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IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-12-31 DOI: 10.2174/157488471403191231122122

Georgescu Adriana

引用次数: 0

Oral and Intra-nasal Administration of Nanoparticles in the Cerebral Ischemia Treatment in Animal Experiments: Considering its Advantages and Disadvantages 口服和鼻内给药纳米颗粒治疗脑缺血的动物实验:考虑其优缺点

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-12-31 DOI: 10.2174/22123938otkzpotu1tcvy

Firoozeh Alavian and Nasrin Shams

引用次数: 14

Prevalence and Predictors of Self-Medication Practices in India:  A Systematic Literature Review and Meta-Analysis 印度自我药物治疗的患病率和预测因素: 系统文献综述和荟萃分析

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-11-21 DOI: 10.2174/1574884714666191122103953

Muhammed Rashid, M. Chhabra, A. Kashyap, K. Undela, S. K. Gudi

Background Self-Medication (SM) is a practice of using medications to treat self-diagnosed symptoms without a legitimate prescription by a health care professional. Alongside posing a burden on a patient, SM practices are associated with certain unfavourable health conditions such as drug-resistance, adverse effects, drug-interactions, including death. Objective To systematically review and quantify the prevalence of SM practices and its associated factors in India. Methods A comprehensive systematic search was performed using scientific databases such as PubMed and Cochrane library for the peer-reviewed research articles that were conducted in India without any language and date restrictions. Studies which were cross-sectional by design and assessing the prevalence and predictors of SM practices in India were considered for the review, and all the relevant articles were screened for their eligibility. Results Of 248 articles, a total of 17 articles comprising of 10,248 participants were included in the meta-analysis. Overall, the mean prevalence of SM practices in India was observed to be 53.57%. Familiarity with the medication appears to be a major reason to practice SM (PR: 30.45; 95%  Confidence Interval [CI]: 17.08-43.82; 6 studies), and the practice was noticed more among  individuals from a middle-lower class family with a prevalence rate of 26.31 (95%CI: 2.02-50.60; P<0.0001). Minor ailments were the primary reason for practicing SM (PR: 42.46; 95%CI: 21.87-63.06), among which headache was the most commonly reported (PR: 41.53; 95%CI: 18.05-65.02). Conclusion Self-medication practices are quite frequent in India. While NSAIDs and anti-allergens are the most frequently utilized self-medicated drugs used for headache and cold and cough.

背景自我用药（SM）是一种在没有医疗保健专业人员合法处方的情况下使用药物治疗自我诊断症状的做法。SM做法除了给患者带来负担外，还与某些不利的健康状况有关，如耐药性、不良反应、药物相互作用，包括死亡。目的系统地回顾和量化SM在印度的流行情况及其相关因素。方法使用PubMed和Cochrane图书馆等科学数据库对在印度进行的同行评审研究文章进行全面系统的检索，不受任何语言和日期限制。审查考虑了通过设计和评估印度SM实践的流行率和预测因素进行的横断面研究，并对所有相关文章进行了资格筛选。结果在248篇文章中，共有17篇文章被纳入荟萃分析，共有10248名参与者。总体而言，印度SM实践的平均患病率为53.57%。熟悉药物似乎是实践SM的主要原因（PR:30.45；95% 置信区间[CI]：17.08-43.82；6项研究），这种做法在 个体来自中下层家庭，患病率为26.31（95%CI:2.02-50.60；P<0.0001）。小病是实施SM的主要原因（PR:42.46；95%CI:21.87-63.06），其中头痛是最常见的报告（PR:41.53；95%CI:18.05-65.02）。而非甾体抗炎药和抗过敏原是治疗头痛、感冒和咳嗽最常用的自我药物。

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引用次数: 19

Effects of Probiotics and Prebiotics on Frailty and Ageing: A Narrative Review. 益生菌和益生素对虚弱和衰老的影响：叙述性综述。

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-11-20 DOI: 10.2174/1574884714666191120124548

Kulapong Jayanama, O. Theou

Globally, the population over the age of 60 is growing fast, but people age in different ways. Frailty, shown by the accumulation of age-related deficits, is a state of increased vulnerability to adverse outcomes among people of the same chronological age. Ageing results in a decline in diversity and homeostasis of microbiomes, and gut flora changes are related to health deficit accumulation and adverse health outcomes. In older people, health deficits including inappropriate intake, sarcopenia, physical inactivity, polypharmacy, and social vulnerability are factors associated with gut dysbiosis. The use of probiotics and prebiotics is a cost-effective and widely available intervention. Intake of probiotics and prebiotics may improve the homeostasis of gut microflora and prevent frailty and unhealthy aging. However, health effects vary among probiotics and prebiotics and among individual populations. This narrative review summarizes recent evidence about the relationship of prebiotic and probiotic consumption with health outcomes in older people.

