Hasil untuk "Pharmacy and materia medica"

Monika Gandhi, Rashpal Singh Gill, Aishwarya Sharma et al.

Background: Proper pain control before subarachnoid block (SAB) is must in proximal femur fractures as patients cannot tolerate movement due to severe pain. This study compares ultrasound-guided fascia iliaca compartment block (USG-FICB) with femoral nerve block (USG-FNB) for pre-SAB analgesia. Materials and Methods: Ninety patients scheduled for elective femur fracture surgery under SAB were randomly divided. Group FICB received 25 ml of 0.25% bupivacaine and Group FNB got 15 ml. Pain was assessed using Numerical Rating Scale (NRS) scale. Time for first rescue dose, side effects, and patient satisfaction also noted. Results: Both groups had similar baseline NRS. Group FICB showed faster pain relief and better positioning comfort during SAB (NRS 3.00 vs. 4.28 P = 0.001). Time to first rescue analgesia was more in FICB (4.67 vs. 2.71 h P = 0.001). Satisfaction scores were also higher. Hemodynamics stayed stable, and adverse events were rare. Conclusion: USG-FICB is more effective than USG-FNB in controlling pain before SAB in femur fracture surgery.

Lidia Majewska, Karolina Dorosz, Jacek Kijowski

Patients undergoing epidermal growth factor receptor inhibitor (EGFRI) therapy frequently experience dermatologic side effects, notably papulopustular rash, which impacts 50–90% of recipients. This rash typically appears on the face, chest, and back within weeks of treatment, resembling acne but stemming from distinct pathophysiological mechanisms, causing significant discomfort and reduced quality of life. Prophylactic measures and symptom-based treatment are recommended, emphasizing patient education, topical agents, and systemic therapies for severe cases. A 41-year-old female with advanced colonic mucinous adenocarcinoma developed severe acneiform rash and pruritus during EGFRI therapy with panitumumab. Initial standard treatment with oral doxycycline was discontinued after two days due to severe gastrointestinal intolerance characterized by intense nausea and dyspepsia. With limited access to dermatological consultation, treatment with rose stem cell-derived exosomes (RSCEs) provided rapid symptom relief. Significant improvement was observed within 24 h, with complete resolution of pruritus and substantial reduction in inflammatory lesions within 72 h. RSCEs demonstrate anti-inflammatory effects through the modulation of pro-inflammatory cytokines including interleukin-6, interleukin-1β, and tumor necrosis factor-α, while promoting fibroblast proliferation and collagen synthesis enhancement. They may represent a possible alternative to corticosteroids, avoiding associated side effects such as skin atrophy, delayed wound healing, and local immunosuppression. This case underscores the potential of innovative treatments like RSCEs in managing EGFRI-induced skin complications when standard therapies are not tolerated, particularly in healthcare systems with limited dermato-oncological resources.

Xin Luo, Ting Mao, Xi Wang et al.

Abstract Cholestasis, a bile flow disorder common to many liver diseases, currently lacks effective treatments. Emerging evidence links gut microbiota disturbances to cholestatic liver injury. Here, an antibiotic cocktail (ABX)-treated mouse model confirmed the indispensable role of the intestinal microbiota, with marked shifts including increased Alistipes putredinis (A. putredinis) and decreased Clostridium spp. (C. spp.). In vitro, ferulic acid and wogonin effectively modulated the gut flora, and in vivo they alleviated liver injury. Administration of A. putredinis exacerbated hepatic inflammation by disrupting intestinal barrier integrity and facilitating bacterial translocation, an effect reversed by ferulic acid. Conversely, treatment with C. spp. and wogonin enhanced bile salt hydrolase activity and bile acid excretion. Notably, combined treatment with ferulic acid and wogonin or C. spp. significantly ameliorated cholestatic liver injury. These findings underscore the critical role of gut microbiota in cholestasis and suggest therapeutic potential for microbiota-targeted and natural compound-based interventions.

