Drug Compatibility in Treatment of Chronic Infectious Diseases

The article considers the features of pharmacotherapy of patients with chronic infectious diseases and co-morbidities in conditions of polypharmacy, the principles of drug metabolism, variants of adverse effects and drug-drug interactions, the possibilities of effective drug combinations. The purpose is to substantiate the possibility and emphasize the relevance of the additional search of the creation of the most optimal combinations of drugs for long-term and massive pharmacotherapy, that could be due to a beneficial drug-drug interaction, optimization of the regimen, route of drug administration and multitarget of the therapeutic effect, reduce the pharmacological load while maintaining the effectiveness of the treatment, increase patient adherence to drug therapy.

Analysis of drug compatibility in Y in intravenous therapy: preparation of a preventive tool for a university hospital in Petrolina – PE

Objectives: To elaborate instruments for the analysis of the compatibility of intrave-nous medications, in order to assist in the conduct and routines of the assistance teams of the Federal University of the São Francisco’s Valley (HU-Univasf) Methods: Injectable drugs were initially selected, which belong to the HU-Univasf stand-ardization list. Information on the pH of medicines, compatibilities and incompatibili-ties, were extracted from the databases: Lexi-comp® Inc, Micromedex IV Compatibil-ity, Internet website Stabilis and King Guide to Parenteral Admixtures®. This work was carried out in two stages: (1) Creation of a tool to analyze the compatibility of injectable medications used in the hospital in a guide format; (2) Elaboration of the cross-table for quick consultation of the compatibility of the most prevalent medica-tions in the Intensive and Semi-Intensive Care Unit (UCISIN), in the parenteral dos-age form for intravenous administration (IV). Results: The Guide for analysis of Y compatibility in intravenous drug administration for a University Hospital in Petroli-na-Pe, was published with ISBN (International Standard Book Number): 978-85-92656-19-5 and it is available on the HU-Univas institutional website for free ac-cess. This material suited as the basis for the construction of the drug compatibility chart that contains the 50 most distributed items from the pharmacy to UCISIN. From this table, 1,225 pairs of drugs were obtained, of which 36% (N = 444) corresponded to compatible pairs and 20% (N = 241) to incompatible pairs. It should be noted that a higher value of pairs was observed with the indefinite compatibility 44% (N = 540), that is, without data in the consulted literature. Conclusions: It was possible to prepare the Guide for Analysis of Y Compatibility in Intravenous Medication Administra-tion and the HU-Univasf Y-Drug Incompatibility Cross-Table Graph, already availa-ble for the entire team. Therefore, it is expected that these instruments facilitate the access of the multiprofessional team to quality information, expanding the role of the pharmacist in the care of critical patients, improving patient safety in the use of intra-venous medications in the hospital.

Like Dissolves Like? A Comprehensive Evaluation of Partial Solubility Parameters to Predict Polymer-Drug Compatibility in Ultra-High Drug Loaded Polymer Micelles

<p></p><p>Despite decades of research, our understanding of the molecular interactions between drugs and polymers in drug loaded polymer micelles does not extend much beyond concepts such as “like-dissolves-like“ or hydrophilic/hydrophobic. However, polymer-drug compatibility strongly affects formulation properties and therefore the translation of a formulation into the clinics. Specific interactions such as hydrogen-bonding, π-π stacking or coordination interactions can be utilized to increase drug-loading. This is commonly based on trial-and-error and eventually leads to an optimized drug carrier. Unfortunately, due to the unique characteristics of each drug, the deduction of advanced general concepts remains challenging. Furthermore, the introduction of complex moieties or specifically modified polymers hampers systematic investigations regarding polymer drug-compatibility as well as clinical translation. In this study, we reduced the complexity in order to isolate crucial factors determining drug-loading. Therefore, the compatibility of 18 different amphiphilic polymers for 5 different hydrophobic drugs was determined empirically. Subsequently, the obtained specificities were compared to theoretical compatibilities derived from either the Flory-Huggins interaction parameter or Hansen solubility parameters. In general, Flory-Huggins interaction parameters were less suited to correctly estimate the experimental drug solubilization compared to the Hansen solubility parameters. The latter were able to correctly predict some trend regarding good and poor solubilizers, yet the overall predicitive strength of Hansen Solubility parameters is clearly unsatisfactory.</p><br><p></p>

Like Dissolves Like? A Comprehensive Evaluation of Partial Solubility Parameters to Predict Polymer-Drug Compatibility in Ultra-High Drug Loaded Polymer Micelles

<p></p><p>Despite decades of research, our understanding of the molecular interactions between drugs and polymers in drug loaded polymer micelles does not extend much beyond concepts such as “like-dissolves-like“ or hydrophilic/hydrophobic. However, polymer-drug compatibility strongly affects formulation properties and therefore the translation of a formulation into the clinics. Specific interactions such as hydrogen-bonding, π-π stacking or coordination interactions can be utilized to increase drug-loading. This is commonly based on trial-and-error and eventually leads to an optimized drug carrier. Unfortunately, due to the unique characteristics of each drug, the deduction of advanced general concepts remains challenging. Furthermore, the introduction of complex moieties or specifically modified polymers hampers systematic investigations regarding polymer drug-compatibility as well as clinical translation. In this study, we reduced the complexity in order to isolate crucial factors determining drug-loading. Therefore, the compatibility of 18 different amphiphilic polymers for 5 different hydrophobic drugs was determined empirically. Subsequently, the obtained specificities were compared to theoretical compatibilities derived from either the Flory-Huggins interaction parameter or Hansen solubility parameters. In general, Flory-Huggins interaction parameters were less suited to correctly estimate the experimental drug solubilization compared to the Hansen solubility parameters. The latter were able to correctly predict some trend regarding good and poor solubilizers, yet the overall predicitive strength of Hansen Solubility parameters is clearly unsatisfactory.</p><br><p></p>

CLINICAL PHARMACY IN GALLE SRI LANKA, COLLABORATION AND FRIENDSHIP

Pharmacy undergraduate courses in Ruhuna, while is more practice focus than many of the other courses in Sri Lanka, it is still missing clinical pharmacy elements. Collaboration between academic staff from Ruhuna University and two international clinical pharmacy academics was established in 2014. The aim of this paper is to report on a clinical pharmacy training program, delivered by the international academics and supported by the Sri Lankan academics to pharmacy students in 2015-2016. After short conceptualisation lecture on each topic, there was a workshop which was structured as team case-based learning progressive case studies. Topics included mental health, pharmacokinetics, interpreting laboratory results, parenteral drug compatibility, special hospital compounding and medication review, of which all were assessed in the final examination. Student found team based learning to be engaging and enabled them to independently and critically think in a safe environment and preferable over the traditional lectures.