RESUMO
This work aimed to evaluate the impact of different storage conditions and light and temperature exposures on the visual aspect and chemical composition of the essential oil (EO) of Piper lhotzkyanum Kunth, obtained from leaves by hydrodistillation from a region of high altitude. For this purpose, aliquots of the EO were stored for up to 90 days (a) under a refrigerator condition of 5 ± 3°C, (b) under a long-term (LT) condition of 30 ± 2°C and 75 ± 5% relative humidity (RH) and an accelerated condition (AS) of 40 ± 2°C and 75 ± 5% RH, and (c) in a photostability test achieved in amber and colorless glass vials. The changes were monitored on days 0 (control), 60, and 90 for the refrigerator, LT, and AS conditions. All EO chemical analyses were assessed by GC-FID and GC-MS for quantification and identification, respectively. It is reported, for the first time, that the EO of P. lhotzkyanum is rich in the sesquiterpenes ß-elemene and α-zingiberene. No significant changes in the EO was observed, revealing a minimal impact of temperature on the sample at the different storage conditions. However, there was a change in the content of α-zingiberene to bicyclogermacrene after exposure to light. The visual appearance of the samples was altered for all test conditions except the refrigerator condition. These results can potentially contribute to the product development of a bioactive EO from leaves of P. lhotzkyanum, a sesquiterpene rich natural material.
Assuntos
Óleos Voláteis/análise , Piper/química , Folhas de Planta/química , Óleos de Plantas/análise , Armazenamento de Medicamentos/métodos , Luz , Óleos Voláteis/química , Óleos Voláteis/efeitos da radiação , Óleos de Plantas/química , Óleos de Plantas/efeitos da radiação , Temperatura , Fatores de TempoRESUMO
Diabetes prevalence within the global population has nearly doubled since 1980, with the most rapid growth occurring in low- and middle-income countries. Diabetes management in resource-limited settings such as Haiti presents many challenges, including the storage of insulin. Despite a lack of published data on insulin thermostability, storage at 2-8°C or at room temperature (25°C) is recommended. In Haiti, access to refrigeration and thereby proper insulin storage is severely limited. Commercial storage devices such as the FRIO cooling wallet are cost-prohibitive and not available locally, and alternatives such as small clay pots are fragile and nonportable. Here, we designed and tested the cooling efficacy of a homemade wallet made of acrylate polymer beads and a hand-sewn cotton pouch compared to a FRIO wallet and a clay pot. All studies were conducted over a ten-day period at the Kay Mackenson Clinic in Montrouis, Haiti. Temperature and humidity values were continuously collected using wireless monitors placed inside each device, and hourly ambient temperature and humidity values were manually recorded. Evaporative cooling efficacy was calculated using collected data. The homemade wallet and FRIO cooling wallet demonstrated comparable cooling efficacy with an average of 71% and 73%, respectively. The clay pot demonstrated significantly decreased efficacy with an average of 27% (p < 0.05). The homemade insulin wallet is a promising alternative for the storage of insulin in low-resource settings without the financial and physical barriers of commercial and locally sourced devices. Additionally, this wallet could be readily adapted for the storage of other perishable medical supplies in low-income countries.
Assuntos
Insulina , Refrigeração/instrumentação , Água/fisiologia , Temperatura Baixa , Armazenamento de Medicamentos/métodos , Desenho de Equipamento , Haiti , Humanos , Umidade , Insulina/uso terapêutico , Microesferas , Refrigeração/métodos , Temperatura , Água/químicaRESUMO
Introdução: a falta de um medicamento durante a internação hospitalar, põe em risco o correto cumprimento dos planos terapêuticos traçados para os pacientes, o que pode vir a gerar a recidiva de um quadro clínico, o prolongamento do tempo de internação e o consequente aumento de custos para a instituição, seja ela pública ou privada. Dentro da cadeia logística do medicamento, diversas são as etapas que podem contribuir para o desabastecimento. No âmbito hospitalar essa logística se dá por meio do ciclo da assistência farmacêutica que compreende as etapas de seleção, programação, aquisição, armazenamento, distribuição e dispensação de medicamentos. Os estoques da farmácia hospitalar são caracterizados por ciclos de demandas e de ressuprimentos, com flutuações significativas, o que dificulta a disponibilidade na mesma proporção da utilização do medicamento. Tendo em vista esta complexidade torna-se necessário o uso de indicadores, que avaliem os processos de trabalho. Objetivos: o objetivo deste estudo foi identificar as principais causas de desabastecimento de medicamentos em uma unidade de saúde e desenvolver um manual para otimização da aquisição de medicamentos. Materiais e método: Inicialmente foi realizado um mapeamento do fluxo de valor a fim de compreender a movimentação de materiais e informações envolvidos no processo de aquisição de medicamentos. Posteriormente, confeccionou-se uma planilha para registrar o fluxo logístico dos produtos, que resultou na obtenção dos pontos críticos do processo. A coleta dos dados de aquisição de medicamentos foi realizada durante o ano de 2019. Os critérios avaliados foram definidos com base nas ocorrências que mais contribuíram para o desabastecimento, seja pela relevância, ou pela frequência. Por fim foi elaborado um manual contendo critérios, normas, e procedimentos, a serem seguidos a fim de se evitar o desabastecimento. Resultados: Elaboração de um manual para otimização da aquisição de medicamentos composto por: mapa do fluxo de valor logístico de medicamentos, planilha para registro da logística de aquisição de medicamentos, procedimentos operacionais padrão para a gestão da aquisição de medicamentos. Conclusão: com o manual espera-se otimizar a gestão logística de medicamentos e reduzir a incidência de problemas com desabastecimento, gerando um impacto positivo na assistência ao paciente