在全球范围内，60岁以上的人口正在快速增长，但人们的衰老方式各不相同。衰弱，表现为与年龄相关的缺陷的积累，是一种对相同实际年龄的人的不利结果更容易受到伤害的状态。衰老导致微生物群多样性和动态平衡的下降，肠道菌群的变化与健康赤字积累和不良健康结果有关。在老年人中，健康缺陷包括不适当的摄入、肌肉减少症、缺乏身体活动、多种药物和社会脆弱性是与肠道生态失调相关的因素。使用益生菌和益生元是一种具有成本效益和广泛可用的干预措施。摄入益生菌和益生元可以改善肠道菌群的动态平衡，防止虚弱和不健康的衰老。然而，益生菌和益生元对健康的影响因人群而异。这篇叙述性综述总结了最近关于益生元和益生菌消费与老年人健康结果关系的证据。

引用次数: 19

Tenofovir urine assay to monitor adherence to HIV pre-exposure prophylaxis (PrEP). 替诺福韦尿检测监测HIV暴露前预防(PrEP)依从性。

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-11-11 DOI: 10.2174/1574884714666191111125348

G. Moorthy, L. Lalley-Chareczko, H. Koenig, A. Zuppa

BACKGROUNDTenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) are prodrugs of tenofovir and have excellent long-term efficacy and tolerability for the treatment of HIV. An objective marker of adherence to tenofovir-based therapy could be clinically useful in supporting adherence to TDF-based HIV pre-exposure prophylaxis (PrEP) in populations in whom self-report has been shown to be unreliable, and could play a role in resource-limited settings to support HIV and hepatitis B treatment adherence.METHODSA semi-quantitative high-performance liquid chromatography-mass spectrometry method for tenofovir quantification of urine samples was developed. This assay detects tenofovir concentration in log10 levels between 1 and 10,000 ng/mL, and was shown to distinguish between recent adherence and low/non-adherence to both TDF and TAF, with a concentration of >1000 ng/mL highly predictive of medication ingestion in the last 24-48 hours.RESULTSThis assay was validated relative to other markers of adherence including dried blood spot and self-report in a highly adherent population of PrEP patients, and tenofovir was shown to be stable at room temperature in urine for at least 14 days. The assay was successfully used in a clinical setting to maintain high PrEP adherence and retention in care in 50 young men who have sex with me (MSM) over 48 weeks, to assess PrEP adherence in youth with mental health conditions, and to monitor drug levels relative to plasma levels in a case study of chewed TDF/FTC (tenofovir/emtricitabine) for PrEP.CONCLUSIONThe findings of this review confirm the utility of tenofovir urine assay to monitor adherence to HIV pre-exposure prophylaxis. Further studies are underway to implement the tenofovir urine assay to monitor adherence and pre-exposure prophylaxis, nationally and internationally.

背景富马酸替诺福韦二酯（TDF）和替诺福韦·阿拉芬酰胺（TAF）是替诺福韦的前药，对治疗HIV具有良好的长期疗效和耐受性。在自我报告被证明不可靠的人群中，坚持以替诺福韦为基础的治疗的客观标志物可能在临床上有助于支持坚持以TDF为基础的HIV暴露前预防（PrEP），并可能在资源有限的环境中发挥作用，以支持HIV和乙型肝炎治疗的坚持。方法建立了尿中替诺福韦的半定量高效液相色谱-质谱分析方法。该测定检测到替诺福韦的log10浓度在1至10000 ng/mL之间，并被证明可以区分最近对TDF和TAF的依从性和低/不依从性，>1000 ng/mL的浓度高度预测最后24-48小时内的药物摄入。结果在高度粘附的PrEP患者群体中，该测定相对于其他粘附标记物（包括干血点和自我报告）得到了验证，并且替诺福韦在室温下在尿液中至少稳定14天。该测定在临床环境中成功用于在48周内对50名与我发生性关系的年轻男性（MSM）保持高PrEP依从性和护理保留，并在一项咀嚼TDF/FTC（替诺福韦/恩曲他滨）治疗PrEP的病例研究中监测药物水平相对于血浆水平的关系。结论本综述的研究结果证实了泰诺福韦尿液分析法在监测HIV暴露前预防依从性方面的实用性。国家和国际上正在进行进一步的研究，以实施替诺福韦尿液分析来监测依从性和暴露前预防。

