Saudi Pharmaceutical Journal最新文献

Objectives

Methods

Results

Conclusions

Objective

Drug addiction is a complex disorder caused by multiple factors, including environmental and genetic factors. Stress-related genes such as Galanin (GAL) and Oxytocin (OXT) have been linked to the reward pathways that contribute to the development and progression of substance addiction. This study aimed to explore the correlation between several polymorphisms of stress-related genes and drug addiction among Jordanian males.

Methods

The study included 500 participants, consisting of both healthy controls and drug-addicted Jordanian males. The genetic material and clinical data were collected, and 18 SNPs in four candidate genes were genotyped using the Sequenom MassARRAY® system. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 25.0 and the SNPStats website.

Results

The study identified a significant correlation between three SNPs of the GAL gene and drug addiction, specifically rs3136544, rs3136541, and rs694066. The study also found that different genotypes of these variants were significantly associated with drug addiction. Furthermore, different haplotypes of the GAL, GALR1, and OXTR polymorphisms were also significantly correlated with drug addiction. The study also identified a correlation between several drug addiction features and the studied variants, including the association of rs2717162 of Galanin receptor 1 (GALR1) with age at use onset and the association of rs3136541 of GAL with the type of substance and number of substances used.

Conclusion

Stress-related genes can play a significant role in the development and progression of addiction among the Jordanian population, and further investigations are necessary to understand the underlying mechanisms better and improve future treatment strategies.

Liraglutide, a type2 diabetes mellitus (T2DM)-related treatment, improves glycemic control and reduces the risks of adverse cardiovascular events in T2DM patients. However, the underlying mechanisms of the above-mentioned beneficial effects of Liraglutide are not well understood. To have better understanding of these mechanisms, we aimed to study the metabolic impacts of Liraglutide on the metabolome and corresponding pathways in T2DM patients, especially metabolism plays a very fundamental role in health and diseases and is influenced by drugs. In this study, plasma samples collected from T2DM patients (n = 20) and taken pre- and post-Liraglutide treatment were used for untargeted metabolomics analyses, including metabolome profiling and metabolic pathway/network analyses. The metabolome profiling analyses identified 93 endogenous metabolites that were significantly affected by Liraglutide treatment where 49 and 44 metabolites were up and down regulated, respectively. Liraglutide caused metabolic alterations impacting metabolic pathways such as pentose and glucuronate interconversion and alanine, aspartate and glutamate metabolism in T2DM patients. Since the last-mentioned pathways are affected by Liraglutide, it could explain partially the overall beneficial effects of Liraglutide in T2DM, especially that glucuronate interconversion pathway is known by its important roles in eliminating toxic and undesirable substances from the human body to maintain good health status. In addition, the metabolism of amino acids induced by Liraglutide could improve the function of immune cells, strengthening the immunity of T2DM patients. Also, Liraglutide induced the level of other metabolites that help in the defense mechanism against oxidative events. Overall, the findings of this study provide a deeper understanding of the underlying mechanisms involved in the beneficial effects of Liraglutide in T2DM from the metabolic aspect.

The impact of Engineered nanomaterials (ENMs) (i.e., Zinc Oxide nanoparticles (ZnO NPs)) on human health has been investigated at high and unrealistic exposure levels, overlooking the potential indirect harm of subtoxic and long exposures. Therefore, this study aimed to investigate the impacts of subtoxic concentrations of zinc oxide (ZnO NPs) on breast cancer cells’ response to Doxorubicin. Zinc oxide nanoparticles caused a concentration-dependent reduction of cell viability in multiple breast cancer cell lines. A subtoxic concentration of 1.56 µg/mL (i.e., no observed adverse effect level) was used in subsequent mechanistic studies. Molecularly, miRNA profiling revealed significant downregulation of 13 oncogenic miRNAs (OncomiRs) in cells exposed to the sub-toxic dose of ZnO NPs followed by doxorubicin treatment. Our comprehensive bioinformatic analysis has identified 617 target genes enriched in ten pathways, mainly regulating gene expression and transcription, cell cycle, and apoptotic cell death. Several tumor suppressor genes emerged as validated direct targets of the 13 OncomiRs, including TFDP2, YWHAG, SMAD2, SMAD4, CDKN1A, CDKN1B, BCL2L11, and TGIF2. This study insinuates the importance of miRNAs in regulating the responsiveness of cancer cells to chemotherapy. Our findings further indicate that being exposed to environmental ENMs, even at levels below toxicity, might still modulate cancer cells’ response to chemotherapy, which highlights the need to reestablish endpoints of ENM exposure and toxicity in cancer patients receiving chemotherapeutics.