Introduction: the lack of a drug during hospitalization puts at risk the correct compliance with the therapeutic plans outlined for the patients, which can lead to the recurrence of a clinical condition, the extension of the hospital stay and the consequent increase in costs for the institution, whether public or private. Within the drug's logistics chain, there are several steps that can contribute to shortages. In the hospital context, this logistics takes place through the pharmaceutical care cycle, which comprises the stages of selection, programming, acquisition, storage, distribution and dispensing of medicines. Hospital pharmacy stocks are characterized by cycles of demand and resupply, with significant fluctuations, which makes availability in the same proportion as the use of the medication difficult. Due to this complexity, it is necessary to use indicators that assess work processes. Objectives: The aim of this study was to identify the main causes of drug shortages in a health unit and to develop a manual for optimizing drug acquisition. Materials and method: Initially, a mapping of the value stream was carried out in order to understand the flow of materials and information involved in the drug procurement process. Subsequently, a spreadsheet was made to record the logistical flow of the products, which resulted in the critical points of the process being obtained. Logistic data for drug acquisition during 2019 were collected and the criteria evaluated were defined based on the occurrences that most contributed to the shortage, either by relevance or by the frequency with which they occurred. Finally, a manual was created containing criteria, norms, and procedures to be followed in order to avoid shortages. Results: Preparation of a manual for optimizing drug procurement, comprising: a map of the logistical value flow of drugs, a spreadsheet for recording the logistics of drug procurement, standard operating procedures for managing drug procurement. Conclusion: the manual is expected to optimize the logistical management of medicines and reduce the incidence of problems with shortages, generating a positive impact on patient care
Assuntos
Humanos , Masculino , Feminino , Serviço de Farmácia Hospitalar/métodos , Serviço Hospitalar de Compras/organização & administração , Armazenamento de Medicamentos/métodos , Serviço de Farmácia Hospitalar/organização & administração , Otimização de Processos/métodos , Administração de Materiais no Hospital/tendênciasRESUMO
This study's objective was to analyze Brazilian and international scientific evidence on the reasons people store medication at home and the disposal methods used. This systematic literature review includes studies published from 2001 to 2016 and indexed in PubMed, Lilacs and Elsevier's Scopus Database, using the following key words: Disposal of medicines in household, Disposal of drugs expired, Residential expired drugs, Management of expired medications in household. Thirty-three studies were selected after applying inclusion and exclusion criteria. The studies reveal that the main reasons people keep a stock of medicines at home include the possibility of future use, leftovers from previous treatments, and self-medication. Inappropriate disposal methods prevail, such as throwing medicines in the household trash or flushing them into the sewer. Some countries have adopted programs to educate on proper storage and disposal of medicines, though only one study describes a national program guiding these practices that is free of charge. Evidence shows there is a need to implement public policies intended to provide guidance on the proper storage and disposal of medicines at home.
Este estudo teve como objetivo analisar a evidência científica nacional e internacional existente sobre o motivo do estoque e a forma de descarte dos medicamentos no domicílio. Realizou-se uma revisão sistemática da literatura de 2001 a 2016 nas bases de dados PubMed, Lilacs e Elsevier's Scopus Database, utilizando os seguintes unitermos: "Disposal of medicines in household", "Disposal of expired drugs", "Residential expired drugs", "Management of expired medications in household". Foram selecionados 33 estudos originais após aplicação dos critérios de inclusão e exclusão. Os estudos analisados demonstraram que os principais motivos de estoque no domicílio foram: automedicação; guarda para uso futuro e sobras de tratamentos anteriores. E quanto ao descarte dos medicamentos, prevalecem práticas inadequadas, como descarte no lixo comum e na rede de esgoto. Alguns países têm adotado programas de orientação sobre o armazenamento e o descarte correto, no entanto, foi apenas encontrado um estudo que descreve um programa nacional gratuito, para orientar essas práticas. A partir das evidências cientificas verificou-se a importância do incentivo para a elaboração e a implementação de políticas públicas voltadas para o uso e descarte adequado de medicamentos no domicílio.
