Quality of medicines stored together in multi-compartment compliance aids

Background and Objective: Dispensing medicines into compliance aids is a common practice in pharmacy contrary to manufacturers’ advice and studies have shown the appearance of light-sensitive tablets is compromised by such storage; we previously found evidence of reduced bioavailability at elevated temperature and humidity. Our objective was to examine the physicochemical stability of two generic atenolol tablets in different compliance aids and with aspirin co-storage at room temperature and at 40 °C/75% relative humidity. Methods: The physicochemical stability of atenolol tablets was evaluated after 28 days of storage and compared with controls by examining visual appearance, weight, disintegration, dissolution, friability and hardness to accepted standards and using a previously validated HPLC method for chemical assay. Results and Discussion: The response to storage was brand-dependent and not straightforward. With one make of atenolol (Alpharma), storage in compliance aids even at room temperature impacted on physical stability, reducing tablet hardness, with storage in Dosett® exerting a greater impact than storage in Medidos® (t-test P < 0·001). Co-storage at elevated temperature and humidity also impacted on the appearance of non-coated aspirin tablets (Angette™). The chemical stability of atenolol was not affected and we did not find evidence of changes to bioavailability with either make. Certainly data for one atenolol make (CP Pharmaceuticals) co-stored with aspirin (Angette™ and Nu-Seals) in both compliance aids at room temperature provided evidence of short-term stability. But medicines are dispensed into compliance aids in multi-factorial ways so our study highlights not only the lack of evidence but also a realization that evidence to support real practice may not be accomplished through research. Conclusion: Reassuring practitioners of the continued stability of medicines in compliance aids under the countless condition in which they are dispensed in practice may requires a different approach involving medical device regulators and more definitive professional guidance.

When semantics aids phonology: a processing advantage for iconic word forms in aphasia

Iconicity is the non-arbitrary relation between properties of a phonological form and semantic content (e.g. “moo”, “splash”). It is a common feature of both spoken and signed languages, and recent evidence shows that iconic forms confer an advantage during word learning. We explored whether iconic forms conferred a processing advantage for 13 individuals with aphasia following left-hemisphere stroke. Iconic and control words were compared in four different tasks: repetition, reading aloud, auditory lexical decision and visual lexical decision. An advantage for iconic words was seen for some individuals in all tasks, with consistent group effects emerging in reading aloud and auditory lexical decision. Both these tasks rely on mapping between semantics and phonology. We conclude that iconicity aids spoken word processing for individuals with aphasia. This advantage may be due to a stronger connection between semantic information and phonological forms.