The Experts below are selected from a list of 135 Experts worldwide ranked by ideXlab platform
Prakash Nair - One of the best experts on this subject based on the ideXlab platform.
-
A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for TransNasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery
International Journal of Neural Systems, 2017Co-Authors: Ajay Prasad Hrishi, Karen Ruby Lionel, Prakash NairAbstract:Introduction TransNasal transsphenoidal (TNTS) approach is preferred for surgical excision of the pituitary gland. Despite its numerous merits, the TNTS approach creates wide fluctuations in hemodynamic parameters that are attributed to the routine application of adrenaline-soaked Nasal packing and the intense noxious stimulus during the surgery. Aims To evaluate the effect of dexmedetomidine for preoperative Nasal passage Preparation on the surgical field visualization and hemodynamic profile of patients during TNTS surgery. Material and Methods Cotton strips soaked in dexmedetomidine were used for Nasal Preparation. The primary outcomes studied were the quality of surgical field visualization through the endoscope and the amount of bleeding that occurred while raising the Nasal mucosal flap. The secondary outcomes assessed were the intraoperative anesthetic and analgesic requirement and the hemodynamic profile. Statistical Analysis Data from the study were summarized as mean and SD. Associations were tested using chi-square test for nonparametric data and for continuous variables ANOVA for repeated measures. A p-value Results Seventeen (85%) patients had a Formmer's score of 1, which was an excellent surgical field quality. Two (10%) patients had a Formmer's score of 2, and one (5%) had a Formmer's score of 3. There were no statistically significant variations in heart rate and blood pressure with reduced anesthetic requirement. Conclusion IntraNasal dexmedetomidine provides good surgical field conditions with the added advantage of lesser hemodynamic fluctuations.
-
A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for TransNasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery
Indian Journal of Neurosurgery, 2017Co-Authors: Ajay Prasad Hrishi, Karen Ruby Lionel, Prakash NairAbstract:Introduction TransNasal transsphenoidal (TNTS) approach is preferred for surgical excision of the pituitary gland. Despite its numerous merits, the TNTS approach creates wide fluctuations in hemodynamic parameters that are attributed to the routine application of adrenaline-soaked Nasal packing and the intense noxious stimulus during the surgery. Aims To evaluate the effect of dexmedetomidine for preoperative Nasal passage Preparation on the surgical field visualization and hemodynamic profile of patients during TNTS surgery. Material and Methods Cotton strips soaked in dexmedetomidine were used for Nasal Preparation. The primary outcomes studied were the quality of surgical field visualization through the endoscope and the amount of bleeding that occurred while raising the Nasal mucosal flap. The secondary outcomes assessed were the intraoperative anesthetic and analgesic requirement and the hemodynamic profile. Statistical Analysis Data from the study were summarized as mean and SD. Associations were tested using chi-square test for nonparametric data and for continuous variables ANOVA for repeated measures. A p-value < 0.05 was considered as statistically significant and < 0.01 as highly significant. SPSS 17.0 was used for analysis. Results Seventeen (85%) patients had a Formmer's score of 1, which was an excellent surgical field quality. Two (10%) patients had a Formmer's score of 2, and one (5%) had a Formmer's score of 3. There were no statistically significant variations in heart rate and blood pressure with reduced anesthetic requirement. Conclusion IntraNasal dexmedetomidine provides good surgical field conditions with the added advantage of lesser hemodynamic fluctuations.
Corina Glanzmann - One of the best experts on this subject based on the ideXlab platform.
