The present study was divided between two different drug delivery goals, each involving naltrexone (NTX) or its active metabolite, 6-β-naltrexol (NTXOL). First, amino acid esters of NTX and NTXOL were prepared in order to test their candidacy for microneedle-enhanced transdermal delivery. Second, a 3-O-(-)-cytisine-naltrexone (CYT-NTX) codrug was prepared for screening as a potential oral delivery form of NTX and (-)-cytisine (CYT). The amino acid prodrugs were intended for the treatment of alcohol abuse, while the codrug was designed as a single agent for the treatment of alcoholism and tobacco-dependency co-morbidities. One hypothesis of this work was that prodrugs of NTX or NTXOL can be designed that possess superior skin transport properties through microneedle-treated skin compared to parent NTX or NTXOL. Nine amino acid ester prodrugs were prepared, and only three 6-O amino acid ester prodrugs of NTXOL were stable enough at skin pH (pH 5.0) to move forward to studies in 50% human plasma. 6-O-β-Ala-NTXOL, the lead compound, exhibited the most rapid bioconversion to NTXOL in human plasma (t1/2 = 2.2 ± 0.1 h); however, this in vitro stability value indicates that the prodrug may require hepatic enzyme-mediated hydrolysis for sufficiently rapid bioconversion to NTXOL in vivo. A second hypothesis of this work was that a CYT-NTX codrug could be designed with appropriate stability characteristics for oral delivery. CYT-NTX was found to be stable over the time course of 24 h in buffer systems of pH 1.5, 5.0, 7.4 and 9.0, and in 80% rat plasma, 80% human plasma, simulated gastric fluid and simulated intestinal fluid. Six (3 rats/group) Sprague-Dawley male rats were dosed i.v. with 1 mg/kg CYT-NTX codrug, or 10 mg/kg, p.o. Oral administration of a 10 mg/kg dose of CYT-NTX codrug resulted in rapid absorption and distribution (5 min) of CYT-NTX codrug, and NTX was released from codrug with a peak plasma concentration of 6.8 ± 0.9 nmol/L reached within 65 minutes. Plasma CYT was not detected; however, NTX delivery was achieved with a fraction absorbed value of 13%. Thus, CYT-NTX may hold promise as a potential oral codrug for further optimization and development.

Os eventos adversos a medicamentos são comuns e provavelmente irão ocorrer em qualquer sistema, entretanto, é essencial identificar suas causas e tentar minimizar os riscos visando à segurança do paciente. O objetivo desse estudo foi analisar os eventos adversos a medicamentos em um hospital público do estado do Amazonas, com base nos relatos da equipe de enfermagem e propor estratégias à instituição para otimizar o sistema de medicamentos para a segurança do paciente. Um estudo do tipo descritivo, adotando-se a Técnica do Incidente Crítico como norteadora dos procedimentos metodológicos foi realizado com 15 enfermeiros, 09 auxiliares e 44 técnicos de enfermagem de um hospital de ensino de Manaus-AM. A análise dos dados constou da identificação e agrupamento das situações, comportamentos e consequências. A maioria dos profissionais entrevistados era do sexo feminino (89,7%), predominando a classe de idade de 31 a 35 anos (30,9%). Os resultados foram agrupados e categorizados em 47 situações, correspondentes a nove tipos de erros de medicação. Dos tipos de erros identificados pela equipe de enfermagem, os erros de diluição (23,4%), dose (14,9%), medicamentos não autorizados (14,9%), erro de via de administração (10,6%) e erro de paciente (8,5%) foram os mais frequentes. Com relação às categorias de comportamentos, estes foram distribuídos em função da percepção e comunicação do erro (36) e entre as consequências identificadas no estudo (103), 47 eram relacionadas aos pacientes e 56 aos profissionais de enfermagem. Os resultados apresentados indicam a necessidade de tomada imediata de iniciativas que minimizem essas situações e previna a ocorrência de futuros eventos adversos a medicamentos. / Adverse drug events are common and will probably occur in any system, however, it is essential to identify their causes and try to minimize the risks to patients\' safety. This descriptive study aimed to analyze adverse drug events at a public hospital in the state of Amazonas, based on the reports of the nursing team. The goal was to propose strategies for the institution to optimize the medication system for patient safety. The Critical Incident Technique guided the methodological procedures, carried out with 15 nurses, 09 nursing auxiliaries and 44 nursing technicians from a teaching hospital in Manaus, state of Amazonas. Data analysis consisted of identifying and grouping situations, behaviors and consequences. Most of the interviewed professionals were female (89.7%) from the age group of 31 to 35 (30.9%) years. Results of the studies were grouped and categorized into 47 situations, corresponding to nine types of medication errors. Of the types of errors identified by the nursing team, dilution errors (23.4%), dosing errors (14.9%), unauthorized medication (14.9%), wrong administration route (10.6%) and mistaken patient (8.5%) were the most frequent. The categories of behavior were distributed according to the perception and communication of error (36) and among the consequences identified in the study (103), of which 47 were related to patients and 56 to nursing professionals. The results indicate the need for immediate initiatives that minimize these situations and prevent the occurrence of future adverse drug events.

