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This book describes the theories, applications, and challenges for different oral controlled release formulations.This book differs from most in its focus on oral controlled release formulation design and process development.

Background Oral Medication administration is one of the paramount nursing procedures, where nurses must pay their utmost commitment. The vital aims are to reduce medication errors and ensure patient safety. The objectives of this study were to evaluate whether the nursing students could learn and retain the basic guidelines for oral medication administration when they are taught using a video-assisted teaching method compared with the lecture-demonstration method and to assess the students’ attitudes towards the two types of teaching methods. Methods This study was conducted as a quasi-experimental study with a pre and post-test design. Forty-five students in the first year of the bachelor’s degree in nursing programme participated. All the participants completed a self- administered questionnaire, including socio demographic data and questions of oral medication administration. Subsequently, participants were randomly assigned to two groups. Oral medication administration procedure was taught using two different teaching methods. Finally, the post-test knowledge scores of both groups were assessed and analysed using the paired-sample t-test. Results The results revealed that there was no significant difference in terms of age, gender and type of residence of students in the two groups. When comparing the pre-test mean score and post-test mean score using paired sample t-test, there was a statistically significant difference in both video demonstration group (t = − 4.533, p < 0.001) and lecture-demonstration group (t = − 4.208, p < 0.001). Almost all the students obtained good knowledge scores regardless of the method used in teaching oral medication administration. However, when comparing post-test scores of both groups using an independent sample t-test, it was identified that there was no significant difference between the two groups. Therefore, it was difficult to identify which method was effective than the other. According to the student feedback obtained at the end of the study, 67% of them preferred to have more video demonstrations in their skills classes. Conclusion The results of this study suggested that oral medication administration can be effectively taught using lecture-demonstration and video-demonstration teaching methods.

One of the critical factors that affect medication adherence is cost-sharing (the percentage that a patient pays out-of-pocket to cover health expenses), which sometimes may become a barrier to initiate or refill prescription medications. The primary aim of this study was to assess the association between adherence to oral antidiabetic medications (OADs) using the Adherence to Refills and Medicines Scale for Diabetes (ARMS-D) questionnaire and cost-sharing among patients with type 2 diabetes. The secondary aim was to evaluate the extent to which patients are adherent to their OADs, and which factors were significantly affecting patients' adherence to their OADs. Four hundred adult patients that visited the Diabetes Clinic of the Jordan University Hospital who were on OADs were interviewed by the researcher and were asked to complete the study questionnaire. The questionnaire consists of two sections: patients' characteristics and ARMS-D. Simple and multivariable linear regression analyses were used to assess the determinants (demographic, clinical, and economic characteristics) associated with patient's adherence to their OADs. When measured by ARMS-D (sores range from 11 to 44), where higher scores indicate lower adherence, 71% of participants reported lower adherence (scores > 11) to their OADs, while 29% achieved full adherence (scores = 11). Our analysis identified that there was no significant association between adherence to OADs and cost-sharing ( > 0.05). However, multiple regression analysis revealed that demographic factors, such as age and education level, along with clinical factors, such as the number of pills per day, the number of anti-diabetic-medications side effects, and frequent episodes of hyperglycemia, were significantly affecting patients' adherence to OADs ( < 0.05). The key findings of this study indicate that the effect of patients' characteristics on adherence is therefore caused primarily by demographic and clinical factors rather than economic factors.

The oral route is the most preferred route for systemic and local drug delivery. However, the oral drug delivery system faces the harsh physiological and physicochemical environment of the gastrointestinal tract, which limits the bioavailability and targeted design of oral drug delivery system. Innovative pharmaceutical approaches including nanoparticulate formulations, biomimetic drug formulations, and microfabricated devices have been explored to optimize drug targeting and bioavailability. In this review, the anatomical factors, biochemical factors, and physiology factors that influence delivering drug via oral route are discussed and recent advance in conventional and novel oral drug delivery approaches for improving drug bioavailability and targeting ability are highlighted. We also address the challenges and opportunities of oral drug delivery systems in future.

