Friday, June 25, 2021

SARS-COV-2 DELTA VARIANT AND DELTA PLUS VARIANT - SYMPTOMS, TREATMENT, & VACCINE EFFICACY

 

SARS-COV-2 DELTA VARIANT AND DELTA PLUS VARIANT

Experts believe that the Delta Plus variant has increased transmissibility but it is still not very clear as to how virulent this new strain is in comparison to other variants. Medical experts say it is too early to predict the effectiveness of the existing vaccines on the new variant. A detailed study would be required to establish any effect of the mutant on the immune system.

What is SARS-CoV-2 Delta variant?

·         It is also known as lineage B.1.617.2

·         It is a variant of lineage B.1.617 of SARS-CoV-2, the virus that causes COVID-19.

·         It was first detected in India in late 2020.

·         The World Health Organization (WHO) named it the Delta variant on 31 May 2021.

·         Public Health England (PHE) and WHO classified it as a variant of concern (VOC) based on an assessment of transmissibility.

·         It showed evidence of higher transmissibility and reduced neutralization.

·         The variant is thought to be partly responsible for India's second wave of the pandemic beginning in February 2021.

·         The Delta genome has 13 mutations.

·         Don’t get confused with the delta-coronavirus which mainly affects birds.

What is Delta Plus variant?

·         The new Delta plus variant has been formed due to a mutation in the Delta or B.1.617.2 variant.

·         It is a sub-lineage of the Delta variant .

·         Delta with K417N corresponds to lineages AY.1 and AY.2 is know as Delta Plus.

·         It has been nicknamed "Nepal variant".

·         It has the K417N mutation which is also present in the Beta variant.

·         As of June 16, at least 197 cases had been found from 11 countries — Britain (36), Canada (1), India (8), Japan (15), Nepal (3), Poland (9), Portugal (22), Russia (1), Switzerland (18), Turkey (1), the United States (83), India(40 cases in Maharashtra, Kerala and Madhya Pradesh).

·         No deaths were reported among the UK and Indian cases.

What are the symptoms of Delta and Delta Plus Variants?

·         Headaches,

·         A sore throat and

·         A runny nose

·         Fever.

What is the treatment?

The treatment for those infected by the SARS-CoV-2 Delta variant is as per others infected by COVID-19.

Are Vaccines effective against new variants?

·         The WHO has said current vaccines will continue to be effective against the variant. There may be some evidence of "reduced neutralization’. 

·         A study conducted by the Public Health England, has found that both Pfizer-BioNTech and AstraZeneca-Oxford vaccines provide a 33% protection against symptomatic disease caused by the variant after the first dose. Two weeks after the second dose the Pfizer-BioNTech vaccine was found to be 88% effective at stopping symptomatic disease from the Delta variant while the AstraZeneca-Oxford vaccine was 60% effective against the variant.

·         In June 2021, Public Health England announced it had conducted a study which found that after two shots, the Pfizer-BioNTech vaccine and the AstraZeneca vaccine are respectively 96% and 92% effective at preventing hospitalisation from the Delta variant.

·         ICMR found that convalescent sera of the COVID-19 cases and recipients of Bharat Biotech's BBV152 (Covaxin) were able to neutralise VUI B.1.617 although with a lower efficacy.

·         Another study by the Centre for Cellular and Molecular Biology (CCMB) in Hyderabad found Covishield (Oxford–AstraZeneca) vaccinated sera offers protection against lineage B.1.617.

Covid-19 vaccines made by AstraZeneca and the Pfizer-BioNTec alliance remains broadly effective against Delta variant. However, it is not yet clear if the existing vaccines are effective against delta plus.

 

References:

1.       "Confirmed cases of COVID-19 variants identified in UK". www.gov.uk.

2.       "Expert reaction to cases of variant B.1.617 (the 'Indian variant') being investigated in the UK". Science Media Centre.

3.       "Covid: WHO renames UK and other variants with Greek letters". BBC News. 31 May 2021.

4.       "Confirmed cases of COVID-19 variants identified in UK". www.gov.uk. 7 May 2021.

5.       WHO labels a Covid strain in India as a 'variant of concern' — here's what we know, CNBC, 11 May 2021.

6.       "India's second COVID-19 wave", The Wire Science, 22 April 2021.

7.       The COVID-19 Delta Variant: Here's Everything You Need to Know (US publication Healthline)

8.       Yadav, PD; Sapkal, GN; Abraham, P; Ella, R; Deshpande, G; Patil, DY; et al. (7 May 2021). "Neutralization of variant under investigation B.1.617 with sera of BBV152 vaccinees". Clinical Infectious Diseases. doi:10.1093/cid/ciab411. PMID 33961693

9.       "Covishield Covaxin effective against 'Indian strain' of coronavirus study suggests". The Week. Retrieved 27 April 2021.

10.   "Vaccines highly effective against hospitalisation from Delta variant". www.gov.uk. Public Health England. 14 June 2021. This article contains OGL licensed text This article incorporates text published under the British Open Government Licence v3.0:

11.   "UK study finds vaccines offer high protection against hospitalisation from Delta variant". Reuters. 14 June 2021.