Rama Rao Tadikonda, Aditya Anand

Carrier technology offers a innovative method for medication distribution by connecting drugs to carrier particles like liposomes, nanoparticles, or microspheres. Microspheres, with their small size and effective characteristics, are crucial in this particle medication delivery method. Mucoadhesive microspheres achieve better drug absorption by sticking to the mucosal surface and releasing the medication over an extended period. Microspheres are spherical, freely flowing, made of natural or synthetic polymers with a particle size range of 1-1000μm. Due to their unique size-dependent property and ability to include medications in carriers, lipid microspheres offer potential for novel treatments. There are several methods for preparing microspheres and releasing the medication at the intended site of action in a steady and regulated way. Due to their enhanced half-life, oral delivery capabilities, and better therapeutic responses, microspheres have gained interest in targeting and treating various illnesses. This article reviewed about the mucoadhesive microspheres, its mechanism, preparation methods and also the recent trends being achieved on mucoadhesive microspheres.

Gema J. Cabañero-Resta, Bárbara Sánchez-Dengra, Alejandro Ruiz-Picazo et al.

Itraconazole is a drug used in veterinary medicine for the treatment of different varieties of dermatophytosis at doses between 3–5 mg/kg/day in cats. Nevertheless, in Spain, it is only available in the market as a 52 mL suspension at 10 mg/mL. The lack of alternative formulations, which provide sufficient formulation to cover the treatment of large animals or allow the treatment of a group of them, can be overcome with compounding. For this purpose, it has to be considered that itraconazole is a weak base, class II compound, according to the Biopharmaceutics Classification System, that can precipitate when reaching the duodenum. The aim of this work is to develop alternative oral formulations of itraconazole for the treatment of dermatophytosis. Several oral compounds of itraconazole were prepared and compared, in terms of dissolution rate, permeability, and stability, in order to provide alternatives to the medicine commercialized. The most promising formulation contained hydroxypropyl methylcellulose and β-cyclodextrin. This combination of excipients was capable of dissolving the same concentration as the reference product and delaying the precipitation of itraconazole upon leaving the stomach. Moreover, the intestinal permeability of itraconazole was increased more than two-fold.

Fitra Romadhonsyah, Putrilia Dyah Puspitasari, Shubhi Mahmashony Harimurti et al.

Masyarakat Indonesia dikenal memiliki cara pengobatan tradisional dengan menggunakan tanaman obat dengan berlandaskan warisan atau cerita turun-temurun dari nenek moyang dan bersifat immaterial atau mitos. Minimnya dokumentasi membuat penggunaan obat tradisional belum maksimal. Penelitian ini bertujuan untuk mengetahui pengetahuan masyarakat terkait penggunaan tanaman obat sebagai pengobatan dan mengetahui jenis tanaman yang digunakan untuk pengobatan di Kampung Demi, Bantul, Yogyakarta. Teknik pengambilan sampel yang digunakan adalah purposive sampling dengan observasi menggunakan instrument berupa kuesioner. Jumlah sampel responden yang memenuhi kriteri inklusi sebanyak 51 responden. Data hasil dianalisis menggunakan ICF (Informant Consensus Factor). Hasil penelitian menunjukkan 97,12% responden memahami kemanfaatan tanaman obat, 64,70% responden menyatakan bahwa memahami pengobatan tradisional merupakan turun-temurun dari keluarga, 49,02% responden mendapatkan tanaman obat dari pekarangan sendiri, 74,51% responden sering menggunakan obat tradisional dibanding obat konvensional, dan ada 11 jenis tanaman obat yang dipakai oleh responden untuk pengobatan. Kategori penyakit yang diobati dengan jenis tumbuhan obat terbanyak ada 10 jenis penyakit medis (ICF = 1,0) dan 2 jenis kebiasaan magis/non-medis (ICF = 1,0).

Rajathilagam Thiruvengadam, Initha B, Varahi Vedam V A et al.

