It is the purpose of this thesis to develop a course of study for pharmacy schools on drug regulation by the Food and Drug Administration (FDA). A summarization of the history of the development of the Food and Drug Administration (FDA) and of pharmacy education reveals a lack of interface between the two. The necessity for the interface of pharmacy education and the agency which has significant control over the products forming the basis of the pharmacy profession will be made apparent. A period of residency through which the course of study on drug regulation by the FDA was to be developed, will be described. This description details the responsibilities and functions of the various segments of the FDA involved in the regulation of drugs as acquired through discussion with agency officials during the residency. It is intended to be used as the textual material for the didactic portion of the course of study to be offered at schools of pharmacy. Based upon the experience, recommendations will be made regarding the applicability of the course of study to include possible residencies for pharmacy students at the agency.

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Colorectal cancer (CRC) is one of the most common malignancies worldwide. However, adjuvant chemotherapeutic agents exhibit poor accumulation in the tumor mass and frequently result in serious side effects due to nonspecific damage to normal organs. Therefore, the development of more selective anticancer drugs with targeted delivery to tumor sites is the current trend in cancer therapies. Among these sites, tumor neovasculature is an attractive target for anticancer agents. It is because tumor growth is largely limited by blood supply which is dependent on the extent of angiogenesis in the tumor. / Experimental analysis suggested that TCP-1 phage and synthetic TCP-1 peptide specifically homed to colorectal cancer tissues and co-localized with the tumor vasculature. Moreover, TCP-1 peptide also recognized the vasculature of human colorectal cancer specimens. Subsequently, the homing abilities of TCP-1 phage were extensively tested in other cancer models. Results showed that TCP-1 peptide could also target the vasculature of orthotopic gastric cancer induced by human colon cancer cell line (MKN45) in BALB/c nude mice. Meanwhile, TCP-1 phage exhibited binding activity to colorectal cancer cells such as colon 26 and SW1116. TCP-1 peptide could carry a pro-apoptotic peptide into these cells and markedly enhanced its pro-apoptotic action. / In summary, we have used the phage display technology to isolate two unique peptides TCP-1 and TCP-2, which targeted the vasculature of orthotopic colorectal cancer and also recognized the vasculature of human colorectal cancer. Moreover, they could deliver fluorescein or pro-apoptotic peptide only to the tumor vasculature but not to other normal tissues, for imaging detection and targeted therapy. In conclusion, both TCP-1 and TCP-2 may have significant clinical applications as carriers in diagnostic imaging and ligand-mediated targeted therapy for human colorectal cancer. / Similarly, TCP-2 phage or its peptide also targeted specifically the orthotopic colorectal cancer, and co-localized with the tumor vasculature in mice. Meanwhile, TCP-2 peptide recognized the vasculature of human colorectal cancer specimens. FITC-labeled TCP-2 peptide could also be used to detect cancer tissues in tumor-bearing mice. / To identify specific ligands targeting the tumor neovasculature, in vivo phage display technology has been extensively used. Several dozens of peptides homing to normal or diseased vasculature have been identified through this technology. However, these peptides target mainly the tumors growing at distant sites but not at the primary organ, thus limiting their clinical application. To obtain specific peptides targeting the neovasculature of colorectal cancer growing in situ, we established an orthotopic colorectal cancer model in normal BALB/c mice by using syngeneic colon cancer cells (colon 26). Subsequently, in vivo phage display technology was utilized to isolate peptides which specifically recognized the vasculature of the cancer. Four peptides (termed TCP-1, 2, 3, 4) were enriched more than once after four-round selections. Further investigation disclosed that TCP-1 and TCP-2 phages had relatively stronger binding abilities to cancer tissues among the four phage clones. They were chosen for further study. / We further demonstrated that TCP-1 could serve as a carrier for image detection and drug delivery. FITC-labeled TCP-1 could specifically produce a strong fluorescence signal in the tumors after intravenous injection into the orthotopic tumor-bearing mice. Moreover TCP-1, when conjugated with a pro-apoptotic peptide, could also specifically induce apoptosis of tumor vasculature in vivo. / Li, Zhijie. / Adviser: Cho Chiltin. / Source: Dissertation Abstracts International, Volume: 72-04, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 194-221). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Adverse drug events (ADE) cause many deaths annually in addition to affecting the quality of life of many others. The descriptive mixed methods approach, specifically exploratory case study and experimental design that guided this research utilized the survey and focus group methods to evaluate perceptions about robotic technology (RT) to reduce the rate of ADEs in U.S. nursing homes (NH). There is a lack of scholarly research into whether a conceptual approach rooted in RT can be implemented to assist with drug administrations in NHs. The purpose of this study was twofold. The first purpose was to evaluate the causes of ADEs specifically related to tablets, capsules, and pills. The second purpose was to evaluate the perceptions of nurses and administrators relative to the use of RT to assist in reducing ADEs. In the quantitative part, the sample means from 102 surveys from nurses and administrators were evaluated with the t test and the paired t test; while in the qualitative part, survey results, reported errors, and focus group data was assessed collectively. The research results did not indicate any new causes of ADEs and showed that the participants had a favorable perception of RT. Based on the results of this research, RT may be tailored in such a way that it can significantly reduce ADE occurrences for citizens in U.S. NHs.

