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Syed Ata Ur Rahman, Abdullah Alsaedi, Abdulelah Alhusayni, Abdulmalik Alqurshi, Sameh Ahmed, Yaser M. Alahmadi, Alaa Omer M. Abdullaal, Badr Ahmed A. Taher, El-Sayed E. Habib
Pharmacology & Pharmacy, Volume 12, pp 1-9; doi:10.4236/pp.2021.121001

Epilepsy is a chronic and the fourth most common neurological disorder which affects people of all age groups. Recently research and awareness on epilepsy-related deaths have rapidly grown over the past two decades. Many previous studies are attributed to the guidelines that apprise health care professionals in handling these deaths, but there is a relative scarcity of information accessible for clinicians and pharmacists who are responsible for manufacturing or preparing the extemporaneous anti-epileptic suspensions in the hospitals. Mostly in partial seizures, phenytoin is one of the first-choice drugs. In Saudi Arabian hospitals, the extemporaneous preparation of phenytoin suspension is common, but the hot climatic weather in Saudi Arabia possesses stability problems that should be tackled as the prepared suspension should pass all the stability tests to ensure uniform dosage of the extemporaneous formulation. In the current study, the commercial capsules were used to prepare the oral phenytoin sodium extemporaneous suspension. The physical, chemical and microbiological stability of phenytoin sodium suspension is analyzed at various temperatures.
Toshio Kurihara, Honami Kojima, Miyako Yoshida, Mizuho Oshio, Rino Kunikata, Haruka Nishikawa, Takahiro Uchida
Pharmacology & Pharmacy, Volume 12, pp 43-54; doi:10.4236/pp.2021.122004

The purpose of this study was to evaluate the palatability of dry syrups for pediatric use by human gustatory sensation testing and the artificial taste sensor. The bitterness intensities of dry syrups mixed with various beverages were also evaluated using the taste sensor. Twenty dry-syrup formulations of antibacterial and anti-allergic drugs containing bitter active ingredients, frequently used in pediatric medicine in Japan, were selected for testing. The main factors influencing palatability were determined by factor analysis of data from human gustatory sensation testing using the semantic differential method. It was shown that the bitterness intensity of dry syrups in water could be predicted by the artificial taste sensor. The influence of different beverages (orange juice, milk or cocoa) mixed with the dry syrups was evaluated using the artificial taste sensor. Taste and texture were found to be the principal factors influencing the palatability of dry syrups. While the bitterness intensities of some dry syrups were increased by mixing with orange juice, the bitterness intensities of most dry syrups were decreased by mixing with milk or cocoa. This suggests that one or more constituents of milk or cocoa may reduce the bitterness intensities of dry syrups.
Ali Mofleh Alshahrani, Taghreed Mubarak Alotaibi, Nawal Safar Alrabie, Bashayer Mohammed Althobaiti, Fatimah Nasser Alshelawi, Maram Abdullah Althobaiti, Mona Yaser Alsheikh, Ahmed Ibrahim Fathelrahman
Pharmacology & Pharmacy, Volume 12, pp 63-72; doi:10.4236/pp.2021.123006

Background: Community pharmacists play a significant role in dispensing and counseling about medications and pharmaceuticals including beauty and cosmetic products. Aims and Objectives: The current study was conducted to assess the viewpoint of community pharmacists in the Western region of Saudi Arabia about their professional role in dispensing beauty products. Methods: A cross-sectional study was conducted between September and December 2019 using an online questionnaire. Expert professors from college of pharmacy, Taif University validated the questionnaire. Results: Five hundred seventy-seven community pharmacists completed the questionnaire. Most of the participants were male (99%) and aged 23 - 34 years old (71.1%). Slightly less than half (45.58%) of community pharmacists have 6 - 10 years of experience. Most pharmacists (96.9%) communicate directly with customers/ patients and most of them (85.3%) ask and counsel patients about their product. Pharmacists strongly agreed that pharmacists must keep in developing their communication skills with customers/patients. Conclusion: Most of the community pharmacists surveyed in this study reported a good perceived knowledge and attitudes and demonstrated an acceptable level of practices regarding beauty products. Saudi FDA is encouraged to adopt Good Pharmacy Practice standards and guidelines to improve current practice of community pharmacists concerning Beauty Products.
Michel Tagliati, Marianna Leopoulou, Jo Ann LeQuang, Charles E. Wollmuth, Joseph V. Pergolizzi, Kailyn Mitchell, Peter Magnusson
Pharmacology & Pharmacy, Volume 12, pp 10-24; doi:10.4236/pp.2021.121002

