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The presence of contaminants in parenteral solutions is a constant nemesis against which pharmaceutical manufacturers, as well as medical, pharmacy , and nursing practitioners mus t vigilantly struggle to provide quality health care. At each level in the parenteral drug delivery system, contamination is possible before the patient actually receives the infusion. The implementation of better practices and procedures continues in the quest of contaminant-free parenterals, nevertheless, the literature is replete with articles documenting contamination of parenteral medication. Foreign body particulate matter has been found sequestered in the lungs of patients who have received intravenous therapy. The entrapment of foreign bodies can occur in other body organs besides the lungs. The hazardous effects of this particulate matter has been the subject of much concern. Other forms of parenteral contaminants have been reported in the literature. These include both bacterial and fungal contaminants. Contaminant detection in parenteral solutions has been accomplished by several methods. These have included: visual inspection, nephelometric methods, methods of membrane filtration with subsequent microscopic examination, and methods employing various electronic adaptations. No references have been published describing viral contamination of parenterals or methods for viral detection in parenteral solutions . Yet, viral contaminants infused directly into the blood of a patient may be of grave clinical significance. Thus, the objective of this project was to develop a method for detecting the presence of viruses in small and bulk parenteral solutions. Both small and large volumes of Sodium Chloride Injection U.S.P. and 5 percent Dextrose Injection U.S.P. were inoculated with 100 I.U . or 1 I.U. of Tobacco Mosaic Virus (TMV) per ml of solution . The contents of these parenterals were concentrated to a retentate volume using molecular filtration . The retentate volume was examined for viral content using transmission electron microscopy with negative staining techniques. Efficacy was determined by comparison of the results of the contaminated controls with the contaminated test groups . Statistically significant differences were observed between the control groups, which were not subjected to the test method, and the test groups for both small and large volume parenteral solutions. Efficiency, which denotes the viral contamination level at which viruses are detectable, was determined by comparing the control groups of uncontaminated parenteral solutions with contaminated test groups of the same solutions . Both groups were subjected to the test methodology. The control and the test groups showed statistically significant differences at the 100 and the 1 I.U. TMV contamination levels. The results showed that the defined method of viral detection is efficacious and efficient at the tested TMV contamination levels . This method could probably be applied to the detection of other viral contaminants of parenteral solutions as well as to biological viral analysis methods.

The quality of worlds’ water resources is facing new challenges, for instance detectable concentration of various trace contaminants under the term micropollutants is discharging into water bodies from both municipal wastewater treatment plants and from on-site wastewater facilities. A project called RedMic aim at identifying and quantifying emissions of micropollutants from on-site wastewater treatments as a basis for providing innovative treatment technologies to reduce potential risks for groundwater and surface water contamination. This thesis work deals with two of the work packages in the RedMic project: a column experiment to test the capability of 10 adsorbents to remove micropollutants and a multi-criteria analysis is conducted to evaluate if a filter composed of granulated activated carbon (GAC) or ozonation can be used for on-site wastewater treatment facilities. Based on the removal efficiency of dissolved organic carbon (DOC) of selected adsorbents, two types of activated carbon reduced up to 90% DOC concentration in the effluents. Moreover, six other adsorbents also showed good removal efficiency with around 60% in the second sampling. However, the data used in this thesis was only from the initial part of the experiment that continued and the final results will be published elsewhere. Two system solutions were evaluated with multi-criteria analysis: sandbed filter with either GAC filtration (1) or with ozonation (2) System solution 1 was found to have advantage compared to system 2.

The purpose of this study was to design, evaluate, and determine the cost benefit of a pharmacokinetic service for home-based patients. Four randomly selected patient populations were used in evaluating the service for six months. The experimental group consisted of 17 patients who were under the care of family practice physicians in private practice and who received pharmacokinetic consultation and monitoring by a pharmacist as a home health care service. The retrospective control consisted of the same 17 patients of the experimental group whose past medical history for a period of six months was used. The concurrent control consisted of 17 patients who were concurrently treated by the same family practice physicians in private practice who treated the patients in the experimental group. The fourth group consisted of 17 patients who were concurrently treated by family practice physicians in a general hospital outpatient clinic. The service was evaluated by comparing the following variables: serum levels ordered, serum levels ordered inappropriately, physicians' office visits, hospitalizations secondary to pulmonary problems, and emergency room visits secondary to pulmonary problems. A one-way analysis of variance, Scheffe's post hoc test, and t test were used to analyze the results. There was a significant difference (P greater than 0.05) in the number of inappropriate levels ordered, physician's office visits, and emergency room visits. The cost of the service was $134 and the benefit was $218. It was concluded that a homebased pharmacokinetic service is cost beneficial in this patient population.

This research project was designed to test whether the in vitro percutaneous penetration of benzocaine through human cadaver skin could be enhanced by dimethyl sulfoxide (DMSO), urea, polyoxyethylene (20) isohexadecyl ether and 1-dodecylazacycloheptan-2-one (Azone) in propylene glycol/water systems. Solubility and partitioning of benzocaine in propylene glycol/water systems was investigated. The adjuvant effects were studied in a 60/40 (V/V) propylene glycol/water co-solvent system. The well known drug penetration enhancer dimethyl sulfoxide did not enhance the penetration of benzocaine at any concentration level of DMSO under the conditions of the experiment. This lack of enhancement effect was probably due to increased solubility of benzocaine in the DMSO/water system and a consequent decrease in the partitioning of drug into the skin. Urea enhanced benzocaine penetration initially but no significant steady-state penetration enhancement was noted. Polyoxyethylene (20) isohexadecyl ether appeared to retard rather than enhance the percutaneous penetration of benzocaine at concentrations below and around the critical micelle concentration. Azone showed concentration dependence for its enhancement effect on penetration of benzocaine. With 1% V/V Azone, the initial benzocaine penetration rate was higher compared to the other Azone concentrations. On the basis of comparative analysis of the steady-state rates, 5% V/V Azone was observed to be the most effective penetration enhancer for benzocaine. Azone also showed additive enhancement properties with increasing percentages of propylene glycol. The results of this investigation emphasize the importance of in vitro skin penetration studies prior to clinical evaluation. The results also underscore the importance of a proper experimental design that will minimize variables during the study in order to properly identify cause and effect relationships.

The efficacy of risperidone (Risperdal) for the treatment of 3 chronically aggressive children was evaluated using an open-label, multiple-baseline design in a private practice setting. Results of both parent and teacher ratings demonstrated a reduction in aggressive and delinquent behavior in 2 of 3 participants upon introduction of Risperdal, with the third responding in similar fashion upon final dose adjustment. Each participant reported no occurrences of side effects. These findings suggest that Risperdal was well tolerated, and may serve as a safe and effective treatment modality for this challenging population.