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A variety of terms, such as "antiepileptic," "anticonvulsant," and "antiseizure" have been historically applied to medications for the treatment of seizure disorders. Terminology is important because using terms that do not accurately reflect the action of specific treatments may result in a misunderstanding of their effects and inappropriate use. The present International League Against Epilepsy (ILAE) position paper used a Delphi approach to develop recommendations on English‐language terminology applicable to pharmacological agents currently approved for treating seizure disorders. There was consensus that these medications should be collectively named "antiseizure medications". This term accurately reflects their primarily symptomatic effect against seizures and reduces the possibility of health care practitioners, patients, or caregivers having undue expectations or an incorrect understanding of the real action of these medications. The term "antiseizure" to describe these agents does not exclude the possibility of beneficial effects on the course of the disease and comorbidities that result from the downstream effects of seizures, whenever these beneficial effects can be explained solely by the suppression of seizure activity. It is acknowledged that other treatments, mostly under development, can exert direct favorable actions on the underlying disease or its progression, by having "antiepileptogenic" or "disease‐modifying" effects. A more‐refined terminology to describe precisely these actions needs to be developed. [ABSTRACT FROM AUTHOR]

A paper spray tandem mass spectrometric (PS-MS/MS) method without column separation was developed for the rapid screening of clonidine in dietary supplements. PS-MS/MS provided acceptable performance compared to high-performance liquid chromatography – tandem mass spectrometry (HPLC-MS/MS) in terms of limits of detection and quantification, accuracy, and precision. To overcome ionization suppression of complicated plant-based pharmaceutical products, nizatidine, tizanidine, and apraclonidine were investigated as internal standards. A more similar structured internal standard is most suitable for matrix effect compensation. The developed method has advantages of simplicity and speed for the screening of clonidine in dietary supplements. [ABSTRACT FROM AUTHOR]

The need for providing rapid and, possibly, on-the-spot analytical results in the case of intoxication has prompted researchers to develop rapid, sensitive, and cost-effective methods and analytical devices suitable for use in nonspecialized laboratories and at the point of need (PON). In recent years, the technology of paper-based microfluidic analytical devices (μPADs) has undergone rapid development and now provides a feasible, low-cost alternative to traditional rapid tests for detecting harmful compounds. In fact, µPADs have been developed to detect toxic molecules (arsenic, cyanide, ethanol, and nitrite), drugs, and drugs of abuse (benzodiazepines, cathinones, cocaine, fentanyl, ketamine, MDMA, morphine, synthetic cannabinoids, tetrahydrocannabinol, and xylazine), and also psychoactive substances used for drug-facilitated crimes (flunitrazepam, gamma-hydroxybutyric acid (GHB), ketamine, metamizole, midazolam, and scopolamine). The present report critically evaluates the recent developments in paper-based devices, particularly in detection methods, and how these new analytical tools have been tested in forensic and clinical toxicology, also including future perspectives on their application, such as multisensing paper-based devices, microfluidic paper-based separation, and wearable paper-based sensors. [ABSTRACT FROM AUTHOR]

Two easy-to-use, rapid, and inexpensive colorimetric-based assays for the detection of active constituent in nasal decongestant phenylephrine hydrochloride (PHP), in solution and their respective pharmaceutical preparations were reported. The assay principle depends on the diazotized sulfadimidine (DSDM) coupling with PHP active pharmaceutical compound under alkaline conditions to produce a colored azo-dye product. A UV/VIS spectrophotometry method was utilized to monitor the color absorbance change at 460 nm, with a linear calibration graph in the concentration range of 1-20 mg L-1 and a limit of detection of 0.22 mg L-1 and limit of quantification of 0.72 mg L-1 . A comparison was done using a paper-based microfluidic analytical device (µPADs) and color intensity change was measured using a Samsung note 9 camera to capture digital images and Image J software to analyze the color intensity development. A linear trend was observed above approximately 10 mg L-1 . Thus, paper-based microfluidic analytical devices (µPADs) can be used as an alternative platform to conventional methods to perform a semi-quantitative PHP drug analysis. The proposed method was applied for the determination of PHP in commercial pharmaceutical preparations. [ABSTRACT FROM AUTHOR]

