The current outbreak of second wave of COVID-19 in India has seen the rise of opportunistic infections, a deadly one being mucormycosis or “black fungus.” As of now, there are over 9000 cases of this deadly disease which have been reported from several states in India. Nine states in India including Punjab, Uttar Pradesh, Rajasthan, and Bihar have declared mucormycosis as an epidemic. There are five types of mucormycosis – rhino-orbital-cerebral, pulmonary, gastrointestinal, cutaneous, and disseminated. Out of these, rhino-orbital-cerebral and pulmonary mucormycoses are most common in post-COVID patients. The clinical presentation of such patients include cough, fever, breathlessness, chest pain, sinusitis, pain on one side of the face with lack of sensation and proptosis of eye. Diagnosis could be done through analysis of clinical findings, direct microscopy, serum antigen tests, culture, histopathology, radio imaging, and polymerase chain reaction/matrix-assisted laser desorption ionization time-of-flight. Treatment will include preventive measures taken at home or at hospital for post-COVID patients. Medical treatment of mucormycosis mainly includes installing a central catheter (line), maintaining adequate systemic hydration, and infusion of normal intravenous saline before antifungal amphotericin B infusion. Since amphotericin is nephrotoxic, alternative drugs, such as posaconazole or isavuconazole, can be suggested. Adjuvant therapy with caspofungin, deferasirox, statins, aspirin, and hyperbaric oxygen may have to be considered as well. Extensive surgical debridement can also be suggested to remove all necrotic tissues. This review emphasizes the different aspects of mucormycosis such as epidemiology, etiopathogenesis, risk factors, diagnosis, preventive measures, and treatment strategies that can be adopted to tackle this fungal menace in COVID-19.
{"title":"Mucormycosis - The black menace in COVID-19","authors":"C. Pattanayak, Sougata Sarkar, V. Srivastava","doi":"10.4103/jpp.jpp_93_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_93_21","url":null,"abstract":"The current outbreak of second wave of COVID-19 in India has seen the rise of opportunistic infections, a deadly one being mucormycosis or “black fungus.” As of now, there are over 9000 cases of this deadly disease which have been reported from several states in India. Nine states in India including Punjab, Uttar Pradesh, Rajasthan, and Bihar have declared mucormycosis as an epidemic. There are five types of mucormycosis – rhino-orbital-cerebral, pulmonary, gastrointestinal, cutaneous, and disseminated. Out of these, rhino-orbital-cerebral and pulmonary mucormycoses are most common in post-COVID patients. The clinical presentation of such patients include cough, fever, breathlessness, chest pain, sinusitis, pain on one side of the face with lack of sensation and proptosis of eye. Diagnosis could be done through analysis of clinical findings, direct microscopy, serum antigen tests, culture, histopathology, radio imaging, and polymerase chain reaction/matrix-assisted laser desorption ionization time-of-flight. Treatment will include preventive measures taken at home or at hospital for post-COVID patients. Medical treatment of mucormycosis mainly includes installing a central catheter (line), maintaining adequate systemic hydration, and infusion of normal intravenous saline before antifungal amphotericin B infusion. Since amphotericin is nephrotoxic, alternative drugs, such as posaconazole or isavuconazole, can be suggested. Adjuvant therapy with caspofungin, deferasirox, statins, aspirin, and hyperbaric oxygen may have to be considered as well. Extensive surgical debridement can also be suggested to remove all necrotic tissues. This review emphasizes the different aspects of mucormycosis such as epidemiology, etiopathogenesis, risk factors, diagnosis, preventive measures, and treatment strategies that can be adopted to tackle this fungal menace in COVID-19.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46075299","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}
D. Elango, D. Malathi, PriyadharsiniRaman Palanisamy
Oliceridine an intravenous opioid approved in 2020 by the Food and Drug Administration (FDA) to treat moderate-to-severe pain. Oliceridine developed with a novel mechanism that is biased agonism toward G-protein-coupled receptors pathway. Being biased agonist, it does not activate beta arrestin pathway responsible for opioid-related adverse events (ORAE), especially respiratory depression. Because of the novel mechanism, oliceridine has paved a pathway to decrease ORAE. Oliceridine has received breakthrough status by FDA. However, FDA denied oliceridine approval and withdrew breakthrough status by 2019. FDA made this decision because of the inadequacy of the safety data. Abuse potential and QT prolongation studies are conducted as per FDA recommendation in the year 2019; oliceridine was approved for moderate to severe pain in adults. This review will briefly summarize the pharmacological properties and study results of oliceridine in the management of pain. Thorough literature search was done for the efficacy and safety of oliceridine, search was done in electronic database of PubMed and Cochrane from inception till June 2021. Oliceridine was found to be effective in acute severe pain with less OREA when compared to morphine. Oliceridine has many drawbacks than what is hypothesized earlier, but this approach has opened new options for patients suffering from severe pain. Long-term effect of oliceridine has to be monitored to assess the effects of biased agonism.
