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Granulation and Production Approaches of Orally Disintegrating Tablets
Published in Dilip M. Parikh, Handbook of Pharmaceutical Granulation Technology, 2021
Tansel Comoglu, Fatemeh Bahadori
Hari et al. have prepared and evaluated of drotaverine hydrochloride ODTs by melt granulation method. Drug–polymer melt granules have been manufactured by using either compritol or precirol using distinct drug–polymer ratios of 1:7, 1:5, 1:2, and 1:1. According to taste evaluation results, the drug–polymer ratios 1:7 with compritol and (1:5) with precirol have been optimized. The granules have been prepared with an optimized drug–polymer ratio, and they have been evaluated. All the prepared drotaverine HCl ODTs that contain mannitol and melt granulated mixture have been characterized on the basis of orally disintegrating tablet criteria like taste and dissolution. Among these studies, ODTs prepared with croscarmellose sodium with mannitol as diluent gave complete drug release in 60 minutes with acceptable taste and mouth feel. Hence, ODT formulations prepared with croscarmellose sodium and mannitol by using this method show suitable ODT properties [35].
Birth choices in Eastern Europe and Russia
Published in Hannah Dahlen, Bashi Kumar-Hazard, Virginia Schmied, Birthing Outside the System, 2020
Daniela Drandić, Nicholas Rubashkin, Tamara Sadovaya, Svetlana Illarionova
In the late 1980s, a young woman named Tamara Sadovaya gave birth to her first child in an ordinary Soviet maternity hospital. According to the obstetric standards of that time, all went well. Tamara had a seven-hour labour, during which she was subjected to the following: (a) a single intramuscular injection of drotaverine (pain relief); (b) amniotomy without indication in the first stage; (c) classically managed pushing on her back in the second stage; (d) Kristeller manoeuvre (fundal pressure to push the baby out); (e) episiotomy; and (f) the feeling of being a soulless object that was manipulated as she gave birth. The result was a healthy boy of 4 kg, which was not put on Tamara’s chest even for a minute. While she was left lying in the hallway with an icy water bottle on her abdomen, her baby was left alone and screaming on a changing table. She was allowed her baby the next day, every four hours for a feed. For her next pregnancy, Tamara chose to birth at home. This birth was not a conscious choice; rather, it was an escape from the system, a response to the fear of entrusting herself and her baby to people in white coats. The birth took place at home with just Tamara and her husband. This experience was so joyful it inspired both Tamara’s future choice to give birth to her third child at home and her desire to become a midwife.
Pharmacological and non-pharmacological pain relief for office hysteroscopy: an up-to-date review
Published in Climacteric, 2020
G. Riemma, A. Schiattarella, N. Colacurci, S. G. Vitale, S. Cianci, A. Cianci, P. De Franciscis
Antispasmodics are commonly used in outpatient gynecologic procedures due to their specific action on the cervical–uterine plexus, reducing spasms achieved by cervical smooth muscle cells and at the same time acting as a bland cervical dilatator. However, no agreement about their usefulness is available in the current literature. The antispasmodic drotaverine, administered orally with mefenamic acid before in-office hysteroscopy and endometrial biopsy, was compared to paracervical block achieved with 1% lignocaine. In this randomized controlled trial, oral drotaverine plus mefenamic acid was more effective than paracervical block in reducing pain perception36.
Side effects associated with pharmacotherapy for pediatric irritable bowel syndrome and functional abdominal pain – not otherwise specified: a systematic review
Published in Expert Opinion on Drug Safety, 2019
Robyn Rexwinkel, Judith Zeevenhooven, Faridi S. van Etten-Jamaludin, Marc A. Benninga, Merit M. Tabbers
There are several reasons to be cautious about interpreting the results described in this review. It is well-known that reporting side effects is influenced by the methods used to capture them [43]. Incomplete reporting is a common problem with descriptions as ‘no unexpected side effects were seen’ or ‘there was no difference between groups with regard to side effects’ [44,45]. Also, the documentation of drop-outs is often vague. Reasons for discontinuation may vary from ‘serious toxicity’ to ‘non-medical reasons’ [46]. In line with this, seven (41%) of the included RCTs and cohort studies did not predefine potential side effects, and the definition of side effects differed between studies. Besides, it is remarkable that 4/10 (25%) RCTs which were excluded during study selection, did not report or predefine side effects. Furthermore, seven different methods were used to monitor side effects, in these studies duration and frequency of monitoring were often poorly reported. Moreover, it does not necessarily mean that the absence of reported side effects suggests that they there are indeed absent. One study found that unpublished trials gave more information on side effects than published trials [47]. Additionally, included studies not reporting any side effects of medication could still report side effects of the placebo-treatment since it is well-known placeboes are frequently accompanied by side effects [48]. Indeed in this review, three studies reported side effects of placebo [37–39]. Last, drotaverine, mebeverine, fluranizine, and domperidone are not available in the United States (US) and thus have limited value to US clinical practitioners [49]. For these reasons, the findings of this review should be interpreted with caution, given the relatively poor quality of the included studies.