Advanced pharmaceutical manufacturing: A functional definition
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Rodolfo J. Romañach↗
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Robust State Estimation of Feeding-Blending Systems in Continuous Pharmaceutical Manufacturing.
Abstract not provided.
Laird, Carl Damon↗
Pharmacology Risk Report
It seems very likely that the actions of administered drugs on crewmembers during spaceflight are different than they are on Earth, but even after more than 40 years of spaceflight experience, the answers to most questions about medication use during missions remain unanswered. Use of medications with insufficient knowledge about their actual activities may result in inadequate treatment and may even reduce performance and well-being in particular circumstances. There is evidence that this has already occurred during and immediately after spaceflights. The spaceflight pharmaceutical activity knowledge base must be improved to enable flight surgeons and crewmembers to make better decisions about using pharmaceuticals inflight. The spaceflight environment induces changes in human physiology, and these changes have been the subject of much study over the past few decades. These studies are confounded by the small number of potential subjects, as well by the inability to separate the different stressors of spaceflight (radiation exposure from microgravity, for example). In every physiological system, the details of spaceflight-induced physiological changes are not well understood. Despite this fact, crewmembers are treated with pharmaceuticals to reduce or prevent medical problems, with insufficient information as to drug function on their altered physiological systems. There are two major concerns about pharmaceutical use in the unusual environment of spaceflight. The actions of pharmaceuticals on physiology altered by a spaceflight environment are currently assumed to be the same as the actions in terrestrial use. This has yet to be established. The wide range of physiological systems altered by spaceflight and the degree of change experienced in some of them make it very likely that alterations in pharmaceutical action will be seen. As the duration of missions lengthens to include more distant exploration, it becomes more likely that problems will be encountered. Secondly, the integrity of stored pharmaceuticals must be established to ensure that adequate amounts of active compounds are available in each dose and that degradation to toxic compounds is minimized. This risk is also dependent on mission duration, since longer missions will require that drugs be stored much longer than their usual terrestrial shelf-lives.
Source record↗
Innovative Drug Selection, Storage, and Shelf-Life Strategies for Exploration Spaceflight
Medications have been a part of space travel dating back to the Apollo missions. A safe and effective medication formulary is essential to maintaining crew health and performance during long-duration spaceflight outside of low Earth orbit (LEO). Distance from Earth creates four key operational changes that increase medical risks, including communication, resupply, crewmember health, and evacuation. The current spaceflight pharmaceutical formulary consists of medications indicated to treat a variety of anticipated medical events and healthcare needs during spaceflight, but depends on a robust consumables resupply chain, which may be strained for a Lunar, and possibly non-existent for a Mars mission. The specific medications selections for the formulary may change to optimally align with the mission, crew compliment, and spacecraft design. Medical support at long-duration exploration missions will differ from LEO missions due to mission duration, lack of consumables resupply, prolonged exposure to space radiation, and the absence of emergency medical return capability. Loss of medication resupply limits or removes the ability to replace medications that have been exhausted or degraded, potentially exacerbating the medical risk posture. To address these anticipated risks, long-duration missions must consider use of novel medical technologies, treatment modalities, and smart medical systems that offer greater crew autonomy, such as physiologically based pharmacokinetic modeling, drug repurposing, on demand drug synthesis, or wearable drug delivery / monitoring devices. Once an ideal formulary for exploration space is determined, it is essential to establish the chemical and physical stability of each medication compound, as well as its safety by identifying its degradation profiles and products. Although few studies have been conducted to provide evidence on the physicochemical stability of pharmaceuticals during space missions, the data suggests that the spaceflight environment may promote degradation in some pharmaceuticals. Formulary drug purity and efficacy should be verified by pharmaceutical stability assessments, and can be realized non-destructively, and accessed in remote environments. Non-destructive pharmaceutical analysis and statistical modelling techniques could optimize exploration spaceflight medical care by enabling early detection of suboptimal therapeutics. Likewise, novel packaging, storage strategies, and dosage form innovations are promising countermeasures to optimize pharmaceutical shelf life, purity, and quality of exploration spaceflight medications. As we prepare for more distant exploration missions, risk management planning for astronaut healthcare should include the assembly of a medication formulary that is comprehensive enough to prevent or treat anticipated medical events, remains safe and chemically stable, and retains sufficient potency to last for the duration of the mission. Following extensive review of the literature, we will present innovative formulary optimization strategies, pharmaceutical stability assessment techniques, and storage and packaging solutions that could enhance drug safety and efficacy for future exploration spaceflight missions.