Assuntos
Armazenamento de Medicamentos/métodos , Preparações Farmacêuticas , Eliminação de Resíduos/métodos , Brasil , Humanos , Política PúblicaRESUMO
Resumo Este estudo teve como objetivo analisar a evidência científica nacional e internacional existente sobre o motivo do estoque e a forma de descarte dos medicamentos no domicílio. Realizou-se uma revisão sistemática da literatura de 2001 a 2016 nas bases de dados PubMed, Lilacs e Elsevier's Scopus Database, utilizando os seguintes unitermos: "Disposal of medicines in household", "Disposal of expired drugs", "Residential expired drugs", "Management of expired medications in household". Foram selecionados 33 estudos originais após aplicação dos critérios de inclusão e exclusão. Os estudos analisados demonstraram que os principais motivos de estoque no domicílio foram: automedicação; guarda para uso futuro e sobras de tratamentos anteriores. E quanto ao descarte dos medicamentos, prevalecem práticas inadequadas, como descarte no lixo comum e na rede de esgoto. Alguns países têm adotado programas de orientação sobre o armazenamento e o descarte correto, no entanto, foi apenas encontrado um estudo que descreve um programa nacional gratuito, para orientar essas práticas. A partir das evidências cientificas verificou-se a importância do incentivo para a elaboração e a implementação de políticas públicas voltadas para o uso e descarte adequado de medicamentos no domicílio.
Abstract This study's objective was to analyze Brazilian and international scientific evidence on the reasons people store medication at home and the disposal methods used. This systematic literature review includes studies published from 2001 to 2016 and indexed in PubMed, Lilacs and Elsevier's Scopus Database, using the following key words: Disposal of medicines in household, Disposal of drugs expired, Residential expired drugs, Management of expired medications in household. Thirty-three studies were selected after applying inclusion and exclusion criteria. The studies reveal that the main reasons people keep a stock of medicines at home include the possibility of future use, leftovers from previous treatments, and self-medication. Inappropriate disposal methods prevail, such as throwing medicines in the household trash or flushing them into the sewer. Some countries have adopted programs to educate on proper storage and disposal of medicines, though only one study describes a national program guiding these practices that is free of charge. Evidence shows there is a need to implement public policies intended to provide guidance on the proper storage and disposal of medicines at home.
Assuntos
Humanos , Preparações Farmacêuticas , Eliminação de Resíduos/métodos , Armazenamento de Medicamentos/métodos , Política Pública , BrasilRESUMO
Beginning in 1974, the date on which the Expanded Program on Immunization was established in the Americas, the number of deaths and disabilities due to certain infectious diseases decreased considerably thanks to universally applied vaccines. A program that initially included four vaccines that protected against six diseases (tuberculosis, diphtheria, pertussis, tetanus, polio and measles) was consolidated, over the years, by incorporating new vaccines and significantly raising coverage rates. The Sociedad Argentina de Pediatría (Argentine Society of Pediatrics), as a leader of opinion, played a leading role in the incorporation of new vaccines, currently reaching one of the most complete vaccination calendars in the world, which improves the levels of inequality and inequity in public health. Taking into account the significant role of the pediatrician in decision-making, the National Committee of Infectious Diseases, together with the Subsidiary Committees, prepared a document on updates and recommendations for 2018 on Polio, Rotavirus, Pneumococcus, Meningococcus, Human Papillomavirus, Chickenpox, Flu, Dengue vaccines and Whooping Cough.
A partir del año 1974, cuando se estableció el Programa Ampliado de Inmunizaciones en las Américas, la cantidad de muertes y discapacidades por enfermedades infecciosas disminuyó de manera considerable gracias a las vacunas aplicadas. Inicialmente, se incluyeron cuatro vacunas que protegían contra seis enfermedades (tuberculosis, difteria, coqueluche, tétanos, polio y sarampión), y, a través de los años, al incorporar nuevas vacunas, aumentaron considerablemente las tasas de cobertura. La Sociedad Argentina de Pediatría tuvo un rol destacado en la incorporación de nuevas vacunas y, en la actualidad, hay uno de los calendarios de vacunación más completos del mundo, lo que permite mejorar los niveles de desigualdad e inequidad en salud pública. Teniendo en cuenta el rol que tiene el pediatra en la toma de decisiones, el Comité Nacional de Infectología, junto con comités de filiales, elaboró un documento sobre actualizaciones y recomendaciones de 2018 acerca de polio, rotavirus, neumococo, meningococo, virus del papiloma humano, varicela, gripe, dengue y coqueluche.