{"title":"Oliceridine - Breakthrough in the Management of Pain","authors":"D. Elango, D. Malathi, PriyadharsiniRaman Palanisamy","doi":"10.4103/jpp.jpp_116_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_116_21","url":null,"abstract":"Oliceridine an intravenous opioid approved in 2020 by the Food and Drug Administration (FDA) to treat moderate-to-severe pain. Oliceridine developed with a novel mechanism that is biased agonism toward G-protein-coupled receptors pathway. Being biased agonist, it does not activate beta arrestin pathway responsible for opioid-related adverse events (ORAE), especially respiratory depression. Because of the novel mechanism, oliceridine has paved a pathway to decrease ORAE. Oliceridine has received breakthrough status by FDA. However, FDA denied oliceridine approval and withdrew breakthrough status by 2019. FDA made this decision because of the inadequacy of the safety data. Abuse potential and QT prolongation studies are conducted as per FDA recommendation in the year 2019; oliceridine was approved for moderate to severe pain in adults. This review will briefly summarize the pharmacological properties and study results of oliceridine in the management of pain. Thorough literature search was done for the efficacy and safety of oliceridine, search was done in electronic database of PubMed and Cochrane from inception till June 2021. Oliceridine was found to be effective in acute severe pain with less OREA when compared to morphine. Oliceridine has many drawbacks than what is hypothesized earlier, but this approach has opened new options for patients suffering from severe pain. Long-term effect of oliceridine has to be monitored to assess the effects of biased agonism.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44852363","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}
Systemic autoimmune disorders are one of the leading causes of death and disability. They include a heterogeneous group of inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE), systemic vasculitis, scleroderma, psoriasis, and Sjogren’s syndrome that affects multiple organ systems.[1] The pharmacotherapy of systemic autoimmune disorders is rather challenging due to chronic treatment regimens and a higher disease relapse rate.[2] The complex drug regimen is associated with a high risk of drug-related problems (DRPs).[3] As DRPs are becoming one of the major concerns in modern clinical practice, timely identification and their resolution are critical in lowering the therapeutic related harm. Patient satisfaction can be enhanced through drug therapy optimization, reducing economic and iatrogenic burdens.[4]
{"title":"Impact of Clinical Pharmacist Interventions in Resolving Drug-Related Problems in Patients with Systemic Autoimmune Disorders","authors":"S. Sah, Subramanian Ramaswamy, M. Ramesh","doi":"10.4103/jpp.jpp_149_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_149_21","url":null,"abstract":"Systemic autoimmune disorders are one of the leading causes of death and disability. They include a heterogeneous group of inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE), systemic vasculitis, scleroderma, psoriasis, and Sjogren’s syndrome that affects multiple organ systems.[1] The pharmacotherapy of systemic autoimmune disorders is rather challenging due to chronic treatment regimens and a higher disease relapse rate.[2] The complex drug regimen is associated with a high risk of drug-related problems (DRPs).[3] As DRPs are becoming one of the major concerns in modern clinical practice, timely identification and their resolution are critical in lowering the therapeutic related harm. Patient satisfaction can be enhanced through drug therapy optimization, reducing economic and iatrogenic burdens.[4]","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45291189","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}
{"title":"Prof. M. N. Ghosh: A Pharmacologist Beyond Compare","authors":"Syed Ziaur Rahman","doi":"10.4103/jpp.jpp_179_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_179_21","url":null,"abstract":"","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43573972","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}