Background: Hypertension is a chronic disorder and a prevalent non-communicable disease in India. With the increasing burden of hypertension, adherence to antihypertensive therapy plays a vital role to control blood pressure and preventing its complications. Therefore, this study was done in our tertiary care hospital to understand the medication adherence level in hypertension patients. Aims and Objectives: To assess adherence to antihypertensive medications in hypertensive patients using pre-tested structured questionnaire. Materials and Methods: A prospective observational study was conducted for 3 months in 100 hypertensive patients. The adherence status of patients to antihypertensive medications was assessed using an eight-item Morisky's Medication Adherence Scale (MMAS-8). Results: Majority of the study participants in our study were >50 years (68%) and females (64%). We observed that patients taking combination therapy better adhered to medication than monotherapy. We assessed in detail the medication adherence level among study participants using MMAS-8 and analyzed the reasons for non-adherence. Conclusion: The medication adherence rate in our study was found to be moderate to high, which needs to be maintained to attain optimal clinical benefit and also to prevent hypertension-related complications. [Natl J Physiol Pharm Pharmacol 2023; 13(6.000): 1282-1288]

Mohammadhossein Hooshangi, Aynaz Nouri, Fatemeh Soleymani Lashkenari

Background The precision Medicine initiative is a new research exertion intending to offer personalized medicine in many illnesses, including cancer. The purpose of the current article is to offer novel insights about the role of personalized medicine in patients with colorectal liver metastases (CRLM). Experimental An assess the writing in regards to personalized medication and cancer in patient with colorectal liver metastases was performed in the MEDLINE/PubMed database. Result and discussion Surgical resection remains the main hope for a cure of CRLM. Worked on surgical scheme to improve remnant liver volume are as of late presented and making progress. Following resection of CRLM scoring methods have been evolved by amalgamated certain preoperative factors, for example, microsatellite instability KRAS expression and sensitivity to immunotherapy with programmed Death-1 inhibitor. conclusion Multidisciplinary management of patients with CRLM has particularly added to survival. While the most recent quite a few years have been described by these significant developments, future advances for patients with CRLM will rely upon a superior comprehension of genomics and molecular biology to promote with the portrayal of a specific tumor "identity" so that individualized therapy for each CRLM patient turns into the rule, and not the exception.

Paulo Teixeira-da-Silva, Jonás Samuel Pérez-Blanco, Dolores Santos-Buelga et al.

(1) Background: The aim of this study was to explore the valproic acid (VPA) pharmacokinetic characteristics in a large population of pediatric and adult Caucasian patients and to establish a robust population pharmacokinetic (PopPK) model. (2) Methods: A total of 2527 serum VPA samples collected from 1204 patients included in a therapeutic drug monitoring program were retrospectively analyzed. Patients were randomly assigned to either a model development group or an external evaluation group. PopPK analysis was performed on 1751 samples from 776 patients with NONMEM using a nonlinear mixed-effect modelling approach. The influence of demographic, anthropometric, treatment and comedication variables on the apparent clearance (CL/F) of VPA was studied. The bootstrap method was used to evaluate the final model internally. External evaluation was carried out using 776 VPA serum samples from 368 patients. (3) Results: A one-compartment model with first-order absorption and elimination successfully described the data. The final model included total body weight, age and comedication with phenytoin, phenobarbital and carbamazepine with a significant impact on VPA elimination. Internal and external evaluations demonstrated the good predictability of the model. (4) Conclusions: A PopPK model of VPA in Caucasian patients was successfully established, which will be helpful for model-informed precision dosing approaches in clinical patient care.

Pemula Gowtham, Koyeli Girigoswami, Pragya Pallavi et al.

Carbon-decorated ferrite nanodots (MNF@Cs) have been enhanced with superparamagnetism and higher fluorescence quantum yield by encapsulation with an alginate derivative to create a cost-effective and less toxic multimodal contrast agent for replacing the conventional heavy metal Gd-containing contrast agent used in MR imaging. The novel surface-engineered particles (MNF@C-OSAs), devoid of labels, can simultaneously provide both longitudinal and transverse relaxation-based magnetic resonance imaging (MRI) and fluorescence emission. According to the findings of in vitro studies, the calculated molar relaxivities and the molar radiant efficiencies are indicative of the multimodal efficacy of MNF@C-OSA as compared with MNF@C particles and conventional contrast agents used in medical imaging. MNF@C-OSAs were shown to be significantly biocompatible and negligibly toxic when assessed against A549 cells and zebrafish embryos, indicating their potential for use as theranostic agents.

