Background Most residents in elderly care homes in Sri Lanka do not receive formal, on-site, patient care services. Objective To evaluate the appropriateness of prescribing, dispensing, administration, and storage practices of medication used by residents in selected elderly care homes in Colombo District, Sri Lanka. Methodology This was a prospective, cross-sectional, multi-center study of 100 residents with chronic, non-communicable diseases, who resided in nine selected elderly care homes in Sri Lanka. Medication histories were obtained from each resident/caregiver and the appropriateness of medications in their current prescription was reviewed using standard treatment guidelines. Prescriptions were cross-checked against respective dispensing labels to identify dispensing errors. Medication administration was directly observed on two separate occasions per resident for accuracy of administration, and matched against the relevant prescription instructions. Medication storage was also observed in terms of exposure to temperature and sunlight, the suitability of container, and adequacy of separation if using multiple medications. Results The mean age of residents was 70±10.5 years and the majority were women (72%). A total of 168 errors out of 446 prescriptions were identified. The mean number of prescribing errors per resident was 1.68±1.23 [median, 2.00 (1.00-3.00)]. Inappropriate dosing frequencies were the highest (37.5%;63/168), followed by missing or inappropriate medications

Sabalingam et al.: Dextrinized Starch-starch as Exclusive Tablet Fillers Traditional tablet filler combinations, lactose-maize starch were replaced with a new dextrinized maize starch-maize starch filler combination. Dextrinization process under controlled conditions was targeted for this purpose and specifications were determined for the dextrinized product. Granules were prepared by wet granulation method using the new filler combination. Placebo tablets T1 were first prepared with lactose-maize starch filler combination as a model. Based on the properties of resulting tablets, lactose was replaced with dextrinized maize starch, introduced a different binder and the active ingredient furosemide anticipating a tablet of acceptable quality. The flow properties of dextrinized maize starch had improved over maize starch with an angle of repose of 40°. Hausner ratio and Carr's index of dextrinized maize starch and lactose were found to be 1.34, 1.54, and 25.45, 35.24 %, respectively favourable to the former. The placebo tablets (T2) prepared with the new filler combination using 12.0 % w/w maize starch binder resulted in unacceptable hardness and friability. However, furosemide tablets (T3) prepared with the new filler combination and the binder solution of low substituted hydroxypropyl cellulose 3.2 % w/w showed excellent physical properties. The study shows that dextrinized maize starch and maize starch filler combination without lactose could be employed successfully in tablet manufacture.

Purpose: Cashew tree Anacardium occidentale is a spreading ever green perennial tree. The plant is naturalized and cultivated in the warmer parts of Sri Lanka. This study focused on evaluating purified cashew gum as an effective binding agent in tablet formulation using a range of binder solution strengths and different tablet formulations. A difficult to formulate "all starches filler tablet" was attempted as a challenge for the binding strength of the purified cashew gum. Method: Crude cashew gum was collected from the main trunk and purified by dialysis. The aqueous solution containing higher molecular mass fraction obtained from dialysis was then lyophilized. Placebo, pyridoxine hydrochloride 2 mg and carbamazepine 100 mg tablets were prepared using the high molecular mass fraction known as purified cashew gum. The physico-chemical properties of the purified gum were investigated. Physical properties of the tablets prepared with four binders, purified cashew gum, gum xanthan, hydroxypropyl methylcellulose and maize starch were studied and compared with respect to diameter, thickness, hardness, friability, weight variation and disintegration time. Results: The purified cashew gum was of a light amber color, glistening pieces and was odorless. It was found that the gum resembles the properties of gum acacia with parameters well within those of British Pharmacopeia specifications. A unique all starches filler tablets were a success. Tablets prepared with all four binders exhibited similar physical properties. Conclusion: It was possible to purify the gum to a specified quality similar to that of gum acacia. Tablets made with the cashew gum met the tested British Pharmacopeia specifications similar to the conventional binders indicating the potential for the use of purified cashew gum as a pharmaceutical binding agent.