DARU, Journal of Pharmaceutical Sciences
Volume:20 Issue: 2, 2012

The use of medicines by elderly people is a growing area of concern in social pharmacy. A significant proportion of older people do not follow the recommendations from physicians and refrain from buying prescribed medications. The aim of this study is to evaluate associations between self-rated health, somatic complaints and refraining from buying prescribed medications by elderly people. Data was collected in a cross-sectional study in 2009. We received 624 completed questionnaires (response rate – 48.9%) from persons aged 60–84 years living in Kaunas (Lithuania). Somatic complaints were measured with the 24 item version of the Giessen Complaint List (GBB-24). Logistic regression (Enter model) was used for evaluation of the associations between refraining from buying medications and somatic complaints. These associations were measured using odds ratio (OR) and calculating the 95% confidence interval (CI). The mean scores in total for the GBB scale and sub-scales (exhaustion, gastrointestinal and cardiovascular) were lowest among respondents who did not refrain from buying prescribed medications (means for GBB-24 scale: 21.04 vs. 24.82; p=0.001). Logistic regression suggests that somatic complaints were associated with a increased risk of refraining from buying prescribed medications (OR=1.35, 95% CI=1.15-1.60). Somatic complaints were significantly associated with the decision to refrain from buying prescribed medications.

The high cost and low level of cancer survival urge the finding of new drugs having better mechanisms. There is a high trend of patients to be «back to nature» and use natural products as an alternative way to cure cancer. The fact is that some of available anticancer drugs are originated from plants, such as taxane, vincristine, vinblastine, pacitaxel. Curcumin (diferuloylmethane), a dietary pigment present in Curcuma longa rizhome is reported to induce cell cycle arrest in some cell lines. Other study reported that genistein isolated from Glycine max seed inhibited phosphorylation of cdk1, gene involved during G2/M transition and thus could function as G2 checkpoint abrogator. The inhibition of cdk1 phosphorylation is one of alternative strategy which could selectively kill cancer cells and potentially be combined with DNA damaging agent such as curcumin. T47D cell line was treated with different concentrations of curcumin and genistein, alone or in combination; added together or with interval time. Flow Cytometry and MTT assay were used to evaluate cell cycle distribution and viability, respectively. The presence of apoptotic cells was determined using acridine orange-ethidium bromide staining. In this study curcumin induced G2 arrest on p53 deficient T47D cells at the concentration of 10 muM. Increasing concentration up to 30 muM increased the number of cell death. Whilst genistein alone at low concentration (<=10 muM) induced cell proliferation, addition of genistein (20 muM) 16 h after curcumin resulted in more cell death (89 %), 34 % higher than that administered at the same time (56 %). The combination treatment resulted in apoptotic cell death. Combining curcumin with high dose of genistein (50 muM) induced necrotic cells. Genistein increased the death of curcumin treated T47D cells. Appropriate timing of administration and concentration of genistein determine the outcome of treatment and this method could potentially be developed as an alternative strategy for treatment of p53 defective cancer cells.

None of the current pleurodesing agents fulfil all the criteria for best pleural sclerosant. Therefore, the search for the ideal agent for chemical pleurodesis still continues. The aim of the present study was to compare the effectiveness of erythromycin, tetracycline, Aerosil™ 200 (hydrophilic fumed amorphous silica), and erythromycin plus Aerosil™ 200 in producing pleurodesis in rats. In the present study, talc was not used as a pleurodesing agent due to an unavailability of its sterile and pure form in Iran. Overall, 75 adult male Spraque-Dawley rats were randomized to 5 treatment groups. Each group received an intrapleural injection via 5 Fr Silastic tubes of one of the following sterile agents: 35mg/kg erythromycin in 2 ml of saline, 35mg/kg tetracycline in 2 ml of saline, 35mg/kg Aerosil™ 200 in 2ml of saline, erythromycin (35mg/kg in 2 ml of saline) plus Aerosil™ 200 (35mg/kg in 2 ml of saline), or 2 ml of saline as a control. The animals were euthanized and necropsied 30 days after injection. The pleurae were assessed for macroscopic and microscopic evidence of surrounding inflammation and fibrosis. The median macroscopic score in the Aerosil™ 200 group was significantly higher than that in the erythromycin group (P < 0.005). The median microscopic score in the erythromycin group was significantly lower than that in the Aerosil™ 200 and erythromycin plus Aerosil™ 200 groups (P < 0.005). Furthermore, maximum and minimum pleural fibrosis was observed in the erythromycin plus Aerosil™ 200 and erythromycin groups, respectively (P < 0.05). This study suggests that Aerosil™ 200 with or without erythromycin may be more potent pleurodesis agent than erythromycin and tetracycline.

Inhibitors of pancreatic alpha-amylase are potential drugs to treat diabetes and obesity. In order to find compounds that would be effective amylase inhibitors, in vitro and in vivo models are usually used. The accuracy of models is limited, but these tools are nonetheless valuable. In vitro models could be used in large screenings involving thousands of chemicals that are tested to find potential lead compounds. In vivo models are still used as preliminary mean of testing compounds behavior in the whole organism. In the case of alpha-amylase inhibitors, both rats and rabbits could be chosen as in vivo models. The question was which animal could present more accuracy with regard to its pancreatic alpha-amylase. As there is no crystal structure of these enzymes, a molecular modeling study was done in order to compare the rabbit and rat enzymes with the human one. The overall result is that rabbit enzyme could probably be a better choice in this regard, but in the case of large ligands, which could make putative interactions with the 4 subsite of pancreatic alpha-amylase, interpretation of results should be made cautiously. Molecular modeling tools could be used to choose the most suitable model enzyme that would help to identify new enzyme inhibitors. In the case of alpha-amylase, three-dimensional structures of animal enzymes show differences with the human one which should be taken into account when testing potential new drugs.

