ORCID Profile
0000-0002-5444-3312
Current Organisation
James Cook University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: MDPI AG
Date: 11-06-2014
Publisher: MDPI AG
Date: 04-12-2022
Abstract: The pharmacist preceptor is key to the success of pharmacy student experiential placements with a recent focus being placed on the quality of preceptors. This study sought to investigate student perceptions of the ideal roles and attributes of pharmacist preceptors to inform the development of a preceptor training program. This was a mixed methods study using an online survey of pharmacy students from levels two to four of an undergraduate pharmacy honours program at a regional Australian university followed by qualitative, semi-structured focus group interviews. Surveys were analysed using descriptive statistics and content analysis while interviews were thematically analysed. Thirty-seven complete survey responses were received, and three student focus groups were conducted. Students identified the key role of preceptors in linking theory to practice and felt that the role of the preceptor in student assessment should focus on practical skills, such as communication and professionalism. There was overall strong agreement between the quantitative and qualitative findings on the ideal preceptor attributes with good communication, enthusiasm for the profession and the provision of clear and honest student feedback thought to be most important. Students regarded these attributes as essential for a good preceptor–student relationship to promote learning in the practice environment.
Publisher: Wiley
Date: 06-2007
DOI: 10.1002/J.2055-2335.2007.TB00036.X
Abstract: Oral liquid preparations are often the dosage form of choice in paediatric and geriatric populations. Many drugs are not available in oral liquid dosage forms because of the complexity of formulating liquids and the small market size. Pharmacists are often challenged with the extemporaneous preparation of oral liquids from commercially available products. Most problems associated with the stability of these preparations have been attributed to interactions between the drug substance and excipients (tablet and formulation) rather than the degradation of the drug substance by standard routes. However, a review of 83 such dosage forms revealed that only 7.2% exhibited stability concerns. To address these challenges pharmacists may consider the management plan for oral liquid dosage forms presented in this paper to ensure the provision of safe, effective and quality drug products to patients.
Publisher: Oxford University Press (OUP)
Date: 20-07-2023
DOI: 10.1093/IJPP/RIAD050
Abstract: Pharmacist preceptors are fundamental to experiential placements and their training is considered essential to provide a quality and consistent student placement experience. To optimise the impact of training, the views of key stakeholders are required to inform the design of a training program. This commentary aims to synthesise the perceptions of the stakeholders, including community pharmacy preceptors, academic staff and students on preceptor training requirements. Their opinions were sought to gain an understanding of preceptor roles and associated skills and attributes, training and support requirements, and barriers and enablers to training. Responses indicated a preference for a flexible online training program, with content including an overview of the university curriculum and expectations, teaching strategies, how to provide feedback and student management. A role was identified for the university to acknowledge the work of preceptors and ensure that they are included in their plans for future experiential placement activities and curriculum development. Several barriers were identified, which challenged precepting, providing the opportunity for this commentary to focus on preceptor training that will address these key challenges, in the context of a clinical teaching environment.
Publisher: Elsevier BV
Date: 08-2019
Publisher: Wiley
Date: 26-12-2019
DOI: 10.1002/ETC.4302
Abstract: Owing to the dynamic interaction between frog skin and the environment, xenobiotics in frog habitats are of particular concern, and knowledge of percutaneous absorption in frog skin is necessary for risk-mitigation purposes. Baseline transdermal kinetics in adult aquatic and arboreal frog species have recently been reported however, there is little information regarding absorption kinetics in adult terrestrial species. The present study investigated the in vitro absorption kinetics of 3 model chemicals-caffeine, benzoic acid, and ibuprofen-through different skin regions in the terrestrial toad Rhinella marina. Caffeine flux was consistently higher than that of the other 2 chemicals (p < 0.001), whereas the fluxes of the moderately and highly lipophilic chemicals (benzoic acid and ibuprofen) were similar, regardless of skin region. When considering in idual chemicals, caffeine demonstrated increased flux through the ventral pelvic skin compared with the ventral thoracic or dorsal skin regions. Flux did not differ between skin regions for either benzoic acid or ibuprofen. These findings have implications for management of environmental contamination in frog habitats, as many environmental xenobiotics are of moderate to high lipophilicity and would be expected to be equally absorbed from all skin surfaces in terrestrial toads. Environ Toxicol Chem 2019 :361-367. © 2018 SETAC.
Publisher: Elsevier BV
Date: 11-2015
Publisher: Springer Science and Business Media LLC
Date: 10-2014
DOI: 10.1007/S11096-014-0016-9
Abstract: People are at greater risk of health problems when travelling and a significant number of travel-related health problems are associated with the effects of travel on pre-existing chronic diseases. Medications play a key role in the management of these conditions. However, there is a notable lack of research evaluating the potential medication-related risks associated with travel. To apply a systematic pharmaceutical care model developed to evaluate potential pharmaceutical risks (PPRs) and pharmaceutical care issues (PCIs) in travellers. Adult travellers leaving Cairns International Airport, Australia, for an international destination. A cross-sectional survey using semi-structured interviews, including a systematic medication history, followed by the application of a pharmaceutical care model to evaluate each participant for PPRs and PCIs. Evaluation of standard clinical and travel-related PPRs and PCIs. Medications for chronic diseases were being taken by 47.7% of the 218 travellers interviewed. Although 75.2% of participants presented with no PPRs, a total of 274 PCIs were identified across 61.5% of the participants, with an average of 2.04 PCIs per participant. The most prevalent PCIs related to the inadequate precautions taken by some travellers visiting malaria-endemic regions. Although 91 participants recognised that they were travelling to malaria-endemic regions, 65.9% of these participants were not using malarial chemoprophylaxis, and only 16.5% were using chemoprophylaxis that fully complied with standard recommendations. The second most prevalent PCI was the need for 18.8% of participants to be educated about their medications. Other PCIs identified have the potential to increase the risk of acute, travel-related conditions, and complicate the care of travellers, if they inadvertently became unwell while overseas. PPRs and PCIs were not identified in all participants. However, the impact of many of the identified medication-related issues could be substantial to the traveller. This study represents the novel application of a pharmaceutical care model to identify potential PPRs and PCIs in travellers that may not be identified by other pre-travel risk assessment methods.
Publisher: Springer Science and Business Media LLC
Date: 2004
Publisher: Oxford University Press (OUP)
Date: 14-09-2023
DOI: 10.1093/IJPP/RIAD064
Publisher: Springer Science and Business Media LLC
Date: 11-2003
DOI: 10.1023/B:PHAM.0000003372.56993.39
Abstract: The aim of this project was to develop a colloidal dosage form for the oral delivery of rif icin and isoniazid in combination with the aid of artificial neural network (ANN) data modeling. Data from the 20 pseudoternary phase triangles containing miglyol 812 as the oil component and a mixture of surfactants or a surfactant/cosurfactant blend were used to train, test, and validate the ANN model. The weight ratios of in idual components were correlated with the observed phase behavior using radial basis function (RBF) network architecture. The criterion for judging the best model was the percentage success of the model prediction. The best model successfully predicted the microemulsion region as well as the coarse emulsion region but failed to predict the multiphase liquid crystalline phase for cosurfactant-free systems indicating the difference in microemulsion behavior on dilution with water. A novel microemulsion formulation capable of delivering rif icin and isoniazid in combination was created to allow for their differences in solubility and potential for chemical reaction. The developed model allowed better understanding of the process of microemulsion formation and stability within pseudoternary colloidal systems.
Publisher: Springer Science and Business Media LLC
Date: 06-06-2014
Publisher: Walter de Gruyter GmbH
Date: 03-10-2009
Abstract: Thermoanalytical methods have found increasing application in medicine due to the improved sensitivity and usability of the available instrumentation. Studies have identified important findings applied to medicine, including information on the thermal properties of the skin and the effect of insertion into body cavities of implants and prosthetics. These studies have explored the thermal stability of various materials to provide insight into drug penetration in order to design drug delivery systems, which are not only safe but capable of delivering improved and predictable therapeutic outcomes for patients. Differential scanning calorimetry (DSC) has also been applied to the study of disease states such as diabetes, where changes in the collagen structure of the skin which may lead to long-term complications in these patients, can be detected. Although these results may at this stage not have significant clinical implications, they do provide medical researchers with a starting point for future investigations. The application of these techniques has been further extended to examinations of body systems and other disease states. The key for the future will be the ability of these techniques not only to provide information on alterations in these biological systems, but also to determine whether these alterations are clinically relevant.
Publisher: Wiley
Date: 08-2019
DOI: 10.1002/JPPR.1525
Publisher: Bentham Science Publishers Ltd.
Date: 06-2011
DOI: 10.2174/157016311795563884
Abstract: Nifedipine is a dihydropyridine calcium channel antagonist effective in the clinical management of cardiovascular disease. Due to nifedipine's poor water solubility and erratic bioavailability, complexation with selected cyclodextrins was studied in order to overcome these limitations. The aim was to develop a quantitative structure property relationship (QSPR) to identify cyclodextrin molecular properties important in complex formation and provide a predictive tool which would be valuable during preformulation studies. The QSPR developed indicates that the major driving forces for nifedipine complexation, in addition to cyclodextrin concentration, are hydrophobicity and Van der Waals interactions (3D solubility parameters, hydrophilic surface area and differential connectivity index).
Publisher: Springer Science and Business Media LLC
Date: 2004
Publisher: Wiley
Date: 03-2006
DOI: 10.1002/J.2055-2335.2006.TB00881.X
Abstract: Despite the widespread use of dose administration aids (DAAs) there is little available data on the stability of drugs during repackaging or storage in these devices. To investigate the physicochemical stability of paracetamol tablets repackaged in DAAs. Physicochemical stability studies were performed on a commonly used paracetamol tablet directly after heat‐sealing in a DAA frequently employed in practice, then at ambient (25 °C 60% relative humidity) and accelerated (40 °C 75% relative humidity) conditions, over a 3‐month period. Physical characteristics of the tablets (weight uniformity, physical appearance, thickness, hardness, friability, disintegration, dissolution rates) were evaluated at time = 0, directly after heat‐sealing, 1 month and 3 months. Chemical stability was confirmed by high performance liquid chromatography (HPLC). The results were compared to control s les stored in the original packaging at the various environmental conditions studied. All compendial requirements for physicochemical stability were met for both ambient and accelerated conditions over the 3‐month period. Chemical stability of paracetamol content fell within the required range of 95–105% of the labelled amount, for all environmental conditions. This study provides evidence on the stability of paracetamol tablets in a DAA, to support pharmacists in making sound clinical and operational decisions regarding the repackaging of paracetamol in these devices.
Publisher: MDPI AG
Date: 31-05-2020
Abstract: Worldwide, the numbers of travellers are increasing, with pharmacists having the potential to play a significant role in the provision of pre-travel health services to a large number of these travellers. However, studies examining whether pharmacists have the travel health knowledge to provide these services are limited. This study thus aimed to explore the travel health knowledge of Australian pharmacists. Surveys assessing pharmacists’ knowledge of travel health were distributed through the Pharmaceutical Society of Australia and community pharmacies for self-completion. Overall, the travel health knowledge of participants was found to be good. However, although the majority of participants were aware of the common causes of morbidity and mortality in travel health, some slightly overestimated the prevalence of malaria and were less knowledgeable about the global distribution of some diseases. Most participants also demonstrated an ability to give appropriate advice on the management of traveller’s diarhoea, the selection of appropriate items for inclusion in travel first aid kits, vaccinations, and malarial chemoprophylaxis for travellers visiting endemic areas. This study highlights that Australian pharmacists have the knowledge to deliver travel health advice, with the potential to improve both access and outcomes for travellers.
Publisher: Springer Science and Business Media LLC
Date: 09-09-2023
Publisher: Public Library of Science (PLoS)
Date: 29-07-2020
Publisher: Bentham Science Publishers Ltd.
Date: 04-2008
DOI: 10.2174/187231208784040933
Abstract: Since the majority of lead compounds identified for drug clinical trials fail to reach the market due to poor efficacy in humans or poor pharmacokinetics (PKs), the prediction of PK properties in humans plays an important role in selection of potential drug candidates. The aim of the present study was to develop novel models for the prediction of separate PK parameters for a erse set of drugs. Prediction would be based on the retention of each drug using micellar liquid chromatography (MLC) and selected theoretically-derived descriptors. Retention time, half life (t((1/2))), and volume of distribution (Vd) for each of the 26 training drugs were extracted from literature while molecular descriptors were generated using Molecular Modeling Pro. A total of 35 molecular descriptors describing molecular size, shape and solubility were calculated from the 3D molecular structure of each compound. Artificial neural network (ANN) modeling was used to correlate the calculated descriptors and retention time with half life and volume of distribution. A sensitivity analysis procedure was used to refine the models. The final predictive models showed significant correlations with literature values of t((1/2)) and Vd: 0.854 and 0.855 respectively for the internal testing data and 0.720 and 0.827 respectively for the external validation set of compounds. Absolute predicted values were in good agreement with literature values. Analysis of descriptors in the optimum models revealed a large degree of overlap. Solubility characteristics, hydrogen bonding, and molecular size and shape were shown to play important roles in determining drug t((1/2)) and Vd. The reciprocal of retention time was also included in both optimum models attesting to the significance of this particular physicochemical parameter and the complexity of the models developed. This novel combination of theoretical and experimental data for pharmacokinetic modeling may lead to further progress in drug development.
Publisher: Springer Science and Business Media LLC
Date: 2003
Publisher: Bentham Science Publishers Ltd.
