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Sample records for electronic drug monitor

  1. Therapeutic Drug Monitoring

    MedlinePlus

    ... be limited. Home Visit Global Sites Search Help? Therapeutic Drug Monitoring Share this page: Was this page ... Monitored Drugs | Common Questions | Related Pages What is therapeutic drug monitoring? Therapeutic drug monitoring is the measurement ...

  2. An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring.

    PubMed

    Krummenacher, Isabelle; Cavassini, Matthias; Bugnon, Olivier; Schneider, Marie P

    2011-05-01

    To ensure successful treatment, HIV patients must maintain a high degree of medication adherence over time. Since August 2004, patients who are (or are at risk of) experiencing problems with their HIV antiretroviral therapy (ART) have been referred by their physicians to an interdisciplinary HIV-adherence program. The program consists of a multifactorial intervention along with electronic drug monitoring (MEMS(TM)). The pharmacists organize individualized semi-structured motivational interviews based on cognitive, emotional, behavioral, and social issues. At the end of each session, the patient brings an adherence report to the physician. This enables the physician to use the adherence results to evaluate the treatment plan. The aim of this study was to retrospectively analyze this on-going interdisciplinary HIV-adherence program. All patients who were included between August 2004 and the end of April 2008 were analyzed. One hundred and four patients were included (59% women, median age 39 (31.0, 46.0) years, 42% black ethnicity). Eighty (77%) patients were ART-experienced patients and 59% had a protease inhibitor-based treatment. The retention rate was high (92%) in the program. Patient inclusion in this HIV-adherence program was determined by patient issues for naive patients and by nonadherence or suboptimal clinical outcomes for ART-experienced patients. The median time spent by a subject at the pharmacy was 35 (25.0, 48.0) minutes, half for the medication handling and half for the interview. The adherence results showed a persistence of 87% and an execution of 88%. Proportion of undetectable subjects increased during study. In conclusion, retention and persistence rates were high in this highly selected problematic population. PMID:21271406

  3. Therapeutic drug monitoring: antiarrhythmic drugs

    PubMed Central

    Campbell, T J; Williams, K M

    2001-01-01

    Antiarrhythmic agents are traditionally classified according to Vaughan Williams into four classes of action. Class I antiarrhythmic agents include most of the drugs traditionally thought of as antiarrhythmics, and have as a common action, blockade of the fast-inward sodium channel on myocardium. These agents have a very significant toxicity, and while they are being used less, therapeutic drug monitoring (TDM) does significantly increase the safety with which they can be administered. Class II agents are antisympathetic drugs, particularly the b-adrenoceptor blockers. These are generally safe agents which do not normally require TDM. Class III antiarrhythmic agents include sotalol and amiodarone. TDM can be useful in the case of amiodarone to monitor compliance and toxicity but is generally of little value for sotalol. Class IV antiarrhythmic drugs are the calcium channel blockers verapamil and diltiazem. These are normally monitored by haemodynamic effects, rather than using TDM. Other agents which do not fall neatly into the Vaughan Williams classification include digoxin and perhexiline. TDM is very useful for monitoring the administration (and particularly the safety) of both of these agents. PMID:11564050

  4. Monitoring drug therapy.

    PubMed

    Buclin, Thierry; Gotta, Verena; Fuchs, Aline; Widmer, Nicolas; Aronson, Jeffrey

    2012-06-01

    Drug development has improved over recent decades, with refinements in analytical techniques, population pharmacokinetic-pharmacodynamic (PK-PD) modelling and simulation, and new biomarkers of efficacy and tolerability. Yet this progress has not yielded improvements in individualization of treatment and monitoring, owing to various obstacles: monitoring is complex and demanding, many monitoring procedures have been instituted without critical assessment of the underlying evidence and rationale, controlled clinical trials are sparse, monitoring procedures are poorly validated and both drug manufacturers and regulatory authorities take insufficient account of the importance of monitoring. Drug concentration and effect data should be increasingly collected, analyzed, aggregated and disseminated in forms suitable for prescribers, along with efficient monitoring tools and evidence-based recommendations regarding their best use. PK-PD observations should be collected for both novel and established critical drugs and applied to observational data, in order to establish whether monitoring would be suitable. Methods for aggregating PK-PD data in systematic reviews should be devised. Observational and intervention studies to evaluate monitoring procedures are needed. Miniaturized monitoring tests for delivery at the point of care should be developed and harnessed to closed-loop regulated drug delivery systems. Intelligent devices would enable unprecedented precision in the application of critical treatments, i.e. those with life-saving efficacy, narrow therapeutic margins and high interpatient variability. Pharmaceutical companies, regulatory agencies and academic clinical pharmacologists share the responsibility of leading such developments, in order to ensure that patients obtain the greatest benefit and suffer the least harm from their medicines. PMID:22360377

  5. Electronic monitoring gains more acceptance.

    PubMed

    1998-02-01

    Most methods of gauging compliance are unreliable as they rely on subjective reporting by patients who may have forgotten to take a dose, taken it at the wrong time, or overstate adherence to please their provider. Using a self-reporting system, it is also difficult to monitor how well patients are taking the drugs on time, and checking drug serum concentrations is subject to metabolic and absorption rates. Electronic monitoring systems are now being used for some patients who have problems with compliance. One system uses ordinary-looking bottle caps with a microchip to record when the bottle is opened, and another sophisticated system uses bottle caps that can be programmed to alert patients when they need to take a dose. The manufacturers anticipate the devices being used by only a small percentage of people who are challenged in their adherence. PMID:11365038

  6. Electron launching voltage monitor

    DOEpatents

    Mendel, C.W.; Savage, M.E.

    1992-03-17

    An electron launching voltage monitor measures MITL voltage using a relationship between anode electric field and electron current launched from a cathode-mounted perturbation. An electron launching probe extends through and is spaced from the edge of an opening in a first MITL conductor, one end of the launching probe being in the gap between the MITL conductor, the other end being adjacent a first side of the first conductor away from the second conductor. A housing surrounds the launching probe and electrically connects the first side of the first conductor to the other end of the launching probe. A detector detects the current passing through the housing to the launching probe, the detected current being representative of the voltage between the conductors. 5 figs.

  7. Electron launching voltage monitor

    DOEpatents

    Mendel, Clifford W.; Savage, Mark E.

    1992-01-01

    An electron launching voltage monitor measures MITL voltage using a relationship between anode electric field and electron current launched from a cathode-mounted perturbation. An electron launching probe extends through and is spaced from the edge of an opening in a first MITL conductor, one end of the launching probe being in the gap between the MITL conductor, the other end being adjacent a first side of the first conductor away from the second conductor. A housing surrounds the launching probe and electrically connects the first side of the first conductor to the other end of the launching probe. A detector detects the current passing through the housing to the launching probe, the detected current being representative of the voltage between the conductors.

  8. [The importance of therapeutic drug monitoring for psychotropic drugs].

    PubMed

    Messer, Thomas; Schmauss, Max

    2006-05-15

    The goal of therapeutic drug monitoring (TDM) is the optimization of the psychiatric pharmacotherapy. Above all, TDM is absolutely indicated for the prevention of adverse drug effects or poisoning. TDM is well-established for therapies with antidepressants, antipsychotic drugs and mood stabilizers. For anti-dementia drugs, anxiolytic drugs, hypnotic drugs and medications for treating addiction, monitoring is currently applied to the interpretation of side effects, drug interactions and to forensic questions. PMID:20104722

  9. Monitoring of drug-drug and drug-food interactions.

    PubMed

    Garabedian-Ruffalo, S M; Syrja-Farber, M; Lanius, P M; Plucinski, A

    1988-07-01

    A program for detecting and preventing potentially serious drug-drug and drug-food interactions is described. Two clinical pharmacists developed drug interaction alert (DIA) cards for each potential interaction to be monitored. The cards contain information about the proposed mechanism and potential result of the interaction, as well as information about how to monitor or circumvent the interaction. Staff pharmacists check for the occurrence of potential interactions daily as they verify the filling of the patient-medication cassettes; a poster of all the interactions that are included in the program is posted in each satellite pharmacy to serve as a quick reference for the pharmacists. When a pharmacist detects a potential interaction, he or she completes a DIA card and places it in the medication cassette drawer (if the notice is directed to the nurse) or on the front of the patient's chart (if the notice is directed to the physician). The program was introduced to hospital personnel through inservice education programs and departmental newsletters. The results of a quality assurance review indicated that 95 of 279 (34%) cards dispensed to nurses and 40 of 49 (82%) cards dispensed to physicians resulted in some form of action. The program to detect and prevent potentially serious drug-drug and drug-food interactions has been successful. PMID:3414718

  10. Record linkage for drug monitoring.

    PubMed Central

    Skegg, D C; Doll, R

    1981-01-01

    A study was carried out to assess the feasibility of using record linkage for drug monitoring. For two years, three types of records were collected for a total of 43 117 people: (1) details of basic attributes, such as sex and age; (2) details of prescriptions dispensed; and (3) records of hospital admissions, obstetric deliveries, and deaths. The records about each person were linked together, and analyses were performed to reveal associations between drugs and diagnoses. The study suggested that record linkage would be useful both for generating and for testing hypotheses about the adverse effects of drugs. The method would be especially valuable for detection of delayed effects (such as the induction of cancer), sudden deaths outside hospital, and effects of the fetus-all of which are difficult to study by other means. A full-scale project would need to cover a large population, and some of the practical issues that would arise are discussed. PMID:7264530

  11. Therapeutic drug monitoring in neonates.

    PubMed

    Pauwels, Steven; Allegaert, Karel

    2016-04-01

    Therapeutic drug monitoring (TDM) aims to integrate drug measurement results into clinical decision making. The basic rules apply when using TDM in neonates (aminoglycosides, vancomycin, phenobarbital, digoxin), but additional factors should also be taken into account. First, due to both pharmacokinetic variability and non-pharmacokinetic factors, the correlation between dosage and concentration is poor in neonates, but can be overcome with the use of more complex, validated dosing regimens. Second, the time to reach steady state is prolonged, especially when no loading dose is used. Consequently, the timing of TDM sampling is important in this population. Third, the target concentration may be uncertain (vancomycin) or depend on specific factors (phenobarbital during whole body cooling). Finally, because of differences in matrix composition (eg, protein, bilirubin), assay-related inaccuracies may be different in neonates. We anticipate that complex validated dosing regimens, with subsequent TDM sampling and Bayesian forecasting, are the next step in tailoring pharmacotherapy to individual neonates. PMID:26803050

  12. Using Electronic Drug Monitor Feedback to Improve Adherence to Antiretroviral Therapy Among HIV-Positive Patients in China

    PubMed Central

    DeSilva, Mary Bachman; Hamer, Davidson H.; Xu, Keyi; Zhang, Jianbo; Li, Tao; Wilson, Ira B.; Gill, Christopher J.

    2009-01-01

    Effective antiretroviral therapy (ART) requires excellent adherence. Little is known about how to improve ART adherence in many HIV/AIDS-affected countries, including China. We therefore assessed an adherence intervention among HIV-positive patients in southwestern China. Eighty subjects were enrolled and monitored for 6 months. Sixty-eight remaining subjects were randomized to intervention/control arms. In months 7–12, intervention subjects were counseled using EDM feedback; controls continued with standard of care. Among randomized subjects, mean adherence and CD4 count were 86.8 vs. 83.8% and 297 vs. 357 cells/μl in intervention vs. control subjects, respectively. At month 12, among 64 subjects who completed the trial, mean adherence had risen significantly among intervention subjects to 96.5% but remained unchanged in controls. Mean CD4 count rose by 90 cells/μl and declined by 9 cells/μl among intervention and control subjects, respectively. EDM feedback as a counseling tool appears promising for management of HIV and other chronic diseases. PMID:19771504

  13. Immunoassays in monitoring biotechnological drugs.

    PubMed

    Gygax, D; Botta, L; Ehrat, M; Graf, P; Lefèvre, G; Oroszlan, P; Pfister, C

    1996-08-01

    For the evaluation and interpretation of pharmacokinetic data reliable quantitative determinations are a requirement that can only be met by well-characterized and fully validated analytical methods. To cope with these requirements a method is being established that is based on an integrated and automated fiber-optic biospecific interaction analysis system (FOBIA) for immunoassays. Performance characteristics of this system used in monitoring of recombinant hirudin (CGP 39 393) are presented. Recombinant hirudin is a highly potent and selective inhibitor of human thrombin. Owing to its size and charge, recombinant hirudin is mainly eliminated by glomerular filtration. But only a fraction of the hirudin dose seems to be reabsorbed at the proximal tubule by luminal endocytosis and hydrolyzed by lysosomal enzymes, leaving approximately 50% of the dose to be extracted in the urine. Thus, renal clearance of recombinant hirudin in the absence of renal insufficiency appears to depend primarily on the glomerular filtration rate. During a 3-month i.v. tolerability study in dogs, some of the dogs developed antibodies against recombinant hirudin. The hirudin-antibody complex accumulated in plasma and apparent hirudin plasma concentrations were therefore much higher than expected from single-dose kinetics. Hirudin captured by antibodies showed an extended half-life and the hirudin-antibody complex is still pharmacologically active, as demonstrated by the observed increase in thrombin time. In conclusion, only appropriate analytical methods allow adequate monitoring and pharmacokinetic characterization of biotechnology drugs in biological materials. PMID:8857560

  14. Drug Interactions and Antiretroviral Drug Monitoring

    PubMed Central

    Foy, Matthew; Sperati, C. John; Lucas, Gregory M.

    2014-01-01

    Due to the improved longevity afforded by combination antiretroviral therapy (cART), HIV-infected individuals are developing several non-AIDS related comorbid conditions. Consequently, medical management of the HIV-infected population is increasingly complex, with a growing list of potential drug-drug interactions (DDIs). This article reviews some of the most relevant and emerging potential interactions between antiretroviral medications and other agents. The most common DDIs are those involving protease inhibitors or non-nucleoside reverse transcriptase inhibitors which alter the cytochrome P450 enzyme system and/or drug transporters such as p-glycoprotein. Of note are the new agents for the treatment of chronic hepatitis C virus infection. These new classes of drugs and others drugs which are increasingly used in this patient population represent a significant challenge with regard to achieving the goals of effective HIV suppression and minimization of drug-related toxicities. Awareness of DDIs and a multidisciplinary approach are imperative in reaching these goals. PMID:24950731

  15. Novel Approaches for Visualizing and Analyzing Dose-Timing Data from Electronic Drug Monitors, or “How the ‘Broken Window’ Theory Pertains to ART Adherence”

    PubMed Central

    DeSilva, Mary Bachman; Hamer, Davidson H.; Keyi, Xu; Wilson, Ira B.; Sabin, Lora

    2016-01-01

    Adherence to antiretroviral medications is usually expressed in terms of the proportion of doses taken. However, the timing of doses taken may also be an important dimension to overall adherence. Little is known about whether patients who mistime doses are also more likely to skip doses. Using data from the completed Adherence for Life randomized controlled trial, we created visual and statistical models to capture and analyze dose timing data collected longitudinally with electronic drug monitors (EDM). From scatter plots depicting dose time versus calendar date, we identified dominant patterns of dose taking and calculated key features [slope of line over calendar date; residual mean standard error (RMSE)]. Each was assessed for its ability to categorize subjects with ‘suboptimal’ (<95 % of doses taken) using area under the receiver operating characteristic (AROC) curve analysis. Sixty eight subjects contributed EDM data, with ~300 to 400 observations/subject. While regression line slopes did not predict ‘sub-optimal’ adherence (AROC 0.51, 95 % CI 0.26–0.75), the variability in dose timing (RMSE) was strongly predictive (AROC 0.79, 95 % CI 0.62–0.97). Compared with the lowest quartile of RMSE (minimal dose time variability), each successive quartile roughly doubled the odds of ‘sub-optimal’ adherence (OR 2.1, 95 % CI 1.3–3.4). Patterns of dose timing and mistiming are strongly related to overall adherence behavior. Notably, individuals who skip doses are more likely to mistime doses, with the degree of risk positively correlated with the extent of dose timing variability. PMID:25893658

  16. Novel Approaches for Visualizing and Analyzing Dose-Timing Data from Electronic Drug Monitors, or "How the 'Broken Window' Theory Pertains to ART Adherence".

    PubMed

    Gill, Christopher J; DeSilva, Mary Bachman; Hamer, Davidson H; Keyi, Xu; Wilson, Ira B; Sabin, Lora

    2015-11-01

    Adherence to antiretroviral medications is usually expressed in terms of the proportion of doses taken. However, the timing of doses taken may also be an important dimension to overall adherence. Little is known about whether patients who mistime doses are also more likely to skip doses. Using data from the completed Adherence for Life randomized controlled trial, we created visual and statistical models to capture and analyze dose timing data collected longitudinally with electronic drug monitors (EDM). From scatter plots depicting dose time versus calendar date, we identified dominant patterns of dose taking and calculated key features [slope of line over calendar date; residual mean standard error (RMSE)]. Each was assessed for its ability to categorize subjects with 'sub-optimal' (<95 % of doses taken) using area under the receiver operating characteristic (AROC) curve analysis. Sixty eight subjects contributed EDM data, with ~300 to 400 observations/subject. While regression line slopes did not predict 'sub-optimal' adherence (AROC 0.51, 95 % CI 0.26-0.75), the variability in dose timing (RMSE) was strongly predictive (AROC 0.79, 95 % CI 0.62-0.97). Compared with the lowest quartile of RMSE (minimal dose time variability), each successive quartile roughly doubled the odds of 'sub-optimal' adherence (OR 2.1, 95 % CI 1.3-3.4). Patterns of dose timing and mistiming are strongly related to overall adherence behavior. Notably, individuals who skip doses are more likely to mistime doses, with the degree of risk positively correlated with the extent of dose timing variability. PMID:25893658

  17. 21 CFR 880.2420 - Electronic monitor for gravity flow infusion systems.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Electronic monitor for gravity flow infusion... and Personal Use Monitoring Devices § 880.2420 Electronic monitor for gravity flow infusion systems. (a) Identification. An electronic monitor for gravity flow infusion systems is a device used...

  18. 21 CFR 880.2420 - Electronic monitor for gravity flow infusion systems.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Electronic monitor for gravity flow infusion... and Personal Use Monitoring Devices § 880.2420 Electronic monitor for gravity flow infusion systems. (a) Identification. An electronic monitor for gravity flow infusion systems is a device used...

  19. 21 CFR 880.2420 - Electronic monitor for gravity flow infusion systems.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Electronic monitor for gravity flow infusion... and Personal Use Monitoring Devices § 880.2420 Electronic monitor for gravity flow infusion systems. (a) Identification. An electronic monitor for gravity flow infusion systems is a device used...

  20. 21 CFR 880.2420 - Electronic monitor for gravity flow infusion systems.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Electronic monitor for gravity flow infusion... and Personal Use Monitoring Devices § 880.2420 Electronic monitor for gravity flow infusion systems. (a) Identification. An electronic monitor for gravity flow infusion systems is a device used...

  1. 21 CFR 880.2420 - Electronic monitor for gravity flow infusion systems.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Electronic monitor for gravity flow infusion... and Personal Use Monitoring Devices § 880.2420 Electronic monitor for gravity flow infusion systems. (a) Identification. An electronic monitor for gravity flow infusion systems is a device used...

  2. Microextraction techniques in therapeutic drug monitoring.

    PubMed

    Farhadi, Khalil; Hatami, Mehdi; Matin, Amir Abbas

    2012-08-01

    Therapeutic drug monitoring (TDM), as part of clinical process of medical treatments, is commonly used to maintain 'therapeutic' drug concentrations. TDM is useful to identify the causes of unwanted or unexpected responses, to prevent unnecessary diagnostic testing, to improve clinical outcomes, and even to save lives. The determination of drug concentration in blood samples requires an excellent sample preparation procedure. Recent trends in sample preparation include miniaturization, automation, high-throughput performance, on-line coupling with analytical instruments and low-cost operation through extremely low or no solvent consumption. Microextraction techniques, such as liquid- and solid-phase microextraction, have these advantages over the traditional techniques. This paper reviews the recent developments in microextraction techniques used for drug monitoring in serum, plasma or blood samples. PMID:22767149

  3. Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications

    PubMed Central

    Krasowski, Matthew D.

    2010-01-01

    In the past twenty years, 14 new antiepileptic drugs have been approved for use in the United States and/or Europe. These drugs are eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin and zonisamide. In general, the clinical utility of therapeutic drug monitoring has not been established in clinical trials for these new anticonvulsants, and clear guidelines for drug monitoring have yet to be defined. The antiepileptic drugs with the strongest justifications for drug monitoring are lamotrigine, oxcarbazepine, stiripentol, and zonisamide. Stiripentol and tiagabine are strongly protein bound and are candidates for free drug monitoring. Therapeutic drug monitoring has lower utility for gabapentin, pregabalin, and vigabatrin. Measurement of salivary drug concentrations has potential utility for therapeutic drug monitoring of lamotrigine, levetiracetam, and topiramate. Therapeutic drug monitoring of the new antiepileptic drugs will be discussed in managing patients with epilepsy. PMID:20640233

  4. Therapeutic drug monitoring and tyrosine kinase inhibitors

    PubMed Central

    Herviou, Pauline; Thivat, Emilie; Richard, Damien; Roche, Lucie; Dohou, Joyce; Pouget, Mélanie; Eschalier, Alain; Durando, Xavier; Authier, Nicolas

    2016-01-01

    The therapeutic activity of drugs can be optimized by establishing an individualized dosage, based on the measurement of the drug concentration in the serum, particularly if the drugs are characterized by an inter-individual variation in pharmacokinetics that results in an under- or overexposure to treatment. In recent years, several tyrosine kinase inhibitors (TKIs) have been developed to block intracellular signaling pathways in tumor cells. These oral drugs are candidates for therapeutic drug monitoring (TDM) due to their high inter-individual variability for therapeutic and toxic effects. Following a literature search on PubMed, studies on TKIs and their pharmacokinetic characteristics, plasma quantification and inter-individual variability was studied. TDM is commonly used in various medical fields, including cardiology and psychiatry, but is not often applied in oncology. Plasma concentration monitoring has been thoroughly studied for imatinib, in order to evaluate the usefulness of TDM. The measurement of plasma concentration can be performed by various analytical techniques, with liquid chromatography-mass spectrometry being the reference method. This method is currently used to monitor the efficacy and tolerability of imatinib treatments. Although TDM is already being used for imatinib, additional studies are required in order to improve this practice with the inclusion of other TKIs. PMID:27446421

  5. Monitoring occupational exposure to cancer chemotherapy drugs

    NASA Technical Reports Server (NTRS)

    Baker, E. S.; Connor, T. H.

    1996-01-01

    Reports of the health effects of handling cytotoxic drugs and compliance with guidelines for handling these agents are briefly reviewed, and studies using analytical and biological methods of detecting exposure are evaluated. There is little conclusive evidence of detrimental health effects from occupational exposure to cytotoxic drugs. Work practices have improved since the issuance of guidelines for handling these drugs, but compliance with the recommended practices is still inadequate. Of 64 reports published since 1979 on studies of workers' exposure to these drugs, 53 involved studies of changes in cellular or molecular endpoints (biological markers) and 12 described chemical analyses of drugs or their metabolites in urine (2 involved both, and 2 reported the same study). The primary biological markers used were urine mutagenicity, sister chromatid exchange, and chromosomal aberrations; other studies involved formation of micronuclei and measurements of urinary thioethers. The studies had small sample sizes, and the methods were qualitative, nonspecific, subject to many confounders, and possibly not sensitive enough to detect most occupational exposures. Since none of the currently available biological and analytical methods is sufficiently reliable or reproducible for routine monitoring of exposure in the workplace, further studies using these methods are not recommended; efforts should focus instead on wide-spread implementation of improved practices for handling cytotoxic drugs.

  6. Therapeutic drug monitoring of psychotropic medications

    PubMed Central

    Mitchell, Philip B

    2001-01-01

    Therapeutic drug monitoring (TDM) of a number of psychotropic medications has proven to be of value, enabling minimization of the limitations of considerable genetic variability in their metabolism and the high rates of poor compliance with many psychiatric disorders. Therapeutic ranges have been established for lithium, some of the tricyclic antidepressants, and clozapine. TDM has also been shown to be useful in avoiding toxicity (as many psychotropics have narrow therapeutic indices), particularly that due to interactions with other compounds. PMID:11564052

  7. Therapeutic drug monitoring of psychotropic medications

    PubMed Central

    Mitchell, Philip B

    2000-01-01

    Therapeutic drug monitoring (TDM) of a number of psychotropic medications has proven to be of value, enabling minimization of the limitations of considerable genetic variability in their metabolism and the high rates of poor compliance with many psychiatric disorders. Therapeutic ranges have been established for lithium, some of the tricyclic antidepressants, and clozapine. TDM has also been shown to be useful in avoiding toxicity (as many psychotropics have narrow therapeutic indices), particularly that due to interactions with other compounds. PMID:10759685

  8. Electronics will transform drug delivery devices.

    PubMed

    Mazzoni, Paolo

    2004-03-01

    The drug delivery device sector will be transformed by electronically controlled alternatives that will maximise user safety and medical effectiveness and open the way to the introduction of high-power, next-generation drugs. Current business partnerships will need to change to allow this to happen. PMID:15154333

  9. Drug Monitoring Programs Do Curb Overdose Deaths: Study

    MedlinePlus

    ... 159528.html Drug Monitoring Programs Do Curb Overdose Deaths: Study Opioid epidemic demands such measures, researcher says ... News) -- Drug monitoring programs appear to help reduce deaths from prescription painkillers called opioids, a new study ...

  10. Therapeutic Drug Monitoring By Reverse Iontophoresis

    PubMed Central

    Nair, Anroop B; Goel, Ankit; Prakash, Shashi; Kumar, Ashok

    2011-01-01

    Therapeutic molecules possessing distinct pharmacokinetic variation, narrow therapeutic index and concentration dependent therapeutic/adverse effects demand constant monitoring. The current methods for blood sampling are invasive and possess low patient compliance. Human skin, selective and effective membrane to chemical permeation, offers an alternative route for the extraction of endogenous molecules in the body. Significant attention has been received in the application of reverse iontophoresis in extracting drugs/biomaterials from the subdermal region. This technique involves transiting of a low electric current across the skin usually with couple of skin electrodes to extract charged as well as neutral molecules. Electromigration and electroosmosis are the two basic mechanisms involved in transport of molecules. Several in vitro and in vivo experiments demonstrated the potential of reverse iontophoresis as a noninvasive tool in clinical chemistry and therapeutic drug monitoring. This technology is currently being used in device such as Glucowatch Biogrpaher which allows blood glucose detection across skin layers. Advances in technology and rapid progress in research has widely improved the opportunity of this system, and the recent trend indicates that several products are likely to be developed very soon. This review provides an overview about the recent developments in reverse iontophoresis for therapeutic drug monitoring. PMID:24826025

  11. When not to trust therapeutic drug monitoring

    PubMed Central

    Westergreen-Thorne, Mathew; Lee, Sook Yan; Shah, Nilesh; Dodd, Alan

    2016-01-01

    Therapeutic drug monitoring (TDM) is the measurement of serum or plasma drug concentration to allow the individualization of dosing. We describe the case of a patient who was prescribed inappropriately large doses of vancomycin due to inaccurate TDM. Specifically, our laboratory reported progressively lower vancomycin concentrations despite dose increases. Eventually, when duplicate samples were sent to a different laboratory vancomycin concentrations were found to be in the toxic range. We hypothesize this was due to the patient generating immunoglobulin antibodies against her infection that interfered with the original TDM immunoassay. Immunogenic TDM interference has been known to rarely occur in patients with immune related comorbidities; however, if we are correct, this is a unique case as this patient did not have such a background. This case illustrates the importance of using clinical judgement when interpreting TDM as, in this case, substantial harm to the patient was likely only narrowly avoided. PMID:27606069

  12. When not to trust therapeutic drug monitoring.

    PubMed

    Westergreen-Thorne, Mathew; Lee, Sook Yan; Shah, Nilesh; Dodd, Alan

    2016-09-01

    Therapeutic drug monitoring (TDM) is the measurement of serum or plasma drug concentration to allow the individualization of dosing. We describe the case of a patient who was prescribed inappropriately large doses of vancomycin due to inaccurate TDM. Specifically, our laboratory reported progressively lower vancomycin concentrations despite dose increases. Eventually, when duplicate samples were sent to a different laboratory vancomycin concentrations were found to be in the toxic range. We hypothesize this was due to the patient generating immunoglobulin antibodies against her infection that interfered with the original TDM immunoassay. Immunogenic TDM interference has been known to rarely occur in patients with immune related comorbidities; however, if we are correct, this is a unique case as this patient did not have such a background. This case illustrates the importance of using clinical judgement when interpreting TDM as, in this case, substantial harm to the patient was likely only narrowly avoided. PMID:27606069

  13. [Electronic drug prescription - auto pilot for drug therapy?].

    PubMed

    Schubert, Sten; Neininger, Martina Patrizia; Smers, Stefan; Winter, Alfred; Frontini, Roberto; Bertsche, Astrid; Bertsche, Thilo

    2015-06-01

    In tertiary care, computerized physician order entries may improve performance, cross-linking, and documentation when prescribing drugs. A clinical decision support integrated in these systems is discussed to prevent additional medication errors. For an optimal performance, the implementation into the clinical information systems is required to gain access to patient data (e. g. from laboratory). In routine care, the question rises whether a benefit of the systems can be proven in clinical studies and whether there is a difference between the systems. To achieve optimal results, these systems should also consider specific requirements, i. e. the patient groups and prescribed drugs in the local setting. We performed a systematic literature evaluation searching for published data in the topic electronic prescribing to assess them in a structured analysis considering medical-pharmaceutical aspects. Additionally, we assessed three databases in German language and one in English language taking drug-drug-interactions as an example to compare the identification of drug-related problems. Medication data from our own patients in a paediatric intensive care unit of a university hospital were analysed by the systems. Our results revealed strengths but also limitations of electronic prescribing. PMID:26364374

  14. Therapeutic drug monitoring of antiepileptic drugs by use of saliva.

    PubMed

    Patsalos, Philip N; Berry, Dave J

    2013-02-01

    Blood (serum/plasma) antiepileptic drug (AED) therapeutic drug monitoring (TDM) has proven to be an invaluable surrogate marker for individualizing and optimizing the drug management of patients with epilepsy. Since 1989, there has been an exponential increase in AEDs with 23 currently licensed for clinical use, and recently, there has been renewed and extensive interest in the use of saliva as an alternative matrix for AED TDM. The advantages of saliva include the fact that for many AEDs it reflects the free (pharmacologically active) concentration in serum; it is readily sampled, can be sampled repetitively, and sampling is noninvasive; does not require the expertise of a phlebotomist; and is preferred by many patients, particularly children and the elderly. For each AED, this review summarizes the key pharmacokinetic characteristics relevant to the practice of TDM, discusses the use of other biological matrices with particular emphasis on saliva and the evidence that saliva concentration reflects those in serum. Also discussed are the indications for salivary AED TDM, the key factors to consider when saliva sampling is to be undertaken, and finally, a practical protocol is described so as to enable AED TDM to be applied optimally and effectively in the clinical setting. Overall, there is compelling evidence that salivary TDM can be usefully applied so as to optimize the treatment of epilepsy with carbamazepine, clobazam, ethosuximide, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, primidone, topiramate, and zonisamide. Salivary TDM of valproic acid is probably not helpful, whereas for clonazepam, eslicarbazepine acetate, felbamate, pregabalin, retigabine, rufinamide, stiripentol, tiagabine, and vigabatrin, the data are sparse or nonexistent. PMID:23288091

  15. RFID Tag Helix Antenna Sensors for Wireless Drug Dosage Monitoring.

    PubMed

    Huang, Haiyu; Zhao, Peisen; Chen, Pai-Yen; Ren, Yong; Liu, Xuewu; Ferrari, Mauro; Hu, Ye; Akinwande, Deji

    2014-01-01

    Miniaturized helix antennas are integrated with drug reservoirs to function as RFID wireless tag sensors for real-time drug dosage monitoring. The general design procedure of this type of biomedical antenna sensors is proposed based on electromagnetic theory and finite element simulation. A cost effective fabrication process is utilized to encapsulate the antenna sensor within a biocompatible package layer using PDMS material, and at the same time form a drug storage or drug delivery unit inside the sensor. The in vitro experiment on two prototypes of antenna sensor-drug reservoir assembly have shown the ability to monitor the drug dosage by tracking antenna resonant frequency shift from 2.4-2.5-GHz ISM band with realized sensitivity of 1.27 [Formula: see text] for transdermal drug delivery monitoring and 2.76-[Formula: see text] sensitivity for implanted drug delivery monitoring. PMID:27170865

  16. Biomarkers to monitor drug-induced phospholipidosis

    SciTech Connect

    Baronas, Elizabeth Tengstrand; Lee, Ju-Whei; Alden, Carl; Hsieh, Frank Y. . E-mail: frank.hsieh@nextcea.com

    2007-01-01

    Di-docosahexaenoyl (C22:6)-bis(monoacylglycerol) phosphate (BMP) was identified as a promising phospholipidosis (PL) biomarker in rats treated with either amiodarone, gentamicin, or azithromycin. Sprague-Dawley rats received either amiodarone (150 mg/kg), gentamicin (100 mg/kg) or azithromycin (30 mg/kg) once daily for ten consecutive days. Histopathological examination of tissues by transmission electron microscopy (TEM) indicated different degrees of accumulation of phospholipidosis in liver, lung, mesenteric lymph node, and kidney of drug-treated rats but not controls. Liquid chromatography coupled to mass spectrometry (LC/MS) was used to identify levels of endogenous biochemical profiles in rat urine. Urinary levels of di-docosahexaenoyl (C22:6)-bis(monoacylglycerol) phosphate (BMP) correlated with induction of phospholipidosis for amiodarone, gentamicin and azithromycin. Rats treated with gentamicin also had increased urinary levels of several phosphatidylinositol (PI), phosphatidylcholine (PC), and phosphatidylethanolamine (PE) species.

  17. Scanning electron image analysis to monitor of implant degradation and host healing following implantation of a drug-eluting bone graft void filler - biomed 2013.