Neglected tropical diseases (NTD) in low- and middle-income countries are still not on target per the World Health Organization's (WHO) elimination goal of 2020. Mass drug administration (MDA) is one of the effective strategies supported by the WHO for the control and subsequent elimination of NTD. This quantitative study explored how supply chain logistic capacity may be hampering MDA coverage in countries in which the diseases are endemic. The study examined secondary data from WHO data bank for MDA coverage, to quantify the relationship between supply chain logistics capacity, as measured by the World Bank's logistics performance index (LPIs), and the control of NTD using MDA. The ecological theory of health behavior was the theoretical framework for this study. The research questions explored whether a low- and/or middle-income country's supply chain infrastructure, logistics services, customs and border procedures, and supply chain reliability, predict the coverage of MDA in controlling NTD. A multiple regression model determined the linear relations between each predictor: supply chain infrastructure (H1), logistics services (H2), custom and border procedures (H3), and supply chain reliability (H4) and the control of neglected diseases as determine by MDA. Results indicated that supply chain capacity, custom and border processes, and supply chain reliability are statistically significant in predictors of MDA coverage in the control of NTD in developing countries. This study may enhance social change by improving supply chain capacity for more effective distribution of PCT drugs, thus helping with the elimination of NTDs and improved health outcomes in low- and middle-income countries.

There has been growing interest in designing and development of suitable micro or nano drug delivery system with the ability to target site specifically and release the payload in a predetermined fashion. Recently a new type of system called polyelectrolyte microcapsules and thin films have been proposed and developed for applications such as, biomedical devices to micro sensing and drug delivery. Owing to its advantages of mild preparation conditions, multifunctionality, with programmable characteristics and to encapsulate large amount of materials, it has shown immense potential. In the present research, multilayer polyelectrolyte thin films composed of Poly(methacrylic acid) (PMA) and Poly (vinyl pyrrolidone) (PVP) were deposited on the flat substrates using layer by layer (LBL) technique. The film growth and its deconstruction under physiological conditions were characterized using UV Visible spectrophotometer and Scanning Electron Microscopy (SEM). Hollow microcapsules composed of PMA and PVP were also produced with the help of sacrificial silica template using the same LBL adsorption technique. After coating the desired number of PVP and PMA layers, the colloidal template was removed with a buffer system composed of Hydrofluoric acid (HF) and Ammonium fluoride (NH4F). The obtained capsules were characterized for its surface morphology using SEM and Atomic Force Microscopy (AFM). The hydrogen bonding in capsule formation was confirmed by Fourier Transform Infrared Spectroscopy (FTIR). Encapsulation and release with the microcapsules was carried out using Rifampicin (Antitubercular drug) as a model drug. The interaction of empty and drug loaded capsules with Mycobacterium Smegmatis cell line was investigated. It was found that the empty capsules did not affect the cell growth indicating their biocompatibility. Confocal microscopy studies with Doxorubicin (anticancer drug), which is a naturally fluorescent molecule, showed the drug is indeed encapsulated inside the hollow capsule. From the above studies, it was concluded that polyelectrolyte capsules have the potential to be used for delivering drugs.