-
Medication safety in children
2020Co-Authors: Corina GlanzmannAbstract:Background: The issue of medication safety has received considerable attention in the last few years. Especially drug related problems (DRP) are a major safety issue. Hospital pharmacists are best placed to oversee the quality of the entire drug distribution, Preparation and administration chain and can fulfil an important role in improving medication safety. Despite the awareness that children are at increased risk for DRPs, little is known about the epidemiology of these problems and where the gaps remain in our present knowledge. We undertook three studies to help provide a better understanding of (1) acute kidney injury (AKI) as a possible adverse drug event, (2) prescribing errors, which are considered as a subgroup of medication errors and (3) high drug exposure as an important medication safety issue. Methods: First, we performed a retrospective case-control study in a paediatric intensive care unit (PICU). Cases were patients who developed AKI during PICU stay. Patients without AKI served as controls and were matched to cases on age category and gender in a one to one ratio. Secondly, we performed therefore a prospective observational study to determine the number and type of medication prescribing errors in critically ill children in a PICU. Prescribing errors were prospectively identified by a clinical pharmacist. Lastly, a retrospective observational study was performed to determine the number and profile of drugs and their association with socio-demographic, diagnostic and severity of illness parameters. Number of drugs was defined as the number of different drugs that a study subject received during the first 24 hours. Results: 100 case-control pairs were included. Cases were not statistically different from controls with regard to median weight and main diagnoses, but differed with regard to the need of mechanical ventilation, the severity of illness, and the median length of PICU stay. Multivariate models revealed a statistically significantly higher risk of developing AKI for patients treated with Metamizol, Morphine, Paracetamol and Tropisetron. A similar risk could be shown for medication groups, namely glucocorticoids, betalactam antibiotics, opioids and non-steroidal anti-inflammatory drugs. In the second study a total of 1’129 medication orders were analysed. There were 151 prescribing errors, giving an overall error rate of 14% (95% CI 11 to 16). The medication groups with the highest proportion of medication prescribing errors (MPEs) were antihypertensives, antimycotics and drugs for Nasal Preparation with error rates of each 50%, followed by antiasthmatic drugs (25%), antibiotics (15%) and analgesics (14%). 104 errors (70%) were classified as MPEs which required interventions and/or resulted in patient harm equivalent to 9% of all medication orders (95% CI 6.5 to 14.4). 45 MPEs (30%) did not result in patient harm. In the third study 1751 medication orders in the first 24 hours were included. The patients received a median of 4 (range 1; 25) different drugs. The most frequently prescribed drug groups were analgesics without opioids (19%), opioids (12%), betalactam antibiotics (12%) and cardiac stimulants (7%). There was a statistically significant association between the number of drugs and age, some diagnosis and the severity of illness parameters, respectively. Socio-economic status and sex was not associated with numbers of drugs. Three medication groups (cardiac stimulants, opioids and analgesics without opioids) showed a statistically significant association with the severity of illness parameters. Conclusion: Our studies reveal different risk factors associated with the administration of drugs in children. With a view to reduce these risk factors and improve patient safety, the data presented here help us to prevent errors before they occur. In addition, prevention of DRPs requires a team approach, where clinical pharmacists play an important role in optimizing drug therapy in critically ill children. Careful evaluation of each drug, precise prescription and the awareness of the most vulnerable population may improve patient’s outcome.
-
Analysis of medication prescribing errors in critically ill children
European Journal of Pediatrics, 2015Co-Authors: Corina Glanzmann, Bernhard Frey, Christoph R. Meier, Priska VonbachAbstract:Medication prescribing errors (MPE) can result in serious consequences for patients. In order to reduce errors, we need to know more about the frequency, the type and the severity of such errors. We therefore performed a prospective observational study to determine the number and type of medication prescribing errors in critically ill children in a paediatric intensive care unit (PICU). Prescribing errors were prospectively identified by a clinical pharmacist. A total of 1129 medication orders were analysed. There were 151 prescribing errors, giving an overall error rate of 14 % (95 % CI 11 to 16). The medication groups with the highest proportion of MPEs were antihypertensives, antimycotics and drugs for Nasal Preparation with error rates of each 50 %, followed by antiasthmatic drugs (25 %), antibiotics (15 %) and analgesics (14 %). One hundred four errors (70 %) were classified as MPEs which required interventions and/or resulted in patient harm equivalent to 9 % of all medication orders (95 % CI 6.5 to 14.4). Forty-five MPEs (30 %) did not result in patient harm. Conclusion : With a view to reduce MPEs and to improve patient safety, our data may help to prevent errors before they occur. What is Known: • Prescribing errors may be the most frequent medication errors. • In paediatric populations, the incidence of prescribing errors is higher than in adults. What is New: • Several risk factors for medication prescribing errors, such as medication groups, long PICU stay, and mechanical ventilation could be presented. • Analysing the combination of the most frequent prescribing errors and the severity of these errors.
-
Analysis of medication prescribing errors in critically ill children
European Journal of Pediatrics, 2015Co-Authors: Corina Glanzmann, Bernhard Frey, Christoph R. Meier, Priska VonbachAbstract:Medication prescribing errors (MPE) can result in serious consequences for patients. In order to reduce errors, we need to know more about the frequency, the type and the severity of such errors. We therefore performed a prospective observational study to determine the number and type of medication prescribing errors in critically ill children in a paediatric intensive care unit (PICU). Prescribing errors were prospectively identified by a clinical pharmacist. A total of 1129 medication orders were analysed. There were 151 prescribing errors, giving an overall error rate of 14 % (95 % CI 11 to 16). The medication groups with the highest proportion of MPEs were antihypertensives, antimycotics and drugs for Nasal Preparation with error rates of each 50 %, followed by antiasthmatic drugs (25 %), antibiotics (15 %) and analgesics (14 %). One hundred four errors (70 %) were classified as MPEs which required interventions and/or resulted in patient harm equivalent to 9 % of all medication orders (95 % CI 6.5 to 14.4). Forty-five MPEs (30 %) did not result in patient harm.