 

 

Monday, June 21, 2021

US FDA Issued Form 483 to Alkem Laboratories Ltd. After Inspection of Its St Louis-based Formulation Plant

An FDA Form 483 is issued to a firm management at the conclusion of an inspection when an investigator has observed any conditions that in their judgment may constitute violations of the Food Drug and Cosmetic Act and related Acts.

US FDA Issued Form 483 to Alkem Laboratories Ltd.


 Alkem Laboratories Ltd., incorporated in the year 1973, is a Large Cap company (having a market cap of Rs 37,343.74 Crore) operating in Pharmaceuticals sector.

Alkem Laboratories Limited is an Indian multinational pharmaceutical company headquartered in Mumbai, Maharashtra, India that manufactures and sells pharmaceutical generics, formulations and nutraceuticals in India and globally.

Alkem set up its innovative work office for ANDA improvement at Taloja in 2003. In 2006 enemy of infective medication Taxim of Alkem turned into the principal hostile to infective medication in the Indian drug industry to cross 1,000 million as far as homegrown deals in India. In 2014 Clavam other medication from Alkem crossed 2,000 million imprint as far as homegrown deals in India. In 2007 the organization recorded its first ANDA for drug Amlodipine which was endorsed in 2009. Alkem has fostered an arrangement of 705 marked conventional medications, with 13 of the brands included among the main 300 brands in India for the monetary year 2015 and an arrangement of 705 brands in India in the a half year finished 30 September 2015. Alkem have 21 assembling offices, 19 in India and 2 in US. 5 of the offices are US FDA, TGA, UK MHRA supported.

As on today, Alkem has :

  • 21 Manufacturing units
  • Over 800 brands
  • Business footprint in over 50 countries
  • A 14,500 plus strong workforce
  • Multiple acquisitions and joint ventures
  • Consolidated revenue at Rs. 83,444 million in FY2019-20
Alkem, which has operations spread across multiple territories abroad, produces a complete range of formulations of controlled substances at its finished dosage manufacturing facility in St Louis, Missouri. The US-FDA had conducted an inspection of the company's manufacturing plant at St Louis, USA from June 14-18, 2021.

At the end of the investigation, the company received Form 483 with two observations from the US-FDA. It notifies the company's management of objectionable conditions at the facility.

A FDA Form 483 is given to a firm administration at the end of an inspection when an US FDA auditor has noticed any conditions that in their judgment may establish infringement of the Food Drug and Cosmetic Act and related Acts.

The company shall submit to USFDA within the stipulated timeline, a detailed response to close out all the observations associated with this inspection.


Friday, June 18, 2021

Career Opportunity With Genericart Medicine Pvt. Ltd. - Start Your Own Franchisee / Company outlet / Join As A Pharmacist

 About Genericart Medicines Pvt. Ltd.

Genericart Medicines Pvt. Ltd. is at the top of Generic Medicine store, PAN India with ISO 9001:2015, engaged in appointing franchisee of Generic Medicine shops all over India. It has more than 1200 registered stores under Swast Aushadhi Seva / Genericart Medicines Pvt. Ltd. across seven states. The aim of the company is to open more than 25000 stores across India and give the best possible service to people.

Job / Business Opportunities with Genericart Medicines Pvt. Ltd.

Company has generated 10,000 employment through the franchise model directly or indirectly. In the coming year the company is planning to establish its own stores across PAN INDIA. We invite experienced people from sales to boost the business. We have more than 700 openings for District Head business profiles and we require more than 1000 pharmacists from different states.

Franchise Model

Genericart Medicines Pvt. Ltd. offers different franchise model:

COCO (Company Operated Company Owned) - If you have a space and want to start business with us. Here company will establish all the shops on their own and will make you a partner in business.

FOCO (Franchisee Owned Company Operated) - If you want to become a business partner with us then you can opt this model. Here the entire investment is done by the shop owner and the shop will be managed by the company or shop owner can invest half amount and half will be done by the company. All management will be done by the company on profit sharing.

FOFO (Franchisee Owned Franchisee Operated) - This is the best model where the entire setup, investment and management is done by the shop owner. All training will be provided by the company. As well as the company will provide on field support for shop owners.



What are the requirement for Franchisee ?

Investment - You should be able to invest 8 to 10 lakh rupees with expandable capital of Rs 3 to 4 lakhRequired - 1 or 2 pharmacistSpace - Minimum space of 150 sq feet ( Basement or semi basement not allowed)Location - Should be on main road of the city or market place etc.100% Documentation & Licensing - As per FDA Guidelines

To apply for Franchisee & More Details Contact: 

ROHINI VIBHUTE, District  Head, Thane.

Contact No. 9819257872

While booking franchise what will you check....

1.No. 1 organization-

2. Experience - Almost 10 years

3. Highest shops in market 

4. Highest product range 

5. Content name product

6. special products available with us

7. HIV/CANCER products/ Insulin - We have. ✅

8. Free Trasport ✅

9. Bill to bill 1 month credit ✅

10.Bill cash discount ✅

11. Online portal/ Stock ✅

12. Software backup✅

13. Quality control report ✅

14. Franchise referral schemes ✅

15. Support and training from heads/directors ✅

16. Mobile application ✅

17. Contest for shops owner✅

18. Good margins✅

Upcoming things-

19. New addition products

Online training video - sale booster.

20. Upgraded online sales support. 

Just you name it....we have everything

Job Opportunities 

Genericart Medicine Pvt. Ltd. is highering Sr. Pharmacist & Pharmacist at its various outlets in Thane Dist.