Date: 2009
DOI: 10.2174/157488609787354459
Abstract: Although increasing use of compliance aids is resulting in improved clinical outcomes for patients, the stability of some drugs being repackaged into these aids is being questioned. This is due to the fact that despite their widespread use, there is limited availability of relevant stability data. This review presents clinical evidence for repackaging into Dose Administration Aids (DAAs), the Australian Pharmaceutical Advisory Committee and other guidelines on general stability issues related to repackaging and a summary of evidence for stability studies conducted in the practice. For frusemide and prochlorperazine chosen as candidates for study because of their light sensitivity, while discoloration on light exposure rendered them unacceptable for patient use, precautions in repackaging and patient counselling can easily overcome this problem. In the case of sodium valproate however, hygroscopicity results in these tablets being unusable after exposure to accelerated storage conditions. In the absence of specific data on the stability of drug products repackaged into compliance aids, the guidelines, practical recommendations for repackaging and the management of compliance aids put forward in this article provide the pharmacist with the tools to make an informed decision on this process.
Publisher: Wiley
Date: 10-07-2019
DOI: 10.1002/JPPR.1528
Publisher: Elsevier
Date: 2008
Publisher: Springer Science and Business Media LLC
Date: 23-05-2023
Publisher: Oxford University Press (OUP)
Date: 07-2005
Abstract: Melatonin, a naturally occuring chemical mediator, although assigned a erse range of functions, has attracted interest because of its ability to function as a free radical scavenger. Its major hepatic metabolite and photoproduct, 6-hydroxymelatonin (6-OHM), also shares this property. Since singlet oxygen and quinolinic acid (QUIN) are critically involved in the pathology of neurotoxicity, the objective of this study was to investigate the ability of 6-OHM to scavenge singlet oxygen and evaluate its ability to scavenge superoxide anions and reduce QUIN-induced neurotoxicity in the hippoc us in-vivo. The results show that 6-OHM is an efficient inhibitor of singlet oxygen formation as indicated by the rate constants and quantum yields reported for 6-OHM and zinc phthalo-cyanine (ZnPc), respectively. 6-OHM, appears to reduce QUIN-induced superoxide anion generation in the hippoc us, which provides some evidence of the neuroprotective effects of 6-OHM.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.CPTL.2017.05.014
Abstract: Self-determination theory (SDT), which describes a continuum of motivation regulators, is proposed as an appropriate framework to study pharmacy student motivation. The aim was to develop a Pharmacy Motivation Scale (Pharm-S) to determine motivation regulators in undergraduate students and explore a possible link to professional identity development. The Pharm-S was adapted from the SDT-based, Sports Motivation Scale (SMS-II), and administered to undergraduate students in an Australian pharmacy course. Convergent validity was assessed by conducting a correlation analysis between the Pharm-S and MacLeod Clark Professional Identity Scale (MCPIS-9). Face, content and construct validity were established for the Pharm-S through the analysis of 327 survey responses. Factor analysis extracted four of the six theoretical subscales as proposed by SDT (variance explained: 65.7%). Support for the SDT structure was confirmed by high factor loadings in each of the subscales and acceptable reliability coefficients. Subscale correlations revealed a simplex pattern, supporting the presence of a motivation continuum, as described by SDT. A moderate positive correlation (0.64) between Pharm-S responses and the validated professional identity instrument, MCPIS-9, indicated a possible link between levels of motivation and professional identity. and conclusions: Content and structural validity and internal consistency of the Pharm-S confirmed the reliability of the Pharm-S as a valid tool to assess motivational regulators. Pharm-S and the MCPIS-9 were positively correlated, lending support to a link between motivation and professional identity. This suggests a potential role for the Pharm-S as a valid tool to measure pharmacy student professional identity development.
Do health warnings on cigarette sticks dissuade smokers and non-smokers? A focus group and interview study of Australian university students
Publisher: Informa UK Limited
Date: 05-2019
DOI: 10.2147/PRBM.S193754
Publisher: Wiley
Date: 06-2021
DOI: 10.1111/AJR.12739
Abstract: To explore pharmacist and stakeholder perspectives of pharmacists providing expanded services in rural community pharmacies. A descriptive qualitative study with an ethnographic lens of rural culture collected data via in‐depth semi‐structured interviews with stakeholder representatives and rural and remote pharmacists. Regional, rural and remote practice settings as defined by the Modified Monash Model MM3‐MM7. Twelve rural or remote pharmacists and eight stakeholder representatives from various government and professional organisations participated in the study. Macro‐, meso‐ and micro‐level perspectives of pharmacists providing expanded pharmacy services in rural community pharmacies. At the macro‐level, both pharmacists and stakeholders agreed that governance is needed to clarify the terms used to describe expanded practice as a first step to developing an expanded practice framework. The meso‐level revealed that pharmacist participants expected expanded practice to improve rural pharmacist recruitment and retention through improved professional satisfaction. The importance of effective collaboration and coordination with other health care providers in a community was described by pharmacists and stakeholders to ensure success of expanded services. All participants agreed that sustainability of these services relied on appropriate remuneration. At the micro‐level, expanded pharmacy services are expected to save consumers’ time and money as patients are redirected into appropriate health care settings. Enablers and barriers across policy, health professional, consumer and community levels need to be addressed in order to design and develop sustainable expanded pharmacy services to improve health service provision in rural and remote communities.
Publisher: MDPI AG
Date: 16-01-2023
Abstract: Infertility impacts millions of people of reproductive age worldwide, with approximately 10–15% of couples affected. When infertility is present, there are many potential barriers to treatment, leading to inequity of access. Assisted reproductive technologies (ART) are the mainstay of medical treatment for infertility and include procedures such as in vitro fertilisation. This scoping review aims to explore the barriers to accessing assisted reproductive technologies to highlight a potential role for the pharmacist in addressing these barriers. Five databases, including CINAHL, Emcare, Medline, Scopus, and Web of Science, were searched using keywords that resulted in 19 studies that explored barriers to initially accessing or continuing ART. Studies identified more than one barrier to accessing ART, with the most mentioned barrier being the geographic location of the patient, with others themed as psychological, financial, minority groups, educational level, and the age of the patient. Recommendations were made to address barriers to accessing ART, which included changes to government regulations to increase health education and promotion of infertility. Pharmacists’ accessibility, even in geographically remote locations, places them in an ideal position to address many of the challenges experienced by people accessing infertility treatment to improve outcomes for these people.
Publisher: MDPI AG
Date: 11-08-2022
DOI: 10.3390/PHARMACEUTICS14081667
Abstract: Dose administration aids (DAAs) are commonly used to assist patients with chronic disease to manage multiple medications and thus improve adherence. Several brands of telmisartan, commonly prescribed for hypertension, are available in Australia. Manufacturer’s storage advice is to leave tablets in the blister strip until administered to patients. This study aimed to investigate the stability of telmisartan tablets when repackaged and stored in DAAs, to identify a brand, which is sufficiently stable to be repackaged. All available brands of telmisartan tablets in Australia, which contain different excipients, were repackaged into DAAs and stored at 30 °C, 75% RH for 28 days before screening, using visual inspection and physical testing. A candidate brand was then selected for physicochemical and photostability testing using pharmacopoeial methods. Repackaged Mizart® tablets were shown to be sufficiently stable, when repackaged and stored under tropical conditions (30 °C, 75% RH) for 28 days. Several of the other brands were deemed inappropriate for repackaging, due to physical instability, highlighting the importance of considering not only the drug, but also excipients to ensure the stability of repackaged medicines. Although the repackaging of telmisartan tablets is not advised, this study provides evidence to support the Mizart® brand as an option for pharmacists to recommend for repackaging.
Publisher: Bentham Science Publishers Ltd.
Date: 10-2007
DOI: 10.2174/157016307782109670
Abstract: Omeprazole (OME), a proton pump inhibitor used to treat acid reflux disease and gastric ulcers presents a formulation challenge due to its rapid decomposition at acidic and neutral pHs. Thus, the aim of this project was to investigate whether interaction with sulfobutylether-beta-cyclodextrin (Captisol-CD) could improve omeprazole stability and provide more efficient oral liquid formulations. A stability-indicating high performance liquid chromatography assay allowed for the quantitation of S- and R-forms of OME in the presence and absence of Captisol-CD. The developed method was validated to discriminate between OME and its degradation products and used to describe the kinetic model of OME at different pH values over a period of 36 days. Calculated degradation constants (k(obs)), were directly correlated with the H(+) concentrations of the solutions regardless of whether the omeprazole was complexed with the Captisol-CD or not. Moreover, the pH-rate profile curve indicated that in all cases, maximum stability was achieved at pH 11. Though it was anticipated that interaction of OME with Captisol-CD might increase the relative stability of OME at a lower pH, the cavity of the cyclodextrin was too small to allow the inclusion to occur. However the R-isomer of OME, both in the presence or absence of the cyclodextrin appeared to be slightly less stable than the corresponding S-form at the same pH conditions.
Publisher: Springer Science and Business Media LLC
Date: 09-2023
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/EN13098
Abstract: Environmental context Diclofenac, a common non-steroidal anti-inflammatory drug, is not completely removed from surface and drinking water by conventional treatment methods. Consequently, this drug is present in the aquatic environment and has been subsequently linked to toxic effects on organisms. We show that photolysis and TiO2-catalysed degradation in circulating batch reactors efficiently results in diclofenac removal under a variety of conditions. These photochemical methods thus may lead to more effective water treatment processes. Abstract The occurrence of diclofenac (DCF) as an emerging pollutant in surface waters and drinking water has been attributed to elevated global consumption and the inability of sewage treatment plants to remove DCF. In this study, DCF spiked drinking water and river water was subjected to photolysis and TiO2 photocatalytic treatments in a circulating laboratory-scale (immersion-well) and a demonstration-scale loop reactor (Laboclean). The operational parameters for the immersion-well reactor were optimised as follows: TiO2 P25 loading, 0.1gL–1 natural pH, 6.2 initial concentration, 30mgL–1 water type, distilled water. Complete DCF removal was realised within 15min under the optimised conditions using the immersion-well reactor. Sunlight-mediated photochemical degradation required a prolonged exposure period of up to 360min for complete DCF removal. DCF in distilled and drinking water was efficiently degraded in the larger Laboclean reactor. Differences were, however, observed based on their pseudo-first-order rate constants, which implies that the water matrix has an effect on the degradation rate. Six major photoproducts, 2-(8-chloro-9H-carbazol-1-yl)acetic acid, 2-(8-hydroxy-9H-carbazol-1-yl)acetic acid, 2,6-dichloro-N-o-tolylbenzenamine, 2-(phenylamino)benzaldehyde, 1-chloromethyl-9H-carbazole and 1-methyl-9H-carbazole, generated from TiO2 photocatalysis of DCF were identified by liquid chromatography–mass spectrometry (LCMS) and Fourier transform–ion cyclotron resonance–mass spectrometry (FT-ICR-MS). This work has shown that photocatalytic degradation kinetics of DCF are dependent on both the geometry of the photoreactor and the nature of the water matrices.
Publisher: Oxford University Press (OUP)
Date: 16-03-2018
DOI: 10.1093/MMY/MYY010
Abstract: Captive and wild hibians are under threat of extinction from the deadly fungal pathogen Batrachochytrium dendrobatidis (Bd). The antifungal drug terbinafine (TBF) is used by pet owners to treat Bd-infected frogs however, it is not widely used in academic or zoological institutions due to limited veterinary clinical trials. To assess TBF's efficacy, we undertook treatment trials and pharmacokinetic studies to investigate drug absorption and persistence in frog skin and then we correlated these data to the minimal lethal concentrations (MLC) against Bd. Despite an initial reduction in zoospore load, the recommended treatment (five daily 5 min 0.01% TBF baths) was unable to cure experimentally infected alpine tree frogs and naturally infected common eastern froglets. In vitro and in vivo pharmacokinetics showed that absorbed TBF accumulates in frog skin with increased exposure, indicating its suitability for treating cutaneous pathogens via direct application. The MLC of TBF for zoosporangia was 100 μg/ml for 2 h, while the minimal inhibitory concentration was 2 μg/ml, suggesting that the drug concentration absorbed during 5 min treatments is not sufficient to cure high Bd burdens. With longer treatments of five daily 30 min baths, Bd clearance improved from 12.5% to 50%. A higher dose of 0.02% TBF resulted in 78% of animals cured however, clearance was not achieved in all in iduals due to low TBF skin persistence, as the half-life was less than 2 h. Therefore, the current TBF regime is not recommended as a universal treatment against Bd until protocols are optimized, such as with increased exposure frequency.
Publisher: Portland Press Ltd.
Date: 20-11-2007
DOI: 10.1007/S10540-007-9052-1
Abstract: The fact that the full extent of the function of the pineal gland has not yet been elucidated, has stimulated melatonin research worldwide. This review introduces melatonin's mechanism of action, direct and indirect antioxidant actions as well as the antioxidant properties of its metabolites, 6-hydroxymelatonin (6-OHM) and N-acetyl-N-formyl-5-methoxykynurenamine (AFMK). At present the mechanism of action is proposed to be receptor-, protein- and nonprotein-mediated. From its popular role in the treatment of jetlag, melatonin is now implicated in the reduction of oxidative stess, both as a free radical scavenger and antioxidant. Melatonin's direct scavenging action in respect of the following will be discussed: superoxide anions, hydrogen peroxide, hydroxyl radicals, singlet oxygen, peroxy radicals and nitric oxide eroxy nitrite anions. In addition melatonin also possesses indirect antioxidant activity and the role of its metabolites, AFMK and 6-OHM will be presented. It is these free radical scavenging and antioxidant properties of melatonin that has shifted the focus from that of merely strengthening circadian rhythms to that of neuroprotectant: a new place in therapy.
