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Wyświetlanie 1-10 z 198
Tytuł:
Knowledge and attitude of community pharmacy employees towards an automatic drug substitution of generics and biosimilars
Autorzy:
Łukasik, Zuzanna M.
Nowicki, Michał
Tematy:
biosimilars
pharmacist
follow-on biologics
generic substitution
automatic therapeutic substitution
Pokaż więcej
Wydawca:
Polskie Towarzystwo Farmaceutyczne
Powiązania:
https://bibliotekanauki.pl/articles/895482.pdf  Link otwiera się w nowym oknie
Opis:
Rationale: In recent years many patent protections of original biopharmaceuticals have expired and biosimilar medicines are being developed and are entering the pharmaceutical market. Polish legal framework does not narrow down automatic therapeutic substitution (ATS) of biopharmaceuticals at the pharmacy level. The aim was to assess the awareness of Polish community pharmacy employees and their attitude towards ATS of generics and biosimilar medicines. Methods: A self-designed online questionnaire consisting of 27 questions addressing ATS of generics and biopharmaceuticals was created. The survey respondents were approached personally at local pharmacies, via pharmacy managers, chain pharmacy owners and Chambers of Apothecaries. Data collected was entered into descriptive statistics tool provided by the survey hosting server. Simultaneously a printed survey dedicated to patients was created to asses patterns of behaviour related to ATS. Results: According to Polish community pharmacy employees the main reason for ATS was price competitiveness, unavailability of the reference drug and patient’s wish. 7.3% of respondents have ever taken part in any drug safety monitoring program. 9.1% of pharmacy technicians and 46.8% masters of pharmacy claimed to have considerable knowledge about biosimilar drugs and evaluated biosimilars as carrying a higher risk of adverse events than generics. 17.2% would offer a substitution of a biopharmaceutical. 33.3% of patients did not tell their prescribing doctor about the ATS. Conclusions: There is strong need of establishing explicit legislation regulating ATS between reference biopharmaceuticals and biosimilars. Introduction of the framework should be simultaneously accompanied by shared trainings for medical professionals participating in the pharmacotherapy.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Optimal ordering quantities for substitutable items under joint replenishment with cost of substitution
Autorzy:
Mishra, V. K.
Shanker, K.
Tematy:
inventory
substitutable item
joint replenishment
cost of substitution
critical substitution rate
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Wydawca:
Politechnika Wrocławska. Oficyna Wydawnicza Politechniki Wrocławskiej
Powiązania:
https://bibliotekanauki.pl/articles/406577.pdf  Link otwiera się w nowym oknie
Opis:
An inventory system of two mutually substitutable items has been studied where an item is out of stock, demand for it is met by the other item and any part of demand not met due to unavailability of the other item is lost. In the event of substitution, there is an additional cost of substitution involved for each unit of the substituted item. The demands are assumed to be deterministic and constant. Items are ordered jointly in each ordering cycle, in order to take advantage of joint replenishment. The problem is formulated and a solution procedure is suggested to determine the optimal ordering quantities that minimize the total inventory cost. The critical value of the substitution rate is defined to help in deciding the optimal value of decision parameters. Extensive numerical experimentation is carried out, which shows that prior knowledge of the critical value of the substitution rate helps to minimize the total inventory cost. Sensitivity analysis is carried out for the improvement in the optimal total cost with substitution as compared to the case without substitution to draw insights into the behaviour of the model.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Legitimacy and potential savings in automatic substitution of biological products in Poland, the example of insulin
Autorzy:
Wąż, Piotr
Gruchała, Katarzyna A.