Francesc Navarro-Pujol, Sanja Bulut, Charlotte Hessman et al.

The European Medical Agency (EMA) has issued a draft guideline on the quality and equivalence of topical products. The equivalence for complex semisolid formulations involves several steps: the same quantitative content, the same microstructure, the same release, and permeation profile. In this paper, several batches of a low strength topical product, which we used as a reference/comparator product, were evaluated according to the recommendations of the EMA draft guideline. The batches were 0.025% capsaicin emulsions from the same manufacturer that were evaluated in terms of droplet size, X-ray diffraction patterns, rheology, release, and permeation profile. The generated data revealed a large batch-to-batch variability, and if the EMA guideline was applied, these batches would not be considered equivalent, although they were produced by the same manufacturer. The result of this work illustrates the difficulties in obtaining equivalence according to the current draft guidelines. It also highlights that the equivalence guidelines should consider the variability of the comparator product, and in our opinion, the guidelines should allow for claiming equivalence by comparing the limits in the variability of the data generated for the comparator product with the limits in the variability of the data generated for the intended equivalence product.

Lukas Becker, Jasleen Singh Badwal, Fabian Brandl et al.

Anthrax toxin has evolved to translocate its toxic cargo proteins to the cytosol of cells carrying its cognate receptor. Cargo molecules need to unfold to penetrate the narrow pore formed by its membrane-spanning subunit, protective antigen (PA). Various alternative cargo molecules have previously been tested, with some showing only limited translocation efficiency, and it may be assumed that these were too stable to be unfolded before passing through the anthrax pore. In this study, we systematically and quantitatively analyzed the correlation between the translocation of various designed ankyrin repeat proteins (DARPins) and their different sizes and thermodynamic stabilities. To measure cytosolic uptake, we used biotinylation of the cargo by cytosolic BirA, and we measured cargo equilibrium stability via denaturant-induced unfolding, monitored by circular dichroism (CD). Most of the tested DARPin cargoes, including target-binding ones, were translocated to the cytosol. Those DARPins, which remained trapped in the endosome, were confirmed by CD to show a high equilibrium stability. We could pinpoint a stability threshold up to which cargo DARPins still get translocated to the cytosol. These experiments have outlined the requirements for translocatable binding proteins, relevant stability measurements to assess translocatable candidates, and guidelines to further engineer this property if needed.

Gabriela Brzuska, Gabriela Pastuch-Gawolek, Monika Krawczyk et al.

Tick-borne encephalitis virus (TBEV) transmitted by ticks is a pathogen of great medical importance. As still no effective antiviral treatment is available, in the present study, a series of uridine glycoconjugates containing amide or/and 1,2,3-triazole moiety in the linker structure was synthesized and evaluated for the antiviral activity against two strains of TBEV: a highly virulent Hypr strain and less virulent Neudoerfl strain, using standardized previously in vitro assays. Our data have shown that four compounds from the series (<b>18–21</b>) possess strong activity against both TBEV strains. The half maximal inhibitory concentration (IC₅₀) values of compounds <b>18–21</b> were between 15.1 and 3.7 μM depending on the virus strain, which along with low cytotoxicity resulted in high values of the selectivity index (SI). The obtained results suggest that these compounds may be promising candidates for further development of new therapies against flaviviruses.

Xavier Badia, Alicia Gil, José Luis Poveda-Andrés et al.

