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Related Concept Videos

Factors Influencing Drug Absorption: Pharmaceutical Parameters01:28

Factors Influencing Drug Absorption: Pharmaceutical Parameters

Solid dosage forms such as tablets and capsules undergo rigorous manufacturing processes to ensure stability and effectiveness. Their dissolution and absorption properties are influenced significantly by the choice of excipients (inactive ingredients that serve various roles in the formulation), and the methodology applied during production. The manufacturing parameters, such as compression force and granulation techniques, significantly affect dissolution rates. Elevated compression forces...
Factors Affecting Dissolution: Drug Permeability, Stability and Stereochemistry01:20

Factors Affecting Dissolution: Drug Permeability, Stability and Stereochemistry

Orally administered drugs primarily enter the systemic circulation via passive diffusion through the intestinal membranes. The drug's absorption is influenced by drug stability in the gastrointestinal GI tract, membrane permeability, the surface area available for absorption, luminal drug concentration, and residence time in the lumen. Drug permeability can be enhanced by adjusting the lipophilicity, polarity, or molecular size of the drug, promoting its passive transport across intestinal...
Bioavailability Enhancement: Drug Stability Enhancement and GI Retention01:05

Bioavailability Enhancement: Drug Stability Enhancement and GI Retention

Improving a drug's stability in the gastrointestinal (GI) tract is paramount for enhancing its bioavailability and therapeutic effectiveness. Various strategies are employed to protect the drug from the harsh gastric milieu and to ensure its release and absorption at the desired site within the GI tract.Polymer coatings are one such method used to shield drugs from the stomach's acidic environment. By preventing premature drug release, these coatings improve the bioavailability of unstable...
Pharmaceutical Alternatives: Polymorphic Form-Related and Particle Size-Related Therapeutic Nonequivalence01:27

Pharmaceutical Alternatives: Polymorphic Form-Related and Particle Size-Related Therapeutic Nonequivalence

Changes in polymorphic forms can significantly influence the bioavailability of poorly soluble drugs. Although the FDA defines pharmaceutical equivalence based on having the same active ingredient, dosage form, and route of administration, it does not automatically disqualify products with different polymorphic forms. This means two products with different polymorphs can still be deemed pharmaceutically equivalent. However, polymorphic differences can affect properties like wettability,...
Formulation and Manufacturing Process: Physical Attributes of Generic Tablets and Capsules01:18

Formulation and Manufacturing Process: Physical Attributes of Generic Tablets and Capsules

Bioequivalence in generic drugs, such as tablets and capsules, refers to their pharmaceutical equivalence to the brand-name counterparts. However, for therapeutic equivalence, manufacturers must also consider physical attributes like size, shape, and weight (FDA Guidance for Industry, December 2003). Discrepancies in these aspects could impact patient compliance and cause medication errors. For instance, swallowing difficulties, often experienced with larger tablets or capsules, can lead to...
Drug Delivery Systems: Different Types01:27

Drug Delivery Systems: Different Types

Conventional oral drug products, termed immediate-release (IR) formulations, are engineered to promptly release their active pharmaceutical ingredient (API) upon ingestion, typically in tablets or capsules. This rapid release often results in swift drug absorption and consequent pharmacodynamic effects, although the timing and intensity can vary depending on the drug's properties. Prodrugs within these formulations require metabolic conversion to activate their pharmacodynamic effects,...

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Related Experiment Video

Updated: Jul 11, 2026

Calcium Carbonate Formation in the Presence of Biopolymeric Additives
09:31

Calcium Carbonate Formation in the Presence of Biopolymeric Additives

Published on: May 14, 2019

Coasting-what is the best formula?

O Levinsohn-Tavor1, S Friedler, M Schachter

  • 1IVF and Infertility Unit, Department of Obstetrics and Gynecology, Assaf-Harofeh Medical Center, Zerifin, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Human Reproduction (Oxford, England)
|May 2, 2003
PubMed
Summary

To reduce ovarian hyperstimulation syndrome (OHSS), coasting involves pausing gonadotrophins. This strategy is most effective when initiated with specific estradiol levels and follicle size, limited to under four days, and ending when estradiol falls below 3000 pg/ml.

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Area of Science:

  • Reproductive Endocrinology
  • Infertility Treatment
  • Clinical Protocols

Background:

  • Ovarian hyperstimulation syndrome (OHSS) is a risk in assisted reproductive technology.
  • Coasting, a method to mitigate OHSS, has variable application and inconsistent efficacy reports.
  • Lack of standardized coasting protocols hinders optimal patient outcomes.

Purpose of the Study:

  • To establish a recommended protocol for the coasting strategy in assisted reproduction.
  • To analyze existing literature to define optimal initiation, duration, and cessation criteria for coasting.
  • To improve the safety and efficacy of coasting in preventing severe OHSS.

Main Methods:

  • Systematic review and analysis of 10 relevant studies identified through a Medline search.
  • Evaluation of heterogeneous criteria for initiating and ending the coasting process.
  • Data synthesis to determine optimal serum estradiol (E2) levels and follicle size for coasting initiation and cessation.

Main Results:

  • Recommended coasting initiation: serum E2 > 3000 pg/ml and leading follicles ≥ 15-18 mm.
  • Recommended coasting duration: < 4 days to maintain implantation and pregnancy rates.
  • Recommended hCG administration: withheld until serum E2 < 3000 pg/ml.
  • Suggested guidelines yield <2% severe OHSS and satisfactory fertilization (55-71%) and pregnancy (36.5-63%) rates.

Conclusions:

  • Standardized coasting protocols can significantly reduce severe OHSS incidence.
  • Adherence to proposed guidelines ensures acceptable pregnancy and fertilization rates.
  • Further multicenter randomized prospective studies are needed to validate these findings.