Assuntos
Programas de Imunização/normas , Esquemas de Imunização , Vacina contra Coqueluche/administração & dosagem , Vacinas Estreptocócicas/administração & dosagem , Vacinas Virais/administração & dosagem , Adolescente , Argentina/epidemiologia , Varicela/epidemiologia , Varicela/prevenção & controle , Criança , Pré-Escolar , Tomada de Decisão Clínica , Contraindicações , Dengue/epidemiologia , Dengue/prevenção & controle , Diagnóstico Diferencial , Armazenamento de Medicamentos/métodos , Feminino , Saúde Global , Humanos , Lactente , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , América Latina/epidemiologia , Masculino , Infecções Meningocócicas/epidemiologia , Infecções Meningocócicas/prevenção & controle , Infecções Meningocócicas/transmissão , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Pediatria , Vacina contra Coqueluche/efeitos adversos , Vacina contra Coqueluche/imunologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Poliomielite/diagnóstico , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Poliomielite/transmissão , Vacinas contra Poliovirus/administração & dosagem , Vacinas contra Poliovirus/efeitos adversos , Vacinas contra Poliovirus/imunologia , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/prevenção & controle , Sociedades Médicas , Vacinas Estreptocócicas/efeitos adversos , Vacinas Estreptocócicas/imunologia , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/efeitos adversos , Vacinas Conjugadas/imunologia , Vacinas Virais/efeitos adversos , Vacinas Virais/imunologia , Coqueluche/epidemiologia , Coqueluche/prevenção & controleRESUMO
One year ago, Hurricane Maria passed over the archipelago of Puerto Rico, leaving widespread disruption of nearly all human services, including the health care sector. In the aftermath of the hurricane, limited access to medical care and prescription medications presented a serious challenge to maintaining control of preexisting chronic diseases. Many patients did not have access to refrigeration for heat-sensitive medications. Significant dietary changes due to the limited availability of shelf-stable foods further exacerbated chronic conditions such as heart failure and diabetes. The role of community pharmacists following a natural disaster has previously been documented, and may include the triage of evacuees, assessment of immunization needs, and provision of prescription medications under a collaborative practice agreement. However, our experience in Puerto Rico demonstrated a variety of barriers limited pharmacists' ability to adequately respond to the magnitude of this disaster. These included medication shortages, extended loss of power, and limited telecommunications for contacting prescribers, disaster relief agencies, and third-party payers. Ultimately, the lack of preexisting emergency protocols made overcoming such barriers difficult. As the first and sometimes only accessible health care provider to many patients following a natural disaster, we must build a solid evidence base and better understanding of the individual, interpersonal, and environmental factors that contribute to the community pharmacist response. To date, however, a paucity of data exists on both the pharmacist and patient factors, which may contribute to an effective immediate response to patient needs at the community pharmacy following a natural disaster. Future research must focus on these multi-level factors to better inform public policy and effective disaster planning. Ultimately, such research and planning will lead to increased resiliency in our primary health care systems in the face of future disasters.
Assuntos
Serviços Comunitários de Farmácia/organização & administração , Tempestades Ciclônicas , Desastres Naturais , Planejamento em Desastres/organização & administração , Armazenamento de Medicamentos/métodos , Fontes de Energia Elétrica/provisão & distribuição , Abastecimento de Alimentos , Humanos , Medicamentos sob Prescrição/provisão & distribuição , Porto Rico , Telecomunicações/provisão & distribuiçãoRESUMO
BACKGROUND: Gamma-glutamyltransferase (GGT) is present mainly in proximal renal tubule, and urinary GGT is an indicator of tubular damage since it may show renal changes before they are identified by using conventional measurements. Therefore, it is of interest to establish the reference limits of urinary GGT for a healthy population, as well as to investigate the stability of GGT in urine samples stored at 4⯰C and -20⯰C. METHODS: GGT was assessed in urine samples from 127 healthy patients by use of a reference method based on the 5-Amino-2-Nitrobenzoate formation. Stability of GGT was evaluated in 10 urine samples stored at temperatures of 4⯰C and -20⯰C for a period up to 4â¯weeks. RESULTS: Urinary GGT values for healthy volunteers were 14â¯U/g creatinine for the lower reference limit and 79â¯U/g creatinine for the upper reference limit. Urinary GGT values were approximately 56% lower in samples stored at -20⯰C than fresh samples, while samples stored at 4⯰C presented a decrease of 11% in GGT values compared to fresh samples. CONCLUSIONS: Reference limits for urinary GGT in healthy subjects were 14 to 79â¯U/g creatinine, and it is recommended to measure urinary GGT in fresh specimens.
Assuntos
Criopreservação/métodos , gama-Glutamiltransferase/normas , Criopreservação/normas , Armazenamento de Medicamentos/métodos , Armazenamento de Medicamentos/normas , Estabilidade Enzimática , Voluntários Saudáveis , Humanos , Valores de Referência , Temperatura , gama-Glutamiltransferase/metabolismo , gama-Glutamiltransferase/urinaRESUMO
After the 2010 earthquake, Haiti committed to introducing 4 new antigens into its routine immunization schedule, which required improving its cold chain (ie, temperature-controlled supply chain) and increasing vaccine storage capacity by installing new refrigerators. We tested the feasibility of using remote temperature monitoring devices (RTMDs) in Haiti in a sample of vaccine refrigerators fueled by solar panels, propane gas, or electricity. We analyzed data from 16 RTMDs monitoring 24 refrigerators in 15 sites from March through August 2014. Although 5 of the 16 RTMDs exhibited intermittent data gaps, we identified typical temperature patterns consistent with refrigerator door opening and closing, propane depletion, thermostat insufficiency, and overstocking. Actual start-up, annual maintenance, and annual electricity costs for using RTMDs were $686, $179, and $9 per refrigerator, respectively. In Haiti, RTMD use was feasible. RTMDs could be prioritized for use with existing refrigerators with high volumes of vaccines and new refrigerators to certify their functionality before use. Vaccine vial monitors could provide additional useful information about cumulative heat exposure and possible vaccine denaturation.