Introduction: The inflammatory mechanisms of COVID-19 suggest that corticosteroids may be beneficial, but their benefits must outweigh their potential risks. The RECOVERY trial results suggest that dexamethasone 6 mg/day (but not other steroids) may confer mortality benefits on ventilated COVID-19 patients. Methods: This is a narrative review of the literature about the use of ciclesonide and dexamethasone for COVID-19 patients. Literature is being created rapidly and this review is offered as a state-of-the-science narration. Results: The SARS-CoV-2 virus is an RNA virus whose RNA is transcribed via open reading frames, making its elimination difficult. Coronaviruses have evolved multiple strategies for proteolytic activation of the spike; viral replication occurs entirely in the cytoplasm. In this connection, the RNA-cleaving endoribonuclease (NSP-15 also known as EndoU) may play a key role by facilitating viral double-stranded RNA recognition by the host’s macrophages. Furthermore, the virus is able to undergo RNA recombination rapidly, enabling it to evade host immunity and develop drug resistance. Ciclesonide is an inhaled corticosteroid that reduces lung inflammation and blocks the activity of specific kinases which may explain its anti-inflammatory effect. Dexamethasone is known to reduce mortality in ventilated COVID-19 patients. Discussion: Systemic corticosteroids were used in previous coronavirus epidemics (SARS and MERS) and pulmonary histology of these patients is similar to those in COVID-19 patients. Acute respiratory distress syndrome is the main cause of death in most COVID-19 infections and steroids may be effective in addressing that condition, brought on by cytokine storm. However, it should be noted that inhaled steroids likely have a narrower window for effect than systemic regimens. Conclusion: Dexamethasone has been proven to confer mortality benefits on ventilated COVID-19 patients and may be used with inhaled ciclesonide, which has few side effects and can be locally metabolized. Further study is needed.
Sohel Rana, Maruf Hasan, Eshak Enan, Fatema-Tuz Zohora, A. T. M. Zafrul Azam
Pharmacology & Pharmacy, Volume 12, pp 25-41; doi:10.4236/pp.2021.121003

Coronavirus infectious disease 2019 (COVID-19) first reported in Wuhan, China, causes serious respiratory illnesses such as lung failure and pneumonia. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) the pathogenic agent of COVID-19 has been confirmed as a novel coronavirus. WHO announced COVID-19 a global pandemic and now the whole world is eagerly waiting for vaccines and therapeutic treatment to get rid of this unstoppable coronavirus. As COVID-19 infection, a global threat creates unwanted human casualties and serious economic loss. To stop the ongoing uncontrolled situation researchers are racing to develop prevention and treatment strategies. Vaccines of different countries are in clinical and preclinical trials and the repurposed-drugs are providing to find out a positive result against COVID-19. The report is an analysis of published information focusing on treatment options including vaccination, drug-therapy, cytokines, therapeutic antibodies. Most of the vaccine’s development strategies and drugs target the surface structural spike glycoprotein or S-protein, the major inducer of pathogenic responses. Here, it is reviewed the features of SARS-CoV-2 and the global current status of therapeutic, and vaccine development for the prevention and effective treatment of COVID-19.
Yuka Miyachi, Chika Nakayama, Taeyuki Oshima
Pharmacology & Pharmacy, Volume 12, pp 55-62; doi:10.4236/pp.2021.122005

