Expired drugs

Pseudomonas aeruginosa harboring Verona Integron-encoded metallo-β-lactamase enzymes (VIM-CRPA) have been associated with infection outbreaks in several parts of the world. In the US, however, VIM-CRPA remain rare. Starting in December 2018, we identified a cluster of cases in our institution. Herein, we present our epidemiological investigation and strategies to control/manage these challenging infections. This study was conducted in a large academic healthcare system in Miami, FL, between December 2018 and January 2022...

In the present investigation, the corrosion tendency of mild steel under acidic pH was studied by employing unused expired amiodarone (EAD) drug as a potential corrosion inhibitor by adopting the weight loss measurement method. The corrosion inhibition efficiency (IE) of the formed protective film (EAD) on the steel surface was analyzed using potentiodynamic polarization and AC-impedance spectroscopy studies. The surface morphology of the mild steel before and after corrosion (in 1.0 M HCl) was analyzed via scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDAX), atomic force microscopy (AFM), and thermodynamic studies...

A now-expired medication called isoprinosine was examined in NaOH (0.50 M) solutions as a potential novel inhibitor of aluminum corrosion. The inhibitory effectiveness of the isoprinosine compounds was examined utilizing different electrochemical tests (open circuit potential OCP, potentiodynamic polarization and electrochemical impedance spectroscopy EIS), surface examination and quantum calculations. Increases in isoprinosine concentration were seen to increase the inhibitory efficacy. It was discovered that the inhibitory action, which results in the inhibition of charge and mass transfer and protects the aluminum against harmful ions, was brought on by isoprinosine molecules adhering to the aluminum surface...

Sensorineural hearing loss and chronic rhinosinusitis with nasal polyps affect a large proportion of the UK population. However, treatment with high efficacy to manage these pathologies remains to be found. With the development of biologic drug treatments, there is hope that this will improve quality of life for patients affected by these conditions. A literature review was carried out using PubMed. Studies that investigated the use of biologic drug treatment in chronic rhinosinusitis with nasal polyps, head and neck squamous cell carcinoma and sensorineural hearing loss were included in this paper...

OBJECTIVES: Some therapeutic monoclonal antibodies, like daratumumab and elotuzumab, produce interfering monoclonal bands on serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE). Whether other common therapeutic antibodies also produce interference has not been systematically evaluated. DESIGN AND METHODS: SPEP/IFE from patients receiving isatuximab (48 patients), belantamab mafodotin (BM; 41), and denosumab (41) were retrospectively reviewed for therapeutic antibody interference...

BACKGROUND: General anesthesia is inevitable for pediatric patients undergoing surgery, though volatile anesthetic agents may cause neuroinflammation and neurodevelopmental impairment; however, the underlying pathophysiology remains unclear. We aimed to investigate the neuroinflammation mechanism in developing rat brains associated with sevoflurane exposure time, by identifying the specific damage-associated molecular patterns (DAMPs) pathway and evaluating the effects of non-steroidal anti-inflammatory drugs (NSAIDs) in alleviating neuroinflammation...

PURPOSE: Adalimumab has evolved to one of the more affordable first-line biologics for the treatment of inflammatory bowel disease (IBD), since its patent expired. However, poor adherence to adalimumab is a concern and may limit its effectiveness. It is plausible that good adherence improves treatment outcomes in IBD patients, but evidence is scarce. The aim of this study was to assess whether high refill-adherence (medication possession ratio (MPR) ≥ 80%) to adalimumab is associated with less active disease in IBD patients...

BACKGROUND: Commonly used prognostic scores for acute on-chronic liver failure (ACLF) have complex calculations. We tried to compare the simple counting of numbers and types of organ dysfunction to these scores, to predict mortality in ACLF patients. METHODS: In this prospective cohort study, ACLF patients diagnosed on the basis of Asia Pacific Association for Study of the Liver (APASL) definition were included. Severity scores were calculated. Prognostic factors for outcome were analysed...

In this work, we studied the corrosion of Cu metal in 0.5 mol L-1 HCl and the inhibition effect of the expired Cefazolin drug. The inhibition efficiency (IE) of Cefazolin varied according to its concentration in solution. As the Cefazolin concentration increased to 300 ppm, the IE increased to 87% at 298 K and decreased to 78% as the temperature increased to 318 K. The expired drug functioned as a mixed-type inhibitor. The adsorption of the drug on the copper surface followed Temkin's adsorption model. The magnitudes of the standard free energy change (Δ Go ads ) and adsorption equilibrium constant ( Kads ) indicated the spontaneous nature and exothermicity of the adsorption process...

Rituximab, the first monoclonal antibody approved for the treatment of lymphoma, eventually became one of the most popular and versatile drugs ever in terms of clinical application and revenue. Since its patent expiration, and consequently, the loss of exclusivity of the original biologic, its repurposing as an off-label drug has increased dramatically, propelled by the development and commercialization of its many biosimilars. Currently, rituximab is prescribed worldwide to treat a vast range of autoimmune diseases mediated by B cells...