To apply for Job Contact: 

ROHINI VIBHUTE, District  Head, Thane.

Contact No. 9819257872

Thursday, June 17, 2021

A POST COVID-19 INFECTION: BLACK FUNGUS (MUCORMYCOSIS)

 

                       

Recently, several cases of mucormycosis in people with COVID-19 have been increasingly reported world-wide, in particular from India. The primary reason that appears to be facilitating Mucorales spores to germinate in people with COVID-19 is an ideal environment of low oxygen (hypoxia), high glucose (diabetes, new-onset hyperglycemia, steroid-induced hyperglycemia), acidic medium (metabolic acidosis, diabetic ketoacidosis [DKA]), high iron levels (increased ferritins) and decreased phagocytic activity of white blood cells (WBC) due to immunosuppression (SARS-CoV-2 mediated, steroid-mediated or background comorbidities) coupled with several other shared risk factors including prolonged hospitalization with or without mechanical ventilators.

The Indian government reported that more than 11,700 people were receiving care for mucormycosis as of 25 May 2021. Many Indian media outlets called it "black fungus" because of the black discoloration of dead and dying tissue the fungus causes. Even before the COVID-19 pandemic, rates of mucormycosis in India were estimated to be about 70 times higher than in the rest of the world. Due to its rapidly growing number of cases many Indian state governments have declared it an epidemic.

Mucormycosis (previously called zygomycosis) is a serious but rare fungal infection caused by a group of molds called mucormycetes. These molds live throughout the environment. Mucormycosis mainly affects people who have health problems, weak immunity or take medicines that lower the body’s ability to fight germs and sickness. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. It can also occur on the skin after a cut, burn, or other type of skin injury.

Immunocompromising conditions are the main risk factor for mucormycosis. Patients with uncontrolled diabetes mellitus, especially those with ketoacidosis, are at high risk.

Doctors believe mucormycosis, which has an overall mortality rate of 50%, may be being triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients.

Steroids reduce inflammation in the lungs for Covid-19 and appear to help stop some of the damage that can happen when the body's immune system goes into overdrive to fight off coronavirus. But they also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients. It's thought that this drop in immunity could be triggering these cases of mucormycosis.

 SIGNS AND SYMPTOMS OF MUCORMYCOSIS

Signs and indications of Mucormycosis rely upon the area in the body of the infection. Infection normally starts in the mouth or nose and enters the focal sensory system through the eyes.

In the event that the contagious contamination starts in the nose or sinus and reaches out to mind, side effects and signs may incorporate uneven eye torment or migraine, and might be joined by torment in the face, deadness, fever, loss of smell, a hindered nose or runny nose. The individual may seem to have sinusitis. The face may look swollen on one side, with quickly advancing "dark sores" across the nose or upper within mouth. One eye may look swollen and swelling, and vision might be blurred.

The symptoms of mucormycosis depend on where in the body the fungus is growing.  Contact your healthcare provider if you have symptoms that you think are related to mucormycosis.

Symptoms of rhinocerebral (sinus and brain) mucormycosis include:

  • One-sided facial swelling
  • Headache
  • Nasal or sinus congestion
  • Black lesions on nasal bridge or upper inside of mouth that quickly become more severe
  • Fever

Symptoms of pulmonary (lung) mucormycosis include:

  • Fever
  • Cough
  • Chest pain
  • Shortness of breath

Cutaneous (skin) mucormycosis can look like blisters or ulcers, and the infected area may turn black. Other symptoms include pain, warmth, excessive redness, or swelling around a wound.

Symptoms of gastrointestinal mucormycosis include:

  • Abdominal pain
  • Nausea and vomiting
  • Gastrointestinal bleeding

Disseminated mucormycosis typically occurs in people who are already sick from other medical conditions, so it can be difficult to know which symptoms are related to mucormycosis. Patients with disseminated infection in the brain can develop mental status changes or coma.

TESTING OF MUCORMYCOSIS

  • Healthcare providers consider your medical history, symptoms, physical examinations, and laboratory tests when diagnosing mucormycosis. 
  • Healthcare providers who suspect that you have mucormycosis in your lungs or sinuses might collect a sample of fluid from your respiratory system to send to a laboratory. 
  • Your healthcare provider may perform a tissue biopsy, in which a small sample of affected tissue is analyzed in a laboratory for evidence of mucormycosis under a microscope or in a fungal culture. 
  • You may also need imaging tests such as a CT scan of your lungs, sinuses, or other parts of your body, depending on the location of the suspected infection. 
  • There are no specific blood tests to detect mucormycosis.

TREATMENT OF MUCOURMYCOSIS

Treatment involves a combination of antifungal drugs, surgically removing infecting tissue and correcting underlying medical problems such as diabetic ketoacidosis.

Medicines

Intravenous bag for antifungal medicine, usually Amphotericin B, Posaconazole, or Isavuconazole. Mucormycosis is a serious infection and needs to be treated with prescription antifungal medicine, usually Amphotericin B, Posaconazole, or Isavuconazole. These medicines are given through a vein (Amphotericin B, Posaconazole, Isavuconazole) or by mouth (Posaconazole, Isavuconazole). Other medicines, including fluconazole, voriconazole, and echinocandins, do not work against fungi that cause mucormycosis.