Johns Hopkins Aramco Healthcare (JHAH) is a leading healthcare organization dedicated to revolutionizing healthcare practices in Saudi Arabia. This review article features the significant strides made by the JHAH ambulatory care pharmacy to symbolize Saudi Arabia’s ambitious vision of healthcare transformation. This evolving journey includes details of JHAH’s adoption of modern automation tools, several technological advancements, and establishing a pharmacist role far beyond dispensing medications. Moreover, it underscores the cultivation of patient-centered care initiatives like tele-pharmacy services through pharmacy call center, systematic patient satisfaction surveys, streamlined medication home delivery services, state-of-the-art medication drive-thru pick-up facility, the efficacious Q-Matic patient queue management architecture, and the establishment of discreet individual dispensing cubicles. Key focal points encompass technological enhancements, such as the incorporation of electronic health record Epic, cutting-edge pharmacy automation systems, and the patient-centric online portal MyChart®. The article also summarizes the multifaceted ambulatory care enhancements among clinical pharmacy services offered at JHAH. This includes a pharmacist-led medication management clinic, specialized anticoagulation clinic, psychiatric and hepatitis medication management, renal dose optimization, precision-driven thyroid and benign prostatic hyperplasia patients’ treatment optimization, and clinical decision support system-backed clinical interventions. All these substantial enhancements at JHAH’s ambulatory pharmacy have been made to improve the quality of pharmaceutical services. Besides automation and technological advancements, these also include the establishment of pharmacy competency and continuous education programs, the development of an internal pharmacy webpage on the JHAH website, the implementation of a mechanism for formulary management by the pharmacy and therapeutic committee, and very importantly the adoption of electronic incidence reporting system Datix. The review highlights JHAH’s commitment to bringing ambulatory care pharmacy practice to new heights, thereby establishing a benchmark for patient-centric care and innovative excellence within the Saudi Arabian healthcare landscape.

Introduction

Despite the availability of new cardio-protective oral hypoglycemic drugs, insulin is often recommended as an add-on therapy for type-2 diabetes with hemoglobin A1C (HbA1C) ≥ 9. Introducing insulin as a choice for patients with uncontrolled hyperglycemia (HbA1C≥9) has been questionably associated with cardiovascular sequelae. This study aims to examine the association between insulin use and cardiovascular effects in type-2 diabetic patients with uncontrolled hyperglycemia.

Methodology

A retrospective observational cohort study was conducted to identify cardiovascular complications between the two groups (patients with HbA1C≥9% on insulin versus those with HbA1C≥9% without insulin) at King Saud University Medical City (KSUMC). Patients with type-2 diabetes whose HbA1C was ≥ 9 during the period from 2015 to 2018 and who were followed up within the hospital for at least 5 years until the end of 2022 were included in the study.

Results

A total of 366 patients were included in the study; 286 patients were on insulin, while 80 patients were not. The median baseline HbA1C levels were comparable between the two groups (10.2 versus 9.8). After 5 years of follow-up, there was no significant difference between the groups (29.4 % of insulin users versus 18.8 % of non-insulin users; p = 0.065). However, the incidence of other diabetes complications, such as retinopathy, nephropathy, and neuropathy, was significantly higher among patients who were on insulin compared to those not on insulin (50.7 % versus 27.5 %; p = 0.005). Additionally, the average of the last three HbA1C readings and the overall average HbA1C readings were significantly higher among patients who were on insulin (9.67 % versus 9.07 %; p = 0.001) compared to those not on insulin (9.64 % versus 9.11 %; p = 0.005).

Conclusion

Our study did not find a significant association between the use of insulin and cardiovascular complications. The association between insulin therapy and the development of other diabetes complications warrants further investigation.

Opuntia (Cactaceae) species are native to arid and semi-arid regions of Mexico and the southern United States and grow in various climatic zones. Opuntia dillenii is a cactus fruit with many beneficial properties, and it is used as a medicinal plant in various countries. This review paper provides updated information on the phytochemical and pharmacological aspects of O. dillenii. The fruit contains valuable compounds such as flavonoids, phenolics, ascorbic acid, betanin, and essential elements, which have been isolated and identified. The fruit also exhibits diverse pharmacological activities, such as antioxidant, anti-inflammatory, anti-tumor, neuroprotective, hepatoprotective, hypotensive, anti-diabetic, antifungal, and anticancer effects. Moreover, molecular docking and ADMET predictions were performed to evaluate the antibacterial potential of the fruit against Escherichia coli protein. This paper suggests that O. dillenii has significant potential as a complementary therapy for various pathological conditions.

Purpose

Despite the surge of melatonin supplement consumption in recent years, data on the prevalence and patterns of melatonin usage in Saudi Arabia is lacking. The aim of this study was to assess the prevalence and pattern of sleep-related melatonin usage among adults in Saudi Arabia.