Zimmermann, Agnieszka
Tematy:
biologics
biosimilars
substitution
Pokaż więcej
Wydawca:
Polskie Towarzystwo Farmaceutyczne
Powiązania:
https://bibliotekanauki.pl/articles/895667.pdf  Link otwiera się w nowym oknie
Opis:
Currently in Poland there is no regulation aiming at framing the complexity of substitution process arising at pharmacy level. In practice such process exists in variety type of products, both generic and biological scope. Lack of integrity in terms of this process between authorised medical professions who held it, might lead to further costs both for the health care system and patients. The aim of the study is to explain, that the economic advantage, which very often is the result of performed substitution process, in some types of products such as bio-logical ones, should be preceded with the decision of the treating physi-cian. Only then, in the cooperation between persons prescribing and dispensing certain medicinal product the process of substitution may fully use its potential of money saving along with the control over a certain patient. The study brings the yet unknown classification of dif-ferences in costs between actually performed automatic substitution of products containing human insulin in the pharmacy setting in Poland in four year period in five Voivodeships.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Nukleofilowe podstawienie wodoru w nitroarenach. Proces analogiczny i komplementarny do podstawienia elektrofilowego
Nucleophilic substitution of hydrogen in nitroarenes. An alogous and complementary process to electrophilic substitution
Autorzy:
Mąkosza, M.
Tematy:
podstawienie elektrofilowe
podstawienie nukleofilowe
pierścienie aromatyczne
nitroarenes
nucleophilic substitution
oxidation
vicarious substitution
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Wydawca:
Polskie Towarzystwo Chemiczne
Powiązania:
https://bibliotekanauki.pl/articles/171966.pdf  Link otwiera się w nowym oknie
Opis:
Nucleophiles add to electron-deficient arenes, also those containing halogens, initially in positions occupied by hydrogen to form óH adducts. This addition is faster than addition in similarly activated positions occupied by halogens. Formation of the óH adducts is a reversible process, thus they dissociate and slower addition in positions occupied by halogens results in formation of óH adducts followed by fast departure of X– to form products of nucleophilic substitution of halogen, SNAr. In the review it is shown that there are a few ways for fast further conversion of initially formed óH adducts into products of nucleopilic substitution of hydrogen such as oxidative substitution, vicarious substitution, etc. Since formation of óH adducts is faster than óH adducts and the former undergo fast transformations into products of nucleophilic substitution of hydrogen we should accept than this is the major, primary reaction whereas conventional nucleophilic substitution of halogens, SNAr reaction “ipso” substitution is just a secondary process. In modern textbooks only SNAr reactions are discussed whereas nucleophilic substitution of hydrogen is not mentioned, thus it is necessary to introduce proper corrections in textbooks and teaching of this chapter of chemistry of arenes.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Guidelines for quantitative and qualitative studies of sensory substitution experience
Autorzy:
Wierzchoń, Michał
Łukowska, Marta
Majchrowicz, Bartosz
Kałwak, Weronika
Reuter, Magdalena
Opis:
Information that is normally accessed through a sensory modality (substituted modality, e.g., vision) is provided by sensory substitution devices (SSDs) through an alternative modality such as hearing or touch (i.e., substituting modality). SSDs usually support disabled users by replacing sensory inputs that have been lost, but they also offer a unique opportunity to study adaptation and flexibility in human perception. Current debates in sensory substitution (SS) literature focus mostly on its neural correlates and behavioural consequences. In particular, studies have demonstrated the neural plasticity of the visual brain regions that are activated by the substituting modality. Participants also adapt to using the devices for a broad spectrum of cognitive tasks that usually require sight. However, little is known about the SS experience. Also, there is no agreement on how the phenomenology of SS should be studied. Here, we offer guidelines for the methodology of studies investigating behavioural adaptation to SS and the effects of this adaptation on the subjective SS experience. We also discuss factors that may influence the results of SS studies: (1) the type of SSD, (2) the effects of training, (3) the role of sensory deprivation, (4) the role of the experimental environment, (5) the role of the tasks participants follow, and (6) the characteristics of the participants. In addition, we propose combining qualitative and quantitative methods and discuss how this should be achieved when studying the neural, behavioural, and experiential consequences of SS.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Dealing with hypodysfibrinogenemia during pregnancy with a successful outcome
