Research progress in the route of administration and corresponding dosage form of triamcinolone acetonide / 中国药房

As a glucocorticoid drug with wide clinical application， triamcinolone acetonide can be administered by multiple routes， such as eye， nose， joint cavity， and skin， for the treatment of various local diseases such as arthritis， macular edema， rhinitis， and urticaria. As a drug with extremely low solubility in water， the dose form of triamcinolone acetonide is closely correlated with administration route and site. The dosage form of triamcinolone acetonide administered via injection（including joint cavity injection， vitreous injection， suprachoroidal injection， intramuscular injection） is mainly suspension， and the representative drugs include Kenalog-40®， Zilretta®， Triesence®， Xipere®， etc.； the dosage forms of nasal mucosal administration are mostly sprays， and the representative drug is Nasacort®； the dosage forms of oral mucosal administration are mostly patches， ointments and creams， and the representative drug is Oracort®； the dosage forms for transdermal administration are mostly ointments， creams and lotions， and the representative drugs include Trianex®， Teva-Triacomb®， etc. At present， the research on dosage forms of triamcinolone acetonide by various administration routes mainly focuses on the construction of delivery carriers， the addition of cosolvents or the use of new delivery tools.

Injection administration of mangosteen, Garcinia mangostana, husk extract enhances physiological and immune-neuroendocrinological regulation of Macrobrachiumrosenbergii.

The study aimed to investigate the effects of injecting mangosteen husk hot-water extracts (MHE) on immune and physiological factors in Macrobrachium rosenbergii. Different doses of MHE (10, 20, and 40 µg prawn-1) were injected into the prawns, and various immune and physiological parameters were evaluated. The results revealed that higher doses of MHE (20 and 40 µg prawn-1) led to significant increases in immune parameters, improved phagocytic activity, and clearance efficiency. However, certain parameters, such as phenoloxidase activity per granulocyte, plasma glucose, and lactate levels were decreased after injection. Moreover, prawns injected with MHE and subjected to hypothermal stress exhibited changes in haemolymph dopamine and norepinephrine. Prawns injected with MHE for 7 days showed increased survival rates when challenged with Lactococcus garvieae. The relative survival percentages were 11.8%, 46.6%, and 47.1% for MHE doses of 10, 20, and 40 µg prawn-1 injection, respectively, indicating enhanced resistance to the pathogen. In conclusion, injecting MHE can act as an immunostimulant and physiological and neuroendocrine regulator for prawns, enhancing their resistance to L. garvieae.

Task-shifting directly observed treatment and multidrug-resistant tuberculosis injection administration to lay health workers: stakeholder perceptions in rural Eswatini.

BACKGROUND: Eswatini is facing a critical shortage of human resources for health (HRH) and limited access to multidrug-resistant tuberculosis (MDR-TB) treatment in rural areas. This study assessed multiple stakeholders' perceptions of task-shifting directly observed treatment (DOT) supervision and administration of intramuscular MDR-TB injections to lay health workers (LHWs). METHODS: A mixed methods study comprising a cross-sectional survey using a semi-structured questionnaire with community treatment supporters (CTSs) and a focus group discussion with key stakeholders including representatives from the Eswatini Ministry of Health (MOH), donor organisations, professional regulatory institutions, nursing academia, civil society and healthcare providers was conducted in May 2017. Descriptive statistics, thematic content analysis and data triangulation aided in the interpretation of results. RESULTS: A large majority of CTSs (n = 78; 95.1%) were female and 33 (40.2%) were older than 50 years. Most (n = 7; 70.0%) key stakeholders had over 10 years of work experience in policy-making, advocacy in the fields of HRH or day-to-day practice in MDR-TB management. Task-shifting of MDR-TB injection administration was implemented without national policy guidance and regulation. Stakeholders viewed the strategy to be driven by the prevailing shortage of professional frontline HRH and limited access to MDR-TB treatment. Task-shifting was perceived to improve medication adherence, and reduce stigma and transport-related MDR-TB treatment access barriers. Frontline healthcare workers and implementing donor partners fully supported task-shifting. Policy-makers and other stakeholders accepted task-shifting conditionally due to fears of poor standards of care related to perceived incompetence of CTSs. Appropriate compensation, adequate training and supervision, and non-financial incentives were suggested to retain CTSs. A holistic task-shifting policy and collaboration between the MOH, academia and nursing council in regulating the practice were recommended. CONCLUSIONS: Stakeholders generally accepted the delegation of DOT supervision and administration of intramuscular MDR-TB injections to LHWs as a strategy to increase access to treatment, albeit with some apprehension. Findings from this study stress that task-shifting is not a panacea for HRH shortages, but a short-term solution that must form part of an overall simultaneous strategy to train, attract and retain adequate numbers of professional healthcare workers in Eswatini. To address some of the apprehension and ambivalence about expanding access to MDR-TB services through task-shifting, attention should be paid to important aspects such as competence-based training, certification and accreditation, adequate supportive on-the-job supervision, recognition, compensation, and expediting policy and regulatory support for LHWs.