Surgery

Often, mucormycosis requires surgery to cut away the infected tissue. Surgery can be very drastic, and in some cases of disease involving the nasal cavity and the brain, removal of infected brain tissue may be required. Removal of the palate, nasal cavity, or eye structures can be very disfiguring. Sometimes more than one operation is required.

The prognosis (outcomes) of mucormycosis infections range from fair to poor; there is about a 50% death rate that rises to about 85% for rhinocerebral and GI infections.

WAYS TO PROTECT / PREVENT FROMMUCORMYCOSIS

It’s difficult to avoid breathing in fungal spores because the fungi that cause mucormycosis are common in the environment. There is no vaccine to prevent mucormycosis. For people who have weakened immune systems, there may be some ways to lower the chances of developing mucormycosis.

A)     Protect yourself from the environment

It’s important to note that although these actions are recommended, they haven’t been proven to prevent mucormycosis.

o    Try to avoid areas with a lot of dust like construction or excavation sites. If you can’t avoid these areas, wear an N95 respirator (a type of face mask) while you’re there. 

o    Avoid direct contact with water-damaged buildings and flood water after hurricanes and natural disasters.

o    Avoid activities that involve close contact to soil or dust, such as yard work or gardening. If this isn’t possible,

o    Wear shoes, long pants, and a long-sleeved shirt when doing outdoor activities such as gardening, yard work, or visiting wooded areas.

o    Wear gloves when handling materials such as soil, moss, or manure.

o    To reduce the chances of developing a skin infection, clean skin injuries well with soap and water, especially if they have been exposed to soil or dust.

B)      Antifungal medication

If you are at high risk for developing mucormycosis (for example, if you’ve had an organ transplant or a stem cell transplant), your healthcare provider may prescribe medication to prevent mucormycosis and other mold infections. Doctors and scientists are still learning about which transplant patients are at highest risk and how to best prevent fungal infections.

CONCLUSION

Mucormycosis isn’t contagious, so you can’t get it from an infected person. Self-care measures are the best way to prevent this type of infection. If you have a weakened immune system, it’s important to keep yourself safe outdoors. Wearing a mask while doing yardwork and bandaging all wounds until they heal will help prevent fungal infections.

You may also consider taking extra precautions during the summer and autumn months, when there’s an increased amount of the fungi in the environment. Preventive measures include wearing a face mask in dusty areas, washing hands, avoiding direct contact with water-damaged buildings, and protecting skin, feet, and hands where there is exposure to soil or manure such as gardening or certain outdoor work. In high-risk groups such as organ transplant, antifungal drugs may be given as a preventative.

REFERENCES

·         Lewis RE, Kontoyiannis DP. Epidemiology and treatment of mucormycosisexternal icon. Future Microbiol. 2013 Sep;8(9):1163-75.

·         Spellberg B, Edwards Jr. J, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and managementexternal icon. Clin Microbiol Rev. 2005 Jul;18(3):556-69.

·         Ribes JA, Vanover-Sams CL, Baker DJ. Zygomycetes in human diseaseexternal icon. Clin Microbiol Rev 2000; 13:236-301.

·         Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported casesexternal icon. Clin Infect Dis. 2005 Sep 1;41(5):634-53.

·         Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosisexternal icon. Clin Infect Dis. 2012 Feb;54 Suppl 1:S23-34.

·         Walsh TJ, Gamaletsou MN, McGinnis MR, Hayden RT, Kontoyiannis DP. Early clinical and laboratory diagnosis of invasive pulmonary, extrapulmonary, and disseminated mucormycosis (zygomycosis)external icon. Clin Infect Dis. 2012 Feb;54 Suppl 1:S55-60.

·         Avery RK, Michaels MG. Strategies for safe living after solid organ transplantationexternal icon. Am J Transplant. 2013 Mar;13 Suppl 4:304-10.

·         CDC. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR Recomm Rep. 2000 Oct;49(RR-10):1-125, CE1-7.

·         Davies BW, Smith JM, Hink EM, Durairaj VD. Increased incidence of rhino-orbital-cerebral mucormycosis after Colorado floodingexternal icon. Ophthalmic Plast Reconstr Surg. 2017 May;33(3S Suppl 1):S148-S151.

·         Brizendine KD, Vishin S, Baddley JW. Antifungal prophylaxis in solid organ transplant recipientsexternal icon. Expert Rev Anti Infect Ther. 2011 May;9(5):571-81.

·         Rogers TR, Slavin MA, Donnelly JP. Antifungal prophylaxis during treatment for haematological malignancies: are we there yet? external iconBr J Haemato. 2011 Jun;153(6):681-97.

Book Review on A TEXTBOOK OF PHARMACEUTICAL QUALITY ASSURANCE [As per syllabus of Pharmacy council of India (PCI)] By Dr. Harshal Ashok Pawar

 


About Author:

Harshal Ashok Pawar, M. Pharm., PhD (Pharmacy), MD (AM)

He is currently working as an Assistant Professor with Dr. L. H. Hiranandani College of Pharmacy, Ulhasnagar, (Affiliated to University of Mumbai, India). He has 15 years of teaching and industry research experience. He also worked as a Head of Department of Quality Assurance for six years. He worked with various pharmaceutical industries like Medley, Charak and Alkem Research Centre, Mumbai. He has published more than 60 research and review articles in various national / international journals of repute. He has also presented various research papers in national / international conference, seminars, symposia and workshops. He has two Indian and two international patents to his credit. He has received research grants from University of Mumbai. He is on editorial board and reviewer of various National / International journals. He has guided 25 M. Pharmacy Research scholars in the subject of Quality Assurance. He is also recognized PhD guide of University of Mumbai. He has authored seven books in the field of Pharmaceutical sciences. He is a life member of Association of Pharmaceutical Teachers of India (APTI).