Publisher: Wiley
Date: 09-2001
DOI: 10.1034/J.1600-079X.2001.310209.X
Abstract: Melatonin (N-acetyl-5-methoxytryptamine) has a erse range of functions, including the control of neuroendocrine events. A number of studies have shown that melatonin may be of potential benefit for the treatment of insomnia, as well as neurodegenerative disorders. At present, there are numerous dosage forms of melatonin, with the oral route of administration being most popular. Presently, there is little information on the stability of melatonin over a pH range. With the changes in pH in the gastro-intestinal tract, as well as in different experimental conditions, information on the stability of melatonin would be important. We used a high-performance liquid chromatography method to determine the stability of melatonin solutions over a pH range (1.2-12) at room temperature and at 37 degrees C over a period of 21 days. The results show that no melatonin degradation occurred in the first 2 days. From days 3 to 21, there was a gradual decline in melatonin at all pHs, with the decline not exceeding 30%. No decline in melatonin levels occurred in the first 2 days at 37 degrees C. From days 3 to 21, melatonin levels declined gradually, with the decline not exceeding 29%.
Publisher: MDPI AG
Date: 17-09-2023
Publisher: Springer Science and Business Media LLC
Date: 26-05-2016
Publisher: BMJ
Date: 06-04-2018
Publisher: Frontiers Media SA
Date: 04-07-2013
DOI: 10.18433/J38887
Abstract: Although the world’s population is ageing and as a result of this an increasing number of patients are experiencing difficulty in swallowing, there remains a lack of commercially available oral liquids for both these older and paediatric patients. This presents a problem to health care professionals, especially the pharmacist in practice, who is often required to provide a solution for these patients by preparing oral liquids extemporaneously from commercially available products. Preparation of these oral liquids is challenging, both due to the lack of pharmacopoeial and stability-indicating formulae and the fact that their stability is not only determined by the active pharmaceutical ingredient, but also the ability of excipients from the commercial product to interact with each other and the active pharmaceutical ingredient. This increases the complexity of the stability considerations to be taken into account within these oral liquids, highlighting the number of parameters to be considered in the extemporaneous preparation of oral liquids. This paper presents new evidence on the stability of 42 oral liquids prepared from commercially available products, reported on in the literature since the previous review published in 2006. However, unlike the previous review where the stability concerns in 7.2% of the extemporaneously prepared oral liquids were mainly due to interaction between the active pharmaceutical ingredients and the excipients in the commercial product, most of these stability considerations have been recognised and this has resulted in the authors proposing solutions to these problems prior to the extemporaneous preparation of the oral liquid. As such this paper also focuses on the increased level of research that has been undertaken to solve previous issues related to stability, especially in terms of the use of commercial products, which is common practice in the extemporaneous preparation of oral liquids. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.ETAP.2018.03.019
Abstract: Frog skin structure and physiology differs between skin regions, however little is known about how these differences affect transdermal absorption of chemicals. Further, no information is available regarding how the relative lipophilicity of a chemical influences its transdermal pharmacokinetics in frog skin. This study investigated the in vitro percutaneous absorption of three model chemicals - benzoic acid, caffeine, and ibuprofen - through dorsal and ventral skin of the tree frog Litoria caerulea. Flux was significantly higher through the ventral skin for all chemicals. Relative lipophilicity affected flux differently in different skin regions. These differences are likely due to significantly thicker dorsal skin increasing absorption path length, and also possibly owing to lipoid secretions on the dorsum providing an additional diffusional barrier. This knowledge can advise risk mitigation of xenobiotics in agricultural and industrial settings, and also guide selection of chemicals and doses when considering transdermal drug therapy in captive frogs.
Publisher: Oxford University Press (OUP)
Date: 30-06-2020
DOI: 10.1111/IJPP.12648
Abstract: Expanded pharmacy service delivery for rural and remote Australia has potential to address the rural health disparity. Pharmacists practising to their full scope are recognised as being most beneficial in rural and regional communities, where access to health professionals (HPs) is not comparable to those in metropolitan areas. However, research on HP perspectives on expanded pharmacy practice is limited. This study aims to determine rural and remote HP (doctors, nurses, allied health and other HPs) perspectives of expanded services to be delivered through community pharmacy. Australian rural and remote HPs participated in a questionnaire survey which explored views on expanded pharmacy services in their local communities. Potential expanded pharmacy services were provided, and participants were asked to indicate what expanded pharmacy would benefit their local community and their level of support for the services. Analysis of the data included frequency analyses and one-way ANOVA tests with post hoc Tukey’s HSD tests using IBM SPSS Statistic 25. Health professionals (N = 121) from rural and remote locations participated. Sexually transmitted disease testing, vaccinations, diabetes and asthma management were the most frequently chosen services that HPs agreed would improve the health of people in their community. Doctors chose the least number of services (mean = 1 services) compared with all other HPs (mean =& 5 services). Sixty-eight per cent of participants agreed/strongly agreed that providing these additional services would improve health, with participants (73%) agreeing/strongly agreeing that they would support the implementation of these additional services, not otherwise available in their community. Comparing professional groups, doctors were only half as supportive of expanded pharmacy services, when compared with all other HPs. This study confirms the importance of a collaborative, local model to deliver expanded pharmacy services for rural communities. Health professionals were found to largely support expanding pharmacy practice, agreeing about the improved access to health care that would be provided for people living in rural and remote Australia.
Publisher: Hindawi Limited
Date: 07-03-2017
DOI: 10.1017/JSC.2017.3
Abstract: Introduction: The efficacy of varenicline as a smoking cessation aid is affected by commonly-occurring issues, such as intolerable adverse events, cravings and withdrawal symptoms, and poor medication adherence. Improvement in quit rates may be achieved through tailoring doses relative to in idual smokers’ behaviours, and previous experiences with smoking cessation medications. Aims: The aim of this review is to evaluate smoking cessation outcomes from published randomised controlled trials that have attempted to improve the efficacy and tolerability of varenicline through modifying its dosage regimen compared to placebo. Methods: A systematic search of the literature up to June 2016 was conducted to identify randomised controlled trials, where varenicline was administered in a regimen not consistent with the current clinical guidelines. Outcome measures evaluated included continuous abstinence rates, changes in cravings, withdrawal symptoms, smoking behaviours, adverse event rates, and premature therapy discontinuations. Results: Ten randomised controlled trials, encompassing four different modifications to standard varenicline therapy, matched the eligibility criteria. Modifications such as the extended duration of therapy and the use of a flexible quit date were effective compared to placebo and have been implemented into some clinical guidelines, whereas other modifications do not appear to produce any benefit for smokers, or require further research to ascertain their suitability for clinical practice. Conclusions: Some varenicline therapy modifications may lead to improvements in efficacy and tolerability. Further research on the effect of modifications such as daily doses higher than 2mg, tapering doses, and the use of extended pre-quit varenicline may advance varenicline therapy outcomes.
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.IJPHARM.2008.04.039
Abstract: The objective of this study was to develop a simple, direct and non-destructive method to assess crystal purity of mebendazole raw material and to establish its stability in a suspension formulation using diffuse reflectance ultraviolet (DRA-UV) spectroscopy and attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy. Quantitation of mebendazole, found to exhibit polymorphism with three polymorphic forms A, B and C identified, was carried out with ATR-FTIR spectroscopy. Artificial neural network (ANN) was employed as a data-modelling tool. The developed ANN models confirmed that the characteristic absorptions in the infrared (IR) spectral region are directly proportional to the measured amounts of mebendazole crystal forms present in the s les (r(2)>0.94), which was confirmed with X-ray diffraction (XRD) at r(2)>0.97. These models also predicted that the mebendazole raw material contained 7.21+/-1.25% (ATR-FTIR data) and 10.38+/-0.18% (XRD data) of form A as an impurity. ATR-FTIR data for the suspension formulation showed some dissolution of form C and recrystalisation as the more stable form A. These quantitative results obtained for the binary crystal form mixtures clearly demonstrate the strong potential of ATR-FTIR for use in the determination of the polymorphic content not only in bulk pharmaceuticals but also in liquid formulations.
Publisher: MDPI AG
Date: 20-04-2023
Abstract: Rural and remote populations are predisposed to poorer health outcomes, largely associated with limited access to health services and health professionals. This disparity provides an opportunity for health professionals to work collaboratively in interdisciplinary teams to deliver improved health outcomes for rural and remote communities. This study aims to explore exercise physiologist and podiatrist perceptions of interprofessional practice opportunities with pharmacists. Role theory provided a framework for this qualitative study. Interviews were conducted, recorded, transcribed, and thematically analysed according to the constructs of role theory (role identity, role sufficiency, role overload, role conflict, and role ambiguity). The perceptions of participants varied, largely due to the lack of understanding of the role and scope of the practice of a pharmacist. Participants acknowledged and adopted a flexible approach to the way in which they delivered health services to meet the needs of the community. They also described a more “generalist” approach to care, owing to the high prevalence of disease and disease complexity, along with a lack of staffing and resources. The potential for increased interprofessional collaboration was supported and identified as a strategy to manage significant workloads and provide improved patient healthcare. The application of role theory to this qualitative study provides insight into perceptions of interprofessional practice that may inform future development of remote practice models of care.
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.JPBA.2008.02.009
Abstract: Omeprazole, commonly used in the treatment of various gastrointestinal disorders degrades rapidly in acidic pHs and results in inter-in idual variability due to different rates of metabolism amongst patients. Since S-omeprazole shows more predictable bioavailability and excipients have been known to interact with active pharmaceutical ingredients to produce altered bioavailability, it was decided to investigate the compatibility of omeprazole sodium isomers with mannitol, the major excipient in omeprazole formulations using differential scanning calorimetry (DSC) for bulk drug, attenuated total reflectance (ATR) infrared (IR) spectroscopy in a powder mixture and localized thermal analysis (LTA) from a drug disk. DSC results clearly indicate an interaction between mannitol and R-omeprazole sodium due to decreased melting temperatures and broadening peaks. The DSC of S-omeprazole sodium does not show melting temperature although the drug was crystalline. Because of the accelerated temperature conditions during DSC experiments applied in this work, ATR-IR was undertaken to determine whether these results occurred at room temperature for the solid dosage form. The ATR-IR results show a difference between R- and S-omeprazole sodium with mannitol by the appearance of both the amino (N-H) and imino (N-H) stretching frequencies for R-omeprazole and only the N-H for the S-omeprazole sodium. It may thus be concluded that different ratios for the tautomeric forms for S- and R-omeprazole sodium result in changes in the degree of crystallinity and are responsible for the interaction with mannitol, common excipient in formulation. These interactions may be directly related to the difference in terms of bioavailability.
Publisher: Bentham Science Publishers Ltd.
Date: 12-02-2016
DOI: 10.2174/1574886311207040282
Abstract: Varenicline, the newest agent marketed for smoking cessation is regarded as effective in providing prolonged smoking abstinence. However, its adverse effect profile may cause discontinuation, potentially reducing smoking abstinence rates, thus requiring an examination of the frequency and impact of adverse effects on discontinuation. We sought only Randomised Controlled Trials (RCTs) evaluating the effectiveness and safety of varenicline on humans, with a follow-up period of at least three months and an average Fagerstrom Test for Nicotine Dependence (FTND) score at least 5 (moderate dependence) for both the active and placebo groups. PubMed, Medscape, JCU One Search, ClinicalTrials.gov (U.S.), and the Cochrane Collaboration from January 2006 to January 2015 were searched. Fixed and random effects models were run to determine relationships between adverse effects and premature discontinuation from varenicline. 12 RCTs were included, involving 5 459 patients, with those receiving varenicline found to be nearly twice as likely (Odds ratio (OR) = 1.82 [1.47 2.26]) to experience adverse effects compared to those patients on a placebo. The active group experienced nearly a 1.5 times higher (OR = 1.47 [1.19 1.81]) rate of discontinuation. Nausea, insomnia, and headache are the most commonly reported adverse effects, with ORs of 4.40 [3.80 5.11], 1.75 [1.48 2.08], and 1.20 [1.02 1.41] respectively. Adverse effects experienced during varenicline treatment appear to be associated with higher discontinuation, which are linked to lowered smoking cessation rates, suggesting a need for strategies to minimise the impacts of adverse effects, to better ensure adherence.
Publisher: Elsevier BV
Date: 09-2008
DOI: 10.1016/J.JPBA.2008.04.008
Abstract: Recent reports that a wide variety of natural and man-made compounds are capable of competing with natural hormones for estrogen receptors serve as timely ex les of the need to advance screening techniques to support human health and ascertain ecological risk. Quantitative structure-activity relationships (QSARs) can potentially serve as screening tools to identify and prioritize untested compounds for further empirical evaluations. Computer-based QSAR molecular models have been used to describe ligand-receptor interactions and to predict chemical structures that possess desired pharmacological characteristics. These have recently included combined and differential relative binding affinities of potential estrogenic compounds at estrogen receptors (ER) alpha and beta. In the present study, artificial neural network (ANN) QSAR models were developed that were able to predict differential relative binding affinities of a series of structurally erse compounds with estrogenic activity. The models were constructed with a dataset of 93 compounds and tested with an additional dataset of 30 independent compounds. High training correlations (r2=0.83-0.91) were observed while validation results for the external compounds were encouraging (r2=0.62-0.86). The models were used to identify structural features of phytoestrogens that are responsible for selective ligand binding to ERalpha and ERbeta. Numerous structural characteristics are required for complexation with receptors. In particular, size, shape and polarity of ligands, heterocyclic rings, lipophilicity, hydrogen bonding, presence of quaternary carbon atom, presence, position, length and configuration of a bulky side chain, were identified as the most significant structural features responsible for selective binding to ERalpha and ERbeta.
