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Study of Drug Use Evaluation and Bleeding Risk of Anticoagulants by Has-Bled In Geriatrics 老年哈斯出血患者抗凝药物使用评价及出血风险研究
Pub Date : 2021-08-07 DOI: 10.46624/ajptr.2021.v11.i4.002
Angela Mariam Reji, Christy Abraham, Nancy Antony, Rupali Kumar, Mrs., Lincy George, K. Krishnakumar
Anticoagulant therapy being the most conventional form of therapeutic intervention is the cornerstone for the treatment and prevention of various ailments including Atrial Fibrillation (AF), Acute Coronary Syndrome (ACS), Venous Thromboembolism (VTE) and patients undertaking cardiac procedures1. Bleeding is the principal complication of anticoagulants even though used within its therapeutic limit. An innovative tool HAS-BLED score come up with the assessment of bleeding risk among patients under anticoagulant therapy supporting the physicians in a better clinical decision making2,3. The objective is to evaluate drug use and bleeding risk of anticoagulant drugs using HAS-BLED Score among geriatric patients. A prospective observational study was conducted in a tertiary care hospital among hundred patients for a period of six months. It was found that 61% were males and 49% were females. Most of the patients were from the age group of 65-70 (53%), 71-75 (31%) and least less than 75 (16%). The most commonly prescribed dosage form was parenteral (79%) and drug was heparin (52%). The bleeding risk of twenty patients taking warfarin was assessed using HAS- BLED Score, the risk categories shows greater than or equal to 3 (60%) high risk and score between 1-2 (40%) moderate risk. Drug use pattern of anticoagulants needs uninterrupted and repeated surveillance not only to discern therapeutic efficacy but also to scrutinize potential adverse drug reaction. From the HAS-BLED score distribution of patients taking warfarin conveys the need to monitor the parameters especially INR before and after initiation of anticoagulant therapy. Keywords: Drug Use Evaluation, Anticoagulant Therapy, HAS-BLED Score, Atrial Fibrillation, Bleeding Risk, Warfarin
抗凝治疗是最传统的治疗干预形式,是治疗和预防各种疾病的基石,包括心房颤动(AF)、急性冠状动脉综合征(ACS)、静脉血栓栓塞(VTE)和接受心脏手术的患者。出血是抗凝剂的主要并发症,即使在其治疗限度内使用。一种创新的HAS-BLED评分工具用于评估抗凝治疗患者的出血风险,支持医生更好地做出临床决策2,3。目的是评估药物使用和出血风险的抗凝血药物在老年患者中使用HAS-BLED评分。一项前瞻性观察研究在一家三级护理医院进行了为期6个月的100名患者。其中男性占61%,女性占49%。大多数患者年龄在65 ~ 70岁(53%),71 ~ 75岁(31%),最小小于75岁(16%)。最常见的处方剂型是静脉注射(79%),药物是肝素(52%)。采用HAS- BLED评分法对20例服用华法林患者的出血风险进行评估,风险类别大于等于3级(60%)高风险,1-2级(40%)中度风险。抗凝血药物的使用模式需要不间断的、反复的监测,不仅可以发现治疗效果,而且可以发现潜在的药物不良反应。从服用华法林患者的ha - bled评分分布来看,需要在抗凝治疗开始前后监测参数,特别是INR。关键词:用药评价,抗凝治疗,哈斯-出血评分,心房颤动,出血风险,华法林
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引用次数: 0
Case Report On Hepatorenal Syndrome 肝肾综合征1例报告
Pub Date : 2021-08-07 DOI: 10.46624/ajptr.2021.v11.i4.004
Hepatorenal syndrome (HRS) is a potentially reversible renal impairment where the kidney function is stopped due to renal vasoconstriction resulting from extreme vasodilation. This case report describes a 64 year old female with Decompensated Chronic Liver Disease. Her clinical history and physical findings shows a decreased renal function secondary to chronic liver disease and was later diagnosed as HRS. HRS can be managed effectively with Terlipressin, Midodrine, Albumin. Such combination therapy at the early stage of diagnosis can prevent further complications. Keywords: HRS, CLD, Albumin, Terlipressin, Midodrine.