About Book:

A Textbook of Pharmaceutical Quality Assurance is an outcome of sincere efforts made by author to collect, compile and simplify various aspects of Quality assurance keeping in view the level and learning objectives of Pharmacy students at undergraduate level. This book is prepared according to new syllabus of B. Pharmacy, introduced by Pharmacy Council of India (PCI). The present efforts will help the students to understand the subject matter easily.

 This book mainly covers the syllabus in the subject of Pharmaceutical Quality Assurance at the undergraduate level, implemented in most of the Indian and Foreign Universities. The book provides an overview about quality assurance, Good Manufacturing Practice (GMP), validation, Good Laboratory Practices (GLP) and documentation practice followed in industry. It is the most comprehensive book which deals with the important aspects of Quality assurance like cGMP, Quality control tests on packaging material, Pharmaceutical documentation, Quality certifications and Regulatory affairs. The principles of GMP and GLP are discussed which are expected to guide the manufacturer and the regulator for maintaining high scientific and professional standards for ensuring only drugs and pharmaceuticals of highest quality are produced and marketed.

The present book is divided in to five units.  The unique feature of this book is the presentation of fundamental concepts in a simple, lucid and self-explanatory form. Each unit includes learning objectives, general introduction to the topics covered, discussion on various regulatory aspects considering current regulatory guidelines and Pharmacopoeial requirements. At the end of each unit a list of probable questions to be asked in semester examination is provided so as to help the student to evaluate themselves. Every effort is taken to provide most authenticated and precise information and views, but readers are advised to refer the latest guidelines and cited references for more details.

BOOK CONTENTS

1.  QUALITY ASSURANCE AND QUALITY MANAGEMENT CONCEPTS...... 1

1.  Introduction..................................................................................................... 1

1.1.  Definition of Quality................................................................................. 2

1.2 Quality of a Pharmaceutical Product...................................................... 2

2.  Concept Of Quality Assurance.................................................................... 3

2.1  Objectives of Quality Assurance.............................................................. 4

2.2  Requirements of Quality Assurance System as per WHO.................. 4

2.3  Quality Assurance Methods..................................................................... 5

3. Good Manufacturing Practices (GMP) For Pharmaceutical Products...... 6

3.1  What is Good Manufacturing Practice (GMP)?..................................... 6

3.2  What GMP covers?..................................................................................... 7

4.  Quality Control............................................................................ 8

4.1  Objectives of Quality Control................................................................... 8

4.2  Basic Requirements of Quality Control.................................................. 9

4.3  Tools /Methods /Techniques of Quality Control............................... 10

5.  Comparison Of Quality Assurance and Quality Control................... 10

2.  TOTAL QUALITY MANAGEMENT (TQM).................................................... 12

1.  Introduction.................................................................................................. 12

2.  Quality Management Philosophies.............................................. 14

3.  Definitions Of TQM..................................................................................... 17

4.  Benefits Of TQM........................................................................................... 17

5.  Disadvantages / Limitations of TQM.......................................... 18

6.  Characteristics Of TQM.............................................................................. 18

7.  Total Quality Management Principles................................................... 18

8.  Elements Of TQM....................................................................... 18

9.  TQM In Pharmaceutical Industry............................................................ 22

9.1 Application of TQM in Pharmaceutical Industry................................ 23

10.  Reasons of Failures in Implementation of TQM Approach............. 25

3.  ICH GUIDELINES.......................................................................... 28

1.  Introduction.................................................................................................. 28

1.1  Mission of ICH.......................................................................................... 29

1.2  The Need to Harmonise........................................................................... 30

1.3  Process of Harmonization....................................................................... 31

2.  Organization of ICH................................................................... 33

3.  Classification of ICH Guidelines.............................................................. 35

4.  Stability Testing Guidelines (Q1A - Q1F)*............................................ 38

4.1.  Stability Testing Guidelines for New Drug Substance..................... 41

4.2.  New Drug Product.................................................................................. 47

4.3 Photostability Testing (Q1B Guidelines).............................................. 56

4.  QUALITY BY DESIGN (QBD)......................................................................... 59

1.  Introduction.................................................................................................. 59

1.1  QbD in Pharmaceutical Development................................................. 61

1.2  Definitions of Quality by Design........................................................... 63

1.3  Objectives of Pharmaceutical QbD....................................................... 63

1.4  Comparison of Traditional and QbD Approach of Pharmaceutical

Development................................................................................................................... 63