Objective: There are differences between countries regarding data requirements for orphan drug evaluation and it is also unknown which criteria might determine the price and reimbursement decision. This study aimed to identify the key criteria for price and reimbursement of orphan drugs in Spain, approved by the European Commission, between January 2012 and June 2018. Method: A descriptive analysis of the orphan drugs and its characteristics was performed. Outcomes criteria assessed were: therapeutic area, existence of alternative treatment, rarity of the disease, clinical trial outcomes and therapeutic positioning report assessment. Hypotheses for each variable regarding Spanish pricing and reimbursement were made and tested with two regression analyses. Results: Out of 78 orphan drugs approved by the European Commission, 82.1% asked pricing and reimbursement in Spain. From this, 43.8% had pricing and reimbursement approved and 20.3% rejected. Mean time from Spanish marketing authorisation approval to pricing and reimbursement approval was 12.1 ± 5.1 months. Having a positive therapeutic positioning report and no therapeutic alternatives would be associated with a positive pricing and reimbursement in Spain. Conclusions: It remains challenging to establish which are the driving criteria for pricing and reimbursement approval of orphan drugs in Spain. Further research should be done including other variables that might influence the pricing and reimbursement final decision in Spain.

Flor Álvarez de Toledo

Meritxell Pujal Herranz

Objective: The aim of this study is to evaluate the prevalence of proton pump inhibitors (PPIs) prescription, and the level of adequacy of the indication of these drugs in oncohematologic patients under ambulatory oncoespecific treatment. Method: An observational descriptive study in oncohematologic patients under ambulatory oncoespecific treatment. A protocol for the rational use of PPI targeted to oncohematologic patients based on the PPI protocol of our hospital was designed. Patients under active treatment with PPIs were quantified and the appropriateness of their indications evaluated. Results: 111 patients (71 oncologic and 40 hematologic) were included. 56% of all oncologic patients and 63% of all hematologic patients were under active treatment with PPIs. After reviewing the indications for PPI in all patients, 72% of oncologic and 12% of hematologic patients did not present evidence justifying treatment with these drugs. Conclusion: It is important the pharmacist to detect unappropriated prescriptions of PPIs, especially among oncologic patients, and to promote a deprescription of these drugs

Azizur Rahman, Mohamad Haniki Nik Mohamad, Shazia Jamshed

Objective: Electronic cigarette (e-cig) is recently growing substitute for smoking. The attention and practice of e-cig among consumers is expanded globally, and Malaysia is not an exception to this, but the paucity of local data motivates us to do the current research. Methods: A total of 220 e-cig vapers recruited for the study and divided into two categories based on smoking status as a single user and dual user. Both users observed for 1 month period to assess smoking cessation rate, adverse effects, withdrawal symptoms, and smoking-related diseases. Results: A month follow-up showed still 28.44% (P ≤ 0.001) of the entire study population (62 of 218, intention to treat analysis) were abstained from tobacco smoking. However, a high number of single user shown more quit rate as compared to of dual users (72.9% [51] vs. 7.4% [11]: Odds ratio 33.43; 95% confidence interval: 0.102–3.410) and merely two persons (<1%) started e-cig by ever smokers. The key adverse effects and withdrawal symptoms that observed in dual users were coughing, breathing problems, and craving, whereas in single users high appetite cases documented; however, no cases of any diseases reported among both users during the whole study period. Conclusion: A month follow-up showed a good smoking cessation rate among Malaysian vapers mainly in single users, whereas less number of quitters but the high reduction in tobacco cigarette consumption observed in dual users without any harmful effects. Furthermore, extended period studies are warranted to confirm its long-term safety and effectiveness among different Malaysian population.

P. del Río Pérez

Elizabeth Igne Ferreira

Ralf Landgraf, Qian Zhang

The use of nucleic acid derived aptamers has rapidly expanded since the introduction of SELEX in 1990. Nucleic acid aptamers have demonstrated their ability to target a broad range of molecules in ways that rival antibodies, but advances have been very uneven for different biochemical classes of targets, and clinical applications have been slow to emerge. What sets different aptamers apart from each other and from rivaling molecular recognition platforms, specifically proteins? What advantages do aptamers as a reagent class offer, and how do the chemical properties and selection procedures of aptamers influence their function? Do the building blocks of nucleic acid aptamers dictate inherent limitations in the nature of molecular targets, and do existing aptamers give us insight in how these challenges might be overcome? This review is written as an introduction for potential endusers of aptamer technology who are evaluating the advantages of aptamers as a versatile, affordable, yet highly expandable platform to target a broad range of biological processes or interactions.