Poorly water soluble drugs have been manipulated to make them more soluble, increasing the bioavailability of these drugs. Several cryogenic processes allow for production of drug nanoparticles, without mechanical stress that could cause degradation. The Ultra Rapid Freezing (URF) process is a technique which improves water solubility of drugs by reducing primary drug particle size by producing amorphous solid dispersions. Heat conduction is improved, using a cryogenic material with a high thermal conductivity relative to the solution being frozen to maintain the surface temperature and heat transfer rate while the solution is being frozen. With URF technology, the freezing rate is fixed, which drives the particle formation and determines its characteristics. Supersaturation of drug in aqueous solution can allow for better absorption of the drug via the oral and pulmonary routes. Drug formulations that supersaturate the dissolution media show the possibility for increased bioavailability from an amorphous drug form. If the concentration of drug in solution is significantly increased, higher chemical potential will lead to an increase in flux across an exposed membrane, leading to higher blood levels for an amorphous drug, compared to an identical crystalline formulation. During oral delivery, supersaturated drug concentrations would also saturate PGP efflux sites in the gut lumen, increasing the drug's bioavailability. Saturated PGP sites show zero order efflux kinetics, so increasing the drug concentration in supersaturated biological fluid will increase serum drug levels. High supersaturation levels maintained for prolonged periods would have a beneficial effect on a drug's absolute bioavailability. Pulmonary administration offers therapeutic advantages over more invasive routes of administration. Limited amount of metabolizing enzymes like CYP 3A4 in lung tissue along with avoidance of first pass metabolism are advantages to pulmonary delivery. The objective of the research presented in this dissertation is to show the versatility of nanoparticulate poorly water soluble drug formulations. Due to the reduced particle size and the URF manufacturing process, a wide range of applications can be used with these nanoparticles. Oral and pulmonary administration routes can be explored using nanoparticles, but in vitro cell culture testing can show clinical benefits from this type of processing technology. / text

FDA decisions and late-stage clinical trial results regarding new pharmaceutical approvals can cause extreme moves in the share price of small biopharmaceutical companies. Throughout the clinical trial process, many potential investors are exposed to market-moving information before such information is made available to the investing public. An investor who wished to profit from advance knowledge about clinical trial results may use the publicly traded options markets in order to increase leverage and maximize profits. This research examined options data surrounding the public release of information pertaining to the efficacy of clinical trials and approval decisions made by the FDA. Events were identified for small pharmaceutical companies with fewer than three currently approved drugs in an attempt to isolate the effect of individual clinical trial and FDA-related events on the share price of the underlying company. Option data were analyzed using logistic regression models in an attempt to predict phase II and III clinical trial outcome results and FDA new drug approval decisions. Implied volatility, open interest, and option contract delta values were the primary independent variables used to predict positive or negative event outcomes. The dichotomized version of a predictor variable designed to estimate total investment exposure incorporating open interest, option contract delta values, and the underlying stock price was a significant predictor of negative pharmaceutical related events. However, none of ii the variables examined in this research were significant predictors of positive drug research related events. The estimated total investment exposure variable used in this research can be applied to the prediction of future clinical trial and FDA decision related events when this predictor variable shows a negative signal. Additional research would help confirm this finding by increasing the sample size of events that potentially follow the same pattern as those examined in this research. / text

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

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