Notes

DPP-4 inhibitors along with likelihood of microbe infections: the meta-analysis involving randomized manipulated trial offers.
oride and 5% dextrose diluents for at least 4 hours at the concentrations tested in this study.Water activity refers to the amount of water in a system that is available for microbial growth. Commercial water activity meters are precision instruments with the ability to determine water activity to within 0.001 units and carry prices of $10,000 or more. The purpose of the study was to build a robust water activity meter from commercially available components and measure the water activity of liquids commonly used in compounded formulations. SHT-85 sensors were connected to an Adafruit Feather HUZZAH microcontroller. Standard salt slurries and common oral liquid vehicles were monitored in airtight containers until equilibrium was reached. Standard curves were used to convert sensor outputs to water activity values. The standard curves were linear with R2 >0.99. Oral liquid vehicles showed water activity values between 0.62 and 0.99. Samples equilibrated within 9.5 hours in 16-ounce jars or 2.5 hours in 20-mL vials. Stirring the sample during measurement reduced equilibration time in 16-ounce jars, but not in 20-mL vials. The inexpensive meter was accurate and precise in measuring the water activity of standards and selected oral vehicles. An accurate and precise water activity meter was constructed at a cost of approximately $150. Common oral formulation components have a water activity of >0.6, the United States Pharmacopeial threshold for requiring a preservative. Pharmacists should use caution when diluting preserved vehicles.Intravenous admixture compounding is common practice in most hospitals throughout the world. In this intravenous admixture series, we are covering important and practical topics. This issue presents considerations related to ready-to-use products in preparing/compounding admixtures and in actually compounding ready-to-use preparations in the pharmacy for patient use; most compounded intravenous admixtures are ready-to-use for a specific patient. Considerations include room, refrigerated, and frozen ready-to-use, activated ready-to-use, compounding with ready-to-use, implementing a ready-to-use program, and examples of ready-to-use products, their composition, container size, and packaging.Pediatric patients are sensitive to bitter-tasting substances and often resist taking them orally; however, they do like sweet substances from birth through mid-adolescence. INS018055 To improve compliance, compounding pharmacists need to consider the palatability of compounded medications in addition to stability, safety, and effectiveness. Metronidazole compounded oral suspension is commonly prepared with the benzoate ester because it does not have a bitter taste; however, it has been on backorder and unavailable for months. A palatable metronidazole compounded oral suspension needs to be developed using the metronidazole base in order to meet the treatment needs of pediatric patients and improve compliance during this shortage.Although prostatectomy and radiotherapy yield excellent- long term survival rates for men with prostate cancer, adverse effects (erectile dysfunction and/or urinary incontinence with subsequent undesired lifestyle modifications, anxiety about the loss of intimacy, negative self-perception, and the effects of such stressors on work performance and family relationships) frequently afflict patients who have undergone these procedures. Surgeons who specialize in the treatment of prostate cancer are dedicated to ensuring the optimal clinical result but often do not provide information about the likelihood of experiencing those sequelae or the additional support and aftercare necessary to ensure posttreatment sexual and urologic function to their patients' satisfaction. In response to the needs of these underserved patients, the authors designed the Stanley Prostate-cancer Treatment Protocol for erectile dysfunction and urinary incontinence. The goal of the Stanley Protocol is to achieve an improved outcome after surgery or radiation therapy for prostate cancer via comprehensive therapy, patient monitoring, and detailed training. Each Protocol program is customized to address the individual patient's needs as he attains his desired level of sexual function and urinary control. Feedback consistently indicates that patients who participate in the Stanley Protocol achieve those goals, and the authors suggest that this program can be incorporated into any compounding practice to provide the same result. In this article, the most common questions that compounders ask about the Stanley Protocol are answered, an outline of that therapeutic guideline is presented, and formulations proven to optimize the outcome of prescribed treatment are provided.This represents part two of a two-part article on the topic of gender bias within hormone replacement therapy and the well-orchestrated attempt by the pharmaceutical industry to eliminate bioidentical hormones, as well as to downplay the important role of compounding pharmacies in fulfilling the needs of women in this longstanding gender gap. Part one of this two-part article was published in the November/December 2020 issue of the International Journal of Pharmaceutical Compounding. That article discussed two of the four most prevalent reasons for this bias, Protecting the Bottom Line and Lack of Patent Protection. This article concludes this discussion with reasons three and four, Exclusion of Women in Medical Research and Fear and Retribution.Over the last century, the concept and use of the cleanroom have continually evolved to provide an increasingly restricted environment with a low burden of contaminants (especially those that are airborne). Although no cleanroom in active use can be kept sterile, the particulate burden circulated via airflow and deposited on surfaces in such areas must be reduced to levels considered acceptable, especially when sterile compounding is performed. In this article on cleanroom cleanliness, pivotal events in cleanroom development are briefly reviewed, contamination control in the sterile-compounding environment is discussed, factors that affect levels of contamination in cleanroom suites are examined, and suggestions for contamination prevention are presented.
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