In recent years, consumers are becoming more health-conscious. Supplements are becoming popular as they can be purchased easily. In Japan, the “Food with Function Claims” system began in 2015; the market for supplements is expected to continue to expand. However, the use of some supplements has not been supported with sufficient scientific evidence; some products have even caused health problems. In addition, consumers may not be able to make correct decisions based on the information from the Internet. Unlike medicine, the instruction on the usage of supplements is not precise. Therefore, improving the quality of the information on the supplements will become more necessary in the future. This study aims to improve the quality of the information on supplements by surveying the disintegration and dissolution behavior of the carnitine-containing supplements and evaluated their quality. The products tested here were supplements containing commercial carnitine. Disintegration test and dissolution test were conducted according to the Japanese Pharmacopoeia. Carnitine was quantified by high-performance liquid chromatography. The disintegration tests revealed that the products had different disintegration times, varying from 35 to 100 minutes; some products took more than 5 hours to disintegrate. Thus, some products had a slow rise in their dissolution rate. These results suggest that the carnitine-containing supplements used in this study may affect the absorption process. Therefore, in the case of oral administration, the expected effect might not be achieved depending on the product.
Moyan Uddin Pk, Mohammad Sayful Islam, Shariful Haque, LutfA Akther, Rumana Pervin
Pharmacology & Pharmacy, Volume 12, pp 73-84; doi:10.4236/pp.2021.123007

The current study evaluated the antioxidant, α-amylase inhibitory and anti-Staphylococcus aureus activities of the fruiting bodies of Ganoderma lucidum. Methanolic extract of G. lucidum (MEGL) was investigated for its in vitro antioxidant activity using 1,1-diphenyl 2-picrylhydrazyl (DPPH) assay and EC50 value was determined. α-Amylase inhibitory and anti-S. aureus activities were carried out by conventional methods. The mushroom extract showed maximum free radical scavenging activity at a dose of 500 μg/mL with EC50 value of 22.1399 μg/mL. EC50 value for the inhibition of α-amylase activity was found 22.6011 μg/mL. G. lucidum extracts exhibited a concentration-dependent Anti-S. aureus activity. The vast differences of this inhibition between lower and higher doses were assessed significantly (p G. lucidum has moderate antioxidant, α-amylase inhibitory, and anti-S. aureus activities. Thus this mushroom may be the alternative plant source for the antioxidant, anti-diabetic and antibacterial agents and further in vivo studies and isolation of bioactive compounds are required.
Brice Boris Legba, Victorien Dougnon, Jerrold Agbankpe, Kafayath Fabiyi, Christelle Lougbegnon, Arnaud Soha, Césaire Ayena, Esther Deguenon, Hornel Koudokpon, Lamine Baba-Moussa
Pharmacology & Pharmacy, Volume 11, pp 226-234; doi:10.4236/pp.2020.119020

Recent ethnopharmacological data cited Senna siamea as one of the most widely used medicinal plants in the management of salmonellosis in Benin. However, data related to its activity on non-typhoidal Salmonella spp are limited. This study aimed to assess the antibacterial activity of Senna siamea on multidrug-resistant Salmonella. Ethanolic and aqueous extracts of S. siamea were tested for their antibacterial activity on four multidrug-resistant Salmonella: Salmonella Typhimurium ATCC 14028 and three Salmonella spp. isolated from animals intended for human consumption in Benin. Well diffusion technique combined with the determination by microdilution of Minimum Bactericidal Concentration (MBC) and Minimum Inhibitory Concentration (MIC) were used for antibacterial testing. From antibacterial testing, inhibition diameters of the extracts ranged from 7 to 11 mm, for the susceptible strains. Colistin (reference antibiotic) was active on all Salmonella spp. with inhibition diameters between 18 and 19 mm. The MICs ranged from 3.125 to 25 mg/ml while MBCs of the extracts are greater than 100 mg/ml, so none of the extracts have antibacterial power (p.a). From these results, it appears that the use of Senna siamea in the traditional treatment of salmonellosis is justified. These results must be valued in the development of anti-salmonella phytomedicines.
Rivain Fefe Iteke, David Mwembo Mutombo, Franck Namegabe Zirhumana, Olivier Kabiriko Mukuku, Emmanuel Kiyana Muyumba, Tinsley Mukakala Kibonge, Jean Francois Brichant, Adolphe Manzanza Kilembe, Yapo Brouh, Jean Baptiste Zambeze Sakatolo Kakoma
Pharmacology & Pharmacy, Volume 11, pp 196-208; doi:10.4236/pp.2020.118018

