Pub Date : 2014-10-29DOI: 10.4172/2167-065X.1000125
M. Vázquez, P. Fagiolino, Silvana Alvariza, M. Ibarra, Cecilia Maldonado, R. González, A. Laborde, M. Uría, A. Carozzi, C. Azambuja
Purpose: Cutaneous reactions can be associated with phenytoin administration. Such reactions can be explained by the formation of reactive species (arene oxide and quinones) capable of interacting covalently with cell macromolecules during phenytoin metabolism. Enzymes involved in reactive species detoxification are polimorphically expressed in humans. A genetic abnormality leading to a defective microsomal epoxidase hydrolase (main detoxification enzyme) activity could be one of the causes leading to this kind of adverse effect, but not the only one. The purpose of this study was to give a deeper insight into the main causes leading to skin reactions. Methods: Cutaneous reactions experienced by some healthy volunteers enrolled in a pharmacokinetic study of phenytoin were analyzed in depth. The activity of the microsomal epoxidase enzyme was determined. Results: Six out of twelve healthy volunteers receiving phenytoin in multiple doses exhibited rash. More female subjects or volunteers with a rapid input of the drug and/or a faster phenytoin metabolism or defective microsomal epoxidase hydrolase activity experienced these cutaneous reactions. Conclusions: Arene oxide metabolite seems to be the responsible entity for cutaneous reactions. The genesis of this adverse effect after phenytoin administration is multifactorial revealing that other risks factors (not only the genetic one) such as being a woman in the fertile life period or under contraceptive therapy, or a rapid drug input and /or a faster phenytoin metabolism could lead to a higher formation rate of the arene oxide.
{"title":"Skin Reactions Associated to Phenytoin Administration: Multifactorial Cause","authors":"M. Vázquez, P. Fagiolino, Silvana Alvariza, M. Ibarra, Cecilia Maldonado, R. González, A. Laborde, M. Uría, A. Carozzi, C. Azambuja","doi":"10.4172/2167-065X.1000125","DOIUrl":"https://doi.org/10.4172/2167-065X.1000125","url":null,"abstract":"Purpose: Cutaneous reactions can be associated with phenytoin administration. Such reactions can be explained by the formation of reactive species (arene oxide and quinones) capable of interacting covalently with cell macromolecules during phenytoin metabolism. Enzymes involved in reactive species detoxification are polimorphically expressed in humans. A genetic abnormality leading to a defective microsomal epoxidase hydrolase (main detoxification enzyme) activity could be one of the causes leading to this kind of adverse effect, but not the only one. The purpose of this study was to give a deeper insight into the main causes leading to skin reactions. \u0000Methods: Cutaneous reactions experienced by some healthy volunteers enrolled in a pharmacokinetic study of phenytoin were analyzed in depth. The activity of the microsomal epoxidase enzyme was determined. \u0000Results: Six out of twelve healthy volunteers receiving phenytoin in multiple doses exhibited rash. More female subjects or volunteers with a rapid input of the drug and/or a faster phenytoin metabolism or defective microsomal epoxidase hydrolase activity experienced these cutaneous reactions. \u0000Conclusions: Arene oxide metabolite seems to be the responsible entity for cutaneous reactions. The genesis of this adverse effect after phenytoin administration is multifactorial revealing that other risks factors (not only the genetic one) such as being a woman in the fertile life period or under contraceptive therapy, or a rapid drug input and /or a faster phenytoin metabolism could lead to a higher formation rate of the arene oxide.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88393775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-10-07DOI: 10.4172/2167-065X.1000124
J. D. Wolf, T. Dilles, R. V. Stichele, M. Elseviers
In 2005, the PHEBE study highlighted the problem of polypharmacy and the emerging use of psychotropic medication in nursing home residents (PHEBE 1). In 2011, new collected data were compared (PHEBE 2). The total mean number of prescriptions in PHEBE 1 was 8.4, containing a mean of 7.6 for chronic medication only. For PHEBE 2 this was 8.6 for total and 8.1 for chronic medication. In both investigations (2005-2011, resp.) the main categories were ‘Nervous system’ (88.3-89.2%), followed by ‘Cardiovascular system’ (78.0-84.8%) and ‘Alimentary tract and metabolism’ (81.1-83.2%). This study found that polypharmacy remains a major problem in residential care. The use of chronic medication further increased with a high consumption of psychotropic medication, beta-blockers and laxatives.