Assuntos
Armazenamento de Medicamentos/métodos , Refrigeração/instrumentação , Tecnologia de Sensoriamento Remoto/instrumentação , Vacinas , Temperatura Baixa , Custos e Análise de Custo , Armazenamento de Medicamentos/economia , Haiti , Humanos , Refrigeração/economia , Refrigeração/métodos , Tecnologia de Sensoriamento Remoto/economia , Tecnologia de Sensoriamento Remoto/métodosRESUMO
INTRODUCTION: Facial filling with hyaluronic acid (HA) is a dermatological procedure that has been emerging today. There are not many references regarding safety of reusing the remaining product for later touch-up in the same patient. OBJECTIVE: To determine the microbiological safety of reusing hyaluronic acid that is remnant from syringes used for facial filling, stored at room temperature or cooled in a refrigerator at 4°C. MATERIALS AND METHODS: In culture medium, small aliquots of leftovers from 31 hyaluronic acid fillers, previously used for facial filling, were inoculated. The fillers were stored in their original syringes at room temperature or cooled in a standard refrigerator at 4°C for a period ranging from 1 week to 12 months after initial use. LIMITATIONS: The small number of samples limits extrapolation of the results obtained. RESULTS: After 42 days of inoculation in culture medium, none of the samples showed any aerobic or anaerobic bacterial or fungal growth. CONCLUSION: Hyaluronic acid fillers did not show any fungal or bacterial contamination after being opened and stored at room temperature in nonaseptic conditions. The possibility of reusing the remaining portion of the material in the syringe can be safe and economically viable.
Assuntos
Preenchedores Dérmicos/efeitos adversos , Contaminação de Medicamentos , Ácido Hialurônico/efeitos adversos , Seringas/microbiologia , Contagem de Colônia Microbiana , Estudos Transversais , Armazenamento de Medicamentos/métodos , Face , Humanos , Rejuvenescimento , Retratamento , Envelhecimento da Pele , Fatores de TempoRESUMO
Candid#1 is the first live attenuated vaccine produced and registered in Argentina. Produced since 2003 at the INEVH to prevent Argentine hemorrhagic fever, it is obtained by harvesting supernatants of diploid cells infected with an attenuated strain of Junin virus and subsequent lyophilization. The stability of this vaccine is crucial to ensure its effectiveness. This study was aimed to evaluate the stability of Candid#1 by exposing it to different time and temperature conditions. Three vaccine batches produced in 2003 were analysed according to the following storage scheme: (a) reconstituted vaccine at 2 °C to 8 °C for 8 days; (b) lyophilized vaccine at 2 °C to 8 °C for 6 months; (c) lyophilized vaccine at -18 °C to -20 °C for 10 years. The potency was assessed in Vero cell monolayers under agar. The results were: (a) reconstituted vaccine was stable between 2 °C and 8 °C for 8 days, (b) lyophilized vaccine was stable between 2 °C and 8 °C for 2 months, and (c) lyophilized vaccine was stable 9 years between -18 °C and -20 °C, keeping all its properties. These results allowed us to establish the following storage conditions and expiration times for Candid#1: (a) reconstituted: 12 hours between 2 °C and 8 °C, (b) lyophilized: 30 days between 2 °C and 8 °C and (c) lyophilized: 9 years between -18 °C and -20 °C. Based on our results, favorable changes were made in the conditions of transport, storage and distribution of the vaccine. Domestic freezers in strategically located centers were installed, allowing the preservation of vaccine stocks for distribution to secondary vaccination centers.
Assuntos
Anticorpos Antivirais/imunologia , Arenavirus do Novo Mundo/imunologia , Armazenamento de Medicamentos/métodos , Febre Hemorrágica Americana/prevenção & controle , Vacinas Virais/imunologia , Argentina , Estabilidade de Medicamentos , Humanos , Vacinas Atenuadas/imunologiaRESUMO
Candid#1 es la primera vacuna a virus vivo atenuado producida y registrada en Argentina. Se produce en el INEVH desde 2003 para prevenir la fiebre hemorrágica argentina y se obtiene mediante cosecha de sobrenadantes de cultivos de células diploides infectadas con una cepa atenuada del virus Junín, formulación y posterior liofilización. Su estabilidad es crucial para asegurar su efectividad. El objetivo de este trabajo fue evaluar la estabilidad de Candid#1 exponiéndola a distintas condiciones de temperatura y tiempo. Tres lotes producidos en 2003 fueron sometidos al siguiente esquema de almacenamiento: (a) vacuna reconstituida conservada entre 2 °C y 8 °C durante 8 días, (b) vacuna liofilizada conservada entre 2 °C y 8 °C durante 6 meses, y (c) vacuna liofilizada conservada entre -18 °C y -20 °C durante 10 años. La potencia fue evaluada en monocapa de células Vero bajo agar. Los resultados fueron: (a) Candid#1 reconstituida fue estable 8 días entre 2 °C y 8 °C, (b) Candid#1 liofilizada fue estable 2 meses entre 2 °C y 8 °C y (c) Candid#1 liofilizada fue estable 9 años entre -18 °C y -20 °C manteniendo todos sus atributos. Estos resultados permitieron establecer las siguientes condiciones de almacenamiento: reconstituida 12 horas entre 2 °C y 8 °C, liofilizada 30 días entre 2 °C y 8 °C y 9 años entre -18 °C y -20 °C. A la luz de estos resultados, se generaron cambios favorables en las condiciones de transporte, almacenamiento y distribución de la vacuna. Se implementó la instalación de freezers domésticos en centros estratégicamente distribuidos, permitiendo preservar stocks de vacuna y distribuir las dosis necesarias a vacunatorios.