    PubMed

    Davidoff, Sherry N; Lawson, Scott T; Grainger, David W; Brooks, Amanda E

    2013-01-01

    Osteomyelitis is most commonly caused by Staphylococcus aureus and often sourced during orthopedic surgical intervention. Successful treatment or prevention of this bone penetrating infection requires antibiotics be delivered in excess of the minimal inhibitory concentration to prohibit the growth of the causative organism for sufficient duration. Unfortunately, current standard-of-care antibiotic therapies, administered via intravenous or oral delivery, suffer not only from systemic toxicity and low patient compliance but also provide insufficient local concentrations for therapy. To overcome these clinical inadequacies, a synthetic bone graft material was coated with an antibiotic (tobramycin)-releasing polymer (polycaprolactone) matrix to create a polymer-controlled antibiotic- releasing combination therapy for use as a bone void filler in orthopedic surgeries. Even though this local delivery strategy allows antibiotic delivery over a clinically relevant time frame to prevent infection, complete healing requires the host bone to infiltrate and reabsorb the bone void filler, ultimately replacing the defect with healthy tissue. Unfortunately, the same polymer matrix that allows for controlled local antibiotic delivery may also discourage host bone healing. Efficient orthopedic healing requires the rate of polymer degradation to match the rate of host-bone infiltration. Current imaging techniques, such as histological staining and x-ray imaging, are insufficient to simultaneously assess polymer degradation and host bone integration. Alternative techniques relying on backscatter electron detection during scanning electron microscopy (SEM) imaging may allow a visual differentiation between host bone, synthetic bone, and polymer. Analysis of backscattered SEM images was automated using a custom MATLAB program to determine the ratio of bone to polymer based upon the contrast between the bone (white) and polymer (dark grey). By collecting images of the implant over time

  18. Ethical Questions in Medical Electronic Adherence Monitoring.

    PubMed

    Campbell, Jeffrey I; Eyal, Nir; Musiimenta, Angella; Haberer, Jessica E

    2016-03-01

    Electronic adherence monitors (EAMs) record and report an array of health behaviors, ranging from taking daily medications to wearing medical devices. EAMs are utilized in research worldwide and are being investigated for clinical use. However, there is also growing popular concern about the extent to which electronic devices may be used to monitor individuals, including allegations in the media that EAMs represent a move towards "Big Brother" in medicine. Here, we highlight the unique benefits as well as the potential ethical challenges that electronic adherence monitoring generates. These challenges surround autonomy, privacy and confidentiality, trust, and ancillary care obligations. We describe key questions within each of these domains that warrant further investigation, and present potential solutions to many of the concerns raised. PMID:26358284

  19. The CMS Beam Halo Monitor electronics

    NASA Astrophysics Data System (ADS)

    Tosi, N.; Dabrowski, A. E.; Fabbri, F.; Grassi, T.; Hughes, E.; Mans, J.; Montanari, A.; Orfanelli, S.; Rusack, R.; Torromeo, G.; Stickland, D. P.; Stifter, K.

    2016-02-01

    The CMS Beam Halo Monitor has been successfully installed in the CMS cavern in LHC Long Shutdown 1 for measuring the machine induced background for LHC Run II. The system is based on 40 detector units composed of synthetic quartz Cherenkov radiators coupled to fast photomultiplier tubes (PMTs). The readout electronics chain uses many components developed for the Phase 1 upgrade to the CMS Hadronic Calorimeter electronics, with dedicated firmware and readout adapted to the beam monitoring requirements. The PMT signal is digitized by a charge integrating ASIC (QIE10), providing both the signal rise time, with few nanosecond resolution, and the charge integrated over one bunch crossing. The backend electronics uses microTCA technology and receives data via a high-speed 5 Gbps asynchronous link. It records histograms with sub-bunch crossing timing resolution and is read out via IPbus using the newly designed CMS data acquisition for non-event based data. The data is processed in real time and published to CMS and the LHC, providing online feedback on the beam quality. A dedicated calibration monitoring system has been designed to generate short triggered pulses of light to monitor the efficiency of the system. The electronics has been in operation since the first LHC beams of Run II and has served as the first demonstration of the new QIE10, Microsemi Igloo2 FPGA and high-speed 5 Gbps link with LHC data.

  20. Electronic fetal monitoring: a Canadian survey.

    PubMed Central

    Davies, B L; Niday, P A; Nimrod, C A; Drake, E R; Sprague, A E; Trépanier, M J

    1993-01-01

    OBJECTIVES: To determine the current status of electronic fetal monitoring (EFM) in Canadian teaching and nonteaching hospitals, to review the medical and nursing standards of practice for EFM and to determine the availability of EFM educational programs. DESIGN: National survey in 1989. PARTICIPANTS: The directors of nursing at the 737 hospitals providing obstetric care were sent a questionnaire and asked to have it completed by the most appropriate staff member. The response rate was 80.5% (593/737); 44 hospitals did not have deliveries in 1988 and were excluded. The remaining hospitals varied in size from 8 to 1800 (mean 162.1) beds and had 1 to 7500 (mean 617.1) births in 1988; 18.8% were teaching hospitals. RESULTS: Of the 549 hospitals 419 (76.3%) reported having at least 1 monitor (range 1 to 30; mean 2.6); the mean number of monitors per hospital was higher in the teaching hospitals than in the nonteaching hospitals (6.2 v. 1.7). Manitoba had the lowest mean number of monitors per hospital (1.1) and Ontario the highest (3.7). In 71.8% of the hospitals with monitors almost all of the obstetric patients were monitored at some point during labour. However, 21.6% of the hospitals with monitors had no policy on EFM practice. The availability of EFM educational programs for physicians and nurses varied according to hospital size, type and region. CONCLUSIONS: Most Canadian hospitals providing obstetric services have electronic fetal monitors and use them frequently. Although substantial research has questioned the benefits of EFM, further definitive research is required. In the meantime, a national committee should be established to develop multidisciplinary guidelines for intrapartum fetal assessment. PMID:8485677

  1. Therapeutic drug monitoring of psychotropic drugs. TDM "nouveau".

    PubMed

    Bengtsson, Finn

    2004-04-01

    TDM applied in psychiatry dates back several decades. The reason for this is that, after the advent of modern clinical psychopharmacology around the middle of the past century, an insight came to common knowledge about the existence of (1) a large interindividual pharmacokinetic (PK) variability for virtually all psychoactive drugs and (2) a worse clinical efficacy not only in inadequate drug concentrations but also in excessively high concentrations. From this concept, the definition of a therapeutic concentration "window" was evidenced for a substantial number of, primarily, antidepressant drugs. However, with the further extensive development of the clinically available pharmacopoeia of psychoactive drugs from the later 1980s until today, the concept of less toxic compounds than before has commonly been launched in the marketing strategies for these newer drugs. This concept also led to the idea that TDM was no longer necessary for the newer types of psychoactive drugs, a position backed up by difficulties in unraveling concentration-effect relationships generally for these drugs in clinical trials. The present survey summarizes the background history for TDM in psychiatry and makes a critical appraisal of why a "lack" of definition of concentration-effect relationships for newer psychoactive drugs is now common. This survey also provides the reader with a novel concept challenging ambient TDM strategies (referred to as TDM "traditionelle") in psychiatry by forwarding a theoretical model called TDM "nouveau." In this model both inter- and intraindividual (over time) PK variation is suggested to be used for dose optimization by TDM in a naturalistic clinical setting. The previous concept of a simple, common concentration "window" existing for all such drugs is questioned by promotion of the use of available PK data merely as "guiding principles" rather than as "reference values" when interpreting the TDM outcome in individual cases. PMID:15228155

  2. Performance comparison of electronic radon monitors.

    PubMed

    Lin, Chi-Feng; Wang, Jeng-Jong; Lin, Shih-Jung; Lin, Chien-Kung

    2013-11-01

    The electronic radon monitors are noted for their convenience and acceptable accuracy. Even so, it is necessary to reassure their data quality regularly. We utilized a performance comparison system for this purpose. The instruments in our laboratories (Alphaguard, RAD7, RTM-2100 and Safety Siren) were tested via the comparison experiments. We conclude that by utilizing this system with the concept of calibration factor, it can be helpful to decide whether to send the monitors back to the original manufacturers for adjustment. PMID:23566805

  3. Prescription drug monitoring programs in the United States of America

    PubMed Central

    Félix, Sausan El Burai; Mack, Karin

    2015-01-01

    SYNOPSIS Since the late 1990s, the number of opioid analgesic overdose deaths has quadrupled in the United States of America (from 4 030 deaths in 1999 to 16 651 in 2010). The objectives of this article are to provide an overview of the problem of prescription drug overdose in the United States and to discuss actions that could help reduce the problem, with particular attention to the characteristics of prescription drug monitoring programs (PDMPs). These programs consist of state-level databases that monitor controlled substances. The information compiled in the databases is at the disposal of authorized persons (e.g., physicians, pharmacists, and other health-care providers) and may be used only for professional purposes. Suppliers can use such information to prevent interaction with other drugs or therapeutic duplication, or to identify drug-search behavior. Law enforcement agencies can use these programs to identify improper drug prescription or dispensing patterns, or drug diversion. PMID:25563153

  4. [Prescription drug monitoring programs in the United States of America].

    PubMed

    El Burai Félix, Sausan; Mack, Karin

    2014-10-01

    Since the late 1990s, the number of opioid analgesic overdose deaths has quadrupled in the United States of America (from 4 030 deaths in 1999 to 16 651 in 2010). The objectives of this article are to provide an overview of the problem of prescription drug overdose in the United States and to discuss actions that could help reduce the problem, with particular attention to the characteristics of prescription drug monitoring programs (PDMPs). These programs consist of state-level databases that monitor controlled substances. The information compiled in the databases is at the disposal of authorized persons (e.g., physicians, pharmacists, and other health-care providers) and may be used only for professional purposes. Suppliers can use such information to prevent interaction with other drugs or therapeutic duplication, or to identify drug-search behavior. Law enforcement agencies can use these programs to identify improper drug prescription or dispensing patterns, or drug diversion. PMID:25563153

  5. Electronic compliance monitoring of topical treatment after ophthalmic surgery.

    PubMed

    Hermann, Manuel Marcel; Ustündag, Can; Diestelhorst, Michael

    2010-08-01

    The success of many medical treatments is built on compliance. Electronic monitoring is the most accurate tool to quantify compliance by measuring adherence. In order to assess the efficiency of a recently introduced miniature monitoring device for eye drop application, we evaluated adherence in ophthalmic patients undergoing post-operative short-term topical treatment. This pilot study enrolled 30 outpatients (mean age 61.8 +/- 18.5 years) after cataract (n = 24) and glaucoma filtration surgery (n = 6) applying fixed-combination eye drops containing prednisolone and gentamicin five times daily for 2 weeks. Patients received eye drops in conventional bottles each equipped with a miniature monitoring device recording events of application. Two patients failed to bring back the monitoring device; therefore data collected from only 28 patients could be examined. Data showed highly variable results with a mean dose compliance of 50.2%. Dose compliance was below 25% in approximately one out of five patients. Four cataract patients, but no glaucoma patient, discontinued therapy prematurely. The observed mean dosage interval was calculated for each patient and ranged 4.6-19.7 h. Thirty percent of analysed dosage intervals exceeded 12.0 h. Different patterns of compliance behaviour-like early non-persistence, drug holiday and low treatment frequency could be identified and illustrated using electronic data. Age or gender did not significantly influence compliance rates. Our pilot study demonstrates successful electronic compliance monitoring using a technology capable of continuous data recording over weeks of treatment. The low compliance rate for a relevant part of the patients demonstrates the necessity to study and improve compliance in ophthalmology. In future, new application methods and electronic application devices may improve treatment response in eye care. PMID:20373127

  6. RFID Tag Helix Antenna Sensors for Wireless Drug Dosage Monitoring

    PubMed Central

    Huang, Haiyu; Zhao, Peisen; Chen, Pai-Yen; Ren, Yong; Liu, Xuewu; Ferrari, Mauro; Hu, Ye; Akinwande, Deji

    2014-01-01

    Miniaturized helix antennas are integrated with drug reservoirs to function as RFID wireless tag sensors for real-time drug dosage monitoring. The general design procedure of this type of biomedical antenna sensors is proposed based on electromagnetic theory and finite element simulation. A cost effective fabrication process is utilized to encapsulate the antenna sensor within a biocompatible package layer using PDMS material, and at the same time form a drug storage or drug delivery unit inside the sensor. The in vitro experiment on two prototypes of antenna sensor-drug reservoir assembly have shown the ability to monitor the drug dosage by tracking antenna resonant frequency shift from 2.4–2.5-GHz ISM band with realized sensitivity of 1.27 \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$\\mu~{\\rm l}/{\\rm MHz}$\\end{document} for transdermal drug delivery monitoring and 2.76-\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$\\mu~{\\rm l}/{\\rm MHz}$\\end{document} sensitivity for implanted drug delivery monitoring. PMID:27170865

  7. Monitoring temperature-sensitive vaccines and immunologic drugs, including anthrax vaccine.

    PubMed

    Frank, K J

    1999-10-15

    The experience of the U.S. Army Medical Materiel Center, Europe (USAMMCE), in monitoring temperature-sensitive vaccines and immunologic drugs, including anthrax vaccine, during storage and shipment is discussed. USAMMCE uses an electronic monitoring device to monitor and archive the time-temperature history of shipments of various vaccines, immunoglobulins, and other drugs requiring refrigeration. Using these monitors, USAMMCE can track its carriers' performance, reduce product loss, and validate quality. USAMMCE trains people to pack refrigerated items and to activate and place the monitoring device inside the packing container. Over 1200 temperature-monitor readings from 44 U.S. military logistical depots, hospitals, and clinics located outside the United States are evaluated annually by the USAMMCE pharmacist; each reading represents one shipment or packed box. When deactivated during unpacking, the device flashes green for a successful shipment (all temperature readings within the ideal range) or red for a potentially problematic shipment. From January through October 1998, the device was used in 750 temperature-sensitive shipments; 72% of the devices were returned to USAMMCE in green condition and the remainder in red. Of the red-flashing monitors, 15% were determined to signal that the drugs were received in unacceptable condition. USAMMCE successfully shipped more than 26,000 vials of anthrax vaccine from February through October 1998 within the manufacturer's guidelines for storage temperature. Temperature monitoring is essential for proper storage and transport of vaccines and immunologic drugs. PMID:10541032

  8. Electronic noses for environmental monitoring applications.

    PubMed

    Capelli, Laura; Sironi, Selena; Del Rosso, Renato

    2014-01-01

    Electronic nose applications in environmental monitoring are nowadays of great interest, because of the instruments' proven capability of recognizing and discriminating between a variety of different gases and odors using just a small number of sensors. Such applications in the environmental field include analysis of parameters relating to environmental quality, process control, and verification of efficiency of odor control systems. This article reviews the findings of recent scientific studies in this field, with particular focus on the abovementioned applications. In general, these studies prove that electronic noses are mostly suitable for the different applications reported, especially if the instruments are specifically developed and fine-tuned. As a general rule, literature studies also discuss the critical aspects connected with the different possible uses, as well as research regarding the development of effective solutions. However, currently the main limit to the diffusion of electronic noses as environmental monitoring tools is their complexity and the lack of specific regulation for their standardization, as their use entails a large number of degrees of freedom, regarding for instance the training and the data processing procedures. PMID:25347583

  9. Electronic Noses for Environmental Monitoring Applications

    PubMed Central

    Capelli, Laura; Sironi, Selena; Rosso, Renato Del

    2014-01-01

    Electronic nose applications in environmental monitoring are nowadays of great interest, because of the instruments' proven capability of recognizing and discriminating between a variety of different gases and odors using just a small number of sensors. Such applications in the environmental field include analysis of parameters relating to environmental quality, process control, and verification of efficiency of odor control systems. This article reviews the findings of recent scientific studies in this field, with particular focus on the abovementioned applications. In general, these studies prove that electronic noses are mostly suitable for the different applications reported, especially if the instruments are specifically developed and fine-tuned. As a general rule, literature studies also discuss the critical aspects connected with the different possible uses, as well as research regarding the development of effective solutions. However, currently the main limit to the diffusion of electronic noses as environmental monitoring tools is their complexity and the lack of specific regulation for their standardization, as their use entails a large number of degrees of freedom, regarding for instance the training and the data processing procedures. PMID:25347583

  10. Optimal experimental design and therapeutic drug monitoring.

    PubMed

    Kulcsár, C; Pronzato, L; Walter, E

    1994-06-01

    A simple example of intravenous theophylline therapy is used to present and compare various drug administration policies based on stochastic control theory. The simplest approach (Heuristic-Certainty-Equivalence (HCE) control) assumes that the model parameters are known. Prior uncertainty on these parameters can be taken into account by using average optimal (AO) control. The available knowledge about the system can be improved by measuring the drug concentration some time after the beginning of the treatment. This corresponds to the notion of feedback and leads to the HCE feedback (HCEF) and AO feedback (AOF) policies. A further step towards optimality consists in choosing the optimal measurement time given that the final purpose is the control of the system and not the estimation of its parameters. Finally, closed-loop optimal (CLO) control optimally chooses both the dosage regimen and measurement time. PMID:7927864

  11. A study on drug safety monitoring program in India.

    PubMed

    Ahmad, A; Patel, Isha; Sanyal, Sudeepa; Balkrishnan, R; Mohanta, G P

    2014-09-01

    Pharmacovigilance is useful in assuring the safety of medicines and protecting the consumers from their harmful effects. A number of single drugs as well as fixed dose combinations have been banned from manufacturing, marketing and distribution in India. An important issue about the availability of banned drugs over the counter in India is that sufficient adverse drug reactions data about these drugs have not been reported. The most common categories of drugs withdrawn in the last decade were nonsteroidal antiinflammatory drugs (28%), antidiabetics (14.28%), antiobesity (14.28%), antihistamines (14.28%), gastroprokinetic drugs (7.14%), breast cancer and infertility drugs (7.14%), irritable bowel syndrome and constipation drugs (7.14%) and antibiotics (7.14%). Drug withdrawals from market were made mainly due to safety issues involving cardiovascular events (57.14%) and liver damage (14.28%). Majority of drugs have been banned since 3-5 years in other countries but are still available for sale in India. The present study compares the drug safety monitoring systems in the developed countries such as the USA and UK and provides implications for developing a system that can ensure the safety and efficacy of drugs in India. Absence of a gold standard for a drug safety surveillance system, variations in culture and clinical practice across countries makes it difficult for India to completely adopt another country's practices. There should be a multidisciplinary approach towards drug safety that should be implemented throughout the entire duration spanning from drug discovery to usage by consumers. PMID:25425751

  12. A Study on Drug Safety Monitoring Program in India

    PubMed Central

    Ahmad, A.; Patel, Isha; Sanyal, Sudeepa; Balkrishnan, R.; Mohanta, G. P.

    2014-01-01

    Pharmacovigilance is useful in assuring the safety of medicines and protecting the consumers from their harmful effects. A number of single drugs as well as fixed dose combinations have been banned from manufacturing, marketing and distribution in India. An important issue about the availability of banned drugs over the counter in India is that sufficient adverse drug reactions data about these drugs have not been reported. The most common categories of drugs withdrawn in the last decade were nonsteroidal antiinflammatory drugs (28%), antidiabetics (14.28%), antiobesity (14.28%), antihistamines (14.28%), gastroprokinetic drugs (7.14%), breast cancer and infertility drugs (7.14%), irritable bowel syndrome and constipation drugs (7.14%) and antibiotics (7.14%). Drug withdrawals from market were made mainly due to safety issues involving cardiovascular events (57.14%) and liver damage (14.28%). Majority of drugs have been banned since 3-5 years in other countries but are still available for sale in India. The present study compares the drug safety monitoring systems in the developed countries such as the USA and UK and provides implications for developing a system that can ensure the safety and efficacy of drugs in India. Absence of a gold standard for a drug safety surveillance system, variations in culture and clinical practice across countries makes it difficult for India to completely adopt another country's practices. There should be a multidisciplinary approach towards drug safety that should be implemented throughout the entire duration spanning from drug discovery to usage by consumers. PMID:25425751

  13. Cardiovascular safety monitoring during oncology drug development and therapy.

    PubMed

    Turner, J Rick; Panicker, Gopi Krishna; Karnad, Dilip R; Cabell, Christopher H; Lieberman, Ronald; Kothari, Snehal

    2014-01-01

    Assessments of cardiac and cardiovascular toxicity are prominent components of drug safety endeavors during drug development and clinical practice. Oncologic drugs bring several challenges to both domains. First, during drug development, it is necessary to adapt the ICH E14 "Thorough QT/QTc Study" because the cytotoxic nature of many oncologics precludes their being administered to healthy individuals. Second, appropriate benefit-risk assessments must be made by regulators: given the benefit these drugs provide in life-threatening illnesses, a greater degree of risk may be acceptable when granting marketing authorization than for drugs for less severe indications. Third, considerable clinical consideration is needed for patients who are receiving and have finished receiving pharmacotherapy. Paradoxically, although such therapy has proved very successful in many cases, with disease states going into remission and patients living for many years after cessation of treatment, cardiotoxicities can manifest themselves relatively soon or up to a decade later. Oncologic drugs have been associated with various off-target cardiovascular responses, including cardiomyopathy leading to heart failure, cardiac dysrhythmias, thromboembolic events, and hypertension. Follow-up attention and care are, therefore, critical. This article reviews the process of benefit-risk estimation, provides an overview of nonclinical and preapproval clinical assessment of cardiovascular safety of oncology drugs, and discusses strategies for monitoring and management of patients receiving drugs with known cardiotoxicity risk. These measures include cardiac function monitoring, limitation of chemotherapy dose, use of anthracycline analogs and cardioprotectants, and early detection of myocardial cell injury using biomarkers. PMID:24451296

  14. Applications of translation monitoring using electronic tacheometry

    NASA Astrophysics Data System (ADS)

    Obidowski, Ray M.; Teskey, William F.

    1994-03-01

    Monitoring the translations of points on structures and machinery is an important procedure in industrial engineering. Two low-cost translation monitoring systems using electronic tachometers have been developed and tested at the University of Calgary. The systems use both network and nonnetwork (direct) methods to measure relative point translations with submillimeter accuracy. The systems are simple and efficient, requiring only one observer using normal surveying instruments. Two case studies undertaken by the authors are described, demonstrating applications of the new monitoring systems. The first study is the measurement of thermal growth of a rotating gas turbine/compressor system during startup. The thermal movements were measured and found to be consistent with their expected behavior to a precision of 0.2 mm. The second study is the measurement of point displacements on a concrete structure and test frame during a load test at the University's Civil Engineering Structures Lab. The translations measured agree with the theoretical values from a finite element analysis.

  15. Medication monitoring and drug testing ethics project.

    PubMed

    Payne, Richard; Moe, Jeffrey L; Sevier, Catherine Harvey; Sevier, David; Waitzkin, Michael

    2015-01-01

    In 2012, Duke University initiated a research project, funded by an unrestricted research grant from Millennium Laboratories, a drug testing company. The project focused on assessing the frequency and nature of questionable, unethical, and illegal business practices in the clinical drug testing industry and assessing the potential for establishing a business code of ethics. Laboratory leaders, clinicians, industry attorneys, ethicists, and consultants participated in the survey, were interviewed, and attended two face-to-face meetings to discuss a way forward. The study demonstrated broad acknowledgment of variations in the legal and regulatory environment, resulting in inconsistent enforcement of industry practices. Study participants expressed agreement that overtly illegal practices sometimes exist, particularly when laboratory representatives and clinicians discuss reimbursement, extent of testing, and potential business incentives with medical practitioners. Most respondents reported directly observing probable violations involving marketing materials, contracts, or, in the case of some individuals, directly soliciting people with offers of clinical supplies and other "freebies." While many study respondents were skeptical that voluntary standards alone would eliminate questionable business practices, most viewed ethics codes and credentialing as an important first step that could potentially mitigate uneven enforcement, while improving quality of care and facilitating preferred payment options for credentialed parties. Many were willing to participate in future discussions and industry-wide initiatives to improve the environment. PMID:25750169

  16. Compact noninvasive electron bunch-length monitor

    SciTech Connect

    Roberts, Brock; Poelker, Matt; Mammei, Russell R.; McCarter, James L.

    2012-12-01

    A compact RF cavity was constructed that simultaneously resonates at many harmonic modes when excited by a bunched electron beam passing through its bore. The excitation of these modes provides a Fourier description of the temporal characteristics of the bunchtrain. The cavity was used to non-invasively characterize electron bunches produced from thin and thick GaAs photocathodes inside a DC high voltage photogun illuminated with 37 ps (FWHM) laser pulses at repetition rates near 500 and 1500 MHz, at average beam current from 5 uA to 500 uA and at beam energy from 75 keV to 195 keV. The cavity bunchlength monitor could detect electron bunches as short as 57 ps (FWHM) when connected directly to a sampling oscilloscope, and could clearly distinguish bunches with varying degrees of space-charge induced growth and with different tail signatures. Efforts are underway to detect shorter bunches, by designing cavities with increased bandwidth and improved coupling uniformity. This demonstration lends credibility to the idea that these cavities could also be used for other applications, including bunching and shaping, when driven with external RF.

  17. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... Electronic media has the same meaning given this term in 45 CFR 160.103. E-prescribing means the transmission... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and...

  18. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    .... Electronic media has the same meaning given this term in 45 CFR 160.103. E-prescribing means the transmission... 42 Public Health 3 2011-10-01 2011-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and...

  19. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... professional practice. Electronic media has the same meaning given this term in 45 CFR 160.103. E-prescribing... 42 Public Health 3 2014-10-01 2014-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost...

  20. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... professional practice. Electronic media has the same meaning given this term in 45 CFR 160.103. E-prescribing... 42 Public Health 3 2012-10-01 2012-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost...

  1. 42 CFR 423.159 - Electronic prescription drug program.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... professional practice. Electronic media has the same meaning given this term in 45 CFR 160.103. E-prescribing... 42 Public Health 3 2013-10-01 2013-10-01 false Electronic prescription drug program. 423.159... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost...

  2. Quantitative monitoring of drug-tissue interaction in perfused organs

    NASA Astrophysics Data System (ADS)

    Kessler, Manfred D.; Nastac, Dumitru I.; Frank, Klaus H.

    2002-06-01

    In pharmacology many optical sensors are applied for investigations in vitro and in reduced systems. Due to a lack of sensors for optical imaging of functional structures in capillaries as well as in subcellular spaces the drug-tissue interaction in organs could not be monitored systematically. However, recent developments opened the door of this microcosm of life in its smallest entities. This will enable a better understanding of the questions of area and quality of drug action in tissue.

  3. Drug-induced falls in older persons: is there a role for therapeutic drug monitoring?

    PubMed Central

    Hartholt, Klaas A.; Becker, Matthijs L.; van der Cammen, Tischa J. M.

    2016-01-01

    Background: Falls are the leading cause of injuries among older persons. Because of ageing societies worldwide, falls are expected to become a prominent public health problem. The usage of several types of drugs has been associated with an increased fall and fracture risk. In order to reduce future falls, preventative measures are needed. Therapeutic drug monitoring may help to identify persons who are at risk for falls due to drug use. The aim was to demonstrate how drugs can contribute to falls and the role of therapeutic drug monitoring. Methods: We present a descriptive case series of four patients. Results: All patients were referred to the geriatric outpatient clinic of a university medical center. The presented cases contained different underlying mechanisms contributing to an increased fall risk in older adults, including renal failure, genetic variation, overdose and ageing. Conclusion/discussion: Older adults are more prone to the side effects of drug use, including falls. Therapeutic drug monitoring may be useful to identify the patients who have an increased drug-related fall risk and to prevent future falls by individualizing the drug regime. PMID:27034772

  4. SPALLATION NEUTRON SOURCE BEAM CURRENT MONITOR ELECTRONICS.

    SciTech Connect

    KESSELMAN,M.; DAWSON,W.C.

    2002-05-06

    This paper will discuss the present electronics design for the beam current monitor system to be used throughout the Spallation Neutron Source (SNS) under construction at Oak Ridge National Laboratory. The beam is composed of a micro-pulse structure due to the 402.5MHz RF, and is chopped into mini-pulses of 645ns duration with a 300ns gap, providing a macro-pulse of 1060 mini-pulses repeating at a 60Hz rate. Ring beam current will vary from about 15ma peak during studies, to about 50Amps peak (design to 100 amps). A digital approach to droop compensation has been implemented and initial test results presented.

  5. Preliminary studies on the use of modulation sensing for noninvasive monitoring of drug compliance

    NASA Astrophysics Data System (ADS)

    Abugo, Omoefe O.; Gryczynski, Zygmunt; Lakowicz, Joseph R.

    1999-05-01

    Presently two methods in concert, a marker method and an electronic monitoring method, have been emphasized for an objective monitoring of drug compliance in ambulatory care. While the marker method proves dose ingestion, the electronic monitoring method provides continuous record of timing of presumptive drug doses. The marker method is however time intensive with associated safety problems, and the electronic monitoring method is easily defeated. We here present preliminary results on modulation sensing, a new method that could be used to non-invasively monitor patient compliance. Measurement is based on observing the amplitude modulation of the emission from both a short lifetime marker fluorophore of interest and a long lifetime reference fluorophore contained in the monitoring device. At some intermediate frequencies, the observed modulation of the combined emission is nearly equivalent to the fractional intensity of the marker fluorophore. This method precludes problems associated with measuring fluorescence intensities in highly scattering media. Using this method we measured the presence of rhodamine 800 (Rh800) in intralipid suspensions and chicken tissue. Rh800 is excited at long wavelengths not absorbed by tissues. Micromolar concentrations of this dye were detected in intralipid and chicken muscle covered with a layer of chicken skin.

  6. Best Practices for Prescription Drug Monitoring Programs in the Emergency Department Setting: Results of an Expert Panel.

    PubMed

    Greenwood-Ericksen, Margaret B; Poon, Sabrina J; Nelson, Lewis S; Weiner, Scott G; Schuur, Jeremiah D

    2016-06-01

    Prescription drug monitoring programs are generally underused in emergency departments (ED) and nationwide enrollment is low among emergency physicians. We aimed to develop consensus recommendations for prescription drug monitoring program policy and design to optimize their functionality and use in the ED. We assembled a technical expert panel with key stakeholders in emergency medicine, public health, and public policy. The panel included academic and community-based emergency physicians, a pediatric fellowship-trained emergency physician, a medical toxicologist, a public health expert, a patient advocate, a legal expert, and two state prescription drug monitoring program administrators. We compiled prescription drug monitoring program policies and characteristics and organized them into domains based on user-prescription drug monitoring program interaction. The panel convened for 3 rounds in which the policies and characteristics were introduced, discussed, and modified in an iterative fashion to achieve consensus. The process yielded policy recommendations and design features, with majority agreement. The panel made 18 policy recommendations within these main themes: enrollment should be mandatory, with an automatic process to mitigate the workload; registration should be open to all prescribers; delegates should have access to prescription drug monitoring program to alleviate work flow burdens; prescription drug monitoring program data should be pushed into hospital electronic health records; prescription drug monitoring program review should be mandatory for patients receiving opioid prescriptions and based on objective criteria; the prescription drug monitoring program content should be standardized and updated in a timely manner; and states should encourage interstate data sharing. An expert panel identified 18 recommendations that can be used by states and policymakers to improve prescription drug monitoring program design to increase use in the ED

  7. Therapeutic drug monitoring of psychoactive drugs during pregnancy in the genomic era: challenges and opportunities.

    PubMed

    DeVane, C Lindsay; Stowe, Zachary N; Donovan, Jennifer L; Newport, D Jeffrey; Pennell, Page B; Ritchie, James C; Owens, Michael J; Wang, Jun-Sheng

    2006-07-01

    Various symptoms of mental illness occur commonly during pregnancy. It is estimated that serious mental disorders, including major depression, bipolar disorder, schizophrenia, panic and other anxiety disorders, occur with a frequency of 10 to 25% in community samples of US women in their child-bearing years. As a result, approximately a third of all women take at least one psychoactive drug during pregnancy. Fetal drug exposure has been documented for all psychoactive drugs studied to date. However, the rate and extent of placental transfer within and between psychoactive drug classes remains ill defined. The contribution of various genetic factors such as the role of polymorphic drug metabolizing enzymes and drug transporters in controlling the variability of fetal drug exposure is also unclear. Therapeutic drug monitoring (TDM) has traditionally played an important role in psychiatric pharmacotherapy during pregnancy to ensure an adequate drug dose to achieve desired benefits while avoiding excessive fetal accumulation for drugs. In the genomic era, individualized treatment with specific drugs tailored to the mother's and fetus's genotype should eventually become the standard of care. Several methodological problems need to be overcome for this prediction to become reality. One approach to this goal taken by the Specialized Center of Research on Sex and Gender Factors Affecting Women's Health at the Emory University Women's Mental Health Program is described. This research is grounded on TDM of pregnant women receiving antidepressants, antipsychotics, anti-epileptic drugs and mood stabilizers. The use of pharmacokinetic and pharmacogenetic models to predict maternal plasma drug concentrations, fetal drug exposure, and maternal and neonatal outcomes, is expected to improve our understanding of dose-response relationships of psychoactive drugs in pregnancy. PMID:16785271

  8. The Electronic Fetal Monitor: Should Every Mother Have One?

    PubMed Central

    Dixon, Anthony S.

    1981-01-01

    In little more than a decade, the use of electronic fetal monitoring has become standard obstetric practice. Increasingly it is being suggested that all labors should be monitored electronically, and that such universal monitoring will result in improved neonatal outcome. This paper reviews the evidence in what has been termed “the fetal monitoring debate”,1 concluding that there is no indication for monitoring low risk labors, and that in fact too many—rather than too few—labors are being monitored. PMID:21289757

  9. Constructing a Real-Time Prescription Drug Monitoring System

    PubMed Central

    Lee, Youn Tae; Jo, Emmanuel C.

    2016-01-01

    Objectives The objective of this investigation was to demonstrate the possibility of the construction of a real-time prescription drug monitoring system (PDMOS) using data from the nationwide Drug Utilization Review (DUR) system in Korea. Methods The DUR system collects information on drug prescriptions issued by healthcare practitioners and on drugs dispensed by pharmacies. PDMOS was constructed using this data. The screen of PDMOS is designed to exhibit the number of drug prescriptions, the number of prescriptions dispensed by pharmacies, and the dispensed prescription drug costs on a daily and weekly basis. Data was sourced from the DUR system between June 1, 2016 and July 18, 2016. The TOGA solution developed by the EYEQMC Co. Ltd. of Seoul, Korea was used to produce the screen shots. Results Prescription numbers by medical facilities were more numerous than the number of prescriptions dispensed by pharmacies, as expected. The number of prescriptions per day was between 2 to 3 million. The prescriptions issued by primary care clinics were most numerous, at 75% of the total number of prescriptions. Daily prescription drug costs were found to be approximately US $50 million. The prescription drug costs were highest on Mondays and were reduced towards the end of the week. Prescriptions and dispensed prescriptions numbered approximately 1,200 and 1,000 million, respectively. Conclusions The construction of a real-time PDMOS has been successful to provide daily and weekly information. There was a lag time of only one day at the national level in terms of information extraction, and scarcely any time was required to load the data. Therefore, this study highlights the potential of constructing a PDMOS to monitor the estimate the number of prescriptions and the resulting expenditures from prescriptions. PMID:27525159

  10. Presenting Multiple Drug Alerts in an Ambulatory Electronic Prescribing System

    PubMed Central

    Weinger, M.B.; Gregg, W.M.; Johnson, K.B.