{"title":"Evolution of Drug Utilization in Nursing Homes in Belgium","authors":"J. D. Wolf, T. Dilles, R. V. Stichele, M. Elseviers","doi":"10.4172/2167-065X.1000124","DOIUrl":"https://doi.org/10.4172/2167-065X.1000124","url":null,"abstract":"In 2005, the PHEBE study highlighted the problem of polypharmacy and the emerging use of psychotropic medication in nursing home residents (PHEBE 1). In 2011, new collected data were compared (PHEBE 2). \u0000The total mean number of prescriptions in PHEBE 1 was 8.4, containing a mean of 7.6 for chronic medication only. For PHEBE 2 this was 8.6 for total and 8.1 for chronic medication. In both investigations (2005-2011, resp.) the main categories were ‘Nervous system’ (88.3-89.2%), followed by ‘Cardiovascular system’ (78.0-84.8%) and ‘Alimentary tract and metabolism’ (81.1-83.2%). \u0000This study found that polypharmacy remains a major problem in residential care. The use of chronic medication further increased with a high consumption of psychotropic medication, beta-blockers and laxatives.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84053176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-10-01DOI: 10.4172/2167-065X.1000123
S. Aghahowa, H. Obianwu, A. Isah
Background: The policy governing the treatment of malaria in Nigeria was changed in 2005 instituting the Artemisinin-Based Combination Therapies [ACTs] as first-line Drugs instead of Chloroquine due to rapidly developing resistance of Plasmodium falciparum. Methodology: The tolerability to [ACTs] was assessed in patients using a structured questionnaire and Visual analogue scale. These instruments were distributed systematically among the patients that presented with uncomplicated malaria after obtaining consent from the University of Benin Teaching Hospital, Benin City, Nigeria. Results: Among the five hundred and twenty patients that participated in the tolerability assessment of four different types of ACTs, male and female ratio was 1.3:1, Mean age 32.06 ± 2.3 years [Mean ± SD]. Artemether-Lumefantrine was the most frequently utilized and most tolerable. Two hundred and five [52.69%] respondents reported with forty-one different types of adverse effects of nine major systemic classes. Body weakness was the most frequent adverse effects reported in 112[54.63%] respondents. Adverse effects were significantly dependent on the type of ACTs used p<0.05; these were found to be most common with Artesunate-Mefloquine. Eleven patients were hospitalized due to very severe Body weakness and Dizziness. These severities were found common with Artesunate-Amodiaquine and Artesunate- Mefloqunie respectively. Despite the adverse effects, four hundred and seventy-six respondents (91.53%) were willing to repeat ACTs another time they have malaria. There were significant differences in symptomatic response on Days 0, 1, 2, 3, 7, 14 and 28 (p<0.05). 93% respondents felt extremely sick on Day 0, 68% had persistent fever on the third day of treatment and 71% had improved response after day 7. Conclusion: Anecdotal reports showed that ACTs have a modest tolerability, they are therefore recommended for patients that have uncomplicated malaria.