Candid#1 is the first live attenuated vaccine produced and registered in Argentina. Produced since 2003 at the INEVH to prevent Argentine hemorrhagic fever, it is obtained by harvesting supernatants of diploid cells infected with an attenuated strain of Junin virus and subsequent lyophilization. The stability of this vaccine is crucial to ensure its effectiveness. This study was aimed to evaluate the stability of Candid#1 by exposing it to different time and temperature conditions. Three vaccine batches produced in 2003 were analysed according to the following storage scheme: (a) reconstituted vaccine at 2 °C to 8°C for 8 days; (b) lyophilized vaccine at 2 °C to 8 °C for 6 months; (c) lyophilized vaccine at -18 °C to -20 °C for 10 years. The potency was assessed in Vero cell monolayers under agar. The results were: (a) reconstituted vaccine was stable between 2 °C and 8 °C for 8 days, (b) lyophilized vaccine was stable between 2 °C and 8 °C for 2 months, and (c) lyophilized vaccine was stable 9 years between -18 °C and -20 °C, keeping all its properties. These results allowed us to establish the following storage conditions and expiration times for Candid#1: (a) reconstituted: 12 hours between 2 °C and 8 °C, (b) lyophilized: 30 days between 2 °C and 8 °C and (c) lyophilized: 9 years between -18 °C and -20 °C. Based on our results, favorable changes were made in the conditions of transport, storage and distribution of the vaccine. Domestic freezers in strategically located centers were installed, allowing the preservation of vaccine stocks for distribution to secondary vaccination centers.
Assuntos
Humanos , Vacinas Virais/imunologia , Arenavirus do Novo Mundo/imunologia , Armazenamento de Medicamentos/métodos , Febre Hemorrágica Americana/prevenção & controle , Anticorpos Antivirais/imunologia , Argentina , Vacinas Atenuadas/imunologia , Estabilidade de MedicamentosRESUMO
The objective of this study was to evaluate the stability of 10 commonly used active pharmaceutical ingredients compounded in oral suspensions using an internationally used suspending vehicle (SyrSpend SF PH4): alprazolam 1.0 mg/mL, atropine sulfate 0.1 mg/mL, glutamine 250.0 mg/mL, levofloxacin 50.0 mg/mL, metoprolol tartrate 10.0 mg/mL, nitrofurantoin 2.0 mg/mL, ondansetron hydrochloride 0.8 mg/mL, oxandrolone 3.0 mg/mL, pregabaline 20.0 mg/mL, riboflavin 10.0 mg/mL. All suspensions were stored at both controlled refrigeration (2°C to 8°C) and controlled room temperature (20°C to 25°C). Stability was assessed by measuring the percent recovery at varying time points throughout a 90-day period. Active pharmaceutical ingredients quantification was performed by high-performance liquid chromatography via a stability-indicating method. Given the percentage of recovery of the active pharmaceutical ingredients within the suspensions, the beyond-use date of the final products (active pharmaceutical ingredients + vehicle) was at least 90 days for all suspensions with regard to both temperatures. This suggests that the vehicle is stable for compounding active pharmaceutical ingredients from different pharmacological classes.
Assuntos
Preparações Farmacêuticas/química , Suspensões/química , Alprazolam/química , Atropina/química , Composição de Medicamentos/métodos , Estabilidade de Medicamentos , Armazenamento de Medicamentos/métodos , Glutamina/química , Levofloxacino/química , Metoprolol/química , Nitrofurantoína/química , Ondansetron/química , Oxandrolona/química , Pregabalina/química , Refrigeração/métodos , Riboflavina/química , TemperaturaRESUMO
AIM: Insulin loses potency when stored at high temperatures. Various clay pots part-filled with water, and other evaporative cooling devices, are used in less-resourced countries when home refrigeration is unavailable. This study examined the cooling efficacy of such devices. METHODS: Thirteen devices used in Sudan, Ethiopia, Tanzania, Mali, India, Pakistan and Haiti (10 clay pots, a goat skin, a vegetable gourd and a bucket filled with wet sand), and two identical commercially manufactured cooling wallets were compared. Devices were maintained according to local instructions. Internal and ambient temperature and ambient humidity were measured by electronic loggers every 5 min in Khartoum (88 h), and, for the two Malian pots, in Bamako (84 h). Cooling efficacy was assessed by average absolute temperature difference (internal vs. ambient), and % maximal possible evaporative cooling (allowing for humidity). RESULTS: During the study period, mean ambient temperature and humidity were 31.0°C and 32.0% in Khartoum and 32.9°C and 39.8% in Bamako. All devices reduced the temperature (P < 0.001) with a mean (sd) reduction from 2.7 ± 0.5°C to 8.3 ± 1.0°C, depending on the device. When expressed as % maximal cooling, device efficacy ranged from 20.5% to 71.3%. On cluster analysis, the most efficacious devices were the goat skin, two clay pots (from Ethiopia and Sudan) and the suspended cooling wallet. CONCLUSIONS: Low-cost devices used in less-resourced countries reduce storage temperatures. With more efficacious devices, average temperatures at or close to standard room temperature (20-25°C) can be achieved, even in hot climates. All devices are more efficacious at lower humidity. Further studies are needed on insulin stability to determine when these devices are necessary.