    2014-01-01

    Summary Objective This study explores alternative approaches to the display of drug alerts, and examines whether and how human-factors based interface design can be used to improve the prescriber’s perception about drug alert presentation, signal detection from noisy alert data, and their comprehension of clinical decision support during electronic prescribing. Methods We reviewed issues with presenting multiple drug alerts in electronic prescribing systems. User-centered design, consisting of iterative usability and prototype testing was applied. After an iterative design phase, we proposed several novel drug alert presentation interfaces; expert evaluation and formal usability testing were applied to access physician prescribers’ perceptions of the tools. We mapped drug alert attributes to different interface constructs. We examined four different interfaces for presenting multiple drug alerts. Results A TreeDashboard View was better perceived than a text-based ScrollText View with respect to the ability to detect critical information, the ability to accomplish tasks, and the perceptional efficacy of finding information. Conclusion A robust model for studying multiple drug-alert presentations was developed. Several drug alert presentation interfaces were proposed. The TreeDashboard View was better perceived than the text-based ScrollText View in delivering multiple drug alerts during a simulation of electronic prescribing. PMID:25024753

  11. Examining Big Brother's Purpose for Using Electronic Performance Monitoring

    ERIC Educational Resources Information Center

    Bartels, Lynn K.; Nordstrom, Cynthia R.

    2012-01-01

    We examined whether the reason offered for electronic performance monitoring (EPM) influenced participants' performance, stress, motivation, and satisfaction. Participants performed a data-entry task in one of five experimental conditions. In one condition, participants were not electronically monitored. In the remaining conditions, participants…

  12. Wire Position Monitoring with FPGA based Electronics

    SciTech Connect

    Eddy, N.; Lysenko, O.; /Fermilab

    2009-01-01

    This fall the first Tesla-style cryomodule cooldown test is being performed at Fermilab. Instrumentation department is preparing the electronics to handle the data from a set of wire position monitors (WPMs). For simulation purposes a prototype pipe with a WMP has been developed and built. The system is based on the measurement of signals induced in pickups by 320 MHz signal carried by a wire through the WPM. The wire is stretched along the pipe with a tensioning load of 9.07 kg. The WPM consists of four 50 {Omega} striplines spaced 90{sup o} apart. FPGA based digitizer scans the WPM and transmits the data to a PC via VME interface. The data acquisition is based on the PC running LabView. In order to increase the accuracy and convenience of the measurements some modifications were required. The first is implementation of an average and decimation filter algorithm in the integrator operation in the FPGA. The second is the development of alternative tool for WPM measurements in the PC. The paper describes how these modifications were performed and test results of a new design. The last cryomodule generation has a single chain of seven WPMs (placed in critical positions: at each end, at the three posts and between the posts) to monitor a cold mass displacement during cooldown. The system was developed in Italy in collaboration with DESY. Similar developments have taken place at Fermilab in the frame of cryomodules construction for SCRF research. This fall preliminary cryomodule cooldown test is being performed. In order to prepare an appropriate electronic system for the test a prototype pipe with a WMP has been developed and built, figure 1. The system is based on the measurement of signals induced in pickups by 320 MHz signal carried by a wire through the WPM. The 0.5 mm diameter Cu wire is stretched along the pipe with a tensioning load of 9.07 kg and has a length of 1.1 m. The WPM consists of four 50 {Omega} striplines spaced 90{sup o} apart. An FPGA based

  13. [Pharmacokinetic alterations in pregnancy and use of therapeutic drug monitoring].

    PubMed

    Panchaud, Alice; Weisskopf, Etienne; Winterfeld, Ursula; Baud, David; Guidi, Monia; Eap, Chin B; Csajka, Chantal; Widmer, Nicolas

    2014-01-01

    Following the thalidomide tragedy, pharmacological research in pregnant women focused primarily on drug safety for the unborn child and remains only limited regarding the efficacy and safety of treatment for the mother. Significant physiological changes during pregnancy may yet affect the pharmacokinetics of drugs and thus compromise its efficacy and/or safety. Therapeutic drug monitoring (TDM) would maximize the potential effectiveness of treatments, while minimizing the potential risk of toxicity for the mother and the fetus. At present, because of the lack of concentration-response relationship studies in pregnant women, TDM can rely only on individual assessment (based on an effective concentration before pregnancy) and remains reserved only to unexpected situations such as signs of toxicity or unexplained inefficiency. PMID:25011648

  14. Addiction research centres and the nurturing of creativity. Monitoring the European drug situation: the ongoing challenge for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

    PubMed

    Griffiths, Paul; Mounteney, Jane; Lopez, Dominique; Zobel, Frank; Götz, Wolfgang

    2012-02-01

    The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the designated hub for drug-related information in the European Union. The organization's role is to provide the European Union (EU) and its Member States with a factual overview of European drug problems and a common information framework to support the drugs debate. In order to achieve its mission, the EMCDDA coordinates and relies on a network of 30 national monitoring centres, the Reitox National Focal Points. The Centre publishes on a wide range of drug-related topics, across epidemiology, interventions, laws and policies. Every November, the EMCDDA publishes its Annual Report, providing a yearly update on the European drug situation, translated into 23 EU languages. In line with its founding regulation, the EMCDDA has a role acting as an interface between the worlds of science and policy. While not a research centre in the formal sense, the results the Centre generates serve as catalysts for new research questions and help to identify priorities. Current challenges facing the agency include continuing to increase scientific standards while maintaining a strong institutional role, as well as supporting European efforts to identify, share and codify best practice in the drugs field. PMID:21539630

  15. How Parents of Teens Store and Monitor Prescription Drugs in the Home

    ERIC Educational Resources Information Center

    Friese, Bettina; Moore, Roland S.; Grube, Joel W.; Jennings, Vanessa K.

    2013-01-01

    Qualitative interviews were conducted with parents of teens to explore how parents store and monitor prescription drugs in the home. Most parents had prescription drugs in the house, but took few precautions against teens accessing these drugs. Strategies for monitoring included moving the drugs to different locations, remembering how many pills…

  16. The role of electronic healthcare record databases in paediatric drug safety surveillance: a retrospective cohort study

    PubMed Central

    de Bie, Sandra; Coloma, Preciosa M; Ferrajolo, Carmen; Verhamme, Katia M C; Trifirò, Gianluca; Schuemie, Martijn J; Straus, Sabine M J M; Gini, Rosa; Herings, Ron; Mazzaglia, Giampiero; Picelli, Gino; Ghirardi, Arianna; Pedersen, Lars; Stricker, Bruno H C; van der Lei, Johan; Sturkenboom, Miriam C J M

    2015-01-01

    Aim Electronic healthcare record (EHR)-based surveillance systems are increasingly being developed to support early detection of safety signals. It is unknown what the power of such a system is for surveillance among children and adolescents. In this paper we provide estimates of the number and classes of drugs, and incidence rates (IRs) of events, that can be monitored in children and adolescents (0–18 years). Methods Data were obtained from seven population-based EHR databases in Denmark, Italy, and the Netherlands during the period 1996–2010. We estimated the number of drugs for which specific adverse events can be monitored as a function of actual drug use, minimally detectable relative risk (RR) and IRs for 10 events. Results The population comprised 4 838 146 individuals (25 575 132 person years (PYs)), who were prescribed 2170 drugs (1 610 631 PYs drug-exposure). Half of the total drug-exposure in PYs was covered by only 18 drugs (0.8%). For a relatively frequent event like upper gastrointestinal bleeding there were 39 drugs for which an association with a RR ≥4, if present, could be investigated. The corresponding number of drugs was eight for a rare event like anaphylactic shock. Conclusion Drug use in children is rare and shows little variation. The number of drugs with enough exposure to detect rare adverse events in children and adolescents within an EHR-based surveillance system such as EU-ADR is limited. Use of additional sources of paediatric drug exposure information and global collaboration are imperative in order to optimize EHR data for paediatric safety surveillance. PMID:25683723

  17. Electronic solutions for combating counterfeit drugs

    PubMed Central

    Hemalatha, R.; Rao, A. Srinivasa

    2015-01-01

    Introduction: The problem of counterfeiting of drugs is assuming alarming proportions and is getting difficult to combat due to its trans-national character. It is undermining the faith of people on health care system. Therefore, there is a need to adopt zero tolerance approach to combat the problem. The Way Forward: There are many solutions available which are being adopted in piece meal manner by individual manufacturers. However, for wholesalers and resellers it is getting difficult to maintain multiple solutions. Therefore, there is a need to adopt a unified solution preferably with the help of the government. Conclusions: This paper discusses the available solutions, their shortcomings and proposes a comprehensive solution where at each level in the supply chain the authenticity is verified preferable linking it with Unique identification. PMID:26229359

  18. Using linked data for mining drug-drug interactions in electronic health records.

    PubMed

    Pathak, Jyotishman; Kiefer, Richard C; Chute, Christopher G

    2013-01-01

    By nature, healthcare data is highly complex and voluminous. While on one hand, it provides unprecedented opportunities to identify hidden and unknown relationships between patients and treatment outcomes, or drugs and allergic reactions for given individuals, representing and querying large network datasets poses significant technical challenges. In this research, we study the use of Semantic Web and Linked Data technologies for identifying drug-drug interaction (DDI) information from publicly available resources, and determining if such interactions were observed using real patient data. Specifically, we apply Linked Data principles and technologies for representing patient data from electronic health records (EHRs) at Mayo Clinic as Resource Description Framework (RDF), and identify potential drug-drug interactions (PDDIs) for widely prescribed cardiovascular and gastroenterology drugs. Our results from the proof-of-concept study demonstrate the potential of applying such a methodology to study patient health outcomes as well as enabling genome-guided drug therapies and treatment interventions. PMID:23920643

  19. Using Linked Data for Mining Drug-Drug Interactions in Electronic Health Records

    PubMed Central

    Pathak, Jyotishman; Kiefer, Richard C.; Chute, Christopher G.

    2014-01-01

    By nature, healthcare data is highly complex and voluminous. While on one hand, it provides unprecedented opportunities to identify hidden and unknown relationships between patients and treatment outcomes, or drugs and allergic reactions for given individuals, representing and querying large network datasets poses significant technical challenges. In this research, we study the use of Semantic Web and Linked Data technologies for identifying drug-drug interaction (DDI) information from publicly available resources, and determining if such interactions were observed using real patient data. Specifically, we apply Linked Data principles and technologies for representing patient data from electronic health records (EHRs) at Mayo Clinic as Resource Description Framework (RDF), and identify potential drug-drug interactions (PDDIs) for widely prescribed cardiovascular and gastroenterology drugs. Our results from the proof-of-concept study demonstrate the potential of applying such a methodology to study patient health outcomes as well as enabling genome-guided drug therapies and treatment interventions. PMID:23920643

  20. Therapeutic drug monitoring of aminoglycosides in acute myeloid leukaemia patients.

    PubMed

    Mareville, Julie; Gay, Julie; Cliquennois, Emmanuel; Herbaux, Charles; Pasquier, Florence; Allorge, Delphine; Blondiaux, Nicolas; Berthon, Céline; Alfandari, Serge

    2012-05-01

    International guidelines limit the use of aminoglycosides in febrile neutropenia to severe situations. We retrospectively reviewed the use of aminoglycosides in adult acute myeloid leukaemia patients admitted in 2009. Our guidelines include precise indications (severe sepsis, shock, drug resistance), dosing regimens (once-daily 20 mg/kg/day amikacin, 5 mg/kg/day gentamicin), durations of treatment, drug monitoring timing, and target C(max) concentrations (40 mg/l amikacin, 20 mg/l gentamicin). Thirty-one patients received 46 aminoglycoside courses: 31 amikacin and 15 gentamicin. The mean prescribed dosage was 19 ± 2.8 mg/kg/day for amikacin and 4.7 ± 0.9 mg/kg/day for gentamicin. The mean duration of use was 2.9 days for both drugs. The mean C(max) for amikacin was 47 ± 13 mg/l and for gentamicin was 13.6 ± 7.5 mg/l. In compliant regimens, all amikacin patients and a third of gentamicin patients had adequate C(max). Among 23 isolated pathogens, 65.5% were susceptible to both drugs and 11.5% to amikacin only. This vindicates the 20 mg/kg/day amikacin dosage and suggests a need to increase the gentamicin dosage. PMID:22235869

  1. Therapeutic drug monitoring of alprazolam in adolescents with asthma.

    PubMed

    DeVane, C L; Hill, M; Antal, E J

    1998-06-01

    Children and adolescents with severe asthma frequently experience anxiety or depression with anxiety, which can undermine their response to treatment. In addition, these patients often receive theophylline and a variety of adrenergic stimulants, which can exacerbate or worsen anxiety. Such children occasionally are candidates for treatment with anxiolytic therapy. There is a paucity of drug disposition data in adolescents for benzodiazepines, the most frequently used antianxiety drugs. The authors monitored the steady state alprazolam plasma concentration in six children with severe asthma who were administered standard doses of alprazolam. In one patient administered concurrent therapy with troleandomycin, a recognized cytochrome 3A4 inhibitor, alprazolam plasma concentration was markedly elevated. Overall, the disposition data of alprazolam was consistent with data previously reported in adults. Alprazolam appeared to be safe and effective for use in adolescents with asthma. PMID:9631921

  2. Design and implementation of an electronic investigational drug accountability system.

    PubMed

    Grilley, B J; Trissel, L A; Bluml, B M

    1991-12-01

    A software system designed to maintain protocol-specific investigational drug accountability records is described. The University of Texas M. D. Anderson Cancer Center and Cygnus Systems Development, Inc., worked together to create an electronic investigational drug accountability system (IDRx), which meets the requirements of the National Cancer Institute. This system performs record keeping, stores information on drugs and protocols, and generates standard and customized reports. On-screen assistance makes it easy to use. Security is achieved by granting access only to authorized users, and an audit trail is automatically generated. Systematic implementation at M. D. Anderson, initially in the investigational drug control area and subsequently in the satellite pharmacies, has resulted in increased accuracy and efficiency, and few problems have been encountered. The IDRx software package is useful for keeping records, generating reports, and tracking and evaluating data associated with an investigational drug accountability system. PMID:1814202

  3. Electron line shape of the KATRIN monitor spectrometer

    NASA Astrophysics Data System (ADS)

    Slezák, M.; Bauer, S.; Dragoun, O.; Erhard, M.; Schlösser, K.; Špalek, A.; Vénos, D.; Zbořil, M.

    2013-12-01

    Conversion electrons emitted from 83mKr implanted into a solid substrate will serve as a powerful tool for monitoring of the energy scale stability in the KATRIN neutrino experiment. An appropriate description of the conversion line shape is essential to determine the energy of the emitted electrons. It is shown that the Doniach-Šunjić line shape gives a significantly better fit to the conversion electron spectra than the previously used double Voigt model. The electron spectra were obtained with the KATRIN MAC-E filter monitor spectrometer.

  4. Monitoring the Halitosis with an Electronic Nose

    NASA Astrophysics Data System (ADS)

    Marchetti, Enrico; Pennazza, Giorgio; Santonico, Marco; Capuano, Rosamaria; Mummolo, Stefano; Marzo, Giuseppe; Di Natale, Corrado

    2011-09-01

    Halitosis disease results in a distinctive volatile fingerprint of the individual exhaled breath. Here a QMB based electronic nose has been used to study such fingerprints. This study aimed at following the time evolution of halitosis conditions in patients undergoing two different treatments. Professional operators assessed oral odor, and their evaluation was used for classifier training. Results show that the electronic nose can identify the presence of oral malodor and the attenuation of the condition achieved by the application of the treatment.

  5. A Fibrous Localized Drug Delivery Platform with NIR-Triggered and Optically Monitored Drug Release.

    PubMed

    Liu, Heng; Fu, Yike; Li, Yangyang; Ren, Zhaohui; Li, Xiang; Han, Gaorong; Mao, Chuanbin

    2016-09-01

    Implantable localized drug delivery systems (LDDSs) with intelligent functionalities have emerged as a powerful chemotherapeutic platform in curing cancer. Developing LDDSs with rationally controlled drug release and real-time monitoring functionalities holds promise for personalized therapeutic protocols but suffers daunting challenges. To overcome such challenges, a series of porous Yb(3+)/Er(3+) codoped CaTiO3 (CTO:Yb,Er) nanofibers, with specifically designed surface functionalization, were synthesized for doxorubicin (DOX) delivery. The content of DOX released could be optically monitored by increase in the intensity ratio of green to red emission (I550/I660) of upconversion photoluminescent nanofibers under 980 nm near-infrared (NIR) excitation owing to the fluorescence resonance energy transfer (FRET) effect between DOX molecules and the nanofibers. More importantly, the 808 nm NIR irradiation enabled markedly accelerated DOX release, confirming representative NIR-triggered drug release properties. In consequence, such CTO:Yb,Er nanofibers presented significantly enhanced in vitro anticancer efficacy under NIR irradiation. This study has thus inspired another promising fibrous LDDS platform with NIR-triggered and optics-monitored DOX releasing for personalized tumor chemotherapy. PMID:27557281

  6. Quantitative EEG Brain Mapping In Psychotropic Drug Development, Drug Treatment Selection, and Monitoring.

    PubMed

    Itil, Turan M.; Itil, Kurt Z.

    1995-05-01

    Quantification of standard electroencephalogram (EEG) by digital computers [computer-analyzed EEG (CEEG)] has transformed the subjective analog EEG into an objective scientific method. Until a few years ago, CEEG was only used to assist in the development of psychotropic drugs by means of the quantitative pharmaco EEG. Thanks to the computer revolution and the accompanying reductions in cost of quantification, CEEG can now also be applied in psychiatric practice. CEEG can assist the physician in confirming clinical diagnoses, selecting psychotropic drugs for treatment, and drug treatment monitoring. Advancements in communications technology allow physicians and researchers to reduce the costs of acquiring a high-technology CEEG brain mapping system by utilizing the more economical telephonic services. PMID:11850678

  7. Collection of medical drug information in pharmacies: Drug Event Monitoring (DEM) in Japan.

    PubMed

    Hayashi, Sei-ichiro; Nanaumi, Akira; Akiba, Yasuji; Komiyama, Takako; Takeuchi, Koichi

    2005-07-01

    To establish a system for collecting and reporting information from community pharmacists such as that on adverse effects, the Japan Pharmaceutical Association (JPA) conducts Drug Event Monitoring (DEM). In the fiscal year 2002, a survey was carried out to clarify the incidence of sleepiness due to antiallergic drugs. The investigated active ingredients were ebastine, fexofenadine hydrochloride, cetirizine hydrochloride, and loratadine. Community pharmacists asked the following question to patients who visited their pharmacies: "Have you ever become sleepy after taking this drug?" During a 4-week survey period, reports of 94256 cases were collected. To evaluate the incidence of sleepiness, we analyzed cases in which reports showed alleged absence of concomitant oral drugs, and drug use in conformity with the dose and method described in package inserts. The incidence of sleepiness was significantly different among the drugs (chi(2)-test, p<0.001). The observed incidences of sleepiness due to the drugs (8.8-20.5%) were higher than those described in each package insert (1.8-6.35%). This may be because an active question was used ("Have you ever become sleepy after taking this drug?"). Active intervention by pharmacists may be useful for collecting more information on improvement in the QOL of patients and safety. In addition, the pharmacists were asked to report events other than "sleepiness" in the free description column of the report. Some symptoms not described in the package inserts were reported, suggesting that DEM may lead to the discovery of new adverse effects. These results suggest that community pharmacists have a good opportunity to collect information in DEM, and safety information such as that on adverse effects can be obtained from pharmacies. PMID:15997212

  8. Microchip system for monitoring microbial physiological behaviour under drug influences.

    PubMed

    Arora, S; Lim, C S; Foo, J Y; Sakharkar, M K; Dixit, P; Liu, A Q; Miao, J M

    2009-08-01

    Single-step real-time high-throughput monitoring of drug influences on bacterial cell behaviour has become important with growing interests in personalized therapy and medication. Conventional microchip assemblies to perform similar work do exist. However, most of these devices have complex set-ups incorporating micromixers, separators, pumps, or valves. These microcomponents can sometimes damage the entities being monitored because of the creation of unfavourable biological environments. This paper presents a microchip-based system that enables single-step mixing of two solutions in various ratios, without the need for additional microcomponents such as mixers and pumps, in order to screen effectively their combinatory effects on cell outcomes. In this work, in-vitro experiments were carried out using ampicillin at various concentrations to investigate their effects on Escherichia coli (E. coli). Results showed that the microchip provided effective screening, which yielded useful results such as effective dosages, ineffective dosages, and other possible outcomes; for instance, in this case, the occurrence of adaptive mutation of the bacteria at certain drug concentrations. Comparative microbiological laboratory tests were carried out as standard for confirmation of the results. PMID:19743643

  9. Therapeutic Drug Monitoring of Everolimus: A Consensus Report.

    PubMed

    Shipkova, Maria; Hesselink, Dennis A; Holt, David W; Billaud, Eliane M; van Gelder, Teun; Kunicki, Paweł K; Brunet, Mercè; Budde, Klemens; Barten, Markus J; De Simone, Paolo; Wieland, Eberhard; López, Olga Millán; Masuda, Satohiro; Seger, Christoph; Picard, Nicolas; Oellerich, Michael; Langman, Loralie J; Wallemacq, Pierre; Morris, Raymond G; Thompson, Carol; Marquet, Pierre

    2016-04-01

    In 2014, the Immunosuppressive Drugs Scientific Committee of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology called a meeting of international experts to provide recommendations to guide therapeutic drug monitoring (TDM) of everolimus (EVR) and its optimal use in clinical practice. EVR is a potent inhibitor of the mammalian target of rapamycin, approved for the prevention of organ transplant rejection and for the treatment of various types of cancer and tuberous sclerosis complex. EVR fulfills the prerequisites for TDM, having a narrow therapeutic range, high interindividual pharmacokinetic variability, and established drug exposure-response relationships. EVR trough concentrations (C0) demonstrate a good relationship with overall exposure, providing a simple and reliable index for TDM. Whole-blood samples should be used for measurement of EVR C0, and sampling times should be standardized to occur within 1 hour before the next dose, which should be taken at the same time everyday and preferably without food. In transplantation settings, EVR should be generally targeted to a C0 of 3-8 ng/mL when used in combination with other immunosuppressive drugs (calcineurin inhibitors and glucocorticoids); in calcineurin inhibitor-free regimens, the EVR target C0 range should be 6-10 ng/mL. Further studies are required to determine the clinical utility of TDM in nontransplantation settings. The choice of analytical method and differences between methods should be carefully considered when determining EVR concentrations, and when comparing and interpreting clinical trial outcomes. At present, a fully validated liquid chromatography tandem mass spectrometry assay is the preferred method for determination of EVR C0, with a lower limit of quantification close to 1 ng/mL. Use of certified commercially available whole-blood calibrators to avoid calibration bias and participation in external proficiency-testing programs to allow continuous cross

  10. Impact of Laboratory Practices on Interlaboratory Variability in Therapeutic Drug Monitoring of Immunosuppressive Drugs.

    PubMed

    Christians, Uwe; Vinks, Alexander A; Langman, Loralie J; Clarke, William; Wallemacq, Pierre; van Gelder, Teun; Renjen, Varun; Marquet, Pierre; Meyer, Eric J

    2015-12-01

    The immunosuppressants cyclosporine, tacrolimus, sirolimus, everolimus, and probably also mycophenolic acid require therapeutic drug monitoring (TDM)-guided dosing to ensure that blood concentrations are kept within the target range in transplant patients. Reliable, accurate, and precise test methods are therefore essential to effectively monitor levels and to make proper dose adjustments. Data from proficiency testing programs have shown substantial interlaboratory variability. Only few attempts have been made to study the underlying causes. The aim of this study was to systematically document current practices used for immunosuppressant drug TDM in clinical laboratories and identify methodological and practice differences, which may cause the variability observed among laboratories. Data collection was primarily conducted by a structured Web-based survey. Invitations to participate in the survey were distributed to clinical laboratories providing immunosuppressant drug TDM. Surveys were completed by 76 laboratories in 14 countries. The results of our survey suggest that there are 3 main reasons for interlaboratory variability: (1) lack of standardization of laboratory procedures and workflows starting with sample collection and handling, (2) lack of use of appropriate reference materials (eg, isotope-labeled internal standards for liquid chromatography-tandem mass spectroscopy), and (3) poor compliance with internationally accepted good laboratory practice guidelines (eg, related to quality control, quality assurance, validation, training of personnel). The results of the survey also suggest that interlaboratory variability is a multifactorial problem. Technical-level consensus on laboratory operational procedures, quality systems, and personnel training will be of great importance to improve quality and interlaboratory comparability. PMID:26291980

  11. Intelligent Janus nanoparticles for intracellular real-time monitoring of dual drug release

    NASA Astrophysics Data System (ADS)

    Cao, Han; Yang, Yuhong; Chen, Xin; Shao, Zhengzhong

    2016-03-01

    fluorescence resonance energy transfer (FRET) and surface-enhanced Raman scattering (SERS). The FRET acceptor Dox is attached to CMR (as a FRET donor) conjugated MS with a pH-responsive linker hydrazone, and 6MP is conjugated to the Au surface through the gold-thiol interaction. As the Janus nanoparticle enters into tumor cells, the breakage of the hydrazone bond in an acidic environment and the substitution of glutathione (GSH) overexpressed in cancer cells give rise to the release of Dox and 6MP, respectively. Thus, the change of the CMR fluorescence signal and the SERS decrease of 6MP can be used to monitor the dual-drug release within living cells in real time. In addition, this work demonstrates the enhanced anticancer effect of the designed dual-drug loaded nanosystem. Therefore, the current study may provide new perspectives for the real-time study of intelligent multi-drug delivery and release, as well as cellular responses to drug treatment. Electronic supplementary information (ESI) available. See DOI: 10.1039/c6nr00987e

  12. Asparaginase pharmacokinetics and implications of therapeutic drug monitoring

    PubMed Central

    Asselin, Barbara; Rizzari, Carmelo

    2015-01-01

    Asparaginase is widely used in chemotherapeutic regimens for the treatment of acute lymphoblastic leukemia (ALL) and has led to a substantial improvement in cure rates, especially in children. Optimal therapeutic effects depend on a complete and sustained depletion of serum asparagine. However, pronounced interpatient variability, differences in pharmacokinetic properties between asparaginases and the formation of asparaginase antibodies make it difficult to predict the degree of asparagine depletion that will result from a given dose of asparaginase. The pharmacological principles underlying asparaginase therapy in the treatment of ALL are summarized in this article. A better understanding of the many factors that influence asparaginase activity and subsequent asparagine depletion may allow physicians to tailor treatment to the individual, maximizing therapeutic effect and minimizing treatment-related toxicity. Therapeutic drug monitoring provides a means of assessing a patient's current depletion status and can be used to better evaluate the potential benefit of treatment adjustments. PMID:25586605

  13. Naked-eye nanobiosensor for therapeutic drug monitoring of methotrexate.

    PubMed

    Yockell-Lelièvre, H; Bukar, N; Toulouse, J L; Pelletier, J N; Masson, J-F

    2016-01-21

    Sensing of methotrexate at clinically-relevant concentrations was achieved with a plasmon-coupling assay. In this assay, free methotrexate and folic acid Au nanoparticles competed for human dihydrofolate reductase (hDHFR)-functionalized Au nanoparticles (Au NP). The hDHFR-functionalized Au NPs were immobilized on a small glass sensor inserted in a portable 4-channel LSPR reader. This allowed rapid (minutes) and sensitive (nanomolar range) measurement of methotrexate concentration by means of total internal reflection plasmonic spectroscopy. The large bathochromic shifts of the plasmon-coupling assay led to striking colour changes visible to the naked eye for methotrexate at clinically-relevant concentrations. The results demonstrate the potential for therapeutic drug monitoring of a widely used chemotherapy agent, as assessed with the naked eye. PMID:26229988

  14. A graphene quantum dot-based FRET system for nuclear-targeted and real-time monitoring of drug delivery

    NASA Astrophysics Data System (ADS)

    Chen, Hui; Wang, Zhuyuan; Zong, Shenfei; Chen, Peng; Zhu, Dan; Wu, Lei; Cui, Yiping

    2015-09-01

    the drug release dynamics. Our strategy for the assembly of a FRET-based drug delivery system may be unique and universal for monitoring the dynamic release process. This study may give more exciting new opportunities for improving the therapeutic efficacy and tracking precision. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr03454j

  15. [Practice of drug monitoring based on comprehensive pharmaceutical judgment].

    PubMed

    Katayama, Toshiya

    2015-01-01

    With the revisions to the pay for performance of pharmaceutical service of inpatients in April 2012, the ward permanent time of pharmacists grew longer than previously; however, there are as yet few reports on the pharmaceutical outcome of the new medical service. To improve the pharmaceutical service requires that pharmacists collect useful medical information and extract the problems of pharmaceutical care for inpatients. Since many cases of treatment with multidrug regimens are regularly performed, pharmacists cannot contribute to medical treatment only by knowledge of a single disease. Therefore quick and comprehensive judgment of pharmacists is necessary in addition to acquisition of pharmaceutical knowledge. We especially highlight medical emergencies such as severe cases of sepsis and infection to which physicians require rapid judgment. Pharmacists alike require appropriate knowledge of drug administration to avoid medical treatment failure. Moreover, it is necessary for pharmacists to apply advanced drug monitoring in difficult cases. On the other hand, integrated team medical treatment is now advancing, although pharmacists' roles in clinical decision making are increasing, and pharmacists have a greater burden of responsibility than before. PMID:25747207

  16. HOW CLINICIANS USE PRESCRIPTION DRUG MONITORING PROGRAMS: A QUALITATIVE INQUIRY

    PubMed Central

    Hildebran, Christi; Cohen, Deborah J.; Irvine, Jessica M.; Foley, Carol; O’Kane, Nicole; Beran, Todd; Deyo, Richard A.

    2014-01-01

    Objectives Prescription drug monitoring programs (PDMP) are now active in most states to assist clinicians in identifying potential controlled drug misuse, diversion or excessive prescribing. Little is still known about the ways in which they are incorporated into workflow and clinical decision making, what barriers continue to exist, and how clinicians are sharing PDMP results with their patients. Design Qualitative data were collected through online focus groups and telephone interviews Setting Clinicians from pain management, emergency and family medicine, psychiatry/behavioral health, rehabilitation medicine, internal medicine and dentistry. Subjects 35 clinicians from 9 states participated. Methods We conducted two online focus groups and seven telephone interviews. A multidisciplinary team then used a grounded theory approach coupled with an immersion-crystallization strategy for identifying key themes in the resulting transcripts. Results Some participants, mainly from pain clinics, reported checking the PDMP with every patient, every time. Others checked only for new patients, for new opioid prescriptions, or for patients for whom they suspected abuse. Participants described varied approaches to sharing PDMP information with patients, including openly discussing potential addiction or safety concerns; avoiding discussion altogether; and approaching discussion confrontationally. Participants described patient anger or denial as a common response and noted the role of patient satisfaction surveys as an influence on prescribing. Conclusion Routines for accessing PDMP data and how clinicians respond to it vary widely. As PDMP use becomes more widespread, it will be important to understand what approaches are most effective for identifying and addressing unsafe medication use. PMID:24833113

  17. Application of the Electronic Tongue to Milk Quality Monitoring

    NASA Astrophysics Data System (ADS)

    Legin, A.; Rudnitskaya, A.; Lvova, L.; Vlasov, Yu.; D'Amico, A.; di Natale, C.; Paolesse, R.

    2000-12-01

    Electronic tongue comprising an array of 31 different chemical sensors with pattern recognition engine has been utilized for milk recognition and quality monitoring. The ability of the system to distinguish between milk samples produced by different manufacturers and theramlly treated in different ways and to monitor the process of milk spoilage has been demonstrated. The measurements and processing of the sensor array response without reference electrode have been successfully performed.

  18. The Development and Evaluation of an Integrated Electronic Prescribing and Drug Management System for Primary Care

    PubMed Central

    Tamblyn, Robyn; Huang, Allen; Kawasumi, Yuko; Bartlett, Gillian; Grad, Roland; Jacques, André; Dawes, Martin; Abrahamowicz, Michal; Perreault, Robert; Taylor, Laurel; Winslade, Nancy; Poissant, Lise; Pinsonneault, Alain

    2006-01-01

    Objective: To develop and evaluate the acceptability and use of an integrated electronic prescribing and drug management system (MOXXI) for primary care physicians. Design: A 20-month follow-up study of MOXXI (Medical Office of the XXIst Century) implementation in 28 primary care physicians and 13,515 consenting patients. Measurement: MOXXI was developed to enhance patient safety by integrating patient demographics, retrieving active drugs from pharmacy systems, generating an automated problem list, and providing electronic prescription, stop order, automated prescribing problem alerts, and compliance monitoring functions. Evaluation of technical performance, acceptability, and use was conducted using audit trails, questionnaires, standardized tasks, and information from comprehensive health insurance databases. Results: Perceived improvements in continuity of care and professional autonomy were associated with physicians' expected use of MOXXI. Physician speed in using MOXXI improved substantially in the first three months; however, only the represcribing function was faster using MOXXI than by handwritten prescription. Physicians wrote electronic prescriptions in 36.9 per 100 visits and reviewed the patient's drug profile in 12.6 per 100 visits. Physicians rated printed prescriptions, the current drug list, and the represcribing function as the most beneficial aspects of the system. Physicians were more likely to use the drug profile for patients who used more medication, made more emergency department visits, had more prescribing physicians, and lower continuity of care. Conclusion: Primary care physicians believed an integrated electronic prescribing and drug management system would improve continuity of care, and they were more likely to use the system for patients with more complex, fragmented care. PMID:16357357

  19. Hospital pharmacy practice in Saudi Arabia: Drug monitoring and patient education in the Riyadh region

    PubMed Central

    Alsultan, Mohammed S.; Mayet, Ahmed Y.; Khurshid, Fowad; Al-jedai, Ahmed H.