Vernie R Daniels↗
Optimization of key energy and performance metrics for drug product manufacturing
During the development of pharmaceutical manufacturing processes, detailed systems-based analysis and optimization are required to control and regulate critical quality attributes within specific ranges, to maintain product performance. As discussions on carbon footprint, sustainability, and energy efficiency are gaining prominence, the development and utilization of these concepts in pharmaceutical manufacturing are seldom reported, which limits the potential of pharmaceutical industry in maximizing key energy and performance metrics. Based on an integrated modeling and techno-economic analysis framework previously developed by the authors, this study presents the development of a combined sensitivity analysis and optimization approach to minimize energy consumption while maintaining product quality and meeting operational constraints in a pharmaceutical process. The optimal input process conditions identified were validated against experiments and good agreement resulted between simulated and experimental data. Here, the results also allowed for a comparison of the capital and operational costs for batch and continuous manufacturing schemes under nominal and optimized conditions. Using the nominal batch operations as a basis, the optimized batch operation results in a 71.7% reduction of energy consumption, whereas the optimized continuous case results in an energy saving of 83.3%.
59 BASIC BIOLOGICAL SCIENCES↗
Electrochemical Oxidation of Organic Molecules at Lower Overpotential: Accessing Broader Functional Group Compatibility with Electron-Proton Transfer Mediators
CONSPECTUS: Electrochemical organic oxidation reactions are highly appealing because protons are often effective terminal electron acceptors, thereby avoiding undesirable stoichiometric oxidants. These reactions are often plagued by high overpotentials, however, that greatly limit their utility. Single-electron transfer (SET) from organic molecules generates high energy radical-cations. Formation of such intermediates often requires electrode potentials far above the thermodynamic potentials of the reaction and frequently causes decomposition and/or side reactions of ancillary functional groups. In this Account, we show how electrocatalytic electron-proton transfer mediators (EPTMs) address this challenge. EPTMs bypass the formation of radical-cation intermediates by supporting mechanisms that operate at electrode potentials much lower (=1 V) than analogous direct electrolysis reactions. The stable aminoxyl radical TEMPO (2,2,6,6-tetramethylpiperidine N-oxyl) is an effective mediator for electrochemical alcohol oxidation, and we have employed such processes for applications ranging from pharmaceutical synthesis to biomass conversion. A complementary electrochemical alcohol oxidation method employs a cooperative Cu/TEMPO mediator system that operates at 0.5 V lower electrode potential than the TEMPO-only mediated process. This difference, which arises from a different catalytic mechanism, rationalizes the broad functional group tolerance of Cu/TEMPO-based aerobic alcohol oxidation catalysts. Aminoxyl mediators address long-standing challenges in the "Shono oxidation", an important method for a-C–H oxidation of tertiary amides and carbamates. Shono oxidations are initiated by a high-potential SET step that limits their utility. Aminoxyl-mediated Shono-type oxidations have been developed that operate at much lower potentials and tolerate diverse functional groups. Analogous reactivity underlies a-C–H cyanation of secondary cyclic amines, a new method that enables efficient diversification of piperidine-based pharmaceutical building blocks and preparation of non-natural amino acids. Electrochemical oxidations of benzylic C–H bonds are commonly initiated by SET to generate radical cations, but such methods are again plagued by large overpotentials. Mediated electrolysis methods that promote hydrogen-atom-transfer (HAT) from benzylic C–H bonds to Fe-oxo species and phthalimide N-oxyl (PINO) support C–H oxygenation, iodination, and oxidative-coupling reactions. A complementary method merges photochemistry with electrochemistry to achieve amidation of C(sp3)–H bonds. This unique process operates at much lower overpotentials compatible with diverse functional groups. These results have broad implications for organic electrochemistry, highlighting the importance of "overpotential" considerations and the prospects for expanding synthetic utility by using mediators to bypass high-energy outer-sphere electron-transfer mechanisms. Principles demonstrated here for oxidation are equally relevant to electrochemical reductions.