1.5  Benefits of QbD to Industry................................................................... 65

1.6  Opportunities........................................................................................... 66

2.  Important Definitions................................................................................ 67

3.  Elements / Components of QbD................................................. 68

4.  Tools of QbD.............................................................................. 75

4.1  Prior Knowledge....................................................................................... 75

4.2  Risk Assessment..................................................................................... 76

4.3  Mechanistic Model, Design of Experiments, and Data Analysis......... 77

4.4  Process Analytical Technology (PAT).................................................... 78

5.  Steps For Pharmaceutical Qbd Implementation................................ 81

5. ISO 9000 AND ISO 14000............................................................. 84

1. Introduction.................................................................................................. 85

2. History And Revisions: Iso 9000:2000, 2008, 2015.................... 86

3. ISO 9000.................................................................................... 86

3.1  Objectives of ISO 9000............................................................................ 87

3.2  Benefits of ISO 9000 (Why to adopt ISO 9000?)................................ 87

3.3  ISO 9000 Series standards.................................................................... 88

3.4 ISO 9000:2000.......................................................................................... 89

3.5 ISO 9004.................................................................................................... 89

4.  Elements Of ISO 9000 Quality Management Systems................. 90

5.  ISO9000 Principles Of Quality Management...................................... 93

6.  Advantages Of ISO 9000............................................................ 94

7.  Disadvantages Of ISO 9000........................................................ 96

8. ISO 14000................................................................................. 97

9.  Components Of ISO 14000 Series.............................................. 97

10. Benefits Of ISO 14000 (Why To Adopt The ISO 14000 Standard?)..... 99

11. Registration Process - Steps To Follow............................................. 100

6.  NABL ACCREDITATION.............................................................. 103

1.  Introduction............................................................................................... 103

2.  Why Laboratory Accreditation?............................................................ 106

2.1  Benefits of Accreditation...................................................................... 106

2.2  Scope of Accreditation.......................................................................... 108

3.  Preparation And Eligibility For Accreditation.................................. 108

4.  Process Of Accreditation......................................................................... 110

7.  ORGANIZATION AND PERSONNEL.............................................. 114

1.  Introduction................................................................................................ 114

2.  Personnel (Who Guidelines).................................................................... 116

2.1  Principle.................................................................................................. 116

2.2  General requirements........................................................................... 116

2.3  Key personnel......................................................................................... 117

3.  Training

3.1  Types of training.................................................................................... 121

3.2  Training as per WHO guidelines......................................................... 122

4.  Personal Hygiene (WHO guidelines)..................................................... 123

5.  Personnel Records..................................................................................... 124

8.  PREMISES.................................................................................. 126

1.  Introduction................................................................................................ 126

1.1 Essentials / Elements (General Requirements of Quality Premises)....... 127

2.  Location....................................................................................................... 127

3.  Pharmaceutical Plant Layout................................................................. 128

3.1  What is a pharmaceutical plant layout?........................................... 128

3.2  Features of a good pharmaceutical plant layout............................. 128

3.3  Advantages of a good pharmaceutical plant layout......................... 129

4.  Design And Construction........................................................................ 129

4.1  Plan and Layout..................................................................................... 130

4.2 Design, Construction, And Validation Of Pharmaceutical Facilities.... 132

4.3  Premises.................................................................................................. 136

5.  Maintenance............................................................................................... 141

6.  Sanitation................................................................................ 141

6.1 Requirements as per WHO guidelines................................................. 142

6.2 Sanitation for sterile pharmaceutical products..................................... 142

7.  Utilities And Sterile Area......................................................... 143

7.1 Water systems........................................................................................ 143

7.2 Compressed gases and vacuum systems.............................................. 145

7.3 Cooling systems...................................................................................... 145

8.  Aseptic Area And Parenteral Production............................................ 146

8.1 Areas in parenteral processing............................................................. 146

8.2 Requirements for design of aseptic area................................................ 148

9.  Control Of Contamination........................................................ 151

9.1 Sources of Contamination and its Prevention....................................... 152

10.  Environmental Control.......................................................... 154

9.  EQUIPMENT’S AND RAW MATERIALS......................................... 157

1.  Introduction............................................................................................... 157

2.  Equipment’s............................................................................ 158

2.1  Types of Equipment’s........................................................................... 159

2.2  Life cycle of an Equipment.................................................................. 159

2.3  Management of Equipment’s in Pharmaceutical Plants as per International GMP


Literature...................................................................................................... 159

3.  Equipment Selection................................................................................ 160

3.1  Factors to be considered during equipment selection................... 160

4.  Purchasing.................................................................................................. 162

4.1  Stores and purchase committee........................................................ 162

4.2  Purchase specifications....................................................................... 163

5.  Maintenance Of Equipment’s................................................................ 164

5.1  Objectives of Maintenance.................................................................. 164

5.2  Types of maintenance.......................................................................... 164

6.  Requirements For Equipment As Per Who Guidelines............... 165

7.  Raw Materials.......................................................................... 166

7.1 Factors to be considered while purchasing the materials................. 167

7.2  Purchase specification......................................................................... 167

7.3  General Specifications for Raw Materials (Contents of Raw

material monograph)................................................................................... 168

7.4  Steps involved in purchase procedure.............................................. 169

7.5  Vendor selection and Certification.................................................... 169

8.  Maintenance Of Stores............................................................................ 170

9.   WHO Guidelines For Raw Materials........................................... 171

9.1  General requirements.......................................................................... 171

9.2  Starting materials................................................................................. 172

9.3  Packaging materials............................................................................. 173

9.4  Finished products................................................................................. 174

10.  QUALITY CONTROL.................................................................. 176

1.  Introduction............................................................................................... 176

1.1  Definitions.............................................................................................. 177


1.2  Types of Package................................................................................... 178

1.3  Associated Components...................................................................... 179

2.  Ideal Requirements of Good Package / Container (Hazards Encountered


By Package)....................................................................................................... 179