{"title":"Tolerabilities of Artemisinin-Based Combination Drugs among Patients with Uncomplicated Malaria in a Tertiary Institution Benin City, Nigeria","authors":"S. Aghahowa, H. Obianwu, A. Isah","doi":"10.4172/2167-065X.1000123","DOIUrl":"https://doi.org/10.4172/2167-065X.1000123","url":null,"abstract":"Background: The policy governing the treatment of malaria in Nigeria was changed in 2005 instituting the Artemisinin-Based Combination Therapies [ACTs] as first-line Drugs instead of Chloroquine due to rapidly developing resistance of Plasmodium falciparum. \u0000Methodology: The tolerability to [ACTs] was assessed in patients using a structured questionnaire and Visual analogue scale. These instruments were distributed systematically among the patients that presented with uncomplicated malaria after obtaining consent from the University of Benin Teaching Hospital, Benin City, Nigeria. \u0000Results: Among the five hundred and twenty patients that participated in the tolerability assessment of four different types of ACTs, male and female ratio was 1.3:1, Mean age 32.06 ± 2.3 years [Mean ± SD]. Artemether-Lumefantrine was the most frequently utilized and most tolerable. Two hundred and five [52.69%] respondents reported with forty-one different types of adverse effects of nine major systemic classes. Body weakness was the most frequent adverse effects reported in 112[54.63%] respondents. Adverse effects were significantly dependent on the type of ACTs used p<0.05; these were found to be most common with Artesunate-Mefloquine. Eleven patients were hospitalized due to very severe Body weakness and Dizziness. These severities were found common with Artesunate-Amodiaquine and Artesunate- Mefloqunie respectively. Despite the adverse effects, four hundred and seventy-six respondents (91.53%) were willing to repeat ACTs another time they have malaria. There were significant differences in symptomatic response on Days 0, 1, 2, 3, 7, 14 and 28 (p<0.05). 93% respondents felt extremely sick on Day 0, 68% had persistent fever on the third day of treatment and 71% had improved response after day 7. \u0000Conclusion: Anecdotal reports showed that ACTs have a modest tolerability, they are therefore recommended for patients that have uncomplicated malaria.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85695347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-09-23DOI: 10.4172/2167-065X.1000120
A. Chamberlain, B. Varisco
Acute Respiratory Distress Syndrome (ARDS) is a common respiratory complication of critical severe illness or injury. Despite steady improvement in outcomes over the last three decades, ARDS remains a common cause of morbidity and mortality in pediatric and adult intensive care units. Due to its extensive burden, ARDS has been the focus of numerous multi-center clinical trials which have attempted to translate animal, ex vivo, and small single center studies into wider practice. Since the results of several of these large studies have been recently published, we sought to review the pharmacology of ARDS, summarize the major non-pharmacologic interventions shown to improve outcome, and update the reader on evolving therapies which may enter clinical practice in the coming decade.
{"title":"The Pharmacology of Acute Respiratory Distress Syndrome","authors":"A. Chamberlain, B. Varisco","doi":"10.4172/2167-065X.1000120","DOIUrl":"https://doi.org/10.4172/2167-065X.1000120","url":null,"abstract":"Acute Respiratory Distress Syndrome (ARDS) is a common respiratory complication of critical severe illness or injury. Despite steady improvement in outcomes over the last three decades, ARDS remains a common cause of morbidity and mortality in pediatric and adult intensive care units. Due to its extensive burden, ARDS has been the focus of numerous multi-center clinical trials which have attempted to translate animal, ex vivo, and small single center studies into wider practice. Since the results of several of these large studies have been recently published, we sought to review the pharmacology of ARDS, summarize the major non-pharmacologic interventions shown to improve outcome, and update the reader on evolving therapies which may enter clinical practice in the coming decade.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81393938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-09-23DOI: 10.4172/2167-065X.1000122
M. Hussein, J. Lenjisa, M. Woldu, Gobeze Temesgen Tegegne, G. Umeta, Hunduma Dins, B. K. Gelaw
Hypertension is an important worldwide public-health challenge because of its high frequency and risk factor for cerebrovascular, cardiovascular and kidney disease. Drug therapy problems are a significant challenge to health care providers. It severely compromises the effectiveness of treatment making this a critical issue in population health both from the perspective of quality of life and of health economics. Therefore, the objective of this study is to determine the pattern and magnitude of drug therapy problems in the study hospital and to find out risk factors for these problems. The study was questionnaire-based Cross sectional design which was conducted from April to May 2014 at Adama Hospital Medical College. A convenient sampling method was used and a total of 192 hypertensive patients were included in the study. Data were analyzed using SPSS software program. In this study 155 (80.7%) patients have at least one drug therapy problem and a total of 452 drug therapy problems were identified in them. The most common drug therapy problem identified in this study was drug interaction (n=259, 58.7%), followed by non-adherence and adverse drug interaction constituting 19.5% and 18.6% respectively. Under dose accounts only 0.9% of all drug therapy identified. Marital status, number of drugs and number of co morbidities significantly affect drug therapy problems. The study showed that 80.7% of the patients in the study have drug therapy problems. Number of complications and number of drugs significantly affect drug therapy problems. Therefore, patients with multiple diagnosis and patients using multiple drugs should be closely monitored for drug therapy problem, to avoid clinically significant harmful consequences.