INTRODUCTION: Medicine plays a crucial role in the field of healthcare as a therapeutically significant pharmaceutical product. By effectively preventing diseases, medicine has the power to save countless lives and improve the quality of life for people worldwide. However, despite hospitals' efforts to provide medical care to patients, a significant issue arises from the substantial amount of drugs that go unused due to expiration dates. This problem is particularly prevalent in resource-limited countries like Ethiopia, where the pharmaceutical supply system fails to adequately address the issue of expired drugs in public hospitals, leading to an unsatisfactory situation...

Introduction Unused and expired medicines are potentially toxic substances that should be managed effectively to avoid possible environmental hazards. The absence of well-defined protocols in India regarding the proper disposal of unused, unwanted, and expired medications raises concerns about the potential for accidental poisoning and environmental threats. Consequently, this research was conducted to evaluate the disposal practices of medications within both urban slum households and pharmacies. Methods This questionnaire-based, mixed-method study was conducted among 385 general public residing in urban slums and 10 registered pharmacies in Bhubaneswar city, India, from September 2020 to August 2021...

BACKGROUND: Recent studies, based on clinical data, have identified sex and age as significant factors associated with an increased risk of long COVID. These two factors align with the two post-COVID-19 clusters identified by a deep learning algorithm in computed tomography (CT) lung scans: Cluster 1 (C1), comprising predominantly females with small airway diseases, and Cluster 2 (C2), characterized by older individuals with fibrotic-like patterns. This study aims to assess the distributions of inhaled aerosols in these clusters...

The question of the use of expired medication is a constant debate of many years most especially in a difficult environment. In this research, a literature review and reported practice of some countries are used. Findings show that some medications, if properly stored, remain safe to use after the expiry date and this sometimes could be extended by many years. However, the pharmaceutical manufacturers have an interest in producing products with short shelf life. To dispose of expired ones is to generate a sale and therefore put the profit into the improvement and development of new products for the benefit of medicine...

OBJECTIVE: The improper disposal of household pharmaceutical waste (HPW) is an emerging cause of environmental pollution. Behavioural practices are intricately linked to individuals' knowledge levels and attitudes. Thus, this systematic review aims to assess the knowledge, attitude, and practice (KAP) of HPW disposal among the public and to examine the interconnectedness of these KAP components. METHODS: A literature review for articles published from 2013 to 2023 was carried out in scientific databases PubMed, Scopus, and Web of Science, identifying quantitative studies involving the assessment of KAP of the public concerning HPW disposal...

INTRODUCTION: Uveitis is a heterogeneous group of ocular conditions characterized by inflammation of the uveal tract and is one of the leading causes of vision impairment. In developed countries, noninfectious uveitis (NIU) represents most cases and is challenging to treat due to its severity, chronicity, and high recurrence rates. The advent of anti-tumor necrosis factor-α (anti-TNF-α) agents have dramatically improved outcomes and changed treatment paradigms in NIU. AREAS COVERED: The index article summarizes the present experience of anti-TNF-α agents in NIU pharmacotherapy and highlights the barriers to further research and development of anti-TNF-α agents for uveitis...

OBJECTIVE: The aim of this study was to examine older individuals' rational drug use behavior, their knowledge of rational drug use, and the factors affecting it. METHODS: This study was conducted cross-sectionally with 440 patients aged 65 years who received inpatient treatment in internal medicine and surgery clinics between October 2021 and November 2022 using a Rational Drug Use Scale and rational drug use behavior questions. RESULTS: The findings showed that the mean age of older adults was 72...

Manual data entry is time-consuming, inefficient, and error prone. In contrast, leveraging two-dimensional (2D) barcodes and barcode scanning tools is a rapid, efficient, and effective practice for automatically entering data accurately and completely during vaccine inventorying and administration. CDC pilots in a variety of healthcare settings documented the clinical and public health impact of 2D barcode scanning practices on data quality and completeness, time savings, workflow efficiencies, and staff experience...

Carmustine is an intravenous alkylating agent that inhibits DNA synthesis and protein synthesis by forming cross-links in DNA and RNA and ultimately causing cell death. We report a rare case of Takotsubo cardiomyopathy that is thought to be related to carmustine, where the patient presented with chest pain, and ST depression within 12 hours of carmustine therapy. Workup, including echocardiography, showed global hypokinesis of the left ventricle with regional variations; mid and apical anterior septum and apex were akinetic with left ventricular ejection fraction (EF) of 30%...

BACKGROUND: Intrathecal administration of amphotericin B represents an important adjunctive therapy for management of severe fungal meningitis. Intrathecal preparations have traditionally used amphotericin B deoxycholate. Liposomal amphotericin B is an alternative formulation with good clinical outcomes as systemic therapy, but scant data exist investigating intrathecal use. OBJECTIVE: The aim of this exploratory study was to evaluate outcomes following intrathecal administration of liposomal amphotericin B for treatment of severe fungal meningitis...