Wang, Fei↗
Anthropogenic Markers in Alta Irrigation District Water Supply Wells
In July 2016, LLNL produced a report for the Kings River Watershed Coalition Authority (KRWCA) entitled “Groundwater Age and Nitrate Isotopic Composition in Alta Irrigation District Water Supply Wells” (Esser et al., 2016). That report summarized groundwater age and nitrate isotopic composition data produced by LLNL for Alta Irrigation District (AID) groundwater wells sampled by KRWCA in a pilot project to test the utility of advanced isotopic methods for constraining the timing and source of nitrate in groundwater at selected sites in the Kings River service area. One section of that report made recommendations for follow-on study. The first and strongest recommendation was to measure a wider suite of source tracers including co-contaminants such as herbicides, pesticides, pharmaceuticals, personal care products, and food constituents and additives. KRWCA followed up on this recommendation in Phase II of the pilot study by re-sampling the original set of wells and submitting the samples to a commercial laboratory for analysis of a limited range of co-contaminants (including pharmaceuticals, personal care products , and food constituents and additives, but not including herbicides or pesticides). They have asked that LLNL review and interpret these data in the context of previous LLNL analyses and to evaluate the utility of such co-contaminant analyses in providing additional constraints on the source of groundwater nitrate contamination in Alta Irrigation District water supply wells. The goal of the second phase of this pilot project is to evaluate the utility of co-contaminant occurrence for constraining nitrate source in groundwater at selected sites in the Kings River service area, with special reference to the use of such data in conjunction with advanced isotopic methods such as nitrate isotopic composition and groundwater age. Nitrate isotopic composition alone cannot distinguish nitrate derived from animal manure from nitrate derived from human septic waste. The presence or absence of agricultural chemicals (herbicides, pesticides, veterinary pharmaceuticals) or chemicals associated with people (human pharmaceuticals, artificial sweeteners) can help make this distinction. Co-contaminant analyses using multi-analyte LC-MS-MS protocols are now commercially available and reasonably priced. The feasibility and utility of the using co-contaminants for nitrate source attribution can be evaluated by 1) determining the degree to which co-contaminants occur in distinct and easily attributable groupings (e.g. agricultural chemicals vs personal care products and food additives); 2) determining the degree to which co-contaminant occurrence is consistent with nitrate isotopic composition and groundwater age (e.g. no co-contaminant occurrence in very old groundwater; co-contaminants consistent with animal manure or human septic waste occurring in groundwaters having nitrate isotopic composition also consistent with animal manure or human septic waste); and 3) determining the degree to which co-contaminants provide additional constraint on nitrate source over and beyond nitrate isotopic composition and groundwater age (e.g. distinguishing between animal manure and human septic waste).
58 GEOSCIENCES↗
The Use of Heavy Ion Radiation as an Analog for Space Radiation Environment and Its Effects on Drug Stability
While it is common knowledge that electromagnetic radiation such as x-rays and gamma rays affect physical-chemical characteristics (PC) of compounds in addition to their toxic and mutagenic effects on biological systems, there are no reports on the effects of cosmic radiation encountered during space missions on stability of pharmaceuticals. Alterations in PC of drug formulations can adversely affect treatment with medications in space. Preliminary evaluation of stability and shelf-life of select pharmaceuticals (12) flown on space missions revealed that 37% and 40% of the formulations failed to meet USP requirements after shuttle and ISS flights, respectively. Based on these results, the current investigation is designed to examine the effect of proton (P) and heavy ion (Fe) radiation on 20 pharmaceutical preparations flown aboard the shuttle and ISS. The objectives of this project are: 1) Examine susceptibility of pharmaceuticals to short acute bouts of high intensity ionizing radiation species encountered during space flights; 2) Estimate extent of degradation of susceptible formulations as a function of intensity of each beam (P & Fe); and 3) compare and contrast the effects of single beam irradiation to that of a combined beam (P + Fe) that simulates space craft environment on drug stability. Irradiations were conducted at the Brookhaven National Laboratories (BNL) with beam strengths of 10 cGy, 10 or 50Gy of P and Fe beams separately. Preliminary evaluation of results revealed a reduction in the chemical content of label claim ranging 12-55 % for Augmentin, 7% for promethzine tablets and 9% for ciprofloxacin ointment. These results are in agreement, although less in magnitude than those observed during space flight and after gamma irradiation.