    2013-01-01

    Background The purpose of this national survey is to evaluate hospital pharmacy practice in the Riyadh region of Saudi Arabia. The results of the survey pertaining to the monitoring and patient education of the medication use process were presented. Methods We have invited pharmacy directors from all 48 hospitals in the Riyadh region to participate in a modified-American Society of Health-System Pharmacists (ASHP) survey questionnaire. The survey was conducted using similar methods to those of the ASHP surveys. Results The response rate was 60.4% (29/48). Most hospitals (23, 79%) had pharmacists regularly monitor medication therapy for patients. Of these hospitals, 61% had pharmacists monitoring medication therapy daily for less than 26% of patients, 17% monitored 26–50% of patients and 22% monitored more than half of patients daily. In 41% of hospitals, pharmacists routinely monitored serum medication concentrations or their surrogate markers; 27% gave pharmacists the authority to order initial serum medication concentrations, and 40% allowed pharmacists to adjust dosages. Pharmacists routinely documented their medication therapy monitoring activities in 52% of hospitals. Overall, 74% of hospitals had an adverse drug event (ADE) reporting system, 59% had a multidisciplinary committee responsible for reviewing ADEs, and 63% had a medication safety committee. Complete electronic medical record (EMR) systems were available in 15% of hospitals and 81% had a partial EMR system. The primary responsibility for performing patient medication education lays with nursing (37%), pharmacy (37%), or was a shared responsibility (26%). In 44% of hospitals, pharmacists provided medication education to half or more inpatients and in a third of hospitals, pharmacists gave medication education to 26% or more of patients at discharge. Conclusion Hospital pharmacists in the Riyadh region are actively engaged in monitoring medication therapy and providing patient medication education

  20. Polymedication Electronic Monitoring System (POEMS) – a new technology for measuring adherence

    PubMed Central

    Arnet, Isabelle; Walter, Philipp N.; Hersberger, Kurt E.

    2013-01-01

    Introduction: Reliable and precise measurement of patient adherence to medications is feasible by incorporating a microcircuitry into pharmaceutical packages of various designs, such that the maneuvers needed to remove a dose of drug are detected, time-stamped, and stored. The principle is called “electronic medication event monitoring” but is currently limited to the monitoring of a single drug therapy. Aim: Our aims were introducing a new technology; a clear, self-adhesive polymer film, with printed loops of conductive wires that can be affixed to multidrug punch cards for the electronic adherence monitoring of multiple medication regimens (Polymedication Electronic Monitoring System, POEMS), and illustrating potential benefits for patient care. We present a preliminary report with one patient experience. Materials and methods: Our illustrative case was supplied with a pre-filled 7-day multiple medication punch card with unit-of-use doses for specific times of the day (six pills in the morning cavity, two pills in the evening cavity, and one pill in case of insomnia in the bedtime cavity), with the new electronic film affixed on it. Results: The intake times over 1 week were extremely skewed (median intake hours at 2:00 pm for the morning doses and at 6:40 pm for the evening doses). After an intervention aimed at optimizing the timing adherence, the morning and evening intake hours became more balanced, with 42.3% of correct dosing intervals (±3 h) for drugs with twice daily intake (vs. 0% before the intervention). Discussion: The electronic monitoring of the entire therapy revealed an intake pattern that would have remained undiscovered with any other device and allowed a personalized intervention to correct an inadequate medication intake behavior. POEMS may guide health professionals when they need to optimize a pharmacotherapy because of suspected insufficient adherence. Further, knowing the intake pattern of the entire pharmacotherapy can elucidate

  1. DRUG-DRUG INTERACTION PROFILES OF MEDICATION REGIMENS EXTRACTED FROM A DE-IDENTIFIED ELECTRONIC MEDICAL RECORDS SYSTEM.

    PubMed

    Butkiewicz, Mariusz; Restrepo, Nicole A; Haines, Jonathan L; Crawford, Dana C

    2016-01-01

    With age, the number of prescribed medications increases and subsequently raises the risk for adverse drug-drug interactions. These adverse effects lower quality of life and increase health care costs. Quantifying the potential burden of adverse effects before prescribing medications can be a valuable contribution to health care. This study evaluated medication lists extracted from a subset of the Vanderbilt de-identified electronic medical record system. Reported drugs were cross-referenced with the Kyoto Encyclopedia of Genes and Genomes DRUG database to identify known drug-drug interactions. On average, a medication regimen contained 6.58 medications and 2.68 drug-drug interactions. Here, we quantify the burden of potential adverse events from drug-drug interactions through drug-drug interaction profiles and include a number of alternative medications as provided by the Anatomical Therapeutic Chemical Classification System. PMID:27570646

  2. An Electronic Pillbox for Continuous Monitoring of Medication Adherence

    PubMed Central

    Hayes, Tamara. L.; Hunt, John M.; Adami, Andre; Kaye, Jeffrey A.

    2010-01-01

    We have developed an instrumented pillbox, called a MedTracker, which allows monitoring of medication adherence on a continuous basis. This device improves on existing systems by providing mobility, frequent and automatic data collection, more detailed information about nonadherence and medication errors, and the familiar interface of a 7-day drug store pillbox. We report on the design of the MedTracker, and on the results of a field trial in 39 homes to evaluate the device. PMID:17946369

  3. 29. View of typical radio frequency monitor group electronic tubetype ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    29. View of typical radio frequency monitor group electronic tube-type cabinet. System is water-cooled with antenna assist. - Clear Air Force Station, Ballistic Missile Early Warning System Site II, One mile west of mile marker 293.5 on Parks Highway, 5 miles southwest of Anderson, Anderson, Denali Borough, AK

  4. Electronic Monitoring of Sex Offenders: Identifying Unanticipated Consequences and Implications

    ERIC Educational Resources Information Center

    Demichele, Matthew; Payne, Brian K.; Button, Deeanna M.

    2008-01-01

    In recent years, increased legislative attention has been given to strategies to supervise sex offenders in the community. Among other policies, several states have passed laws calling for the use of electronic monitoring technologies to supervise sex offenders in the community. When initially developed, this community-based sanction was designed…

  5. Feasibility demonstration of a second-generation electronic monitoring system

    NASA Astrophysics Data System (ADS)

    Murphy, John H.

    1997-02-01

    First generation electronic monitoring systems are being used by the criminal justice system to effect behavioral modifications of persons in pre-trial release programs, on parole, and on probation. Current systems are merely radio frequency proximity detection systems that operate over limited ranges, on the order of 45 to 70 meters. One major defect with proximity detection systems is that when the offenders leave the area being monitored, there is no way to ensure that the offenders travel where they should. As a result, the first generation electronic monitoring systems are only applied to a restricted number of low risk cases. There is a growing need for a second generation electronic monitoring system which utilizes community-wide tracking and location technologies to increase the public safety and to expand the number of offenders monitored by these systems. Even though GPS (Global Positioning System) is rapidly becoming the technology of choice for vehicle tracking and location, GPS is not an ideal candidate for the second generation electronic monitoring system. Urban environments prevent GPS systems from providing continuous and accurate location service due to satellite occlusion by obstacles such as: hills, mountains, vehicles, buildings, and trees. An inverse-GPS approach which overcomes these urban environment related limitations has been evaluated by Northrop Grumman as a means to track people. This paper presents the results of a National Institute of Justice funded program to demonstrate in downtown Pittsburgh the feasibility of spread spectrum based time-of-arrival location systems for intelligently tracking people on probation and parole.

  6. Electronic noses and their applications in environmental monitoring

    SciTech Connect

    Hashem, S.; Keller, P.E.; Kouzes, R.T.; Kangas, L.J.

    1995-12-31

    Compact, portable systems capable of quickly identifying contaminants in the field are of great importance when monitoring the environment. In this paper, we examine the effectiveness of using artificial neural networks for real-time data analysis of a sensor array. Analyzing the sensor data in parallel may allow for rapid identification of contaminants in the field without requiring highly selective component sensors. A sensor array combined with a data analysis module is referred to as an electronic nose. In this paper, we investigate the trade off between sensor sensitivity and selectivity relating to the applications of neural network based-electronic noses in environmental monitoring. We use a prototype electronic nose which consists of nine tin-oxide Taguchi-type sensors, a temperature sensor, and a humidity sensor. We illustrate that by using neural network based analysis of a sensor data, the selectivity of a sensor array may be significantly improved, especially when some (or all) sensors are not highly selective.

  7. Hepatic microsomal drug oxidation and electron transport in newborn infants.

    PubMed

    Aranda, J V; MacLeod, S M; Renton, K W; Eade, N R

    1974-10-01

    Many drugs require oxidative metabolism for termination of action and/or for elimination from the body. Many oxidative reactions are catalyzed by hepatic microsomal enzymes. The activities of various drug-metabolizing enzymes, namely, NADPH cytochrome c reductase, NADPH oxidase, aminopyrine-N-demethylase, and analine P-hydroxylase, and the content of cytochrome P-450, were measured in hepatic microsomes obtained from seven newborn infants and four adult patients. The results in the newborn infant show increasing activities of these enzymes (except aminopyrine-N-demethylase) related to advancing age. Good correlation between three components of the hepatic microsomal mixed function oxidase system and aniline p-hydroxylase was established, whereas only NADPH oxidation correlated with aminopyrine N-demethylation. The rate of substrate or drug oxidation and the activities of the components of the microsomal electron transport pathway were lower than comparable values in the adult. The data demonstrate a possible biochemical basis for the transient deficiency in drug metabolism seen in newborn infants. PMID:4155438

  8. Optical properties of the chemotherapy drugs used in the central nervous system lymphoma therapy: monitoring drug delivery

    NASA Astrophysics Data System (ADS)

    Myllylä, T.; Popov, A.; Surazyński, L.; Oinas, J.; Bibikova, O.; Bykov, A.; Wróbel, M. S.; Gnyba, M.; Jedrzejewska-Szczerska, M.; Meglinski, I.; Kuittinen, O.

    2015-07-01

    Our aim is to optically monitor the delivery of the chemotherapy drugs for brain tumours, particularly used in the central nervous system (CNS) lymphoma therapy. In vivo monitoring would help to optimize the treatment and avoiding unnecessary medications. Moreover, it would be beneficial to be able to measure which of the multi-regimen drugs actually do penetrate and how well into the brain tissue. There exist several potential optical measurement techniques to be utilised for the purpose. The most desired method would allow the detection of the drugs without using optical biomarkers as a contrast agent. In this case, for non-invasive sensing of the drug in the brain cortex, the drug should have a reasonably strong optical absorption band somewhere in the range between 600 nm and 1700 nm, and not directly coincident with the strong bands of haemoglobin or water. Alternatively, mid-infrared (MIR) range has the potential for invasive drug monitoring techniques. In this paper, we report the optical properties of several chemotherapy drugs used in CNS lymphoma therapy, such as rituximabi, cyclophosphamide and etoposide. We measured their transmittance and reflectance spectra in near-infrared (NIR) range, particularly 900 nm - 2500 nm, to be considered when choosing the in vivo monitoring method to be developed. The absorption and scattering coefficients were retrieved from the measurements and applying Beer's law. For the measurement of the sum of total transmission and reflection in NIR range we used integrating sphere with spektralo to enable calculation of the scattering coefficient.

  9. Antiretroviral Drug Interactions: Overview of Interactions Involving New and Investigational Agents and the Role of Therapeutic Drug Monitoring for Management

    PubMed Central

    Rathbun, R. Chris; Liedtke, Michelle D.

    2011-01-01

    Antiretrovirals are prone to drug-drug and drug-food interactions that can result in subtherapeutic or supratherapeutic concentrations. Interactions between antiretrovirals and medications for other diseases are common due to shared metabolism through cytochrome P450 (CYP450) and uridine diphosphate glucuronosyltransferase (UGT) enzymes and transport by membrane proteins (e.g., p-glycoprotein, organic anion-transporting polypeptide). The clinical significance of antiretroviral drug interactions is reviewed, with a focus on new and investigational agents. An overview of the mechanistic basis for drug interactions and the effect of individual antiretrovirals on CYP450 and UGT isoforms are provided. Interactions between antiretrovirals and medications for other co-morbidities are summarized. The role of therapeutic drug monitoring in the detection and management of antiretroviral drug interactions is also briefly discussed. PMID:24309307

  10. Proton-Electron Discrimination Detector (PEDD) for space weather monitoring

    NASA Astrophysics Data System (ADS)

    Whitney, Chad M.; Johnson, Erik B.; Chen, Xiao Jie; Stapels, Christopher; Vogel, Sam; Christian, James

    2015-09-01

    Electronics used for space applications (e.g. communication satellites) are susceptible to space weather, primarily consisting of electrons and protons. As more critical equipment is used in space, a comprehensive monitoring network is needed to mitigate risks associated with radiation damage. Compact detectors suited for this requirement have been too complicated or do not provide sufficient information. As the damage from electrons (e.g. total ionizing dose effects) is significantly different compared to protons (e.g. displacement damage effects), monitors that can provide unique measurements of the dose and/or spectral information for electrons and protons separately are necessary for mission assessment to determine strategies for maintaining function. Previously, we demonstrated that the Proton-Electron Discrimination Detector (PEDD) is space-compatible and can discriminate fast electrons from protons using a diphenylanthrecene (DPA) scintillator coupled to a CMOS silicon photomultiplier (SiPM). The SiPM has a temperature dependence, and a circuit has been developed to provide a stable response as a function of temperature. The PEDD detector is scheduled to participate on the RHEME experiment to be flown on the ISS, scheduled for launch in 2016.

  11. Predictive modeling of structured electronic health records for adverse drug event detection

    PubMed Central

    2015-01-01

    Background The digitization of healthcare data, resulting from the increasingly widespread adoption of electronic health records, has greatly facilitated its analysis by computational methods and thereby enabled large-scale secondary use thereof. This can be exploited to support public health activities such as pharmacovigilance, wherein the safety of drugs is monitored to inform regulatory decisions about sustained use. To that end, electronic health records have emerged as a potentially valuable data source, providing access to longitudinal observations of patient treatment and drug use. A nascent line of research concerns predictive modeling of healthcare data for the automatic detection of adverse drug events, which presents its own set of challenges: it is not yet clear how to represent the heterogeneous data types in a manner conducive to learning high-performing machine learning models. Methods Datasets from an electronic health record database are used for learning predictive models with the purpose of detecting adverse drug events. The use and representation of two data types, as well as their combination, are studied: clinical codes, describing prescribed drugs and assigned diagnoses, and measurements. Feature selection is conducted on the various types of data to reduce dimensionality and sparsity, while allowing for an in-depth feature analysis of the usefulness of each data type and representation. Results Within each data type, combining multiple representations yields better predictive performance compared to using any single representation. The use of clinical codes for adverse drug event detection significantly outperforms the use of measurements; however, there is no significant difference over datasets between using only clinical codes and their combination with measurements. For certain adverse drug events, the combination does, however, outperform using only clinical codes. Feature selection leads to increased predictive performance for both

  12. Controlled release of drugs from cellulose acetate matrices produced from sugarcane bagasse: monitoring by square-wave voltammetry.

    PubMed

    Rodrigues Filho, Guimes; Almeida, Flávia; Ribeiro, Sabrina D; Tormin, Thiago F; Muñoz, Rodrigo A A; Assunção, Rosana M N; Barud, Hernane

    2016-07-01

    In this paper, cellulose triacetate (CTA) was produced from sugarcane bagasse and used as matrices for controlled release of paracetamol. Symmetric and asymmetric membranes were obtained by formulations of CTA/dichloromethane/drug and CTA/dichloromethane/water/drug, respectively, and they were characterized by scanning electron microscopy (SEM) and differential scanning calorimetry (DSC). Different morphologies of membranes were observed by SEM, and the incorporation of paracetamol was confirmed by lowering of the glass transition temperature (Tg) in the DSC curves. This indicates the existence of interactions between the matrix and the drug. The evaluation of drug release was based on the electrochemical monitoring of paracetamol through its oxidation at a glassy carbon electrode surface using square-wave voltammetry (SWV), which provides fast, precise and accurate in situ measurements. The studies showed a content release of 27% and 45% by the symmetric and asymmetric membranes, respectively, during 8 h. PMID:26596497

  13. Electronic medication ordering with integrated drug database and clinical decision support system.

    PubMed

    Cufar, Andreja; Droljc, Anže; Orel, Andrej

    2012-01-01

    Medication errors have been identified as one of the most important causes of adverse drug events. Computerized physician order-entry (CPOE) systems, coupled with decision support (Medication allergy checking, drug interactions, and dose calculations), are considered to be appropriate solutions for reducing medication errors and standardizing care. It is quite useful if clinical information system (CIS) supports order sets, which help with standardizing care, preventing omission errors, and expediting the ordering process. Order sets are predefined groups of orders pertinent to one or more specific clinical conditions or diagnoses. The article describes how a clinical information system can be used to support medication process (prescribing, ordering, dispensing, administration and monitoring) and offer participating medical teams real time warnings and key information regarding medications and patient status, thus reducing medication errors. Integrated electronic prescribing support system benefits for total parenteral nutrition (TPN) are discussed at the end. PMID:22874280

  14. Should Therapeutic Drug Monitoring for Monoclonal Antibodies Remain the Exception or Become the Norm?

    PubMed

    Stroh, M; Lum, B L

    2016-09-01

    Therapeutic drug monitoring (TDM) aims to maintain circulating drug concentrations at a desired level to optimize clinical outcome. The vast majority of marketed drugs do not require TDM, suggesting the clinical benefit of TDM has not been sufficiently demonstrated in most cases. With the continued emergence and prominence of monoclonal antibodies (mAbs) as drugs, especially in inflammation and cancer therapeutic areas, we are at a juncture to consider applicability of TDM for mAbs. PMID:26971373

  15. Can Current Electronic Systems Meet Drug Safety and Effectiveness Requirements?

    PubMed Central

    Holbrook, Anne; Grootendorst, Paul; Willison, Don; Goldsmith, Charles; Sebaldt, Rolf; Keshavjee, Karim

    2005-01-01

    Background Every health policy jurisdiction is endeavoring to enhance its ability to evaluate drug effectiveness, safety and cost in the real world (pharmacosurveillance). Methods A nominal group consensus conference of stakeholders finalized data items deemed necessary for pharmacosurveillance. Large administrative datasets (LADs), electronic health records (EHRs) and electronic patient registries (PRs), were investigated as sources of this information and for their vulnerability to methodologic bias. Health data privacy legislation and research guidelines were systematically reviewed for their constraint to linked data resource analyses. Results More than 129 data items were strongly recommended for routine pharmacosurveillance. LADs had very complete information, but restricted to a small number of required data items. EHRs, especially with e-pharmacy links, offer by far the most complete set of health information domains but data entry completeness is highly variable. Adjustment methods for channeling bias are inadequate to mimic randomized trials. Anonymized, linked data held within a secure academic research environment, poses the least privacy concerns. Conclusions Notwithstanding major technical, methodologic and privacy challenges, individual-level linkage of health data resources poses the best option for pharmacosurveillance today. In future, drug regulators and reimbursement agencies should consider mandatory post-marketing randomized trials. PMID:16779057

  16. New fast beam profile monitor for electron-positron colliders.

    PubMed

    Bogomyagkov, A V; Gurko, V F; Zhuravlev, A N; Zubarev, P V; Kiselev, V A; Meshkov, O I; Muchnoi, N Yu; Selivanov, A N; Smaluk, V V; Khilchenko, A D

    2007-04-01

    A new fast beam profile monitor has been developed at the Budker Institute of Nuclear Physics. This monitor is based on the Hamamatsu multianode photomultiplier with 16 anode strips and provides turn-by-turn measurement of the transverse beam profile. The device is equipped with an internal memory, which has enough capacity to store 131,072 samples of the beam profile. The dynamic range of the beam profile monitor allows us to study turn-by-turn beam dynamics within the bunch charge range from 1 pC up to 10 nC. Using this instrument, we have investigated at the VEPP-4M electron-positron collider a number of beam dynamics effects which cannot be observed by other beam diagnostics tools. PMID:17477653

  17. eDrug: a dynamic interactive electronic drug formulary for medical students

    PubMed Central

    Maxwell, Simon R J; McQueen, Daniel S; Ellaway, Rachel

    2006-01-01

    What is already known about this subject Delivering education about an ever-increasing number of prescribable drugs to medical students represents a major challenge. Drug names are generally not logical or intuitive, and many students find learning them akin to learning a foreign language. Pharmacology and therapeutics teaching is struggling for visibility in some integrated medical curricula. What this study adds Development of electronic tools allowing web delivery of a restricted student formulary facilitates dynamic access to core learning materials, improves the profile of this aspect of the curriculum and is highly appreciated by students. Aims Prescribing drugs is a key responsibility of a doctor and requires a solid grounding in the relevant scientific disciplines of pharmacology and therapeutics (PT). The move away from basic science disciplines towards a more system-based and integrated undergraduate curriculum has created difficulties in the delivery of PT teaching in some medical schools. We aimed to develop a web-based strategy to overcome these problems and improve the PT learning experience. Methods We designed and introduced ‘eDrug’, a dynamic interactive web-based student formulary, as an aid to teaching and learning of PT throughout a 5-year integrated medical curriculum in a UK medical school of 1300 students. This was followed by a prospective observational study of student-reported views about its impact on their PT learning experience. Results eDrug was rated highly by students and staff, with the main benefits being increased visibility of PT in the curriculum, clear identification of core drugs, regular sourcing of drug information via direct links to accredited sources including the British National Formulary, prioritization of learning, immediate access and responsiveness. It has also served as a focus of discussion concerning core PT learning objectives amongst staff and students. Conclusions Web-based delivery of PT learning

  18. Effects of Shared Electronic Health Record Systems on Drug-Drug Interaction and Duplication Warning Detection

    PubMed Central

    Rinner, Christoph; Grossmann, Wilfried; Sauter, Simone Katja; Wolzt, Michael; Gall, Walter

    2015-01-01

    Shared electronic health records (EHRs) systems can offer a complete medication overview of the prescriptions of different health care providers. We use health claims data of more than 1 million Austrians in 2006 and 2007 with 27 million prescriptions to estimate the effect of shared EHR systems on drug-drug interaction (DDI) and duplication warnings detection and prevention. The Austria Codex and the ATC/DDD information were used as a knowledge base to detect possible DDIs. DDIs are categorized as severe, moderate, and minor interactions. In comparison to the current situation where only DDIs between drugs issued by a single health care provider can be checked, the number of warnings increases significantly if all drugs of a patient are checked: severe DDI warnings would be detected for 20% more persons, and the number of severe DDI warnings and duplication warnings would increase by 17%. We show that not only do shared EHR systems help to detect more patients with warnings but DDIs are also detected more frequently. Patient safety can be increased using shared EHR systems. PMID:26682218

  19. Development and application of a system for monitoring drug abuse: the Malaysian experience.

    PubMed

    Navaratnam, V; Foong, K

    1989-01-01

    Monitoring systems are useful epidemiological instruments for assessing the problem of drug abuse. The rapid growth of the drug dependence problem in Malaysia led to increased awareness of the need for a system for continuous monitoring of the situation. Preliminary work on the design of an appropriate monitoring system was initiated in 1976. A fully integrated national reporting system was established in 1978, linking all public services and agencies coming into contact with drug-dependent persons, including law enforcement agencies, drug abuse treatment and rehabilitation centres, and social and welfare institutions. The information system included a mechanism for systematic gathering, processing, analysing and presenting essential data on the prevention, control and management of drug abuse problems. It also included reporting on drug-related events, such as hospitalizations and arrests, as well as data on known drug-dependent persons and new cases of dependence. The system has been used for routine monitoring of the extent, trends, patterns and other characteristics of drug abuse problems in Malaysia, providing basic information for policy-making and programme planning. On the basis of data generated by the system, it was estimated that the prevalence rate of drug-dependent persons per 100,000 population increased from 84.3 in 1976 to 754.6 in 1986. It was estimated that there were 119,001 drug-dependent persons in Malaysia in 1986. PMID:2765720

  20. Engineered hybrid cardiac patches with multifunctional electronics for online monitoring and regulation of tissue function

    NASA Astrophysics Data System (ADS)

    Feiner, Ron; Engel, Leeya; Fleischer, Sharon; Malki, Maayan; Gal, Idan; Shapira, Assaf; Shacham-Diamand, Yosi; Dvir, Tal

    2016-06-01

    In cardiac tissue engineering approaches to treat myocardial infarction, cardiac cells are seeded within three-dimensional porous scaffolds to create functional cardiac patches. However, current cardiac patches do not allow for online monitoring and reporting of engineered-tissue performance, and do not interfere to deliver signals for patch activation or to enable its integration with the host. Here, we report an engineered cardiac patch that integrates cardiac cells with flexible, freestanding electronics and a 3D nanocomposite scaffold. The patch exhibited robust electronic properties, enabling the recording of cellular electrical activities and the on-demand provision of electrical stimulation for synchronizing cell contraction. We also show that electroactive polymers containing biological factors can be deposited on designated electrodes to release drugs in the patch microenvironment on demand. We expect that the integration of complex electronics within cardiac patches will eventually provide therapeutic control and regulation of cardiac function.

  1. Materials for Stretchable Electronics - Electronic Eyeballs, Brain Monitors and Other Applications

    ScienceCinema

    Rogers, John A. [University of Illinois, Urbana Champaign, Illinois, United States

    2010-01-08

    Electronic circuits that involve transistors and related components on thin plastic sheets or rubber slabs offer mechanical properties (e.g. bendability, stretchability) and other features (e.g. lightweight, rugged construction) which cannot be easily achieved with technologies that use rigid, fragile semiconductor wafer or glass substrates.  Device examples include personal or structural health monitors and electronic eye imagers, in which the electronics must conform to complex curvilinear shapes or flex/stretch during use.  Our recent work accomplishes these technology outcomes by use of single crystal inorganic nanomaterials in ?wavy? buckled configurations on elastomeric supports.  This talk will describe key fundamental materials and mechanics aspects of these approaches, as well as engineering features of their use in individual transistors, photodiodes and integrated circuits.  Cardiac and brain monitoring devices provide examples of application in biomedicine; hemispherical electronic eye cameras illustrate new capacities for bio-inspired device design.

  2. Real time monitoring of drug action on T. cruzi parasites using a biospeckle laser method

    NASA Astrophysics Data System (ADS)

    Ansari, M. Z.; Grassi, H. C.; Cabrera, H.; Andrades, E. D. J.

    2016-06-01

    In this paper, we report on a biospeckle laser method used to monitor a specific drug action on T. cruzi parasites. Experimental results from fast biospeckle monitoring of the parasites’ activity under the influence of the drug demonstrate the effectiveness of the proposed method. We measure the speckle parameters such as spatiotemporal correlation and speckle grain size to assess the immediate action of the drug on the parasites during a very short incubation period. From a practical point of view, this aproach allows us to validate biospeckle as a fast, non-invasive and alternative method to test candidate drugs on T. cruzi parasites.

  3. Beam Charge Asymmetry Monitors for Low Intensity Continuous Electron Beam

    SciTech Connect

    Jean-Claude Denard; Arne P. Freyberger; Youri Sharabian

    2001-05-01

    Experimental Hall B at Jefferson Lab typically operates with CW electron beam currents in the range of 1 - 10 nA. This low beam current coupled with a 30 Hz flip rate of the beam helicity required the development of new devices to measure and monitor the beam charge asymmetry. We have developed four independent devices with sufficient bandwidth for readout at 30 Hz rate: a synchrotron light monitor (SLM), two backward optical transition radiation monitors (OTR) and a Faraday Cup. Photomultipliers operating in current mode provided the readout of the light from the SLM and the OTRs, while high bandwidth electronics provided the readout from the Faraday cup. Using {approximately}6 helicity pairs, we measured the beam charge asymmetry to a statistically accuracy which is better than 0.05%. We present the results from the successful operation of these devices during the fall 2000 physics program. The reliability and the bandwidth of the devices allowed us to control the gain on the source laser by means of a feedback loop.

  4. High-priority drug–drug interactions for use in electronic health records

    PubMed Central

    Desai, Amrita A; Bell, Douglas; Yoshida, Eileen; Doole, John; Czochanski, Melissa; Middleton, Blackford; Bates, David W

    2012-01-01

    Objective To develop a set of high-severity, clinically significant drug–drug interactions (DDIs) for use in electronic health records (EHRs). Methods A panel of experts was convened with the goal of identifying critical DDIs that should be used for generating medication-related decision support alerts in all EHRs. Panelists included medication knowledge base vendors, EHR vendors, in-house knowledge base developers from academic medical centers, and both federal and private agencies involved in the regulation of medication use. Candidate DDIs were assessed by the panel based on the consequence of the interaction, severity levels assigned to them across various medication knowledge bases, availability of therapeutic alternatives, monitoring/management options, predisposing factors, and the probability of the interaction based on the strength of evidence available in the literature. Results Of 31 DDIs considered to be high risk, the panel approved a final list of 15 interactions. Panelists agreed that this list represented drugs that are contraindicated for concurrent use, though it does not necessarily represent a complete list of all such interacting drug pairs. For other drug interactions, severity may depend on additional factors, such as patient conditions or timing of co-administration. Discussion The panel provided recommendations on the creation, maintenance, and implementation of a central repository of high severity interactions. Conclusions A set of highly clinically significant drug-drug interactions was identified, for which warnings should be generated in all EHRs. The panel highlighted the complexity of issues surrounding development and implementation of such a list. PMID:22539083

  5. Stability of bioreductive drug delivery systems containing melphalan is influenced by conformational constraint and electronic properties of substituents.

    PubMed

    Weerapreeyakul, N; Hollenbeck, R G; Chikhale, P J

    2000-11-01

    The stability of bioreductive drug delivery systems (TDDS) was monitored at various pH values and in the presence of glutathione (GSH). Results suggest that steric hindrance due to conformational constraint in TDDS led to an increase in stability of TDDS toward nucleophilic degradation under aqueous conditions. The electronic properties of substituents influenced TDDS stability at different pH values and in the presence of GSH. PMID:11078186

  6. A cardiomyocyte-based biosensor for antiarrhythmic drug evaluation by simultaneously monitoring cell growth and beating.

    PubMed

    Wang, Tianxing; Hu, Ning; Cao, Jiayue; Wu, Jieying; Su, Kaiqi; Wang, Ping

    2013-11-15

    Drug-induced cardiotoxicity greatly endangers the human health and results in resource waste. Also, it is a leading attribution to drug withdrawal and late-stage attrition in pharmaceutical industry. In the study, a dual function cardiomyocyte-based biosensor was introduced for rapid drug evaluation with xCELLigence RTCA Cardio system. The cardiomyocyte-based biosensor can monitor the cardiomyocyte growth and beating status simultaneously under the drug effects. Two typical cardiovascular drug, verapamil and flecainide were selected as treatment agents to test the performance of this biosensor. The experiment results showed that the performance of cardiomyocyte-based biosensor verified the basic drug effects by beating status and also tested the drug cytotoxicity by the cell index curves of cardiomyocyte growth. Based on the advanced sensor detection technology and cell culture technology, this cardiomyocyte-based biosensor will be a utility platform for the drug preclinical assessment. PMID:23708811

  7. Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2001.

    ERIC Educational Resources Information Center

    Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.

    This report presents an overview of the key findings from the Monitoring the Future 2001 nationwide survey of 8th, 10th, and 12th grade students. A particular emphasis is placed on recent trends in the use of licit and illicit drugs. Trends in the levels of perceived risk and personal disapproval associated with each drug--which this study has…

  8. Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 1999.

    ERIC Educational Resources Information Center

    Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.

    This booklet presents an overview of the findings pertaining to eighth, tenth, and twelfth grade students from the 1999 Monitoring the Future Study. This overview focuses on recent trends in the use of various licit and illicit drugs. It also examines trends in the levels of perceived risk and personal disapproval associated with each drug, which…

  9. Monitoring the Future: National Results on Adolescent Drug Use. Overview of Key Findings, 2002.

    ERIC Educational Resources Information Center

    Michigan Univ., Ann Arbor. Inst. for Social Research.

    This report presents an overview of the key findings from the Monitoring the Future 2002 nationwide survey of 8th, 10th, and 12th grade students. A particular emphasis is placed on recent trends in the use of licit and illicit drugs. Trends in the levels of perceived risk and personal disapproval associated with each drug--which this study has…

  10. Challenges in implementing electronic hand hygiene monitoring systems.

    PubMed

    Conway, Laurie J

    2016-05-01

    Electronic hand hygiene (HH) monitoring systems offer the exciting prospect of a more precise, less biased measure of HH performance than direct observation. However, electronic systems are challenging to implement. Selecting a system that minimizes disruption to the physical infrastructure and to clinician workflow, and that fits with the organization's culture and budget, is challenging. Getting front-line workers' buy-in and addressing concerns about the accuracy of the system and how the data will be used are also difficult challenges. Finally, ensuring information from the system reaches front-line workers and is used by them to improve HH practice is a complex challenge. We describe these challenges in detail and suggests ways to overcome them. PMID:27131139

  11. The LUCID detector ATLAS luminosity monitor and its electronic system

    NASA Astrophysics Data System (ADS)

    Manghi, F. Lasagni

    2016-07-01

    In 2015 LHC is starting a new run, at higher center of mass energy (13 TeV) and with 25 ns bunch-spacing. The ATLAS luminosity monitor LUCID has been completely rebuilt, both the detector and the electronics, in order to cope with the new running conditions. The new detector electronics features a new read-out board (LUCROD) for signal acquisition and digitization, PMT-charge integration and single-side luminosity measurements, and a revisited LUMAT board for combination of signals from the two detectors. This note describes the new board design, the firmware and software developments, the implementation of luminosity algorithms, the optical communication between boards and the integration into the ATLAS TDAQ system.

  12. "Not just eliminating the mosquito but draining the swamp": A critical geopolitics of Turkish Monitoring Center for Drugs and Drug Addiction and Turkey's approach to illicit drugs.