肝肾综合征(HRS)是一种潜在的可逆性肾脏损害,由于肾血管极度舒张导致肾血管收缩而肾功能停止。本病例报告描述一位64岁女性慢性失代偿性肝病。她的临床病史和体格检查显示继发于慢性肝病的肾功能下降,后来被诊断为HRS。特立加压素、米多宁、白蛋白可有效控制HRS。这种联合治疗在早期诊断可以防止进一步的并发症。关键词:HRS, CLD,白蛋白,特利加压素,米多宁。
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引用次数: 0
Development and Evaluation of Floating Sustained Release Bilayer Tablets Containing Dothiepin HCl 盐酸多硫平双层漂浮缓释片的研制与评价
Pub Date : 2021-08-07 DOI: 10.46624/ajptr.2021.v11.i4.007
Ajay Kumar, S. V. Kulkarni, K. Manjunath
Bilayer floating tablets of Dothiepin HCL were developed by direct compression method. Immediate release layer contains 30 mg of drug and super disintegrant sodium starch glycolate, serves the purpose of loading dose. Sustained release layer contained HPMC K4M, natural polymers like xanthan gum, guar gum, karaya gum release the drug for 12 hours’ time. Sodium bicarbonate and citric acid are used to produce effervescence. Floating lag time of optimized tablet is 92 sec, whereas floating duration is more than 12 hours. FTIR results revealed that there was no interaction between drug and HPMC K4M / xanthan gum. The post compression parameters of developed tablets were found to be satisfactory. In this study, it was confirmed that the formulations containing HPMC K4M, have shown better floating properties and finally the formulation containing a combination of HPMC K4M and xanthan gum in 3:1 ratio, has exhibited decent sustained drug release properties. The release kinetics of optimized formulation prepared with the combination of HPMC K4M and xanthan gum followed zero order kinetics. Keywords: Floating Bilayer Tablet, Dothiepin HCL, HPMC K4M, Xanthan Gum, FTIR.
采用直接加压法制备盐酸多硫平双层漂浮片。速释层含有30 mg药物和超强崩解剂乙醇酸淀粉钠,起装药作用。缓释层含有HPMC K4M、黄原胶、瓜尔胶、卡拉亚胶等天然聚合物,缓释时间为12小时。碳酸氢钠和柠檬酸用来产生气泡。优化后的片剂漂浮滞后时间为92秒,而漂浮持续时间在12小时以上。FTIR结果显示,药物与HPMC K4M /黄原胶无相互作用。研制的片剂后压缩参数令人满意。在本研究中,证实了含有HPMC K4M的配方具有较好的漂浮性能,并最终证实了含有HPMC K4M和黄原胶以3:1的比例组合的配方具有良好的缓释性能。以HPMC K4M与黄原胶复合制备的优化制剂的释放动力学服从零级动力学。关键词:漂浮双层片,盐酸多硫平,HPMC K4M,黄原胶,FTIR
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引用次数: 0
A Systematic Review about Covid-19 Sequalae and Syndrome 关于Covid-19后遗症和综合征的系统综述
Pub Date : 2021-08-07 DOI: 10.46624/ajptr.2021.v11.i4.001
S. Sheikh, Sonal Gupta, G. D. Dahikar
A new type of coronavirus (severe acute respiratory syndrome coronavirus 2; SARS-CoV-2) that has began in Wuhan, China in late 2019 has grasped the whole world. Since then, there are approximately 2.59 million deaths has been caused by Covid-19. After numerous attempts and hard work from healthcare system, this deadly virus is in control by using vaccines like Covaxin and Covishield. But new problems are emerging even after the discovery of vaccines. Patients have been experiencing various health problems after recovering from Covid-19. This review article discussed about different sequalae and syndromes that are emerging in patients after postcovid recovery.Keywords: Covid-19, Sequalae, Syndrome, Postrecovery symptoms.