Protein and peptide therapeutics require parenteral administration, which can be a deterrent to medication adherence. For this reason, there have been extensive efforts to develop alternative delivery strategies, particularly for peptides such as insulin that are used to treat endocrine disorders. Oral delivery is especially desirable, but it faces substantial barriers related to the structural organization and physiological function of the gastrointestinal tract. This article highlights strategies designed to overcome these barriers, including permeation enhancers, inhibitors of gut enzymes, and mucus-penetrating and cell-penetrating peptides. It then focuses on the experience with oral peptides that have reached clinical trials, including insulin, calcitonin, parathyroid hormone and vasopressin, with an emphasis on the advances that have recently led to the landmark approval of an oral formulation of the glucagon-like peptide 1 receptor agonist semaglutide for the treatment of type 2 diabetes.Oral delivery of peptide therapeutics could have benefits for treatment adherence, but it faces barriers related to the structural organization and physiological function of the gastrointestinal tract. This article highlights strategies to overcome these barriers and discusses experience with oral peptides that have reached clinical trials, including the recent landmark approval of an oral formulation of semaglutide for the treatment of type 2 diabetes.

Background: Sexual dysfunction is one of the most prevalent complaints in men over age 50, which can negatively affect marital life and self-esteem. Consumption of oral drugs has various limitations, and they have adverse interactions with other oral agents. Methods: In this review article, the Traditional Persian Medicine (TPM) resources were reviewed for topical suggestions on treating sexual dysfunction in men. The herbal medicines and their constituents were searched in modern medical search engines. Results: In TPM resources, various agents in oil, decoction, dry powder, suppository, and enema preparations are suggested to treat decreased libido, premature ejaculation, and erectile dysfunction. These preparations often include volatile agents that enhance percutaneous absorption. Some of the known constituents of these preparations are known to enhance the regional blood flow to the genitalia, some of them induce venous smooth muscle relaxation, and others increase the tonicity of pelvic floor muscles. Conclusion: TPM suggestions in treating sexual dysfunction in men can ignite new ideas for further research based on the proposed mechanisms of action. Keywords * Medicine, Persian * Sexual dysfunction, physiological * Herbal medicine

There are unique challenges in the formulation, manufacture, analytical chemistry, and regulatory requirements of low-dose drugs. This book provides an overview of this specialized field and combines formulation, analytical, and regulatory aspects of low-dose development into a single reference book. It describes analytical methodologies like dissolution testing, solid state NMR, Raman microscopy, and LC-MS and presents manufacturing techniques such as granulation, compaction, and compression. Complete with case studies and a discussion of regulatory requirements, this is a core reference for pharmaceutical scientists, regulators, and graduate students.

Purpose In the past decade, there has been an increase in the development and use of oral anti-cancer medications (OAMs), especially for breast cancer–the most prevalent cancer in women. However, adherence rates for OAMs are often suboptimal, leading to lower survival rate, increased risk of recurrence, and higher healthcare costs. Our goal was to identify potentially modifiable psychosocial facilitators and barriers that may be targeted to increase OAM adherence for breast cancer patients. Methods We systematically searched PubMed for studies published in the U.S. by June 15, 2016 that addressed the following: (1) OAMs for breast cancer; (2) medication adherence; and (3) at least one psychosocial aspect of adherence. Results Of the 1752 papers screened, 21 articles were included and analyzed. The most commonly reported motivators for adherence are patient-provider relationships ( n  = 11 studied, 82% reported significant association) and positive views and beliefs of medication ( n  = 9 studied, 89% reported significant association). We also identified consistent evidence of the impact of depression and emotions, perception of illness, concern of side effects, self-efficacy in medication management and decision making, knowledge of medication, and social support on OAM adherence. Conclusions Compared to traditional demographic, system, and clinical-related factors that have been well documented in the literature but are not easily changed, these cognitive, psychological, and interpersonal factors are more amendable via intervention and therefore could generate greater benefit in improving patient compliance and health outcomes. As OAMs shift treatment administration responsibility onto patients, continuous provider communication and education on illness and regimen are the keys to supporting patients’ medication behavior.