Ajay Prasad Hrishi - One of the best experts on this subject based on the ideXlab platform.
-
A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for TransNasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery
International Journal of Neural Systems, 2017Co-Authors: Ajay Prasad Hrishi, Karen Ruby Lionel, Prakash NairAbstract:Introduction TransNasal transsphenoidal (TNTS) approach is preferred for surgical excision of the pituitary gland. Despite its numerous merits, the TNTS approach creates wide fluctuations in hemodynamic parameters that are attributed to the routine application of adrenaline-soaked Nasal packing and the intense noxious stimulus during the surgery. Aims To evaluate the effect of dexmedetomidine for preoperative Nasal passage Preparation on the surgical field visualization and hemodynamic profile of patients during TNTS surgery. Material and Methods Cotton strips soaked in dexmedetomidine were used for Nasal Preparation. The primary outcomes studied were the quality of surgical field visualization through the endoscope and the amount of bleeding that occurred while raising the Nasal mucosal flap. The secondary outcomes assessed were the intraoperative anesthetic and analgesic requirement and the hemodynamic profile. Statistical Analysis Data from the study were summarized as mean and SD. Associations were tested using chi-square test for nonparametric data and for continuous variables ANOVA for repeated measures. A p-value Results Seventeen (85%) patients had a Formmer's score of 1, which was an excellent surgical field quality. Two (10%) patients had a Formmer's score of 2, and one (5%) had a Formmer's score of 3. There were no statistically significant variations in heart rate and blood pressure with reduced anesthetic requirement. Conclusion IntraNasal dexmedetomidine provides good surgical field conditions with the added advantage of lesser hemodynamic fluctuations.
-
A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for TransNasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery
Indian Journal of Neurosurgery, 2017Co-Authors: Ajay Prasad Hrishi, Karen Ruby Lionel, Prakash NairAbstract:Introduction TransNasal transsphenoidal (TNTS) approach is preferred for surgical excision of the pituitary gland. Despite its numerous merits, the TNTS approach creates wide fluctuations in hemodynamic parameters that are attributed to the routine application of adrenaline-soaked Nasal packing and the intense noxious stimulus during the surgery. Aims To evaluate the effect of dexmedetomidine for preoperative Nasal passage Preparation on the surgical field visualization and hemodynamic profile of patients during TNTS surgery. Material and Methods Cotton strips soaked in dexmedetomidine were used for Nasal Preparation. The primary outcomes studied were the quality of surgical field visualization through the endoscope and the amount of bleeding that occurred while raising the Nasal mucosal flap. The secondary outcomes assessed were the intraoperative anesthetic and analgesic requirement and the hemodynamic profile. Statistical Analysis Data from the study were summarized as mean and SD. Associations were tested using chi-square test for nonparametric data and for continuous variables ANOVA for repeated measures. A p-value < 0.05 was considered as statistically significant and < 0.01 as highly significant. SPSS 17.0 was used for analysis. Results Seventeen (85%) patients had a Formmer's score of 1, which was an excellent surgical field quality. Two (10%) patients had a Formmer's score of 2, and one (5%) had a Formmer's score of 3. There were no statistically significant variations in heart rate and blood pressure with reduced anesthetic requirement. Conclusion IntraNasal dexmedetomidine provides good surgical field conditions with the added advantage of lesser hemodynamic fluctuations.
Ming-xia Chen - One of the best experts on this subject based on the ideXlab platform.
-
Preparation of freeze-dried powder of recombinate hirudin-2 nanoparticle for Nasal delivery and permeability through Nasal membrane in vitro
Journal of Chinese medicinal materials, 2013Co-Authors: Ming-xia Chen, Jian-bao Zhang, Ji-ping Yu, Jing Ye, Yu-jie ZhangAbstract:OBJECTIVE: To optimize the freeze-dried powder Preparation technology of recombinate hirudin-2 (rHV2) nanoparticle which has bio-adhesive characteristic for Nasal delivery, also to investigate its stability and permeability through Nasal membrane in vitro. METHODS: Taking the appearance, rediffusion of nanoparticle and rHV2 encapsulation efficiency as the evaluation indexes. Cryoprotector, the preparative technique and the effect of illumination and high temperature factors on its stability for rHV2 freeze-dried powder were investigated. Using Fraze diffusion cell technique, the permeability of rHV2 across rabbit Nasal mucous membrane in chitosan solution, chitosan nanoparticle, and nanoparticle frozen-dried powder were compared with that in normal saline solution. RESULTS: The optimized Preparation of rHV2 nanoparticle freeze-dried powder was as follows: 5% trehalose and glucose (1:1) was used as cryoprotector, nanoparticle solution was freezed for 24 h in vacuum frozen-dryer after being pre-freezed for 24 h. The content of rHV2 in the freeze-dried powder was 1.1 ug/mg. Illumination had little effect on the appearance, rediffusion and encapsulation efficiency of the rHV2 freeze-dried powder. High temperature could obviously influence the appearance of nanoparticle freeze-dried powder. The permeability coefficient (P) of nanoparticle was 5 times more than that in chictonson solution. It was indicated that chitosan nanoparticle has effect on increasing the permeability of rHV2. CONCLUSION: The freeze-dried powder of chitosan nanoparticle can be a good Nasal Preparation of rHV2.