Surface-enhanced Raman spectroscopy (SERS) is a unique technique that allows us to detect samples in trace quantities. The spectral intensities of the characteristic Raman peaks of the analyte molecule are enhanced manifold in the presence of noble metal nanoparticles (NPs). The existence of NPs is necessary to couple the incident electromagnetic field with NPs through the localized surface plasmon resonance phenomenon, which primarily contributes to the enhancement of an SERS signal. The present work demonstrates the working of a paper-based SERS substrate to detect and quantify two pharmaceutical drugsâ€"paracetamol and aspirinâ€"in water. The proposed SERS substrate was obtained by drop-casting silver NPs over printing grade 100 grams per square meter (GSM) paper. 100 GSM denotes the class of paper where 100 grams of raw materials (cellulose) is used per square meter to manufacture the paper. The performance of the designed SERS substrate was initially evaluated with two Raman active samplesâ€"malachite green and rhodamine-6G. The applicability of the proposed SERS substrate was evaluated further through monitoring the Raman spectra of the two aforementioned pharmaceutical drugs in different field-collected water samples, thus establishing the reliability of the scheme in a real field environment. [ABSTRACT FROM AUTHOR]

The article discusses the top 10 papers in cardio-oncology from the year 2023. It highlights various topics such as tailored cardiomyopathy surveillance recommendations for childhood and young adult cancer patients, the use of dexrazoxane for cardioprotection in high-risk patients, the effectiveness of statin therapy in preventing anthracycline cardiotoxicity, the timing and benefits of exercise therapy for breast cancer patients, the impact of radiation dose exposure on major ischaemic events in breast cancer patients, the treatment strategies for immune checkpoint inhibitor myocarditis, the increased risk of ICI myocarditis in patients with thymic epithelial tumors, the prediction and management of cardiovascular events after CAR-T therapy, the optimal duration of anticoagulation therapy for distal deep vein thrombosis in cancer patients, and the increased risk of arterial thromboembolism in atrial fibrillation/flutter patients with newly diagnosed cancer. The article emphasizes the need for further research in these areas and provides recommendations for clinical practice. [Extracted from the article]

There is growing demand for simple to operate, sensitive, on-site quantitative assays to investigate concentrations of drug molecules in pharmaceutical preparations for quality assurance. Here, we report on the development of two colorimetric analysis methods for the study the antibiotic doxycycline hyclate (DOX) and the nasal decongestant oxymetazoline hydrochloride (OXY), in solution as well as in their respective formulations. We compare a UV/vis spectrophotometry method with a color change recorded on a microfluidic paper-based analytical device (μPAD). Detection is based on the pharmaceutical compounds coupling with diazotized 4-aminoacetophenone (DAAP) under alkaline conditions to produce colored azo-dye products. These azo-compounds were monitored by absorbance at 425 nm for DOX and 521 nm for OXY, with linear calibration graphs in the concentration range of 0.5–35 mg L−1 (DOX) and 1.0–40 mg L−1 (OXY) and limits of detection of 0.24 mg L−1 (DOX) and 0.32 mg L−1 (OXY). For the μPAD method, color intensity was measured from photographs and a linear increase was observed at concentrations from above approximately 15 mg L−1 for both compounds and up to 35 mg L−1 for DOX and 40 mg L−1 for OXY. The developed methods were also applied to the formulated pharmaceuticals and no interference was found from the excipient. Thus, the paper-based device provides an inexpensive, simple alternative approach for use outside centralized laboratories with semi-quantitative capability. Image 1 • Azo-coupling using 4-aminoacetophenone for colorimetric analysis of pharmaceuticals. • Semi-quantitative detection of pharmaceutical products using paper-based platform. • Real time analysis of active component within pharmaceutical formulations. [ABSTRACT FROM AUTHOR]

Older people are often affected by impaired organ and bodily functions resulting in multimorbidity and polypharmacy, turning them into the main user group of many medicines. Very often, medicines have not specifically been developed for older people, causing practical medication problems for them like limited availability of easy to swallow formulations, easy to open packaging and dosing instructions for enteral administration. In 2020, the European Medicines Agency (EMA) published a reflection paper 'Pharmaceutical development of medicines for use in the older population', which discusses how the emerging needs of an ageing European population can be addressed by medicines regulation. The paper intends to help industry to better consider the needs of older people during pharmaceutical/clinical medicines development by summarising data on the most relevant topics, providing early suggestions on how to move forward and prompting expert discussions and studies into knowledge gaps. Topics include patient acceptability, (dis)advantages of an administration route, formulation, dosage form, packaging, dosing device and user instruction. While the paper is directed at older people and the pharmaceutical industry, the reflections are also relevant to younger patients with similar disease‐related needs and of value to other stakeholders parties, e.g., healthcare professionals, academics, patients and caregivers, as the paper makes clear what can be expected from industry and where collaborative work is needed. This commentary provides an overview of the different steps in the development of the reflection paper, discusses points considered most controversial and/or subject to (multidisciplinary) expert discussions and indicates their value for real world clinical practice. [ABSTRACT FROM AUTHOR]