Assuntos
Silicatos de Alumínio , Armazenamento de Medicamentos/métodos , Armazenamento de Medicamentos/normas , Temperatura Alta , Insulina , Refrigeração/instrumentação , Refrigeração/métodos , Argila , Clima , Temperatura Baixa , Estabilidade de Medicamentos , Etiópia , Haiti , Humanos , Umidade , Índia , Mali , Paquistão , Sudão , Tanzânia , Resultado do TratamentoRESUMO
The objective of this study was to evaluate the feasibility of 10 commonly used active pharmaceutical ingredients (APIs) compounded in oral suspensions using an internationally used suspending vehicle (SyrSpend(®) SF PH4 liquid): (i) amlodipine, (as besylate) 1.0mg/mL; (ii) chloroquine phosphate,15.0 mg/mL; (iii) dapsone, 2.0 mg/mL; (iv) phenytoin, 15.0 mg/mL; (v) pyridoxine hydrochloride, 50.0 mg/mL; (vi) sulfadiazine, 100.0 mg/mL; (vii) sulfasalazine, 100.0 mg/mL; (viii) tetracycline hydrochloride, 25.0 mg/mL; (ix) trimethoprim, 10.0 mg/mL; and (x) zonisamide, 10.0 mg/mL. All suspensions were stored both at controlled refrigeration (2-8 °C) and controlled room temperature (20-25 °C). Feasibility was assessed by measuring the percent recovery at varying time points throughout a 90-day period. API quantification was performed by high-performance liquid chromatography (HPLC-UV), via a stability-indicating method. Given the percentage of recovery of the APIs within the suspensions, the expiration date of the final products (API+vehicle) was at least 90 days for all suspensions with regard to both the controlled temperatures. This suggests that the vehicle is stable for compounding APIs from different pharmacological classes.
Assuntos
Estabilidade de Medicamentos , Armazenamento de Medicamentos/métodos , Suspensões/análise , Suspensões/normas , Administração Oral , Anlodipino/análise , Anlodipino/normas , Cloroquina/análogos & derivados , Cloroquina/análise , Cloroquina/normas , Cromatografia Líquida de Alta Pressão/métodos , Dapsona/análise , Dapsona/normas , Armazenamento de Medicamentos/normas , Estudos de Viabilidade , Concentração de Íons de Hidrogênio , Isoxazóis/análise , Isoxazóis/normas , Fenitoína/análise , Fenitoína/normas , Piridoxina/análise , Piridoxina/normas , Sulfadiazina/análise , Sulfadiazina/normas , Sulfassalazina/análise , Sulfassalazina/normas , Tetraciclina/análise , Tetraciclina/normas , Trimetoprima/análise , Trimetoprima/normas , ZonisamidaRESUMO
Este trabalho visa avaliar a adequação do armazenamento e da distribuição dos medicamentos nos seis primeiros meses de implantação da integração entre a assistência farmacêutica do Hospital Sanatório Partenon (HSP) e a vigilância epidemiológica no contexto do Programa Estadual de Controle da Tuberculose (PECTRS). (AU)
Assuntos
Humanos , Assistência Farmacêutica , Tuberculose/prevenção & controle , Tuberculose/tratamento farmacológico , Colaboração Intersetorial , Estudo de Avaliação , Monitoramento Epidemiológico , Programas Nacionais de Saúde , Tuberculose/transmissão , Armazenamento de Medicamentos/métodos , Sistemas de Medicação no HospitalRESUMO
BACKGROUND: Unsafe storage of unused medications at home leads to an increased risk of toxicity, accidental childhood poisoning or risk for suicide, whereas an improper disposal of unwanted/expired medications from household raises concern about environmental pollution. OBJECTIVE: The aim of the study was to characterize expired medications collected according to the types of therapeutic groups, pharmaceutical dosage forms, expiration dates and were prescribed or over the counter drugs, and whether they came from Mexican health system or purchased by patients themselves. SETTING: The study was conducted in the metropolitan area of Monterrey during a 12-month period from March 2012 to February 2013. METHOD: Unused/expired drugs were collected according to the collection and disposal of expired medication program instituted by the Department of Health of the State of Nuevo León. Pharmacists and students from The Autonomous University of Nuevo León recorded types of therapeutic groups, total of medicines in each group, among other classification criteria. MAIN OUTCOME MEASURE: The proportion of every collected therapeutic group, type of dosage forms, and expiration date. RESULTS: The amount of medications classified was 22,140 items corresponding to a 30 % of the total collected medications in that period of time; most of them belonged to the non-steroidal anti-inflammatory drugs (16.11 %). According to the pharmaceutical dosage forms, results showed that a high percentage were solid dosage forms (73.39 %), of the total unused/expired medications, most of them were prescription drugs (91 %) which were purchased at private pharmacies. Expiration date of medications ranges from 1995 to 2016, being 2011 the outstanding year (36.66 %). CONCLUSION: Addressing the aspect of unused drug disposition constitutes a challenge for Mexican government, due to health implications related to inadequate disposition. No matter how efficient the programs of collection and disposal of expired drugs are, none of them can collect all unused or expired drugs, that is the reason why the best approach might be to prevent this need.
