International journal of pharmaceutical compounding
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Domperidone is a prokinetic agent used as a second-line treatment option for gastroparesis in those unable to tolerate metoclopramide. Via inhibition of dopamine-2 receptors within the gastrointestinal tract and various parts of the central and peripheral nervous system, domperidone helps to facilitate peristalsis and gastric emptying. A major side effect of domperidone is prolactinemia, allowing it to be used off-label for the purpose of inducing lactation. ⋯ Food and Drug Administration approved due to various case reports and literature associating the risks of sudden cardiac death and ventricular arrhythmia with the use of domperidone. Despite the evidence against the use of domperidone, it is still being widely used in Canada and Europe for both gastroparesis and to induce milk let-down. This article is a literature review intending to assess the risks associated with the use of domperidone in gastroparesis and lactation.
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This article represents the third in a series of articles on tips and hints ofcompounding. In this issue, we will discuss some tips and hints for the compounding of ointments, creams, pastes, gels, and gel-creams. For clarification, a gel-cream is a cream in which the external aqueous phase has been thickened using a gelling agent; the advantage is a more stable cream.
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Antimicrobial preservatives are excipients added to multi-dose containers of both sterile and non-sterile drug products. Antimicrobial preservatives are used primarily to inhibit growth of microbial contamination occurring during the period of use. Demonstration of antimicrobial preservative effectiveness is required for these functional excipients. This article reviews key factors for consideration in the selection of preservatives, principles of the preservative-effectiveness test, and the significance of requirements for preservative-effectiveness testing in the compounding practice.
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Compounding pharmacists throughout the world are compounding a special type of capsule called "slow-release." This type of capsule is a compounding pharmacy application of the commercial hydrophilic matrix tablets. It is a relatively simple system that allows formulating a robust, reliable, and consistent drug system based on 30% w/w to 40% w/w of specific types of hydroxypropyl methylcellulose. The main purpose of these capsules is to attenuate the drug release when there is a clinical need and no commercial medication exists. ⋯ Since the pharmaceutical calculations needed to compound this preparation are time consuming, a suggestion of a faster way to perform these calculations by using a special Excel spreadsheet is provided. The article demonstrates a special table with a comparison between the specifications, results, and conclusions of the five in vitro trials that evaluated the pharmacokinetic rates of compounded slow-release capsules. The regulatory aspect of compounding slow-release capsules is also discussed.