3.  Package Testing Procedure.................................................................... 180

3.1  Testing of material................................................................................ 180

3.2  Testing of Packages.............................................................................. 181

3.3  Instrumental Techniques used for Quality control of Packaging

material.................................................................................... 181

4.  Composition Of Package......................................................................... 181

5.  Quality Control of Packaging Components....................................... 182

5.1  Containers............................................................................................. 182

5.2  Plastic Containers................................................................................. 194

5.3  Metal containers................................................................................... 198

6.  Closures.................................................................................. 201

6.1  Types of closures................................................................................... 201

6.2  Materials used for making closures.................................................. 201

6.3  Test for Closures................................................................................... 202

7.  Secondary Packaging Components...................................................... 204

7.1  Paper, Paperboard and Cardboard.................................................... 205

7.2  Evaluation of Secondary Packaging Components........................... 205

11. GOOD LABORATORY PRACTICES............................................. 210

1.  Introduction............................................................................................... 211

1.1  Aims / Goals of GLP............................................................................. 211

1.2  Benefits of GLP...................................................................................... 212

1.3  Fundamentals of GLP........................................................................... 213

1.4  Definition and Principles of GLP......................................................... 213

2.  General Provisions................................................................... 218

2.1  Scope....................................................................................................... 218

2.2  Important Definitions.......................................................................... 218

2.3  Applicability to studies performed under grants and contracts... 220

2.4  Inspection of a testing facility............................................................. 220

3.  Organization And Personnel..................................................... 220

3.1  Personnel................................................................................................ 220

3.2  Testing facility management............................................................... 221

3.3  Study director........................................................................................ 222

3.4  Quality assurance unit........................................................................ 222

4.  Facilities...................................................................................................... 224

4.1  General.................................................................................................... 224

4.2  Animal care facilities............................................................................. 224

4.3  Animal supply facilities........................................................................ 224

4.4  Facilities for handling test and control articles................................ 225

4.5  Laboratory operation areas.................................................................. 225

4.6  Specimen and data storage facilities.................................................. 225

5.  Equipment............................................................................... 225

5.1  Equipment design.................................................................................. 225

5.2  Maintenance and calibration of equipment...................................... 225

6.  Testing Facilities Operation................................................................... 226

6.1  Standard operating procedures.......................................................... 226

6.2  Reagents and solutions........................................................................ 227

6.3  Animal care............................................................................................. 227

7.  Test And Control Articles....................................................................... 228

7.1  Test and control article characterization........................................... 228

7.2  Test and control article handling........................................................ 229

7.3  Mixtures of articles with carriers........................................................ 229

8. Protocol For Conduct Of A Nonclinical Laboratory Study.............. 230

8.1  Protocol.................................................................................................... 230

8.2  Conduct of a nonclinical laboratory study........................................ 231

9. Records And Reports................................................................................ 231

9.1  Reporting of nonclinical laboratory study results........................... 231

9.2  Storage and retrieval of records and data......................................... 233

9.3  Retention of records.............................................................................. 233

10.  Disqualification Of Testing Facilities................................................ 235

10.1  Purpose................................................................................................. 235

10.2  Grounds for disqualification.............................................................. 235

10.3 Notice of and opportunity for hearing on proposed disqualification.... 235

10.4  Final order on disqualification.......................................................... 236

10.5  Actions upon disqualification............................................................ 236

10.6  Public disclosure of information regarding disqualification........ 237

10.7  Alternative or additional actions to disqualification..................... 237

10.8  Suspension or termination of a testing facility by a sponsor...... 238

10.9  Reinstatement of a disqualified testing facility.............................. 238

12. COMPLAINT, RETURN GOODS, RECALL AND WASTE DISPOSAL...... 240

1.  Introduction................................................................................................ 240


2.  Complaint................................................................................ 242

2.1  Need for Complaint Handling System................................................ 242

2.2  Types of complaint encountered......................................................... 242

3.  Complaint Handling / Evaluation............................................. 243

3.1  Evaluation of Complaint....................................................................... 244

3.2  Standard operating procedure for handling complaint.................. 245

3.3  WHO Guidelines for Review of Complaint......................................... 246

4.  Handling Of Return Goods........................................................ 247

4.1  Classification of returned goods......................................................... 248

4.2  Record of return goods......................................................................... 248

5.  Product Recall / Withdrawal.................................................................. 248

5.1  Definitions............................................................................................... 248

5.2  Reasons for Recall / withdrawal of Product..................................... 249

5.3  Recall Classification.............................................................................. 249

5.4  Basic information required for recall................................................. 249

5.5  Stages of recall procedure...................................................... 250

5.6  Implementation of recall communication.......................................... 251

5.7  Contents of recall communication........................................... 251

5.8  WHO guidelines for Recall................................................................... 251

6.  Waste Disposal......................................................................... 252

6.1  Procedure for disposal of pharmaceutical waste.............................. 252

13. DOCUMENT MAINTENANCE IN PHARMACEUTICAL INDUSTRY..... 256

1.  Introduction............................................................................................... 257

1.1  Purpose of Documentation.................................................................. 257

2.  General Requirements About Documentation (As

Per WHO Guidelines)..................................................................................... 258