Injection of an extract of fresh cacao pod husks into Litopenaeus vannamei upregulates immune responses via innate immune signaling pathways.

Immunostimulation is a novel method and a promising development in aquaculture. Products derived from plants exhibit various biological activities. In this study, the hot-water extract isolated from fresh cacao (Theobroma cacao) pod husks (CPHs) was administered by injection to evaluate cellular signaling pathways of innate immunity, the immunostimulating potential, disease resistance, and hypothermal tolerance of white shrimp, Litopenaeus vannamei. Results showed significant increases in the total hemocyte count, semigranular cells, granular cells, phenoloxidase activity, and respiratory bursts (RBs) of hemocytes per unit of hemolymph at 1 day, and in phagocytic activity toward and the clearance efficiency of Vibrio alginolyticus at 1-3 days after shrimp were injected with fresh CPH extract at 40 µg shrimp-1. However, only RBs per hemocyte had significantly decreased at 1 day after the injection. All immune parameters had returned to control levels by 3 days after receiving fresh CPH extract except for RBs, phagocytic activity, and the clearance efficiency, which had returned to control values by 7 days. Furthermore, at 1 day after the injection, the peroxinectin, prophenoloxidase (proPO) II, toll-like receptors (TLR) 3, signal transducer and activator of transcription (STAT), and crustin in shrimp receiving fresh CPH extract at 20 µg shrimp-1, and the lipopolysaccharide and ß-1,3-glucan-binding protein, proPO II, TLR1, and STAT in shrimp receiving fresh CPH extract at 40 µg shrimp-1 were significantly higher than those of shrimp receiving saline. After injecting fresh CPH extract at 10-40 µg shrimp-1 and 40 µg shrimp-1, the mortality of shrimp challenged with V. alginolyticus and exposed to 14 °C for 96 h significantly decreased, respectively. These results suggest that fresh CPH extract can be used as an immunostimulant and a physiological regulator for shrimp through injection administration to enhance immunological and physiological responses, which can elevate the resistance against V. alginolyticus and tolerance against hypothermal stress in L. vannamei.

Patient satisfaction with directly observed treatment and multidrug-resistant tuberculosis injection administration by lay health workers in rural Eswatini.

BACKGROUND: The human resources for health crisis in rural Eswatini led to a novel community-based multidrug-resistant tuberculosis (MDR-TB) treatment strategy based on task-shifting, that is delegation of directly observed treatment (DOT) and administration of MDR-TB injections, traditionally restricted to professional nurses, to lay community treatment supporters (CTSs). AIM: This study assessed the level of patient satisfaction with receiving community-based MDR-TB care from a CTS. SETTING: The study was conducted at three MDR-TB-treating facilities in the mostly rural Shiselweni region. METHODS: A cross-sectional survey of a purposive sample of 78 patients receiving DOT and intramuscular MDR-TB injections from CTSs was carried out in 2017. Descriptive statistics and regressions were calculated. RESULTS: A high overall general patient satisfaction score for receiving community-based MDR-TB care from a CTS was observed. Adherence counselling, confidentiality, provider selection and treatment costs significantly (p 0.05) influenced satisfaction. A large majority (n = 62; 79.5%) of patients indicated that they would likely recommend their significant others to receive MDR-TB care from a CTS. Respondents identified the need to provide CTSs with adequate training, regular supervision and sufficient incentives and also to broaden the scope of their services. CONCLUSION: This study observed that task-shifting of DOT and MDR-TB injection administration to CTSs was supported from a patient perspective. However, adherence counselling, confidentiality, provider selection and treatment costs should be taken into account in community-based MDR-TB care programming. Further to the patients, community-based tuberculosis care could be enhanced by improving CTSs' training, supervision and incentives, and broadening the scope of their services.

