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drug dosage calculations

Bhavana Sosale, Aravind Sosale, Arpandev Bhattacharyya
INTRODUCTION: Dapagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, is a promising drug approved for the treatment of type 2 diabetes mellitus (T2DM). However, its cost is an obstacle for use in developing countries like India. Thus, we aimed to analyse the impact on the cost of insulin therapy after adding dapagliflozin for patients using insulin in real-world clinical practice. METHODS: This retrospective chart review study included patients with uncontrolled T2DM previously on maximum doses of OADs and insulin therapy, initiated on dapagliflozin...
October 19, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Fawzia A Ibrahim, Amina M Elbrashy, Jenny Jeehan M Nasr, Mostafa M Badr El-Dien
Three different spectrophotometric and two spectrofluorimetric methods have been developed and validated for the determination of vincamine (VN) and naftidrofuryl oxalate (NF) in tablets. The spectrophotometric methods depend on charge transfer complex formation between each of VN and NF with 7,7,8,8-tetracyano-quinodimethane (TCNQ), 2,6-dichloroquinone-4-chloroimide (DCQ) and 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ) at 843, 580 and 588 nm, respectively. The spectrofluorimetric methods are based on the formation of charge transfer complex between each of the two drugs and TCNQ, with measurement of the fluorophore formed at 312/375 and 284/612 nm, respectively, or with DDQ at 400/475 and 284/396 nm, respectively...
October 18, 2016: Luminescence: the Journal of Biological and Chemical Luminescence
Shashikant Srivastava, Devyani Deshpande, Jotam Pasipanodya, Eric Nuermberger, Soumya Swaminathan, Tawanda Gumbo
BACKGROUND:  When treated with the same antibiotic dose, children achieve different 0- to 24-hour area under the concentration-time curves (AUC0-24) because of maturation and between-child physiological variability on drug clearance. Children are also infected by Mycobacterium tuberculosis isolates with different antibiotic minimum inhibitory concentrations (MICs). Thus, each child will achieve different AUC0-24/MIC ratios when treated with the same dose. METHODS:  We used 10 000-subject Monte Carlo experiments to identify the oral doses of linezolid, moxifloxacin, and faropenem that would achieve optimal target exposures associated with optimal efficacy in children with disseminated tuberculosis...
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Gianluca Gessoni, Sara Valverde, Francesca Gessoni, Letizia Valle, Roberto Valle
BACKGROUND: In this paper we evaluated the relationship between trough DAB concentration with eGFR calculated using CRE and CYS based formulas. MATERIALS AND METHODS: We considered 100 patients. eGFR was calculated using CKD-EPIcreat, CG, MDRD, CKD-EPIcys and CKD-EPIcombined equations. DAB dosage was selected on the basis of CKD-EPIcreat and relationship between trough DAB concentration and eGFRs was evaluated. RESULTS: Trough DAB concentration roughly correlates with eGFR calculated using various formulas...
October 3, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Nienke van Rein, J S Biedermann, S M Bonafacio, M J H A Kruip, F J M van der Meer, W M Lijfering
PURPOSE: The purpose of the study is to determine the immediate and long-term effect of statins on coagulation in patients treated with vitamin K antagonists (VKAs). METHODS: We selected patients on VKAs of two Dutch anticoagulation clinics who initiated treatment with a statin between 2009 and 2013. Patients who initiated or stopped concomitant drugs that interact with VKAs or were hospitalised during follow-up were excluded. The VKA dosage (mg/day) after statin initiation was compared with the last VKA dosage before the statin was started...
October 5, 2016: European Journal of Clinical Pharmacology
Monika Edlinger, Maria A Rettenbacher, Georg Kemmler, Falko Biedermann, Christian G Widschwendter, W Wolfgang Fleischhacker, Alex Hofer
OBJECTIVE: The primary objective of this study was to investigate whether the choice and dosage of antipsychotic medication differ between patients with schizophrenia starting treatment in an inpatient or outpatient unit. In addition, we investigated whether the reason for the introduction of new antipsychotic medication had an impact on the treatment setting and whether the use of benzodiazepines differed between inpatients and outpatients. METHOD: From October 1997 to September 2010, patients with a schizophrenia spectrum disorder according to the International Classification of Diseases, Tenth Revision aged between 18 and 65 years were allocated to a naturalistic drug-monitoring program when starting treatment with a second-generation antipsychotic drug...
