Relative bioavailability of diclofenac potassium from softgel capsule vs. powder for oral solution and immediate-release formulation

Diclofenac potassium is a type of NSAID that is used to treat mild to moderate pain.  The people who take this medication want it to act as fast as possible, so their pain will subside.  This study has determined which formulation, soft gel, powder for oral solution, or tablet, would provide the fastest results.

The softgel is a newer formulation, combining the benefits of a tablet form and an oral solution.  It gives the medication as a solution in a solid dosage form.  The investigators wanted to see if this would effectively treat pain as quickly as the other two formations.

The patients were given one of the three dosage forms in a 50 mg strength.  They fasted for 10 hours before receiving the dose as well as for 4 hours after receiving the dose. Each subject had to give 17 blood samples over the course of 24 hours.

The study came to a few conclusions.  They determined that taking the oral solution formulation led to the highest mean peak plasma concentrations of the drug.  The amount of time that it took for the softgel formulation to reach its maximum effect was 0.5 hours, which was right between the oral solution (0.25 hours) and the tablet (0.75 hours).  Overall, the study concluded that the effectiveness of the softgel formulation of diclofenac potassium was comparable to that of the oral solution and tablet.  Patient compliance was increased when they had the opportunity to take the softgel.

 

Link to article

Bende, G., Biswal, S., Bhad, P., Chen, Y., Salunke, A., Winter, S., Wagner, R. and Sunkara, G. Relative bioavailability of diclofenac potassium from softgel capsule versus powder for oral solution and immediate-release tablet formulation. Clinical Pharmacology in Drug Development, 2016; 5: 76–82.

Student Pharmacists’ Perceptions of a Composite Examination in Their First Professional Year

I chose to read this article because it is directly related to our class as first year students. As P1s, we are thrown into a new type of schooling with difficult exams, usually having more than one professor per exam.  Trial and error is used throughout the year to choose what study habits work best for each course.  This study examines the students’ perceptions on a composite exam before they take it and after they take it.

Each composite exam included 3 to 4 questions per hour of lecture (50 minutes).  The exam included all subjects that the students were currently taking.  There were around 7 CEs throughout the semester.  The students were told ahead of time how many questions would be on the exam for each subject as well as the order of the subjects.

Before the exam, students anticipated that they would study 2 to 4 hours a day, but 31% only studied 1 to 2 hours, 25% studied 3 to 4 hours and 21% studied more than 4 hours.  The type of studyng that the students anticipated to do, cramming, priority studying, studying each day or other, changed from pretest to post test.  In fact, the students’ perceptions of the exam, the ways that they studied, and their personal predicted outcomes all changed from pretest to post test.  Overall, the students favored the format of the CE.  The goal was to reduce the amount of cramming before the exam, so that students would actually retain the information.

The findings in this study show mixed opinions, such as some studies finding that studying in a steady fashion each day will lead to better test results, while some suggest that those who cram can actually do better.  Do you think that we would receive higher semester grades if we would be tested more often?  I think that it will be interesting to answer that question because of the way we are learning Anatomy and Physiology 2 right now, since we are doing small assignments along the way instead of an exam. However, the composite exams used in this study involved all subjects, which I am not sure would work for our pharmacy class.

 

Link to article

McDonough S, et al, Student Pharmacists’ Perceptions of a Composite Examination in Their First Professional Year. American Journal of Pharmaceutical Education. 2016; 80(1):4

Pharmacy Leaflets for Informing Patients About Drug Benefits and Risks

This article examines the medication literature that is given to patients during their trip to the pharmacy.  It states that the 3 main types of literature, pharmacy leaflets, medication guides, and patient package inserts, are not being used to their full potential.

As a community pharmacy intern and a consumer of prescription medications, I see firsthand how this literature is ineffective at getting information across.  Some patients at the pharmacy will ask me to just get rid of their papers and do not even glance at them.  I also think that the amount of information written on the medication guides can be intimidating.