    PubMed

    Evered, Kyle T; Evered, Emine Ö

    2016-07-01

    In the 1970s, Turkey ceased to be a significant producer state of illicit drugs, but it continued to serve as a key route for the trade of drugs between East and West. Over the past decade, however, authorities identified two concerns beyond its continued transit state status. These reported problems entail both new modes of production and a rising incidence of drug abuse within the nation-state - particularly among its youth. Amid these developments, new law enforcement institutions emerged and acquired European sponsorship, leading to the establishment of TUBİM (the Turkish Monitoring Center for Drugs and Drug Addiction). Coordinating with and reporting to the European Union agency EMCDDA (the European Monitoring Center for Drugs and Drug Addiction), TUBİM's primary assigned duties entail the collection and analysis of data on drug abuse, trafficking, and prevention, the geographic identification of sites of concern (e.g. consumption, drug-related crimes, and peoples undergoing treatment), and the production of annual national reports. In this article, we examine the geopolitical origins of TUBİM as Turkey's central apparatus for confronting drug problems and its role as a vehicle for policy development, interpretation, and enforcement. In doing so, we emphasize the political and spatial dimensions inherent to the country's institutional and policy-driven approaches to contend with drug-related problems, and we assess how this line of attack reveals particular ambiguities in mission when evaluated from scales at world regional, national, and local levels. In sum, we assess how Turkey's new institutional and legislative landscapes condition the state's engagements with drug use, matters of user's health, and policy implementation at local scales and amid ongoing political developments. PMID:27267659

  13. The ESA Rad-Hard electron monitor (RADEM) for JUICE

    NASA Astrophysics Data System (ADS)

    Desorgher, Laurent; Hajdas, Wojtek; Goncalves, Patricia; Pinto, Costa; Marques, Arlindo; Chastellain, Frédéric; Gambarara, Fabio; Muff, Reto; Maehlum, Gunnar; Meier, Dirk

    2014-05-01

    The ESA Jupiter Icy moons explorer (JUICE) mission will encounter a harsh radiation environment that is known to be severe but that is not yet fully understood. The Rad-Hard electron monitor (RADEM), currently under development, is a compact instrument (1L, 1kg, 2.2W) that will be set on JUICE for measuring the radiation environment during the mission. Its design is adapted to the harsh Jovian radiation environment and optimized for the detection of high energetic electrons. RADEM will consist of three detector subunits. The magneto-spectrometer will measure the electron spectrum in the 0.3 to 40 MeV range. The directionality sensor will characterize the pitch angle distribution of the electron environment. The Silicon stack detector will be dedicated to measure the spectrum of solar and Jovian protons, as well as the LET spectrum of heavy ions. In this paper we present the status of the development of RADEM, as well as Geant4 Monte Carlo analysis of the capability of the instruments.

  14. Photonic monitoring of chitosan nanostructured alginate microcapsules for drug release

    NASA Astrophysics Data System (ADS)

    Khajuria, Deepak Kumar; Konnur, Manish C.; Vasireddi, Ramakrishna; Roy Mahapatra, D.

    2015-02-01

    By using a novel microfluidic set-up for drug screening applications, this study examines delivery of a novel risedronate based drug formulation for treatment of osteoporosis that was developed to overcome the usual shortcomings of risedronate, such as its low bioavailability and adverse gastric effects. Risedronate nanoparticles were prepared using muco-adhesive polymers such as chitosan as matrix for improving the intestinal cellular absorption of risedronate and also using a gastric-resistant polymer such as sodium alginate for reducing the gastric inflammation of risedronate. The in-vitro characteristics of the alginate encapsulated chitosan nanoparticles are investigated, including their stability, muco-adhesiveness, and Caco-2 cell permeability. Fluorescent markers are tagged with the polymers and their morphology within the microcapsules is imaged at various stages of drug release.

  15. Single-Molecule Electronic Monitoring of DNA Polymerase Activity

    NASA Astrophysics Data System (ADS)

    Marushchak, Denys O.; Pugliese, Kaitlin M.; Turvey, Mackenzie W.; Choi, Yongki; Gul, O. Tolga; Olsen, Tivoli J.; Rajapakse, Arith J.; Weiss, Gregory A.; Collins, Philip G.

    Single-molecule techniques can reveal new spatial and kinetic details of the conformational changes occurring during enzymatic catalysis. Here, we investigate the activity of DNA polymerases using an electronic single-molecule technique based on carbon nanotube transistors. Single molecules of the Klenow fragment (KF) of polymerase I were conjugated to the transistors and then monitored via fluctuations in electrical conductance. Continuous, long-term monitoring recorded single KF molecules incorporating up to 10,000 new bases into single-stranded DNA templates. The duration of individual incorporation events was invariant across all analog and native nucleotides, indicating that the precise structure of different base pairs has no impact on the timing of incorporation. Despite similar timings, however, the signal magnitudes generated by certain analogs reveal alternate conformational states that do not occur with native nucleotides. The differences induced by these analogs suggest that the electronic technique is sensing KF's O-helix as it tests the stability of nascent base pairs.

  16. Computer System for Monitoring Drug Effects in Psychopharmacologic Research

    PubMed Central

    Latham, Georgia S.; Martinez, Rick; Sunderland, Trey

    1990-01-01

    To aid in the evaluation of cognitive effects and side effects of drugs in psychopharmacologic trials, a computerized battery was developed to assess memory, attention, mood, physical side effects, and reaction time. Parallel forms of the battery allow for repeated measures within subjects design. All aspects of task performance are automatically recorded, permitting qualification of drug-induced effects on multiple stages of information processing. Data collected with the battery can be output as hard copy case reports or files formatted for statistical analysis. The battery and its utility in psychopharmacologic trials are described.

  17. Spontaneous Reporting of Adverse Drug Reactions through Electronic Submission from Regional Society Healthcare Professionals in Korea

    PubMed Central

    Lee, Jae-Hyun; Park, Kyung Hee; Moon, Hyun Joo; Lee, Yong Won; Park, Jung-Won

    2012-01-01

    Purpose Pharmacovigilance Research Network built a spontaneous reporting system and collected adverse drug reactions (ADRs) by electronic submission (e-sub) in Korea. We analyzed ADRs spontaneously reported through e-sub from regional health professionals. Materials and Methods Nine hundred and thirty three ADR cases were collected and analyzed from January to December in 2008. "A matter" was defined as one symptom matched to one culprit drug included in an ADR case. We collected and analyzed e-sub ADR cases and matters to determine common culprits and organ specified ADR matters. Results There were 3,049 matters in 933 ADR cases for 1 year, and 3.3 matters per case were reported. In organ specific ADR classification, skin reactions which took the first place in 866 matters (28%) included urticaria and rash. The next cases were neurologic symptom (624 matters, 21%) and gastrointestinal symptom (581 matters, 19%). Doctor (53%) and pharmacist (31%) were the most important participants in e-sub spontaneous reporting system, and 3% of ADR cases were reported by patients or their guardians. WHO-Uppsala Monitoring Center causality assessment results showed certain 10.6%, probable 37.7%, possible 41.7% and below unlikely 10.0%. Culprit drugs were antibiotics (23.4%), neurologic agents (14.7%) and non-steroidal anti-inflammatory drugs (9.4%). Conclusion In our study, antibiotic was most common culprit drug, and skin manifestation was most common symptom in e-sub ADRs collected from regional healthcare practitioners in Korea. PMID:22869488

  18. Early monitoring for detection of antituberculous drug-induced hepatotoxicity

    PubMed Central

    Lee, Chang Min; Lee, Sang Soo; Lee, Jeong Mi; Cho, Hyun Chin; Kim, Wan Soo; Kim, Hong Jun; Ha, Chang Yoon; Kim, Hyun Jin; Kim, Tae Hyo; Jung, Woon Tae; Lee, Ok Jae

    2016-01-01

    Background/Aims: We investigated the time of onset of antituberculous drug-induced hepatotoxicity (ADIH) and related characteristics. Methods: Adult patients (n = 1,031) treated with first-line antituberculous drugs between February 2009 and January 2013 were enrolled. Results: Of the 1,031 patients, 108 patients (10.5%) developed ADIH a mean of 39.6 ± 43.7 days after treatment initiation. Twenty-eight patients (25.9%) developed ADIH within 7 days, 73 (67.6%) within 30 days, and the rest after 30 days. The ≤ 30-day group was characterized by higher peak alanine aminotransferase (ALT) level and a high proportion of patients with maintenance of first-line antituberculous drugs compared to the > 30-day group. In subgroup analysis, the ≤ 7-day group was characterized by higher baseline aspartate aminotransferase and ALT, high proportion of patients with maintenance of first-line antituberculous drugs, and high proportion of patients with extrapulmonary tuberculosis compared to patients with ADIH that developed beyond 7 days. In multivariate analysis, serum ALT > 40 IU/L (odds ratio [OR], 2.995; 95% confidence interval [CI], 1.580 to 5.680; p = 0.001) and presence of anti-hepatitis C virus (OR, 4.204; 95% CI, 1.822 to 9.700, p = 0.001) were independent risk factors for development of ADIH. Conclusions: Approximately 70% of the cases of ADIH occurred in the first month of antituberculous treatment, and were associated with continuation of the first-line drug regimen. PMID:26767859

  19. Computer-generated reports for monitoring variances in the drug budget.

    PubMed

    Horner, L B; Keys, P W

    1987-04-01

    A computerized pharmaceutical-purchasing cost-management system that can be used to monitor variances in the drug budget is described. Variance reports on inflation, volume of drugs used, and changes in inventory are generated monthly to determine whether the pharmacy is operating within its budget. The reports are processed on an IBM personal computer with the use of a dBASE-III management software package. The price and quantity of each drug, as specified in the standard drug budget, are entered into the system; using approximately four hours per month is required for entry of the quantities and prices of drugs received as noted on the invoice. Variances in the budget are reviewed, and drug-use data are assessed to determine trends. Demand intensity (use per 1000 cases) is also tracked to determine the effects of educational programs on the proper use of drugs. Variance reports generated by a computerized budget-monitoring system provide the pharmacy with timely cost data that can be used to monitor the effects of drug-use guidelines and educational programs on the budget. PMID:3578310

  20. [Potential clinical benefit of therapeutic drug monitoring of imatinib in oncology].

    PubMed

    Turjap, M; Juřica, J; Demlová, R

    2015-01-01

    Imatinib mesylate is a competitive inhibitor of BCR/ ABL tyrosine kinase and inhibits also several receptor tyrosin kinases. Since its launch to the market, imatinib has proven to be very valuable in the treatment of Philadelphia chromosome (BCR/ ABL) -  positive (Ph+) chronic myeloid leukemia and Kit (CD117) positive gastrointestinal stromal tumors. The drug is metabolized by cytochrome P450, and there are many clinically important pharmacokinetic drug-drug interactions described in the literature. Frequent polypharmacy in oncological patients increases probability of such interactions, and also adherence may play its role during longterm treatment. Fixed dosing therapeutic regimens fail to respect known interindividual variability in pharmacokinetics of the drug and thus, some patients may not achieve sufficient plasma concentrations. Based on current evidence, there seems to be a relationship between plasma concentration and clinical response to imatinib. Therefore, imatinib appears to be suitable candidate for therapeutic drug monitoring. Here, we present an overview of pharmacokinetics, drug-drug interactions and current knowledge and suggestions on therapeutic drug monitor-ing of imatinib, its potential benefits and limitations. PMID:25882020

  1. Modeling drug exposure data in electronic medical records: an application to warfarin.

    PubMed

    Liu, Mei; Jiang, Min; Kawai, Vivian K; Stein, Charles M; Roden, Dan M; Denny, Joshua C; Xu, Hua

    2011-01-01

    Identification of patients' drug exposure information is critical to drug-related research that is based on electronic medical records (EMRs). Drug information is often embedded in clinical narratives and drug regimens change frequently because of various reasons like intolerance or insurance issues, making accurate modeling challenging. Here, we developed an informatics framework to determine patient drug exposure histories from EMRs by combining natural language processing (NLP) and machine learning (ML) technologies. Our framework consists of three phases: 1) drug entity recognition - identifying drug mentions; 2) drug event detection - labeling drug mentions with a status (e.g., "on" or "stop"); and 3) drug exposure modeling - predicting if a patient is taking a drug at a given time using the status and temporal information associated with the mentions. We applied the framework to determine patient warfarin exposure at hospital admissions and achieved 87% precision, 79% recall, and an area under the receiver-operator characteristic curve of 0.93. PMID:22195139

  2. Modern Methods for Analysis of Antiepileptic Drugs in the Biological Fluids for Pharmacokinetics, Bioequivalence and Therapeutic Drug Monitoring

    PubMed Central

    Park, Yoo-Sin; Kim, Shin-Hee; Kim, Sang-Hyun; Jun, Min-Young

    2011-01-01

    Epilepsy is a chronic disease occurring in approximately 1.0% of the world's population. About 30% of the epileptic patients treated with availably antiepileptic drugs (AEDs) continue to have seizures and are considered therapy-resistant or refractory patients. The ultimate goal for the use of AEDs is complete cessation of seizures without side effects. Because of a narrow therapeutic index of AEDs, a complete understanding of its clinical pharmacokinetics is essential for understanding of the pharmacodynamics of these drugs. These drug concentrations in biological fluids serve as surrogate markers and can be used to guide or target drug dosing. Because early studies demonstrated clinical and/or electroencephalographic correlations with serum concentrations of several AEDs, It has been almost 50 years since clinicians started using plasma concentrations of AEDs to optimize pharmacotherapy in patients with epilepsy. Therefore, validated analytical method for concentrations of AEDs in biological fluids is a necessity in order to explore pharmacokinetics, bioequivalence and TDM in various clinical situations. There are hundreds of published articles on the analysis of specific AEDs by a wide variety of analytical methods in biological samples have appears over the past decade. This review intends to provide an updated, concise overview on the modern method development for monitoring AEDs for pharmacokinetic studies, bioequivalence and therapeutic drug monitoring. PMID:21660146

  3. Prescription Drug Monitoring Program Inquiry in Psychiatric Assessment: Detection of High Rates of Opioid Prescribing to a Dual Diagnosis Population

    PubMed Central

    Hackman, Daniel T.; Greene, Marion S.; Fernandes, Taya J.; Brown, Ashley M.; Wright, Eric R.; Chambers, R. Andrew

    2015-01-01

    Objective An epidemic of prescription drug abuse is disproportionately impacting the mentally ill. We examined the utility of a state prescription drug monitoring database for assessing recent controlled substance prescribing to patients presenting for dual diagnosis treatment. Method In a community mental health center that provides integrated dual diagnosis care, we queried the Indiana Scheduled Prescription Electronic Collection and Tracking (INSPECT) system for all cases that were open as of August 2, 2011, and had been practitioner-diagnosed (per DSM-IV criteria) by January 2, 2012. INSPECT provided a record of controlled substance dispensations to each patient; diagnostic evaluation was conducted blind from prescription data compilation covering the prior 12 months. Demographic data, insurance status, and DSM-IV diagnoses were compiled from the clinic's electronic medical record. Results The sample (N = 201) was 51% female, 56% white, and two-thirds uninsured. Over 80% were dually diagnosed with substance use disorders and psychotic, mood, or anxiety disorders. Nicotine and alcohol disorders were identified in most, with about a third diagnosed with cannabis, cocaine, or opioid disorders. A majority of patients (n = 115) had been prescribed opioids in the prior year, with nearly 1 in 5 prescribed an opioid and benzodiazepine simultaneously. Patients were dispensed a mean of 4 opioid prescriptions and 213 opioid pills. More opioid prescriptions correlated with opioid dependence (OR = 1.08; 95% CI, 1.016–1.145), and more prescribers correlated with personality disorder diagnoses (OR = 1.112; 95% CI, 1.001–1.235). Higher rates and riskier patterns of controlled substance prescribing were identified in patients with Medicaid/Medicare insurance compared to uninsured patients. Conclusions Prescription drug monitoring is a powerful tool for assessing addictions and high frequencies of patient exposures to prescribed opioids in a dual diagnosis clinic. Improved

  4. [Gaviscon in reflux symptoms. Results of a drug monitoring study].

    PubMed

    Hutt, H J; Tauber, O; Flach, D

    1990-10-30

    335 general practitioners participated in an observational study of the alginic acid-containing antacid preparation Gaviscon over a period of eight months. In this period, 2927 patients with reflux disease were treated. Some 62.3% of the patients were treated for six to eight days. Both the tablet and suspension forms of the drug were considered to be effective by both physician and patient in more than 94% of the cases. Drug toleration was also considered good in more than 95% of the cases. The taste of Gaviscon was described as good by 54.7% of the patients, and acceptable by 33.5%. Pregnant women with reflux symptoms were observed in a separate group (n = 52). PMID:2258131

  5. Prioritising anticancer drugs for environmental monitoring and risk assessment purposes.

    PubMed

    Booker, Victoria; Halsall, Crispin; Llewellyn, Neville; Johnson, Andrew; Williams, Richard

    2014-03-01

    Anticancer drugs routinely used in chemotherapy enter wastewater through the excretion of the non-metabolised drug following administration to patients. This study considers the consumption and subsequent behaviour and occurrence of these chemicals in aquatic systems, with the aim of prioritising a selection of these drugs which are likely to persist in the environment and hence be considered for environmental screening programmes. Accurate consumption data were compiled from a hospital survey in NW England and combined with urinary excretion rates derived from clinical studies. Physical-chemical property data were compiled along with likely chemical fate and persistence during and after wastewater treatment. A shortlist of 15 chemicals (from 65) was prioritised based on their consumption, persistency and likelihood of occurrence in surface waters and supported by observational studies where possible. The ecological impact of these 'prioritised' chemicals is uncertain as the measured concentrations in surface waters generally fall below standard toxicity thresholds. Nonetheless, this prioritised sub-list should prove useful for developing environmental screening programmes. PMID:24369294

  6. 78 FR 42084 - Electronic Study Data Submission; Data Standard Support; Availability of the Center for Drug...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... HUMAN SERVICES Food and Drug Administration Electronic Study Data Submission; Data Standard Support; Availability of the Center for Drug Evaluation and Research Data Standards Program Documents AGENCY: Food and...) of the Food and Drug Administration (FDA) is announcing the availability of the CDER Data...

  7. Therapeutic drug monitoring of tamoxifen using LC-MS/MS.

    PubMed

    Tchu, Simone M; Lynch, Kara L; Wu, Alan H B

    2012-01-01

    Tamoxifen is a selective estrogen receptor modulator (SERM) that is used widely in the treatment of estrogen receptor positive breast cancer (ER+). Therapeutic monitoring of tamoxifen, and its metabolites N-desmethyltamoxifen (NDTam) and 4-hydroxy-N-desmethyltamoxifen (endoxifen), may be clinically useful for guiding treatment decisions. Two significant barriers to tamoxifen efficacy are: (1) variability in conversion of tamoxifen into the potent antiestrogenic metabolite, endoxifen, and (2) poor compliance and adherence to tamoxifen therapy. Therapeutic monitoring can be used to address both of these issues. Low levels of endoxifen indicate either poor compliance or poor metabolism of tamoxifen. Low tamoxifen levels would suggest poor compliance while a low ratio of endoxifen to NDTam would be indicative of poor metabolism. Solid phase extraction of patient serum followed by liquid chromatography tandem mass spectrometry (LC-MS/MS) detection enables rapid, accurate, detection of tamoxifen, N-desmethyltamoxifen, and endoxifen. PMID:22767121

  8. On the Slow Diffusion of Point-of-Care Systems in Therapeutic Drug Monitoring

    PubMed Central

    Sanavio, Barbara; Krol, Silke

    2015-01-01

    Recent advancements in point-of-care (PoC) technologies show great transformative promises for personalized preventative and predictive medicine. However, fields like therapeutic drug monitoring (TDM), that first allowed for personalized treatment of patients’ disease, still lag behind in the widespread application of PoC devices for monitoring of patients. Surprisingly, very few applications in commonly monitored drugs, such as anti-epileptics, are paving the way for a PoC approach to patient therapy monitoring compared to other fields like intensive care cardiac markers monitoring, glycemic controls in diabetes, or bench-top hematological parameters analysis at the local drug store. Such delay in the development of portable fast clinically effective drug monitoring devices is in our opinion due more to an inertial drag on the pervasiveness of these new devices into the clinical field than a lack of technical capability. At the same time, some very promising technologies failed in the clinical practice for inadequate understanding of the outcome parameters necessary for a relevant technological breakthrough that has superior clinical performance. We hope, by over-viewing both TDM practice and its yet unmet needs and latest advancement in micro- and nanotechnology applications to PoC clinical devices, to help bridging the two communities, the one exploiting analytical technologies and the one mastering the most advanced techniques, into translating existing and forthcoming technologies in effective devices. PMID:25767794

  9. Response of radiation monitoring labels to gamma rays and electrons

    NASA Astrophysics Data System (ADS)

    Rahim, F. Abdel; Miller, A.; McLaughlin, W. L.

    Many kinds of coated or impregnated reflecting papers change color or become colored by large radiation doses. Such papers or "labels" do not generally supply dosimetry information, but may give useful inventory information, namely a visual indication of whether or not an industrial product or location has been irradiated to high doses. Among labels available worldwide, a few are suitable for indicating absorbed dose regions of slightly less than 10 4 Gy (< 1 Mrad), and some are intended for monitoring high dose ranges (i.e., sterilization dose levels of > 10 4 Gy or > 1 Mrad), and in some cases even up to very high dose regions (˜10 5 to 10 6 Gy or ˜10 to 100 Mrad). Only one labels which is expected to be commercially available, was studied for lower dose levels, 10 1-10 3 Gy (1-100 krad), namely one based on polymerization of diacetylene. Tests of stability, sensitivity of ambient light, and differences in dose rate and radiation type (gamma rays and electron beams) were made on 15 kinds of labels. The results show that, for many types of indicators, diverse effects may give misleading conclusions unless countermeasures are taken. For example, some of the most commonly used labels, which contain dyes that indicate changes of pH due to release of halogen from halogenated substrates, have limited shelf life and must be protected from extreme environmental conditions. Some also show a marked rate dependence of response. Readings of color reflection optical densities on labels or long paper strips permit somewhat more precise discrimination of dose levels, and may sometimes be useful for monitoring differences in local dose distributions or area monitoring of radiation damage probabilities around particle accelerators or large radionuclide sources.

  10. Beam position monitor electronics using DC coupled demodulating logarithmic amplifiers

    SciTech Connect

    Aiello, G.R.; Mills, M.R.

    1992-03-01

    An electronics circuit operating up to 120 MHz suitable for Beam Position Monitor signal processing is described. Two different channels process signals from the electrodes. Each channel is realized with two cascaded DC coupled demodulating logarithmic amplifiers, providing an output voltage proportional to the logarithm of the input signal amplitude. The outputs from the two channels are processed by differential and summing amplifiers. The difference output produces a voltage proportional to the beam displacement between the electrodes, but both the difference and sum outputs are digitized in order to allow for a software correction of the gain and offset mismatches. The electronics show better characteristics than previous implementations utilizing log-amp circuits. The dynamic range has been increased, keeping the linearity error smaller than 1% over a 65 dB input signal range. The noise characteristics have been improved providing good resolution at low currents. The RF burst response has also been tested showing good characteristics for use on a Linac or Transfer Line. One prototype, working at 60 MHz, has been built and is planned for use on one or more machines at the SSC.

  11. Clinical pharmacology and therapeutic drug monitoring of zonisamide.

    PubMed

    Mimaki, T

    1998-12-01

    Zonisamide (1,2-benzisoxazole-3-methanesulfonamide) is a new antiepileptic drug developed in Japan. This compound is insoluble in water, and it is available in tablet and powder form. In experimental animals, this compound has been found to have a strong inhibitory effect on convulsions of cortical origin because it suppresses focal spiking and the spread of secondary generalized seizures. In humans, a series of double-blind, placebo-controlled studies revealed the efficacy of zonisamide for patients with refractory partial seizures and for selected patients with infantile spasms. Its antiepileptic mechanism of action remains unclear, but it is likely to involve blockade of both sodium and T-type calcium channels. Oral bioavailability of zonisamide is excellent in healthy human volunteers. Zonisamide is slowly absorbed and has a mean tmax of 5 to 6 hours. Almost 100% of it is absorbed; there is no difference in bioavailability between tablets and powder. Zonisamide concentrations are highest in erythrocytes and then in whole blood and plasma. It is approximately 40% to 60% bound to plasma proteins, primarily albumin. Its volume distribution is 0.9 to 1.4 L/kg. In adults, the elimination half-life is between 50 and 62 hours, and it takes as long as 2 weeks to reach steady state. The dose-serum level correlation is linear up to doses of 10 to 15 mg/kg per day, and the therapeutic range is 10 to 40 microg/ml. However, the relationship between serum zonisamide levels, clinical response, and adverse effects appears weak. Concurrent enzyme-inducing anticonvulsants such as phenytoin, carbamazepine, or barbiturates stimulate zonisamide metabolism and decrease serum zonisamide levels at steady state. Although zonisamide has been reported to increase the serum levels of phenytoin and carbamazepine in some patients, the interactions of zonisamide with other antiepileptic drugs seem to be of minor clinical relevance. A pilot study of zonisamide suppositories revealed that it

  12. 77 FR 7584 - Draft Guidance for Industry on Heparin for Drug and Medical Device Use; Monitoring Crude Heparin...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Heparin for Drug and Medical Device Use; Monitoring Crude Heparin for Quality; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a...

  13. 78 FR 38058 - Guidance for Industry on Heparin for Drug and Medical Device Use: Monitoring Crude Heparin for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Heparin for Drug and Medical Device Use: Monitoring Crude Heparin for Quality; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of...

  14. Monte Carlo calculation of monitor unit for electron arc therapy

    SciTech Connect

    Chow, James C. L.; Jiang Runqing

    2010-04-15

    Purpose: Monitor unit (MU) calculations for electron arc therapy were carried out using Monte Carlo simulations and verified by measurements. Variations in the dwell factor (DF), source-to-surface distance (SSD), and treatment arc angle ({alpha}) were studied. Moreover, the possibility of measuring the DF, which requires gantry rotation, using a solid water rectangular, instead of cylindrical, phantom was investigated. Methods: A phase space file based on the 9 MeV electron beam with rectangular cutout (physical size=2.6x21 cm{sup 2}) attached to the block tray holder of a Varian 21 EX linear accelerator (linac) was generated using the EGSnrc-based Monte Carlo code and verified by measurement. The relative output factor (ROF), SSD offset, and DF, needed in the MU calculation, were determined using measurements and Monte Carlo simulations. An ionization chamber, a radiographic film, a solid water rectangular phantom, and a cylindrical phantom made of polystyrene were used in dosimetry measurements. Results: Percentage deviations of ROF, SSD offset, and DF between measured and Monte Carlo results were 1.2%, 0.18%, and 1.5%, respectively. It was found that the DF decreased with an increase in {alpha}, and such a decrease in DF was more significant in the {alpha} range of 0 deg. - 60 deg. than 60 deg. - 120 deg. Moreover, for a fixed {alpha}, the DF increased with an increase in SSD. Comparing the DF determined using the rectangular and cylindrical phantom through measurements and Monte Carlo simulations, it was found that the DF determined by the rectangular phantom agreed well with that by the cylindrical one within {+-}1.2%. It shows that a simple setup of a solid water rectangular phantom was sufficient to replace the cylindrical phantom using our specific cutout to determine the DF associated with the electron arc. Conclusions: By verifying using dosimetry measurements, Monte Carlo simulations proved to be an alternative way to perform MU calculations effectively

  15. Drug-Encoded Biomarkers for Monitoring Biological Therapies

    PubMed Central

    Bedenk, Kristina; Zhang, Qian; Frentzen, Alexa; Cappello, Joseph; Fischer, Utz; Szalay, Aladar A.

    2015-01-01

    Blood tests are necessary, easy-to-perform and low-cost alternatives for monitoring of oncolytic virotherapy and other biological therapies in translational research. Here we assessed three candidate proteins with the potential to be used as biomarkers in biological fluids: two glucuronidases from E. coli (GusA) and Staphylococcus sp. RLH1 (GusPlus), and the luciferase from Gaussia princeps (GLuc). The three genes encoding these proteins were inserted individually into vaccinia virus GLV-1h68 genome under the control of an identical promoter. The three resulting recombinant viruses were used to infect tumor cells in cultures and human tumor xenografts in nude mice. In contrast to the actively secreted GLuc, the cytoplasmic glucuronidases GusA and GusPlus were released into the supernatants only as a result of virus-mediated oncolysis. GusPlus resulted in the most sensitive detection of enzyme activity under controlled assay conditions in samples containing as little as 1 pg/ml of GusPlus, followed by GusA (25 pg/ml) and GLuc (≥375 pg/ml). Unexpectedly, even though GusA had a lower specific activity compared to GusPlus, the substrate conversion in the serum of tumor-bearing mice injected with the GusA-encoding virus strains was substantially higher than that of GusPlus. This was attributed to a 3.2 fold and 16.2 fold longer half-life of GusA in the blood stream compared to GusPlus and GLuc respectively, thus a more sensitive monitor of virus replication than the other two enzymes. Due to the good correlation between enzymatic activity of expressed marker gene and virus titer, we conclude that the amount of the biomarker protein in the body fluid semiquantitatively represents the amount of virus in the infected tumors which was confirmed by low light imaging. We found GusA to be the most reliable biomarker for monitoring oncolytic virotherapy among the three tested markers. PMID:26348361

  16. Drug-Encoded Biomarkers for Monitoring Biological Therapies.

    PubMed

    Tsoneva, Desislava; Stritzker, Jochen; Bedenk, Kristina; Zhang, Qian; Frentzen, Alexa; Cappello, Joseph; Fischer, Utz; Szalay, Aladar A

    2015-01-01

    Blood tests are necessary, easy-to-perform and low-cost alternatives for monitoring of oncolytic virotherapy and other biological therapies in translational research. Here we assessed three candidate proteins with the potential to be used as biomarkers in biological fluids: two glucuronidases from E. coli (GusA) and Staphylococcus sp. RLH1 (GusPlus), and the luciferase from Gaussia princeps (GLuc). The three genes encoding these proteins were inserted individually into vaccinia virus GLV-1h68 genome under the control of an identical promoter. The three resulting recombinant viruses were used to infect tumor cells in cultures and human tumor xenografts in nude mice. In contrast to the actively secreted GLuc, the cytoplasmic glucuronidases GusA and GusPlus were released into the supernatants only as a result of virus-mediated oncolysis. GusPlus resulted in the most sensitive detection of enzyme activity under controlled assay conditions in samples containing as little as 1 pg/ml of GusPlus, followed by GusA (25 pg/ml) and GLuc (≥375 pg/ml). Unexpectedly, even though GusA had a lower specific activity compared to GusPlus, the substrate conversion in the serum of tumor-bearing mice injected with the GusA-encoding virus strains was substantially higher than that of GusPlus. This was attributed to a 3.2 fold and 16.2 fold longer half-life of GusA in the blood stream compared to GusPlus and GLuc respectively, thus a more sensitive monitor of virus replication than the other two enzymes. Due to the good correlation between enzymatic activity of expressed marker gene and virus titer, we conclude that the amount of the biomarker protein in the body fluid semiquantitatively represents the amount of virus in the infected tumors which was confirmed by low light imaging. We found GusA to be the most reliable biomarker for monitoring oncolytic virotherapy among the three tested markers. PMID:26348361

  17. Optical absorption properties of electron bubbles and experiments on monitoring individual electron bubbles in liquid helium

    NASA Astrophysics Data System (ADS)

    Guo, Wei

    When a free electron is injected into liquid helium, it forms a microscopic bubble essentially free of helium atoms, which is referred to as an electron bubble. It represents a fine example of a quantum-mechanical particle confined in a potential well. In this dissertation, we describe our studies on bubble properties, especially the optical absorption properties of ground state electron bubbles and experiments on imaging individual electron bubbles in liquid helium. We studied the effect of zero-point and thermal fluctuations on the shape of ground state electron bubbles in liquid helium. The results are used to determine the line shape for the 1S to 1P optical transition. The calculated line shape is in very good agreement with the experimental measurements of Grimes and Adams. For 1S to 2P transition, the obtained transition line width agrees well with the measured data of Zipfel over a range of pressure up to 15 bars. Fluctuations in the bubble shape also make other "unallowed" transitions possible. The transition cross-sections from the 1S state to the 1D and 2D states are calculated with magnitude approximately two orders smaller than that of the 1S to 1P and 2P transitions. In our electron bubble imaging experiments, a planar ultrasonic transducer was used to generate strong sound wave pulse in liquid helium. The sound pulse passed through the liquid so as to produce a transient negative pressure over a large volume (˜ 1 cm3). An electron bubble that was passed by the sound pulse exploded for a fraction of a microsecond and grew to have a radius of around 10 microns. While the bubble had this large size it was illuminated with a flash lamp and its position was recorded. In this way, we can determine its position. Through the application of a series of sound pulses, we can then take images along the track of individual electrons. The motion of individual electron bubbles has been successfully monitored. Interesting bubble tracks that may relate to electrons

  18. Therapeutic drug monitoring (TDM) of antifungal agents: guidelines from the British Society for Medical Mycology

    PubMed Central

    Ashbee, H. Ruth; Barnes, Rosemary A.; Johnson, Elizabeth M.; Richardson, Malcolm D.; Gorton, Rebecca; Hope, William W.

    2014-01-01

    The burden of human disease related to medically important fungal pathogens is substantial. An improved understanding of antifungal pharmacology and antifungal pharmacokinetics–pharmacodynamics has resulted in therapeutic drug monitoring (TDM) becoming a valuable adjunct to the routine administration of some antifungal agents. TDM may increase the probability of a successful outcome, prevent drug-related toxicity and potentially prevent the emergence of antifungal drug resistance. Much of the evidence that supports TDM is circumstantial. This document reviews the available literature and provides a series of recommendations for TDM of antifungal agents. PMID:24379304

  19. Therapeutic drug monitoring for triazoles: A needs assessment review and recommendations from a Canadian perspective

    PubMed Central

    Laverdiere, Michel; Bow, Eric J; Rotstein, Coleman; Autmizguine, Julie; Broady, Raewyn; Garber, Gary; Haider, Shariq; Hussaini, Trana; Husain, Shahid; Ovetchkine, Philippe; Seki, Jack T; Théorêt, Yves

    2014-01-01

    Invasive fungal infections cause significant morbidity and mortality in patients with concomitant underlying immunosuppressive diseases. The recent addition of new triazoles to the antifungal armamentarium has allowed for extended-spectrum activity and flexibility of administration. Over the years, clinical use has raised concerns about the degree of drug exposure following standard approved drug dosing, questioning the need for therapeutic drug monitoring (TDM). Accordingly, the present guidelines focus on TDM of triazole antifungal agents. A review of the rationale for triazole TDM, the targeted patient populations and available laboratory methods, as well as practical recommendations based on current evidence from an extended literature review are provided in the present document. PMID:25587296

  20. Aptamer/Graphene Quantum Dots Nanocomposite Capped Fluorescent Mesoporous Silica Nanoparticles for Intracellular Drug Delivery and Real-Time Monitoring of Drug Release.