September 21, 2016: Journal of Clinical Psychopharmacology
Anupam Kapur, Ranjeeta Angomchanu, Madhusudan Dey
BACKGROUND: Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Different drugs are available for medical management of fibroid uterus including mifepristone, a progesterone antagonist. Varying dosage regimen for mifepristone was studied as medical management of fibroid uterus. The aim of the project was to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
William Wei Lim Chin, Angelika Joos
: Over the past two decades, there has been growing concern over the lack of proper medication for children. This review attempts to evaluate the current progress of EU Pediatric Regulation made since 2007. The lack of properly evaluated pediatric medication has for long been a source of concern in the European Union. The drugs that were used in the past were often not properly evaluated, and dosage was arbitrarily calculated. Therefore, it was necessary to establish the Pediatric Regulation (EC no...
September 19, 2016: European Journal of Pediatrics
Stéphanie Roberge, Kypros Nicolaides, Suzanne Demers, Jon Hyett, Nils Chaillet, Emmanuel Bujold
BACKGROUND: Preeclampsia (PE) and fetal growth restriction (FGR) are major causes of perinatal death and handicap in survivors. Randomized clinical trials (RCTs) have reported that the risk of PE, severe PE and FGR can be reduced by the prophylactic use of aspirin in high-risk women, but the appropriate dose of the drug to achieve this objective is not certain. OBJECTIVE: To estimate the impact of aspirin dosage on the prevention of PE, severe PE and FGR. STUDY DESIGN: We performed a systematic review and meta-analysis of RCTs comparing the effect of daily aspirin or placebo (or no treatment) during pregnancy...
September 15, 2016: American Journal of Obstetrics and Gynecology
Kheir Eddine Kerboua, Fatma Haiba, Djamila Batouche
Treatment of atypical hemolytic uremic syndrome (aHUS) by the complement C5 inhibitor eculizumab (Soliris®) is highly effective but unfortunately, associated with an economic pressure on the health care systems even in high incomes countries. Despite spacing infusions has been proposed as the unique solution to minimize this economic impact, no reliable laboratory assays are available to tailor such therapy optimization. We aimed to propose and evaluate a complement composite marker for eculizumab efficacy monitoring in aHUS...
September 12, 2016: Journal of Immunoassay & Immunochemistry
Brett Williams, Samantha Davis
A student's accuracy on drug calculation tests may be influenced by maths anxiety, which can impede one's ability to understand and complete mathematic problems. It is important for healthcare students to overcome this barrier when calculating drug dosages in order to avoid administering the incorrect dose to a patient when in the clinical setting. The aim of this study was to examine the effects of maths anxiety on healthcare students' ability to accurately calculate drug dosages by performing a scoping review of the existing literature...
September 2016: Nurse Education in Practice
Klaas van der Spek, Debby L Gerritsen, Martin Smalbrugge, Marjorie H J M G Nelissen-Vrancken, Roland B Wetzels, Claudia H W Smeets, Sytse U Zuidema, Raymond T C M Koopmans
BACKGROUND: This study explores the appropriateness of psychotropic drug (PD) use for neuropsychiatric symptoms (NPS) in nursing home patients with dementia. METHODS: A cross-sectional study on 559 patients with dementia residing on dementia special care units in Dutch nursing homes was conducted. Appropriateness of PD use was assessed using the Appropriate Psychotropic drug use In Dementia (APID) index. The APID index score is calculated using information about individual PDs from patients' medical records...
October 2016: International Psychogeriatrics
Asia N Rashed, Stephen Tomlin
INTRODUCTION: Opiate intravenous infusions are the therapy of choice in severe pain. However, administering infusions to children requires complex dosage calculations, rate adjustments and often multiple manipulations of injectable medicines to obtain the final "ready to use" solution for both continuous infusion and additional boluses; potentially putting children at high risk.1 2 AIM: To investigate the practice and accuracy of healthcare professionals (HCPs) in hospital theatres and wards in preparing morphine infusions for nurse/patient controlled analgesia (N/PCA) use in a UK children's hospital...
September 2016: Archives of Disease in Childhood
Lawrence Chen, Chiehfeng Chen, Yun Yen, Ka-Wai Tam
BACKGROUND: Although gemcitabine and platinum-based agents (GP) are currently regarded as the standard chemotherapy for advanced biliary tract cancer (BTC), the prognosis remains poor. Combinations with fluoropyrimidines and targeted therapy have demonstrated modest benefits. Therefore, we conducted a meta-analysis of randomized controlled trials to evaluate the efficacy of different chemotherapy regimens. METHODS: The PubMed, EMBASE, Cochrane Library, Scopus, and ClinicalTrials...