{"title":"Assessment of Drug Related Problems Among Hypertensive Patients on Follow up in Adama Hospital Medical College, East Ethiopia","authors":"M. Hussein, J. Lenjisa, M. Woldu, Gobeze Temesgen Tegegne, G. Umeta, Hunduma Dins, B. K. Gelaw","doi":"10.4172/2167-065X.1000122","DOIUrl":"https://doi.org/10.4172/2167-065X.1000122","url":null,"abstract":"Hypertension is an important worldwide public-health challenge because of its high frequency and risk factor for cerebrovascular, cardiovascular and kidney disease. Drug therapy problems are a significant challenge to health care providers. It severely compromises the effectiveness of treatment making this a critical issue in population health both from the perspective of quality of life and of health economics. Therefore, the objective of this study is to determine the pattern and magnitude of drug therapy problems in the study hospital and to find out risk factors for these problems. The study was questionnaire-based Cross sectional design which was conducted from April to May 2014 at Adama Hospital Medical College. A convenient sampling method was used and a total of 192 hypertensive patients were included in the study. Data were analyzed using SPSS software program. In this study 155 (80.7%) patients have at least one drug therapy problem and a total of 452 drug therapy problems were identified in them. The most common drug therapy problem identified in this study was drug interaction (n=259, 58.7%), followed by non-adherence and adverse drug interaction constituting 19.5% and 18.6% respectively. Under dose accounts only 0.9% of all drug therapy identified. Marital status, number of drugs and number of co morbidities significantly affect drug therapy problems. The study showed that 80.7% of the patients in the study have drug therapy problems. Number of complications and number of drugs significantly affect drug therapy problems. Therefore, patients with multiple diagnosis and patients using multiple drugs should be closely monitored for drug therapy problem, to avoid clinically significant harmful consequences.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72830658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-09-22DOI: 10.4172/2167-065X.1000121
Amit Jagannath Gavasane, H. Pawar
Polymers are becoming increasingly important in the field of drug delivery. The pharmaceutical applications of polymers range from their use as binders in tablets to viscosity and flow controlling agents in liquids, suspensions and emulsions. Use of polymer is now extended to controlled release and targeting drug delivery system. Polymers are obtained from natural source as well as synthesized chemically. Polymers are classified as biodegradable and nonbiodegradable. Biodegradable polymers have been widely used in biomedical applications because of their known biocompatibility and biodegradability. The present review gives an overview of the different biodegradable polymers that are currently being used in the development of controlled drug delivery system.
{"title":"Synthetic Biodegradable Polymers Used in Controlled Drug Delivery System: An Overview","authors":"Amit Jagannath Gavasane, H. Pawar","doi":"10.4172/2167-065X.1000121","DOIUrl":"https://doi.org/10.4172/2167-065X.1000121","url":null,"abstract":"Polymers are becoming increasingly important in the field of drug delivery. The pharmaceutical applications of polymers range from their use as binders in tablets to viscosity and flow controlling agents in liquids, suspensions and emulsions. Use of polymer is now extended to controlled release and targeting drug delivery system. Polymers are obtained from natural source as well as synthesized chemically. Polymers are classified as biodegradable and nonbiodegradable. Biodegradable polymers have been widely used in biomedical applications because of their known biocompatibility and biodegradability. The present review gives an overview of the different biodegradable polymers that are currently being used in the development of controlled drug delivery system.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82548982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-08DOI: 10.4172/2167-065X.1000119
F. Karaca, ÇiÄdem Usul AfÅar, Meral GünaldÄ, Berksoy Åahin
The examination of a twenty-eight-year-old male patient with lower back pain revealed a mass that extended through the spinal canal at the L1-L2 level and exhibited left paravertebral extension which was indistinguishable from the psoas muscle. Neuroblastoma was diagnosed after performing a biopsy. The disease progressed in that same year and in the following years, even after performing surgery, radiotherapy, chemotherapy, and bone marrow transplantation. The course of the disease was resistant to different high-dose chemotherapies and radiotherapy. The patient died four years after diagnosis. Neuroblastoma, a tumor which more frequently appears in children, is seen as an advanced or metastatic disease in adults. Currently there is no standard treatment for neuroblastoma in adults. The treatment protocols applied in children are insufficient for adults. Generally neuroblastoma is characterized as a localized disease, but in adults it is more aggressive.