There are certain medications that are required by the FDA to come with medication literature.  However, there is no standardized information that must be included.  Some leaflets may include side effects while others may not.  One certain aspect that the article mentions that the literature is lacking is providing the patient with the proper information so that they can make the decision to take the medication; that the benefit outweighs the risk.  Some pharmacies have started using a 1-page “Drug Facts Box” to relay information to their patients.

I think that it would be very interesting to do a study on whether or not this shortened type of literature is more beneficial for patients, or if they still see it as just wasting a tree.

 

Link to article

Hung A, Sieluk J, Doshi P. Pharmacy Leaflets for Informing Patients About Drug Benefits and Risks. JAMA Internal Medicine. 2016;176(1):11-12.

Effects of Early Adult Patterns of Physical Activity and Television Viewing on Midlife Cognitive Function

It seems as if the world around us is constantly telling us that we need to engage in more physical activity.  There are even television shows , such as The Biggest Loser, that encourage physical activity.  Seems like an oxymoron, right? Sitting down to watch TV about why you should get up an exercise.  Sure, increasing physical activity and decreasing sedentary activity is a good idea, but why?  What evidence is there to prove this?  This study attempts to answer that question.

This study examined patients over a 25 year period and correlated their physical inactivity to their cognitive function.  The study was conducted via questionnaire over mutliple visits.  The basline television viewing per day was 3 hours per day.  Anything above that was considered high.

The study concluded that high television viewing was linked to poorer performance on various cognitive tests.  It was also concluded that with high television AND low physical activity was linked to double the likelihood of scoring poorly on those various cognitive tests.  Overall, high television watching and low physical activity decrease the skills of executive functioning and processing speeds, which could lead to more health problems as the individual gets older.

 

Hoang T, et. al, Effects of Early Adult Patterns of Physical Activity and Television Activity on Midlife Cognitive Function. JAMA Psychiatry. 2016;73(1):73-79.

Link to article

Parent-Adolescent Communication and Adolescent Safer Sex Behavior

Topics such as sexual behavior can be quite taboo in society these days, but it is important to educate on sexual health because of unwanted pregnancy and sexually transmitted diseases, espeically those that are becoming bacteria-resistant.  This study suggests that communication between parent and adolescent on sexual behavior is beneficial, but that there has been no study to potentially correlate this communication with safer sex practices, such as using oral contraceptives and condoms.

The study concluded that there is a significant positive relationship between communication between parent and adolescent and safe sex behavior.  It was concluded that this relationship is more prevelant in females as well as when these discussions occurred with the adolescent’s mother.  There was no clear difference between increased usage of condoms or oral contraceptives.

This article explains why this type of communication is important as well as why an analysis is necessary.  It is reported that 1/4 of sexually active people are adolescents, but they contract over 1/2 of reported STIs.  There are over 9 million cases each year, with over 8,000 new cases of HIV.  Communication between parents is beneficial for many reasons, including the hope for an honest discussion field.  This study is important because, as they say, you can lead a horse to water but you can’t make it drink.  We can communicate to adolescents as much as we want, but is it actually making a difference in their safe sex practices?  Thankfully, this study suggests that communication is encouraging safer sex practices.
Widman L, Choukas-Bradley S, Noar S, Nesi J, Garrett K. Parent-Adolescent Communication and Adolescent Safe Sex Behavior. JAMA Pediatrics. 2016;170(1):52-61.

Link to article

Patterns of Needlesticks and Sharps Injuries Among Training Residents

This article discusses whether or not there are patterns amongst NSI (needlestick and sharps injuries) occurrences and PGY residency year.  The study observed a wide range of medical practice areas and even included charts and tables.  It shows the most common areas where the injuries happen on the hands.  It also concluded that PGY1 residents were most likely to have an NSI, with the risk decreasing with every additional year of residency experience.

Since the PA laws regarding pharmacy immunizations have recently changed, this article is interesting to me because it reminds me of the safety precautions to take while administering immunizations and using needles.

Link to article

Marnejon T, Gemmel D, Mulhern K. Patterns of Needlestick and Sharps Injuries Among Training Residents. JAMA Internal Medicine. 2016; 172(2):251-252