Vaksman, Z.↗
Space Environment Effects on Stability of Medications Flown on Space Shuttles and the International Space Station (ISS)
The purpose is to assess physical and chemical degradation of select pharmaceutical formulations from the Shuttle and ISS medical kits. Eleven pharmaceuticals dispensed as different dosage forms were selected based on their physical / chemical characteristics and susceptibility to environmental factors such as, temperature, humidity and light sensitivity. When available, ground-controls of the study medications with matching brand and lot numbers were used for comparison. Samples retrieved from flight were stored along with their matching controls in a temperature and humidity controlled environmental chamber. Temperature, humidity, and radiation data from the Shuttle and ISS were retrieved from onboard HOBO U12 Temp/RH Data Loggers, and from passive dosimeters. Physical and chemical analyses of the pharmaceuticals were conducted using validated United States Pharmacopeia (USP) methods. Results indicated degradation of 6 of the 11 formulations returned from space flights. Four formulations, Amoxicillin / Clavulanate, promethazine, sulfamethoxazole / trimethoprim, and ciprofloxacin tablets depicted discoloration after flight. Chemical content analyses using High or Ultra Performance Liquid Chromatography (HPLC / UPLC) methods revealed that dosage forms of Amoxicillin / Clavulanate, promethazine, sulfamethoxazole / trimethoprim, lidocaine, ciprofloxacin and mupirocin contained less than 95% of manufacturer s labeled claim of active drug compound. Shuttle and ISS environments affect stability and shelf life of certain mediations flown on these missions. Data analysis is in progress to examine the effect of specific space flight environmental factors on pharmaceutical stability. The degradation profiles generated from ground studies in analog environments will be useful in establishing predictive shelf-life profiles for medications intended for use during long-term space exploration missions.
Daniels, Vernie↗
Preliminary Evaluation of Commercial Off the Shelf (COTS) Packing Materials for Flight Medication Dispenser (FMD) Technology Development
With the advent of longer duration space missions, pharmaceutical use in space has increased. During the first 33 space shuttle missions, crew members took more than 500 individual doses of 31 different medications . Anecdotal reports from crew members described medications as generally "well tolerated" and "effective". However, reported use of increased medication doses and discrepancies in ground vs. flight efficacy may result from reduced potency or altered bioavailability due to changes in chemical and/or physical parameters of pharmaceutical stability. Based on preliminary results from a ground-based irradiation and an inflight study on pharmaceutical stability, three susceptible medications, Amoxicillin/Clavulanate and Sulfamethoxazole/trimethoprim antibiotics tablets and promethazine (PMZ), an antihistamine were selected for testing using two types of Oliver-Tolas bags, TPC-1475(Clear) and TPF-0599B (Foil) for radiation Shielding effectiveness. The material composition of the bags included aluminum coated Mylar sheathing coated with multifunctional nanocomposities based on polyethylene with dispersed boron-rich nanophases. Two bags of each medication were irradiated for different time intervals with 14.6 rad/min to achieve 0.1 Gy, 1 Gy and 10 Gy of cumulative radiation dose. Active pharmaceutical content (API) in each medication was determined and results analyzed. No significant difference in API content was observed between control and irradiated samples for both antibiotic tablets suggesting both types of bags may offer protection against gamma radiation; results with PMZ were inconclusive. These preliminary results suggest that Oliver-Tolas TPL-1475 and TPF-0599B materials may possess characteristics suitable for protection against ionizing radiation and can be considered for designing and further testing of FMD technology.
Du, Brian↗
Supplying a Pharmacy for NASA Exploration Spaceflight: Challenges and Current Understanding
In order to maintain crew health and performance during long-duration spaceflight outside of low-Earth orbit, NASA and its international partners must be capable of providing a safe and effective pharmacy. Given few directed studies of pharmaceuticals in the space environment, it is difficult to characterize pharmaceutical effectiveness or stability during spaceflight; this in turn makes it challenging to select an appropriate formulary for exploration. Here we present the current state of literature regarding pharmaceutical stability, metabolism, and effectiveness during spaceflight. In particular, we have attempted to highlight the gaps in current knowledge and the difficulties in translating terrestrial-based drug studies to a meaningful interpretation of drug stability, safety, and effectiveness in space. We hope to identify high-yield opportunities for future research that might better define and mitigate pharmaceutical risk for exploration missions.
Rebecca S Blue↗
An integrated data management and informatics framework for continuous drug product manufacturing processes: A case study on two pilot plants
The pharmaceutical industry continuously looks for ways to improve its development and manufacturing efficiency. In recent years, such efforts have been driven by the transition from batch to continuous manufacturing and digitalization in process development. To facilitate this transition, integrated data management and informatics tools need to be developed and implemented within the framework of Industry 4.0 technology. Here, in this regard, the work aims to guide the data integration development of continuous pharmaceutical manufacturing processes under the Industry 4.0 framework, improving digital maturity and enabling the development of digital twins. This paper demonstrates two instances where a data integration framework has been successfully employed in academic continuous pharmaceutical manufacturing pilot plants. Details of the integration structure and information flows are comprehensively showcased. Approaches to mitigate concerns in incorporating complex data streams, including integrating multiple process analytical technology tools and legacy equipment, connecting cloud data and simulation models, and safeguarding cyber-physical security, are discussed. Critical challenges and opportunities for practical considerations are highlighted.