{"title":"Neuroblastoma in the Adult: Which Therapy is Effective?","authors":"F. Karaca, ÇiÄdem Usul AfÅar, Meral GünaldÄ, Berksoy Åahin","doi":"10.4172/2167-065X.1000119","DOIUrl":"https://doi.org/10.4172/2167-065X.1000119","url":null,"abstract":"The examination of a twenty-eight-year-old male patient with lower back pain revealed a mass that extended through the spinal canal at the L1-L2 level and exhibited left paravertebral extension which was indistinguishable from the psoas muscle. Neuroblastoma was diagnosed after performing a biopsy. The disease progressed in that same year and in the following years, even after performing surgery, radiotherapy, chemotherapy, and bone marrow transplantation. The course of the disease was resistant to different high-dose chemotherapies and radiotherapy. The patient died four years after diagnosis. Neuroblastoma, a tumor which more frequently appears in children, is seen as an advanced or metastatic disease in adults. Currently there is no standard treatment for neuroblastoma in adults. The treatment protocols applied in children are insufficient for adults. Generally neuroblastoma is characterized as a localized disease, but in adults it is more aggressive.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80754716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-25DOI: 10.4172/2167-065X.1000118
S. Biro, T. Saikawa, Takatoshi Otonari, Y. Sawayama, M. Ageta, H. Obata, S. Kono, J. Sasaki
Activation of renin angiotensin system is implicated in insulin resistance. In mega trials, it has been suggested that angiotensin receptor blockers may be beneficial on insulin sensitivity in hypertensive patients. We conducted a multicenter, open-label, parallel-group trial to compare the effects of olmesartan and valsartan on insulin sensitivity and adiponectin levels in 206 hypertensive patients with diabetes mellitus or impaired glucose tolerance. Patients were randomly assigned to either olmesartan 20 mg/day or valsartan 80 mg/day treatment for 24 weeks. Blood pressure, fasting glucose, fasting insulin, glycosylated hemoglobin (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), and serum adiponectin levels were measured. The efficacy was evaluated in 197 patients (olmesartan, n=98; valsartan, n=99). At baseline, all parameters except for systolic blood pressure (SBP) and serum triglyceride did not differ between the 2 groups. HbA1c decreased slightly after a 24-week treatment with valsartan, but not olmesartan, while the decrease did not significantly differ in the two groups. There was no difference in the change from the baseline between olmesartan and valsartan groups concerning fasting glucose, fasting insulin, HOMA-IR, and adiponectin levels after 24-week treatment. The decrease in SBP tended to be greater in the olmesartan group than in the valsartan group even with adjustment for the baseline difference. In conclusion, there was no significant difference in insulin sensitivity or adiponectin levels between the olmesartan and valsartan groups. In the standard dose, olmesartan significantly decreased SBP as compared with valsartan.
{"title":"A Comparative Study of Olmesartan and Valsartan on Insulin Sensitivity in Hypertensive Patients with Diabetes Mellitus or Impaired Glucose Tolerance (OVIS Study)","authors":"S. Biro, T. Saikawa, Takatoshi Otonari, Y. Sawayama, M. Ageta, H. Obata, S. Kono, J. Sasaki","doi":"10.4172/2167-065X.1000118","DOIUrl":"https://doi.org/10.4172/2167-065X.1000118","url":null,"abstract":"Activation of renin angiotensin system is implicated in insulin resistance. In mega trials, it has been suggested that angiotensin receptor blockers may be beneficial on insulin sensitivity in hypertensive patients. We conducted a multicenter, open-label, parallel-group trial to compare the effects of olmesartan and valsartan on insulin sensitivity and adiponectin levels in 206 hypertensive patients with diabetes mellitus or impaired glucose tolerance. Patients were randomly assigned to either olmesartan 20 mg/day or valsartan 80 mg/day treatment for 24 weeks. Blood pressure, fasting glucose, fasting insulin, glycosylated hemoglobin (HbA1c), homeostasis model assessment for insulin resistance (HOMA-IR), and serum adiponectin levels were measured. The efficacy was evaluated in 197 patients (olmesartan, n=98; valsartan, n=99). At baseline, all parameters except for systolic blood pressure (SBP) and serum triglyceride did not differ between the 2 groups. HbA1c decreased slightly after a 24-week treatment with valsartan, but not olmesartan, while the decrease did not significantly differ in the two groups. There was no difference in the change from the baseline between olmesartan and valsartan groups concerning fasting glucose, fasting insulin, HOMA-IR, and adiponectin levels after 24-week treatment. The decrease in SBP tended to be greater in the olmesartan group than in the valsartan group even with adjustment for the baseline difference. In conclusion, there was no significant difference in insulin sensitivity or adiponectin levels between the olmesartan and valsartan groups. In the standard dose, olmesartan significantly decreased SBP as compared with valsartan.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82434341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-05-15DOI: 10.4172/2167-065X.1000117