Some observations and reports show that people with high consumption of Solanum aethiopicum (African garden egg) have relief in arthritic pains and swelling. We aimed at assessing the effect of methanol extract of Solanum aethiopicum in experimentally induced inflammation using leukocyte mobilization and vascular permeability tests in rats and human red blood cell (HRBC) membrane stabilization as studies. Twenty five (25) adult Wistar rats of either sex (120 g – 200 g) divided into five groups of five rats each were used for each of the animal models. Groups 2, 3 and 4 were administered varied doses of the extract (100, 200 and 400 mg/kg), while groups 1 (vehicle control) and 5 (treatment control) received normal saline and indomethacin (50 mg/kg) respectively. Vascular permeability was induced by the intra-peritoneal injection of 1 ml of acetic acid and monitored using 0.5 ml intravenous injection of 1% Evans blue solution. Leukocyte mobilization was induced by the intra-peritoneal injection of 0.5 ml of 3% agar suspension in normal saline. Heat and hypotonicity induced heamolysis of HRBC membrane was used to assess membrane stabilization. The methanol extracts of garden egg significantly and dose dependently reduced (p≤0.05) the acetic acid induced vascular permeability and agar induced leukocyte mobilization in rats. The percentage inhibitions of induced vascular permeability were 21 ± 3.39, 25 ±1.92 and 60 ± 3.81 for the 100, 200 and 400 mg/kg of the extract while the inhibitions of the agar induced leucocyte migration were 23 ± 2.17, 26 ± 1.58 and 32 ± 1.58 for the 100, 200 and 400 mg/kg of the extract respectively. The extract also, at doses of 100, 200, 400, 600 and 800 μg/ml significantly inhibited heat induced lysis of the human red cell membrane with values of 66.46 ± 2.89, 65.14 ± 4.58, 46.53 ± 2.52, 61.88 ± 4.51and 86.67 ± 3.06 respectively. These results show that methanol extract of Solanum aethiopicum has anti-inflammatory properties and can reduce inflammatory injury and tissue damage.

Selective serotonin reuptake inhibitors (SSRIs) are the most frequently used antidepressants during pregnancy. There are conflicting results about their influence on pregnancy outcomes. The goal of this study was to update our previous meta-analysis about pregnancy outcomes following exposure to SSRIs. For this purpose, all relevant databases were searched from 1990 to March 2012 for studies investigating the pregnancy outcomes following exposure to any therapeutic dosage of any SSRI (fluoxetine, paroxetine, citalopram, escitalopram, sertraline, fluvoxamine) during pregnancy. Types of outcome investigated were spontaneous abortion, major malformations, cardiovascular malformations, and minor malformations. A total of 25 studies met our criteria and were included in the meta-analysis. The odds ratio (OD) values are 1.87 (95% CI: 1.5 to 2.33, P< 0.0001) for spontaneous abortion, 1.272 (95% CI: 1.098 to 1.474, P = 0.0014) for major malformations, 1.192 (95% CI: 0.39 to 3.644, P= 0.7578) for cardiovascular malformations, and 1.36 (95% CI: 0.61 to 3.04, P= 0.4498) for minor malformations. The results demonstrated that SSRIs increase the risk of spontaneous abortion and major malformations during pregnancy while they don''t increase the risk of cardiovascular malformations and minor malformations. Our previous meta-analysis only showed an increase in the risk of spontaneous abortion following the use of SSRIs during pregnancy. This might be due to increase in the number of studies included or addition of two new SSRIs (citalopram and escitalopram). The message to researchers is to try considering SSRIs individually during pregnancy to reduce heterogeneity, although all are aware of inevitable limitations to study on pregnant mothers.

Organophosphorous (OP) Nerve agents (NAs) are known as the deadliest chemical warfare agents. They are divided into two classes of G and V agents. Most of them are liquid at room temperature. NAs chemical structures and mechanisms of actions are similar to OP pesticides, but their toxicities are higher than these compounds. The main mechanism of action is irreversible inhibition of Acetyl Choline Esterase (AChE) resulting in accumulation of toxic levels of acetylcholine (ACh) at the synaptic junctions and thus induces muscarinic and nicotinic receptors stimulation. However, other mechanisms have recently been described. Central nervous system (CNS) depression particularly on respiratory and vasomotor centers may induce respiratory failure and cardiac arrest. Intermediate syndrome after NAs exposure is less common than OP pesticides poisoning. There are four approaches to detect exposure to NAs in biological samples: (I) AChE activity measurement, (II) Determination of hydrolysis products in plasma and urine, (III) Fluoride reactivation of phosphylated binding sites and (IV) Mass spectrometric determination of cholinesterase adducts. The clinical manifestations are similar to OP pesticides poisoning, but with more severity and fatalities. The management should be started as soon as possible. The victims should immediately be removed from the field and treatment is commenced with auto-injector antidotes (atropine and oximes) such as MARK I kit. A 0.5% hypochlorite solution as well as novel products like M291 Resin kit, G117H and Phosphotriesterase isolated from soil bacterias, are now available for decontamination of NAs. Atropine and oximes are the well known antidotes that should be infused as clinically indicated. However, some new adjuvant and additional treatment such as magnesium sulfate, sodium bicarbonate, gacyclidine, benactyzine, tezampanel, hemoperfusion, antioxidants and bioscavengers have recently been used for OP NAs poisoning.