International journal of pharmaceutical compounding
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The objective of this study was to describe the response by state boards of pharmacy pertaining to personal protective equipment shortages during the early phase of the COVID-19 pandemic. All webpages of state boards of pharmacy were independently reviewed for written guidance pertaining to personal protective equipment conservation strategies in sterile compounding and deviations from United States Pharmacopeia General Chapter <797> standards; each guidance was then reviewed for referenced sources. Of 52 state pharmacy regulatory bodies, 38 (73.08%) provided guidance to modifying personal protective equipment use during sterile compounding activities to mitigate supply shortages. ⋯ Early in the pandemic, pharmacists within sterile compounding practices had to conserve personal protective equipment while mitigating contamination risk. Pharmacists looked to state boards of pharmacy for guidance. This report shows a high level of state response to the personal protective equipment shortage induced by the pandemic.
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It has been reported that sinusitis and rhinitis are included in the list of most common diagnoses made by general practitioners. Even though treatment of diseases of the nasal cavity and paranasal sinuses requires many manufactured medicines, several European countries, as well as the U. S. and Australia, still prescribe extemporaneous prescriptions for nose conditions. ⋯ The analyzed prescriptions contained active ingredients and excipients currently used in Germany, as well as active ingredients and excipients, the use of which, in Germany, is limited or impermissible in the preparation of nasal preparations. More than 70% of analyzed nasal preparations contained two or more active ingredients. Several nasal drops prescribed in Latvia need isotonization to avoid damage to nasal mucosa.
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Physical Compatibility of Medications Used in Critically Ill Patients with Balanced Fluid Solutions.
Using balanced fluids for resuscitation in patients with septic shock may lead to improved patient outcomes. However, compatibility data on co-administering balanced fluids via y-site connector with other intravenous medications is lacking. The purpose of this study was to examine the physical compatibility of frequently used intravenous medications for patients with septic shock with balanced fluids, Plasma-Lyte A, and Lactated Ringers, using a simulated y-site. Medications studied were acyclovir, amiodarone, ampicillin, aztreonam, cefepime, ceftriaxone, ciprofloxacin, heparin, hydrocortisone, gentamicin, levofloxacin, meropenem, piperacillin-tazobactam, tobramycin, and vancomycin. All medications were assessed with Plasma-Lyte A; amiodarone, ampicillin, cefepime, hydrocortisone, and levofloxacin were also assessed for compatibility with Lactated Ringers, based on missing or conflicting compatibility data. The medications were diluted to maximum concentrations used for patient administration and mixed with the balanced fluid solution in equal volumes. Physical compatibility was determined by assessing samples visually against light and dark backgrounds and using a laboratory turbidimeter. ⋯ Each remaining study drug displayed visible and turbidimetric compatibility with the assessed balanced fluid. Acyclovir, ampicillin, aztreonam, cefepime, ceftriaxone, ciprofloxacin, gentamicin, heparin, hydrocortisone, levofloxacin, meropenem, piperacillin-tazobactam, tobramycin, and vancomycin exhibited physical compatibility with Plasma- Lyte A in a simulated y-site for up to one hour. Ampicillin, cefepime, hydrocortisone, and levofloxacin were also physically compatible with Lactated Ringers.
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Preservative selection is a critical step in the preparation of a formulation to ensure its microbiological effectiveness and stability. A number of physicochemical factors must be considered when selecting a preservative, including concentration, solubility, and pH. ⋯ It should also be effective against a wide variety of bacteria, fungi, and yeasts, and be free from incompatibilities. This article discusses some of the factors involved in selecting an appropriate preservative.
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The July-August 2019 issue of the International Journal of Pharmaceutical Compounding includes part 1 of a 3-part article on the topic of excipients used in nonsterile compounding. This article, which discusses dosage form design and excipients related to appearance, palatability, flavoring, sweetening, and coloring, represents part 2 of this 3-part series. ⋯ The topics presented in part 2 are very important for patient compliance. The colors, flavors, sweetening, appearance, and other dosage form characteristics can often be modified to enhance compliance by the patient, which can aid in therapeutic effectiveness.