    PubMed

    Zheng, Fen-Fen; Zhang, Peng-Hui; Xi, Yu; Chen, Jing-Jia; Li, Ling-Ling; Zhu, Jun-Jie

    2015-12-01

    Great challenges in investigating the release of drug in complex cellular microenvironments necessitate the development of stimuli-responsive drug delivery systems with real-time monitoring capability. In this work, a smart drug nanocarrier based on fluorescence resonance energy transfer (FRET) is fabricated by capping graphene quantum dots (GQDs, the acceptor) onto fluorescent mesoporous silica nanoparticles (FMSNs, the donor) via ATP aptamer for real-time monitoring of ATP-triggered drug release. Under extracellular conditions, the fluorescence of FMSNs remains in the "off" state in the low ATP level which is unable to trigger the release of drug. Once specifically recognized and internalized into the target tumor cells by AS1411 aptamer, in the ATP-rich cytoplasm, the conformation switch of the ATP aptamer causes the shedding of the GQDs from the nanocarriers, leading to the release of the loaded drugs and consequently severe cytotoxicity. Simultaneously, the fluorescence of FMSNs turns "on" along with the dissociation of GQDs, which allows real-time monitoring of the release of drug from the pores. Such a drug delivery system features high specificity of dual-target recognition with AS1411 and ATP aptamer as well as high sensitivity of the FRET-based monitoring strategy. Thus, the proposed multifunctional ATP triggered FRET-nanocarriers will find potential applications for versatile drug-release monitoring, efficient drug transport, and targeted cancer therapeutics. PMID:26524192

  1. The Analytical Chemistry of Drug Monitoring in Athletes

    NASA Astrophysics Data System (ADS)

    Bowers, Larry D.

    2009-07-01

    The detection and deterrence of the abuse of performance-enhancing drugs in sport are important to maintaining a level playing field among athletes and to decreasing the risk to athletes’ health. The World Anti-Doping Program consists of six documents, three of which play a role in analytical development: The World Anti-Doping Code, The List of Prohibited Substances and Methods, and The International Standard for Laboratories. Among the classes of prohibited substances, three have given rise to the most recent analytical developments in the field: anabolic agents; peptide and protein hormones; and methods to increase oxygen delivery to the tissues, including recombinant erythropoietin. Methods for anabolic agents, including designer steroids, have been enhanced through the use of liquid chromatography/tandem mass spectrometry and gas chromatography/combustion/isotope-ratio mass spectrometry. Protein and peptide identification and quantification have benefited from advances in liquid chromatography/tandem mass spectrometry. Incorporation of techniques such as flow cytometry and isoelectric focusing have supported the detection of blood doping.

  2. Intelligent Janus nanoparticles for intracellular real-time monitoring of dual drug release.

    PubMed

    Cao, Han; Yang, Yuhong; Chen, Xin; Shao, Zhengzhong

    2016-03-28

    Stimuli-responsive nanomaterials have been receiving much attention as drug delivery carriers, however understanding of multi-drug release from the carriers for efficient therapeutics is highly challenging. Here, we report a novel nanosystem, Janus particle Dox-CMR-MS/Au-6MP (Dox: doxorubicin, CMR: 7-hydroxycoumarin-3-carboxylate, MS: mesoporous silica, Au: gold, 6MP: 6-mercaptopurine) with opposing MS and Au faces, which can monitor intracellular dual-drug (Dox and 6MP) controlled release in real time based on fluorescence resonance energy transfer (FRET) and surface-enhanced Raman scattering (SERS). The FRET acceptor Dox is attached to CMR (as a FRET donor) conjugated MS with a pH-responsive linker hydrazone, and 6MP is conjugated to the Au surface through the gold-thiol interaction. As the Janus nanoparticle enters into tumor cells, the breakage of the hydrazone bond in an acidic environment and the substitution of glutathione (GSH) overexpressed in cancer cells give rise to the release of Dox and 6MP, respectively. Thus, the change of the CMR fluorescence signal and the SERS decrease of 6MP can be used to monitor the dual-drug release within living cells in real time. In addition, this work demonstrates the enhanced anticancer effect of the designed dual-drug loaded nanosystem. Therefore, the current study may provide new perspectives for the real-time study of intelligent multi-drug delivery and release, as well as cellular responses to drug treatment. PMID:26952741

  3. Nanoscale monitoring of drug actions on cell membrane using atomic force microscopy

    PubMed Central

    Li, Mi; Liu, Lian-qing; Xi, Ning; Wang, Yue-chao

    2015-01-01

    Knowledge of the nanoscale changes that take place in individual cells in response to a drug is useful for understanding the drug action. However, due to the lack of adequate techniques, such knowledge was scarce until the advent of atomic force microscopy (AFM), which is a multifunctional tool for investigating cellular behavior with nanometer resolution under near-physiological conditions. In the past decade, researchers have applied AFM to monitor the morphological and mechanical dynamics of individual cells following drug stimulation, yielding considerable novel insight into how the drug molecules affect an individual cell at the nanoscale. In this article we summarize the representative applications of AFM in characterization of drug actions on cell membrane, including topographic imaging, elasticity measurements, molecular interaction quantification, native membrane protein imaging and manipulation, etc. The challenges that are hampering the further development of AFM for studies of cellular activities are aslo discussed. PMID:26027658

  4. Drug eruptions presenting at sites of prior radiation damage (sunlight and electron beam)

    SciTech Connect

    Shelley, W.B.; Shelley, E.D.; Campbell, A.C.; Weigensberg, I.J.

    1984-07-01

    Two patients are described in whom sunburn and electron beam radiodermatitis, respectively, were critical determinants in localizing the initial presentation of drug eruptions. In the first instance, a severe sunburn of the back and thighs was followed 7 months later by the appearance of a toxic epidermal necrolysis drug reaction to trimethoprim-sulfamethoxazole in the exact sites of the previous bullous sunburn reaction. In the second patient, a radiodermatitis of the left upper arm due to electron beam therapy for metastatic breast cancer was followed 7 weeks later by a codeine drug reaction confined to the area of the radiodermatitis. In both instances, oral rechallenge with the offending drug reproduced the eruption.

  5. Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

    PubMed Central

    Meyer, Keith C; Nathanson, Ian; Angel, Luis; Bhorade, Sangeeta M; Chan, Kevin M; Culver, Daniel; Harrod, Christopher G; Hayney, Mary S; Highland, Kristen B; Limper, Andrew H; Patrick, Herbert; Strange, Charlie; Whelan, Timothy

    2012-01-01

    Objectives: Immunosuppressive pharmacologic agents prescribed to patients with diffuse interstitial and inflammatory lung disease and lung transplant recipients are associated with potential risks for adverse reactions. Strategies for minimizing such risks include administering these drugs according to established, safe protocols; monitoring to detect manifestations of toxicity; and patient education. Hence, an evidence-based guideline for physicians can improve safety and optimize the likelihood of a successful outcome. To maximize the likelihood that these agents will be used safely, the American College of Chest Physicians established a committee to examine the clinical evidence for the administration and monitoring of immunosuppressive drugs (with the exception of corticosteroids) to identify associated toxicities associated with each drug and appropriate protocols for monitoring these agents. Methods: Committee members developed and refined a series of questions about toxicities of immunosuppressives and current approaches to administration and monitoring. A systematic review was carried out by the American College of Chest Physicians. Committee members were supplied with this information and created this evidence-based guideline. Conclusions: It is hoped that these guidelines will improve patient safety when immunosuppressive drugs are given to lung transplant recipients and to patients with diffuse interstitial lung disease. PMID:23131960

  6. Psychotropic Drug Use among College Students: Patterns of Use, Misuse, and Medical Monitoring

    ERIC Educational Resources Information Center

    Oberleitner, Lindsay M. S.; Tzilos, Golfo K.; Zumberg, Kathryn M.; Grekin, Emily R.

    2011-01-01

    Objective: To assess whether college students who use psychotropic drugs are (1) aware of potential side effects, (2) appropriately monitored by prescribing physicians, and (3) taking medications as prescribed. Participants: Fifty-five college students, currently taking psychotropic medications, were recruited between Summer 2008 and Fall 2009.…

  7. Adherence to medication and drug monitoring in apparent treatment-resistant hypertension.

    PubMed

    Eskås, Per Anders; Heimark, Sondre; Eek Mariampillai, Julian; Larstorp, Anne Cecilie K; Fadl Elmula, Fadl Elmula M; Høieggen, Aud

    2016-08-01

    Poor drug adherence is one of the main reasons for the failure to achieve treatment targets in hypertensive patients. In patients who receive pharmacological treatment, assessment of drug adherence is of the utmost importance. The aim of this review is to present an update of the methods available to reveal and monitor non-adherence in patients with apparent treatment-resistant hypertension. Methods for monitoring adherence are divided into indirect and direct methods. The indirect methods are mainly based on self-reported adherence and can easily be manipulated by the patient. Directly observed therapy and therapeutic drug monitoring are examples of direct methods. There are limitations and advantages to all of the methods, and because of the patient's ability to manipulate the outcome of indirect methods, direct methods should be preferred. Therapeutic drug monitoring and directly observed therapy with subsequent ambulatory blood pressure measurement are considered to be reliable methods and should be used more in the routine assessment of patients with apparent treatment-resistant hypertension. PMID:26729283

  8. A quality monitor and monitoring technique employing optically stimulated electron emission

    NASA Technical Reports Server (NTRS)

    Yost, William T. (Inventor); Welch, Christopher S. (Inventor); Joe, Edmond J. (Inventor); Hefner, Bill Bryan, Jr. (Inventor)

    1995-01-01

    A light source directs ultraviolet light onto a test surface and a detector detects a current of photoelectrons generated by the light. The detector includes a collector which is positively biased with respect to the test surface. Quality is indicated based on the photoelectron current. The collector is then negatively biased to replace charges removed by the measurement of a nonconducting substrate to permit subsequent measurements. Also, the intensity of the ultraviolet light at a particular wavelength is monitored and the voltage of the light source varied to maintain the light a constant desired intensity. The light source is also cooled via a gas circulation system. If the test surface is an insulator, the surface is bombarded with ultraviolet light in the presence of an electron field to remove the majority of negative charges from the surface. The test surface is then exposed to an ion field until it possesses no net charge. The technique described above is then performed to assess quality.

  9. Remote monitoring of cardiac implantable electronic devices (CIED).

    PubMed

    Zeitler, Emily P; Piccini, Jonathan P

    2016-08-01

    With increasing indications and access to cardiac implantable electronic devices (CIEDs) worldwide, the number of patients needing CIED follow-up continues to rise. In parallel, the technology available for managing these devices has advanced considerably. In this setting, remote monitoring (RM) has emerged as a complement to routine in-office care. Rigorous studies, randomized and otherwise, have demonstrated advantages to patient with CIED management systems, which incorporates RM resulting in authoritative guidelines from relevant professional societies recommending RM for all eligible patients. In addition to clinical benefits, CIED management programs that include RM have been shown to be cost effective and associated with high patient satisfaction. Finally, RM programs hold promise for the future of CIED research in light of the massive data collected through RM databases converging with unprecedented computational capability. This review outlines the available data associated with clinical outcomes in patients managed with RM with an emphasis on randomized trials; the impact of RM on patient satisfaction, cost-effectiveness, and healthcare utilization; and possible future directions for the use of RM in clinical practice and research. PMID:27134007

  10. Monitoring Ligand-Induced Protein Ordering in Drug Discovery.

    PubMed

    Grace, Christy R; Ban, David; Min, Jaeki; Mayasundari, Anand; Min, Lie; Finch, Kristin E; Griffiths, Lyra; Bharatham, Nagakumar; Bashford, Donald; Kiplin Guy, R; Dyer, Michael A; Kriwacki, Richard W

    2016-03-27

    While the gene for p53 is mutated in many human cancers causing loss of function, many others maintain a wild-type gene but exhibit reduced p53 tumor suppressor activity through overexpression of the negative regulators, Mdm2 and/or MdmX. For the latter mechanism of loss of function, the activity of endogenous p53 can be restored through inhibition of Mdm2 or MdmX with small molecules. We previously reported a series of compounds based upon the Nutlin-3 chemical scaffold that bind to both MdmX and Mdm2 [Vara, B. A. et al. (2014) Organocatalytic, diastereo- and enantioselective synthesis of nonsymmetric cis-stilbene diamines: A platform for the preparation of single-enantiomer cis-imidazolines for protein-protein inhibition. J. Org. Chem. 79, 6913-6938]. Here we present the first solution structures based on data from NMR spectroscopy for MdmX in complex with four of these compounds and compare them with the MdmX:p53 complex. A p53-derived peptide binds with high affinity (Kd value of 150nM) and causes the formation of an extensive network of hydrogen bonds within MdmX; this constitutes the induction of order within MdmX through ligand binding. In contrast, the compounds bind more weakly (Kd values from 600nM to 12μM) and induce an incomplete hydrogen bond network within MdmX. Despite relatively weak binding, the four compounds activated p53 and induced p21(Cip1) expression in retinoblastoma cell lines that overexpress MdmX, suggesting that they specifically target MdmX and/or Mdm2. Our results document structure-activity relationships for lead-like small molecules targeting MdmX and suggest a strategy for their further optimization in the future by using NMR spectroscopy to monitor small-molecule-induced protein order as manifested through hydrogen bond formation. PMID:26812210

  11. Assuring the Proper Analytical Performance of Measurement Procedures for Immunosuppressive Drug Concentrations in Clinical Practice: Recommendations of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology Immunosuppressive Drug Scientific Committee.

    PubMed

    Seger, Christoph; Shipkova, Maria; Christians, Uwe; Billaud, Elaine M; Wang, Ping; Holt, David W; Brunet, Mercè; Kunicki, Paweł K; Pawiński, Thomasz; Langman, Loralie J; Marquet, Pierre; Oellerich, Michael; Wieland, Eberhard; Wallemacq, Pierre

    2016-04-01

    Monitoring immunosuppressive drugs (ISDs) in blood or plasma is still a key therapeutic drug monitoring (TDM) application in clinical settings. Narrow target ranges and severe side effects at drug underexposure or overexposure make accurate and precise measurements a must. This overview prepared by the Immunosuppressive Drugs Scientific Committee of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology is intended to serve as a summary and guidance document describing the current state-of-the-art in the TDM of ISDs. PMID:26982493

  12. Optically monitored drug delivery patch based on porous silicon and polymer microneedles

    PubMed Central

    Dardano, Principia; Caliò, Alessandro; Politi, Jane; Rea, Ilaria; Rendina, Ivo; De Stefano, Luca

    2016-01-01

    Fabrication and characterization of an optically monitored hybrid patch for local administration of drugs, based on polymeric micro-needles and a porous silicon free-standing membrane, are reported. The micro-needles are realized by an innovative photolithographic approach that allows fine tuning of geometrical parameters, using polyethylene glycol and a commercial photo-catalyzer. The porous silicon multilayer not only increases the storage of a relevant amount of the drug, but also offers a continuous, naked-eye monitoring of the drug delivery process. As a proof-of-concept experiment, we report our results on the release of a dye molecule (fluorescein, 332 Da) in a phosphate saline buffer. PMID:27231611

  13. Informatics tools to monitor progress and outcomes of patients with drug resistant tuberculosis in Peru.

    PubMed

    Fraser, Hamish S F; Jazayeri, Darius; Mitnick, Carole D; Mukherjee, Joia S; Bayona, Jaime

    2002-01-01

    Multi-drug resistant tuberculosis (MDR-TB) is an important and growing problem in many developing countries. New strategies have been developed to combat the disease but require complex treatment regimens and close monitoring of patients' bacteriology results. We describe a web-based medical record system deployed in Peru to support the management of MDR-TB. Web-based analyses have been developed to track drug sensitivity test results, patterns of sputum smear and culture results and time to conversion from positive to negative cultures. Individual and aggregate drug requirements can also be monitored in real time. Multiple analyses can be linked together and data can be graphed or downloaded to spreadsheets. Over 1200 patients are currently in the system. We argue that such a web-based clinical and epidemiological management system is an important component for successful implementation of complex health interventions in resource poor areas. PMID:12463829

  14. Optically monitored drug delivery patch based on porous silicon and polymer microneedles.

    PubMed

    Dardano, Principia; Caliò, Alessandro; Politi, Jane; Rea, Ilaria; Rendina, Ivo; De Stefano, Luca

    2016-05-01

    Fabrication and characterization of an optically monitored hybrid patch for local administration of drugs, based on polymeric micro-needles and a porous silicon free-standing membrane, are reported. The micro-needles are realized by an innovative photolithographic approach that allows fine tuning of geometrical parameters, using polyethylene glycol and a commercial photo-catalyzer. The porous silicon multilayer not only increases the storage of a relevant amount of the drug, but also offers a continuous, naked-eye monitoring of the drug delivery process. As a proof-of-concept experiment, we report our results on the release of a dye molecule (fluorescein, 332 Da) in a phosphate saline buffer. PMID:27231611

  15. Monitoring of the action of drugs in melanoma cells by dynamic laser speckle

    NASA Astrophysics Data System (ADS)

    González-Peña, Rolando J.; Braga, Roberto A., Jr.; Cibrián, Rosa M.; Salvador-Palmer, Rosario; Gil-Benso, Rosario; Miguel, Teresa San

    2014-05-01

    This work presents the development of a protocol based on the dynamic laser speckle designed to monitor the reaction of cancer cells of line MEL-RC08 to the application of the drug Colcemid in two different concentrations: 0.2 and 0.4 μg/mL. The protocol was designed using the forward scattering approach with an He-Ne laser of 632.8 nm illuminating the samples, a control, and two variations of Colcemid, being monitored along 8 h. The data were analyzed numerically in the time and in the frequency domain, and the results presented the ability of the technique to monitor the action of the drug, particularly Colcemid (0.4 μg/mL).

  16. Monitoring a Nuclear Factor-κB Signature of Drug Resistance in Multiple Myeloma*

    PubMed Central

    Xiang, Yun; Remily-Wood, Elizabeth R.; Oliveira, Vasco; Yarde, Danielle; He, Lili; Cheng, Jin Q.; Mathews, Linda; Boucher, Kelly; Cubitt, Christopher; Perez, Lia; Gauthier, Ted J.; Eschrich, Steven A.; Shain, Kenneth H.; Dalton, William S.; Hazlehurst, Lori; Koomen, John M.

    2011-01-01

    The emergence of acquired drug resistance results from multiple compensatory mechanisms acting to prevent cell death. Simultaneous monitoring of proteins involved in drug resistance is a major challenge for both elucidation of the underlying biology and development of candidate biomarkers for assessment of personalized cancer therapy. Here, we have utilized an integrated analytical platform based on SDS-PAGE protein fractionation prior to liquid chromatography coupled to multiple reaction monitoring mass spectrometry, a versatile and powerful tool for targeted quantification of proteins in complex matrices, to evaluate a well-characterized model system of melphalan resistance in multiple myeloma (MM). Quantitative assays were developed to measure protein expression related to signaling events and biological processes relevant to melphalan resistance in multiple myeloma, specifically: nuclear factor-κB subunits, members of the Bcl-2 family of apoptosis-regulating proteins, and Fanconi Anemia DNA repair components. SDS-PAGE protein fractionation prior to liquid chromatography coupled to multiple reaction monitoring methods were developed for quantification of these selected target proteins in amounts of material compatible with direct translation to clinical specimens (i.e. less than 50,000 cells). As proof of principle, both relative and absolute quantification were performed on cell line models of MM to compare protein expression before and after drug treatment in naïve cells and in drug resistant cells; these liquid chromatography-multiple reaction monitoring results are compared with existing literature and Western blots. The initial stage of a systems biology platform for examining drug resistance in MM has been implemented in cell line models and has been translated to MM cells isolated from a patient. The ultimate application of this platform could assist in clinical decision-making for individualized patient treatment. Although these specific assays have

  17. Versatile FRET-Based Mesoporous Silica Nanoparticles for Real-Time Monitoring of Drug Release

    PubMed Central

    Lai, Jinping; Shah, Birju P.; Garfunkel, Eric; Lee, Ki-Bum

    2013-01-01

    We describe the development of a versatile fluorescence resonance energy transfer (FRET)-based real-time monitoring system, consisting of (a) coumarin-labeled-cysteine tethered mesoporous silica nanoparticles (MSNs) as the drug carrier, (b) a fluorescein isothiocyanate-β-cyclodextrin (FITC-β-CD) as redox-responsive molecular valve blocking the pores, and (c) a FRET donor-acceptor pair of coumarin and FITC integrated within the pore-unlocking event, thereby allowing for monitoring the release of drugs from the pores in real-time. Under non-reducing conditions, when the disulfide bond is intact, the close proximity between coumarin and FITC on the surface of MSNs results in FRET from coumarin to FITC. However, in the presence of the redox stimuli like glutathione (GSH), the disulfide bond is cleaved which leads to the removal of molecular valve (FITC-β-CD), thus triggering drug release and eliminating FRET. By engineering such a FRET-active donor-acceptor structure within the redox-responsive molecular valve, we can monitor the release of the drugs entrapped within the pores of the MSN nanocarrier, following the change in the FRET signal. We have demonstrated that, any exogenous or endogenous change in the GSH concentration will result in a change in the extent of drug release as well as a concurrent change in the FRET signal, allowing us to extend the applications of our FRET-based MSNs for monitoring the release of any type of drug molecule in real-time. PMID:23445171

  18. Monitoring electron donor metabolism under variable electron acceptor conditions using 13C-labeled lactate

    NASA Astrophysics Data System (ADS)

    Bill, M.; Conrad, M. E.; Yang, L.; Beller, H. R.; Brodie, E. L.

    2010-12-01

    Three sets of flow-through columns constructed with aquifer sediment from Hanford (WA) were used to study reduction of Cr(VI) to poorly soluble Cr(III) under denitrifying, sulfate-reducing/fermentative, and iron-reducing conditions with lactate as the electron donor. In order to understand the relationship between electron donors and biomarkers, and to determine the differences in carbon isotope fractionation resulting from different microbial metabolic processes, we monitored the variation in carbon isotopes in dissolved inorganic carbon (DIC), in total organic carbon (TOC), and in lactate, acetate and propionate. The greatest enrichment in 13C in columns was observed under denitrifying conditions. The δ13C of DIC increased by ~1750 to ~2000‰ fifteen days after supplementation of natural abundance lactate with a 13C-labeled lactate tracer (for an influent δ13C of ~2250‰ for the lactate) indicating almost complete oxidation of the electron donor. The denitrifying columns were among the most active columns and had the highest cell counts and the denitrification rate was highly correlated with Cr(VI) reduction rate. δ13C values of DIC ranged from ~540 to ~1170‰ for iron-reducing conditions. The lower enrichment in iron columns was related to the lower biological activity observed with lower yields of RNA and cell numbers in the column effluents. The carbon isotope shift in the sulfate-reducing ~198 to ~1960‰ for sulfate-reducing conditions reflecting the lower levels of the lactate in these columns. Additionally, in two of the sulfate columns, almost complete fermentation of the lactate occurred, producing acetate and propionate with the labeled carbon signature, but relatively smaller amounts of inorganic carbon. For all electron-accepting conditions, TOC yielded similar δ13C values as lactate stock solutions. Differences in C use efficiency, metabolic rate or metabolic pathway contributed to the differing TOC δ13C to DIC δ13C ratios between treatments

  19. Demographic Subgroup Trends for Various Licit and Illicit Drugs, 1975-2009. Monitoring the Future Occasional Paper Series. Paper 73

    ERIC Educational Resources Information Center

    Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

    2010-01-01

    This occasional paper serves as a supplement to one of four annual monographs from the Monitoring the Future (MTF) study, written by the study's investigators and published by the study's sponsor, the National Institute on Drug Abuse. The full 2009 survey results are reported in "Monitoring the Future National Survey Results on Drug Use,…

  20. Compliance with an oral asthma medication: a pilot study using an electronic monitoring device.

    PubMed

    Chung, K F; Naya, I

    2000-09-01

    Compliance with prescribed asthma medication is commonly estimated from tablet counts for oral medications and canister weights for inhaled medications. Recently, electronic medication monitoring devices, developed to evaluate numerical compliance as well as drug use patterns, were used to assess compliance with inhaled steroids and beta2-agonists. This was the first study to electronically assess compliance with an oral asthma medication. Fifty-seven asthmatic patients, stable on inhaled beta2-agonists only with a mean FEV1 of 77% predicted (+/- 13%, SD) began 12 weeks of treatment with zafirlukast 20 mg twice daily. The monitoring device, an electronic TrackCap, recorded the date and time on each occasion that patients removed and replaced their medication bottle caps. Patients were told that compliance would be assessed as part of the study, but patients were not told about the specifics of the TrackCap. Compliance was defined: 1. as the number of TrackCap events per number of prescribed tablets; and 2. as the difference between number of tablets dispensed and number returned per number prescribed. Adherence was defined as the number of days with two TrackCap events at least 8 h apart per the total number of days' dosing. Forty-seven patients completed the study with a median compliance of 89% (mean. 80%) and a median adherence of 71% (mean, 64%) as measured by TrackCap events. Compliance as estimated from return-tablet count was slightly higher (median, 92%). High rates of compliance were maintained throughout the trial. These results show that compliance with and adherence to a treatment of an oral, twice-daily, maintenance asthma medication, such as zafirlukast, is high. PMID:11001076

  1. Alternative matrices for therapeutic drug monitoring of immunosuppressive agents using LC–MS/MS

    PubMed Central

    Ghareeb, Mwlod; Akhlaghi, Fatemeh

    2015-01-01

    Immunosuppressive drugs used in solid organ transplants typically have narrow therapeutic windows and high intra- and intersubject variability. To ensure satisfactory exposure, therapeutic drug monitoring (TDM) plays a pivotal role in any successful posttransplant maintenance therapy. Currently, recommendations for optimum immunosuppressant concentrations are based on blood/plasma measurements. However, they introduce many disadvantages, including poor prediction of allograft survival and toxicity, a weak correlation with drug concentrations at the site of action and the invasive nature of the sample collection. Thus, alternative matrices have been investigated. This paper reviews tandem-mass spectrometry (LC–MS/MS) methods used for the quantification of immunosuppressant drugs utilizing nonconventional matrices, namely oral fluids, fingerprick blood and intracellular and intratissue sampling. The advantages, disadvantages and clinical application of such alternative mediums are discussed. Additionally, sample extraction techniques and basic chromatography information regarding these methods are presented in tabulated form. PMID:25966013

  2. Fetal Sex Differences in Intrapartum Electronic Fetal Monitoring.

    PubMed

    Porter, Anne C; Triebwasser, Jourdan E; Tuuli, Methodius; Caughey, Aaron B; Macones, George A; Cahill, Alison G

    2016-07-01

    Objective The article aimed to estimate differences in electronic fetal monitoring (EFM) patterns in term gestations attributable to fetal sex. Study Design We conducted a prospective cohort study of consecutive, singleton, nonanomalous, term gestations that labored during admission. EFM characteristics in the 30 minutes prior to delivery were evaluated. Logistic regression models estimated adjusted risks for EFM features by sex. To further estimate the impact of sex, we limited the analysis to gestations without composite morbidity (morbidity defined as arterial cord pH <7.20, 5-minute Apgar <7, or neonatal intensive care unit admission). Results Of 2,639 deliveries, 1,400 (53%) were male. Male fetuses had a higher number of decelerations (median [interquartile range]: 8 [5, 11] vs. 7 [4, 10], p < 0.003) and increased total deceleration area (adjusted odds ratio [aOR]: 1.11, 95% confidence interval [CI] :1.04, 1.18). Male fetuses were at increased risk for prolonged decelerations (aOR: 1.21, 95% CI: 1.03, 1.42) and repetitive variable decelerations (aOR: 1.24, 95% CI: 1.05, 1.47). Among neonates without composite morbidity (n = 2,446, 92.7%), male sex conferred an increased risk of late decelerations (aOR: 1.21, 95% CI: 1.02, 1.43) and increased total deceleration area (aOR: 1.12, 95% CI: 1.05, 1.20). Conclusion There are significant sex differences in EFM patterns at term among pregnancies without evidence of acidemia. This suggests that interpretation of EFM patterns may need to take into account factors such as fetal sex. PMID:26906183

  3. A New Reporter Cell Line to Monitor HIV Infection and Drug Susceptibility in vitro

    NASA Astrophysics Data System (ADS)

    Gervaix, Alain; West, Daniel; Leoni, Lorenzo M.; Richman, Douglas D.; Wong-Staal, Flossie; Corbeil, Jacques

    1997-04-01

    Determination of HIV infectivity in vitro and its inhibition by antiretroviral drugs by monitoring reduction of production of p24 antigen is expensive and time consuming. Such assays also do not allow accurate quantitation of the number of infected cells over time. To develop a simple, rapid, and direct method for monitoring HIV infection, we generated a stable T-cell line (CEM) containing a plasmid encoding the green fluorescent protein (humanized S65T GFP) driven by the HIV-1 long terminal repeat. Clones were selected that displayed low constitutive background fluorescnece, but a high level of GFP expression upon infection with HIV. HIV-1 infection induced a 100- to 1,000-fold increase in relative fluorescence of cells over 2 to 4 days as monitored by fluorescence microscopy, cytofluorimetry, and flow cytometry. Addition of inhibitors of reverse transcriptase, protease, and other targets at different multiplicities of infection permitted the accurate determination of drug susceptibility. This technique also permitted quantitation of infectivity of viral preparations by assessment of number of cells infected in the first round of infection. In conclusion, the CEM-GFP reporter cell line provides a simple, rapid, and direct method for monitoring HIV infectivity titers and antiretroviral drug susceptibility of syncytium-inducing strains.

  4. Ultra-structural hair alterations of drug abusers: a scanning electron microscopic investigation.

    PubMed

    Turkmenoglu, Fatma Pinar; Kasirga, Ugur Baran; Celik, Hakan Hamdi

    2015-01-01

    As drug abuse carries a societal stigma, patients do not often report their history of drug abuse to the healthcare providers. However, drug abuse is highly co-morbid with a host of other health problems such as psychiatric disorders and skin diseases, and majority of individuals with drug use disorders seek treatment in the first place for other problems. Therefore, it is very important for physicians to be aware of clinical signs and symptoms of drug use. Recently diagnostic value of dermatologic tissue alterations associated with drug abuse has become a very particular interest because skin changes were reported to be the earliest noticeable consequence of drug abuse prompting earlier intervention and treatment. Although hair is an annex of skin, alterations on hair structure due to drug use have not been demonstrated. This study represents the first report on ultra-structural hair alterations of drug abusers. We have investigated ultra-structure of the hair samples obtained from 6 cocaine, 6 heroin, 7 cannabis and 4 lysergic acid diethylamide (LSD) abusers by scanning electron microscope (SEM). SEM analysis of hair samples gave us drug-specific discriminating alterations. We suggest that results of this study will make a noteworthy contribution to cutaneous alterations associated with drug abuse which are regarded as the earliest clinical manifestations, and this SEM approach is a very specific and effective tool in the detection of abuse of respective drugs, leading early treatment. PMID:26309532

  5. Ultra-structural hair alterations of drug abusers: a scanning electron microscopic investigation

    PubMed Central

    Turkmenoglu, Fatma Pinar; Kasirga, Ugur Baran; Celik, Hakan Hamdi

    2015-01-01

    As drug abuse carries a societal stigma, patients do not often report their history of drug abuse to the healthcare providers. However, drug abuse is highly co-morbid with a host of other health problems such as psychiatric disorders and skin diseases, and majority of individuals with drug use disorders seek treatment in the first place for other problems. Therefore, it is very important for physicians to be aware of clinical signs and symptoms of drug use. Recently diagnostic value of dermatologic tissue alterations associated with drug abuse has become a very particular interest because skin changes were reported to be the earliest noticeable consequence of drug abuse prompting earlier intervention and treatment. Although hair is an annex of skin, alterations on hair structure due to drug use have not been demonstrated. This study represents the first report on ultra-structural hair alterations of drug abusers. We have investigated ultra-structure of the hair samples obtained from 6 cocaine, 6 heroin, 7 cannabis and 4 lysergic acid diethylamide (LSD) abusers by scanning electron microscope (SEM). SEM analysis of hair samples gave us drug-specific discriminating alterations. We suggest that results of this study will make a noteworthy contribution to cutaneous alterations associated with drug abuse which are regarded as the earliest clinical manifestations, and this SEM approach is a very specific and effective tool in the detection of abuse of respective drugs, leading early treatment. PMID:26309532

  6. Quasi Real Time Data Analysis for Air Quality Monitoring with an Electronic Nose

    NASA Technical Reports Server (NTRS)

    Zhou, Hanying; Shevade, Abhijit V.; Pelletier, Christine C.; Homer, Margie L.; Ryan, M. Amy

    2006-01-01

    Cabin Air Quality Monitoring: A) Functions; 1) Incident monitor for targeted contaminants exceeding targeted concentrations. Identify and quantify. 2) Monitor for presence of compounds associated with fires or overheating electronics. 3) Monitor clean-up process. B) Characteristics; 1) Low mass, low power device. 2) Requires little crew time for maintenance and calibration. 3) Detects, identifies and quantifies selected chemical species at or below 24 hour SMAC.

  7. Self-carried curcumin nanoparticles for in vitro and in vivo cancer therapy with real-time monitoring of drug release

    NASA Astrophysics Data System (ADS)

    Zhang, Jinfeng; Li, Shengliang; An, Fei-Fei; Liu, Juan; Jin, Shubin; Zhang, Jin-Chao; Wang, Paul C.; Zhang, Xiaohong; Lee, Chun-Sing; Liang, Xing-Jie

    2015-08-01

    stability in physiological environments with drug loading capacities >78 wt%. Both confocal microscopy and flow cytometry confirmed the cellular fluorescence ``OFF-ON'' activation and real-time monitoring of the Cur molecule release. In vitro and in vivo experiments clearly show that the therapeutic efficacy of the PEGylated Cur NPs is considerably better than that of free Cur. This self-carried strategy with real-time monitoring of drug release may open a new way for simultaneous cancer therapy and monitoring. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr03259h

  8. The gas-liquid chromatograph and the electron capture detection in equine drug testing.

    PubMed Central

    Blake, J. W.; Tobin, T.

