Inaug.-diss. - Basel. / Curriculum vitae. "Literatur-verzeichnis": p. [91]

BACKGROUND: Stereochemistry is often used in the development of drugs. Enantiomers of a chiral drug are two non-superimposable mirror images of the molecule and a racemic mixture consists of equal quantities of both enantiomers. This study looks at the phenomenon of “chiral switching” where a molecule previously developed and marketed by an innovator company as a racemate medicine is later developed and launched as a single enantiomer. Drug utilization and market share data of three molecules that underwent chiral switching were investigated retrospectively to determine the clinical and economic impact of these occurrences in the private South African pharmaceutical market. METHOD: Unit sales and rand sales data of the racemate (and its generics) and the single enantiomer of three drug substance pairs, namely omeprazole-esomeprazole, citalopram-escitalopram and cetirizine-levocetirizine were gathered a year preceding the launch of the single enantiomer to three years subsequent to the launch of the single enantiomer onto the private market. DATA ANALYSIS: Descriptive statistical analysis included plotting trend lines of the annual unit and rand sales of both the racemate (and its generics) and the single enantiomer products during the study period, pie charts illustrating the year on year differences in market share (in both unit sales and rand value of sales) as well as box and whisker plots of the racemate and its generics plotted for the year before the single enantiomer was launched, the year after its launch, two years after launch and three years after launch. The probability of the enantiomer being prescribed/ sold instead of the racemate at different time points was also calculated to determine whether the drug utilization of the single enantiomer increased or decreased from introduction until three years subsequent to its launch. CONCLUSION: Results were consistent with global literature indicating that “chiral switching’ is a successful strategy employed by innovator companies to extend their market share. Drug utilization of the single enantiomer generally showed an upward trend following its launch indicating that there is a perceived belief of enhanced clinical outcomes for the patient. There are, however, many other influencing factors such as pricing strategies, prescription status, marketing efforts to physicians and/or consumers and patent challenges specific to each market that make it difficult to draw a general conclusion from the case studies.

.A Thesis presented for the degree of Doctor of Medicine at the University of the Witwatersrand SEPTEMBER 1962. / Plasmoquine (piasmochin, paiuaquin) was the first synthetic antimalarial drug, and it aroused a great deal of interest when it became available in 1926. Dixon (1933) estimated that at least 415 papers relating to plasmoquine hid appeared in the first 4 years following iti introduction, thereafter the volume of communications decreased somewhat,until fresh interest was stimulated by the Second world <.ar and the horean »,ar with fighting in maiariou. areas / IT2018

Thesis (MSc(Med)(Pharmacy)) -- University of Limpopo, 2012. / The role of the pharmacist has evolved over the last two decades beyond the traditional functions of dispensing and stock control. The focus has shifted toward patient-oriented functions, in which the pharmacist assumes responsibility for the patient’s drug- and healthcare needs as well as the outcome of treatment. The aim of this research was to assess the need for pharmaceutical care to the Surgical Intensive Care Unit of Steve Biko Hospital. The surgical and trauma ICU is a 12 bed unit to which the researcher rendered pharmaceutical care over an eight week period, from 14 February to 26 March 2011. Interventions to assess drug therapy and achieve definite outcomes to improve patients’ quality of life were documented for 51 study patients according to the system developed by the American Society of Health-System Pharmacists (1992). Of the 51 patients, 35 were male and 16 were female. The age of the patients ranged from 12 years to 86 years, with most patients admitted to the unit in the age groups 21 to 30 years, and 51 to 60 years. The patients’ estimated weights ranged from 40kg to 120kg with older patients, from age 41 upwards, weighing more. The average stay in the unit was 8.7 days, with the minimum stay for one patient being only one day, and the maximum stay for one patient was 26 days. In the study, the HIV status of only 13 of the 51 patients was tested. Of the 13 patients, six were HIV positive, while seven tested negative. All the patients admitted to the unit were not tested for HIV, because they were not admitted to the unit for HIV-related causes, and test results would not have had an effect on their outcome. Diagnoses encountered most frequently in the unit were trauma (21 patients), skeletal involvement or fractures (16 patients), infections or sepsis (15 patients) and gastro-intestinal bleeds (14 patients). In most cases more than one diagnosis applied to the same patient, since patients admitted with trauma also had skeletal or gastro-intestinal involvement. An Assessment of the need of Pharmaceutical Services in the Intensive Care Unit and High Care Unit of Steve Biko Academic Hospital viii The medications prescribed most frequently were enoxaparin (49 patients), sucralfate (41 patients) and multivitamin syrup (47 patients); in accordance with the standard ward protocol for prophylactic regimens. The drug class most often used was the anti-infectiveshaving124 items prescribed during the study period. Of these, the broad spectrum antibiotics were used most frequently, e.g. piperacillin/tazobactam (22 patients), meropenem (11 patients) and imipenem (11 patients). An average of 12 medications was prescribed for each patient in the ward. A total of 181 interventions were suggested for the 51 patients during the study period, of which 127 (70%) were accepted and implemented by the medical and nursing staff. The average number of interventions per patient ranged from 0 to 13 with a median of 3.5 interventions per patient. The four most frequent problem types were untreated medical conditions (15.5%), length or course of therapy inappropriate (13.8%), investigations indicated or outstanding (12.2%) and prescribed doses and dosing frequency appropriate (11%). Interventions were also made regularly to address system errors or non-compliance and factors hindering achievement of therapeutic effect. The perceived need for pharmaceutical care by healthcare professionals in the SICU was measured by questionnaires before and after the study period. The feedback by staff regarding the pharmacist working in the ward was very positive. They appreciated the researchers input on ward rounds, as well as assistance with problems encountered with the pharmacy. Of the total time spent in the ward, the researcher spent 28% of her time on patient evaluation. Ward rounds also took up a great deal of time (21.7%), since ward rounds were done with different members of the multidisciplinary team. Most interventions were suggested during ward rounds. The costs saved during the study period were enough to justify the appointment of a pharmacist to the ward on a permanent basis, albeit for limited hours daily. The researcher designed an antibiotic protocol for the unit. The protocol was designed according to international standards, and after discussion with the microbiologists, adapted for use in the specific unit. An Assessment of the need of Pharmaceutical Services in the Intensive Care Unit and High Care Unit of Steve Biko Academic Hospital ix In conclusion, the study results have demonstrated that a pharmacist’s contribution to patient care at ward level in a surgical ICU resulted in clinical outcomes that improved the patient’s quality of life. Drug-related problems were identified and addressed. Medical staff in the S-ICU accepted the pharmacist’s interventions and even welcomed her contribution to other ward functions, for instance managing medication and providing education. Pharmaceutical care should be rendered on a permanent basis to the Surgical ICU and the pharmacist should increasingly become a key part of the multidisciplinary team, taking responsibility for patients’ medication needs.