Objective: The Patient Information Leaflet (PIL) is an authoritative document that all people with epilepsy in the EU receive when prescribed antiseizure medication (ASM). We undertook the first independent, comprehensive assessment to determine how understandable they are. Regulators state that when patients are asked comprehension questions about them, ≥80% should answer correctly. Also, recommended is that PILs have a maximum reading requirement of US grade 8. Methods: Study 1: We obtained 140 current ASM PILs written in English. "Readability" was assessed using four tests, with and without adjustment for influence of familiar, polysyllabic words. A total of 179 online materials on epilepsy were also assessed. Study 2: Two PILs from Study 1 were randomly selected (Pregabalin Focus; Inovelon) and shown to 35 people from the UK epilepsy population. Their comprehension was assessed. Study 3: To understand whether the student population provides an accessible alternative population for future examination of ASM PILs, Study 3 was completed, using the same methods as Study 2, except that participants were 262 UK university students. Results: Study 1: No PIL had a reading level of grade 8. Median was grade 11. Adjusting for context, the PILs were still at grade 10.5. PILs for branded ASMs were most readable. PILs were no more readable than (unregulated) online materials. Study 2: Users struggled to comprehend the PILs' key messages. The eight questions asked about pregabalin were typically answered correctly by 54%. For Inovelon, it was 62%. Study 3: Most student participants comprehended the PILs' key messages. The questions about Inovelon were answered correctly by 90%; for pregabalin it was 86%. Significance: This is the first independent and comprehensive examination of ASM PILs. It found that PILs being used fail to meet recommendations and regulatory requirements and risk not being understandable to a substantial proportion of users. In finding that people from the epilepsy population differ markedly in comprehension of PILs compared to students, this study highlights the importance of completing user testing with the target population. [ABSTRACT FROM AUTHOR]

What is known and objective: Renal impairment (RI) and renal drug‐related problems (rDRP) often remain unrecognized in the community setting. A "renal pharmacist consultant service" (RPCS) at hospital admission can support patient safety by detecting rDRP. However, the efficient information sharing from pharmacists to physicians is still discussed. The aim of the study was to test the implementation of a RPCS and its effectiveness on prescription changes and to evaluate two ways of written information sharing with physicians. Methods: Urological patients with eGFRnon‐indexed of 15‐59 ml/min and ≥1 drug were reviewed for manifest and potential rDRP at admission by a pharmacist. Written recommendations for dose or drug adaptation were forwarded to physicians comparing two routes: July‐September 2017 paper form in handwritten chart; November 2017‐January 2018 digital PDF document in the electronic patient information system and e‐mail alert. Prescription changes regarding manifest rDRP were evaluated and compared with a previous retrospective study without RPCS. Results and discussion: The RPCS detected rDRP in 63 of 234 (26.9%) patients and prepared written recommendations (median 1 rDRP (1‐5) per patient) concerning 110 of 538 (20.5%) drugs at admission. For manifest rDRP, acceptance rates of recommendations were 62.5% (paper) vs 42.9% (digital) (P = 0.16). Compared with the retrospective study without RPCS (prescription changes in 21/76 rDRP; 27.6%), correct prescribing concerning manifest rDRP significantly increased by 27.1%. What is new and conclusion: A RPCS identifies patients at risk for rDRP and significantly increases appropriate prescribing by physicians. In our hospital (no electronic order entry, electronic chart or ward pharmacists), consultations in paper form seem to be superior to a digital PDF document. [ABSTRACT FROM AUTHOR]

Abstract N-benzylphenethylamines derivatives, such as NBOMe and NBOH series, are potent hallucinogen drugs that are usually sold in the illicit market as blotter papers containing "legal" LSD alternatives. The identification of these drugs is mainly performed by liquid or gas chromatography coupled with mass spectrometry, but there is a lack of a rapid screening methods to identify samples containing or not drugs of these series. For this purpose, this work offers a fast and non-destructive method applying a handheld NIR spectrometer for discrimination of drugs absorbed in blotter papers using PLS-DA and SIMCA. The method was developed in a two-stage approach: Model A for identification of samples containing or not drugs and model B for identification of samples containing NBOMe or NBOH drugs. PLS-DA models have provided efficiency rates higher 97% in both training and validation phases. Robustness of model B was evaluated with a random permutation of samples among training and validation phases, given mean efficiency rates higher than 89%. SIMCA models presented equivalent efficiency for model A, but lower efficiency for model B comparing to PLS-DA results. However, SIMCA showed a higher efficiency to deal with samples containing drugs not included in the training phase. Results support use of this method for in loco forensic analysis and as a screening method prior the chromatographic and mass spectrometry analysis. Graphical abstract Unlabelled Image Highlights • In loco analysis of NPS in blotter papers • Analysis of NPS recently described in the literature • Fast screening method for forensic analysis • Two stage model for NPS presence and their identification [ABSTRACT FROM AUTHOR]

