Inhalation device options for the management of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is characterized by chronic respiratory symptoms and airflow limitation, resulting from abnormalities in the airway and/or damage to the alveoli. Primary care physicians manage the healthcare of a large proportion of patients with COPD. In addition to determining the most appropriate medication regimen, which usually includes inhaled bronchodilators with or without inhaled corticosteroids, physicians are charged with optimizing inhalation device selection to facilitate effective drug delivery and patient adherence. The large variety of inhalation devices currently available present numerous challenges for physicians that include: (1) gaining knowledge of and proficiency with operating different device classes; (2) identifying the most appropriate inhalation device for the patient; and (3) providing the necessary education and training for patients on device use. This review provides an overview of the inhalation device types currently available in the United States for delivery of COPD medications, including information on their successful operation and respective advantages and disadvantages, factors to consider in matching a device to an individual patient, the need for device training for patients and physicians, and guidance for improving treatment adherence. Finally, the review will discuss established and novel tools and technology that may aid physicians in improving education and promoting better adherence to therapy.     

Spray freeze drying for dry powder inhalation of nanoparticles

Formulating nanoparticles for delivery to the deep lung is complex and many techniques fail in terms of nanoparticle stability. Spray freeze drying (SFD) is suggested here for the production of inhalable nanocomposite microcarriers (NCM). Different nanostructures were prepared and characterized including polymeric and lipid nanoparticles. Nanoparticle suspensions were co-sprayed with a suitable cryoprotectant into a cooled, stainless steel spray tower, followed by freeze drying to form a dry powder while equivalent compositions were spray dried (SD) as controls. SFD-NCM possess larger specific surface areas (67–77 m²/g) and lower densities (0.02 g/cm³) than their corresponding SD-NCM. With the exception of NCM of lipid based nanocarriers, SFD produced NCM with a mass median aerodynamic diameter (MMAD) of 3.0 ± 0.5 μm and fine particle fraction (FPF ⩽ 5.2 μm) of 45 ± 1.6% with aerodynamic performances similar to SD-NCM. However, SFD was superior to SD in terms of maintaining the particle size of all the investigated polymeric and lipid nanocarriers following reconstitution (S_f/S_i ratio for SFD ≈ 1 versus >1.5 for SD). The SFD into cooled air proved to be an efficient technique to prepare NCM for pulmonary delivery while maintaining the stability of the nanoparticles.     

坤泰胶囊对大鼠胚胎和胎仔的发育毒性研究

目的 评价SD孕鼠在致畸敏感期（怀孕第6～15天）ig给予坤泰胶囊溶液对SD大鼠的母体毒性、胚胎-胎仔毒性和致畸性。方法 雌性SD大鼠低、中、高剂量组在怀孕第6～15天内分别ig给予2.5、5、10 g/(kg?d) 坤泰胶囊成品粉溶液，对照组给予双蒸水。试验期内每天观察动物的一般情况和临床毒性表现；记录孕鼠的体质量；在怀孕第20天进行剖腹检查，摘取卵巢和子宫，观察黄体数、着床数、胚胎生存及死亡情况、生存胎仔的外观、性别、体质量、骨骼及脏器发育等指标。结果 孕鼠及胚胎、胎仔发育的上述各观察指标未见明显异常，与对照组比较无显著差异。结论 在本实验条件下，坤泰胶囊成品粉未见明显的母体毒性与胚胎和胎儿发育毒性。     

舒筋散温熨配合针刺治疗中风偏瘫软瘫期疗效观察

目的:观察舒筋散温熨配合针刺治疗中风偏瘫软瘫期的临床疗效。方法:脑血管意外致偏瘫患者80例,随机分为治疗组与对照组。以简化Fug-Meyer运动功能评分法[1]做指标,观察治疗前后患者症状变化。结果:治疗组疗效优于对照组。结论:舒筋散温熨配合针刺治疗中风偏瘫软瘫期患者具有明显的治疗作用。     

中药黄柏粉配合红霉素治疗72例子宫颈炎患者的临床疗效分析

目的探讨中药黄柏粉配合红霉素治疗子宫颈炎的临床效果。方法选择144例子宫颈炎患者,随机分为治疗组、对照组各72例,治疗组应用中药黄白粉配合红霉素进行治疗,对照组应用消糜灵栓;比较两组的临床治愈率。结果治疗组的急性宫颈炎及各度宫颈糜烂治愈率均较对照组高,差异有统计学意义(P<0.05)。结论黄柏粉配合红霉素治疗子宫颈炎具有良好效果,值得临床推广应用。     

