical barrier function of the skin. These life-long conditions present a significant therapeutic challenge in dermatology. One important example is Congenital Hemidysplasia with Ichthyosiform erythroderma and Limb Defects, or CHILD syndrome. This is a rare congenital ichthyosis caused by mutations in cholesterol biosynthesis. With limited success, the cutaneous features of this condition have historically been managed symptomatically with emollients, topical keratolytics, and topical steroids. However, over the last decade, topical therapy directed at the pathogenesis of this condition has emerged as an effective treatment. Herein, we report a case of successful treatment of the cutaneous features of CHILD syndrome with compounded simvastatin and cholesterol gel and highlight the role of the compounding pharmacist in the care of patients with congenital ichthyosis.When using ventilators in the management of the coronavirus disease 2019 patient, dense and abundant mucous secretions are formed, obstructing the endotracheal tube and making its aspiration difficult. This situation is worsened if in order to minimize the risk of infection of the medical personnel, the humidifier is disconnected. This circumstance forces the tube to be removed, cleaned, or changed, increasing the workload of the intensive care unit staff. Other therapies tested until now, like mesna, acetylcysteine, or hypertonic saline solution, are valid alternatives, although they have not shown great efficacy for this specific procedure in the past. The sanitary emergency forced the collaboration between a pharmacist and an otorhinolaryngologist to develop the cocamidopropyl betaine surfactant formula, after several tests with different concentrations of the surfactant. The objective of this compounding formula was to resolve a mechanical problem and avoid reintubation due to obstruction of the ventilator tube. The cocamidopropyl betaine surfactant solution 0.075% in saline 0.9% (physiological serum) solution demonstrated to be a well-tolerated formula, using inexpensive materials, was simple to prepare, and was easy to use in clinical practice.
Health disorders may affect negatively work productivity of individuals, leading to absence from work (absenteeism) and/or decreased functioning in the workplace (presenteeism).
To assess the health-related work productivity of the adult population in Hungary by the Work Productivity and Activity Impairment questionnaire (WPAI).
A cross-sectional survey was performed in 2019 involving a sample (n = 2023) representative for the adult population of Hungary. Socio-demographic characteristics were recorded. Health-related productivity of the participants was assessed by the WPAI questionnaire, health status was measured by the EQ-5D-3L measurement tool and the Minimum European Health Module (MEHM).
Descriptive statistics were performed, subgroups were compared by Mann-Whitney and Kruskal-Wallis tests. Spearman's rank correlation was applied to analyze the relationship between WPAI, age and EQ-5D-3L index score.
Among those in a paid job (n = 1194, 59%), altogether 70 respondents (6%) were absent from work during the week before the survey, which resulted in an average 1.
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