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引用次数: 7

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IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-10-25 DOI: 10.2174/157488471402190906102203

R. Mehvar

引用次数: 0

Formulation and evaluation of polyherbal cream and lotion to treat psoriasis-induced secondary infections. 多羟基乳膏和洗剂治疗银屑病继发感染的配方和评价。

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-10-17 DOI: 10.2174/1574884714666191017111218

P. Joshi, Sushil Joshi, Urvashi Rajani, R. Semwal, D. Semwal

BACKGROUNDPsoriasis is one of the most common skin diseases in human and affected a major population worldwide. Aim: The aim of the present study is to evaluate the efficacy of selected polyherbal formulations against psoriasis-induced secondary infections. Methods: Samples were collected from the scalp, behind the ears, chest and back of the patients. The microscopic examination of fungal and bacterial growth was carried out with lactophenol cotton blue stain and gram stain respectively. Volatile constituents of essential oils were identified by GC-MS analysis, in order to investigate the relation between chemical composition and biological activity. Nutrient agar media was used for antibacterial activity whereas Sabourauds dextrose agar media was used for antifungal activity. Results: A total of 24 isolates were obtained from 2 patient of scalp psoriasis. Anti-oxidant activity of the samples was determined using DPPH radical scavenging method. In the present study, EOs showed a good antifungal action against Malassezia pachydermatis and other microbial strains. The GC-MS analysis revealed the presence of eugenol, linalool, citral, neral, limonene, terpenes, eucalyptol and thymol in the essential oils. The formulated retention lotion 1 (L4), 2 (L5), 3 (L6) and cream 1 (C1) showed DPPH radical scavenging activity by 23.52%, 24.48%, 28% and 5.08%, respectively. Conclusion: The present study concluded that most of the formulated lotions and creams showed good antimicrobial activity and may be applied topically against scalp psoriasis.

背景银屑病是人类最常见的皮肤病之一，影响着世界范围内的主要人群。目的：本研究的目的是评估选定的多羟基制剂对银屑病诱导的继发感染的疗效。方法：从患者的头皮、耳后、胸部和背部采集样本。分别用乳酚棉蓝染色和克氏染色对真菌和细菌的生长进行显微镜检查。采用气相色谱-质谱联用技术对挥发油的挥发性成分进行了鉴定，以探讨挥发油的化学组成与生物活性之间的关系。营养琼脂培养基用于抗菌活性，而Sabourauds葡萄糖琼脂培养基则用于抗真菌活性。结果：从2例头皮银屑病患者中分离得到24个分离株。采用DPPH自由基清除法测定了样品的抗氧化活性。在本研究中，EOs对厚皮马拉色菌和其他微生物菌株表现出良好的抗真菌作用。GC-MS分析表明，精油中存在丁香酚、芳樟醇、柠檬醛、总黄酮、柠檬烯、萜烯、桉树醇和百里酚。配制的保留洗剂1（L4）、2（L5）、3（L6）和乳膏1（C1）对DPPH自由基的清除活性分别为23.52%、24.48%、28%和5.08%。结论：本研究得出结论，大多数配方乳液和乳膏具有良好的抗菌活性，可用于头皮银屑病的局部治疗。

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引用次数: 3

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IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-03-13 DOI: 10.2174/157488471401190301120023

F. Kugawa

引用次数: 0

Concomitant Use of Cotrimoxazole and Atazanavir in HIV-infected Patients: A Therapeutic Drug Monitoring and Pharmacovigilance Based Dual Approach. 复方新诺明和阿扎那韦在hiv感染者中的联合应用:一种基于药物监测和药物警戒的双重方法。

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-01-01 DOI: 10.2174/1574884714666190405160612

Miantezila B Joe, Landman Roland, Chouchana Laurent, Lê M Patrick, Olivier Sawoo, Tona L Gaston, Eto Bruno, Peytavin Gilles, Pochart Philippe

Background: Cotrimoxazole is the main antibiotic used in primary prophylaxis for opportunistic infections in advanced HIV infection. This drug can inhibit one of the metabolic pathways of atazanavir (ATV), such as the cytochromes P450 (CYP) 2C8/2C9 and could interfere with its safety and efficacy.

