China
Africa
Explore chapters and articles related to this topic
Excipients and Their Attributes in Granulation
Published in Dilip M. Parikh, Handbook of Pharmaceutical Granulation Technology, 2021
Terms “filler,” “diluent,” and “binder” are used somewhat interchangeably in the food and pharma industries and for this chapter, it will be used interchangeably together, but it would be good to set a clear definition of what they mean. A filler is an ingredient that only serves to add bulk or volume to a formulation, much like the gravel in concrete. It does not contribute to the overall physical integrity of the tablet or capsule structure other than to increase the volume of the dosage form. Similarly, the term “diluent” can be used interchangeably with “filler” in this analysis. A diluent is a material used to dilute another material to reduce the parent material’s concentration and add volume. Fillers and diluents are used in direct compression and wet granulation and can be added to both the granulation mix as well as to the running powders. In the context of processing by granulation, the terms themselves imply the intent for the inclusion of the materials in a formulation, as described earlier. The term “binders” usually refers to excipients dissolved in the granulating fluid or added to the granulation pre-mix (dry) to serve as the “glue” that builds and holds the granules together.
Practical reception skills in general practice
Published in Mari Robbins, Medical Receptionists and Secretaries Handbook, 2017
The photocopier is a great time saver. However, lack of training in office standards and procedures can result in poor-quality work and failure to maintain the equipment properly. Good-quality originals are essential for producing fine-quality copies. A ring binder can be kept near to the photocopier with photocopy originals in clear plastic wallets. (Yellow highlighter pen does not show up on photocopies, so use one to write ‘original’ to ensure that the original is easily identifiable and does not get circulated by mistake.)
Injuries of the pelvis
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
The pelvic binder is now used routinely in many countries and applied at the accident scene by paramedics in any suspected case of a pelvic injury. Appropriate application of the binder is key. The binder should be applied at the level of greater trochanters of the hips (not the iliac crest). It is effective in closing the pelvic volume, and providing temporary stability (see Figures 29.4 and 29.5). Ideally, it should not be left on for more than 24 hours as pressure sores can develop. If the facility or expertise to stabilize an unstable pelvis that is the cause of haemodynamic instability is not present within 24 hours, the binder should be released and the pressure areas checked, it can then be reapplied if pressure areas are intact and not threatened. Most pelvic binders have a ratchet locking system so the person applying them knows when they are tight enough. Sometimes, a pelvis can be ‘over-reduced’, causing too much internal rotation of the hemipelvis if there is complete posterior disruption. If this is seen on X-ray or CT scan, the binder can be loosened until an acceptable position is achieved. Even if the pelvis is over-reduced, the pelvic volume has been reduced, hence limiting blood loss and therefore this is preferable to a binder not being applied or one being applied too loosely. The use of a pelvic binder has virtually eliminated the use of an external fixator to provide immediate pelvic stability.
An update on phosphate binders for the treatment of hyperphosphatemia in chronic kidney disease patients on dialysis: a review of safety profiles
Published in Expert Opinion on Drug Safety, 2022
Hiroaki Ogata, Akiko Takeshima, Hidetoshi Ito
Currently, various phosphate binders are clinically available for the management of hyperphosphatemia in patients with advanced CKD. As mentioned above, each phosphate binder has off-target actions, including lowering cholesterol or FGF-23, anti-inflammatory effects, supplementation of calcium or iron for their deficient states, and reduction of intravenous iron or ESA dosing. While various phosphate binders used in clinical practice facilitate the management of hyperphosphatemia, they worsen the pill burden and increase treatment costs. This increased pill burden may compromise or complicate drug safety. For a decade, it has been debated whether non-calcium-based phosphate binders are superior to calcium-based phosphate binders in improving hard outcomes [7,14,35,59]. Although this remains inconclusive, we should examine whether it is worth discussing in clinical practice. In clinical practice, concomitant treatment with multiple phosphate binders is more widely used for refractory hyperphosphatemia than single phosphate binders. Rather than comparing classes of binders, it would be more beneficial to establish novel therapies with higher effectiveness and safety.
Estimating hospital inpatient cost-savings with sucroferric oxyhydroxide in patients on chronic hemodialysis in five European countries: a cost analysis
Published in Journal of Medical Economics, 2021
Jose Antonio Herrero, Mario Salomone, Antonio Ramirez de Arellano, Thilo Schaufler, Sebastian Walpen
The principal strategies to manage hyperphosphatemia in patients with ESRD include dietary phosphate restriction, removal of phosphate by dialysis, and oral phosphate binder therapy10,11. Adequate dietary phosphate restriction is difficult to achieve in clinical practice as it requires extensive patient education and it may also lead to malnutrition12, while conventional hemodialysis treatment does not remove sufficient quantities of ingested phosphate13. As a result, the majority of dialysis patients also require treatment with oral phosphate binders in order to control their serum phosphorus levels2,14. These agents lower serum phosphorus by binding dietary phosphate in the gastrointestinal tract and preventing its systemic absorption15,16. Several types of phosphate binder are available for clinical use, and each of these agents has its own advantages and limitations (reviewed previously10,17). Calcium-based phosphate binders are considered effective and inexpensive; however, regular administration of these agents may induce calcium overload, hypercalcemia, and vascular calcifications and has led to increased use of non-calcium based phosphate binders in clinical practice1,15,18.
Tailoring Education for the Oncology Patient
Published in Oncology Issues, 2018
Kristin Shea Donahue, Anne Marie Fraley Rainey
The establishment of Clearview Cancer Institute's survivorship program, Journey Ahead, brought about more changes in how education is conducted. The survivorship program is targeted toward all newly diagnosed cancer patients. Each patient is given a binder with information about what to expect before, during, and following treatment. Information in the binder includes side effect management education, financial resources, and support group information, among others. These binders are given to patients at their first treatment appointment. Patients are instructed to bring their binders back during each office visit so that they can add to the binder and take notes. Printed materials that have been tailored specifically for the patient have been shown to improve patient recall better than generalized materials10; therefore, Journey Ahead binders can be tailored to include disease-specific and treatment-specific education for the patient. The binders have divided sections for patients to add their pathology report, labs, and imaging reports.