一种新型冠状病毒(严重急性呼吸综合征冠状病毒2型;2019年底在中国武汉爆发的新型冠状病毒(SARS-CoV-2)疫情席卷全球。自那时以来,Covid-19已造成约259万人死亡。经过医疗系统的多次尝试和努力,这种致命的病毒通过使用像Covaxin和Covishield这样的疫苗得到了控制。但是,即使在发现疫苗之后,新的问题也在出现。从Covid-19恢复后,患者出现了各种健康问题。本文综述了新冠肺炎患者康复后出现的各种后遗症和综合征。关键词:新型冠状病毒,后遗症,综合征,康复后症状
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引用次数: 0
Phytochemical and Biological Investigation of Nephrolepis biserrata, a Fern Variety From Côte D’Ivoire 产自Côte科特迪瓦的一种蕨类植物——双角蕨的植物化学和生物学研究
Pub Date : 2021-08-07 DOI: 10.46624/ajptr.2021.v11.i4.003
K. Brice, B. Yves-Alain
This research work was carried out on the species Nephrolepis biserrata (Sw.) Schott (Nephrolepidaceae), a fern from Côte d’Ivoire with the aim of establishing its phytochemical, antioxidant and biological profile. The results obtained from the phytochemical screening show that said species contains alkaloids, coumarins, flavonoids, polyphenols, sterols, terpenes, and tannins. The antioxidant activity was evaluated spectrophotometrically against the DPPH radical in comparison with that of vitamin C. The determination of the antibacterial parameters indicates that N. biserrata doesn’t exhibit any bactericidal action against the bacterial strains tested. Regarding the vermicidal activity against earthworms, decocts of N. biserrata showed an anthelmintic effect, which however remains less pronounced than that of albendazole, the anthelmintic antiparasitic taken as a reference. Keywords: Nephrolepis biserrata, phytochemical screening, antioxidant, antibacterial, vermicide.
本研究工作是对双鼠肾(Nephrolepis biserrata, Sw.)进行的。Schott (Nephrolepidaceae),一种产自Côte d ' ivivire的蕨类植物,目的是建立其植物化学、抗氧化和生物学特征。植物化学筛选结果表明,该物种含有生物碱、香豆素、类黄酮、多酚、甾醇、萜烯和单宁。用分光光度法测定了其对DPPH自由基的抗氧化活性,并与维生素c的抗氧化活性进行了比较。在对蚯蚓的杀虫活性方面,双生藤煎剂有驱虫作用,但不如阿苯达唑的驱虫作用明显。关键词:双色松,植物化学筛选,抗氧化,抗菌,杀虫。
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引用次数: 0
Design, Development and Evaluation Of Anti-Hypertensive Drug Solid Lipid Nano Particles 抗高血压药物固体脂质纳米颗粒的设计、研制与评价
Pub Date : 2021-08-07 DOI: 10.46624/ajptr.2021.v11.i4.006
R. Chethan, P. Ashokkumar
Recently, solid lipid Nano-particles have received much attention by the researchers owing to its biodegradability, biocompatibility and the ability to deliver a wide range of drugs. The aim of the present study was to design Diltiazem solid lipid Nano-particles and to evaluate them. Diltiazem solid lipid Nano-particles were prepared by hot homogenization technique using different lipids (Tristearin, GMS and Comprital), soy lecithin as stabilizers and tween 80, Poloxamer as surfactants. The Nano-particles were evaluated for particle size & PDI, zeta potential, entrapment efficiency and in vitro drug release. The particle size ranged from 49.7 to 523.7 nm. PDI of all formulations were good within the range of 0.189 to 0.427. The zeta potential ranged from -10.5 to -29.6 Mv, Entrapment efficiency of all formulations were observed was in the range of 78.68 to 95.23 %. The cumulative percentage release of Diltiazem from different Diltiazem Nano-particles varied from 53.36 to 88.74% depending upon the drug lipid ratio and the type of lipid used. The average percentage of drug released from different SLNs after 24 hours showed in the following order: F9 (53.35%) < F6 (56.75%) < F4 (61.74%) < F7 (63.8%) < F5(67.77%) < F8(69.04%) < F3(75.31%) < F1(79.36%)
