Nursing strongly values comfort and patient-centered care at the end of life, but little end-of-life content is included in most basic nursing education programs. An innovative way to improve nursing education about the end-of-life transition is to provide nurse educators with an electronic toolkit. This article describes a newly created multimedia toolkit (TNEEL), which includes engaging strategies for teaching and learning about end-of-life care.

Curriculum↗

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Disposition of 13-cis-retinoic acid and N-(2-hydroxyethyl)retinamide in mice after oral doses.

The concentrations of 13-cis-retinoic acid and N-(2-hydroxyethyl)retinamide in serum and tissues from mice were measured after oral dosing with 10 mg/kg. Serum levels of the drugs reached their maxima within 15-30 min and then declined in an exponential fashion with t1/2 values of 19 min and 2.9 hr, respectively. Tissue levels of 13-cis-retinoic acid reached their maxima within 15-30 min, then declined exponentially with t1/2 values of 11-19 min. Tissue levels of N-(2-hydroxyethyl)retinamide reached their maxima within 30 min to 2 hr, then declined exponentially with t1/2 values of 2.1-4.7 hr. Longer t1/2 values were observed for both 13-cis-retinoic acid and N-(2-hydroxyethyl)retinamide in the bladder (51 min and 7.3 hr, respectively). Only small amounts of the unchanged retinoids were observed in bile and feces, and none was found in urine. Polar materials, however, were present in bile, feces, and urine.

Administration, Oral↗

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Effects of phenobarbital, 3-methylcholanthrene, and retinoid pretreatment on disposition of orally administered retinoids in mice.

Following oral administration of doses of 10 mg/kg, the concentrations of all-trans-retinoic acid (RA), N-(2-hydroxyethyl)retinamide (N-HOERA), and 13-cis-retinoic acid (13-cis-RA) were measured in serum and tissues of mice with and without pretreatment with phenobarbital (PB), 3-methylcholanthrene (3MC), or the respective retinoid. For RA, the areas under the concentration-time curves (AUC values) for serum and tissues, relative to controls, were reduced, on the average, by 54 or 37% on pretreatment with RA or PB, respectively. Pretreatment with 3MC did not affect disposition of RA. The AUC values for N-HOERA were reduced, on the average, by 39 or 30% following pretreatment with PB or 3MC, respectively, but only 13% by the retinoid. For 13-cis-RA, the AUC values were reduced, on the average, by 56 or 37% following pretreatment with PB or 3MC, respectively; pretreatment with the retinoid had no appreciable effect. Thus, the disposition of orally administered retinoids appears to be affected by several inducible metabolic processes. Furthermore, comparison of data on the tissue distribution of retinoids with in vivo results demonstrates a general correlation between distribution and anticarcinogenic activity.

Administration, Oral↗

PubMedDate not supplied

Pharmacokinetics and pharmacodynamics of subcutaneous interleukin-2 in HIV-infected patients.

STUDY OBJECTIVES: To assess the pharmacokinetics and pharmacodynamics of subcutaneously administered interleukin-2 (IL-2) in patients infected with the human immunodeficiency virus (HIV). DESIGN: Open, dose-escalating phase I clinical trial. SETTING: Government research hospital. PATIENTS: Eighteen patients infected with HIV. INTERVENTIONS: Recombinant IL-2 at dosages of 12, 15, or 18 MIU/day was administered subcutaneously once or twice/day for 5 consecutive days every 2 months. A total of 28 cycles of therapy were included in the analysis. MEASUREMENTS AND MAIN RESULTS: Concentrations of IL-2 in serum were determined by a commercial enzyme-linked immunosorbent assay. Interleukin-2 was well absorbed, with peak concentrations from 21.9-112.9 IU/ml. Absorption was slow, with mean (+/- SD) time to maximum of 4.4 +/- 1.8 hours and a lag time of 26.9 +/- 13.7 minutes. Elimination half-life was 3.3 +/- 0.9 hours. The concentrations had wide variability both within and among patients. Levels of tumor necrosis factor-alpha were increased. Maximum body temperature and systemic side effects were associated with peak serum levels. CONCLUSION: Interleukin-2 is well absorbed after subcutaneous injection in HIV-infected patients, and that route of administration is an alternative to intravenous infusions.

Adult↗