-
The pharmacokinetics and pharmacodynamics of recombinant hirudin-2 Nasal spray
Acta pharmaceutica Sinica, 2006Co-Authors: Yu-jie Zhang, Qiang Zhang, Xiao-liang Wang, Ming-xia ChenAbstract:AIM: To investigate the pharmacokinetics and the anticoagulation action of recombinant hirudin-2 (rHV2) Nasal spray after administration of the Preparation. METHODS: rHV2 concentration in plasma was determined by chromogenic substrate method and the relative bioavailability was calculated. The anticoagulation action of rHV2 spray after intraNasal administration in normal rats and DIC model rabbits after intraNasal administration of rHV2 spary were studied. RESULTS: The in vivo course of rHV2 in rats fitted to the one-compartment model after intraNasal administration of rHV2 spray and the relative bioavailability was 28.53%. Coagulating times of APTT and TT were significantly prolonged in normal rats, and APTT in DIC model rabbits was significantly shortened and was close to the normal values after administration of rHV2 Nasal spray. CONCLUSION: rHV2 spray could be an effective Nasal Preparation of rHV2.
Yu-jie Zhang - One of the best experts on this subject based on the ideXlab platform.
-
Preparation of freeze-dried powder of recombinate hirudin-2 nanoparticle for Nasal delivery and permeability through Nasal membrane in vitro
Journal of Chinese medicinal materials, 2013Co-Authors: Ming-xia Chen, Jian-bao Zhang, Ji-ping Yu, Jing Ye, Yu-jie ZhangAbstract:OBJECTIVE: To optimize the freeze-dried powder Preparation technology of recombinate hirudin-2 (rHV2) nanoparticle which has bio-adhesive characteristic for Nasal delivery, also to investigate its stability and permeability through Nasal membrane in vitro. METHODS: Taking the appearance, rediffusion of nanoparticle and rHV2 encapsulation efficiency as the evaluation indexes. Cryoprotector, the preparative technique and the effect of illumination and high temperature factors on its stability for rHV2 freeze-dried powder were investigated. Using Fraze diffusion cell technique, the permeability of rHV2 across rabbit Nasal mucous membrane in chitosan solution, chitosan nanoparticle, and nanoparticle frozen-dried powder were compared with that in normal saline solution. RESULTS: The optimized Preparation of rHV2 nanoparticle freeze-dried powder was as follows: 5% trehalose and glucose (1:1) was used as cryoprotector, nanoparticle solution was freezed for 24 h in vacuum frozen-dryer after being pre-freezed for 24 h. The content of rHV2 in the freeze-dried powder was 1.1 ug/mg. Illumination had little effect on the appearance, rediffusion and encapsulation efficiency of the rHV2 freeze-dried powder. High temperature could obviously influence the appearance of nanoparticle freeze-dried powder. The permeability coefficient (P) of nanoparticle was 5 times more than that in chictonson solution. It was indicated that chitosan nanoparticle has effect on increasing the permeability of rHV2. CONCLUSION: The freeze-dried powder of chitosan nanoparticle can be a good Nasal Preparation of rHV2.
-
The pharmacokinetics and pharmacodynamics of recombinant hirudin-2 Nasal spray
Acta pharmaceutica Sinica, 2006Co-Authors: Yu-jie Zhang, Qiang Zhang, Xiao-liang Wang, Ming-xia ChenAbstract:AIM: To investigate the pharmacokinetics and the anticoagulation action of recombinant hirudin-2 (rHV2) Nasal spray after administration of the Preparation. METHODS: rHV2 concentration in plasma was determined by chromogenic substrate method and the relative bioavailability was calculated. The anticoagulation action of rHV2 spray after intraNasal administration in normal rats and DIC model rabbits after intraNasal administration of rHV2 spary were studied. RESULTS: The in vivo course of rHV2 in rats fitted to the one-compartment model after intraNasal administration of rHV2 spray and the relative bioavailability was 28.53%. Coagulating times of APTT and TT were significantly prolonged in normal rats, and APTT in DIC model rabbits was significantly shortened and was close to the normal values after administration of rHV2 Nasal spray. CONCLUSION: rHV2 spray could be an effective Nasal Preparation of rHV2.
