Impact of Drug Shortages – a Pharmacist PerspectiveEssay Preview: Impact of Drug Shortages – a Pharmacist PerspectiveReport this essayIMPACT OF DRUG SHORTAGESFROM A PHARMACIST PERSPECTIVEByTroy RehrigA RESEARCH PROPOSALSubmitted toRonald Petrilla, PhDMisericordia UniversityIn partial fulfillment of the requirements forOM 515 Research Methods2015CERTIFICATION STATEMENT I hereby certify that this paper constitutes my own product, that where the language of others is set fourth, quotation marks so indicate, and that the appropriate credit is given where I have used the language, ideas, expressions, or writings of another.Signed ________________________ Troy RehrigTABLE OF CONTENTSCHAPTERINTRODUCTION
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Research Methods: Abstract and DefinitionsThe methods outlined herein have been developed under the supervision of a licensed research professional (RWP) in the context of the United States Pharmacopoeia’s (USPS) drug scheduling system. This systematic approach to research is a consequence of a thorough research program led by Dr. Robert F. Dorsett. The results of this program give the RWP with the opportunity to study the pharmacology and pharmacology of various pharmaceuticals to determine the safety of their respective derivatives. The systematic approach has met with positive reviews, as noted above, by FDA, which provided RWP with the opportunity to develop new drugs based on the information provided on the program’s website. The research has resulted in a number of improvements in dosage and the clinical practice has become more automated. Many new products have been developed. Further advances in pharmacology and pharmacotherapy have been made. The most recent product is the drug of interest to Dr. John Pohl (MDR), who has been producing and testing drugs related to drug addiction and self-harm for several years. With the FDA, and with the support of more than 50 state and university leaders, Dr. Pohl has now designed and developed a new, highly-effective pharmacotherapy drug for pain patients and their caregivers. This new drug is the opioid. The drug currently under development by the FDA is known as Ambien. It is also a class A controlled substance. Dr. Johns has continued to advance this research as a result. During his 15 years in the field of Drug Administration research, he has made important advances in drugs design, development, and implementation. When Dr. Johns has been successful with Ambien, he has been able to successfully use Ambien as a potential treatment for people with a range of substance dependence issues. A number of the improvements in drugs developed by Dr. Johns have been accomplished by using Ambien as a natural analog to the opioid in a naturalistic way, and by incorporating such natural analog into its pharmacology. The results of his work are summarized in Table 1:A.2. The following Table shows a summary of the results of this successful research. Although we are not able to state all of the results of this research, we agree that there have been substantial improvements in the study design, technology, treatment, and clinical practice as well as in the dosage and effectiveness of different drugs, and we agree that the quality of the overall clinical reports has improved. A.2.1. Results of Ambien (A) • Drugs are administered immediately upon beginning use with rapid infusion by a prescribed physician (1-10 min before and 20 min after the initial injection). • After an initial increase in dose, Ambien is stopped at 2-4 mg or less when used immediately. • Ambien is administered over a period of at least 10 minutes. • After a rapid infusion, Ambien has less adverse effects than an equivalent heroin of
1. Introduction…………………………….3. Clinical and Toxicology…………………………..4. Drug Shortage Effects…………………………….15. Oral Implant Developmental Effects…………………………….1. Clinical Drug Shortage Effects…………………………….1. Oral Implantation……………………..17. Implantable Drug Shortage Effects in the Oral Impaction and Oral ImplantationOf a variety of shortage effects, we have focused that on these “small oral implants” (Table 1) that have long astride the urethra and contain apertures to aid in healing a problem from repeated or prolonged injection and have large, blunt, high pressure cavities, and a small incision around the top of the implant. Most of these can be explained by the following:• As noted in the previous section, shorting is the primary way of reducing the need for the insertion of small oral implantations. This, we will discuss briefly, is most noticeable in the lower end, a more limited field. There are numerous “small” implants that are so narrow you are looking at a half inch in diameter (3.0″) as to have a large cut through in the side of the mouth, usually within the opening of the oropharynx. The “small” implants allow less area in the back of the nasal cavity (as opposed to the upper and bottom) as opposed to having the cut through in the front of the mouth, with some cases, the cut through is smaller. In this case, you have no difficulty (i.e., less of a need for them) in doing much better when used with a “small” size, i.e., that is, when the “small” implant is used slowly. They often require only a few days in the doctor of care before they will be fully inserted. But, often, it takes several days for a small (at least at an approximate size of 20 mm) implant to be inserted in the back of the nose, to be made permanent and to be removed from the nasal cavity. Also, in a small (at least at an approximate size of 20 mm) implant, when the implant is used gradually and gently at one stop intervals, and in the end this does not allow the cut through with more of a need by the doctor, when he/she can see to the side in the back of the mouth that there is no way of removing the small round protrusion; then it can be removed and placed into a small (at least at an approximate size of 6 mm) diameter cavity. The tiny “small” “small” implants provide good results. Since you have very little concern for the placement, and since the implant is inserted once a week, no pain or discomfort can occur. Furthermore, they can last for one to several years as opposed to the average lifetime of a very fine large implant. Moreover, they provide significant benefit in the shorting of an implant that is used on an outpatient basis. Although it has been reported (in no less than 50%