Os enfermeiros têm a responsabilidade ética, legal e profissional de promover uma assistência segura na administração de medicamentos. A aprendizagem da administração de medicamentos está centrada no conhecimento que os enfermeiros constroem em sua formação acadêmica e na vivência profissional. O objetivo deste trabalho foi compreender o significado da administração de medicamentos, pelo estudante de enfermagem nas suas primeiras experiências. Dada a natureza do problema, esta investigação utilizou uma abordagem qualitativa, tendo como referencial metodológico a Teoria Fundamentada nos Dados, à luz do Interacionismo Simbólico. Como estratégias para a coleta de dados foi utilizada a observação não-participante e entrevistas semi-estruturadas, tendo como sujeitos 13 estudantes de uma instituição pública de ensino superior, localizada no interior do Estado de São Paulo. Os dados foram coletados, organizados e analisados por meio da estratégia da análise comparativa constante. Os resultados revelaram que os estudantes de enfermagem, ao vivenciarem o processo da administração de medicamentos, experienciaram insegurança ao administrar medicamentos; evidenciando as categorias: não valorizando a execução de determinados procedimentos básicos e emergindo sentimentos de dúvida para \"ser Enfermeiro\" no contexto desta ação. Como condições causais do fenômeno despontam a vivência de situações de erros e a percepção de conhecimentos teórico-práticos insuficientes; e como estratégia de ação a importância do laboratório e do campo de prática para o aprendizado. As condições intervenientes que influenciaram a realização dessa ação foram: tendo apoio dos colegas, família e professor e tendo dificuldades no relacionamento com o cliente. Como conseqüências as categorias: despertando para a responsabilidade da \"ação\" de administrar medicamentos e despertando para a profissão: sentindo-se enfermeiro ao administrar medicamentos. Enfim, os estudantes de enfermagem participantes do estudo atribuíram o significado da administração de medicamento como uma atividade de ilimitado valor e responsabilidade, conduzindo-os a um despertar para a futura profissão. / Nurses have the ethical, legal and professional responsibility to promote safe care in medication administration. Learning about medication administration is centered on the knowledge that nurses develop during their academic education and professional experience. This work aimed at understanding the meaning of medication administration to nursing students during their first experiences. Due to the nature of the problem addressed, a qualitative approach was used according to the Grounded Theory, in the light of Symbolic Interactionism. Non-participant observation and semi-structured interviews were used as strategies for data collection from 13 subjects who were students at a public college in São Paulo state. Data were collected, organized and analyzed through the strategy of constant comparative analysis. The results showed that, during the process of medication administration, the nursing students experienced insecurity according to the following categories: not valuing the execution of basic procedures and with feelings of doubt \"about being a nurse\" emerging in the context of this action. The causes for the phenomenon were: experiencing situations of error and the perception that theoretical and practical knowledge was insufficient. As action strategies, the following must be cited: the importance of laboratory and practical activities for learning; as interventional conditions that would influence the performance of this action: having support from colleagues, relatives, teachers and having difficulties in the relationship with the client, and as consequences: awakening to the responsibility of the \"action\" of administering medication and awakening to the profession: feeling as a nurse when administering medication. Finally, the nursing students participating in the study attributed the meaning of medication administration as an activity of unlimited value and responsibility which leads them to the awakening to a future profession.

RNR Polymerase I (RNA Pol I) is a “factory” that orchestrate the transcription of ribosomal rRNA for constructing ribosomes as a primary workshop for protein translation to sustain cell growth. Misregulation of RNA Pol I can cause uncontrolled cell proliferation, which leads to the development of cancer. Yeast (Saccharomyces cerevisiae) is a valuable model system to study RNA Pol I. Recently, the X-ray crystal structure of the yeast homologue of RNA Pol I was elucidated, offering the structural basis to selectively target this transcriptional machinery. The approach to selective RNA Pol I targeting was to disrupt the interaction between a specific transcription factor, RRN3 that bind distinct regions of RNA Pol I. For this purpose, a recombined plasmid was designed to carry human rDNA plus its promoter as target together with a selection marker gene. Therefore, this plasmid could not only introduce the target gene into the yeast (host), but also facilitate the passage of this target gene into a stable yeast strain. In this project, one uracil deficient yeast strain of YBR140C was transformed with the recombined yeast integrative plasmid of pHmrDNA-YIPlac211-TG1. This is a recombined plasmid containing not only the human rDNA but also the URA3 gene as a selection marker. PCR amplification of the human ribosomal DNA was indicative of successful integration of the human ribosomal DNA into the genome of the two yeast strains. Virtual screening using a library of 700 FDA-approved compounds was docked into the RRN3-RNA Pol I complex to identify small molecule disruptors of the RRN3-RNA Pol I as a selective strategy. Using growth assays, gel electrophoresis and transcriptional assays, we identified cerivastatin sodium as a lead virtual hit. The result implicates cerivastatin sodium as a selective RNA Pol I inhibitor worthy of further development with potential as targeted anticancer therapeutic.

Glaucoma is the leading cause of blindness in the United States accounting for 9-12% of all cases of blindness. Currently, the front line treatment for glaucoma are prostaglandins that may have to be taken up to several times a day. Even with proper treatment, roughly 11% of the patients using the treatment are non-compliant and lose their vision. In this project, ForSight Laboratories has developed a pharmaceutical drug delivering implant with the capability of sustaining long-term release of a prostaglandin as a new way to treat the condition. This project reports the product development of a polymer drug matrix with a controlled release in order to better treat glaucoma. Accompanying product development, a mathematical model was created in order to strengthen the understanding of the dosage profile and to predict long term dosages.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Uppsala : Univ., 2002. / Härtill 5 uppsatser.

Thesis--Copenhagen. / At head of title: Johs. Ipsen. "The translation from Danish is by Mr. Einar Christensen."--Pref. "Dansk resume": p. [151]-157. "Literature": p. [246]-248.

Thesis (M.S.)--University of Michigan, 1999. / Running title: Psychotropics and agitation. Includes bibliographical references.