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The aim of the study was to explore the involvement of interleukin 6 in SARS-CoV-2 infection, and to position the drug siltuximab in the management of severe forms of COVID-19. A bibliographic search was performed in Pubmed on the immune response to the disease, and in on clinical trials with interleukin 6 blockers. Interleukin 6 is involved in the cytokine cascade, which originates as a consequence of an excessive immune response secondary to viral infection, aggravating lung affectation. Blockers of this cytokine (tocilizumab, sarilumab and siltuximab) are being studied as a strategy for treating the disease. Siltuximab is a monoclonal antibody indicated in Castleman's disease that could be administered in a single dose.
Objectives. To determine the influence of different buffers, pH and meropenem concentrations on the degradation rates of meropenem in aqueous solution during storage at 32°C, with the aim of developing a formulation suitable for 24-hour infusion in an ambulatory elastomeric device, compliant with the latest National Health Service Pharmaceutical Quality Assurance Committee Yellow Cover Document (YCD) requirements. Methods. Meropenem was diluted to 6.25 mg/mL and 25 mg/mL in aqueous solutions adjusted to various pH with phosphate or citrate buffer and assessed for stability.
Objectives. In recent years, various formulations containing rapamycin, mainly petrolatum-based, have been tested on facial angiofibromas in tuberous sclerosis. They are often poorly tolerated due to irritation and bleeding. In addition, their effectiveness was insufficient in young adults. The objective of this study was to develop and characterise a hydro-alcoholic gel containing solubilised rapamycin. The stability of the product stored at 4°C was evaluated over 1 year. Methods. Two different 0.1% rapamycin gels were formulated with or without α-tocopherol and urea. Different methods were used to characterise the gels: HPLC, gas chromatography, pH, visual observation and optical microscopy. A physico-chemical and microbiological stability
Background and importance. Mitomycin C is used in different regimens for the treatment of bladder, anus and lung cancer. According to the data sheet, reconstitution of the vial should be carried out with water for preparation of injectables or with 20% dextrose. Despite this, sodium chloride solutions are commonly used for its administration. However, it is known that the stability of mitomycin C molecule is affected by the pH of the preparation as degradation increases with pH values <7. Sodium chloride solutions have an approximate pH of 5.4. There are no published data to support how pH affects mitomycin C stability in 0.9% sodium chloride solutions (NSS). Aim and objectives. To study the stability of mitomycin C in NSS under different pH
Objectives. To analyse the results of fluorouracil (5-FU) plasma concentration monitoring in patients with advanced colorectal cancer after 5-FU treatment, and to provide a reference for the application prospect of 5-FU plasma concentration monitoring technology. Methods. A retrospective analysis was performed with advanced colorectal cancer patients treated with 5-FU from March 2015 to August 2018.
Extravasation is the leakage of intravenously administered solution into surrounding tissues, which can cause serious damage to the patient. The impact of extravasation is mostly determined by the localisation and volume of extravasation, but the physicochemical properties of the drugs are also important. In this paper a stepwise approach to managing an extravasation is described, with recommendations on the role of the pharmacist. Information on osmolality, pH, pKa and the buffering capacity of drugs is given in relation to extravasation, which is summarised in a practical crash card that can be used in clinical practice.
Objectives. Although levetiracetam presents an easy dosing and tolerability, therapeutic drug monitoring may be recommended in certain situations. Measurement of levetiracetam in serum plasma is commonly done by high performance liquid chromatography (HPLC). After ARK Diagnostics marketed an enzyme immunoassay (IA) for levetiracetam in serum or plasma, automated determinations are possible. In this study, the performance of this immunoassay and the impact of automation on the follow-up in patients treated with levetiracetam is evaluated . We also detected those subpopulations of patients who may benefit the most from this therapeutic drug monitoring. Methods. Samples from 50 outpatients diagnosed with epilepsy and treated with levetiracetam w.
Background and importance. Otomycosis is a suppurative fungal infection that affects the external auditory canal. Patients have a high rate of recurrence and are prone to invasive fungal infections after receiving limited therapeutic options with low response. Aim and objectives. The aim of the study was to describe the use of a sterile formulation of topical voriconazole ear drops (VE) for the treatment of otomycosis and analyse its effectiveness and safety. Material and methods. Antifungal ear drops are not commercially available. The otolaryngology service requested a broad spectrum topical antifungal for recurrent otomycosis. After a literature review, a sterile aqueous formulation of voriconazole 10 mg/mL was considered, ensuring the abse.
Objectives. Published in vitro stability data for ceftolozane–tazobactam supports intermittent short duration infusions. This method of delivery is not feasible for many outpatient antimicrobial therapy services that provide only one or two visits per day. This study aimed to assess time, temperature and concentration-dependent stability of ceftolozane–tazobactam in an elastomeric infusion device for continuous infusion across clinically relevant ranges encountered in outpatient antimicrobial therapy. Methods. Ceftolozane–tazobactam was prepared to achieve initial concentrations representing total daily doses for ‘renal’, ‘standard’ and ‘high’ dose schedules in elastomeric infusion devices with a volume of 240 mL. Infusion devices incubated a.
Background. A combination of methylprednisolone sodium succinate and tropisetron hydrochloride is commonly used to treat the nausea and vomiting associated with antineoplastic therapy. The objective of this study was to investigate the stability of tropisetron hydrochloride and methylprednisolone sodium succinate in 0.9% sodium chloride injection for up to 48 hours. Methods. Commercial solutions of methylprednisolone sodium succinate and tropisetron hydrochloride were obtained and further diluted with 0.9% sodium chloride injection to final concentrations of either 0.4 or 0.8 mg/mL (methylprednisolone sodium succinate) and 0.05 mg/mL (tropisetron). The admixtures were assessed for periods of up to 48 hours after storage at 4°C with protection.