Theoretical and Experimental Evaluation of Flow Pattern of Pharmaceutical Powder Blends Discharged From Intermediate Bulk Containers (IBCs)

The purpose of this study is to assess the prevalence of funnel flow pattern for common pharmaceutical powder blends, upon discharging from modern intermediate bulk containers (IBCs) in drug product manufacturing. The estimation was built upon Jenike’s original radial stress field theory. It was modified to account for the stress-dependence of wall friction angle commonly observed in pharmaceutical powders. A total of 260 flow pattern estimations, based on 20 real-life IBCs and 13 investigational powder blends, were made. The estimated results showed that the mass flow pattern is present in less than 5% of all cases. Funnel flow pattern is clearly prevalent among pharmaceutical powder blends. The prevalence of funnel flow stems from several factors: 1) relatively shallow hopper section shared by all IBCs, 2) the common transition-type geometry, leading to even shallower hopper inclination at the edge of the hopper section, and 3) relatively high wall friction angles resulting from low wall normal stresses. This conclusion was verified through at-scale experiments, by discharging multiple pharmaceutical powder blends from a representative IBC. In general, our study suggests that, unless the powder wall friction can be substantially reduced, pharmaceutical powders are likely to discharge under funnel flow from modern IBCs.     

湿阻中焦证对葡萄糖代谢糖异生途径的影响及藿香正气散干预后的变化

目的:探究湿阻中焦证动物模型以及藿香正气散的干预对葡萄糖代谢糖异生途径的影响,揭示湿阻中焦证动物模型对葡萄糖代谢糖异生途径的影响的相关机制,从代谢组学层面揭示脾胃参与调控能量代谢以及藿香正气散燥湿和胃的科学内涵。方法:参照前期较成熟的湿阻中焦证动物模型的造模方法,自然造模与综合造模相结合,模拟湿病产生的三大主要因素,建立湿阻中焦证模型。检测湿阻中焦证模型及藿香正气散干预后的大鼠肝脏葡萄糖、丙酮酸、丙酮酸羧化酶、葡萄糖-6-磷酸酶的含量变化。结果:与空白组比较,湿阻中焦证模型丙酮酸含量降低,丙酮酸羧化酶、葡萄糖-6-磷酸酶、肝脏葡萄糖含量均增加;藿香正气散能增强葡萄糖代谢糖异生作用。结论:造模前后,肝脏葡萄糖含量增加,这可能是因为湿阻中焦证会导致能量消耗增加,而机体对葡萄糖的吸收和利用不足。同时这可能是湿阻中焦证身倦乏力、食少纳差的病理基础之一;藿香正气散对湿阻中焦证模型的糖异生有增强作用,且对葡萄糖的分解、转化有一定的作用,这可能是藿香正气散治疗湿病,缓解其身倦乏力、食少纳差等症状的作用机制之一。     

粉末直接压片法制备诺氟沙星片的工艺研究

目的进行诺氟沙星片粉末直接压片法的工艺研究。方法采用正交实验筛选处方,以物料流动性、硬度、溶出度、脆碎度、片重差异限度范围为评价指标选择最佳处方并验证。通过稳定性试验对片子的外观、含量、溶出度、有关物质进行考察。结果所选处方物料流动性好,有效成分溶出快,各项指标符合规定,稳定性良好。结论本工艺简单、便捷,质量稳定,适合工业化生产。     

Preparation and characterization of co-processed starch/MCC/chitin hydrophilic polymers onto magnesium silicate

It was aimed to investigate the compressibility, compactibility, powder flow and tablet disintegration of a new excipient comprising magnesium (Mg) silicate co-processed (5%–85% w/w) onto chitin, microcrystalline cellulose (MCC) and starch as the hydrophilic polymers of interest. Initially, the mechanism of tablet disintegration was studied by measuring water infiltration rate, moisture sorption, swelling capacity and hydration ability. Moreover, the powders compression behavior was carried out by applying Kawakita model of compression analysis in addition to porosity and radial tensile strength measurements. In vitro drug release of compacts made of 400?mg ibuprofen and 300?mg of the hydrophilic polymers containing 30% w/w Mg silicate co-precipitate was investigated in phosphate buffer (pH 7.8). This work demonstrated that the incorporation of Mg silicate to the hydrophilic polymers lead to the improvement of powder flowability, compactibility, stability (with regard to storage conditions), compacts crushing strength, and disintegration time in addition to faster drug release. The overall findings are practically advantageous in the context of finding a low cost and multifunctional co-processed excipient of natural origins.