近年来,固体脂质纳米颗粒因其生物可降解性、生物相容性和广泛的药物递送能力而受到研究人员的广泛关注。本研究的目的是设计地尔硫卓固体脂质纳米颗粒并对其进行评价。采用热均质技术,以不同脂质(Tristearin、GMS和Comprital)、大豆卵磷脂为稳定剂、tween 80、poloxomer为表面活性剂制备了地尔硫卓固体脂质纳米颗粒。对纳米颗粒的粒径、PDI、zeta电位、包封效率和体外药物释放度进行了评价。粒径范围为49.7 ~ 523.7 nm。各配方的PDI在0.189 ~ 0.427范围内均较好。zeta电位范围为-10.5 ~ -29.6 Mv,包封率为78.68% ~ 95.23%。不同的地尔硫卓纳米颗粒对地尔硫卓的累积释放百分比根据药物脂质比和所使用的脂质类型而变化,从53.36%到88.74%不等。24 h后不同sln的平均释药率依次为:F9 (53.35%) < F6 (56.75%) < F4 (61.74%) < F7 (63.8%) < F5(67.77%) < F8(69.04%) < F3(75.31%) < F1(79.36%)
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引用次数: 0
Method Development, Validation and Stress Degradation Study of Teneligliptin by RP-HPLC 方法采用反相高效液相色谱法对替尼格列汀的开发、验证及应激降解进行研究
Pub Date : 2021-06-07 DOI: 10.46624/ajptr.2021.v11.i3.004
Kalyani V. Tighare, Amol V. Sawale
To develop and validate simple, rapid, linear, accurate, precise and economical reverse phase-highperformance liquid chromatography (RP-HPLC) method for of stress degradation study of Teneligliptin. The separation and quantization were achieved on Inertsil C18(250 mm × 4.6ID,5 um ). The mobile phase selected was Methanol: Water (90:10) at a flow rate of 0.8 ml/min and detection of analytes was carried out at 248nm at pH 3. The method exhibited good linearity over the range of 10–50 μg/mL. The drug is freely soluble in organic solvents Methanol. The drug was identified in terms of solubility studies and on the basis of melting point done by capillary tube method. The drug which when subjected to thermal, photolytic, oxidative, and acidic stress degraded into many degradation products. In most of the cases, the degradation rate was seen to be directly proportional to the amount of stress applied. The thermal stress was increased by increasing the incubation temperature, the faster the degradation took place. The values of LOD were found to be 0.956 ug/ml for TNG and the calculated LOQ values were found to be 0.171 ug/ml.
建立简单、快速、线性、准确、精确、经济的反相高效液相色谱(RP-HPLC)法研究替尼格列汀的应力降解。在Inertsil C18(250 mm × 4.6ID,5 um)上进行分离和定量。选择流动相为甲醇:水(90:10),流速为0.8 ml/min,检测波长为248nm, pH值为3。方法在10 ~ 50 μg/mL范围内线性良好。本品易溶于有机溶剂甲醇。根据溶解度研究和毛细管法的熔点对药物进行了鉴定。在热、光解、氧化和酸性胁迫下降解成许多降解产物的药物。在大多数情况下,降解率与施加的应力成正比。随着培养温度的升高,热应力增大,降解速度越快。测定的定量限为0.956 ug/ml,计算的定量限为0.171 ug/ml。
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引用次数: 0
Phytochemical investigation of Cissus aralioides stems from Côte d’Ivoire 产自Côte d ' ivire的山羊草的植物化学研究
Pub Date : 2021-06-07 DOI: 10.46624/ajptr.2021.v11.i3.005
Kouassi Affoue Delphine, Baguia-Broune Fatou Diane Michelle, N’gaman-Kouassi Kohué Christelle Chantal, Mamyrbékova-Békro Janat Akhanovna, V. David, B. Yves-Alain
As part of research on plants of interest for the floristic biodiversity of Côte d'Ivoire, a phytochemical investigation of the stems of Cissus aralioides, a species with medicinal properties of the botanical family Vitaceae, was produced. The mineral and organic compositions of said extract were determined, respectively by X-ray fluorescence spectrometry and by GC-MS. Elemental chemical analysis revealed considerable levels of trace elements (Fe, Mn, Zn), macro elements (Ca, Mg, P, K), and the presence of other elements (Ba, Ti, La, Cs, Rb, Ta, Cd). Analysis by GC-MS shows the existence of several active ingredients such as phenol acids, flavonoids, stilbenes and phytosterols. A major phytosterol (E-resveratrol) has been isolated from C. aralioides growing in Ivory Coast.