Objective. Roux-en-Y gastric bypass (RYGB) surgery induces major changes in the gastrointestinal tract that may alter the pharmacokinetics of orally administered drugs. Results from pharmacokinetic studies are sparse. This study aimed to investigate the effect of RYGB on the bioavailability of metoprolol from immediate release (IR) and controlled release (CR) tablets in female patient volunteers before and after surgery. Methods. An explorative, two-phase, single oral dose pharmacokinetic study of metoprolol in female patients undergoing RYGB was carried out. The dose was administered twice in each patient, 1 month before and 6 months after surgery. After intake of either 100 mg of metoprolol IR or CR tablet serum concentration-time profiles
Background and importance. Initially, the aim of centralisation of the management of antiblastic drugs was for the quality of preparations, workers’ protection, patient safety and reduction of the risks associated with environmental contamination. In recent years, optimisation of hospital processes has become more relevant. In 2017, a new time slot model for the delivery of cancer therapies was introduced in the galenic preparation laboratory. This type of model consists of time slots defined on the basis of fixed criteria. Aim and objectives. The aim was to optimise the management of anticancer drugs. Material and methods. A pharmacoeconomic analysis was carried out on anticancer therapies administered in two oncology departments, one of whic.
Background and importance. Immunosuppression related to organ transplant is a risk factor for multidrug resistant infections. Aim and objectives. To evaluate the prevalence of nosocomial infections (NI) by multidrug resistant (MDR) pathogens, aetiologic agents and treatments given to a cohort of patients undergoing kidney transplantation (KT). Material and methods. A retrospective observational study was carried out in a cohort of patients having undergone a KT during 2016–2017.
Background and importance. The antimicrobial stewardship programmes are essential to achieve proper use of antibiotics, especially in units of special complexity, such as the intensive care unit (ICU). Aim and objectives. To show the antibiotic pressure in the ICU and the groups of antibiotics with greatest deviation in their consumption (2017); to describe the activities carried out by the ICU antimicrobial stewardship team (ICU-AST) from 2018 to June 2019; and to show the results obtained in 2018 and in the first and second quarters of 2019. Material and methods. • This was a prospective intervention study from January 2018 (when 2017 ICU antibiotic pressure data were obtained) to June 2019. • The ICU-AST comprised an intensive care doctor,
Background and importance. Multiple food allergy (MFA), in its severe stage, is a pathology with nutritional and pharmacotherapeutic restrictions. Drug intolerance to available medicines and lack of alternatives can lead to magistral formulations. Aim and objectives. To compound oral liquid formulations of iron, zinc and sirolimus by eliminating all preservatives, antioxidants, colourings and flavourings, and evaluate their use in a paediatric patient with MFA. Material and methods. We made a literature review including physicochemical characteristics of the active principles studied and the compounding magistral formulations described. We also compared the composition between these commercialised drugs and simple syrups. We accomplished all o.
Objective. Tacrolimus is administered to patients undergoing haematopoietic stem cell transplantation (HSCT) as prophylaxis for graft-versus-host disease. As a high blood tacrolimus concentration within a narrow therapeutic range must be maintained after HSCT, therapeutic drug monitoring (TDM) is necessary. We investigated the correlation between blood tacrolimus concentration and blood cell count in HSCT patients to assess how changes in blood cell count affect tacrolimus TDM. Methods. A retrospective analysis was performed for 24 patients who underwent allogeneic HSCT and received tacrolimus. The correlation between variations in blood tacrolimus concentration and blood cell count was evaluated for three consecutive weeks, starting 1 week a.
Background and objective. Infusion containing paracetamol, alizapride, ketorolac and tramadol is used after a general anaesthesia in order to limit pain, fever and nausea. Currently, these infusions are prepared according to demand in the anaesthesia unit, but the preparation in advance could improve quality of preparation and time management. The aim of this study was to investigate the long-term stability of this infusion in glass bottles at 5°C ± 3 °C. Method. Five bottles of infusion were stored at 5°C ± 3 °C for 60 days. A visual and microscope inspection were performed periodically to observe any particle appearance or colour change. pH and absorbance at three wavelengths were measured. The concentrations were measured by ultra-high per.
Objective. Usage of tacrolimus is complicated by its narrow therapeutic index and wide between- and within-subject pharmacokinetic variability. We aimed to obtain more information regarding the influence of various covariates on the disposition of tacrolimus in the early phase after cardiac transplantation using a population pharmacokinetic method, and provide information for the individualisation of drug dosing in the clinical setting. Methods. Routine therapeutic drug monitoring concentrations (897 observations) were retrospectively collected from 146 hospitalised patients. One compartment model with first-order absorption (absorption rate constant K a was fixed as 4.48/hour) was employed to establish the population pharmacokinetic model us.
Background and importance. The incidence of medicine shortages (MS) has increased in the past few years, causing difficulties for clinicians, patients and regulators. MS can occur for many reasons, including manufacturing and quality problems, regulatory issues and business decisions. The role of the pharmacist is essential in their management. Aim and objectives. To analyse the MS that have affected the outpatient clinic (OC) between January 2018 and September 2019, and to evaluate their economic impact and effect on the daily work of a hospital pharmacist in a general hospital (280 beds). Material and methods. A descriptive, observational and retrospective study was carried out analysing data between January 2018 and September 2019. Data wer.

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