Publisher: Cambridge University Press (CUP)
Date: 2021
DOI: 10.1017/S1463423621000487
Abstract: In Australia, around 3.6 million people suffer from hearing loss, more than 1.3 million with preventable hearing conditions. Ear diseases are prevalent in Indigenous populations, particularly children and are associated with poor educational outcomes and subsequent high rates of unemployment and incarceration. In Australia, rural and remote communities have rates of middle ear perforations five times the rate that the World Health Organisation regards to be a significant public health problem. Barriers to accessing ear health services have been identified including gaps in testing during the ‘early years’ and difficulty in accessing these services. Reducing the risk of hearing loss through improved ear health care can directly impact the ability to learn and develop. Collaboration between community, health providers and government is crucial to ensure necessary support for change. An opportunity presents for rural community pharmacists, who are both qualified and accessible to provide an ear health programme and thus improve health outcomes for both Indigenous and non-Indigenous Australians in their communities. The aim of this study was to identify published evidence of pharmacists’ involvement in ear health care interventions to inform the development of ear health services able to be delivered in rural community pharmacy in Australia. The search strategy was applied to the following electronic databases: MEDLINE, Scopus, CINAHL, Emcare, Cochrane, Google Scholar and Google. Study selection articles were included if they described an ear health intervention in a community pharmacy setting. The interventions reported in the articles were evaluated for their inclusion of effectiveness, whether the service was sustainable, and the inclusion of enablers and barriers to the provision of ear care. The articles were also thematically analysed using the Deadly Ears Deadly Kids Deadly Communities Framework . A total 8427 articles were identified and evaluated against inclusion and exclusion criteria, with eleven eligible articles suitable for inclusion in the review. The articles included were conducted in Australia ( n = 4), England ( n = 4), United States of America ( n = 2) and Brazil ( n = 1). The ear health interventions identified included hearing screening ( n = 3), otoscopy pilot studies ( n = 2), audiometry services ( n = 1), specific education for undergraduate pharmacy students ( n = 2) and a pharmacy-based clinic ( n = 3). Effectiveness and sustainability were not formally reported in any of the included articles. Positive outcomes, funding availability, consumer access to community pharmacy, cost savings for consumers and improved connection to health providers were identified as enablers. Difficulty in attracting funding was the most commonly reported barrier. Improving ear health of both Indigenous and non-Indigenous peoples through services provided in community pharmacy presents as an important opportunity for rural pharmacists. Pharmacists are accessible and thus well placed to improve ear healthcare and resultant quality of life for these vulnerable populations. This review has identified factors required to effectively develop ear health models of care in community pharmacy including a pharmacist training program, continuous funding to ensure sustainability and support from pharmacy stakeholders and the community.
Publisher: Informa UK Limited
Date: 24-01-2020
DOI: 10.1080/10410236.2019.1567442
Abstract: University students are exposed to casual smoking, increasing their risk of developing nicotine addiction, which can extend into adulthood. A novel anti-tobacco intervention being investigated is the use of health warnings on in idual cigarette sticks. We explored the perceptions of university students on the effectiveness of health warnings on cigarette packaging and in idual cigarette sticks. An online survey was distributed to first-year university students enrolled at a regional university in North-Eastern Australia. Participants rated on 5-point Likert scales and commented using open-text comment boxes, the effectiveness of current cigarette packaging warnings, and 12 text warnings ( ided into four themes immediate and short-term consequences [ISC], long-term and mortality consequences [LMC], social and financial consequences [SFC], and supportive messages to quit [SMQ]) on in idual cigarette sticks, in preventing non-smokers from smoking, and in encouraging current smokers to quit. Participants (
Publisher: MDPI AG
Date: 22-12-2020
DOI: 10.3390/DJ9010002
Abstract: This review sheds light on the recent published scientific evidence relating to the use of professionally delivered local antimicrobial agents (LA’s). The review also analyses drug delivery systems available to date and provides an update on the latest scientific evidence about the benefits, limitations, and clinical results obtained by use of local drugs in the treatment of periodontal disease. The search strategy revealed randomized controlled trials (RCTs) that compared the efficacy of adjunctive LA’s to mechanical therapy alone. Based on the available evidence gathered from this review, we can infer that the use of local antimicrobial agents in conjunction to scaling and root debridement (SRD) delivers significant benefits in periodontal therapy and it is a useful aid, avoiding many of the side effects that systemic antibiotic therapy may involve. Local drug delivery (LDD) is an efficient and effective means of delivering drugs based on the evidence presented in the review. The authors of this review would suggest the use of local antimicrobials in cases of localized periodontitis or in idual areas that do not respond to the usual mechanical therapy alone. This review summarizes the current use of local drug delivery in periodontal management ensuring that the general practitioners are able to choose an appropriate local antimicrobial.
Publisher: Springer Science and Business Media LLC
Date: 28-01-2021
DOI: 10.1186/S12917-021-02765-5
Abstract: Infectious disease, particularly the fungal disease chytridiomycosis (caused by Batrachochytrium dendrobatidis ), is a primary cause of hibian declines and extinctions worldwide. The transdermal route, although offering a simple option for drug administration in frogs, is complicated by the lack of knowledge regarding percutaneous absorption kinetics. This study builds on our previous studies in frogs, to formulate and predict the percutaneous absorption of a drug for the treatment of infectious disease in frogs. Chlor henicol, a drug with reported efficacy in the treatment of infectious disease including Batrachochytrium dendrobatidis , was formulated with 20% v/v propylene glycol and applied to the ventral pelvis of Rhinella marina for up to 6 h. Serum s les were taken during and up to 18 h following exposure, quantified for chlor henicol content, and pharmacokinetic parameters were estimated using non-compartmental analysis. Serum levels of chlor henicol reached the minimum inhibitory concentration (MIC 12.5 μg.mL − 1 ) for Batrachochytrium dendrobatidis within 90–120 min of exposure commencing, and remained above the MIC for the remaining exposure time. C max (17.09 ± 2.81 μg.mL − 1 ) was reached at 2 h, while elimination was long (t 1/2 = 18.68 h). The model, based on in vitro data and adjusted for formulation components and in vivo data, was effective in predicting chlor henicol flux to ensure the MIC for Batrachochytrium dendrobatidis was reached, with serum levels being well above the MICs for other common bacterial pathogens in frogs. Chlor henicol’s extended elimination means that a 6-h bath may be adequate to maintain serum levels for up to 24 h. We suggest trialling a reduction of the currently-recommended continuous (23 h/day for 21–35 days) chlor henicol bathing for chytrid infection with this formulation.
Publisher: Springer Science and Business Media LLC
Date: 24-08-2013
Publisher: Wiley
Date: 15-11-2018
DOI: 10.1111/AJR.12462
Abstract: The objective of this review was to scope the impact of university rural curriculum and rural clinical placements on students' intentions to practise rurally and rural pharmacists' choice of rural practice. The scoping review used Arskey and O'Malley's methodological framework, searching the following databases: MEDLINE, CINAHL, Informit and Scopus. This scoping review followed PRISMA for article reporting. Studies were selected from those conducted in Australia, USA, Canada and Africa. Pharmacy undergraduate students, interns, registered and academic pharmacists were included. The pharmacy curriculum at universities and placements undertaken, specifically in rural and remote settings, were evaluated to determine their influence on intention to practise as a rural pharmacist. The search strategy generated 294 records, 31 of which were included in the scoping review. Key findings were mapped to two domains, which broadly included the impact of rural placements and curriculum on intention to practise rurally. Some universities have attempted to introduce a rural curriculum, but reported resources as a barrier and the lack of resulting evidence of students' intention to practise rurally. Although results indicate rural placements have had a positive influence on students' intention to work rurally, this intention has been measured immediately after exposure to rural practice and might not reflect future intentions. This review highlights significant gaps in the impact particularly of a rural curriculum and rural clinical placements in relation to the current rural pharmacist workforce. A greater understanding of this topic may guide recommendations for future strategies to address rural pharmacy workforce maldistribution.
Publisher: Wiley
Date: 30-04-2002
DOI: 10.1034/J.1600-079X.2002.01866.X
Abstract: Ultraviolet (UV) light is known to induce the generation of free radicals in biological tissues such as skin. Of these free radicals, the O2-. and particularly the.OH radical can induce cellular damage including lipid peroxidation. Thus, the use of antioxidants to prevent such damage induced by UV irradiation has received much attention recently. One such antioxidant, which has the potential to be incorporated into sunscreens, is the pineal secretory product melatonin. One of the concerns of using melatonin in sunscreens is its photostability. In the present study, we investigated the photostability of melatonin subjected to UV irradiation. In addition, we used liquid chromatography mass spectrometry (LC-MS) to identify the degradants and we also assessed the ability of the degradants to inhibit O2-. generation as well as lipid peroxidation in rat brain homogenate. The results show that UV irradiation of melatonin (0.1 mg/mL) using a 400-W l for 2 hr caused a significant decline of melatonin to 18% of its original concentration after 20 min, with the decline continuing until the melatonin concentration reaches zero at 120 min. The LC-MS results show that the degradants of melatonin are 6-hydroxymelatonin and N1-acetyl-N2-formyl-5-methoxykynurenamine (AFMK). These degradants were able to provide equipotent activity against potassium cyanide (KCN)-induced superoxide generation compared to non-irradiated melatonin. Thus, the study shows that although melatonin is rapidly degraded by UV irradiation, the degradants retain antioxidant activity, making melatonin a likely candidate for inclusion in sunscreens.
Publisher: Wiley
Date: 04-2021
DOI: 10.1111/AJR.12741
Abstract: Distribution of the Australian health workforce is uneven, with the majority of health professionals favouring metropolitan areas over rural and remote regions. Although nurses account for the largest proportion of the Australian rural and remote health workforce, difficulties with staff recruitment and retention can impact the health care outcomes of these vulnerable populations. Satellite university c uses that offer undergraduate nursing programs might therefore contribute to a more sustainable rural and remote nursing workforce. This narrative literature review aimed at investigating the barriers and enablers that affect students enrolled at satellite nursing c uses, education delivery methods and academic and non‐academic strategies employed to enhance the student learning experience. The literature was reviewed across 6 health and education databases. After screening, 12 articles met the inclusion criteria and were analysed, and the data were synthesised using a thematic approach. Three themes arose from the review: student characteristics and associated barriers and enablers to studying nursing at a satellite c us teaching strategies and learning experiences and academic and pastoral support. Students studying at satellite c uses were found to have different education experiences and faced challenges unique to their context however, home support networks and small class sizes were seen as enabling factors. Education delivery methods and support strategies varied depending on remoteness and resources available. Consideration of the factors that affect satellite c us nursing students has the potential to increase student satisfaction and retention, which could result in a more sustainable rural and remote nursing workforce.
Publisher: MDPI AG
Date: 15-06-2021
Abstract: Unaddressed hearing loss affects an estimated 466 million people worldwide, costing over $750 billion globally, with rural communities being particularly disadvantaged, due to the greater inequity in access to healthcare services. This mixed-methods study aimed to use the PRECEDE-PROCEED model to develop and pilot a rural community pharmacy-based ear health service, LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Program). The PRECEDE process involved an assessment of the predisposing, reinforcing and enabling constructs to support practice change through a scoping review, stakeholder surveys and interviews and consultation with governing bodies and regulatory authorities. The PROCEED segment structured the evaluation of the service pilot and informed planned implementation, process, impact and outcome evaluation. The pilot study conducted in February 2021 included 20 participants, with the most common ear complaints presented being pain, pressure or blockage. All these participants reported high levels of satisfaction with the service, would recommend the service to others and would attend the pharmacy first before seeing a GP for future ear complaints. The PRECEDE-PROCEED model provides a comprehensive model to guide the design of the LISTEN UP program, an innovative model, expanding services offered by rural community pharmacies, with preliminary results demonstrating high consumer satisfaction.
Publisher: Royal Pharmaceutical Society
Date: 03-2000
Publisher: Therapeutic Guidelines Limited
Date: 08-2011
Publisher: Informa UK Limited
Date: 03-2022
DOI: 10.2147/JMDH.S360654
Publisher: Elsevier BV
Date: 11-2015
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.CTCP.2019.01.004
Abstract: Complementary and alternative medicine (CAM) use in cancer is increasing. The purpose of this study was to systematically review the literature to determine demographic profiles and prevalence and reasons for use in cancer patients. In this systematic review, the databases OVID, PubMed, and Scopus were searched for studies on CAM use in cancer between 2009 and June 2018. The results showed that an average of 51% of cancer patients used CAM. Common independent demographic characteristics associated with CAM use were younger, female cancer patients, having higher education, earning a higher income and having previously used CAM. Frequent reasons for use, grouped into themes were shown to be to influence their cancer and general health and to treat complications of the cancer or therapy. The review provides an insight and will serve to better inform health professionals on how this population is using CAM.
Publisher: Oxford University Press (OUP)
Date: 18-07-2018
DOI: 10.1111/IJPP.12470
Abstract: We aimed to identify the experiences of Australian community pharmacists with smokers and their associated perceptions of effective health warnings on in idual cigarette sticks. A mixed-methods online survey was distributed to Australian pharmacists through pharmacy-specific social media pages, and the Pharmaceutical Society of Australia, followed by semi-structured face-to-face interviews with pharmacists in Townsville, Australia, who were purposively s led. The interviews continued until data saturation was achieved. Participants described their experiences with smokers, perceptions and effectiveness ratings of current cigarette packaging warnings, and 12 text warnings ( ided into four themes) on in idual cigarette sticks, and their general opinions on effective anti-tobacco health warnings. Seventy pharmacists participated in the survey and 17 pharmacists in the interviews. Both groups of pharmacists cited smoking-related personal or close-contact illness, pressure by family members or physicians and the financial costs of smoking as being the main drivers for quit attempts. Most interviewed pharmacists interact with smokers several times per week. Cigarette stick warnings describing mortality consequences (especially the ‘minutes of life lost’ warning) and the financial consequences of tobacco use were rated as significantly more effective than current packaging warnings (odds ratio [OR] = 2.23 95% confidence interval [CI]: 1.12–4.12, P = 0.02, and 1.97 95%CI: 1.01–3.84, P = 0.04, respectively). Pharmacists have considerable experience assisting smokers with quitting and based on these experiences believe that novel and tangible health warnings on cigarette sticks may be an effective future measure to combat tobacco use. Further research on the opinions of a more erse range of health professionals and the general community will generate more robust findings regarding this method of intervention.
