Saturday infusion helps decompress the other five days of the week, and may be especially good for those patients who are on regimens that last many months and who would prefer not to take off work. The average nurse to patient ratio in the infusion center is one nurse to four patients (Table 17). Pharmacists, not nurses, do 89 percent of the chemotherapy infusion mixing in hospitals, whether the pharmacy is in the infusion center or in the hospital pharmacy (Table 18). Most programs purchase cancer drugs through multiple distributors, but a single GPO (Table 21). Most respondents' programs do not participate in alternative acquisition programs (Table 22).
Most programs report purchasing medication through the pharmacy department rather than conducting their own purchasing program (Table 23). Medication is typically stocked in the hospital pharmacy with the pharmacy department responsible for managing the inventory (Table 24). A new device creates tiny capsules filled with multiple inner droplets by funneling different ingredients through two inner needles. Chemotherapy often comes with powerful side effects, and one of the reasons for this is that the drugs used to kill cancer cells can also damage other fast-growing cells in the body, like hair follicles. The search for such targeted drug delivery options for chemotherapy and other treatments inspired a team of researchers from the University of Science and Technology of China and The Ohio State University to develop a new way to package two or more ingredients into a single capsule.
The researchers report their method for multi-ingredient encapsulation and triggered mixing in a new paper in the journal Applied Physics Letters. For such drugs to work on a large scale, there must be a way to quickly, controllably, and cost-effectively produce capsules with two or more active ingredients. Xu and his colleagues from the University of Science and Technology of China developed a device that can produce tiny capsules approximately 100 microns across (about the size of a speck of dust) with multiple inner ingredients. The researchers tested their device with colored paraffin wax - red in one needle and blue in the other. Depending on the experimental conditions, the team was able to produce between 1,000 to 100,000 capsules per second, and nearly 100 percent of the inner liquids were incorporated into the capsules without any waste. The key features of the new device are its high efficiency and yield, and the fact that the size of the droplets can be uniformly controlled, Xu said. While Xu and his colleagues were motivated by drug delivery, their device might also find wider use in a range of applications that require controlled reactions, such as regenerative medicine, and nuclear and chemical engineering, Xu said.

Researchers have developed a new technique to produce a 3D 'micro-printed' array of needles capable of drug delivery.
The likelihood that you will be swallowing a capsule robot in the near future has just jumped up dramatically.
For medics on the battlefield and doctors in remote or developing parts of the world, getting rapid access to the drugs needed to treat patients can be challenging.
An episode of major depression can be crippling, impairing the ability to sleep, work, or eat. In the mid-1980s as the AIDS epidemic was exploding across the United States, two Yale PhDs, William Prosser and Tai-Shun Lin worked to find anti-viral drugs to fight HIV, the virus that causes AIDS. For some of OOTD’s younger readers, you may not know how different AIDS in this country was twenty years ago.
The range of reported ratios is as low as one nurse to two patients and as high as one nurse to 13 patients.
Hospitals with dedicated pharmacies are less likely to restrict access to injectables (Table 19). For most community cancer centers, approximately 20 drugs make up 80 percent of drug costs. As all the ingredients exit the needles through a single nozzle, a high-speed gas forces the liquids into a narrow stream that breaks up into individual droplets. But one possibility for reducing these side effects may be if the chemotherapy drugs only become toxic when they reach the tumor. If the ingredients must be mixed for the drug to work, doctors could trigger the mixing in targeted area of the body, boosting drug efficiency while reducing side effects. While the work has shown promise because it allows the researcher to produce micro capsules, they have not yet used the technique to encapsulate cancer treatments. One possible way to address the problem could be to make the drugs non-toxic when injected into the body and trigger mixing that would produce a toxic product only near the tumor site. If the drugs are to be injected and spread through the body via the bloodstream, the capsules should also be small.
Ting Si, the first author on the paper and an expert in fluid mechanics, also developed mathematical models that show the relationship between process parameters, like flow rate and needle diameter, and the size of the final capsules. The inner needles run parallel to each other and are both enclosed in a larger outer needle, which contains an ingredient for making the outer shell of the capsule.

The outer shell was made from sodium alginate - a material extracted from seaweed that turned gelatinous when the droplets fell into a calcium chloride solution.
Once encapsulated, the two colors of wax did not mix, because of surface tension, but the team demonstrated that they could force the red and blue wax to merge by vibrating the capsules.
By further fine-tuning the device's operation Xu predicts that the team could make capsules that are 3-5 microns across, about the size of a red blood cell. Qingmin Ji of the National Institute for Materials Science (Japan), in joint study with Prof.
In the real world, they are often networked to each other through hydrogen bonding or are bound to other molecules in the surrounding environment.
Prosser, who some call the father of anti-viral chemotherapy for his work on finding drug to fight infant keratitis, worked with Yale to patent the drug and sell the rights to Bristol-Meyers Squibb.
The mean infusion center square footage is just under 5,000 square feet, compared to the average physician office, which might be in the hundreds of square feet.
Today more than ever, cancer programs need to assign a staff member to monitor drugs costs on a weekly basis and direct purchasing efforts to the least expensive source for the high-cost drugs. If such capsules can be made, they will have to prove safe and effective in clinical trials before becoming widely available to treat cancer. The team also demonstrated that they could release the inner droplets by dissolving the outer shell. The process can also be easily scaled up by building an array of nozzles and could be modified to encapsulate 3 or more active ingredients by adding additional inner needles. To ensure that significant cash is not tied up in excess drug stock, cancer programs should regularly review drug stock as well as preset automatic reordering (PAR) levels.
Depending on the relative flow rates, each droplet may contain two or more smaller inner droplets made from the ingredients in the inner needles. Lin passed away prior to 2000) pressured Bristol-Meyers to lower the price of stavudine in Africa from $2.23 a dose to 15 cents a dose, and allow for generics to be made in order to fight the AIDS epidemic in Africa.

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