Nivedita Tiwari, A. Thakur, Vinay Kumar, A. Dey, Vikas Kumar
Diabetes mellitus is a common form of metabolic disorder where level of blood glucose in the bloodstream raises high, because of deficiency of insulin and development of insulin resistance in diabetic individuals. It is categorize under modern age life style disorder, commonly affected by middle-aged people and the children in adolescents in most developed countries. Diabetic patients develop serious complication with the development of disease, such as obesity, risk of stroke and heart failure. The worldwide prevalence of diabetes is likely to increase from 382 million people in 2013 to 592 million by 2035. Globally antidiabetic drugs formulate the second-largest market by sales in the pharmaceuticals industry after cancer. Various novel targets have identified and recently various therapeutic leads successfully completed their different phases of clinical trials such as GLP-1 agonist, DPP-IV inhibitors, SGLT2 inhibitors, and are going to be the next generation therapy for management of diabetes. Presently the information was collects from PubMed, Science Direct, SciFinder and Google Scholar. In this review, we spotlighted on some common therapeutic targets involved in type 2 diabetes, offering a new concept for developing new drug candidates to produce newer generation antidiabetic drugs against type 2 diabetes.
{"title":"Therapeutic Targets for Diabetes Mellitus: An Update","authors":"Nivedita Tiwari, A. Thakur, Vinay Kumar, A. Dey, Vikas Kumar","doi":"10.4172/2167-065X.1000117","DOIUrl":"https://doi.org/10.4172/2167-065X.1000117","url":null,"abstract":"Diabetes mellitus is a common form of metabolic disorder where level of blood glucose in the bloodstream raises high, because of deficiency of insulin and development of insulin resistance in diabetic individuals. It is categorize under modern age life style disorder, commonly affected by middle-aged people and the children in adolescents in most developed countries. Diabetic patients develop serious complication with the development of disease, such as obesity, risk of stroke and heart failure. The worldwide prevalence of diabetes is likely to increase from 382 million people in 2013 to 592 million by 2035. Globally antidiabetic drugs formulate the second-largest market by sales in the pharmaceuticals industry after cancer. Various novel targets have identified and recently various therapeutic leads successfully completed their different phases of clinical trials such as GLP-1 agonist, DPP-IV inhibitors, SGLT2 inhibitors, and are going to be the next generation therapy for management of diabetes. Presently the information was collects from PubMed, Science Direct, SciFinder and Google Scholar. In this review, we spotlighted on some common therapeutic targets involved in type 2 diabetes, offering a new concept for developing new drug candidates to produce newer generation antidiabetic drugs against type 2 diabetes.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82699983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-05-02DOI: 10.4172/2167-065X.S2-006
N. Koseva
Cisplatin and its analogues display common drawbacks such as unfavorable toxicological profile, short blood circulation time and non-specific bio-distribution. Besides that, in biological fluids cisplatin is inactivated by nitrogenand sulphur-containing biomolecules. Drug conjugation to a water soluble polymer is a feasible approach to enhance therapeutic efficiency. Examples of carboxylate-containing polymer carriers of cisplatin and the effect of macromolecular architecture on the behavior of conjugates are discussed.
{"title":"Macromolecular Design of Platinum Drug Conjugates","authors":"N. Koseva","doi":"10.4172/2167-065X.S2-006","DOIUrl":"https://doi.org/10.4172/2167-065X.S2-006","url":null,"abstract":"Cisplatin and its analogues display common drawbacks such as unfavorable toxicological profile, short blood circulation time and non-specific bio-distribution. Besides that, in biological fluids cisplatin is inactivated by nitrogenand sulphur-containing biomolecules. Drug conjugation to a water soluble polymer is a feasible approach to enhance therapeutic efficiency. Examples of carboxylate-containing polymer carriers of cisplatin and the effect of macromolecular architecture on the behavior of conjugates are discussed.","PeriodicalId":10410,"journal":{"name":"Clinical Pharmacology & Biopharmaceutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84355427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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