Kleva Shpati, G. Stroni, Erina Hilaj, Aurora Napuçe, G. Rexha
Cardiovascular diseases are the first disease in Albania that caused mortality and morbidity according to the Public Health Institute the Statistical Institute of Albania.[1,2] Hydroxymethylglutaryl-CoA reductase inhibitors (known as statins) are widely used as lipid-lowering drugs. They caused adverse events such as myotoxicity, renal, and hepatic problems which are considerably elevated in combination with other drugs. Drug–drug interactions (DDIs) can result in a change in either drug efficacy or toxicity. The value of therapy is defined by ineffectiveness or increased toxicity. Statins are the therapeutic class of medicines that reduce morbidity and mortality in patients with atherosclerotic cardiovascular disease.[3,4] Adverse events caused by DDI with clinical significance are preventable. DDIs involving statins include individual pharmacokinetics characteristics (e.g., binding affinity, half-life, dose of medications, and timing and sequence of administration duration of therapy) patients’ factors (e.g., age, sex, lifestyle, disease implicating metabolism hepatic, renal impairments and cardiac failure), genetic polymorphism, hypersensitivity, etc. Physicians choose a noninteracting alternative, but if none is available, they prescribe in combination by evaluating the benefits and risks of the co‐commitment of medications.[5,6]
{"title":"Monitoring Adverse Drug Reactions and Incidence of Potential Statin-Drug Interactions","authors":"Kleva Shpati, G. Stroni, Erina Hilaj, Aurora Napuçe, G. Rexha","doi":"10.4103/jpp.jpp_79_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_79_21","url":null,"abstract":"Cardiovascular diseases are the first disease in Albania that caused mortality and morbidity according to the Public Health Institute the Statistical Institute of Albania.[1,2] Hydroxymethylglutaryl-CoA reductase inhibitors (known as statins) are widely used as lipid-lowering drugs. They caused adverse events such as myotoxicity, renal, and hepatic problems which are considerably elevated in combination with other drugs. Drug–drug interactions (DDIs) can result in a change in either drug efficacy or toxicity. The value of therapy is defined by ineffectiveness or increased toxicity. Statins are the therapeutic class of medicines that reduce morbidity and mortality in patients with atherosclerotic cardiovascular disease.[3,4] Adverse events caused by DDI with clinical significance are preventable. DDIs involving statins include individual pharmacokinetics characteristics (e.g., binding affinity, half-life, dose of medications, and timing and sequence of administration duration of therapy) patients’ factors (e.g., age, sex, lifestyle, disease implicating metabolism hepatic, renal impairments and cardiac failure), genetic polymorphism, hypersensitivity, etc. Physicians choose a noninteracting alternative, but if none is available, they prescribe in combination by evaluating the benefits and risks of the co‐commitment of medications.[5,6]","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48999843","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}
S. Samajdar, Shatavisa Mukherjee, Dipan Saha, D. Jumani, S. Tripathi
Erectile dysfunction (ED) is the inability to achieve or maintain an erection that is required for satisfactory sexual performance, and affects a considerable proportion of men around the globe at least occasionally. Although roles for nonendocrine and endocrine pathways have been propose, presence of comorbidities, psychogenic factors may contribute to its development. Large number of published reports link many commonly prescribed drugs with sexual dysfunction. Many common drugs such asanti-hypertensive, anti-psychotic, and anti-histaminic are linked with iatrogenic ED. On the other hand, psychogenic ED may be wrongly perceived to be of iatrogenic origin. While dealing a subject with ED it is important for the clinicians to take a detailed medical, surgical, sexual and drug/substance abuse history. In this article, we have described two such cases which would reflect the importance of determining the cause of ED before initiating treatment.