59 BASIC BIOLOGICAL SCIENCES↗
Critical Review of Brazil Disk Techniques for Tensile Strength Characterization With an Emphasis on High Explosive Materials
Mechanical properties are a critical performance metric for many high explosive (HE) materials and tensile strength properties are particularly important. Direct tensile measurements using dogbone shaped samples are the gold standard but they have the disadvantage that they are fairly large and require samples machined from billets. Diametral compression, more commonly known as Brazil disk (BD) testing, is an indirect method for measuring tensile strength on smaller and more easily fabricated samples. A review of the BD literature is presented with an emphasis on tensile strength measurements in high explosive materials. BD literature is reviewed in three primary areas: (i) rocks and concrete, (ii) pharmaceutical materials, and (iii) high explosive materials. The literature for rocks/concrete is extensive and dates back over 80 years; despite this there is no consensus on the validity/accuracy of the BD technique or the optimal variant of the BD technique to employ. The pharmaceutical literature is the opposite, being limited in scope and quantity of studies. BD literature on high explosive materials falls in between, not as impressive as in the rocks/concrete community but more substantiative than in the pharmaceutical community. After the review of the literature practical parameters for HE BD testing and recommended future work is discussed.
Brazil disk↗
Contribution of sewage to occurrence of phosphodiesterase-5 inhibitors in natural water
Phosphodiesterase-5 inhibitors (PDE-5i, such as Sildenafil, Tadalafil and Vardenafil, mainly prescribed to treat erectile dysfunction) and their generic drug equivalents have been widely marketed and consumed in Korea. From the concentrations detected in wastewater, we could deduce that relatively large amounts of PDE-5i were consumed without a legal prescription. Thus, PDE-5i’s presence in the environment via sewage is unavoidable, and their environmental fate within a sewage treatment plant (STP) should be evaluated. In this study, we investigated the occurrence of three PDE-5i analogs in the influent and effluent of two STPs and the receiving water bodies. The PDE-5i concentration in total reached 62 ± 12 (STP#1) and 88 ± 37 ng L -1 (STP#2) in the sewage influent; about 70% of it was Sildenafil in both STPs. However, they were hardly removed by the STPs as the removal efficiency of the STPs was less than 10% ± 5%. Therefore, the pharmaceuticals were detected in the receiving water (lower than 7 ng L -1 as a total amount) and the concentration slightly increased downstream of the STPs. A simple mass balance model applied for the compounds in the STP effluent and receiving water bodies also confirmed that the discharged PDE-5i were quite persistent. Lastly, we identified temporal and regional patterns in the consumption of the drugs from daily variations of PDE-5i in the influent to these two STPs. For instance, the levels of PDE-5i in the sewage significantly increased on weekends (from Friday to Saturday), and especially in the area where adult-entertainment businesses are common. We estimated that the amount of PDE-5i consumption in this area was 31% higher than that in the area with fewer nightlife spots. Considering that they are pharmaceutically active and resistant to treatment processes within an STP, it is advised that a regular monitoring and management program for PDE-5i should be developed to prevent the discharge of the pharmaceuticals into the water environment.
54 ENVIRONMENTAL SCIENCES↗
Co-Exposure of Nanopolystyrene and Other Environmental Contaminants—Their Toxic Effects on the Survival and Reproduction of Enchytraeus crypticus
Plastics in all shapes and sizes have become widespread across ecosystems due to intense anthropogenic use. As such, they can interact with other contaminants that accumulate in the terrestrial environment, such as pharmaceuticals, metals or nanomaterials (NMs). These interactions can potentiate combined toxic effects in the exposed soil organisms, with hazardous long-term consequences to the full ecosystem. In the present study, a terrestrial model species, Enchytraeus crypticus (oligochaeta), was exposed through contaminated soil with nanopolystyrene (representative of nanoplastics (NPls)), alone and in combination with diphenhydramine (DPH, representative of pharmaceuticals), silver nitrate (AgNO3, representative of metals) and vanadium nanoparticles (VNPs, representative of NMs). AgNO3 and VNPs decreased E. crypticus reproduction at 50 mg/kg, regardless of the presence of NPls. Moreover, at the same concentration, both single and combined VNP exposures decreased the E. crypticus survival. On the other hand, DPH and NPls individually caused no effect on organisms’ survival and reproduction. However, the combination of DPH (10 and 50 mg/kg) with 300 mg NPls/kg induced a decrease in reproduction, showing a relevant interaction between the two contaminants (synergism). Our findings indicate that the NPls can play a role as vectors for other contaminants and can potentiate the effects of pharmaceuticals, such as DPH, even at low and sub-lethal concentrations, highlighting the negative impact of mixtures of contaminants (including NPls) on soil systems.