作为对Côte科特迪瓦植物区系生物多样性感兴趣的植物研究的一部分,对植物科Vitaceae中具有药用特性的物种Cissus aralioides的茎进行了植物化学调查。分别用x射线荧光光谱法和气相色谱-质谱法测定提取物的矿物成分和有机成分。元素化学分析显示,微量元素(Fe, Mn, Zn),宏量元素(Ca, Mg, P, K)和其他元素(Ba, Ti, La, Cs, Rb, Ta, Cd)的含量相当高。经气相色谱-质谱分析,其有效成分为酚酸、黄酮类化合物、二苯乙烯和植物甾醇等。一种主要的植物甾醇(e -白藜芦醇)已经从象牙海岸生长的C. aralioides中分离出来。
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引用次数: 1
Future of Pharma Industry and Medical Devices after Corona Pandemic 冠状病毒大流行后制药行业和医疗设备的未来
Pub Date : 2021-06-07 DOI: 10.46624/ajptr.2021.v11.i3.002
Sahil, I. Kaushik, Aaradhita Kaler
A respiratory disease of unknown cause detected in Wuhan, China was first reported to the WHO Country Office in China on 31 December 2019. The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020. On 11 February 2020, WHO announced a name for the new coronavirus disease: COVID19. WHO is working 24 X 7 to provide advice, analyze data, coordinate with partners, help countries prepare, increase supplies and manage networks with experts. By 11 June 2020 Current evidence suggests that most transmission occurs from symptomatic people through close contact with others very rapidly. Correspondingly, most of recommendations by WHO on personal protective measures like use of masks and physical or social distancing are based on controlling transmission from symptomatic patients, including those with mild symptoms who are not easy to identify early. Comprehensive studies on transmission from asymptomatic patients are difficult to conduct, as they require testing of large population cohorts and more data are needed to better understand and quantify the transmissibility of SARSCoV-2. During this global pandemic, the medical device regulatory environment is quickly adapting to meet the challenge of supplying sufficient PPE to front-line healthcare providers and lifesaving equipment to those people in medical need. Manufacturers of medical device have to rise up to meet this challenge and embrace these opportunities to bring their device faster to the market and help us to take us out safely on the other side of the COVID-19 curve. One industry that is majorly impacted by this global crisis is the ventilator industry. There’s currently thought to be a global shortage of thousands of ventilators as the world attempts to tackle the deadly pandemic. During this pandemic health care systems are overwhelmed, and the effective delivery of medical care to all patients has become a challenge worldwide. Insufficient attention to early warning signs, inadequate stockpiling, lack of access to testing kits and personal protective equipment (PPE), and nationwide variability in the approaches to testing, distribution of PPE, and timing and degree of social distancing measures likely all affected the spread of the disease. Inadequate PPE, overcrowding, and difficulty protecting existing patients are key challenges to the medical industry.