{"title":"Drug-Induced Erectile Dysfunction: Two Interesting Cases","authors":"S. Samajdar, Shatavisa Mukherjee, Dipan Saha, D. Jumani, S. Tripathi","doi":"10.4103/jpp.jpp_129_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_129_21","url":null,"abstract":"Erectile dysfunction (ED) is the inability to achieve or maintain an erection that is required for satisfactory sexual performance, and affects a considerable proportion of men around the globe at least occasionally. Although roles for nonendocrine and endocrine pathways have been propose, presence of comorbidities, psychogenic factors may contribute to its development. Large number of published reports link many commonly prescribed drugs with sexual dysfunction. Many common drugs such asanti-hypertensive, anti-psychotic, and anti-histaminic are linked with iatrogenic ED. On the other hand, psychogenic ED may be wrongly perceived to be of iatrogenic origin. While dealing a subject with ED it is important for the clinicians to take a detailed medical, surgical, sexual and drug/substance abuse history. In this article, we have described two such cases which would reflect the importance of determining the cause of ED before initiating treatment.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44264821","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}
Eosinophilic gastroenteritis disorder is an uncommon inflammatory disorder of the gastrointestinal tract, affecting predominantly, stomach and small intestine. Subserosal inflammation is a major source of minor-to-moderate ascites. We present the case of an 8-year-old girl child who was brought to the hospital with complaints of chronic abdomen pain and mild ascites. There was a remarkable finding of eosinophils in ascitic fluid. Other differential diagnosis was excluded. Treatment abdomen with deflazacort gave significant resolution of symptoms over the time.
{"title":"Eosinophilic Gastroenteritis: An Unclear Etiology of Ascites and Dramatic Response to Steroids Can be a Diagnostic Key","authors":"A. Bhardwaj, Shoma Mukherjee","doi":"10.4103/jpp.jpp_104_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_104_21","url":null,"abstract":"Eosinophilic gastroenteritis disorder is an uncommon inflammatory disorder of the gastrointestinal tract, affecting predominantly, stomach and small intestine. Subserosal inflammation is a major source of minor-to-moderate ascites. We present the case of an 8-year-old girl child who was brought to the hospital with complaints of chronic abdomen pain and mild ascites. There was a remarkable finding of eosinophils in ascitic fluid. Other differential diagnosis was excluded. Treatment abdomen with deflazacort gave significant resolution of symptoms over the time.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43414505","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}
Coronavirus pandemic has brought forth the urgency of providing affordable health care to everyone. Generic medicines are often one-fourth to one-tenth of the cost of the branded drugs, and so offer a remarkable opportunity to significantly lower the health-care expenditure. However, the argument for promoting generic medicines is indisputable, we have to think about the other enabling conditions which are necessary for a successful health policy on encouraging generics without causing unintended adverse repercussions. This paper attempts to answer such questions by considering the motivations of the various stakeholders of the broader health services ecosystem in India and undertaking a systematic analysis of the winners and losers from such a policy. We argue that generic prescription will not be successful without prior improvement in the state capacity for quality control of drug manufacturing; rise in awareness among the doctors, patients, and pharmacists; improved trust in the medical systems; and innovative demand-side interventions.
{"title":"Hurdles in Mandatory Generic Medicine Prescription","authors":"V. Virdi, Money Gupta, Rohit Gupta","doi":"10.4103/jpp.jpp_74_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_74_21","url":null,"abstract":"Coronavirus pandemic has brought forth the urgency of providing affordable health care to everyone. Generic medicines are often one-fourth to one-tenth of the cost of the branded drugs, and so offer a remarkable opportunity to significantly lower the health-care expenditure. However, the argument for promoting generic medicines is indisputable, we have to think about the other enabling conditions which are necessary for a successful health policy on encouraging generics without causing unintended adverse repercussions. This paper attempts to answer such questions by considering the motivations of the various stakeholders of the broader health services ecosystem in India and undertaking a systematic analysis of the winners and losers from such a policy. We argue that generic prescription will not be successful without prior improvement in the state capacity for quality control of drug manufacturing; rise in awareness among the doctors, patients, and pharmacists; improved trust in the medical systems; and innovative demand-side interventions.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43889703","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}
Mucormycosis is an acute fungal infection with 90% of cases in the form of rhino-orbito-cerebellar. It is an aggressive and life-threatening fungal infection causing 50% mortality in people with coronavirus disease 2019 (COVID-19). In COVID-infected patients due to, diabetic ketoacidosis, epithelial damage, ciliary dysfunction, dysfunctional phagocytic mechanism, and immunosuppression, there is impaired chemotaxis and defective intracellular killing leads to fungal spores to invade, germinate and penetrate in surrounding tissues. The use of broad-spectrum antibiotics disrupts the normal microbiomes and increases the probability of growth of Rhizopus spp. Commercially available probiotics such as Lactobacillus, Bifidobacterium, Enterococcus, Streptococcus, and Saccharomyces when administered in adequate quantities form siderophores which induces iron stress in fungus and inhibits spore germination.