Publisher: Springer Science and Business Media LLC
Date: 02-08-2022
DOI: 10.1186/S12912-022-00996-X
Abstract: Nurses constitute most of the rural and remote Australian health workforce, however staff shortages in these regions are common. Rural exposure, association, and undertaking rural clinical placements can influence health students’ decision to work rurally after graduation, however attending university in rural and remote regions has been shown to be a great contributor. An improved understanding of these nursing students’ experiences may inform changes to teaching and support strategies for these students, which in turn could improve their retention and completion rates, contributing to a more sustainable rural and remote Australian nursing workforce. This study aimed to explore and describe students’ experiences of studying nursing in the context of a satellite university c us located in a remote town, with a focus on education delivery methods, staff, support, student services, and barriers and enablers to successful study. Nine students participated in this qualitative descriptive study. Semi-structured interviews were undertaken, allowing participants to reflect on their experiences as nursing students in the context of a geographically remote satellite university c us. The resulting data were grouped into common themes and summarised. Students were generally positive regarding lectures delivered by videoconference or recorded lectures, as they allowed for greater flexibility which accommodated their busy personal lives. Face-to-face teaching was especially valuable, and students were particularly positive about their small cohort size, which enabled the creation of strong, supportive relationships between students, their cohort, and teaching and support staff. However, barriers related to student demographics and some difficulties with course engagement and c us staffing were experienced. The experiences of nursing students at remote university c uses are different from those experienced by traditional, metropolitan university students. Although these nursing students face additional barriers unique to the remote c us context, they benefit from a range of enabling factors, including their close relationships with other students, staff, family, and their local community.
Publisher: Elsevier BV
Date: 11-1999
DOI: 10.1016/S0378-5173(99)00292-6
Abstract: More than 50 years ago, a paper by E.G. Prout and F.C. Tompkins was published in the Transactions of the Faraday Society. The paper dealt with the kinetics of the thermal decomposition of crystals of potassium permanganate, and suggested a rate equation, which has become known as the Prout-Tompkins equation, for use in the kinetic analysis of solid state reactions. The paper has been extensively cited in the literature. Applications of the Prout-Tompkins equation in pharmaceutical stability studies are reviewed in this short review.
Publisher: American Society of Tropical Medicine and Hygiene
Date: 07-07-2021
Abstract: Antibiotics are commonly reported as being substandard or falsified in low- to middle-income countries, having potential to contribute to the development of antimicrobial resistance and drug-resistant infections. Amoxicillin, used to treat a number of infections and listed by the WHO as an essential medicine, presented as a good drug candidate for this study. We aimed to measure the prevalence of substandard and falsified amoxicillin oral products (tablets, capsules, and suspensions) in the National Capital District of Papua New Guinea (PNG). These oral products were surveyed in 2018 and 2019 from retail pharmacies, private and public health facilities, and the Area Medical Store, representing more than 90% of licensed medicine outlets. The product packaging was visually inspected, and the s les were analyzed for amoxicillin content using a validated high-performance liquid chromatography method. Although no falsified products were identified, 15% of the 190 products analyzed contained substandard amounts of amoxicillin. Quality varied with the dosage form ( P = 0.002), with capsules exhibiting the lowest incidence of substandard content (4% in 2019) and tablets collected in 2018 experiencing the highest failure rate (50%). Suspension (40%) quality was compromised by failure to achieve homogeneity on reconstitution. A higher incidence of substandard content ( P = 0.002) was associated with one major retail group. Routine testing of medicines by resource-poor countries is often unachievable, leading to the circulation of poor quality drugs, which is a global public health concern. Our study highlighted that substandard amoxicillin oral products are indeed prevalent in the NCD of PNG.
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.5688/AJPE79572
Publisher: Springer Science and Business Media LLC
Date: 2004
Publisher: Elsevier BV
Date: 09-2006
DOI: 10.1016/J.JPBA.2005.12.039
Abstract: The physical properties of drug substances may affect stability, manufacturing, dissolution and bioavailability. Variations in the degree of crystallinity in a pharmaceutical substance may exhibit physicochemical differences that impact at therapeutic, manufacturing, commercial and legal levels, yet no reference has been found on the physical properties of micronised omeprazole. This study reports on the physical and thermal characterisation of the sodium salts of S- and R-omeprazole, using diffuse reflectance infrared Fourier transform spectroscopy (DRIFT), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), microthermal analysis (microTA) and powder X-ray diffraction (XRPD). DSC experiments were performed in order to determine not only their thermal stability, but also the thermal history of both forms. SEM results indicate similar morphology, particle size and shape of powdered drug, while, microTA of processed discs shows different topographical images for S- and R-omeprazole, exhibiting a smoother surface for the S-form, indicative of the smoother particle size not evident in the SEM results. The low level of crystallinity of both enantiomers was confirmed by DRIFT spectroscopy and XRPD. Thermal stability by DSC of S- and R-omeprazole sodium salts was superior to that of the neutral omeprazole. This study has examined the physical and thermal properties of both forms and in highlighting their differences provides an explanation for the potential differences in bioavailability and therapeutic efficacy.
Publisher: Hindawi Limited
Date: 2002
DOI: 10.1155/S1110662X01000277
Abstract: The photostability of selected drug molecules, including furosemide, prochlorperazine, diclofenac, piroxicam, midazolam and nifedipine was studied, the kinetics of photodegradation, identification of the photodegradants investigated and mechanisms of photodegradation proposed. Selected cyclodextrins altered the photodegradation profiles of diclofenac, piroxicam, midazolam and nifedipine by either accelerating or retarding the rate of photodegradation and generating novel photodegradants.
Publisher: Wiley
Date: 09-2012
DOI: 10.1002/J.2055-2335.2012.TB00171.X
Abstract: Although guidelines indicate that dispersible aspirin tablets should not be repacked into dose administration aids, it is common practice especially among older people. To determine the stability of acetylsalicylic acid (ASA) in aspirin tablets repacked into Dosette boxes. Dispersible aspirin 300 mg tablets were removed from their primary (foil) packaging, and repacked as whole and split (halved) tablets into Dosette boxes under 4 storage conditions: refrigeration (2–8 °C), controlled room temperature (25 °C 60% relative humidity [RH]), accelerated (40 °C 75% RH), and ‘in‐use’ with natural variations in daylight exposure and internal temperature fluctuations (23–26 °C 45–60% RH) for 1 week. The high performance liquid chromatography method developed was validated for accuracy, precision, linearity and range, sensitivity, robustness and specificity, and the suitability of extraction media evaluated. Linearity (r 2 0.999), precision (relative standard deviation 2%) accuracy (recovery: 95–102%) and selectivity for the high performance liquid chromatography method were confirmed. The ASA content remained within specifications (95–105% of labelled amount) for all except the accelerated storage condition, with 93% of the ASA remaining. The split tablets did not display any additional ASA degradation when compared to the whole tablets under the same conditions. While the ASA content of the dispersible aspirin tablets remained within specifications at room temperature, there were changes in the physical appearance under accelerated storage conditions.
Publisher: Wiley
Date: 09-2013
DOI: 10.1002/J.2055-2335.2013.TB00258.X
Abstract: Paracetamol tablets are often repackaged into dose administration aids (DAAs) for prn use. Pharmacists have limited information regarding the long‐term stability of prn medicines stored in DAAs for extended periods due to infrequent dosing. According to current guidelines, in the absence of specific data, medicines should not be stored in a DAA for longer than 8 weeks. To determine the physicochemical stability of paracetamol tablets repackaged into DAAs and stored for 12 months. Paracetamol (Panamax) tablets were removed from primary packaging, repackaged into DAAs (Multi Dose Webster‐pak) and stored under ambient (25 °C 60% relative humidity) and accelerated (40 °C 75% relative humidity) conditions for 12 months. Physical characteristics of the tablets, such as appearance, weight uniformity, thickness, hardness, friability, disintegration and dissolution rates were evaluated at baseline, 3, 6 and 12 months. Chemical stability was confirmed by high performance liquid chromatography. All compendial requirements for physical stability were met for tablets stored under ambient and accelerated conditions over the 12‐month period. Chemical stability was confirmed, with paracetamol content in the tablets within the British Pharmacopoeial range of 95% to 105% of the labelled amount. This study provides data on the stability of paracetamol tablets repackaged into DAAs and stored under ambient and accelerated conditions for 12 months. Pharmacists will be able to make risk–benefit assessments and recommend a 12‐month expiry on paracetamol prn DAAs.
Publisher: Wiley
Date: 12-2019
DOI: 10.1002/JPPR.1619
Publisher: MDPI AG
Date: 12-01-2022
Abstract: Aim: The aim of this study is to explore pharmacist perspectives of the implementation of a community pharmacy-based ear health service in rural communities. Method: A community pharmacy-based health service model was designed and developed to provide an accessible ear care service (LISTEN UP—Locally Integrated Screening and Testing Ear aNd aUral Program) and pharmacist’s perspectives of the implementation of LISTEN UP were explored. Thematic analysis was conducted and data coded according to the Consolidated Framework for Implementation Research. Results: A total of 20 interviews were conducted with 10 pharmacists, averaging 30 min. Visualistion of the ear canal was reported as the greatest advantage of the service, whilst the time required for documentation reported as a complexity. The number of pharmacists working at one time and the availability of a private consultation room were identified as the two limiting factors for execution. On reflection, the need for government funding for service viability and sustainability was highlighted. Discussion/Conclusion: Expanded pharmacy practice is emerging for the Australian pharmacy profession. Rural community pharmacists are recognised as integral members of healthcare teams, providing accessible medication supply and health advice to seven million people in Australia who call rural and remote regions home. However, there are no structured models supporting them to provide expanded services to improve health outcomes in their communities. This study provides lessons learnt to guide future design and development of expanded models of pharmacy practice.
Publisher: MDPI AG
Date: 11-06-2023
Abstract: Expanding the scope of practice has provided an opportunity to reflect on the business management role of the community pharmacist. This study aimed to determine stakeholder perspectives of what business management skills are required for the community pharmacist, potential barriers impeding changes to management in the pharmacy program or community pharmacy setting, and strategies to improve the business management role of the profession. Purposively selected community pharmacists across two states in Australia were invited to participate in semi-structured phone interviews. A hybrid approach of inductive and deductive coding was used to transcribe and thematically analyse interviews. Twelve stakeholders described 35 business management skills in a community pharmacy, with 13 skills consistently used by participants. Thematic analysis revealed two barriers and two strategies to improve business management skills in both the pharmacy curriculum and community pharmacy. Strategies to improve business management across the profession include pharmacy programs covering recommended managerial content, learning from experience-based education and creation of a standardised mentorship program. There is an opportunity for business management culture change within the profession, and this may require community pharmacists developing a dual thinking process to appropriately balance professionalism and business management.
Publisher: Elsevier BV
Date: 03-2003
DOI: 10.1016/S0378-5173(03)00025-5
Abstract: The book "Chemistry of the Solid State", edited by W.E. Garner more than 50 years ago, contained a chapter (Chapter 10) by C.E.H. Bawn which dealt with the kinetics of the thermal decompositions of solids that are accompanied by some melting. Rate equations were derived and this model has become known as the Bawn model or as "Bawn kinetics". This kinetic model has proved particularly useful in pharmaceutical stability studies. The isothermal curves of extent of decomposition, alpha, against time for this model are sigmoidal and the problems of distinguishing this model from other sigmoidal models (Prout-Tompkins, Avrami-Erofeev) have been examined. Under programmed temperature conditions, distinguishability becomes even more difficult.
Publisher: Elsevier BV
Date: 10-2003
DOI: 10.1016/S0891-0618(03)00034-6
Abstract: Both 6-hydroxymelatonin and N-acetyl-N-formyl-5-methoxykynurenamine are photodegradants and enzymatic metabolites of melatonin and are known to retain equipotent activity against potassium cyanide-induced superoxide generation compared to melatonin. It is not clear whether one or both of these metabolites is responsible for this effect. The present study therefore investigates the possible manner in which 6-hydroxymelatonin protects against oxidative stress induced by cyanide in rat brain homogenates. We examined the ability of 6-hydroxymelatonin to scavenge KCN-induced superoxide anion generation as well as lipid peroxidation. In addition, we also examined the effect of this indole on lactate dehydrogenase activity (LDH) as well as mitochondrial electron transport using dichlorophenol-indophenol as an electron acceptor. The results of this study show that 6-hydroxymelatonin significantly reduces KCN-induced superoxide anion generation, which is accompanied by a commensurate reduction in lipid peroxidation. Partial reversal of the KCN-induced reduction in mitochondrial electron transport is accompanied by a similar reversal of mitochondrial LDH activity blunted by KCN. It can thus be proposed that 6-hydroxymelatonin is potentially neuroprotective against KCN-induced neurotoxicity.
Publisher: Wiley
Date: 26-10-2021
DOI: 10.1002/JPPR.1688
Publisher: Springer Science and Business Media LLC
Date: 14-04-2021
DOI: 10.1186/S12917-021-02860-7
Abstract: An amendment to this paper has been published and can be accessed via the original article.
Publisher: Springer Science and Business Media LLC
Date: 2003
Publisher: Springer Science and Business Media LLC
Date: 17-01-2019
Publisher: Springer Science and Business Media LLC
Date: 2001
Publisher: Wiley
Date: 09-2007
DOI: 10.1002/J.2055-2335.2007.TB00738.X
Abstract: Repackaging tablets into a dose administration aid (DAA) requires that the pharmacist consider the stability of the active pharmaceutical ingredient and the excipients of the drug product. Frusemide is susceptible to photodegradation and is commonly repackaged into DAAs. To evaluate the stability (chemical and physical) of frusemide tablets repackaged into DAAs. Frusemide tablets repackaged into DAAs were evaluated for physicochemical stability over a period of 8 weeks at a controlled room temperature (25 ±2 °C) and other relevant in‐use conditions. In addition, photostability studies were performed according to the International Committee on Harmonisation (ICH) guidelines. Chemical stability was confirmed for all storage conditions, including the ICH light conditions, with the frusemide content within the British Pharmacopoeial range of 95 to 105%. Although the physical stability was confirmed by all tests (weight uniformity, hardness, friability, disintegration, dissolution), storage in a simulated pharmacy environment after one week and exposure to ICH light conditions resulted in a yellow colouration of the tablets. Although the chemical and physical stability of frusemide was within acceptable limits during the study, the discolouration of the tablets from light exposure is unacceptable. It is recommended that DAAs are stored protected from light immediately after repackaging with frusemide tablets, and that patients are counselled to store the DAA in a cool dark place.
