Subject pharmaceutical studies

The principle of justice states that individuals should be given what they deserve, be that benefit or burden. Cases that are alike should be treated similarly, and relevant distinctions should be drawn consistently. The principle of justice does not specifically state what distinctions are fair or which criteria are reasonable it simply requires that, once criteria are determined, they be applied fairly. Justice is important in many areas, such as recruitment of research subjects for pharmaceutical studies. For example, researchers must guard against distributing the burdens of participation disproportionately among populations that are poorly equipped to give informed consent, such as children or the mentally incompetent. 

Staff qualifications and availability The investigators study coordinators (also called research nurses, clinical research coordinators (CRCs), or study nurses) play a key role at the investigational site. Their availability and experience are assessed because they screen and enroll subjects, complete subjects case report forms (CRFs), maintain source documents, follow and assess subjects throughout the study, and have more interactions with the CRA and representatives of the pharmaceutical study during study conduction. 

Research on Human Subjects—Pharmaceutical executives claim that the size of human clinical trials has increased dramatically over time. A rapid increase in trial sizes is consistent with an increase in the estimated cost of phase III clinical trials from 5.7 million (in 1990 dollars) for each new chemical entity (NCE) entering the phase in Hansen s study to 14.3 million (in 1990 dollars) in DiMasi s study. Part of the explanation... 

In Structural analysis of active pharmaceutical ingredients, crystal polymorphism is an important subject of study. Crystal structures are determined by X-ray diffraction studies. Once the correlation between crystal polymorphs and their infrared spectra has been established, it can then become a relatively easy task to distinguish polymorphs by measuring their microphotographs and corresponding microscopic infrared spectra, as infrared microspectrometric measurements can be conveniently performed within a much shorter time than X-diffraction analysis. 

Replacing one carbon atom of naphthalene with an a2omethene linkage creates the isomeric heterocycles 1- and 2-a2anaphthalene. Better known by their trivial names quinoline [91-22-5] (1) and isoquinoline [119-65-3] (2), these compounds have been the subject of extensive investigation since their extraction from coal tar in the nineteenth century. The variety of studies cover fields as diverse as molecular orbital theory and corrosion prevention. There is also a vast patent Hterature. The best assurance of continuing interest is the frequency with which quinoline and isoquinoline stmctures occur in alkaloids (qv) and pharmaceuticals (qv), for example, quinine [130-95-0] and morphine [57-27-2] (see Alkaloids). 

In pharmaceutical and medical device development, clinical trials are classified into four main phases designated with Roman numerals 1,11, III and lY The various phases of development trials differ in purpose, length and number of subjects involved. Phase I trials are conducted to determine safe dose levels of a medication, treatment or product (National Institutes of Health, 2002). The main purpose is often to determine an acceptable single dosage - how much can be given without causing serious side-effects. Phase I trials will also involve studies of metabolism and bioavailabity (Pocock, 1983). The sample size of a Phase 1 clinical trial is usually small, ranging from 10-80 subjects (National Institutes of Health, 2002 Pocock, 1983). 

Obviously, the greater the number of subjects studied, the larger the cost. Nevertheless, having too few subjects may lead to inconclusive results, requiring that the study be repeated. Another important consideration is the availability of qualified participants. If the inclusion and exclusion criteria are very restrictive, the cost of recruiting subjects may exceed that of the actual testing. In pharmaceutical development trials, it is not unusual to see recruitment budgets of US 500- 1000 per randomized subject. Thus, for a Phase III development study with several hundred participants, often more than US 500 000 in cost is allotted to efforts to identify qualified subjects who are interested in participation. 

If the product is to be used for pharmaceuticals the GMP rules must be obeyed during plant operation. All chemicals to be tested in clinical studies with humans must be prepared according to GMP. This leads to very detailed documentation since if you haven t documented it, you haven t done it . All procedures for manufacturing and changes in procedures are subject to approval by quality control departments. This decreases the flexibility in process development. Products that are contaminated too much must be reprocessed according to the GMP guidelines. All equipment to be used in the pilot plant must be validated before use. 

Other applications of the previously described optimization techniques are beginning to appear regularly in the pharmaceutical literature. A literature search in Chemical Abstracts on process optimization in pharmaceuticals yielded 17 articles in the 1990-1993 time-frame. An additional 18 articles were found between 1985 and 1990 for the same narrow subject. This simple literature search indicates a resurgence in the use of optimization techniques in the pharmaceutical industry. In addition, these same techniques have been applied not only to the physical properties of a tablet formulation, but also to the biological properties and the in-vivo performance of the product [30,31]. In addition to the usual tablet properties the authors studied the following pharmacokinetic parameters (a) time of the peak plasma concentration, (b) lag time, (c) absorption rate constant, and (d) elimination rate constant. The graphs in Fig. 15 show that for the drug hydrochlorothiazide, the time of the plasma peak and the absorption rate constant could, indeed, be... 

This review does not cover pharmaceutical economic evaluation studies, as the Associacion de Economla de la Salud (AES) commissioned a separate review on this subject. 

There have been recognized specialists in the subject for some years now. Recently we have witnessed the rise of organized specialist research units linked to universities. Examples are the Research Centre for Economics and Health (CRES) at Pompeu Fabra University and the Health and Pharmaceuticals Social Studies Seminar at Carlos III University in Madrid. 

To date, three pharmaceutical companies have entered clinical trials with PHD inhibitors for the treatment of anemia with the most advanced being FG-2216. In clinical studies, compound 2 (likely FG-2216) showed a dose- and time-dependent elevation of plasma erythropoietin after oral administration [66]. Healthy volunteers were orally administered various doses of compound 2 and serum erythropoietin (EPO) concentrations were measured at various times. Compound 2 increased serum EPO levels in a dose-dependent manner and, following administration of the 20 mg/kg dose, a 5-fold increase of EPO levels was observed after 12 h. In the same patent application, the effect of 2 on anemic predialysis patients with no previous rh-EPO exposure was also disclosed. Patients were treated with 2 three times/week for 4 weeks (no dose reported) and the hemoglobin levels were assessed on day 42. The patients who received treatment showed a mean increase in hemoglobin of 1.9 g/dL from baseline values, whereas subjects who received placebo showed a mean decrease of 0.35 g/dL from baseline levels. These data suggest for the first time that an oral PHD inhibitor could be effective for the treatment of anemia. 

Since the rate of absorption of many drugs from the gastrointestinal tract is controlled by their dissolution rate, this becomes the rate-limiting step. Accurate and reliable measurements of dissolution rate are therefore required in the pharmaceutical sciences. The measurement and interpretation of the dissolution rates of solid drugs in the pure state or from formulations, such as tablets, capsules, and suppositories, has an extensive pharmaceutical literature [95-100]. Moreover, the design, operation, and interpretation of dissolution rate measurements on pharmaceutical solids have been the subject of considerable scientific study, technical development, and debate. 

In addition to equipment, many processes/procedures undertaken during pharmaceutical manufacture are also subject to periodic validation studies. Validation of biopharmaceutical aseptic hlling procedures is amongst the most critical. The aim is to prove that the aseptic procedures devised are capable of delivering a sterile bnished product, as intended. 

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