    1976-01-01

    Three gas-liquid chromatographic (G.L.C.) procedures discussed have been designed around the four "esses" of detection tests--speed, sensitivity, simplicity, and specificity. These techniques are admirably applicable to the very low plasma drug levels encountered in blood testing under pre-race conditions. The methods are equally applicable to post-race testing procedures, where both blood and urine samples are tested. Drugs can only rarely be detected by the electron capture detector (E.C.D.) without a prior derivatization step, which conveys to the drug(s) high electron affinity. Because of broad applicability, two derivatizing agents, heptafluorobutyric (HFBA) and pentafluorpropionic (PFPA) anhydrides are employed. The three techniques, allowing broad coverage of various drug classes are: 1) direct derivatization of drugs to form strongly electron capturing amides and esters. 2) reductive fragmentation of drugs with lithium aluminum hydride to form alcohols, with conversion to ester derivatives. 3) oxidative fragmentation of drugs with potassium dichromate to form derivatizable groups, followed by direct derivatization. PMID:1000157

  9. On-line monitoring of food fermentation processes using electronic noses and electronic tongues: a review.

    PubMed

    Peris, Miguel; Escuder-Gilabert, Laura

    2013-12-01

    Fermentation processes are often sensitive to even slight changes of conditions that may result in unacceptable end-product quality. Thus, close follow-up of this type of processes is critical for detecting unfavorable deviations as early as possible in order to save downtime, materials and resources. Nevertheless the use of traditional analytical techniques is often hindered by the need for expensive instrumentation and experienced operators and complex sample preparation. In this sense, one of the most promising ways of developing rapid and relatively inexpensive methods for quality control in fermentation processes is the use of chemical multisensor systems. In this work we present an overview of the most important contributions dealing with the monitoring of fermentation processes using electronic noses and electronic tongues. After a brief description of the fundamentals of both types of devices, the different approaches are critically commented, their strengths and weaknesses being highlighted. Finally, future trends in this field are also mentioned in the last section of the article. PMID:24267060

  10. Impact of therapeutic drug monitoring of voriconazole in a pediatric population.

    PubMed

    Brüggemann, Roger J M; van der Linden, Jan W M; Verweij, Paul E; Burger, David M; Warris, Adilia

    2011-06-01

    Voriconazole trough concentrations more than 1 mg/L are associated with a higher likelihood of success. It is unknown whether these trough concentrations are reached with the current recommended pediatric dosing schedule. We retrospectively analyzed the results of our therapeutic drug monitoring service for voriconazole in 18 children treated at our children's hospital. Thirty-nine voriconazole plasma concentrations were measured. In 44% of patients, the first voriconazole concentration was below the target. Dose adjustment eventually resulted in plasma concentrations within the predefined target range in all patients. Given the high proportion of patients with subtherapeutic concentrations, monitoring plasma concentrations should be performed routinely in pediatric patients receiving voriconazole. PMID:21127454

  11. MONITORING POTENTIAL DRUG INTERACTIONS AND REACTIONS VIA NETWORK ANALYSIS OF INSTAGRAM USER TIMELINES.

    PubMed

    Correia, Rion Brattig; Li, Lang; Rocha, Luis M

    2016-01-01

    Much recent research aims to identify evidence for Drug-Drug Interactions (DDI) and Adverse Drug reactions (ADR) from the biomedical scientific literature. In addition to this "Bibliome", the universe of social media provides a very promising source of large-scale data that can help identify DDI and ADR in ways that have not been hitherto possible. Given the large number of users, analysis of social media data may be useful to identify under-reported, population-level pathology associated with DDI, thus further contributing to improvements in population health. Moreover, tapping into this data allows us to infer drug interactions with natural products-including cannabis-which constitute an array of DDI very poorly explored by biomedical research thus far. Our goal is to determine the potential of Instagram for public health monitoring and surveillance for DDI, ADR, and behavioral pathology at large. Most social media analysis focuses on Twitter and Facebook, but Instagram is an increasingly important platform, especially among teens, with unrestricted access of public posts, high availability of posts with geolocation coordinates, and images to supplement textual analysis. Using drug, symptom, and natural product dictionaries for identification of the various types of DDI and ADR evidence, we have collected close to 7000 user timelines spanning from October 2010 to June 2015.We report on 1) the development of a monitoring tool to easily observe user-level timelines associated with drug and symptom terms of interest, and 2) population-level behavior via the analysis of co-occurrence networks computed from user timelines at three different scales: monthly, weekly, and daily occurrences. Analysis of these networks further reveals 3) drug and symptom direct and indirect associations with greater support in user timelines, as well as 4) clusters of symptoms and drugs revealed by the collective behavior of the observed population. This demonstrates that Instagram

  12. MONITORING POTENTIAL DRUG INTERACTIONS AND REACTIONS VIA NETWORK ANALYSIS OF INSTAGRAM USER TIMELINES

    PubMed Central

    CORREIA, RION BRATTIG; LI, LANG; ROCHA, LUIS M.

    2015-01-01

    Much recent research aims to identify evidence for Drug-Drug Interactions (DDI) and Adverse Drug reactions (ADR) from the biomedical scientific literature. In addition to this “Bibliome”, the universe of social media provides a very promising source of large-scale data that can help identify DDI and ADR in ways that have not been hitherto possible. Given the large number of users, analysis of social media data may be useful to identify under-reported, population-level pathology associated with DDI, thus further contributing to improvements in population health. Moreover, tapping into this data allows us to infer drug interactions with natural products—including cannabis—which constitute an array of DDI very poorly explored by biomedical research thus far. Our goal is to determine the potential of Instagram for public health monitoring and surveillance for DDI, ADR, and behavioral pathology at large. Most social media analysis focuses on Twitter and Facebook, but Instagram is an increasingly important platform, especially among teens, with unrestricted access of public posts, high availability of posts with geolocation coordinates, and images to supplement textual analysis. Using drug, symptom, and natural product dictionaries for identification of the various types of DDI and ADR evidence, we have collected close to 7000 user timelines spanning from October 2010 to June 2015. We report on 1) the development of a monitoring tool to easily observe user-level timelines associated with drug and symptom terms of interest, and 2) population-level behavior via the analysis of co-occurrence networks computed from user timelines at three different scales: monthly, weekly, and daily occurrences. Analysis of these networks further reveals 3) drug and symptom direct and indirect associations with greater support in user timelines, as well as 4) clusters of symptoms and drugs revealed by the collective behavior of the observed population. This demonstrates that

  13. Prescription Drug Monitoring Programs Are Associated With Sustained Reductions In Opioid Prescribing By Physicians.

    PubMed

    Bao, Yuhua; Pan, Yijun; Taylor, Aryn; Radakrishnan, Sharmini; Luo, Feijun; Pincus, Harold Alan; Schackman, Bruce R

    2016-06-01

    State prescription drug monitoring programs are promising tools to rein in the epidemic of prescription opioid overdose. We used data from a national survey to assess the effects of these programs on the prescribing of opioid analgesics and other pain medications in ambulatory care settings at the point of care in twenty-four states from 2001 to 2010. We found that the implementation of a prescription drug monitoring program was associated with more than a 30 percent reduction in the rate of prescribing of Schedule II opioids. This reduction was seen immediately following the launch of the program and was maintained in the second and third years afterward. Effects on overall opioid prescribing and prescribing of non-opioid analgesics were limited. Increased use of these programs and the adoption of new policies and practices governing their use may have contributed to sustained effectiveness. Future studies are needed to evaluate the policies' comparative effectiveness. PMID:27269021

  14. DigiSpenser--a GSM-based drug management and compliance monitoring system.

    PubMed

    Schukat, M; Rudroju, B

    2011-01-01

    Approximately one-third of all independently living elderly people are not compliant with their drug therapy. This lack of medication management results either in undermedication or overmedication, causing unnecessary and often serious health risks. This problem will worsen in the future with the change of demographics and cost constraints in the health sector. Therefore there is a need for (cost-) effective reliable approaches to compliance monitoring. To date numerous care schemes, retrospective assessment procedures and compliance supports tools have been introduced, but none of them has fully solved the problem of medication non-compliance yet. This paper will address some of the factors that need to be considered when designing such systems and will showcase DigiSpenser, a recently developed compliance monitoring and drug management system. PMID:22255537

  15. Engineered hybrid cardiac patches with multifunctional electronics for online monitoring and regulation of tissue function.

    PubMed

    Feiner, Ron; Engel, Leeya; Fleischer, Sharon; Malki, Maayan; Gal, Idan; Shapira, Assaf; Shacham-Diamand, Yosi; Dvir, Tal

    2016-06-01

    In cardiac tissue engineering approaches to treat myocardial infarction, cardiac cells are seeded within three-dimensional porous scaffolds to create functional cardiac patches. However, current cardiac patches do not allow for online monitoring and reporting of engineered-tissue performance, and do not interfere to deliver signals for patch activation or to enable its integration with the host. Here, we report an engineered cardiac patch that integrates cardiac cells with flexible, freestanding electronics and a 3D nanocomposite scaffold. The patch exhibited robust electronic properties, enabling the recording of cellular electrical activities and the on-demand provision of electrical stimulation for synchronizing cell contraction. We also show that electroactive polymers containing biological factors can be deposited on designated electrodes to release drugs in the patch microenvironment on demand. We expect that the integration of complex electronics within cardiac patches will eventually provide therapeutic control and regulation of cardiac function. PMID:26974408

  16. [Chemical analysis of wastewater as a new way of monitoring drugs and medicines consumption at workplace].

    PubMed

    Wiergowski, Marek; Sołtyszewski, Ireneusz; Sein Anand, Jacek

    2015-01-01

    The available information on the quality and frequency of illegal psychoactive substances used or medicines misused by workers, are often out of date at the time of its publication. This is due to the dynamic introduction of new synthetic drugs on the black market, changes in trends in the recreational use of medicines and the lack of readily available and reliable tests for fast identification. Strategy for detection of narcotic and non-medical psychoactive drugs use at workplace should embrace all possible sources of information. Classical sources of information on the use of psychoactive substances at the workplace include: statistical data (general information on trends and magnitude of drug and medicine addiction collected by the Polish National Police, the National Bureau for Drug Prevention and emergency medical services), surveys, psychomotor tests and qualitative and quantitative analyses of biological material. Of the new and promising methods, used throughout the world in recent years, chemical-toxicological analysis of surface water and wastewater deserve special mention. An increasing interest in the study of urban waste water can significantly complement the source of knowledge about drug and medicine addiction using obtainable conventional methods. In recent years, a municipal wastewater analysis has become a new and very promising way of collecting updated information on the use of psychoactive substances and medicines. It seems that this kind of study may play an important role in the ongoing monitoring of drug and/or medicines use by selected groups of population (e.g., students, military, firemen, policemen, etc.). PMID:26674170

  17. [Special qualification of a photometric procedure for determination of salicylic acid in therapeutic drug monitoring].

    PubMed

    Martens, J; Meyer, F P

    1995-01-01

    A procedure for the determination of salicylic acid from human serum is presented. It is based on an acidic extraction, a basic reextraction and the detection of salicylic acid as its iron-III-complex by photometry. The procedure is quantitative over a wide range of linearity, easy to carry out and is especially suitable for therapeutic drug monitoring in the treatment of juvenile rheumatoid arthritis. PMID:7886124

  18. Low invasive in vivo tissue sampling for monitoring biomarkers and drugs during surgery.

    PubMed

    Bojko, Barbara; Gorynski, Krzysztof; Gomez-Rios, German A; Knaak, Jan M; Machuca, Tiago; Cudjoe, Erasmus; Spetzler, Vinzent N; Hsin, Michael; Cypel, Marcelo; Selzner, Markus; Liu, Mingyao; Keshjavee, Shaf; Pawliszyn, Janusz

    2014-05-01

    The techniques currently used for drug, metabolite, and biomarker determination are based on sample collection, and therefore they are not suitable for repeated analysis because of the high invasiveness. Here, we present a novel method of biochemical analysis directly in organ during operation without need of a separate sample collection step: solid-phase microextraction (SPME). The approach is based on flexible microprobe coated with biocompatible extraction phase that is inserted to the tissue with no damage or disturbance of the organ. The method was evaluated during lung and liver transplantations using normothermic ex vivo liver perfusion (NEVLP) and ex vivo lung perfusion (EVLP). The study demonstrated feasibility of the method to extract wide range of endogenous compounds and drugs. Statistical analysis allowed observing metabolic changes of lung during cold ischemic time, perfusion, and reperfusion. It was also demonstrated that the level of drugs and their metabolites can be monitored over time. Based on the methylprednisolone as a selected example, the impairment of enzymatic properties of liver was detected in the injured organs but not in healthy control. This finding was supported by changes in pathways of endogenous metabolites. The SPME probe was also used for analysis of perfusion fluid using stopcock connection. The evaluation of biochemical profile of perfusates demonstrated potential of the approach for monitoring organ function during ex vivo perfusion. The simplicity of the device makes it convenient to use by medical personnel. With the microprobe, different areas of the organ or various organs can be sampled simultaneously. The technology allows assessment of organ function by biochemical profiling, determination of potential biomarkers, and drug monitoring. The use of this method for preintervention analysis could enhance the decision-making process for the best possible personalized approach, whereas post-transplantation monitoring would be

  19. Implementation Of Prescription Drug Monitoring Programs Associated With Reductions In Opioid-Related Death Rates.

    PubMed

    Patrick, Stephen W; Fry, Carrie E; Jones, Timothy F; Buntin, Melinda B

    2016-07-01

    Over the past two decades the number of opioid pain relievers sold in the United States rose dramatically. This rise in sales was accompanied by an increase in opioid-related overdose deaths. In response, forty-nine states (all but Missouri) created prescription drug monitoring programs to detect high-risk prescribing and patient behaviors. Our objectives were to determine whether the implementation or particular characteristics of the programs were effective in reducing opioid-related overdose deaths. In adjusted analyses we found that a state's implementation of a program was associated with an average reduction of 1.12 opioid-related overdose deaths per 100,000 population in the year after implementation. Additionally, states whose programs had robust characteristics-including monitoring greater numbers of drugs with abuse potential and updating their data at least weekly-had greater reductions in deaths, compared to states whose programs did not have these characteristics. We estimate that if Missouri adopted a prescription drug monitoring program and other states enhanced their programs with robust features, there would be more than 600 fewer overdose deaths nationwide in 2016, preventing approximately two deaths each day. PMID:27335101

  20. An automated system for determining drug solubility based on laser monitoring technique.

    PubMed

    Jouyban-Gharamaleki, Vahid; Jouyban-Gharamaleki, Karim; Shayanfar, Ali; Khoubnasabjafari, Mehry; Jouyban, Abolghasem

    2015-02-01

    The aqueous solubility of a drug candidate is a vital physicochemical property that stops a drug candidate from proceeding further in the drug development processes. Classical solubility determination methods, which are commonly used in pharmaceutical laboratories, are expensive and time-consuming. In this work, an automated determination method is proposed that is based on a laser monitoring technique, and the validity of the measured solubilities is checked by comparing the measured solubilities of acetaminophen at various temperatures as proposed in various literatures. An additional set of acetaminophen solubilities in various concentrations of a surface active agent is measured at various temperatures, which has been reported for the first time, and it could be applied in the pharmaceutical industry, where solubilization of acetaminophen in aqueous solutions is required. PMID:25331492

  1. Behavior Change Techniques Implemented in Electronic Lifestyle Activity Monitors: A Systematic Content Analysis

    PubMed Central

    Lewis, Zakkoyya H; Mayrsohn, Brian G; Rowland, Jennifer L

    2014-01-01

    Background Electronic activity monitors (such as those manufactured by Fitbit, Jawbone, and Nike) improve on standard pedometers by providing automated feedback and interactive behavior change tools via mobile device or personal computer. These monitors are commercially popular and show promise for use in public health interventions. However, little is known about the content of their feedback applications and how individual monitors may differ from one another. Objective The purpose of this study was to describe the behavior change techniques implemented in commercially available electronic activity monitors. Methods Electronic activity monitors (N=13) were systematically identified and tested by 3 trained coders for at least 1 week each. All monitors measured lifestyle physical activity and provided feedback via an app (computer or mobile). Coding was based on a hierarchical list of 93 behavior change techniques. Further coding of potentially effective techniques and adherence to theory-based recommendations were based on findings from meta-analyses and meta-regressions in the research literature. Results All monitors provided tools for self-monitoring, feedback, and environmental change by definition. The next most prevalent techniques (13 out of 13 monitors) were goal-setting and emphasizing discrepancy between current and goal behavior. Review of behavioral goals, social support, social comparison, prompts/cues, rewards, and a focus on past success were found in more than half of the systems. The monitors included a range of 5-10 of 14 total techniques identified from the research literature as potentially effective. Most of the monitors included goal-setting, self-monitoring, and feedback content that closely matched recommendations from social cognitive theory. Conclusions Electronic activity monitors contain a wide range of behavior change techniques typically used in clinical behavioral interventions. Thus, the monitors may represent a medium by which

  2. Literature Based Drug Interaction Prediction with Clinical Assessment Using Electronic Medical Records: Novel Myopathy Associated Drug Interactions

    PubMed Central

    Subhadarshini, Abhinita; Karnik, Shreyas D.; Li, Xiaochun; Hall, Stephen D.; Jin, Yan; Callaghan, J. Thomas; Overhage, Marcus J.; Flockhart, David A.; Strother, R. Matthew; Quinney, Sara K.; Li, Lang

    2012-01-01

    Drug-drug interactions (DDIs) are a common cause of adverse drug events. In this paper, we combined a literature discovery approach with analysis of a large electronic medical record database method to predict and evaluate novel DDIs. We predicted an initial set of 13197 potential DDIs based on substrates and inhibitors of cytochrome P450 (CYP) metabolism enzymes identified from published in vitro pharmacology experiments. Using a clinical repository of over 800,000 patients, we narrowed this theoretical set of DDIs to 3670 drug pairs actually taken by patients. Finally, we sought to identify novel combinations that synergistically increased the risk of myopathy. Five pairs were identified with their p-values less than 1E-06: loratadine and simvastatin (relative risk or RR = 1.69); loratadine and alprazolam (RR = 1.86); loratadine and duloxetine (RR = 1.94); loratadine and ropinirole (RR = 3.21); and promethazine and tegaserod (RR = 3.00). When taken together, each drug pair showed a significantly increased risk of myopathy when compared to the expected additive myopathy risk from taking either of the drugs alone. Based on additional literature data on in vitro drug metabolism and inhibition potency, loratadine and simvastatin and tegaserod and promethazine were predicted to have a strong DDI through the CYP3A4 and CYP2D6 enzymes, respectively. This new translational biomedical informatics approach supports not only detection of new clinically significant DDI signals, but also evaluation of their potential molecular mechanisms. PMID:22912565

  3. Automatic cross-sectioning and monitoring system locates defects in electronic devices

    NASA Technical Reports Server (NTRS)

    Jacobs, G.; Slaughter, B.

    1971-01-01

    System consists of motorized grinding and lapping apparatus, sample holder, and electronic control circuit. Low power microscope examines device to pinpoint location of circuit defect, and monitor displays output signal when defect is located exactly.

  4. Electrochemical approach for monitoring the effect of anti tubulin drugs on breast cancer cells based on silicon nanograss electrodes.

    PubMed

    Zanganeh, Somayeh; Khosravi, Safoora; Namdar, Naser; Amiri, Morteza Hassanpour; Gharooni, Milad; Abdolahad, Mohammad

    2016-09-28

    One of the most interested molecular research in the field of cancer detection is the mechanism of drug effect on cancer cells. Translating molecular evidence into electrochemical profiles would open new opportunities in cancer research. In this manner, applying nanostructures with anomalous physical and chemical properties as well as biocompatibility would be a suitable choice for the cell based electrochemical sensing. Silicon based nanostructure are the most interested nanomaterials used in electrochemical biosensors because of their compatibility with electronic fabrication process and well engineering in size and electrical properties. Here we apply silicon nanograss (SiNG) probing electrodes produced by reactive ion etching (RIE) on silicon wafer to electrochemically diagnose the effect of anticancer drugs on breast tumor cells. Paclitaxel (PTX) and mebendazole (MBZ) drugs have been used as polymerizing and depolymerizing agents of microtubules. PTX would perturb the anodic/cathodic responses of the cell-covered biosensor by binding phosphate groups to deformed proteins due to extracellular signal-regulated kinase (ERK(1/2)) pathway. MBZ induces accumulation of Cytochrome C in cytoplasm. Reduction of the mentioned agents in cytosol would change the ionic state of the cells monitored by silicon nanograss working electrodes (SiNGWEs). By extending the contacts with cancer cells, SiNGWEs can detect minor signal transduction and bio recognition events, resulting in precise biosensing. Effects of MBZ and PTX drugs, (with the concentrations of 2 nM and 0.1 nM, respectively) on electrochemical activity of MCF-7 cells are successfully recorded which are corroborated by confocal and flow cytometry assays. PMID:27619088

  5. 76 FR 36919 - Proof of Concept Demonstration for Electronic Reporting of Clean Water Act Compliance Monitoring...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ...The U.S. Environmental Protection Agency (EPA) will conduct a public webinar in order to inform interested parties about an opportunity to participate in a technical proof of concept demonstration for electronic reporting of Clean Water Act (CWA) National Pollutant Discharge Elimination System (NPDES) Discharge Monitoring Report (DMR) compliance monitoring data. This webinar will be held on......

  6. Online fast Biospeckle monitoring of drug action in Trypanosoma cruzi parasites by motion history image.

    PubMed

    Ansari, Mohammad Zaheer; Grassi, Hilda C; Cabrera, Humberto; Velásquez, Ana; Andrades, Efrén D J

    2016-09-01

    This paper reports on the application of the motion history image (MHI) method on dynamic laser speckle processing as a result of a specific drug action on Trypanosoma cruzi parasites. The MHI procedure is based on human action recognition, and unlike other methods which use a sequence consisting of several frames for recognition, this method uses only an MHI per action sequence for recognition. MHI method avoids the complexity as well as the large computation in sequence matching-based methods and detects a change in the speckle pattern. Experimental results of MHI on real-time monitoring of activity (motility) under the influence of the drug demonstrate the effectiveness of the proposed method. The MHI showed an online result without loss of resolution and definition if we compare with routine LASCA method. The obtained results highlight the advantage of the MHI analysis over traditional qualitative image intensity-based methods and demonstrate the potential of measuring the activity of parasites via dynamic laser speckle analysis. The data was further numerically analyzed in the time domain, and the results presented the ability of the technique to monitor the action of the drug, particularly Epirubicin (100 μg/ml). PMID:27349247

  7. Optical sensors for therapeutic drug monitoring of antidepressants for a better medication adjustment

    NASA Astrophysics Data System (ADS)

    Krieg, Anne K.; Hess, Stefan; Gauglitz, Günter

    2013-05-01

    Therapeutic drug monitoring provides the attending physicians with detailed information on a patient's individual serum level especially during long-term medication. Due to the fact that each patient tolerates drugs or their metabolites differently a medication adjustment can reduce the number and intensity of noticeable side-effects. In particular, psychotropic drugs can cause unpleasant side-effects that affect a patient's life almost as much as the mental disease itself. The tricyclic antidepressants amitriptyline is commonly used for treatment of depressions and was selected for the development of an immunoassay using the direct optical sensor technique Reflectometric Interference Spectroscopy (RIfS). RIfS is a simple, robust and label-free method for direct monitoring of binding events on glass surfaces. Binding to the surface causes a shift of the interference spectrum by a change of the refractive index or physical thickness. This technique can be used for time-resolved observation of association and dissociation of amitriptyline (antigen) and a specific antibody using the binding inhibition test format. An amitriptyline derivative is immobilized on the sensor surface and a specific amount of antibodies can bind to the surface unless the binding is inhibited by free amitriptyline in a sample. No fluorescent label is needed making the whole assay less expensive than label-based methods. With this recently developed immunoassay amitriptyline concentrations in buffer (PBS) can easily be detected down to 500 ng/L.

  8. Implementation of transmission NIR as a PAT tool for monitoring drug transformation during HME processing.

    PubMed

    Islam, Muhammad T; Scoutaris, Nikolaos; Maniruzzaman, Mohammed; Moradiya, Hiren G; Halsey, Sheelagh A; Bradley, Michael S A; Chowdhry, Babur Z; Snowden, Martin J; Douroumis, Dennis

    2015-10-01

    The aim of the work reported herein was to implement process analytical technology (PAT) tools during hot melt extrusion (HME) in order to obtain a better understanding of the relationship between HME processing parameters and the extruded formulations. For the first time two in-line NIR probes (transmission and reflectance) have been coupled with HME to monitor the extrusion of the water insoluble drug indomethacin (IND) in the presence of Soluplus (SOL) or Kollidon VA64 hydrophilic polymers. In-line extrusion monitoring of sheets, produced via a specially designed die, was conducted at various drug/polymer ratios and processing parameters. Characterisation of the extruded transparent sheets was also undertaken by using DSC, XRPD and Raman mapping. Analysis of the experimental findings revealed the production of molecular solutions where IND is homogeneously blended (ascertained by Raman mapping) in the polymer matrices, as it acts as a plasticizer for both hydrophilic polymers. PCA analysis of the recorded NIR signals showed that the screw speed used in HME affects the recorded spectra but not the homogeneity of the embedded drug in the polymer sheets. The IND/VA64 and IND/SOL extruded sheets displayed rapid dissolution rates with 80% and 30% of the IND being released, respectively within the first 20min. PMID:26209124

  9. Organic electronics based pressure sensor towards intracranial pressure monitoring

    NASA Astrophysics Data System (ADS)

    Rai, Pratyush; Varadan, Vijay K.

    2010-04-01

    The intra-cranial space, which houses the brain, contains cerebrospinal fluid (CSF) that acts as a fluid suspension medium for the brain. The CSF is always in circulation, is secreted in the cranium and is drained out through ducts called epidural veins. The venous drainage system has inherent resistance to the flow. Pressure is developed inside the cranium, which is similar to a rigid compartment. Normally a pressure of 5-15 mm Hg, in excess of atmospheric pressure, is observed at different locations inside the cranium. Increase in Intra-Cranial Pressure (ICP) can be caused by change in CSF volume caused by cerebral tumors, meningitis, by edema of a head injury or diseases related to cerebral atrophy. Hence, efficient ways of monitoring ICP need to be developed. A sensor system and monitoring scheme has been discussed here. The system architecture consists of a membrane less piezoelectric pressure sensitive element, organic thin film transistor (OTFT) based signal transduction, and signal telemetry. The components were fabricated on flexible substrate and have been assembled using flip-chip packaging technology. Material science and fabrication processes, subjective to the device performance, have been discussed. Capability of the device in detecting pressure variation, within the ICP pressure range, is investigated and applicability of measurement scheme to medical conditions has been argued for. Also, applications of such a sensor-OTFT assembly for logic sensor switching and patient specific-secure monitoring system have been discussed.

  10. Monitoring the Future: National Results on Adolescent Drug Use. Overview of Key Findings 2005. NIH Publication No. 06-5882

    ERIC Educational Resources Information Center

    Johnson, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

    2006-01-01

    Results from the Monitoring the Future's 2005 nationwide survey of 8th, 10th, and 12th grade students are given in this report. Recent trends in the use of licit and illicit drugs are emphasized, as well as trends in the levels of perceived risk and personal disapproval associated with each drug. This study has shown these beliefs and attitudes to…

  11. Demographic Subgroup Trends for Various Licit and Illicit Drugs, 1975-2006. Monitoring the Future Occasional Paper 67

    ERIC Educational Resources Information Center

    Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

    2007-01-01

    This occasional paper is intended to serve as a supplement to the larger annual volume, "Monitoring the Future National Survey Results on Drug Use, 1975-2006: Volume I: Secondary School Students." This supplement contains the graphic presentation of the trends in drug use for various demographic subgroups, namely those defined by gender, college…

  12. Monitoring the Future National Survey Results on Drug Use, 1975-2001. Volume 1: Secondary School Students, 2001.

    ERIC Educational Resources Information Center

    Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.

    Since 1975, the Monitoring the Future project has provided the nation with an important window through which to view the rapidly changing problems of drug use among American youth. This latest two-volume monograph reports the results of the twenty-seventh (2001) national survey of drug use and related attitudes and beliefs among American high…

  13. Monitoring the Future National Survey Results on Drug Use, 1975-2010. Volume I, Secondary School Students

    ERIC Educational Resources Information Center

    Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

    2011-01-01

    The Monitoring the Future (MTF) study involves an ongoing series of national surveys of American adolescents and adults that has provided the nation with a vital window into the important, but largely hidden, problem behaviors of illegal drug use, alcohol use, tobacco use, anabolic steroid use, and psychotherapeutic drug use. For more than a third…

  14. Demographic Subgroup Trends for Various Licit and Illicit Drugs, 1975-2007. Monitoring the Future Occasional Paper 69

    ERIC Educational Resources Information Center

    Johnston, Lloyd D.; O'Malley, Patrick M.; Bachman, Jerald G.; Schulenberg, John E.

    2008-01-01

    This occasional paper is intended to serve as a supplement to the larger annual volume, "Monitoring the Future National Survey Results on Drug Use, 1975-2007: Volume I: Secondary School Students." This supplement contains the graphic presentation of the trends in drug use for various demographic subgroups, namely those defined by gender, college…

  15. Integrated hollow microneedle-optofluidic biosensor for therapeutic drug monitoring in sub-nanoliter volumes

    NASA Astrophysics Data System (ADS)

    Ranamukhaarachchi, Sahan A.; Padeste, Celestino; Dübner, Matthias; Häfeli, Urs O.; Stoeber, Boris; Cadarso, Victor J.

    2016-07-01

    Therapeutic drug monitoring (TDM) typically requires painful blood drawn from patients. We propose a painless and minimally-invasive alternative for TDM using hollow microneedles suitable to extract extremely small volumes (<1 nL) of interstitial fluid to measure drug concentrations. The inner lumen of a microneedle is functionalized to be used as a micro-reactor during sample collection to trap and bind target drug candidates during extraction, without requirements of sample transfer. An optofluidic device is integrated with this microneedle to rapidly quantify drug analytes with high sensitivity using a straightforward absorbance scheme. Vancomycin is currently detected by using volumes ranging between 50–100 μL with a limit of detection (LoD) of 1.35 μM. The proposed microneedle-optofluidic biosensor can detect vancomycin with a sample volume of 0.6 nL and a LoD of <100 nM, validating this painless point of care system with significant potential to reduce healthcare costs and patients suffering.

  16. Renal sympathetic denervation after Symplicity HTN-3 and therapeutic drug monitoring in severe hypertension

    PubMed Central

    Fadl Elmula, Fadl Elmula M.; Larstorp, Anne C.; Kjeldsen, Sverre E.; Persu, Alexandre; Jin, Yu; Staessen, Jan A.

    2015-01-01

    Renal sympathetic denervation (RDN) has been and is still proposed as a new treatment modality in patients with apparently treatment resistant hypertension (TRH), a condition defined as persistent blood pressure elevation despite prescription of at least 3 antihypertensive drugs including a diuretic. However, the large fall in blood pressure after RDN reported in the first randomized study, Symplicity HTN-2 and multiple observational studies has not been confirmed in five subsequent prospective randomized studies and may be largely explained by non-specific effects such as improvement of drug adherence in initially poorly adherent patients (the Hawthorne effect), placebo effect and regression to the mean. The overall blood-pressure lowering effect of RDN seems rather limited and the characteristics of true responders are largely unknown. Accordingly, RDN is not ready for clinical practice. In most patients with apparently TRH, drug monitoring and improvement of drug adherence may prove more effective and cost-beneficial to achieve blood pressure control. In the meantime, research should aim at identifying characteristics of those patients with truly TRH who may respond to RDN. PMID:25709581

  17. Integrated hollow microneedle-optofluidic biosensor for therapeutic drug monitoring in sub-nanoliter volumes.

    PubMed

    Ranamukhaarachchi, Sahan A; Padeste, Celestino; Dübner, Matthias; Häfeli, Urs O; Stoeber, Boris; Cadarso, Victor J

    2016-01-01

    Therapeutic drug monitoring (TDM) typically requires painful blood drawn from patients. We propose a painless and minimally-invasive alternative for TDM using hollow microneedles suitable to extract extremely small volumes (<1 nL) of interstitial fluid to measure drug concentrations. The inner lumen of a microneedle is functionalized to be used as a micro-reactor during sample collection to trap and bind target drug candidates during extraction, without requirements of sample transfer. An optofluidic device is integrated with this microneedle to rapidly quantify drug analytes with high sensitivity using a straightforward absorbance scheme. Vancomycin is currently detected by using volumes ranging between 50-100 μL with a limit of detection (LoD) of 1.35 μM. The proposed microneedle-optofluidic biosensor can detect vancomycin with a sample volume of 0.6 nL and a LoD of <100 nM, validating this painless point of care system with significant potential to reduce healthcare costs and patients suffering. PMID:27380889

  18. Integrated hollow microneedle-optofluidic biosensor for therapeutic drug monitoring in sub-nanoliter volumes

    PubMed Central

    Ranamukhaarachchi, Sahan A.; Padeste, Celestino; Dübner, Matthias; Häfeli, Urs O.; Stoeber, Boris; Cadarso, Victor J.

    2016-01-01

    Therapeutic drug monitoring (TDM) typically requires painful blood drawn from patients. We propose a painless and minimally-invasive alternative for TDM using hollow microneedles suitable to extract extremely small volumes (<1 nL) of interstitial fluid to measure drug concentrations. The inner lumen of a microneedle is functionalized to be used as a micro-reactor during sample collection to trap and bind target drug candidates during extraction, without requirements of sample transfer. An optofluidic device is integrated with this microneedle to rapidly quantify drug analytes with high sensitivity using a straightforward absorbance scheme. Vancomycin is currently detected by using volumes ranging between 50–100 μL with a limit of detection (LoD) of 1.35 μM. The proposed microneedle-optofluidic biosensor can detect vancomycin with a sample volume of 0.6 nL and a LoD of <100 nM, validating this painless point of care system with significant potential to reduce healthcare costs and patients suffering. PMID:27380889

  19. Fault detection monitor circuit provides ''self-heal capability'' in electronic modules - A concept

    NASA Technical Reports Server (NTRS)

    Kennedy, J. J.

    1970-01-01

    Self-checking technique detects defective solid state modules used in electronic test and checkout instrumentation. A ten bit register provides failure monitor and indication for 1023 comparator circuits, and the automatic fault-isolation capability permits the electronic subsystems to be repaired by replacing the defective module.

  20. Electronic simulation of a barometric pressure sensor for the meteorological monitor assembly

    NASA Technical Reports Server (NTRS)

    Guiar, C. N.; Duff, L. W.

    1982-01-01

    An analysis of the electronic simulation of barometric pressure used to self-test the counter electronics of the digital barometer is presented. The barometer is part of the Meteorological Monitor Assembly that supports navigation in deep space communication. The theory of operation of the digital barometer, the design details, and the verification procedure used with the barometric pressure simulator are presented.