Publisher: Frontiers Media SA
Date: 17-10-2018
Publisher: Oxford University Press (OUP)
Date: 29-06-2010
Publisher: International Pharmaceutical Federation (FIP)
Date: 18-09-2022
Abstract: Background: Global demand for work-ready pharmacy graduates has highlighted the role of pharmacy preceptors and the need for training and support from universities. There remains a lack of consensus on the ideal requirements for preceptor training programmes. Objective: To assess community pharmacy preceptor training and support requirements at a regional Australian University. Method: A mixed method study using an online survey of community pharmacy preceptors of James Cook University, followed by qualitative semi-structured interviews. Result: 55 preceptors completed the survey, and ten interviews were conducted. Preferred programme content included role clarification, a curriculum outline and management of poorly performing students. Demands on in iduals’ time and workloads support a flexible online approach to training and highlight the importance of institutional support for optimal preceptor engagement and retention. Conclusion: Good teaching and communication skills were considered by preceptors to be essential for their primary role in linking theory to practice for pharmacy students during experiential placements.
Publisher: National Library of Serbia
Date: 2016
Abstract: Midazolam, a potent anxiolytic drug with sedative properties, is susceptible to degradation by both light and hydrolysis in aqueous solution. When formulated as an intranasal product it was found to be effective in achieving seizure control in epileptic patients. In order to deliver an adequate therapeutic dose to a patient, a nasal formulation requires the concentration of midazolam to be higher than its? aqueous solubility. One way to increase midazolam solubility to a therapeutic concentration, is complexation with randomly methylated-?-cyclodextrin. Thus, it is important to determine how complexation with cyclodextrin affects the rate of degradation and type of midazolam degradants that are formed. We have found that complexation with cyclodextrin decreases its photostability. More importantly, the degradation profile for midazolam is significantly altered when it is complexed with randomly methylated-?-cyclodextrin, what we partly confirmed in our previous work.1 By continuing our study we have found that degradation products, not observed on the photodegradation of uncomplexed midazolam are observed in significant quantities when it is complexed with randomly methylated-?-cyclodextrin. The decreased photostability was accompanied by the appearance of two new degradation products, an intermediate structure and a dimer. Photoproduct formation followed the same pattern as in the forced degradation studies, further confirming the presence of an intermediate. The production of these new photodegradants, characterized with their MS spectra, as well as proposed degradation mechanism of midazolam is discussed.
Publisher: Informa UK Limited
Date: 03-2020
DOI: 10.2147/JMDH.S236488
Publisher: Cambridge University Press (CUP)
Date: 25-09-2012
DOI: 10.1017/S1049023X12001392
Abstract: The need to manage psychological symptoms after disasters can result in an increase in the prescription of psychotropic drugs, including antidepressants and anxiolytics. Therefore, an increase in the prescription of antidepressants and anxiolytics could be an indicator of general psychological distress in the community. The purpose of this study was to determine if there was a change in the rate of prescription of antidepressant and anxiolytic drugs following Cyclone Yasi. A quantitative evaluation of new prescriptions of antidepressants and anxiolytics was conducted. The total number of new prescriptions for these drugs was calculated for the period six months after the cyclone and compared with the same six month period in the preceding year. Two control drugs were also included to rule out changes in the general rate of drug prescription in the affected communities. After Cyclone Yasi, there was an increase in the prescription of antidepressant drugs across all age and gender groups in the affected communities except for males 14-54 years of age. The prescription of anxiolytic drugs decreased immediately after the cyclone, but increased by the end of the six-month post-cyclone period. Control drug prescription did not change. There was a quantifiable increase in the prescription of antidepressant drugs following Cyclone Yasi that may indicate an increase in psychosocial distress in the community. Usher K , Brown LH , Buettner P , Glass B , Boon H , West C , Grasso J , Chamberlain-Salaun J , Woods C . Rate of prescription of antidepressant and anxiolytic drugs after Cyclone Yasi in North Queensland . Prehosp Disaster Med . 2012 27 ( 6 ):1-5 .
Publisher: Elsevier BV
Date: 03-2012
Publisher: Bentham Science Publishers Ltd.
Date: 06-2004
Abstract: Microemulsions, being thermodynamically stable systems, with low viscosity and elegant in appearance have attracted interest not only for the delivery of single drug substances with low water solubility but for the stabilization of drugs in combination due to their preferential solubility in either the water or oil phases. Microemulsion design involves the solubilisation of an optimum amount of the dispersed phase in the continuous phase, utilizing the minimum amount of surfactant/mixture of surfactants/cosurfactants. It is the choice of the surfactant/surfactant mixture and/or cosurfactants, which poses the greatest challenge in the design of a thermodynamically stable microemulsion formulation. This paper will present a strategy for choosing surfactants to achieve a stable, dilutable microemulsion formulation for oral administration. Ternary and pseudo-ternary phase diagrams were constructed by titrating a series of mixtures [lipid (miglyol 812): cosurfactant and/or surfactant (cremophor RH, imwitor 308/742, sorbitol, brij 97, crillet 3)] with water at room temperature, the phases formed visually assessed after each addition and classified as isotropic (ME), liquid crystalline (LC) or coarse emulsions (EM). Results indicate that the surfactant combination of imwitor 308 and crillet 3 proved most successful in incorporating 25 to 30% miglyol 812 into a microemulsion formulation utilizing an intermediate quantity of surfactant and maintaining homogeneity on dilution.
Publisher: MDPI AG
Date: 02-09-2020
Abstract: Pharmaceutical care is a concept which has moved the pharmacy profession from their primary focus on the product to optimising drug therapy for the in idual patient. Expanded pharmacy practice beyond pharmaceutical care will further challenge the role perceptions that other health professionals have about pharmacists. Role theory as a philosophical perspective was used to explore rural and remote health professionals’ beliefs on pharmacists expanding their clinical role by conducting twenty-three semi-structured interviews. Five role theory categories described the data, role ambiguity, role conflict, role overload, role identity and role insufficiency. The health professionals interviewed were found to be uncertain about the boundaries between the traditional roles of the pharmacist compared to that of the expanded roles. A perceived lack of accountability by pharmacists was seen as a major contributor to role conflict, which in turn was found to impact the ability of pharmacists and other health professionals to work collaboratively. Perspectives of other health professionals on pharmacists adopting expanded practice models has highlighted significant concerns with role conflict and role identity. Acknowledging and developing clear strategies to address these concerns is essential to ensure that expanded pharmacy practice can be effectively integrated to improve access to health services and thus health outcomes for rural Australians.
Publisher: Elsevier BV
Date: 06-2023
Publisher: Hindawi Limited
Date: 20-09-2017
DOI: 10.1017/JSC.2017.17
Abstract: Background: Varenicline remains the most effective medication for smoking cessation however, discontinuation as a result of adverse events negatively impacts medication adherence, and the likelihood of a quit attempt being successful. Post-treatment cravings and withdrawal symptoms may also occur, increasing the likelihood of treatment failure, due to lapse and relapse after achieving initial abstinence. This protocol details a trial investigating changes in the effectiveness and tolerability of varenicline, when an extended step-up and step-down regimen are used. Methods: A phase four, randomised, double-blinded, placebo-controlled single-centre study with a treatment period of 16 weeks, and follow-up period of 12 weeks will be conducted. Up to 201 participants will be enrolled and allocated in a 1:1:1 ratio to a placebo-matching control group, step-up, or step-down intervention group, all receiving behavioural counselling and quitting advice. Participants will be contacted weekly during treatment and fortnightly during follow-up. Eligible participants are smokers over 18 years old, willing to quit smoking, are able to attend clinic visits, and have no uncontrolled or serious medical issues. Primary outcome measures are comparisons of biochemically confirmed continuous abstinence rates, 7-day point prevalence abstinence rates, and the frequency, severity and duration of adverse events, cravings and withdrawal symptoms. Secondary outcome measures are participant adherence to the study medication throughout treatment, and comparisons of changes in smoking satisfaction and reward. Effects of each regimen on smoking cessation will be assessed by logistic regression, with survival analyses used for a more precise estimate of when cessation occurs. Primary endpoints will then be compared using a general linear model. Australian New Zealand Clinical Trials Registry: ACTRN12616000802404p
Publisher: Hindawi Limited
Date: 04-2009
DOI: 10.1111/J.1365-2710.2008.00981.X
Abstract: Patients are increasingly requiring their medications to be repackaged into dose administration aids because of the positive outcomes associated with reduction in medication related hospitalization and adverse effects due to improved medicines management. Since the stability of these repackaged medications is not the responsibility of manufacturer, it is important that drug substances with potential stability issues be identified. Thus the objective of this study was to evaluate the stability of prochlorperazine, a light sensitive drug repackaged into dose administration aids (DAAs), in order to provide guidelines to the pharmacist and advice to the patient on appropriate storage. Prochlorperazine tablets were stored repackaged in DAAs and in their original packaging for 8 weeks at ambient (25 +/- 1 degrees C 60 +/- 1.5% RH), accelerated (40 +/- 1 degrees C 75 +/- 1.5% RH) and in-use conditions encountered in situ both in a pharmacy and the patients' home. They were assessed for both chemical (using a validated HPLC method) and physical stability according to British Pharmacopoeial (BP) standards. In addition, photostability testing was undertaken under ICH conditions. Chemical and physical stability was confirmed to be within BP Limits. There were, however, noticeable organoleptic changes in the tablets stored under in-use conditions with a progressive grey discolouration over the 8 weeks, starting in week 2. Despite the confirmation of physical and chemical stability within BP limits, the discoloration and the potential for photodegradants to cause adverse effects in patients must lead us to draw the conclusion that the quality of this medication has been compromised. Pharmacists thus need to take this into account in repackaging and storage of prochlorperazine in DAAs and advise patients to store their DAA protected from light, heat and humidity.
Publisher: Oxford University Press (OUP)
Date: 2006
Abstract: A high-performance liquid chromatography (HPLC) assay is described for the determination of indomethacin in porcine plasma using acetonitrile to precipitate plasma proteins and for the one-step extraction. Calibration curves (using the internal standard method) are linear (r2 > 0.98) over the concentration range of 50.0 to 3000 ng/mL in both mobile phase and plasma. Precision, expressed as the inter- and intraday coefficient of variation (n = 5), is < 7% on the same day and < 5% between days at each plasma control s le of 300, 1000, and 3000 ng/mL, respectively. System precision, calculated as the coefficient of variation (n = 5), is < 7% at 3000 ng/mL of indomethacin, and the limit of quantitation in plasma is 50 ng/mL. The absolute recovery for both indomethacin and the internal standard (mefenamic acid) from plasma is over 97% (n = 3), and the concentrations do not deviate more than -2.9% to 2.4% from their actual values. The specificity of the method is confirmed. This technique is thus reported to be both rapid and specific. The real advantage is the small s le volume required (500 microL), which allows it to be considered for the quantitation of indomethacin in plasma from paediatric patients.
Publisher: Bentham Science Publishers Ltd.
Date: 12-02-2016
DOI: 10.2174/1574886310666150928104931
Abstract: Compliance Aids have gained widespread use to assist patients in managing their medicines, with a view to addressing the issue of adherence. However, although patient outcomes may have been improved through better use of compliance aids, it has been highlighted that there are limited data on the stability of medicines, when removed from the original container and repackaged in a compliance aid. Exposure of medicines to heat, light, moisture and air (oxygen) may impact on both their chemical and physical stability, resulting in the potential for quality of the medicine and thus the safety for the patient being compromised. It is also uncertain whether the compliance aid can provide the same protection from these environmental conditions as the manufacturer's packaging, even though the time frame for repackaging is only 28 days. This paper presents a comprehensive review and detailed discussion of the available literature on the stability implications of repackaging medicines into compliance aids. The importance of repackaging is thus highlighted by its ability to impact on therapeutic outcomes for patients.
Publisher: Springer Science and Business Media LLC
Date: 15-10-2020
DOI: 10.1007/S00455-019-10072-3
Abstract: Dementia is reported to be the overall fourth leading non-communicable cause of death, and accounted for almost two million deaths worldwide (3.5% of the total number) in 2016. Dysphagia and aspiration pneumonia secondary to dementia are the two most serious comorbidities. As the dementia progresses and the severity of an in idual's dysphagia increases, the question of whether to commence an artificial nutrition or allow a person to continue to eat and drink orally is raised, both having associated risks. The purpose of this study was to establish current perspectives regarding the method(s) of feeding being used or preferred, once an in idual with dementia has reached the end stages of the disease and is unable to swallow safely and efficiently, and ascertain the reasons for the choice made. An online search was completed, and articles published in English available up to April 2018 were considered for inclusion. Hand searching inclusive of the grey literature was also completed to obtain the maximum amount of relevant information. The total yield numbered 1888 studies, and following exclusions, full text studies deemed suitable for review amounted to 18. Themes were generated during the review process, relevant information was extracted, and six main themes emerged: feeding method aspiration pneumonia mortality malnutrition ethical considerations, and religion. The review indicated that the preferred method of feeding in end-stage dementia was artificial nutrition, in most cases via percutaneous endoscopic gastrostomy. However, despite the perceived advantage of providing artificial nutrition, no convincing evidence was found to support the use of tube feeding in end-stage dementia. In fact, initiating tube feeding was considered to have adverse effects such as aspiration pneumonia, malnutrition and expedited death. Longitudinal research regarding current practice is therefore indicated to establish an optimal procedure for in iduals with end-stage dementia and dysphagia.