The article discusses the top 10 papers in interventional cardiology published in 2023. The papers cover a range of topics, including percutaneous coronary intervention, coronary physiology and imaging, dual-antiplatelet therapy, cardiogenic shock, structural heart disease, peripheral artery disease, and arterial hypertension. The papers highlight the effectiveness of various interventions and provide insights into improving patient outcomes. However, the article also emphasizes the need for further research in certain areas. [Extracted from the article]

Increased global longevity requires a re‐evaluation of current structures in society to adapt to the consequential demographic shift. As (very) old people are prone to impaired human organ and body functions resulting in, for example, multimorbidity, polypharmacy, hospitalisation and problems in medication management, it is increasingly acknowledged that re‐evaluations should include the suitability of pharmaceutical patient care as one of the cornerstones of public health. Following the 2011 European Medicines Agency (EMA) Geriatric Strategy, in 2017 the EMA published the draft "Reflection paper on the pharmaceutical development of medicines for use in the older population". The draft paper was opened for public consultation and specific attention and feedback (either supportive or with a proposal for revision) was asked on three design aspects: tablet breaking, drug administration through enteral feeding tubes and medication management. Following publication, the draft paper was presented at two public conferences attended by participants from different disciplines. This manuscript is intended to draw the attention of different stakeholder parties to the urgent need to collaborate on the emerging issues arising from increasing longevity and multimorbidity, and especially those associated with pharmaceutical patient care and drug product design, including the need for collaborative research into existing or emerging knowledge gaps. The manuscript focuses on the three aforementioned aspects of pharmaceutical development (tablet breaking, drug administration through enteral feeding tubes and medication management) as these highly relate to medication safety and efficacy and constitute persistent and typical challenges for older people, caregivers and healthcare professionals in daily clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: Medication errors are among the most common medical errors. They can result in mortality, morbidity and additional healthcare costs. Surveillance of medication errors is encouraged to identify gaps in the healthcare system and work on them. This study aimed to compare medication errors in outpatient prescriptions in two hospitals in Jordan: one with a paper‐based and one with an electronic prescription system. Methods: This was a cross‐sectional observational study in two large hospitals in Jordan over a three‐month period. Prescribing and dispensing of medicines were screened for medication errors in both centres: 2500 prescriptions were screened in each hospital. Key findings: In the hospital with electronic prescriptions, of the 2500 prescriptions screened, 631 medication errors were detected: 231 (36.6%) prescription errors and 400 (63.4%) dispensing errors. In the hospital with paper‐based prescriptions, 3714 medication errors were found: 288 (7.8%) prescription errors and 3426 (92.2%) dispensing errors. The most common prescription and dispensing errors in electronic prescriptions were, respectively, prescription of drugs that could have a drug–drug interaction, and omitting to dispense a drug on the prescription. In the paper prescriptions, the most common prescription and dispensing errors were, respectively, inappropriate dose/quantity/frequency or route of administration, and inappropriate and/or inadequate labelling of medication when dispensed, of which there were a large number (2496 (67.2%)). Conclusion: This study highlights the effect of the prescription system used by hospitals. Fewer medication errors were found in the electronic system. Healthcare policymakers, professionals and administrators are encouraged to invest in electronic systems to minimize medication errors. [ABSTRACT FROM AUTHOR]

A fast methodology for the assay of parabens in drug and cosmetic preparations has been presented. The procedure developed is based on paper spray tandem mass spectrometry and isotope dilution approach. For each investigated paraben, the corresponding labeled standard has been used in order to improve the accuracy and reproducibility of the analyses. The MS experiments have been performed under MRM conditions, monitoring the transitions [M‐H]− → m/z 92 and [M‐H]− → m/z 98, respectively, for each analyte and the corresponding labeled internal standard. The quantitative assay has been performed using a calibration curve built from 2 to 15 mg/L. The method accuracy, in all case near 100%, was evaluated using fortified samples at two concentration levels, which are representative of the lower and the higher portion of calibration curve. The good values of LOQ, LOD, and reproducibility confirm the consistency of the developed approach. [ABSTRACT FROM AUTHOR]