2019年12月31日,世卫组织驻华国家办事处首次向中国武汉报告了一种原因不明的呼吸道疾病。此次疫情于2020年1月30日被宣布为国际关注的突发公共卫生事件。2020年2月11日,世卫组织宣布了这种新型冠状病毒疾病的名称:covid - 19。世卫组织正在全天候工作,提供咨询意见、分析数据、与合作伙伴协调、帮助各国做好准备、增加供应并管理专家网络。到2020年6月11日,目前的证据表明,大多数传播是由有症状的人通过与其他人密切接触迅速发生的。相应地,世卫组织关于个人防护措施(如使用口罩和保持身体或社交距离)的大多数建议都是基于控制来自有症状患者的传播,包括那些症状轻微、不易早期发现的患者。对无症状患者的传播进行全面的研究是困难的,因为它们需要对大人群队列进行检测,并且需要更多的数据来更好地了解和量化SARSCoV-2的传播性。在这次全球大流行期间,医疗器械监管环境正在迅速适应,以应对向一线医疗保健提供者提供足够的个人防护装备和向有医疗需求的人提供救生设备的挑战。医疗设备制造商必须奋起应对这一挑战,并抓住这些机会,更快地将他们的设备推向市场,并帮助我们安全地走出COVID-19曲线的另一边。受这场全球危机影响最大的一个行业是呼吸机行业。目前,由于全世界都在努力应对这种致命的流行病,人们认为全球存在数千台呼吸机的短缺。在这次大流行期间,卫生保健系统不堪重负,向所有患者有效提供医疗服务已成为全世界的一项挑战。对早期预警信号重视不足、储备不足、无法获得检测包和个人防护装备(PPE),以及全国范围内检测方法、个人防护装备分发以及社会疏远措施的时机和程度的差异,可能都影响了疾病的传播。个人防护装备不足、过度拥挤以及难以保护现有患者是医疗行业面临的主要挑战。
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引用次数: 0
Low Level Quantification of Potential Genotoxic Impurities In Telmisartan Drug Substance by HPLC 高效液相色谱法测定替米沙坦原料药中潜在遗传毒性杂质含量
Pub Date : 2021-06-07 DOI: 10.46624/ajptr.2021.v11.i3.003
K. Srivalli, N. Annapurna, K. Babu, C. Ramdas, H. Sharma, V. Kumar, K. Kumar, N. Srinivas
A sensitive and rapid HPLC method was developed and validated for the determination of potential genotoxic impurities i.e (Bromomethyl)biphenyl methyl ester and (Dibromomethyl)biphenyl methylester at trace level in Telmisartan drug substance by applying the concept of threshold of toxicological concern (TTC). The HPLC method was developed and optimized on Symmetry Shield RP18, 3.5  (150mm × 4.6mm) column with oven temperature maintaining at 40°C and 0.02M Phosphate buffer pH 2.5 was chosen as mobile phase A and mixture of acetonitrile and Phosphate buffer (55:45) was selected as mobile phase B in gradient reverse phase mode in isocratic mode of composition. Chromatographic parameters i.e flow rate: 1.0 ml/min, wavelength detection: 205 nm, injection volume: 20μl and run time: 25 min were applied in this methodology. Based on validation data, the method is found to be specific, sensitive, accurate and precise. The established limits of Limit of detection and Limit of quantification for subjected impurities are found to be 2.4 μg/g and 4.7 μg/g respectively for each impurity. The recovery at LOQ level obtained was 98.2% for (Bromomethyl) biphenyl methyl ester and 99.2% for (Dibromomethyl) biphenyl methyl ester. This method can be used as good quality control tool for quantization of these impurities at low level. The experimental results are discussed in detail in this research paper.
应用毒理学关注阈值(TTC)概念,建立了一种灵敏、快速的高效液相色谱法测定替米沙坦原料药中痕量(溴甲基)联苯甲酯和(二溴甲基)联苯甲酯的潜在遗传毒性杂质。HPLC方法在Symmetry Shield RP18上建立并优化,色谱柱为3.5(150mm × 4.6mm),恒温箱温度为40℃,温度为0.02M,以pH为2.5的磷酸盐缓冲液为流动相A,以梯度反相方式以55:45的乙腈-磷酸盐缓冲液为流动相B。色谱参数为流速1.0 ml/min,检测波长205 nm,进样量20μl,运行时间25 min。验证数据表明,该方法具有特异、灵敏、准确、精密度高的特点。每种杂质的检出限和定量限分别为2.4 μg/g和4.7 μg/g。在LOQ水平上,(溴甲基)联苯甲酯的回收率为98.2%,(二溴甲基)联苯甲酯的回收率为99.2%。该方法可作为低水平杂质定量的良好质量控制工具。本文对实验结果进行了详细的讨论。
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引用次数: 0
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American Journal of PharmTech Research
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