Publisher: Springer Science and Business Media LLC
Date: 14-06-2021
DOI: 10.1186/S40814-021-00856-6
Abstract: Ear disease is a major cause of preventable hearing loss and is very common in rural communities, estimated to affect 1.3 million Australians. Rural community pharmacists are well placed to provide improved ear health care to people who are unable to easily access a general practitioner (GP). The purpose of this study is to apply an ear health intervention to the rural community-pharmacy setting in Queensland, Australia, to improve the management of ear disease. The aims are the following: (1) to evaluate the feasibility, potential effectiveness and acceptability of a community pharmacy-based intervention for ear health, (2) to evaluate the use of otoscopy and tympanometry by pharmacists in managing ear complaints in community pharmacy and (3) to evaluate the extended role of rural pharmacists in managing ear complaints, with the potential to expand nationally to improve minor ailment management in rural communities. This is a longitudinal pre- and post-test study of a community-pharmacy-based intervention with a single cohort of up to 200 patients from two rural community pharmacies. Usual care practices pertaining to the management of ear complaints will be recorded prior to the intervention for 8 weeks. The intervention will then be piloted for 6 weeks, followed by a 12 month impact study. Patients aged 13 years presenting to the pharmacies with an ear complaint will be invited to participate. Trained pharmacists will conduct an examination including a brief history, hearing screening, otoscopy and tympanometry assessments. Patients will be referred to a general practitioner (GP) if required, according to the study protocol. Patients will complete a satisfaction survey and receive a follow-up phone call at 7 days to explore outcomes including prescribed medications and referrals. Pharmacists and GPs will complete pre- and post- intervention interviews. Patient, pharmacist and GP data will be analysed using descriptive statistics and thematic analysis for the qualitative data. This study will demonstrate the implementation of a screening and referring ear health intervention in rural community pharmacy. Feasibility, potential effectiveness and acceptability of the intervention will be assessed. Australian and New Zealand Clinical Trial Registry Number: ACTRN12620001297910 .
Publisher: Elsevier BV
Date: 02-2020
Publisher: Informa UK Limited
Date: 04-2018
DOI: 10.2147/JMDH.S156161
Publisher: E.U. European Publishing
Date: 31-01-2018
DOI: 10.18332/TID/82191
Publisher: Springer Science and Business Media LLC
Date: 2004
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.JENVMAN.2018.04.103
Abstract: Pharmaceuticals, which are frequently detected in natural and wastewater bodies as well as drinking water have attracted considerable attention, because they do not readily biodegrade and may persist and remain toxic. As a result, pharmaceutical residues pose on-going and potential health and environmental risks. To tackle these emerging contaminants, advanced oxidation processes (AOPs) such as photo-Fenton, sonolysis, electrochemical oxidation, radiation and ozonation etc. have been applied to remove pharmaceuticals. These processes utilize the high reactivity of hydroxyl radicals to progressively oxidize organic compounds to innocuous products. This review provides an overview of the findings from recent studies, which have applied AOPs to degrade pharmaceutical compounds. Included is a discussion that links various factors of TiO
Publisher: Bentham Science Publishers Ltd.
Date: 09-2005
Abstract: The aim of this study to design a stable microemulsion formulation to deliver a combination of rif icin, isoniazid and pyrazinamide in quantities suitable for administration to a paediatric population. The chemical stability of rif icin, isoniazid and pyrazinamide alone and in various combinations was investigated in different solvents, solubilizing agents and surfactants. An artificial neural network was used to model data from the stability studies and a sensitivity analysis was applied to optimize the selection of the formulation components. Imwitor 308 and Crillet 3, exhibiting the highest overall positive sensitivity were selected to formulate the stable microemulsion. Due to drug dose specifications and solubility limitations, the final formulation contained only rif icin and isoniazid, since the solubility of pyrazinamide in the lipid and aqueous components of the microemulsion did not achieve the required dose. The stability and solubility of rif icin were improved in the formulation. Solubilization of the rif icin in the lipid droplets of the internal phase and lipophilic chains of the surfactants increased the quantity of rif icin that can be incorporated, while protecting it from oxidative degradation and also limited its contact with isoniazid, which has been shown to affect its stability. The results of this study indicate that the Artificial Neural Network can be successfully used to optimize the choice of solvents, solubilizing agents and surfactants prior to formulation of the microemulsion, limiting the amount of experiments, thus reducing the costs during the preformulation study.
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.5688/AJPE799142
Publisher: Elsevier BV
Date: 07-2023
Publisher: Informa UK Limited
Date: 12-2020
DOI: 10.2147/JMDH.S279243
Publisher: Elsevier
Date: 2013
Publisher: Wiley
Date: 25-11-2020
DOI: 10.1111/JVP.12824
Abstract: Frogs have permeable skin, so transdermal delivery provides a practical alternative to traditional dosing routes. However, little is known about how frog skin permeability differs interspecifically, and there are different reported clinical outcomes following topical application of the same chemical in different frog species. This study collated in vitro absorption kinetic data previously reported for two frog species: the green tree frog (Litoria caerulea) and the cane toad (Rhinella marina), and used linear mixed-effects modelling to produce a model of absorption. Histology of skin s les from each species was performed to observe morphological differences that may affect absorption. Absorption kinetics differed significantly between species, with the logP of the applied chemical a better predictor of permeability than molecular weight. Application site also influenced permeability, with dorsal permeability consistently higher in cane toads. Ventral permeability was more consistent between species. Skin thickness differed between species and skin regions, and this may explain the differences in absorption kinetics. Guidelines for selecting chemicals and dosing site when treating frogs are presented. The permeability differences identified may explain the poor reproducibility reported in the treatment of disease across frog species, and reinforces the importance of considering interspecies differences when designing therapeutic treatments for frogs.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.CPTL.2022.07.002
Abstract: The literature is dearth in identification and categorization of business management skills required by community pharmacists. While community pharmacy stakeholders (predominantly community pharmacy owners, managers, and pharmacists) and pharmacy students are valuable sources for identifying business management skills, no review is currently available that synthesizes their knowledge. By identifying currently known business skills and organizing these into a managerial skills framework, this review provides a foundation skillset for community pharmacist business management. Six electronic databases were searched for published articles, with titles and abstracts screened according to inclusion criteria. Full articles meeting the specified criteria were assessed and skills identified were mapped to the human, conceptual, and technical skills of a business management framework. Pharmacy stakeholders and students identified 36 business management skills/aptitudes required for community pharmacists. Pharmacy stakeholders most frequently identified the skills of communication, professionalism, general business management, leadership, and teamwork. Although the pharmacy students concurred with many of these skills, they more frequently identified confidence, entrepreneurship, and having prior experience or opportunity in a management role. A substantial number of identified skills/aptitudes were categorized under the human domain of the business management framework. Community pharmacists require training in effective business management, with particular emphasis on human domain skills. The tertiary education system should consider implementing the skills/aptitudes revealed in this review into the pharmacy curriculum. Recruiting business minded personalities into the profession, particularly targeting students with an attraction to business management, is one strategy to improve management skills within the field.
Publisher: Elsevier BV
Date: 10-2020
DOI: 10.5688/AJPE8039
Publisher: Wiley
Date: 04-2019
DOI: 10.1111/AJR.12490
Abstract: This two-phase study aimed to explore the influence of a university rural curriculum and clinical placements on pharmacists' choice to practise in a rural or remote area. A sequential mixed-methods approach involved the design of both a questionnaire and semistructured in-depth interviews to collect quantitative and qualitative data. Regional, rural and remote practice areas according to the Pharmacy Access/Remoteness Index of Australia classifications. Ninety-two pharmacists from varied areas of practice, working in rural and remote locations across Australia, participated in the study. University curriculum and clinical placements during the degree and their influence on the current rural workforce. In the survey s le, two-thirds of the current rural pharmacy workforce's choice of practice location was significantly influenced by positive rural placement experiences. Rural practice was, however, not included in the curriculum for 50% of the rural workforce in the s le, although graduates from regional universities experienced up to 80% more exposure to rural curricula. In this s le, rural origin was also not found to be a significant determinant of rural practice, while rural lifestyle, family commitments, remuneration, career opportunities and other contractual agreements have had a greater influence than university education. Although the positive influence of rural placements has been identified, there is still a way to go in terms of the development of a meaningful rural curriculum. This highlights that universities have a role to play in addressing this issue to produce graduates who are better prepared for the opportunities and challenges of rural pharmacy practice.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.SEIZURE.2015.07.007
Abstract: Sodium valproate, which is commonly repacked to assist with adherence to ensure seizure control, is hygroscopic and therefore sensitive to moisture. The aim of this study was thus to determine the stability implications of removing the enteric coated tablets from their original packaging and repackaging into a Dose Administration Aid (DAA) with storage under various environmental conditions. Physicochemical stability of enteric coated sodium valproate tablets repackaged into a DAA and stored at controlled room temperature, accelerated and refrigerated conditions was evaluated for 28 days. A validated high performance liquid chromatography method was used for the quantitation of the drug content. Although the chemical stability (sodium valproate between 95 and 105% of labelled content) was maintained for 28 days for all storage conditions, for those tablets stored under accelerated conditions the integrity of the enteric coat was compromised after only 8 days. Repackaging of enteric coated sodium valproate should be undertaken with caution and be informed by storage climate. This is particularly relevant for those patients living in hot, humid environments where they should be advised to store their DAA in a refrigerator.
Publisher: Wiley
Date: 12-10-2016
DOI: 10.1111/JVP.12264
Abstract: The permeable nature of frog skin presents an alternative route for the delivery of therapeutic chemicals to treat disease in frogs. However, although therapeutic chemicals are often topically applied to the skin of frogs, their pharmacokinetics have rarely been reported. To provide evidence to guide both candidate drug and formulation selection, we highlight factors expected to influence percutaneous absorption through frog skin, including the anatomy and physiology of the skin and the physicochemical properties of applied therapeutic chemicals. Importantly, we also highlight the effects of the formulation on percutaneous absorption, especially the inclusion of potential penetration enhancers as excipients. Finally, we collate empirical data on the topical application of various therapeutic chemicals in postmetamorphic frogs and show that, in contrast to mammalian species, even large chemicals (i.e. >500 Da) and those with a wide range of log P values (-4 through +6) are likely to be absorbed percutaneously. Topical application in frogs thus promises a convenient and effective method for delivering systemic treatments of a erse range of chemicals however, further experimental quantification is required to ensure optimal outcomes.
Publisher: International Pharmaceutical Federation (FIP)
Date: 19-11-2021
DOI: 10.46542/PE.2021.211.731758
Abstract: Background: Pharmacists are increasingly called to integrate population health approaches into their role. Public health knowledge and skills are recommended to be incorporated into the pharmacy curricula and professional development to enable competence of pharmacists in this area. Aim: To describe the competencies required by pharmacists to contribute to the public health of populations. Methods: A scoping review of peer-reviewed and grey literature discussing competencies in both pharmacy and public health was conducted. Competencies were extracted into a matrix of pharmacy and public health competencies and inductive coding of themes was undertaken. Results: Analysis of 58 papers showed important themes of professionalism, communication and collaboration with communities and other health professionals. Pharmacist services providing health promotion, screening and disease prevention should be directed at community needs. Evolution of pharmacy competencies in global health, health informatics and disaster management are current topics. Conclusion: A public health perspective in all pharmacy competency domains may assist pharmacists to understand their responsibility in improving the health and wellbeing of communities and ensure the profession has a positive impact on local, national and global health indicators.
Publisher: Wiley
Date: 07-11-2022
DOI: 10.1002/JPPR.1838
Abstract: Approximately half of people with cancer are using complementary and alternative medicine (CAM), presenting safety concerns due to potential interactions with conventional cancer treatment. Oncology staff have a role to play in ensuring the safe use of CAMs and so, this study examined their knowledge, attitudes, and practices regarding CAMs. This study aimed to assess the knowledge, attitudes, and practices of Australian doctors, nurses, and pharmacists regarding CAM use in oncology. Members of three national oncology professional associations took part in an online questionnaire, which determined their knowledge, attitudes, and practices regarding CAM. Ninety‐nine completed surveys were obtained from nine doctors, 70 nurses, and 20 pharmacists. Most respondents (68.4%) felt that they did not have adequate knowledge of CAMs to respond to patients' questions. Assessment of attitudes found respondents generally believed that CAMs have a complementary role in oncology but indicated their concerns for the safety of patients. Respondents indicated in practice they would discuss CAMs with less than half of patients (40.6%), with a lack of scientific data and guidelines for CAM use presenting significant barriers to these discussions. Our study suggests that oncology health professionals' knowledge of CAMs potentially leads to a lack of confidence in providing advice to patients and concerns for patient safety. This impacts their discussion of CAMs and lack of disclosure from patients about their use of CAMs. Education on CAMs in oncology would assist in increasing professionals' confidence in discussing these therapies, leading to increased patient disclosure of CAMs and safer treatment decision making for people with cancer.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Oxford University Press (OUP)
Date: 15-06-2023
DOI: 10.1093/IJPP/RIAD037
Abstract: Mental health patients struggle with medication adherence, providing opportunities for pharmacists to have a critical role in implementing key interventions for this patient cohort. This scoping review aimed to identify and evaluate evidence of pharmacists’ involvement in medication adherence interventions in mental health patients. Three databases were searched from January 2013 to August 2022: PubMed, Embase and CINAHL. The first author independently performed screening and data extraction. Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was utilized to report this review. Themes related to the pharmacist’s role in improving medication adherence for mental health patients were identified and the strengths and weaknesses of these studies were evaluated. A total of 3476 studies were identified and 11 studies met the selection criteria. Study types included retrospective cohort studies, quality improvement projects, observational studies, impact studies, service evaluations and longitudinal studies. Pharmacists worked primarily in community pharmacies, hospitals, or interdisciplinary mental health clinics, and improved medication adherence within these settings, at transitions of care, and by utilizing digital health. The patient perspective was valuable in identifying barriers and enablers to medication adherence. Pharmacists had varying levels of education and training, with studies highlighting the importance of completing extended training programs and partaking in expanded roles such as pharmacist prescribing. This review highlighted the need for expanded pharmacist roles within multidisciplinary mental health clinics and further training in psychiatric pharmacotherapy, to aid pharmacists in confidently improving medication adherence for mental health patients.