3.  Batch Formula Record (BFR) / Batch Production Record (BPR)


/ Batch Processing And Control Records (BPCR) /

Batch Manufacturing Record (BMR)......................................................... 259

4.  Mater Formula Record (MFR) / Master Production


Instructions / Master Production And Control Records

(MPCR) / Master Formula Card (MFC)...................................................... 262

5.  Standard Operating Procedure (SOP) And Other Documents....... 263

6.  Quality Audit........................................................................... 266

6.1  Reasons for auditing............................................................................. 267

6.2  Types of Audit......................................................................................... 267

6.3  Procedure for conducting an audit..................................................... 267

6.4  Audit preparation.................................................................................. 268

6.5  Conducting of audit.............................................................................. 268

6.6  Completing and follow up of audit..................................................... 269

7.  Product Quality Review........................................................................... 269

8.  Quality Documentation........................................................................... 270

9.  Reports And Documents......................................................................... 271

10.  Distribution Records.............................................................................. 272

14. CALIBRATION AND VALIDATION

1.  Introduction................................................................................................ 276

2.  Important Definitions.............................................................................. 276

3.  Qualification Process............................................................................... 277

3.1  Qualification stages............................................................................... 278

4.  What Is Equipment Calibration?.......................................................... 281

4.1  Scope/ Purpose of Calibration............................................................ 281

4.2  When to perform Calibration?............................................................. 282

4.3  Types of Calibration.............................................................................. 282

5.  Validation of Equipment.......................................................... 284

5.1  Need of Equipment Validation............................................................. 284

6.  Validation................................................................................ 285

6.1  Various Definitions of Validation........................................................ 285

6.2  Reasons for Validation.......................................................................... 285

6.3  Scope of Validation................................................................................ 286

6.4  Types of Validation................................................................................ 287

6.5  Validation Protocol................................................................................ 289

6.6 Validation Master Plan (VMP) / Master Validation Plans (MVP)....... 290

7.  Calibration of PH Meter............................................................ 293

7.1  Construction of pH meter..................................................................... 293

7.2  Calibration Procedure........................................................................... 294

8.  Qualification Of UV-Visible Spectrophotometers............................. 295

8.1  Installation Qualification...................................................................... 296

8.2  Operational Qualification..................................................................... 296

8.3  Calibration of UV-VIS spectrophotometer......................................... 297

8.4  Performance Qualification.................................................................... 299


9.  General Principles Of Analytical Method Validation...................... 301

9.1  Principle.................................................................................................. 301

9.2  General requirements........................................................................... 302

9.3  Analytical Method Validation.............................................................. 303

15. WAREHOUSING AND MATERIALS MANAGEMENT...................... 312

1.  Introduction................................................................................................ 312

2.  Role / Functions of Warehousing......................................................... 313

3.  Types of Warehouses................................................................ 314

4.  Warehouse Location................................................................................. 315

5.  Why is Good Warehouse Practices (GWP) Important?.................... 315

6.  Good Warehouse Practices (GWP)......................................................... 316

6.1  Premises.................................................................................................. 316

6.2  Security................................................................................................... 316

6.3  Temperature and Humidity Control................................................... 317

6.4  Equipment’s............................................................................................ 317

6.5  Personnel................................................................................................. 317

6.6  Sanitation................................................................................................ 318

6.7  Receipt of incoming goods.................................................................... 318

6.8  Assembling orders and issuing goods................................................ 318

6.9  Packing for transportation................................................................... 319

6.10  Transport.............................................................................................. 319

6.11  Records.................................................................................................. 320

7. Material Management............................................................................ 321

7.1  Objectives................................................................................................ 322

7.2  Functions of Material Management.................................................... 322

7.3  Purchasing.............................................................................................. 322

7.4  Stores Management............................................................................... 325

7.5  Salvaging and disposal of scrap and surplus................................... 326

8.  Materials Management for API (As per US FDA - Q7A -

GMP guidance for API).................................................................................. 326

8.1  General Controls.................................................................................... 326

8.2  Receipt and Quarantine....................................................................... 326

8.3  Sampling and Testing of Incoming Production Materials............... 327

8.4  Storage..................................................................................................... 328

8.5  Re-evaluation......................................................................................... 328

ANNEXURES.................................................................................. 330

MODEL QUESTION PAPERS............................................................ 403

BIBLIOGRAPHY.............................................................................. 404

KEY WORD INDEX.......................................................................... 408

Publishers Note:

Everest's New Arrival for Semester VI B.Pharm All India Colleges

A Textbook of Pharmaceutical Quality Assurance 

by

Dr. Harshal Ashok Pawar

As per PCI Syllabus Guidelines


The Book has been foreworded and recommended by Shri Jagannath Shinde who is the President, Chairman, MD of a number of Chemists, Druggists & Distributors Associations of India, member of various Regulatory Bodies of India such as PCI, Maharashtra State Pharmacy Council etc.  as well as Member of Maharashtra Legislative Council.

Make the most use of the book by increasing the educative beauty of your Library. 

Buy now on www.everestpublishinghouse.com   

Or everestpune@yahoo.co.in  

Or 9822024092

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