Diss. (sammanfattning) Uppsala : Univ., 2003. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1954. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1951. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1954. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 88-90).

Licentiatavhandling Linköping : Linköpings universitet, 2008. / På omslaget felaktig: Faculty of Arts and Sciences FiF-thesis.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in Pharmaceutical Affairs Johannesburg, 2014 / Aim The first step in a wet granulation process is dry mixing. This step has the objective of ensuring that all the raw materials are mixed such that the end product is homogeneous. Dry mixing in a high shear mixer instead of a blender saves cost. However, the mixing parameters have not been well researched. Dry mixing parameters that are currently used, have been established through experience, trial and error and in-process testing. Alexander and Muzzio (2006) confirms this by stating that there are currently no mathematical techniques to predict blending behaviour of granular components without prior experimental work; therefore, blending studies start with a small-scale, try-itand- see approach. Even though they are referring to blending, the same is also true for dry mixing. Both processes are the mixing of powders. Therefore the aim of this research was to develop parameters for dry mixing, based on experimental work. Methods Using a Saral rapid mixer and wet granulator (Saral Engineering Company, India), experiments were performed according to a 24 two-level Plackett-Burman Design method, to determine the effects of different blades (mixer/impeller and chopper) speeds and mixing times on the homogeneity of the mixtures containing different ratios of two powders that have different densities and particle sizes. One of the powders mixed, was enalapril maleate. This was chosen as it can be assayed. Samples were taken from the bowl and tested for assay. The mix for a specific experiment is homogeneous if the results of all 7 assayed samples are within 10 % of the target % w/w value and the % Relative Standard Deviation (% RSD) of the 7 results is less than or equal to 5,0 %. The outcome was being measured in % RSD. A lower % RSD indicates a more homogeneous mix. The parameters developed, will be beneficial to pharmaceutical companies as it can assist them to improve accuracy, consistency and quality of granular mixes. The experimental method used can serve as an example for future experiments. Results The results indicated that impeller blade mixing speed and mixing time are the two factors that have the biggest impact on the homogeneity of a mix in a high shear mixer. Chopper blade speed was also found to be significant, but less than the above two parameters mentioned. Optimal parameters were predicted. Conclusion As there are many parameters to be controlled during dry mixing in a high shear mixer, a statistical design method is suitable to establish the parameters that would have the most impact on the end result. Statistically it was found that mixing speed of the main impeller and chopper blades and overall mixing time are the three factors that have the biggest impact on the homogeneity of a mixture. The mixing time and impeller blade speed have proven to be more significant than the chopper blade speed. Concentration was found to be insignificant. For our experiments and for the specific granulator used the following optimal parameters could be deduced: Impeller blade set at 191 rpm, chopper blade set at 2002 rpm and mixing time set at 3.01 minutes.