Publisher: Springer Science and Business Media LLC
Date: 1996
DOI: 10.1007/BF01041558
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2021-057011
Abstract: Ear disease in rural and remote communities is occurring at high rates, with limited access to health services and health providers contributing to the problem. Community pharmacists are well-placed to provide expanded services to improve ear health in rural communities. We aimed to evaluate the feasibility, accessibility and acceptability of a pharmacist-led intervention for ear disease in consumers presenting to community pharmacy. Prospective preintervention and postintervention mixed-methods study. An ethnographic lens of rural culture was applied to the descriptive qualitative component of the study. Two rural community pharmacies in Queensland, Australia. People aged 6 months or older, who present with an ear complaint to a participating community pharmacy. LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Programme) is a community pharmacy-based intervention to improve the management of ear health. Trained pharmacists conducted ear examinations using otoscopy and tympanometry on consumers following a LISTEN UP protocol. They made recommendations including no treatment, pharmacy only products or general practitioner (GP) referral. Consumers were contacted 7 days later for follow-up. 55 rural consumers participated in the study. The most commonly reported complaints were ‘blocked ear’ and ‘ear pain’. Pharmacists recommended over-the-counter products to two-thirds of the participants and referred one quarter to a GP. 90% (50/55) of the consumers were highly satisfied with the service and would recommend the service. All consumers described the service positively with particular reference to convenience, improved confidence and appreciation of the knowledge gained about their ear complaint. Pharmacists were motivated to upskill and manage workflow to incorporate the service and expected both consumers and GPs to be more accepting of future expanded services as a result of LISTEN UP. However, without funding to provide the service, during the study other remunerated pharmacy tasks took priority over providing LISTEN UP. Rural community pharmacists can provide an acceptable and accessible ear health service however, it is not feasible without a clear funding structure to provide resources including additional pharmacists, equipment and training. ACTRN12620001297910.
Publisher: Royal Society of Chemistry (RSC)
Date: 1993
DOI: 10.1039/P29930002175
Publisher: Elsevier BV
Date: 09-2021
Publisher: Therapeutic Guidelines Limited
Date: 03-12-2018
Publisher: Springer Science and Business Media LLC
Date: 2003
Publisher: Wiley
Date: 09-2005
DOI: 10.1002/J.2055-2335.2005.TB00333.X
Abstract: Isoniazid mixtures are compounded in Australia using commercially available isoniazid tablets. To determine the stability of isoniazid 10 mg/mL mixture compounded from commercially available isoniazid tablets. The stability of the compounded isoniazid mixture stored at a range of temperatures (4–60 °C) was assessed with high performance liquid chromatography. Differential scanning calorimetry was used to investigate the compatibility of isoniazid with the excipient, lactose. The compounded isoniazid mixture exhibited significant degradation (≥ 10% after 3 days at 4 and 25 °C), whereas the control (using isoniazid powder) retained desired stability ( 90% at 30 days) under identical conditions. A replicate control formulation, spiked with lactose, produced statistically similar degradation profiles to that of the compounded isoniazid mixture (p 0.05), indicating lactose to be responsible for the degradation of isoniazid. The thermoanalytical studies demonstrated an incompatibility between isoniazid and lactose (broadening and shifting of melting endotherm of isoniazid at 171.46 °C). The British Pharmaceutical Codex specifies the use of isoniazid powder for compounding isoniazid mixture. This study highlights the importance for stability evaluations on all modified extemporaneous preparations in order to ensure that quality pharmaceuticals are delivered to patients.
Publisher: Penerbit UMT, Universiti Malaysia Terengganu
Date: 31-01-2021
Publisher: Wiley
Date: 21-11-2006
DOI: 10.1111/J.1471-4159.2005.03532.X
Abstract: Oxidative damage of biological macromolecules is a hallmark of most neurodegenerative disorders such as Alzheimer, Parkinson and diffuse Lewy body diseases. Another important phenomenon involved in these disorders is the alteration of iron homeostasis, with an increase in iron levels. The present study investigated whether 6-hydroxymelatonin (6-OHM) can reduce Fe2+-induced lipid peroxidation and necrotic cell damage in the rat hippoc us in vivo. It was found that 6-OHM administration proved successful in reducing Fe2+-induced neurotoxicity in rat hippoc us. This study provides some evidence of the neuroprotective effects of 6-OHM.
Publisher: OMICS Publishing Group
Date: 05-2011
DOI: 10.4066/AMJ.2011.693
Publisher: Wiley
Date: 11-05-2021
DOI: 10.1111/GER.12555
Abstract: To explore the current status of gerodontology in the undergraduate dental curriculum. Internationally, there is recognition for the need to include gerodontology in dental education due to accelerating numbers of older dentate people. There is wide variation in the content and method of delivery of gerodontology in undergraduate curricula of dental schools. A scoping review framework was chosen to identify existing gaps and key concepts in the research on current undergraduate gerodontology education. Arksey and O’Malley's framework was used with the qualitative data analysis software NVivo to identify comparable information on geriatric dental education. Five themes were highlighted in the studies including (1) gerodontology curriculum content, (2) attitudes, skills and knowledge of undergraduate dental students, (3) didactic teaching, (4) elective and compulsory teaching, and (5) extra‐mural learning. The review found large variations in methodologies, presentation of data and findings. All studies emphasised a need for greater inclusion of gerodontology content in the undergraduate dental curriculum. The review found limited research reporting on the educational outcomes of gerodontology in dental curricula with a lack of comprehensive information to inform gerodontology content in dental schools. This review has highlighted the need for national and international guidelines to ensure mandatory inclusion of sufficient and specific gerodontology training to prepare graduates for a growing dentate frail and care‐dependent population.
Publisher: Wiley
Date: 19-10-2004
Publisher: Canadian Society of Hospital Pharmacists (CSHP)
Date: 31-08-2017
Abstract: strong ABSTRACT /strong strong Background: /strong Vaccination is a safe, efficient, and cost-effective means of preventing, controlling, and eradicating many life-threatening infections and diseases. Globally, the World Health Organization estimates that vaccination saves between 2 million and 3 million lives annually. However, low immunization rates are a significant public health concern. In idual factors, along with the vaccination process and system, have been reported as perceived barriers and challenges to immunization. Lack of time, on the part of both health care professionals and patients, has also been reported as a key factor influencing patterns of immunization. Despite the accessibility of pharmacists in community pharmacies in Australia, and initiatives by other countries to introduce pharmacist vaccination services, pharmacists in Australia had not previously delivered this service. The Queensland Pharmacist Immunisation Pilot (QPIP), initially implemented for the 2014 influenza season and later expanded, as QPIP2, to include other vaccines, allowed Australian pharmacists to vaccinate for the first time. strong Objectives: /strong To develop, implement, and evaluate a training program for pharmacists undertaking vaccination services in community pharmacies in Australia. strong Methods: /strong Background content was developed and delivered through 2 online modules. Pharmacists were required to successfully answer a series of multiple-choice questions related to the background reading before attending a face-to-face workshop. The workshop provided practical training in injection skills and anaphylaxis management. Participants were also asked to evaluate the training program. strong Results: /strong Of the 339 pharmacists who completed the training program, 286 (84%) provided an evaluation. Participants were satisfied with the training, as indicated by consistently high scores on the “overall satisfaction” question (mean 4.65/5 for the QPIP and QPIP2 training combined). Participants described the background reading as relevant to their practice and stated that it met their expectations. They also valued the opportunity to practise injections on each other during the face-to-face workshop, and this aspect was noted as a key component of the training. strong Conclusions: /strong QPIP demonstrated that a pharmacist-specific training program could produce competent and confident immunizers and could be used to “retrofit” the profession, to facilitate delivery of vaccination services in Australia. strong RÉSUMÉ /strong strong Contexte : /strong La vaccination est un moyen sécuritaire et efficient de prévenir, d’endiguer et d’éradiquer bon nombre d’infections et de maladies potentiellement mortelles. L’Organisation mondiale de la santé estime que, dans le monde, la vaccination permet de sauver entre 2 millions et 3 millions de vies par année. Cependant, les faibles taux d’immunisation représentent un enjeu de santé publique important. On a noté que des facteurs in iduels ainsi que le processus et le système de vaccination sont perçus comme des obstacles à l’immunisation. Le manque de temps, tant de la part des professionnels de la santé que des patients, a aussi été présenté comme un facteur clé influençant les schémas d’immunisation. Malgré la disponibilité de pharmaciens dans les pharmacies communautaires en Australie et les initiatives lancées par d’autres pays pour mettre en place des services de vaccination offerts par les pharmaciens, les pharmaciens en Australie n’avaient pas prodigué ce service auparavant. L’étude Queensland Pharmacist Immunisation Pilot (QPIP), d’abord mise en place pour la saison de la grippe de 2014, puis reconduite en une version bonifiée nommée QPIP2 afin d’inclure d’autres vaccins, a permis aux pharmaciens australiens de vacciner pour la première fois. strong Objectifs : /strong Élaborer, mettre en place et évaluer un programme de formation pour les pharmaciens qui offrent des services de vaccination dans les pharmacies communautaires en Australie. strong Méthodes : /strong La matière du programme a été élaborée et offerte sous forme de deux modules en ligne. Les pharmaciens devaient répondre adéquatement à une série de questions à choix multiples portant sur les lectures préparatoires à un atelier en personne. L’atelier offrait une formation pratique sur les techniques d’injection et sur la prise en charge de l’anaphylaxie. On a aussi demandé aux participants d’évaluer le programme de formation. strong Résultats : /strong Des 339 pharmaciens ayant terminé le programme de formation, 286 (84 %) ont fourni une évaluation. Les participants étaient satisfaits de la formation, comme l’indiquaient des cotes systématiquement élevées à la question concernant la satisfaction globale (moyenne de 4,65 sur 5 pour la formation des études QPIP et QPIP2 prises ensemble). Les participants ont indiqué que les lectures préparatoires étaient pertinentes pour leur pratique et qu’elles répondaient à leurs attentes. Ils ont aussi apprécié l’occasion de s’exercer à faire des injections les uns sur les autres au cours de l’atelier en personne on a d’ailleurs noté que cet aspect représentait un élément clé de la formation. strong Conclusions : /strong L’étude QPIP a permis de constater qu’un programme de formation destiné aux pharmaciens pouvait produire des vaccinateurs compétents et sûrs d’eux et qu’il pouvait servir à « moderniser » la profession afin de faciliter la prestation de services de vaccination en Australie.
Publisher: Elsevier BV
Date: 05-2003
Publisher: Rural and Remote Health
Date: 26-07-2021
DOI: 10.22605/RRH6158
Publisher: Elsevier BV
Date: 12-2022
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 08-2007
DOI: 10.1002/JPS.20987
Publisher: Oxford University Press (OUP)
Date: 2007
Abstract: The aim of this study is to develop and optimize a simple and reliable high-performance liquid chromatography (HPLC) method for the simultaneous determination of rif icin (RIF), isoniazid (INH), and pyrazinamide (PZA) in a fixed-dose combination. The method is developed and optimized using an artificial neural network (ANN) for data modeling. Retention times under different experimental conditions (solvent, buffer type, and pH) and using four different column types (referred to as the input and testing data) are used to train, validate, and test the ANN model. The developed model is then used to maximize HPLC performance by optimizing separation. The sensitivity of the separation (retention time) to the changes in column type, concentration, and type of solvent and buffer in the mobile phase are investigated. Acetonitrile (ACN) as a solvent and tetrabutylammonium hydroxide (tBAH), used to adjust pH, have the greatest influence on the chromatographic separation of PZA and INH and are used for the final optimization. The best separation and reasonably short retention times are produced on the micro-bondapak C18, 4.6 x 250-mm column, 10 microm/125 A using ACN-tBAH (42.5:57.5, v/v) (0.0002M) as the mobile phase, and optimized at a final pH of 3.10.
Publisher: Elsevier BV
Date: 12-2022
DOI: 10.1016/J.CTIM.2022.102879
Abstract: This study aimed to investigate CAMs used, and reasons for and disclosure of this use by cancer patients in a regional hospital in North Queensland, Australia. Patients attending the Day Oncology Unit of the Townsville University Hospital were invited to participate in a self-completed questionnaire or telephone interview regarding perspectives of their CAM use. Data were analysed using descriptive statistics and chi-squared and independent t-tests were performed to allow comparison between the responses by CAM users and non-users. 102 completed questionnaires were used in the analysis, where 40.2 % of respondents were found to be using some form of CAM. Cannabis, magnesium, and massage were the most prominent therapies used, with cannabis use in cancer, not commonly reported in prior literature. The main reasons given for using CAM were to treat symptoms of cancer, side-effects of treatment or to improve general health. Two-thirds of these respondents disclosed their CAM use to health professionals mostly to obtain a professional opinion or due to concerns of interactions with cancer treatment. CAM users were statistically more likely to have used CAM prior to their cancer diagnosis and have lower emotional wellbeing than non-users. Non-CAM users indicated that a lack of knowledge of CAM or concerns regarding interactions with cancer treatment were the most popular reasons for not adopting these therapies. While lower than the averages of previously published CAM use, our study highlights that there is still a significant group of cancer patients in the North Queensland region using CAMs.
Publisher: Springer Science and Business Media LLC
Date: 2002
No related grants have been discovered for Beverley Glass.