Objective: We studied the drug-drug interaction (DDI) between cotrimoxazole and ATV by using therapeutic drug monitoring (TDM) and pharmacovigilance (PV) approaches.

Methods: We compared a group of patients treated with cotrimoxazole and receiving an ATV-based regimen to controls. This historical cohort analysis used data from Dat'AIDS in HIV-infected patients who had at least two lowest plasma concentrations (C-trough) of ATV during their outpatient follow-up. Likewise, we used the international pharmacovigilance data from VigiBase to evaluate the notifications of hyperbilirubinemia reported with ATV.

Results: In the TDM analysis, the two groups of patients (treated with cotrimoxazole and controls) were almost homogeneous concerning the main baseline features. After at least six months of ATVbased regimen, there was no significant difference in the safety threshold of the ATV C-trough [with an adjusted odds ratio (aOR) of 1.4 (95% CI: 0.5 - 4.4)] compared to controls. We observed similar results with the efficacy thresholds of ATV C-trough. Regarding the PV analysis, there was no difference in hyperbilirubinemia occurring with ATV when cotrimoxazole was concomitant, with an adjusted reporting odds ratio (aROR) of 0.9 (95% CI: 0.6 to 1.2).

Conclusion: This study showed a relevant concomitant use between Cotrimoxazole and ATV based on TDM and PV approaches.

背景:复方新诺明是用于晚期HIV感染机会性感染初级预防的主要抗生素。该药可抑制阿扎那韦(atazanavir, ATV)的代谢途径之一细胞色素P450 (CYP) 2C8/2C9，影响其安全性和有效性。目的:采用治疗药物监测(TDM)和药物警戒(PV)方法研究复方新诺明与ATV的药物相互作用(DDI)。方法:我们将一组接受复方新诺明和以atv为基础的方案的患者与对照组进行比较。这一历史队列分析使用了来自Dat'AIDS的hiv感染患者的数据，这些患者在门诊随访期间至少有两次最低的ATV血浆浓度(c -谷)。同样，我们使用来自VigiBase的国际药物警戒数据来评估ATV报告的高胆红素血症通知。结果:在TDM分析中，两组患者(复方新诺明治疗组和对照组)在主要基线特征上几乎一致。在以ATV为基础的治疗方案至少6个月后，与对照组相比，ATV c -谷的安全阈值无显著差异[校正优势比(aOR)为1.4 (95% CI: 0.5 - 4.4)]。我们观察到与ATV c -谷疗效阈值相似的结果。关于PV分析，复方新诺明合用ATV时发生的高胆红素血症没有差异，校正报告优势比(aROR)为0.9 (95% CI: 0.6至1.2)。结论:本研究显示复方新诺明与ATV在TDM和PV方法基础上的相关合用。

