American Pharmacists Association

About: American Pharmacists Association is a other organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Pharmacist & Pharmacy. The organization has 2413 authors who have published 1969 publications receiving 30470 citations. The organization is also known as: APhA & American Pharmaceutical Association.

The transfer half-life of morphine-6-glucuronide from plasma to effect site assessed by Pupil size measurement in healthy volunteers

Abstract: Background: Clinical and experimental data suggested a long delay between the plasma concentration versus time course of morphine-6-glucuronide and the time course of its central opioid effects. This study was aimed at the quantification of the transfer half-life (t 1/2,ke0 ) of this delay. Methods: Pupil size was used as a measure of central opioid effect. Eight healthy volunteers (four men, four women) participated in that single-blind randomized crossover study. Median dosages administered intravenously were 0.5 mg morphine as loading dose followed by 10.7 mg given as infusion over a period of 4.7 h, and 10.2 mg M6G as loading dose followed by 39.1 mg M6G given over a period of 3.7 h. The duration of the infusion was tailored to achieve submaximum pupil constriction. The pupil diameter was assessed every 20 min for approximately 18 h. Values of t 1/2,ke0 were obtained by semiparametric pharmacokinetic-pharmacodynamic modeling. Results: The estimated median t 1/2,ke0 of M6G was 6.4 h (range, 2.9-16.2 h), and that of morphine was 2.8 h (range, 1.8-4.4 h). The individual t 1/2,ke0 of M6G was always longer than that of morphine. Judged by the concentration at half-maximun effect (EC 50 ) values of the sigmoid pupil size at maximum constriction (E max ) model describing concentration-response relation, M6G was apparently 22 times less potent than morphine (EC 50 = 740.5 nM [range, 500-1,520 nM] for M6G and 36.2 nM [range, 19.7-43.3 nM] for morphine). The steepness of the sigmoid E max model did not significantly differ between morphine and M6G (y = 1.9 and 2.6, respectively). To produce similar pupil effects, the M6G dose had to be 2.8 times greater than the morphine dose. Conclusions: The reported numerical value of the t 1/2,ke0 of M6G in humans obtained after direct administration of M6G is a step toward a complete modeling approach to the prediction of the clinical effects of morphine. The study raises questions about the high interindividual variability of the transfer half-life between plasma and effect site (k e0 ) values and the apparent low potency of M6G.

The transfer half-life of morphine-6-glucuronide from plasma to effect site assessed by pupil size measurement in healthy volunteers.

Abstract: Background: Clinical and experimental data suggested a long delay between the plasma concentration versus time course of morphine-6-glucuronide and the time course of its central opioid effects. This study was aimed at the quantification of the transfer half-life (t 1/2,ke0 ) of this delay. Methods: Pupil size was used as a measure of central opioid effect. Eight healthy volunteers (four men, four women) participated in that single-blind randomized crossover study. Median dosages administered intravenously were 0.5 mg morphine as loading dose followed by 10.7 mg given as infusion over a period of 4.7 h, and 10.2 mg M6G as loading dose followed by 39.1 mg M6G given over a period of 3.7 h. The duration of the infusion was tailored to achieve submaximum pupil constriction. The pupil diameter was assessed every 20 min for approximately 18 h. Values of t 1/2,ke0 were obtained by semiparametric pharmacokinetic-pharmacodynamic modeling. Results: The estimated median t 1/2,ke0 of M6G was 6.4 h (range, 2.9-16.2 h), and that of morphine was 2.8 h (range, 1.8-4.4 h). The individual t 1/2,ke0 of M6G was always longer than that of morphine. Judged by the concentration at half-maximun effect (EC 50 ) values of the sigmoid pupil size at maximum constriction (E max ) model describing concentration-response relation, M6G was apparently 22 times less potent than morphine (EC 50 = 740.5 nM [range, 500-1,520 nM] for M6G and 36.2 nM [range, 19.7-43.3 nM] for morphine). The steepness of the sigmoid E max model did not significantly differ between morphine and M6G (y = 1.9 and 2.6, respectively). To produce similar pupil effects, the M6G dose had to be 2.8 times greater than the morphine dose. Conclusions: The reported numerical value of the t 1/2,ke0 of M6G in humans obtained after direct administration of M6G is a step toward a complete modeling approach to the prediction of the clinical effects of morphine. The study raises questions about the high interindividual variability of the transfer half-life between plasma and effect site (k e0 ) values and the apparent low potency of M6G.

Community Pharmacist–provided Extended Diabetes Care

Abstract: BackgroundPharmacists in various settings have been effective in initiating diabetes treatment. Patients with diabetes require ongoing disease management, and community pharmacists are in a strategic position to provide such extended care. Little is known, however, about the effects of community pharmacist–provided interventions beyond the initial treatment period.ObjectiveTo evaluate the effect of community pharmacist–provided extended diabetes care service on primary clinical outcomes, including hemoglobin A1c (A1C), low-density lipoprotein cholesterol (LDL-C), and blood pressure, and on patients' reported self-care activities.MethodsA randomized controlled trial was conducted in patients with diabetes. Participants had already completed at least 2 diabetes education sessions at a local diabetes education center. Nine specially trained pharmacists administered interventions during up to 4 quarterly visits per patient. Interventions included discussing medications, clinical goals, and self-care activitie...

Renal Allograft Dysfunction Associated with Rifampin–Tacrolimus Interaction

Abstract: OBJECTIVE:To report an interaction between tacrolimus and rifampin with subsequent adverse effects on renal allograft function.CASE SUMMARY:A 61-year-old Chinese man received a cadaveric renal transplant in 1991. Progressive deterioration of allograft function developed during the following six years while the patient was receiving cyclosporine and prednisolone. In January 1998, tacrolimus was substituted for cyclosporine for late biopsy-proven graft rejection, with target trough blood concentrations between 5 and 8 ng/mL. After conversion, serum creatinine fell to 2.0 mg/dL; the nadir was reached within one year. At the same time, rifampin was instituted for controlling tuberculosis and empiric fluconazole was discontinued. Twelve days later, the patient's serum creatinine concentration rose to 2.9 mg/dL and tacrolimus concentration fell to 1.5 ng/mL, along with oliguria. These findings suggested acute rejection, which was successfully reversed by steroid therapy. However, more than a tenfold increase in...

Impact of a Pharmaceutical Care Program in a Community Pharmacy on Patients with Dyslipidemia

Abstract: BACKGROUND:Inappropriate use of medications is a significant problem in health care today. A possible solution to this problem may be achieved through better control of patients' drug therapy.OBJECTIVE:To design a pharmaceutical care program for dyslipidemic patients within a community pharmacy setting that provides education in the areas of medication compliance and lifestyle modifications, while emphasizing the importance of achieving cholesterol goals to ensure improvement in quality of life.METHODS:Patients at an outpatient pharmacy volunteered to be surveyed for 16 weeks. Although both the intervention and control groups were surveyed, the randomly selected intervention group was interviewed more frequently and more comprehensively. Cholesterol, triglycerides, glucose, weight, risk factors, drug-related problems (DRPs), and quality of life were measured via a survey at the onset of the study and continually measured until the study's conclusion.RESULTS:In the intervention group, 26 DRPs were detected...