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Browsing by Subject "reconstitution"

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  • Pihlaja, Liisa (2023)
    In instantization milk powders’ reconstitution properties are improved. Typical instantization processes are agglomeration, in which particle size and porosity are increased, and lecithination, in which powder particle surface is made less hydrophobic. Both instantization methods have some drawbacks: Agglomeration is not sufficient for instantizing high fat milk powders, while lecithination tends to decrease powder’s flowability. The aim of this study was to review suitability of agglomeration in instantizing milk powder (SMP) and whole milk powder (WMP). Powders were agglomerated on fluid bed agglomerator by using different binder liquids. The physical properties, like wettability, flowability and particle size, of the agglomerated powders were characterized and compared to the unprocessed raw materials and reference powders (commercial instantized milk powders). According to the results reconstitution properties were improved more when using other binder liquids than only water. The fastest wetting on agglomerated SMP was achieved with sugar binder liquids. However, sugar also impaired powders’ flowability. On agglomerated WMPs fastest wetting occurred with phospholipid fraction as a binder liquid. Future research could investigate usage of different binder liquids in combination and optimizing agglomeration parameters for each binder liquid.
  • Virtanen, Anne (2023)
    This qualitative study was carried out as a semi-structured interview study, which was supplemented with quantitative information from centralized cytotoxic preparation units in Finland hospital pharmacies and with information about interviewees. Quantitative information was collected using questionnaires. The proportion of centralized cytotoxic preparation units that responded to the background information questionnaire was 95% (19/20) of all centralized cytotoxic preparation units in mainland Finland. In the autumn of 2022, hospital pharmacy employees (n=23) participating in the reconstitution of cancer drugs were interviewed. On average, the interviewees had 14 years of work experience in the reconstitution of anticancer medicines. They represented 75% (15/20) of the centralized cytotoxic preparation units in mainland Finland, covering centralized cytotoxic preparation units of different sizes and locations in different parts of Finland. In 2021, 88% of the anticancer medicines in all centralized cytotoxic preparation units in Finland were reconstituted at the workplaces of interviewed. According to the interviews, the reconstitution of anticancer medicinal products involves the possibility of an error in several stages of the process. An error can occur when prescribing the medicine, transferring prescription information, when selecting the raw materials, reconstituting of the cancer medicine and during transport. The interviewees identified 24 risks associated with these stages, that could lead to patient safety incidents. Safeguards have been built to avert errors or promote the detection of the errors. Based on the research data, the safeguards were classified into six categories: the development of the technology, guiding work through guidelines, strengthening competence, standardizing practices, controlled working environment and learning from deviations. In Finland, it has not previously been studied or classified with which functions and principles the centralized cytotoxic preparation units have built safeguards to prevent patient safety incidents. This study shows that reconstitution of cancer medicines is a risky process. To improve the quality of reconstituted cancer medicines and patient safety, both the system- and person-focused safeguards have been built into the risk points of the processes of the centralized cytotoxic preparation units, but their utilization varied between centralized cytotoxic preparation units. Based on comprehensive data, the research result can be generalized to centralized cytotoxic preparation units in Finland hospital pharmacies.