Monday, April 20, 2015

Can justify the indiscriminate use in all cases of glaucoma, in place of the

Replenish micropump: a "smart" device for drug delivery - Ocular Pharmacology
Micropump is a small implantable device manufactured by Replenish Inc., a small California-based company specializing in the production integrated fridge freezer 50 50 of systems for the release of contralateral drugs directly integrated fridge freezer 50 50 into the eye. It is applied in the space sottotenoniano with surgery integrated fridge freezer 50 50 similar to that of an application of a valve in the course of Ahmed glaucoma. A peculiar characteristic of this device, innovative in its kind, is the ability to program the release of nanoliters of active ingredient in certain intervals (every hour, every month, every day). Other characteristics of the micropump have the ability to recharge the device integrated fridge freezer 50 50 by means of a special injector with microneedle from 31 gauge (Drug Refill System integrated fridge freezer 50 50 ), the presence of one-way valve that prevents the reversal of the flow direction and a telemetry system for the programming and recharging batteries remotely (EyeLink ). There are two different versions, AMP (Anterior micropump ) and PMP (Posterior micropump ) that allow you to apply the cannula dispenser in the anterior chamber, or into the vitreous cavity, depending on the medical needs This device release could dramatically change the treatment options some serious eye diseases. Especially the PMP model deserves special attention because it could solve the problems related to the periodic administration of antiVEGF for the treatment of age-related macular degeneration. Micropump applications must however be carefully selected and limited to particular cases, while I remain puzzled about some statements that would like to explain why this system can revolutionize the entire medical therapy eye. Pertiamo the company's mission: Since pharmaceutical companies can not continue to sell drugs that patients forget to take, Replenish Inc. aims to provide a route of administration of eye medications alternative, more effective, simple and reliable. From the company's mission is realized that the objectives of market extend far beyond what should be the logical and legitimate fields for applying the micropump. In particular, the hypothesis of using this system in all cases of glaucoma, to solve the problem of poor adherence to therapy, is at least shocking. Poor adherence is a problem that is rooted in an inadequate physician-patient relationship and only in a very limited number of cases would need invasive solutions such as application of this device. On the other hand, if you do not introduce the marketing plans pathology oftlmica that guarantees the highest turnover, would not be possible to quantify the potential market of micropump in billions (billions !!!) dollars, with potential savings, in terms of reduced of direct medical costs and indirect damage caused by non-adherence to treatment, estimated up to 290 billion integrated fridge freezer 50 50 dollars. First of all, I wonder how it is possible to make estimates integrated fridge freezer 50 50 of economic processes so complicated and believe that they are reasonable and reliable. Second, in this estimate was not considered the risk and costs associated with complications (which can be assumed to be serious and frequent enough), their prevention and their recognition (pharmacovigilance and device-supervision): saving hypothesized would dramatically downsized, if not totally cleared. We see, for example, the possible complications of the use of micropump: intraoperative complications interfere with the action of the extraocular muscles (diplopia) infections of the application site endophthalmitis tube obstruction leakage of aqueous humor ocular hypotony. postoperative pain device malfunction with lack of therapeutic effect.
Can justify the indiscriminate use in all cases of glaucoma, in place of the "old-growth" and so "little used" eye drops? In conclusion, micropump integrated fridge freezer 50 50 is a "smart" device, interesting, that will overcome some therapeutic range, but the choice of its applications, can not be all-inclusive and replace, in glaucoma, the classic eye drops. The use of micropump must be carefully limited, with an intelligence equal to or greater than that attributed to the device itself.
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