Mendes, Luís A. (ORCID:0000000245738290)↗
Microcapsules and Methods for Making
This invention relates to methods for forming multi-lamellar microcapsules of both hydrophilic and hydrophobic immiscible liquid phases using several polymer/solvent systems. Liquid-Liquid diffusion and spontaneous emulsification are controlled by properly timed sequence exposures of immiscible phases in aqueous vehicles dispersed in hydrocarbon solvents containing small quantities of oil, co-surfactants, and glycerides. Water-in-oil and oil-in-water microcapsules are formed containing selected combinations of several types of drugs, co-encapsulated within fluid compartments inside the microcapsule. Commercial applications of the process and the resultant product relate to drug therapy for treating medical conditions such as cancer, circulatory conditions, and other conditions in which pharmaceuticals are advantageously targeted to specific organs, or delivered in combination with other pharmaceuticals. Small microcapsules may be delivered intravenously to diseased organs or clotted vessels. The use of multiple drugs within the same microcapsule structure provides advantages for applications such as chemoembolization treatments and may be used to deliver both chemotherapeutic drugs, against tumor cells, and an immuno-adjuvant or immunological stimulant to enhance the patient's immune response. Active forms of urokinase and other enzymes may be delivered without dilution to the local site of an embolism for dissolving the embolism. Thus, the invention has several potentially valuable commercial applications related to pharmaceutical and medical applications.
Morrison, Dennis R.↗
Antimicrobial Medication Stability During Space Flight
The current vision for manned space flight involves lunar and Martian exploration within the next two decades. In order for NASA to achieve these goals, a significant amount of preparation is necessary to assure crew health and safety. A mission critical component of this vision centers around the stability of pharmaceutical preparations contained in the space medicine kits. Evidence suggests that even brief periods of space flight have significant detrimental effects for some pharmaceutical formulations. The effects observed include decreases in physical stability of drug formulations of sufficient magnitude to effect bioavailability. Other formulations exhibit decreases in chemical stability resulting in a loss of potency. Physical or-chemical instability of pharmaceutical formulations i n space medicine kits could render the products ineffective. Of additional concern is the potential for formation of toxic degradation products as a result of the observed product instability. This proposal addresses Question number 11 of Clinical Capabilities in the Critical Path Roadmap. In addition, this proposal will reduce the risks and/or enhance the capabilities of humans exposed to the environments of space flight or an extraterrestrial destination by identifying drugs that may be unstable during spaceflight.
Putcha, Lakshmi↗
Estimating the Need for Medical Intervention due to Sleep Disruption on the International Space Station
During ISS and shuttle missions, difficulties with sleep affect more than half of all US crews. Mitigation strategies to help astronauts cope with the challenges of disrupted sleep patterns can negatively impact both mission planning and vehicle design. The methods for addressing known detrimental impacts for some mission scenarios may have a substantial impact on vehicle specific consumable mass or volume or on the mission timeline. As part of the Integrated Medical Model (IMM) task, NASA Glenn Research Center is leading the development of a Monte Carlo based forecasting tool designed to determine the consumables required to address risks related to sleep disruption. The model currently focuses on the International Space Station and uses an algorithm that assembles representative mission schedules and feeds this into a well validated model that predicts relative levels of performance, and need for sleep (SAFTE Model, IBR Inc). Correlation of the resulting output to self-diagnosed needs for hypnotics, stimulants, and other pharmaceutical countermeasures, allows prediction of pharmaceutical use and the uncertainty of the specified prediction. This paper outlines a conceptual model for determining a rate of pharmaceutical utilization that can be used in the IMM model for comparison and optimization of mitigation methods with respect to all other significant medical needs and interventions.
Myers, Jerry G.↗