Methods

This was a cross-sectional, web-based, self-administered survey study conducted across all regions of Saudi Arabia. Participants were recruited from the general population (≥18 years). The survey was distributed between February and April 2023. Chi-squared tests and t-tests were performed for comparative bivariate analyses where binary logistic regression was performed to derive the main predictors of melatonin consumption.

Results

Out of 5,606 participants, 536 (10 %) were consumers of melatonin. Older age (Adjusted OR = 1.01, 95 % CI = 1.01–1.02, p = 0.002), being a male (Adjusted OR = 1.76, 95 % CI = 1.46–2.14, p = 0.001), individuals with a doctorate degree or an equivalent (adjusted OR 2.37 95 % CI = 1.35–4.17, p = 0.003), perceived poor sleep quality (Adjusted OR = 1.52, 95 % CI = 1.10–2.11, p = 0.01), and being diagnosed with a sleep disorder (Adjusted OR = 2.55, 95 % CI = 2.04–3.18, p = 0.001) were all associated with increased likelihood of sleep-related melatonin usage. 35 % of consumers self-reported taking ≥1 tablet per day, while 26 % of them were uncertain about the dosage they consume.

Conclusion

With a notable prevalence of 10% among the general population in Saudi Arabia, melatonin usage was more common in older adults, males, and those with higher education.

Background

The utilization rate of antipsychotics to treat different mental disorders is rising. However, little is known about their side effects’ impact on depression levels. Therefore, the objective of this study was to examine the association between antipsychotic side effects and depression among psychiatric patients treated with antipsychotics.

Methods

This is a prospective, single-center, interview-based, cross-sectional study that examined the association between antipsychotic side effects and depression among adult patients (e.g., ≥18 yrs.) with psychiatric illnesses (e.g., depression, schizophrenia, bipolar disorder) visiting outpatient clinics in a university-affiliated tertiary care center. Antipsychotic side effects were assessed using the Arabic version of the Glasgow Antipsychotic Side-effect Scale (GASS), while depression was assessed using the Arabic version of the 9-item Patient Health Questionnaire (PHQ-9). Univariate and multiple linear regressions were conducted to examine the association between the PHQ-9 and GASS scores.

Results

One hundred patients met the inclusion criteria and consented to participate. Most of the patients were females (72 %) with a mean age of 38 years. Schizophrenia (37 %) and bipolar disorder (54 %) were the most common mental disorders among the recruited patients. The majority of patients were treated with atypical (e.g., second-generation) antipsychotics (88 %) for at least six months (74 %). Controlling for age, gender, annual family income, education, employment status, marital status, number of comorbidities, duration of treatment with antipsychotics, the type of antipsychotic, and psychiatric illness, higher GASS scores, which indicate more severe antipsychotic side effects, predicted higher PHQ-9 score (e.g., higher levels of depression) (β = 0.419, 95 % CI=[0.307–0.532], p-value < 0.0001).

Conclusion

Early identification and management of antipsychotic side effects among psychiatric patients should enhance patient adherence and improve treatment outcomes. Future studies should verify the findings of this study using more robust study designs.

Introduction

This review examines substance misuse disorder (SMD) in Saudi Arabia, drawing insights from 43 prior studies. It explores the prevalence and patterns of SMD across diverse demographics.

Methodology

Our analysis integrated data from various studies involving adolescents, university students, psychiatric patients, and the general population as well as postmortem cases. It identifies key risk factors and challenges in managing SMD, underscoring the importance of comprehensive data collection for evidence-based policymaking.

Results

SMD in Saudi Arabia were categorized into two groups: common traditionally abused drugs (such as Captagon, khat, heroin, ethanol, and cannabis) and substances that have emerged in recent years (e.g., methamphetamine “Shabu”, pregabalin, and benzodiazepines). Trends in SMD include early substance initiation and increased amphetamine and polysubstance use.

Conclusion and recommendations

Drug-related challenges persist in Saudi Arabia; however, because of limited data from recent epidemiological studies on drug disorders, the full extent is unknown. Saudi Arabia is unique because it as an Islamic country with strict regulations against drug trafficking and a religious prohibition on drugs and alcohol, which contributes to distinct trends in substance misuse disorder (SMD). Although some aspects mirror global patterns, others exhibit regional characteristics specific to the country. Despite data variability, actionable recommendations have emerged for SMD prevention and treatment. During the COVID-19 pandemic, a high number of reports was evident; however, SMD publications often reiterate old findings and overlook emerging psychoactive substances (EPS), such as ‘Shabu”, pregabalin, and benzodiazepines. Further studies are needed, including educational initiatives, national surveys, stricter drug regulations, and an early warning system for traditional SMD and EPS.