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Enteral Delivery of Pravastatin Sodium Tablets: Effect of Compounding into a Liquid Form and Co-Administration of Enteral Nutrition.普伐他汀钠片的肠内给药:配制成液体制剂及与肠内营养共同给药的效果
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2
Potassium canrenoate compounding for administration via enteral feeding tubes: a physical and microbiological stability study.复方螺内酯钾经肠内喂养管给药的物理和微生物稳定性研究。
Eur J Hosp Pharm. 2018 Oct;25(e2):e120-e125. doi: 10.1136/ejhpharm-2017-001276. Epub 2017 Aug 5.
3
Oral drug therapy in elderly with dysphagia: between a rock and a hard place!吞咽困难老年人的口服药物治疗:进退两难!
Clin Interv Aging. 2017 Jan 31;12:241-251. doi: 10.2147/CIA.S121905. eCollection 2017.

本文引用的文献

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Difficulties swallowing solid oral dosage forms in a general practice population: prevalence, causes, and relationship to dosage forms.一般实践人群中固体口服剂型吞咽困难的发生率、原因及与剂型的关系。
Eur J Clin Pharmacol. 2013 Apr;69(4):937-48. doi: 10.1007/s00228-012-1417-0. Epub 2012 Sep 29.
2
Swallowing dysfunction and dysphagia is an unrecognized challenge for oral drug therapy.吞咽功能障碍和吞咽困难是口服药物治疗中未被认识到的挑战。
Int J Pharm. 2012 Jul 1;430(1-2):197-206. doi: 10.1016/j.ijpharm.2012.04.022. Epub 2012 Apr 15.
3
Australian and New Zealand Society for Geriatric Medicine. Position statement - dysphagia and aspiration in older people*.澳大利亚和新西兰老年医学协会。立场声明——老年人吞咽困难与误吸*
Australas J Ageing. 2011 Jun;30(2):98-103. doi: 10.1111/j.1741-6612.2011.00537.x.
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Medication administration through enteral feeding tubes.通过肠内喂养管给药
Am J Health Syst Pharm. 2008 Dec 15;65(24):2347-57. doi: 10.2146/ajhp080155.
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Pharmacokinetic comparison of the potential over-the-counter statins simvastatin, lovastatin, fluvastatin and pravastatin.潜在非处方他汀类药物辛伐他汀、洛伐他汀、氟伐他汀和普伐他汀的药代动力学比较。
Clin Pharmacokinet. 2008;47(7):463-74. doi: 10.2165/00003088-200847070-00003.
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Making sure the residents get their tablets: medication administration in care homes for older people.确保居民按时服药:老年人护理院的药物管理
J Adv Nurs. 2006 Oct;56(2):190-9. doi: 10.1111/j.1365-2648.2006.03997.x.
7
Dysphagia after stroke: incidence, diagnosis, and pulmonary complications.中风后吞咽困难:发病率、诊断及肺部并发症
Stroke. 2005 Dec;36(12):2756-63. doi: 10.1161/01.STR.0000190056.76543.eb. Epub 2005 Nov 3.
8
Quantification of pravastatin in human plasma and urine after solid phase extraction using high performance liquid chromatography with ultraviolet detection.采用高效液相色谱-紫外检测法,经固相萃取后对人血浆和尿液中的普伐他汀进行定量分析。
J Chromatogr B Analyt Technol Biomed Life Sci. 2005 Apr 25;818(2):257-62. doi: 10.1016/j.jchromb.2005.01.006.
9
Administration of medicines. Part 1: The law and nursing.
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Medication administration in nursing homes.疗养院中的药物管理。
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用于吞咽困难患者药物治疗的普伐他汀钠盐水溶液的化学和微生物稳定性研究。

Chemical and microbiological stability studies of an aqueous solution of pravastatin sodium salt for drug therapy of the dysphagic patients.

作者信息

Bonacucina Giulia, Logrippo Serena, Cespi Marco, Ganzetti Roberta, Casettari Luca, Sestili Matteo, Perinelli Diego Romano, Ricciutelli Massimo, Marziali Antonella, Polidori Carlo, Palmieri Giovanni Filippo

机构信息

School of Pharmacy, University of Camerino, Camerino, Italy.

Hospital Pharmacy, Italian National Research Centers on Aging (I.N.R.C.A.), Ancona, Italy.

出版信息

Eur J Hosp Pharm. 2016 Sep;23(5):288-293. doi: 10.1136/ejhpharm-2015-000781. Epub 2016 Feb 23.

DOI:10.1136/ejhpharm-2015-000781
PMID:31156867
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6451617/
Abstract

OBJECTIVE

This study is aimed to improve dysphagic patient compliance under therapy with cholesterol-lowering drugs. Patients suffering severe dysphagia, who do not feed independently, receive enteral nutrition through feeding tube and they need alternative oral route also for the administration of pharmacological therapy. This research deals with the development and stability (chemical and microbiological) of an aqueous solution of pravastatin sodium salt that will be administered orally directly in the feeding tube starting from commercial tablets. Tablets formulation is the only pharmaceutical dosage form available on the market for this type of drug.

METHODS

Pravastatin sodium salt tablets are dissolved in a preserved sodium bicarbonate solution at the final concentration of 4 mg/mL. Samples are stored in two different conditions until 60 days. The samples are prepared for high-performance liquid chromatography analysis coupled to a diode array detector (HPLC-DAD), microbiological analysis and pH measurements.

RESULTS

The chemical stability of the solution performed with HPLC-DAD analysis shows peaks' overlapping, which are characteristic of pravastatin, and correspondence of the concentration of the active ingredient in the solution. The detected values are analysed by one-way analysis of variance showing no statistically significant differences. Microbiological analyses proved that there is not microbial growth. By considering the dilution factor applied, it was possible to express the result as <10 CFU/mL in the two different culture media.

CONCLUSION

This study demonstrated the possibility to reformulate pravastatin tablets as liquid pharmaceutical formulation for enteral administration with the aim of improving drug therapy in dysphagic patients.

摘要

目的

本研究旨在提高吞咽困难患者在接受降胆固醇药物治疗时的依从性。患有严重吞咽困难且无法自主进食的患者通过饲管接受肠内营养,他们在接受药物治疗时也需要其他口服途径。本研究探讨了从市售片剂开始,将普伐他汀钠盐制成口服水溶液直接注入饲管的溶液的研制及其稳定性(化学和微生物学方面)。片剂剂型是市场上这种类型药物唯一可用的药物剂型。

方法

将普伐他汀钠盐片溶解于保存的碳酸氢钠溶液中,最终浓度为4 mg/mL。样品在两种不同条件下保存60天。制备样品用于高效液相色谱-二极管阵列检测器分析(HPLC-DAD)、微生物学分析和pH测量。

结果

通过HPLC-DAD分析进行的溶液化学稳定性显示出普伐他汀特有的峰重叠以及溶液中活性成分浓度的对应关系。通过单因素方差分析对检测值进行分析,结果显示无统计学显著差异。微生物学分析证明没有微生物生长。考虑到所应用的稀释因子,在两种不同培养基中结果可表示为<10 CFU/mL。

结论

本研究证明了将普伐他汀片重新制成肠内给药液体制剂以改善吞咽困难患者药物治疗的可能性。