Current development in the formulations of non-injection administration of paclitaxel.

Paclitaxel (PTX) belongs to a class of taxane anti-tumor drug used for the clinic treatment of breast cancer, ovarian cancer, non-small-cell lung cancer, and so on. PTX has poor water solubility and oral bioavailability. It is generally administered via intravenous (i.v.) infusion. Traditional PTX injectable preparations contain Cremophor-EL and ethanol to improve its solubility, which would result in adverse reactions like severe hypersensitivity, neutropenia, etc. Adverse reactions can be reduced only by complicated pretreatment with glucocorticoid and antihistamines drugs and followed by PTX slow infusion for three hours, which has brought significant inconvenience to the patients. Though, a new-generation PTX formulation, Abraxane, free of Cremophor-EL and ethanol, is still being administrated by frequent i.v. infusions and extremely expensive. Therefore, non-injection administration of PTX is urgently needed to avoid the side effects as well as reduce inconvenience to the patients. Recently, a variety of non-injection drug delivery systems (DDSs) of PTX have been developed. This review aims to discuss the progress of non-injectable administration systems of PTX, including oral administration systems, vaginal administration systems, implantable DDSs, transdermal DDSs and intranasal administration for the future study and clinical applications.

Induction treatment of acute myeloid leukemia in an elderly patient with intramarrow injection/administration of cytarabine. Second case report.

We show for the second time that intramarrow injection/administration of chemotherapeutic agents such as cytarabine (Ara-C) can be used safely and effectively and is associated with no toxicity, promising antileukemic activity and possible improved survival.

Research Progress in Bioavailability Improvement Methods for Curcumin / 中国药师

Curcumin is the main active component in turmeric, which possesses many pharmacologic effects, including anti-in-flammatory, antioxidant, anti-tumor, anti-atherosclerosis, liver and kidney protection and so on. However, due to its poor bioavail-ability, its clinical application is limited. Therefore, the methods for improving the bioavailability of curcumin were reviewed by refer-ring to a large number of literatures. The bioavailability of curcumin can be improved by different administration routes and various dos-age forms. The review provides theoretical basis and research ideas for the development of new drugs.

Induction treatment of acute myeloid leukemia in an elderly patient with intramarrow injection/administration of cytarabine: first report of a case.

We have used intramarrow injection/administration of cytarabine (Ara-C) instead of conventional intravenous approach to induce remission in an elderly patient with acute myelogenous leukemia. We show for the first time that the intramarrow injection of chemotherapeutic agents such as Ara-C can be used safely and effectively.

Research Progress in Non-injection Administration Systems of Docetaxel / 中国药师

Objective:To review the research progress in non-injection administration systems of docetaxel. Methods: Based on the related literatures in recent five years, the studies on the application of docetaxel by non-injection ways including oral, transdermal, implantation and rectal administration were summarized and analyzed. Results:The docetaxel non-injection administration systems ex-hibit the advantages of convenient use, high bioavallability and low incidence of adverse drug reaction. . Conclusion:The non-injection administration systems of docetaxel show good development prospect.

Exploration of Rational Use of Injection / 中国药房

OBJECTIVE:To discuss rational use of injection in order to provide reference for rational use of injection in the clinic. METHODS:Drug use was analyzed in respect of route of administration,selection of solvent,compatibility of drugs, speed of intravenous administration,the concentration of mixture,etc. RESULTS&CONCLUSION:There are some mistakes in the application of injections,but some faults and adverse drug reactions (ADRs) can be warned early. By strengthening pharmaceutical monitoring,related faults and ADRs can be reduced to the minimum.