Assuntos
Armazenamento de Medicamentos/normas , Características da Família , Medicamentos sem Prescrição/normas , Medicamentos sob Prescrição/normas , Rotulagem de Medicamentos/métodos , Rotulagem de Medicamentos/normas , Armazenamento de Medicamentos/métodos , Humanos , México/epidemiologia , Medicamentos sem Prescrição/uso terapêutico , Medicamentos sob Prescrição/uso terapêuticoRESUMO
In this essay, based on documental analysis, the limitations associated with the use of pill organizers and cutters are discussed and analyzed as a matter of public health. The use of the organizers for storing and carrying tablets and capsules exposes these medications to environmental factors from which their original packaging protected them, compromising their stability and safeness. Cutters also pose the additional risk of causing loss of efficacy, adverse reactions and overdose. On the other hand, the user carrying their own medication reflects the balance between autonomy and self-care, and splitting is sometimes required to comply with certain regimens. It can be concluded that healthcare professionals should observe and guide patients and caregivers in order to avoid risks.
Assuntos
Cápsulas/administração & dosagem , Embalagem de Medicamentos , Estabilidade de Medicamentos , Armazenamento de Medicamentos/métodos , Comprimidos/administração & dosagem , Embalagem de Medicamentos/métodos , HumanosRESUMO
Com base em análise documental, foram discutidas e problematizadas as limitações associadas à utilização de organizadores e cortadores de comprimidos, como questão de saúde pública. Os organizadores destinados ao armazenamento e transporte de comprimidos e cápsulas expõem essas formas farmacêuticas a fatores ambientais dos quais estariam protegidos em suas embalagens originais, comprometendo sua estabilidade, eficácia e segurança. Os cortadores oferecem risco adicional quanto a perda da eficácia, reações adversas e intoxicação. Por outro lado, o transporte de medicamentos pelo usuário é reflexo da conciliação entre autonomia e autocuidado e a partição de comprimidos é necessária para cumprir certos regimes posológicos. Conclui-se que cabe aos profissionais observar e orientar pacientes e cuidadores, visando à adequação dessas condutas e à prevenção dos riscos envolvidos.
In this essay, based on documental analysis, the limitations associated with the use of pill organizers and cutters are discussed and analyzed as a matter of public health. The use of the organizers for storing and carrying tablets and capsules exposes these medications to environmental factors from which their original packaging protected them, compromising their stability and safeness. Cutters also pose the additional risk of causing loss of efficacy, adverse reactions and overdose. On the other hand, the user carrying their own medication reflects the balance between autonomy and self-care, and splitting is sometimes required to comply with certain regimens. It can be concluded that healthcare professionals should observe and guide patients and caregivers in order to avoid risks.
Objetivo Con base en análisis documental, se discutieron y señalaron los problemas de las limitaciones asociadas a la utilización de organizadores y cortadores de comprimidos, con respecto a la salud pública. Los organizadores destinados al almacenamiento y transporte de comprimidos y cápsulas exponen las formas farmacéuticas a factores ambientales de los cuales estarían protegidos en sus embalajes originales, comprometiendo su estabilidad, eficacia y seguridad. Los cortadores ofrecen riesgo adicional con relación a la pérdida de la eficacia, reacciones adversas e intoxicación. Por otro lado, el transporte de medicamentos por el usuario es reflejo de la conciliación entre autonomía y autocuidado, y la partición de comprimidos es necesaria para cumplir ciertos regímenes posológicos. Se concluye que resta a los profesionales observar y orientar pacientes y cuidadores, buscando la adecuación de esas conductas y la prevención de los riesgos involucrados.
Assuntos
Humanos , Cápsulas/administração & dosagem , Embalagem de Medicamentos , Estabilidade de Medicamentos , Armazenamento de Medicamentos/métodos , Comprimidos/administração & dosagem , Embalagem de Medicamentos/métodosRESUMO
Fourier transform infrared (FTIR) spectroscopy was used to study the structure of the recombinant antibodies 1E10, anti-CD20 and hR3, which are used as anti-cancer therapeutic drugs. We tested their sensitivity against different conditions and treatments such as pH, temperature, freeze-thaw cycles and drying, which are relevant for the practical usefulness of the drugs. All antibodies were stable against moderate temperature increases (up to 50 °C) and pH changes (range 5-9). 1E10 was sensitive to extreme pH values (pH 3 and 12), whereas hR3 was most sensitive to temperature (at and above 60 °C). We did not observe any significant changes upon freeze-thaw and drying treatments. The secondary structure content of all three antibodies was estimated to be similar to that of IgG with â¼64% ß-sheet, 0% α-helix and â¼36% other structure.