{"title":"A Mini Review: Mucormycosis in Coronavirus Disease-19, Host-Iron Assimilation, and Probiotics as Novel Therapy","authors":"A. Bhardwaj, V. Roy, Indu Priyadarshini","doi":"10.4103/jpp.jpp_58_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_58_21","url":null,"abstract":"Mucormycosis is an acute fungal infection with 90% of cases in the form of rhino-orbito-cerebellar. It is an aggressive and life-threatening fungal infection causing 50% mortality in people with coronavirus disease 2019 (COVID-19). In COVID-infected patients due to, diabetic ketoacidosis, epithelial damage, ciliary dysfunction, dysfunctional phagocytic mechanism, and immunosuppression, there is impaired chemotaxis and defective intracellular killing leads to fungal spores to invade, germinate and penetrate in surrounding tissues. The use of broad-spectrum antibiotics disrupts the normal microbiomes and increases the probability of growth of Rhizopus spp. Commercially available probiotics such as Lactobacillus, Bifidobacterium, Enterococcus, Streptococcus, and Saccharomyces when administered in adequate quantities form siderophores which induces iron stress in fungus and inhibits spore germination.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47506905","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}
Abinaya Muralidharan, J. Scott, L. Joseph, S. Jeyabalan
Homoharringtonine (HHT), a cephalotaxus alkaloid has shown promising results in the treatment of several hematological disorders such as chronic myeloid leukemia, acute myeloid leukemia (AML), and myelodysplastic syndrome. It is known for its unique mechanism of action by which it prevents the initial elongation step of protein biosynthesis. Hence, it is used in hematological malignancies where it synergistically potentiates the action of other drugs and induces apoptosis. The relevant studies published were searched using an electronic database from 2002 to 2019. The articles published in English were only considered. Search engines such as PubMed, MEDLINE, Google Scholar, and Semantic scholar were used. In this review, we have discussed the effect of HHT in combination with other chemotherapeutic agents for AML with or without genetic mutation specification and the future perspective of these regimens. Although standard treatment options exist for most of these diseases, still cure rates are low with reported morbidity and the drug resistance emergence is pervasive. Thus, novel treatment approaches are crucial for better outcome. Alternative regimens together with HHT have not been a standard practice, although they have shown a very good potential in AML patients. Many of the combinations were also proved to be safe and effective with very low toxic potential. All these data outcomes of various combinations under different scenarios exhibit that HHT has promising results in the treatment of AML which may lead to its approval in the upcoming years.
{"title":"Effect of Homoharringtonine as a Combined Regimen for Acute Myeloid Leukemia","authors":"Abinaya Muralidharan, J. Scott, L. Joseph, S. Jeyabalan","doi":"10.4103/jpp.jpp_52_21","DOIUrl":"https://doi.org/10.4103/jpp.jpp_52_21","url":null,"abstract":"Homoharringtonine (HHT), a cephalotaxus alkaloid has shown promising results in the treatment of several hematological disorders such as chronic myeloid leukemia, acute myeloid leukemia (AML), and myelodysplastic syndrome. It is known for its unique mechanism of action by which it prevents the initial elongation step of protein biosynthesis. Hence, it is used in hematological malignancies where it synergistically potentiates the action of other drugs and induces apoptosis. The relevant studies published were searched using an electronic database from 2002 to 2019. The articles published in English were only considered. Search engines such as PubMed, MEDLINE, Google Scholar, and Semantic scholar were used. In this review, we have discussed the effect of HHT in combination with other chemotherapeutic agents for AML with or without genetic mutation specification and the future perspective of these regimens. Although standard treatment options exist for most of these diseases, still cure rates are low with reported morbidity and the drug resistance emergence is pervasive. Thus, novel treatment approaches are crucial for better outcome. Alternative regimens together with HHT have not been a standard practice, although they have shown a very good potential in AML patients. Many of the combinations were also proved to be safe and effective with very low toxic potential. All these data outcomes of various combinations under different scenarios exhibit that HHT has promising results in the treatment of AML which may lead to its approval in the upcoming years.","PeriodicalId":16761,"journal":{"name":"Journal of Pharmacology & Pharmacotherapeutics","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46890772","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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