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Related Concept Videos

Dosage Regimens: Partial Pharmacokinetic Parameters01:01

Dosage Regimens: Partial Pharmacokinetic Parameters

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It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
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Pharmaceutical Poisoning: Potential Scenarios01:26

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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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Modified-Release Drug Delivery Systems: Rate-Programmed II01:19

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Rate-programmed drug delivery systems release drugs in a controlled manner to maintain therapeutic levels. Three main designs include reservoir, matrix, and hybrid systems.Reservoir systems consist of a drug core enclosed within a membrane that controls drug release. In non-swelling reservoir systems, polymers like ethyl cellulose or polymethacrylates are used. These do not hydrate in aqueous media and control release through membrane thickness, porosity, or insolubility. This type includes...
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Modified-Release Drug Delivery Systems: Rate-Programmed I01:22

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Rate-programmed drug delivery systems (DDS) are designed to release drugs at specific, controlled rates to maintain consistent therapeutic levels. These systems are categorized based on their release mechanisms, including dissolution-controlled DDS, diffusion-controlled DDS, and combined dissolution-diffusion-controlled DDS.In dissolution-controlled DDS, the release rate depends on the slow dissolution of the drug itself or the surrounding matrix. Drugs with inherently slow dissolution rates,...
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Dosage Regimens: Designs and Approaches01:28

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Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
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Modified-Release Drug Delivery Systems: Classification01:23

Modified-Release Drug Delivery Systems: Classification

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Modified-release drug delivery systems improve drug efficacy and minimize side effects by controlling the rate and location of drug release. These systems fall into three categories: rate-programmed, stimuli-activated, and site-targeted.Rate-programmed systems release drugs at a predetermined rate, maintaining consistent therapeutic levels and reducing fluctuations that could lead to toxicity or subtherapeutic effects. These systems use polymeric matrices, reservoir-based designs, or osmotic...
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Prevalence, effectiveness, and characteristics of pharmacy-based medication synchronization programs.

Alexis A Krumme, Danielle L Isaman, Samuel F Stolpe

  • 1Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St, Ste 3030, Boston, MA 02120.

The American Journal of Managed Care
|March 30, 2016
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Summary

Medication synchronization programs, where pharmacies align prescription fill dates, are available in about 10% of pharmacies. While they show promise for improving medication adherence, further research is needed on their impact on patient outcomes.

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Area of Science:

  • Pharmacy Practice
  • Health Services Research
  • Medication Adherence

Background:

  • Patient nonadherence to maintenance medications is often linked to the burden of multiple pharmacy visits.
  • Medication synchronization programs aim to simplify prescription refills by aligning fill dates for single pick-up.
  • These programs are increasingly offered by pharmacies to improve patient convenience and medication management.

Purpose of the Study:

  • To evaluate the prevalence and structure of medication synchronization programs.
  • To review existing evidence on the impact of these programs on medication adherence and clinical outcomes.

Main Methods:

  • A mixed-methods approach was employed, including semi-structured interviews with key opinion leaders.
  • Data from surveillance activities were used to determine program prevalence.
  • A systematic literature review was conducted using major databases (Medline, EMBASE, Google Scholar) and internet searches.

Main Results:

  • Medication synchronization programs are present in approximately 6-11% of pharmacies, varying by pharmacy type.
  • Most programs feature monthly pharmacist appointments and utilize reminder communications.
  • While literature suggests improved adherence, robust evidence on patient-centered outcomes is still limited.

Conclusions:

  • As medication synchronization programs evolve, rigorous evaluation of their clinical and patient-centered outcomes is crucial.
  • These programs need to balance improving outcomes with enhancing patient engagement and consumer choice.
  • Further research is essential to understand the full impact of synchronization programs on patients with multiple chronic conditions.