August 2016: Medicine (Baltimore)
Roberta Maia de Castro Romanelli, Lêni Márcia Anchieta, Juliana Chaves Abreu Fernandes, Mariana Antunes Faria Lima, Taís Marina de Souza, Viviane Rosado, Wanessa Trindade Clemente, Paulo Augusto Moreira Camargos
Coagulase-negative Staphylococcus has been identified as the main nosocomial agent of neonatal late-onset sepsis. However, based on the pharmacokinetics and erratic distribution of vancomycin, recommended empirical dose is not ideal, due to the inappropriate serum levels that have been measured in neonates. The aim of this study was to evaluate serum levels of vancomycin used in newborns and compare the prediction of adequate serum levels based on doses calculated according to mg/kg/day and m(2)/day. This is an observational reprospective cohort at a referral neonatal unit, from 2011 to 2013...
September 2016: Brazilian Journal of Infectious Diseases
O Fernández, R Arroyo, S Martínez-Yélamos, M Marco, J A García Merino, D Muñoz, E Merino, A Roque
The effectiveness of disease-modifying drugs in the treatment of multiple sclerosis is associated with adherence. RebiSmart® electronic device provides useful information about adherence to the treatment with subcutaneous (sc) interferon (IFN) β-1a (Rebif®). The aim of the study was to determine long-term adherence to this treatment in patients with relapsing-remitting multiple sclerosis (RRMS). This retrospective multicentre observational study analysed 258 patients with RRMS who were receiving sc IFN β-1a (Rebif®) treatment by using RebiSmart® until replacement (36 months maximum lifetime) or treatment discontinuation...
2016: PloS One
Brownsyne Tucker Edmonds, Fatima McKenzie, MacKenzie B Austgen, Leslie Ashburn-Nardo, Marianne S Matthias, Adam T Hirsh
OBJECTIVE: Describe obstetrical providers' management of a hypothetical case on chronic pain in pregnancy and determine whether practices differ based on patient race. DESIGN AND SETTING: This was a self-administered survey at a clinical conference. SUBJECTS: Seventy-six obstetrician-gynecologists and one nurse practitioner were surveyed. METHODS: A case-vignette described a pregnant patient presenting with worsening chronic lower back pain, requesting an opioid refill and increased dosage...
August 14, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
David Dahlgren, Carl Roos, Anders Lundqvist, Bertil Abrahamsson, Christer Tannergren, Per M Hellström, Erik Sjögren, Hans Lennernäs
Currently there are only a limited number of determinations of human Peff in the distal small intestine and none in the large intestine. This has hindered the validation of preclinical models with regard to absorption in the distal parts of the intestinal tract, which can be substantial for BCS class II-IV drugs, and drugs formulated into modified-release (MR) dosage forms. To meet this demand, three model drugs (atenolol, metoprolol, and ketoprofen) were dosed in solution intravenously, and into the jejunum, ileum, and colon of 14 healthy volunteers...
September 6, 2016: Molecular Pharmaceutics
V-R de Ocenda, S Almeida-Prieto, A Luzardo-Álvarez, J L Barja, F J Otero-Espinar, J Blanco-Méndez
The pharmacokinetics of florfenicol (FF) in turbot (Scophthalmus maximus) was studied after single intravenous (10 mg kg(-1) ) and oral (100 mg kg(-1) ) administration. The plasma concentration-time data of florfenicol were described by an open one-compartment model. The elimination half-life (t1/2 ) was estimated to be 21.0 h, and the total body clearance, Cl, was determined as 0.028 L kg h(-1) . The apparent volume distribution (Vd ) was calculated to be 0.86 L kg(-1) and the mean residence time (MRTiv ) was 30...
August 9, 2016: Journal of Fish Diseases
David Dahlgren, Carl Roos, Pernilla Johansson, Anders Lundqvist, Christer Tannergren, Bertil Abrahamsson, Erik Sjögren, Hans Lennernäs
The development of oral modified-release (MR) dosage forms requires an active pharmaceutical ingredient (API) with a sufficiently high absorption rate in both the small and large intestine. Dogs are commonly used in preclinical evaluation of regional intestinal absorption and in the development of novel MR dosage forms. This study determined regional intestinal effective permeability (Peff) in dogs with the aim to improve regional Peff prediction in humans. Four model drugs, atenolol, enalaprilat, metoprolol, and ketoprofen, were intravenously and regionally dosed twice as a solution into the proximal small intestine (P-SI) and large intestine (LI) of three dogs with intestinal stomas...
September 6, 2016: Molecular Pharmaceutics
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