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Related Concept Videos

Observational Studies01:11

Observational Studies

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Observational studies are a type of analytical study where researchers observe events without any interventions. In other words, the researcher does not influence the response variable or the experiment's outcome.
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
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Modified-Release Drug Delivery Systems: Drug Release Characteristics01:22

Modified-Release Drug Delivery Systems: Drug Release Characteristics

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Drug release from modified-release dosage forms is designed to achieve specific therapeutic effects by controlling the rate and extent of drug release. The classification of these drug release systems is based on key pharmacokinetic assumptions: drug disposition follows first-order kinetics, drug release is the rate-limiting step in absorption, and the released drug is rapidly and completely absorbed.There are four major models of drug release patterns. The first model is the slow zero-order...
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Modified-Release Drug Delivery Systems: Bioavailability01:30

Modified-Release Drug Delivery Systems: Bioavailability

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Modified-release (MR) dosage forms are designed to extend drug release over time, thereby maintaining stable plasma concentrations and reducing dosing frequency. However, their bioavailability is typically below 100% due to incomplete drug release and presystemic metabolism, and limitations in drug permeability across the gastrointestinal epithelium, all of which can restrict the fraction of the drug reaching systemic circulation. Consequently, studying the in vivo bioavailability of MR...
16
Modified-Release Drug Delivery Systems: Overview01:19

Modified-Release Drug Delivery Systems: Overview

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Modified-release dosage forms are designed to address the limitations of drugs with short biological half-lives. These forms maintain stable therapeutic drug concentrations over extended periods, reducing the need for frequent dosing. A consistent drug level helps minimize peak-trough fluctuations, which can reduce adverse effects, lower the risk of drug resistance, and improve overall treatment effectiveness.One common type of modified-release form is the extended-release (ER) formulation. ER...
17
Modified-Release Drug Delivery Systems: Classification01:23

Modified-Release Drug Delivery Systems: Classification

18
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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Modified-Release Drug Delivery Systems: Site-Targeted01:24

Modified-Release Drug Delivery Systems: Site-Targeted

18
Site-targeted drug delivery systems enhance therapeutic efficacy while minimizing systemic toxicity and treatment costs. Unlike conventional methods, these systems ensure precise drug delivery, improving bioavailability and reducing side effects. Targeted drug delivery is classified into three levels. First-order targeting directs drugs to the capillary beds of specific organs or tissues. Second-order targets specific cell types, such as tumor cells, using receptor-mediated interactions.
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Modified release paracetamol overdose: a prospective observational study (ATOM-3).

Angela L Chiew1,2,3, Geoffrey K Isbister3,4, Colin B Page5,6

  • 1a Clinical Toxicology Unit/Emergency Department , Prince of Wales Hospital , Randwick , NSW , Australia.

Clinical Toxicology (Philadelphia, Pa.)
|February 17, 2018
PubMed
Summary
This summary is machine-generated.

Modified-release (MR) paracetamol overdose can lead to liver injury even with standard treatment. This study found prolonged elevated paracetamol levels and a need for extended treatment in many patients, highlighting the need for improved strategies.

Keywords:
Paracetamolactivated charcoalhepatotoxicitymodified-release acetylcysteineoverdose

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Area of Science:

  • Toxicology
  • Pharmacology
  • Clinical Medicine

Background:

  • Modified-release (MR) paracetamol, a common formulation, raises concerns regarding increased liver injury risk in overdose cases.
  • Standard treatment algorithms may be less effective for MR paracetamol overdoses, necessitating further investigation.

Purpose of the Study:

  • To characterize the clinical presentation and outcomes of acute modified-release paracetamol overdose.
  • To evaluate the effectiveness of current treatment protocols for MR paracetamol toxicity.

Main Methods:

  • A prospective observational study conducted from January 2013 to June 2017 in Australia.
  • Recruited patients aged over 14 years with significant MR paracetamol ingestion (≥10g or 200mg/kg).
  • Collected data on demographics, ingestion details, laboratory results, treatments, and hepatotoxicity outcomes.

Main Results:

  • 116 patients were included; 73% were female, with a median ingested dose of 32g.
  • 67% had initial paracetamol levels above the nomogram, and 18% developed hepatotoxicity.
  • Prolonged acetylcysteine treatment was required for 67 patients due to persistent elevated paracetamol levels; activated charcoal and increased acetylcysteine doses did not significantly reduce hepatotoxicity risk.

Conclusions:

  • Acute MR paracetamol overdose frequently results in prolonged elevated paracetamol concentrations and necessitates extended treatment.
  • Hepatotoxicity can occur despite early acetylcysteine administration, and current adjunct therapies show limited benefit.
  • Further research is essential to develop more effective treatment strategies for MR paracetamol overdose.