  1. Monitoring the ingestion of anti-tuberculosis drugs by simple non-invasive methods.

    PubMed

    Sirgel, F A; Maritz, J S; Venter, A; Langdon, G; Smith, P J; Donald, P R

    2006-01-13

    This investigation retrospectively assessed inexpensive non-invasive qualitative methods to monitor the ingestion of anti-tuberculosis drugs isoniazid, rifampicin and rifapentine. Results showed that commercial test strips detected the isoniazid metabolites isonicotinic acid and isonicotinylglycine as efficiently as the isonicotinic acid method in 150 urine samples. The presence of rifamycins in urine samples (n=1085) was detected by microbiological assay techniques and the sensitivity compared to the n-butanol extraction colour test in 91 of these specimens. The proportions detected by the two methods were significantly different and the sensitivity of the n-butanol procedure was only 63.8% (95% CL 51.2-76.4%) as compared to that of the superior microbiological method. Final validation (n=691) showed that qualitative assays measure isoniazid and rifamycin ingestion with an efficiency similar to high-performance liquid chromatography. The qualitative procedures may therefore be valuable in clinical trials and in tuberculosis clinics to confirm drug ingestion. PMID:16303269

  2. Dried blood spots analysis with mass spectrometry: Potentials and pitfalls in therapeutic drug monitoring.

    PubMed

    Antunes, Marina Venzon; Charão, Mariele Feiffer; Linden, Rafael

    2016-09-01

    Therapeutic drug monitoring (TDM) relays in the availability of specialized laboratory assays, usually available in reference centers that are not accessible to all patients. In this context, there is a growing interest in the use of dried blood spot (DBS) sampling, usually obtained from finger pricks, which allows simple and cost-effective logistics in many settings, particularly in Developing Countries. The use of DBS assays to estimate plasma concentrations is highly dependent on the hematocrit of the blood, as well as the particular characteristics of the measured analyte. DBS assays require specific validation assays, most of them are related to hematocrit effects. In the present manuscript, the application of mass spectrometric assays for determination of drugs for TDM purposes in the last ten years is reviewed, as well as the particular validation assays for new DBS methods. PMID:27179588

  3. A protocol for developing a clinical practice guideline for therapeutic drug monitoring of vancomycin.

    PubMed

    Ye, Zhi-Kang; Chen, Ken; Chen, Yao-Long; Zhai, Suo-di

    2016-06-01

    This study aimed to develop a guideline for therapeutic drug monitoring (TDM) of vancomycin. We adopted the new guideline definition from the Institute of Medicine (IOM), adhered closely to the six domains of the Appraisal of Guidelines for Research & Evaluation II (AGREE II), and made recommendations based on systematic reviews. We established a Guideline Steering Group and a Guideline Development Group, formulated 12 questions in the form of Population, Intervention, Comparison, Outcome (PICO) and completed a literature search. As far as we know, we will develop the first evidenced-based guideline for vancomycin TDM under the framework of the Grade of Recommendations Assessment, Development and Evaluation (GRADE). PMID:27376822

  4. Detecting, Monitoring, and Reporting Possible Adverse Drug Events Using an Arden-Syntax-based Rule Engine.

    PubMed

    Fehre, Karsten; Plössnig, Manuela; Schuler, Jochen; Hofer-Dückelmann, Christina; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

    2015-01-01

    The detection of adverse drug events (ADEs) is an important aspect of improving patient safety. The iMedication system employs predefined triggers associated with significant events in a patient's clinical data to automatically detect possible ADEs. We defined four clinically relevant conditions: hyperkalemia, hyponatremia, renal failure, and over-anticoagulation. These are some of the most relevant ADEs in internal medical and geriatric wards. For each patient, ADE risk scores for all four situations are calculated, compared against a threshold, and judged to be monitored, or reported. A ward-based cockpit view summarizes the results. PMID:26262252

  5. The tautomerization phenomenon of glibenclamide drug monitored by means of volumetric measurements

    NASA Astrophysics Data System (ADS)

    Wojnarowska, Z.; Paluch, M.; Pionteck, J.

    2011-12-01

    In this paper, we investigate the tautomerization process of glibenclamide drug by monitoring the changes in the specific volume. The density changes observed during the chemical equilibration process, carried out at a pressure of p = 10 MPa and at three different temperatures, enable us to study the kinetics of tautomerization reaction, i.e., to determine the activation energy and to recognize the real time scale of this process at various temperature conditions. The results obtained from analysis of Vsp(t) dependencies were next compared with the kinetic data previously obtained from dielectric spectroscopy studies.

  6. Equipment for Beam Current and Electron Energy Monitoring During Industry Irradiation.

    NASA Astrophysics Data System (ADS)

    Zavadtsev, A. A.

    1997-05-01

    The electron beam irradiation sterilization is placed first among all types of medical items sterilization. The quality of sterilization is determined by value of dose, which is in one's turn determined by beam current, electron energy and beam scanning system parameters. Therefore this parameters have to be controlled during the irradiation process. The equipment for beam current and electron energy monitoring allows to control beam current, electron energy spectrum and nominal deflection of electron beam when scanning during the irradiation process each scanning period or, for example, each tenth period by request.

  7. Creative Uses of Custom Electronics for Environmental Monitoring

    NASA Astrophysics Data System (ADS)

    Hicks, S.; Aufdenkampe, A. K.; Montgomery, D. S.

    2012-12-01

    The ability to build custom electronic devices specifically suited to a unique task has gotten easier and cheaper, thanks to the recent popularity of open source electronics platforms like Arduino. Using Arduino-based processor boards, we have been creating a variety of helpful devices to perform functions that would have been too expensive to implement with standard methods and commercial hardware. The Christina River Basin CZO is currently operating dozens of homemade dataloggers that are connected to different types of environmental sensors. Most of these Arduino loggers have been deployed for over a year, so our experiences with them and their sensors have taught us a lot about the reliability and accuracy of both the loggers and the sensors. Some loggers also have the capability for wireless radio or ethernet data transmission for reporting live data to web sites for instant graphing or archiving. Other Arduino devices have the ability to be controlled remotely through web sites or telephones, making it easy to remotely trigger sample pumps or valves. The open-source nature of Arduino means collaboration is easy because the circuit schematics and source code for programming the boards can be shared between users. And because Arduino devices are easy to use and program, we developed an interface board that allows educators to easily connect a variety of inexpensive environmental sensors to an Arduino board. Then the students can write and upload simple programs to interact with the sensors, making it a very effective tool for teaching electronics and environmental science at the same time. The flexibility and capability of electronics prototyping platforms like Arduino mean these simple boards can cheaply and effectively perform a countless number of tasks for projects in environmental science and education.

  8. A Simplified Method for Routine Outcome Monitoring after Drug Abuse Treatment

    PubMed Central

    Lennox, Richard D.; Sternquist, Marie A.; Paredes, Alfonso

    2013-01-01

    The routine collection of drug treatment outcomes to manage quality of care, improve patient satisfaction, and allocate treatment resources is currently hampered by two key difficulties: (1) problems locating clients once they leave treatment; and (2) the prohibitive cost of obtaining meaningful and reliable post-treatment data. This pilot describes precise methods for an economical staff-based routine outcome monitoring (ROM) system using an 18-item core measure telephone survey. As implemented at Narconon™ of Oklahoma, a behavioral and social skills based, residential drug rehabilitation program, the system was psychometrically adequate for aggregate reporting while providing clinically useful information. Standardized procedures for staff training, collecting client contact information, structuring exit interviews and maintaining post-treatment telephone contact produced follow-up rates that improved from 57.6% to 100% over the course of the project. Aggregate data was used to improve program delivery and thereby post-treatment substance use and social outcomes. These methods and use of data may contribute to the discussion on how to best monitor outcomes. PMID:24092985

  9. Fully automatic flow-based device for monitoring of drug permeation across a cell monolayer.

    PubMed

    Zelená, Lucie; Marques, Sara S; Segundo, Marcela A; Miró, Manuel; Pávek, Petr; Sklenářová, Hana; Solich, Petr

    2016-01-01

    A novel flow-programming setup based on the sequential injection principle is herein proposed for on-line monitoring of temporal events in cell permeation studies. The permeation unit consists of a Franz cell with its basolateral compartment mixed under mechanical agitation and thermostated at 37 °C. The apical compartment is replaced by commercially available Transwell inserts with a precultivated cell monolayer. The transport of drug substances across epithelial cells genetically modified with the P-glycoprotein membrane transporter (MDCKII-MDR1) is monitored on-line using rhodamine 123 as a fluorescent marker. The permeation kinetics of the marker is obtained in a fully automated mode by sampling minute volumes of solution from the basolateral compartment in short intervals (10 min) up to 4 h. The effect of a P-glycoprotein transporter inhibitor, verapamil as a model drug, on the efficiency of the marker transport across the cell monolayer is thoroughly investigated. The analytical features of the proposed flow method for cell permeation studies in real time are critically compared against conventional batch-wise procedures and microfluidic devices. PMID:26615589

  10. A Case Report of Clonazepam Dependence: Utilization of Therapeutic Drug Monitoring During Withdrawal Period.

    PubMed

    Kacirova, Ivana; Grundmann, Milan; Silhan, Petr; Brozmanova, Hana

    2016-03-01

    Clonazepam is long-acting benzodiazepine agonist used in short-acting benzodiazepine withdrawal; however, recent observations suggest the existence of its abuse. We demonstrate a 40-year-old man with a 20-year history of psychiatric care with recently benzodiazepine dependence (daily intake of ∼60 mg of clonazepam and 10 mg of alprazolam). High serum levels of both drugs were analyzed 3 weeks before admission to hospitalization (clonazepam 543.9 ng/mL, alprazolam 110 ng/mL) and at the time of admission (clonazepam 286.2 ng/mL, alprazolam 140 ng/mL) without any signs of benzodiazepine intoxication. Gradual withdrawal of clonazepam with monitoring of its serum levels and increase of gabapentin dose were used to minimize physical signs and symptoms of clonazepam withdrawal. Alprazolam was discontinued promptly. Clinical consequences of the treatment were controllable tension, intermittent headache, and rarely insomia. It is the first case report showing utilization of therapeutic drug monitoring during withdrawal period in the patient with extreme toleration to severe benzodiazepine dependence. PMID:26945373

  11. Porous-Si-based bioreactors for glucose monitoring and drugs production

    NASA Astrophysics Data System (ADS)

    D'Arrigo, Giuseppe; Fichera, Manuela; Libertino, Sebania

    2003-01-01

    Biosensors are a very useful tool to produce drugs or to monitor chemical species through their product of reaction. The sensor is fabricated bounding on its surface specific enzymes that can accomplish the synthesis function. We studied the possibility to fabricate Si-based micro-biosensors to detect glucose in water solutions. We used porous Si (PS) as surface to bound the glucose oxidase enzyme. We ideated an fabricated a novel biosensor structure based on a PS membrane that can be used for glucose monitoring and for drug production, by properly choosing the enzyme to immobilize in the reactor. The fabrication details of the structure, having a suspended and auto-supporting PS membrane, through surface micromachining processes, ULSI compatible, are shown. Micro channels localised below the membrane will allow the buffer solution flow through the porous matrix. Moreover, in this work we acquired the know-how on the enzyme manipulation, bonding and detection on Si-based surfaces. The glucose oxidase was deposited in PS, on bulk Si and on glass to perform photoluminescence, absorbance and optical microscopy measurements.

  12. Cartilage oligomeric matrix protein in monitoring and prognostication of osteoarthritis and its utility in drug development

    PubMed Central

    Das, Bibhu R.; Roy, Arnab; Khan, Faisal R.

    2015-01-01

    Osteoarthritis (OA) is a major public concern as it is one of the leading causes of morbidity and lays a huge medical and economic burden on health resources. Early detection of OA has been a clinical challenge as early signs of joint inflammation are often not evidently identifiable on routine radiographic images. This presents a dire unmet medical need for a biomarker, which could detect early signs of joint inflammation much before irreversible joint damage and radiographic changes set in. Besides, the treatment of OA has remained mainly symptomatic. A disease modifying OA drug (DMOAD), which can act as targeted anti-OA therapy has not been able to receive regulatory approval yet. The clinical development of a DMAOD too warrants the need of a biomarker; which can act as a surrogate clinical endpoint used to monitor therapeutic efficacy and to validate a clinically meaningful change within the restricted time frame of a clinical study. In this regard, the current review focuses on cartilage oligomeric matrix protein (COMP), a potential OA biomarker which has shown significant clinical promise as a tool for early detection, therapeutic monitoring, prognostication and drug development for OA. This brief review is pivoted around the findings of selected relevant publications from PubMed indexed journals. PMID:25657896

  13. Electronic monitoring and counseling to improve medication adherence.

    PubMed

    Rosen, Marc I; Rigsby, Michael O; Salahi, Jamelah T; Ryan, Caitlin E; Cramer, Joyce A

    2004-04-01

    Electronic caps, pill caps that record the date and time of pill bottle opening provide an objective measure of adherence to prescribed medication. A promising intervention to improve adherence, cue-dose training, involves reviewing patients' pill cap-generated reports concerning their medication-taking and offering individualized recommendations for remembering to take medications at specific times of day. In this preliminary study, 79 patients prescribed the antihyperglycemic medication metformin had adherence assessed during a 4-week baseline period. Adherence, defined as proportion of prescribed doses taken within a predetermined 4-h window, was measured using electronic MEMS caps. Those who had less than 80% baseline adherence (n = 33) were randomly assigned to either receive 4 months of cue-dose training (n = 16) or to a control group (n = 17). Cue-dose training was associated with significantly better adherence to metformin (mean improvement of 15%). The effects of cue-dose training on adherence to other antihyperglycemic medication did not reach statistical significance. Glycosylated hemoglobin (a measure of blood sugar control) did not differ between groups. Data from nine patients who reviewed pill cap-generated data with their primary care providers suggested that both patients and providers found the discussion moderately helpful and not at all uncomfortable. PMID:14998735

  14. Relationship between electronic properties and drug activity of seven quinoxaline compounds: A DFT study

    NASA Astrophysics Data System (ADS)

    Behzadi, Hadi; Roonasi, Payman; Assle taghipour, Khatoon; van der Spoel, David; Manzetti, Sergio

    2015-07-01

    The quantum chemical calculations at the DFT/B3LYP level of theory were carried out on seven quinoxaline compounds, which have been synthesized as anti-Mycobacterium tuberculosis agents. Three conformers were optimized for each compound and the lowest energy structure was found and used in further calculations. The electronic properties including EHOMO, ELUMO and related parameters as well as electron density around oxygen and nitrogen atoms were calculated for each compound. The relationship between the calculated electronic parameters and biological activity of the studied compounds were investigated. Six similar quinoxaline derivatives with possible more drug activity were suggested based on the calculated electronic descriptors. A mechanism was proposed and discussed based on the calculated electronic parameters and bond dissociation energies.

  15. AGNP consensus guidelines for therapeutic drug monitoring in psychiatry: update 2011.

    PubMed

    Hiemke, C; Baumann, P; Bergemann, N; Conca, A; Dietmaier, O; Egberts, K; Fric, M; Gerlach, M; Greiner, C; Gründer, G; Haen, E; Havemann-Reinecke, U; Jaquenoud Sirot, E; Kirchherr, H; Laux, G; Lutz, U C; Messer, T; Müller, M J; Pfuhlmann, B; Rambeck, B; Riederer, P; Schoppek, B; Stingl, J; Uhr, M; Ulrich, S; Waschgler, R; Zernig, G

    2011-09-01

    Therapeutic drug monitoring (TDM), i. e., the quantification of serum or plasma concentrations of medications for dose optimization, has proven a valuable tool for the patient-matched psychopharmacotherapy. Uncertain drug adherence, suboptimal tolerability, non-response at therapeutic doses, or pharmacokinetic drug-drug interactions are typical situations when measurement of medication concentrations is helpful. Patient populations that may predominantly benefit from TDM in psychiatry are children, pregnant women, elderly patients, individuals with intelligence disabilities, forensic patients, patients with known or suspected genetically determined pharmacokinetic abnormalities or individuals with pharmacokinetically relevant comorbidities. However, the potential benefits of TDM for optimization of pharmacotherapy can only be obtained if the method is adequately integrated into the clinical treatment process. To promote an appropriate use of TDM, the TDM expert group of the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) issued guidelines for TDM in psychiatry in 2004. Since then, knowledge has advanced significantly, and new psychopharmacologic agents have been introduced that are also candidates for TDM. Therefore the TDM consensus guidelines were updated and extended to 128 neuropsychiatric drugs. 4 levels of recommendation for using TDM were defined ranging from “strongly recommended” to “potentially useful”. Evidence-based “therapeutic reference ranges” and “dose related reference ranges” were elaborated after an extensive literature search and a structured internal review process. A “laboratory alert level” was introduced, i. e., a plasma level at or above which the laboratory should immediately inform the treating physician. Supportive information such as cytochrome P450 substrate and inhibitor properties of medications, normal ranges of ratios of concentrations of drug metabolite to parent drug and

  16. Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists

    PubMed Central

    Rasubala, Linda; Pernapati, Lavanya; Velasquez, Ximena; Burk, James; Ren, Yan-Fang

    2015-01-01

    Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%), 190 (14.1%), and 140 (9.6%) received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (p<0.05). Total numbers of prescribed opioid pills in a 3-month period decreased from 5096 to 1120, signifying a 78% reduction in absolute quantity. Prescriptions for non-opioid analgesics acetaminophen increased during the same periods (p<0.05). We conclude that the mandatory PDMP significantly affected the prescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain. PMID:26274819

  17. Drug transport mechanism of P-glycoprotein monitored by single molecule fluorescence resonance energy transfer

    NASA Astrophysics Data System (ADS)

    Ernst, S.; Verhalen, B.; Zarrabi, N.; Wilkens, S.; Börsch, M.

    2011-03-01

    In this work we monitor the catalytic mechanism of P-glycoprotein (Pgp) using single-molecule fluorescence resonance energy transfer (FRET). Pgp, a member of the ATP binding cassette family of transport proteins, is found in the plasma membrane of animal cells where it is involved in the ATP hydrolysis driven export of hydrophobic molecules. When expressed in the plasma membrane of cancer cells, the transport activity of Pgp can lead to the failure of chemotherapy by excluding the mostly hydrophobic drugs from the interior of the cell. Despite ongoing effort, the catalytic mechanism by which Pgp couples MgATP binding and hydrolysis to translocation of drug molecules across the lipid bilayer is poorly understood. Using site directed mutagenesis, we have introduced cysteine residues for fluorescence labeling into different regions of the nucleotide binding domains (NBDs) of Pgp. Double-labeled single Pgp molecules showed fluctuating FRET efficiencies during drug stimulated ATP hydrolysis suggesting that the NBDs undergo significant movements during catalysis. Duty cycle-optimized alternating laser excitation (DCO-ALEX) is applied to minimize FRET artifacts and to select the appropriate molecules. The data show that Pgp is a highly dynamic enzyme that appears to fluctuate between at least two major conformations during steady state turnover.

  18. Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists.

    PubMed

    Rasubala, Linda; Pernapati, Lavanya; Velasquez, Ximena; Burk, James; Ren, Yan-Fang

    2015-01-01

    Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%), 190 (14.1%), and 140 (9.6%) received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (p<0.05). Total numbers of prescribed opioid pills in a 3-month period decreased from 5096 to 1120, signifying a 78% reduction in absolute quantity. Prescriptions for non-opioid analgesics acetaminophen increased during the same periods (p<0.05). We conclude that the mandatory PDMP significantly affected the prescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain. PMID:26274819

  19. New generation electronics applied to beam position monitors

    SciTech Connect

    Unser, K.B.

    1997-01-01

    Cellular telephones and global positioning system (GPS) satellite receivers are examples of modern rf engineering. Taking some inspiration from those designs, a precision signal-processor module for beam position monitors was developed. It features a heterodyne receiver (100 MHz to 1 GHz) with more than 90 dB dynamic range. Four multiplexed input channels are able to resolve signal differences lower than 0.0005 dB with good long-term stability. This corresponds to sub-micron resolution when used with a beam position pick-up with 40 mm free aperture. The paper concentrates on circuit design and modern dynamic testing methods, used first during development and later for production tests. The frequency synthesizer of the local oscillator, the phase-locked synchronous detector, and the low-noise preamplifier with automatic gain control are discussed. Other topics are design for immunity to electromagnetic interference to ensure reliable operation in an accelerator environment. {copyright} {ital 1997 American Institute of Physics.}

  20. Real-time electronic adherence monitoring is feasible, comparable to unannounced pill counts, and acceptable

    PubMed Central

    Haberer, Jessica E.; Robbins, Gregory K.; Ybarra, Michele; Monk, Alexandra; Ragland, Kathleen; Weiser, Sheri D.; Johnson, Mallory O.; Bangsberg, David R.

    2011-01-01

    Second generation electronic medication adherence monitors provide real-time data on pill bottle opening behavior. Feasibility, validity, and acceptability, however, have not been established. Med-eMonitor is a multi-compartment adherence device with reminder and education capacity that transmits data through a telephone connection. Monthly adherence levels were measured for 52 participants over approximately three months using the Med-eMonitor (unadjusted and adjusted for participant confirmed dosing) and unannounced pill counts. HIV RNA was assessed before and after the three-month period. Acceptability of Med-eMonitor was determined. Over 92% of Med-eMonitor data was transmitted daily. Unannounced pill counts significantly correlated with adjusted Med-eMonitor adherence (r=0.29, p=0.04). HIV RNA significantly correlated with unannounced pill counts (r=−0.34, p=0.02), and trended toward a significant correlation with unadjusted Med-eMonitor adherence (r=−0.26; p=0.07). Most, but not all, participants liked using the Med-eMonitor. Med-eMonitor allows for real-time adherence monitoring and potentially intervention, which may be critical for prolonging treatment success. PMID:21448728

  1. Point-of-care detection and real-time monitoring of intravenously delivered drugs via tubing with an integrated SERS sensor

    NASA Astrophysics Data System (ADS)

    Wu, Hsin-Yu; Cunningham, Brian T.

    2014-04-01

    pharmaceutical compounds (hydrocodone, levorphanol, morphine, oxycodone, methadone, phenobarbital, dopamine, diltiazem, promethazine, and mitoxantrone). We demonstrate dose-dependent SERS signal magnitude, resulting in detection limits (ng ml-1) well below typical administered dosages (mg ml-1). Further, we show that the detected drugs are not permanently attached to the PNA surface, and thus our approach is capable of performing continuous monitoring of drug delivery as materials flow through IV tubing that is connected in series with the sensor. Finally, we demonstrate the potential co-detection of multiple drugs when they are mixed together, and show excellent reproducibility and stability of SERS measurements for periods extending at least five days. The capabilities reported here demonstrate the potential to use PNA SERS surfaces for enhancing the safety of IV drug delivery. Electronic supplementary information (ESI) available: Fabrication of PNA substrates, fabrication details of the flow cell, details of FDTD simulation, characterization of the scattering volume, and detection of diltiazem diluted in DI water and PBS. See DOI: 10.1039/c4nr00027g

  2. Relativistic electron precipitation at International Space Station: Space weather monitoring by Calorimetric Electron Telescope

    NASA Astrophysics Data System (ADS)

    Kataoka, Ryuho; Asaoka, Yoichi; Torii, Shoji; Terasawa, Toshio; Ozawa, Shunsuke; Tamura, Tadahisa; Shimizu, Yuki; Akaike, Yosui; Mori, Masaki

    2016-05-01

    The charge detector (CHD) of the Calorimetric Electron Telescope (CALET) on board the International Space Station (ISS) has a huge geometric factor for detecting MeV electrons and is sensitive to relativistic electron precipitation (REP) events. During the first 4 months, CALET CHD observed REP events mainly at the dusk to midnight sector near the plasmapause, where the trapped radiation belt electrons can be efficiently scattered by electromagnetic ion cyclotron (EMIC) waves. Here we show that interesting 5-20 s periodicity regularly exists during the REP events at ISS, which is useful to diagnose the wave-particle interactions associated with the nonlinear wave growth of EMIC-triggered emissions.

  3. Associations Between Personality Traits and Adherence to Antidepressants Assessed Through Self-Report, Electronic Monitoring, and Pharmacy Dispensing Data: A Pilot Study.

    PubMed

    Wouters, Hans; Amin, Darya F H; Taxis, Katja; Heerdink, Eibert R; Egberts, Antoine C G; Gardarsdottir, Helga

    2016-10-01

    Treatment with antidepressants is often compromised by substantial nonadherence. To understand nonadherence, specific medication-related behaviors and beliefs have been studied, but less is known about broader and temporally stable personality "traits." Furthermore, adherence has often been assessed by a single method. Hence, we investigated associations between the Big Five personality traits and adherence assessed by self-report, electronic drug use monitoring, and dispensing data. Using the Big Five Inventory, we assessed the personality traits "openness," "conscientiousness," "extraversion," "agreeableness," and "neuroticism" of patients treated with antidepressants who were invited through community pharmacies. Self-reported adherence was assessed with the Medication Adherence Rating Scale (score >24), electronic monitoring with medication event monitoring system (MEMS) devices (therapy days missed ≤ 10% and < 4 consecutive days missed), and dispensing data (medication possession ratio ≥ 80%). One hundred four women and 33 men participated (mean age, 51; standard deviation, 14). Paroxetine was most frequently prescribed (N = 53, 38%). Logistic regression analysis revealed that of the personality traits, the third and fourth quartiles of "conscientiousness" were associated with better self-reported adherence (odds ratio, 3.63; 95% confidence interval, 1.34-9.86 and odds ratio, 2.97; 95% confidence interval, 1.09-8.08; P ≤ 0.05). No relationships were found between personality traits and adherence assessed through electronic drug use monitoring or dispensing data. We therefore conclude that adherence to antidepressant therapy seems to be largely unrelated to personality traits. PMID:27454894

  4. Electron density guided fragment-based drug design--a lead generation example.

    PubMed

    Abad, Marta C; Gibbs, Alan C; Zhang, Xuqing

    2011-01-01

    We describe here a method using protein crystallography as the sole detection tool for fragment-based lead discovery. The methodology consists of iterative design, synthesis, and X-ray crystallographic screening of three libraries of compounds. Target-specific compound design, by way of active site electron density in the presence of a bound fragment hit and the intentional lack of solution activity bias form the basis of our approach. We provide an example of this alternative fragment-based drug design (FBDD) method, detailing results from a campaign using ketohexokinase to generate a unique lead series with promising drug-like properties. PMID:21371603

  5. A survey of electronic drug information resources and identification of problems associated with the differing vocabularies used to key them.

    PubMed Central

    Gnassi, J. A.; Barnett, G. O.

    1993-01-01

    Drug information resources are increasingly becoming electronically available. They differ in scope, granularity, and purpose. These considerations have shaped the selection of dissimilar drug name keys, complicating access. An abbreviated and simplified historical context of the development of official controlled vocabularies and their relationships is followed by a review of the kinds of information available in several electronic drug information resources. The key vocabularies used are discussed with examples. Problems using the differing terms of the resource vocabularies are identified. PMID:8130551

  6. Assessment of the use of oral fluid as a matrix for drug monitoring in patients undergoing treatment for opioid addiction.

    PubMed

    Kunkel, Frank; Fey, Elizabeth; Borg, Damon; Stripp, Richard; Getto, Christine

    2015-01-01

    Drug testing is an important clinical tool that is available to physicians who are assessing the effectiveness of drug treatment as well as patient compliance to the administered program. While urine has traditionally been the matrix of choice for drug monitoring, oral fluid, a filtrate of the blood, has shown great promise as an alternative matrix for such applications. Oral fluid collection can be accomplished without the need for highly trained medical staff through the use of a simple, noninvasive oral fluid collection device, which obtains an adequate sample in only a few minutes. There has been a significant amount of research performed on the use of oral fluid for forensic toxicology application; however, more studies assessing the use of oral fluid drug testing are required to validate its ability to achieve clinical drug monitoring goals. Testing for various drugs in oral fluid may yield a different result when compared to the same drugs in urine, requiring an assessment of the utility of oral fluid for such practices. The purpose of this study was to examine the application of oral fluid drug testing in patients undergoing buprenorphine treatment for opioid dependence. A retrospective analysis of drug testing results obtained from 6,928 patients (4,560 unobserved urine collections and 2,368 observed oral fluid collections) monitored for heroin metabolite, amphetamine, benzodiazepines, buprenorphine, tetrahydrocannabinol, cocaine, codeine, hydrocodone, hydromorphone, methadone, morphine, oxycodone, and oxymorphone was completed. Results of this statistical exercise indicated that patients undergoing observed oral fluid collection tested positive more frequently than those unobserved urine collections for several illicit drugs and prescription medications targeted. Oral fluid was shown to detect illicit drug use as well as noncompliance in this patient population under the studied conditions more often than the urine specimens. PMID:26535971

  7. Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access.

    PubMed

    Rutkow, Lainie; Turner, Lydia; Lucas, Eleanor; Hwang, Catherine; Alexander, G Caleb

    2015-03-01

    State prescription drug monitoring programs are common tools intended to reduce prescription drug abuse and diversion, or the nonmedical use of a prescribed drug. The success of these programs depends largely upon physicians' awareness and use of them. We conducted a nationally representative mail survey of 1,000 practicing primary care physicians in 2014 to characterize their attitudes toward and awareness and use of prescription drug monitoring programs. A total of 420 eligible physicians (adjusted response rate: 58 percent) returned completed surveys. Among all physicians surveyed, 72 percent were aware of their state's prescription drug monitoring program, and 53 percent reported using one of the programs. We identified several barriers that may prevent greater use of the programs, including the time-consuming nature of information retrieval and the lack of an intuitive format for data provided by the programs. These results suggest that the majority of US primary care physicians are aware of and use prescription drug monitoring programs at least on occasion, although many did not access these programs routinely. To increase the use of the programs in clinical practice, states should consider implementing legal mandates, investing in prescriber education and outreach, and taking measures to enhance ease of access to and use of the programs. PMID:25732500

  8. Dried blood spots for monitoring and individualization of antiepileptic drug treatment.

    PubMed

    Milosheska, Daniela; Grabnar, Iztok; Vovk, Tomaž

    2015-07-30

    Therapeutic drug monitoring (TDM) is a multi-disciplinary clinical specialty used for optimization and individualization of drug therapy in the general and special populations. Since most antiepileptic drugs (AEDs) are characterized by pronounced intra- and inter-individual variability, it can be especially valuable as an aid for dosing adjustments in patients with epilepsy. Dried blood spots (DBS) sampling technique is recognized as a suitable alternative for conventional sampling methods as TDM interventions should be applied in the most cost-effective, rational and clinically useful manner. In the present review we summarize the latest trends and applications of DBS in TDM of epilepsy. Quantification of AEDs in DBS was employed in various clinical settings and has been already reported for phenobarbital, phenytoin, valproic acid, clonazepam, clobazam, carbamazepine, topiramate, rufinamide, lamotrigine, 10-hydroxycarbazepine and levetiracetam. The major limitation of the published studies are restricted evaluation of critical parameters such as the impact of spotted blood volume, spot homogeneity and haematocrit effect, limited clinical validation and non-established correlations between the DBS and plasma concentrations of AEDs. Standardization of critical technical aspects for appropriate sampling, sample preparation and validation of the analytical procedures for quantification of the drugs, as well as appropriate interpretation of the results are the fields which should get more attention in upcoming studies. Limited data on clinical validation and the fact that this technique has been used in practice only for a few AEDs makes the routine implementation of TDM of AEDs using DBS method a big challenge that should be faced by the pharmaceutical scientists in the future. PMID:25896371

  9. Quantitative Analysis of Therapeutic Drugs in Dried Blood Spot Samples by Paper Spray Mass Spectrometry: An Avenue to Therapeutic Drug Monitoring

    NASA Astrophysics Data System (ADS)

    Manicke, Nicholas Edward; Abu-Rabie, Paul; Spooner, Neil; Ouyang, Zheng; Cooks, R. Graham

    2011-09-01

    A method is presented for the direct quantitative analysis of therapeutic drugs from dried blood spot samples by mass spectrometry. The method, paper spray mass spectrometry, generates gas phase ions directly from the blood card paper used to store dried blood samples without the need for complex sample preparation and separation; the entire time for preparation and analysis of blood samples is around 30 s. Limits of detection were investigated for a chemically diverse set of some 15 therapeutic drugs; hydrophobic and weakly basic drugs, such as sunitinib, citalopram, and verapamil, were found to be routinely detectable at approximately 1 ng/mL. Samples were prepared by addition of the drug to whole blood. Drug concentrations were measured quantitatively over several orders of magnitude, with accuracies within 10% of the expected value and relative standard deviation (RSD) of around 10% by prespotting an internal standard solution onto the paper prior to application of the blood sample. We have demonstrated that paper spray mass spectrometry can be used to quantitatively measure drug concentrations over the entire therapeutic range for a wide variety of drugs. The high quality analytical data obtained indicate that the technique may be a viable option for therapeutic drug monitoring.

  10. Validation of a metered dose inhaler electronic monitoring device: implications for asthma clinical trial use

    PubMed Central

    Pilcher, Janine; Holliday, Mark; Ebmeier, Stefan; McKinstry, Steve; Messaoudi, Fatiha; Weatherall, Mark; Beasley, Richard

    2016-01-01

    Background The SmartTouch Ventolin monitor (Adherium, Auckland, New Zealand) is an electronic monitor for use with a Ventolin metered dose inhaler, which records the date and time of inhaler actuations. This technology has the potential to allow in-depth analysis of patterns of inhaler use in clinical trial settings. The aim of this study was to determine the accuracy of the SmartTouch Ventolin monitor in recording Ventolin actuations. Methods 20 SmartTouch Ventolin monitors were attached to Ventolin metered dose inhalers. Bench testing was performed over a 10-week period, to reflect the potential time frame between visits in a clinical trial. Inhaler actuations were recorded in a paper diary, which was compared with data uploaded from the monitors. Results 2560 actuations were performed during the 10-week study period. Monitor sensitivity for diary-recorded actuations was 99.9% with a lower 97.5% confidence bound of 99.7%. The positive predictive value for diary-recorded actuations was 100% with a 97.5% lower confidence bound of 99.9%. Conclusions The SmartTouch Ventolin monitor is highly accurate in recording and retaining electronic data. It can be recommended for use in clinical trial settings in which training and quality control systems are incorporated into study protocols to ensure accurate data acquisition. PMID:27026805