Autorzy:
Faflik, Zuzanna
Witkowski, Michał
Witkowska, Magdalena
Smolewski, Piotr
Robak, Tadeusz
Tematy:
hypodysfibrinogenemia
pregnancy
fibrynogen
substitution
Pokaż więcej
Wydawca:
Medical Education
Powiązania:
https://bibliotekanauki.pl/articles/2047810.pdf  Link otwiera się w nowym oknie
Opis:
Background: Fibrinogen is a protein playing pleiotropic role in human body. It is engaged in maintaining hemostasis. Congenital fibrinogen disorders comprise quantitative and qualitative fibrinogen anomalies. The symptoms range from bleeding, thrombosis to asymptomatic at all what is the most common case. Hypodysfibrinogenemia with lower level of fibrinogen of reduced activity, is the least common of all congenital fibrinogen disorders. Case report: A 31-year-old woman was reported at the 21 weeks of gestation, suffered from genital tract bleeding and there was a history of stillbirth. Clinical examination with no pathology, however laboratory tests revealed coagulation abnormalities due to prolonged thrombin test, decreased protein S and lower fibrinogen level (70 mg/dl). Autoimmune diseases were excluded and the diagnosis was widened with rotational thromboelastometry and genetic test for hypodysfibrinogenemia. The patient was treated with fibrinogen substitution and prophylactic dose of heparin throughout pregnancy and 2 weeks following labour. At 39 week of gestation Caesarean section was done, with no complications. Results: Genetic test revealed heterozygous mutation in fibrinogen gamma gene confirming hypodysfibrinogenemia. Due to bleeding manifestation in this patient of congenital fibrinogen disorders, fibrinogen substitution was implemented with heparin as a paranticoagulant prophylaxis, what turned out to be successful and enabled the patient to maintain the pregnancy. Conclusions: As hypodysfibrinogenemia symptoms are diverse the management is difficult and each patient’s therapy should be planned separately. Pregnancy may be the first time when congenital fibrinogen disorders reveal and it is especially challenging to prevent from obstetrical complications.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Legal and economic identification and assessment of pharmacy substitution in narrow therapeutic index drugs, on the example of epileptic medications in Poland
Autorzy:
Zimmermann, Agnieszka
Gruchała, Katarzyna
Wąż, Piotr
Kawczak, Piotr
Tematy:
pharmacy substitution
carbamazepine
pharmacy law
Pokaż więcej
Wydawca:
Polskie Towarzystwo Farmaceutyczne
Powiązania:
https://bibliotekanauki.pl/articles/895513.pdf  Link otwiera się w nowym oknie
Opis:
Currently in Poland there is neither regulation aiming at framing the complexity of substitution process arising at pharmacy level, nor further guidelines depending on drug category. FDA describes a narrow therapeutic index drug (NTI) in the 21 Code of Federal Regulations 320.33(c) and highlights that safe and effective use of such drug products require careful titration and patient monitoring. In major therapeutic areas disadvantages of the generic substitution are irrelevant or minor in comparison to the economic benefit. In epilepsy, a number of experts and professional bodies have recommended caution with generic substitution of drugs used in this condition. Aim of the study is to legally and economically identify and assess drug sub-stitution occurrence in Polish background among selected narrow therapeutic index drugs used in epilepsy. Paper is divided into two sections: first is retrospective based and tackles the data received from the National Health Fund; whereas second section takes under consideration questionnaire based results gained during medical history being collect-ed with the patients. Basing on most commonly substituted substance in epilepsy: carbamazepine, the maximum single difference in cost in substitution at the pharmacy was identified around the level of 1.7 PLN, and maximum extra pay at the same level. Ob-served/reported changes, ADRs, discomfort were provided based on the question-naire. The study highlights the necessity of planning process and evaluation of cur-rent market regulations.
Dostawca treści:
Biblioteka Nauki
Artykuł
Wyświetlanie 1-10 z 198

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