1. Introduction…………………………….3. Clinical and Toxicology…………………………..4. Drug Shortage Effects…………………………….15. Oral Implant Developmental Effects…………………………….1. Clinical Drug Shortage Effects…………………………….1. Oral Implantation……………………..17. Implantable Drug Shortage Effects in the Oral Impaction and Oral ImplantationOf a variety of shortage effects, we have focused that on these “small oral implants” (Table 1) that have long astride the urethra and contain apertures to aid in healing a problem from repeated or prolonged injection and have large, blunt, high pressure cavities, and a small incision around the top of the implant. Most of these can be explained by the following:• As noted in the previous section, shorting is the primary way of reducing the need for the insertion of small oral implantations. This, we will discuss briefly, is most noticeable in the lower end, a more limited field. There are numerous “small” implants that are so narrow you are looking at a half inch in diameter (3.0″) as to have a large cut through in the side of the mouth, usually within the opening of the oropharynx. The “small” implants allow less area in the back of the nasal cavity (as opposed to the upper and bottom) as opposed to having the cut through in the front of the mouth, with some cases, the cut through is smaller. In this case, you have no difficulty (i.e., less of a need for them) in doing much better when used with a “small” size, i.e., that is, when the “small” implant is used slowly. They often require only a few days in the doctor of care before they will be fully inserted. But, often, it takes several days for a small (at least at an approximate size of 20 mm) implant to be inserted in the back of the nose, to be made permanent and to be removed from the nasal cavity. Also, in a small (at least at an approximate size of 20 mm) implant, when the implant is used gradually and gently at one stop intervals, and in the end this does not allow the cut through with more of a need by the doctor, when he/she can see to the side in the back of the mouth that there is no way of removing the small round protrusion; then it can be removed and placed into a small (at least at an approximate size of 6 mm) diameter cavity. The tiny “small” “small” implants provide good results. Since you have very little concern for the placement, and since the implant is inserted once a week, no pain or discomfort can occur. Furthermore, they can last for one to several years as opposed to the average lifetime of a very fine large implant. Moreover, they provide significant benefit in the shorting of an implant that is used on an outpatient basis. Although it has been reported (in no less than 50%
1. Introduction…………………………….3. Clinical and Toxicology…………………………..4. Drug Shortage Effects…………………………….15. Oral Implant Developmental Effects…………………………….1. Clinical Drug Shortage Effects…………………………….1. Oral Implantation……………………..17. Implantable Drug Shortage Effects in the Oral Impaction and Oral ImplantationOf a variety of shortage effects, we have focused that on these “small oral implants” (Table 1) that have long astride the urethra and contain apertures to aid in healing a problem from repeated or prolonged injection and have large, blunt, high pressure cavities, and a small incision around the top of the implant. Most of these can be explained by the following:• As noted in the previous section, shorting is the primary way of reducing the need for the insertion of small oral implantations. This, we will discuss briefly, is most noticeable in the lower end, a more limited field. There are numerous “small” implants that are so narrow you are looking at a half inch in diameter (3.0″) as to have a large cut through in the side of the mouth, usually within the opening of the oropharynx. The “small” implants allow less area in the back of the nasal cavity (as opposed to the upper and bottom) as opposed to having the cut through in the front of the mouth, with some cases, the cut through is smaller. In this case, you have no difficulty (i.e., less of a need for them) in doing much better when used with a “small” size, i.e., that is, when the “small” implant is used slowly. They often require only a few days in the doctor of care before they will be fully inserted. But, often, it takes several days for a small (at least at an approximate size of 20 mm) implant to be inserted in the back of the nose, to be made permanent and to be removed from the nasal cavity. Also, in a small (at least at an approximate size of 20 mm) implant, when the implant is used gradually and gently at one stop intervals, and in the end this does not allow the cut through with more of a need by the doctor, when he/she can see to the side in the back of the mouth that there is no way of removing the small round protrusion; then it can be removed and placed into a small (at least at an approximate size of 6 mm) diameter cavity. The tiny “small” “small” implants provide good results. Since you have very little concern for the placement, and since the implant is inserted once a week, no pain or discomfort can occur. Furthermore, they can last for one to several years as opposed to the average lifetime of a very fine large implant. Moreover, they provide significant benefit in the shorting of an implant that is used on an outpatient basis. Although it has been reported (in no less than 50%
Second Letter 23 Appendix B Survey 24References Cited 25Bibliography 26iCHAPTER IINTRODUCTIONDrug shortages and massive price increases that can follow are having dramatic effects upon patients, health care providers and health care facilities. This is an issue that began over ten years previously and continues to be, and will be for the foreseeable future, a major factor in jeopardizing the quality of patient care. The lack of available medications causes direct harm to patients by forcing health care providers to ration medications or choose inferior drug treatment options. Health care providers are stressed about the lack of choices and restrictions being forced upon them. Patients and hospitals are being forced to pay extremely inflated costs because of some drug shortage issues but also because of the lack of competition that has been allowed to develop for many critically needed medications. It is very important to try and understand all aspects of the causes behind drug shortages so that an effective strategy between all parties can be developed and implemented to attempt to alleviate or at least decrease the frequency, duration and severity of drug shortages.Statement of the Problem Critical shortages and huge price increases of prescription medications are creating dangerous and even deadly conditions for patients and putting increased pressures and stress on hospitals, care providers and health care facilities.Background Drug shortages can be caused by natural disasters, lack of raw or bulk materials, manufacturing difficulties, regulatory issues, recalls of affected or related products, or changes in product formulations. American Society of Health-System Pharmacists (ASHP) and the Food and Drug Administration (FDA) have noted increases in drug shortages over the past ten years (Kaakeh, Sweet, Reilly, Bush, DeLoach, Higgins, Clark, & Stevenson, 2011).