{"title":"Concomitant Use of Cotrimoxazole and Atazanavir in HIV-infected Patients: A Therapeutic Drug Monitoring and Pharmacovigilance Based Dual Approach.","authors":"Miantezila B Joe, Landman Roland, Chouchana Laurent, Lê M Patrick, Olivier Sawoo, Tona L Gaston, Eto Bruno, Peytavin Gilles, Pochart Philippe","doi":"10.2174/1574884714666190405160612","DOIUrl":"https://doi.org/10.2174/1574884714666190405160612","url":null,"abstract":"Background: Cotrimoxazole is the main antibiotic used in primary prophylaxis for opportunistic infections in advanced HIV infection. This drug can inhibit one of the metabolic pathways of atazanavir (ATV), such as the cytochromes P450 (CYP) 2C8/2C9 and could interfere with its safety and efficacy.Objective: We studied the drug-drug interaction (DDI) between cotrimoxazole and ATV by using therapeutic drug monitoring (TDM) and pharmacovigilance (PV) approaches.Methods: We compared a group of patients treated with cotrimoxazole and receiving an ATV-based regimen to controls. This historical cohort analysis used data from Dat'AIDS in HIV-infected patients who had at least two lowest plasma concentrations (C-trough) of ATV during their outpatient follow-up. Likewise, we used the international pharmacovigilance data from VigiBase to evaluate the notifications of hyperbilirubinemia reported with ATV.Results: In the TDM analysis, the two groups of patients (treated with cotrimoxazole and controls) were almost homogeneous concerning the main baseline features. After at least six months of ATVbased regimen, there was no significant difference in the safety threshold of the ATV C-trough [with an adjusted odds ratio (aOR) of 1.4 (95% CI: 0.5 - 4.4)] compared to controls. We observed similar results with the efficacy thresholds of ATV C-trough. Regarding the PV analysis, there was no difference in hyperbilirubinemia occurring with ATV when cotrimoxazole was concomitant, with an adjusted reporting odds ratio (aROR) of 0.9 (95% CI: 0.6 to 1.2).Conclusion: This study showed a relevant concomitant use between Cotrimoxazole and ATV based on TDM and PV approaches.","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1574884714666190405160612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37132450","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}

引用次数: 1

The Possibility of Therapeutic Drug Monitoring of the Most Important Interactions in Nursing Homes. 疗养院中最重要相互作用的治疗药物监测的可能性。

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics

Current clinical pharmacology

Pub Date : 2019-01-01 DOI: 10.2174/1574884714666181224144722

Pernille Schjøtt, Martina Šutovská, Jan Schjøtt

Background: Therapeutic drug monitoring is a relevant tool in drug treatment of elderly patients. The aim of this study was to assess the possibility of therapeutic drug monitoring of the most important potential interactions in nursing homes.

Methods: A material of prescribed drugs to 446 patients in three nursing homes in Bergen, Norway from a single day in March 2016 was analysed. Clinically relevant drug interactions (pharmacodynamic or pharmacokinetic) were identified and classified with Stockley`s Interaction Alerts. The most important interaction among several in each patient were ranked by recommended action > severity > evidence according to Stockley`s. The possibility of therapeutic drug monitoring of drug combinations involved in the most important interactions was retrieved from a database of all laboratories performing clinical pharmacology in Norway (the Pharmacology Portal).

Results: Two or more drugs were used by 443 (99.3%) of 446 patients. Three-hundred and eightyfour patients (86.1%) had > 1 interaction. About 95% of the most important interactions were pharmacodynamic. In 280 (72.9%) of these interactions, Stockley`s recommended adjust dose or monitoring. Among the 384 most important interactions, 93% involved one drug and 41% involved two drugs available for therapeutic drug monitoring.

Conclusion: In this pilot study, therapeutic drug monitoring was possible in the majority of the most important interactions in Norwegian nursing homes. This option is of importance since adjust dose or monitoring were frequently recommended actions associated with these interactions.

背景:治疗性药物监测是老年患者药物治疗的相关工具。本研究的目的是评估治疗药物监测疗养院中最重要的潜在相互作用的可能性。方法:对2016年3月挪威卑尔根市3家养老院446例患者的处方药品资料进行分析。临床相关的药物相互作用(药效学或药代动力学)被斯托克利相互作用警报识别和分类。根据Stockley 's，每个患者中几种最重要的相互作用按推荐行动>严重程度>证据排序。从挪威所有临床药理学实验室的数据库(药理学门户)中检索了对涉及最重要相互作用的药物组合进行治疗药物监测的可能性。结果:446例患者中有443例(99.3%)使用两种及以上药物。384例(86.1%)患者有> 1次相互作用。大约95%最重要的相互作用是药效学的。在280例(72.9%)相互作用中，斯托克利建议调整剂量或监测。在384个最重要的相互作用中，93%涉及一种药物，41%涉及两种可用于治疗药物监测的药物。结论:在这项初步研究中，治疗性药物监测在挪威养老院大多数最重要的相互作用中是可能的。这一选择很重要，因为经常建议采取与这些相互作用相关的调整剂量或监测措施。

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