Terbutaline Sulfate

In nature, active Mn3+ –ligand complexes produced by laccase catalyzed oxidation can act as the low‐molecular mass, diffusible redox mediators to oxidize the phenolic substrates overcoming the limitations of natural enzymes. Learning from the metal–ligand coordination of natural functional units, high‐valence Mn metal–organic framework (Mn MOF) is constructed to simulate the catalysis in natural mediator system. Benefiting from the characteristics of nanoscale size, rich metal coordination unsaturated sites, and mixed valence state dominated by Mn(III), Nano Mn(III)‐TP exhibits superior laccase‐mimicking activity, whose Vmax (maximal reaction rate) is much higher than that of natural laccase. Referring to natural systems, relevant free radical experiments prove that the material induces the production of active oxygen species with the assistance of carboxylic acid, and active oxygen species further oxidize phenolic substrates. Based on its robust performances, the primary oxidative degradation of an emerging pollutant triclosan (TCS) is creatively applied, an important antiasthmatic medicine terbutaline sulfate (TBT) detection, and the synthesis of non‐toxic and black near‐natural dyes for dyeing. By simulating the essential mediators of natural enzymatic catalysis, an Mn MOF‐based material that demonstrates multiple novel applications is successfully developed, which introduces a new reliable strategy for achieving versatile nature‐mimicking catalysis.

The Canadian health sector’s carbon footprint is among the highest in the world and is responsible for 4.6% of Canada’s total greenhouse gas emissions, a quarter of which is linked to pharmaceuticals, with metered-dose inhalers (MDIs) contributing disproportionally high amounts.

To describe MDI prescribing, dispensing, use and waste patterns at a Canadian tertiary care academic hospital.

In a retrospective point-prevalence cohort study, 100 consecutive patients discharged from medical and surgical services who were prescribed at least 1 MDI during their admission were included. Data were collected to describe patient demographics, MDI prescribing, dispensing, use and waste patterns. Use and waste data were applied to annual purchasing data to estimate annual usage and waste. Financial cost was computed using local purchasing estimates and carbon cost was calculated using published estimates.

In 100 consecutively discharged patients, 315 MDIs were dispensed in total, of which 96 were unused. This represents 61,440 actuations dispensed, with 56,773 (92%) of doses unused or wasted. Waste data were applied to annual estimates, with a calculated annual carbon footprint of 315.8 tons of carbon dioxide equivalent (tCO2e). We estimate that a 20% waste reduction would result in carbon savings of 68.5 tCO2e. If 20% of salbutamol prescriptions were switched to the dry powder inhaler alternative, terbutaline, a 14% reduction in waste would be required to offset the additional monetary cost.

This study suggests that 92% of MDI doses are unused and wasted. Opportunities for waste reduction exist and would be associated with both financial and carbon savings.