Objective: To evaluate the synergistic effect of a Selective Serotonin Reuptake Inhibitor (SSRI) and a Selective Cyclooxygenase 2 Inhibitor (ISCOx-2) in the management of After Rachianesthesia Headache in Obstetric Care. Patients and Methods: This was an experimental double-blind, randomized, multi-center clinical trial of non-inferiority clinical trials over a 12-month period (May 1, 2018 to April 30, 2019) in six hospitals in southeastern DR Congo, including all patients undergoing surgery or analgesia on spinal anesthesia for obstetrical indication and with headache characteristic of a dural breccia, with no known causes, contraindications to experimental products and informed consent to been obtained. The patients were divided into four different groups depending on the protocol used, namely: Group A = Rehydration + Paracetamol, Group B = Rehydration + Celecoxib, Group C = Rehydration + Nefopam and Group 4 = Rehydration + Celecoxib + Nefopam (Study Group). Using the Statview II software, the statistical analyzes of data obtained from the different tests were made using the ANOVA test for comparing the averages of different samples using the Fisher test. Verification of the normality of the samples was made by the Kurtosis and Skewness flattening and asymmetry test. Results: The protocol associating Celecoxib and Nefopam significantly demonstrates its effectiveness in reducing CPRAOs in the first two days with a gradual decrease in anxiety and length of stay. In addition, the majority of patients (75.6%) had a high overall level of satisfaction with this protocol. Conclusion: The Nefopam-Celecoxib combination shows its effectiveness in the early reduction of these CPRAOs, anxiety and length of stay with a high overall level of patient satisfaction. Given the good tolerance and accessibility of these products, we strongly suggest the use of this protocol for its validation in our environment and elsewhere, although it is desirable to continue research on other non-explored alien pathways.
Jahidul Hasan, Jaime Nead
Pharmacology & Pharmacy, Volume 11, pp 209-225; doi:10.4236/pp.2020.119019

The frontline pharmacists during this pandemic COVID-19 (coronavirus disease 2019) situation are potentially contributing to saving human lives worldwide. The objective of this study was to demonstrate the current contributions of pharmacists among the frontline healthcare professionals in the management of the COVID-19 crisis across the world. MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Web of Science, and Scopus databases were searched for this study from March 20, 2020 to May 20, 2020. The basic keyword “pharmacist and COVID-19” was used to select studies. Relevant English-language studies, guidelines, articles, relevant published reports in different online news portals and official web pages of different organizations were searched. Pharmacists in the United States and United Kingdom are testing patients for COVID-19 and providing medical advice to patients. Community pharmacists in European countries are focused on the smooth supply of essential medicines, and working to build awareness regarding the community transmission of COVID-19. Hospital and clinical pharmacists are working to facilitate the effective medication therapy management for improving the clinical outcomes of COVID-19 patients. Pharmacists in low-and middle-income countries around the world have focused their efforts mainly on awareness-building activities regarding the community transmission of COVID-19, and the mass production of alcohol-based hand-sanitizer. Several resources are globally available for pharmacists to improve their competency and self-protection from COVID-19. Frontline pharmacists are enthusiastically contributing in the prevention and treatment of COVID-19 from a community-to-clinical level worldwide. Their active participation as a member of the frontline healthcare team is crucial in order to address and overcome the challenges that this pandemic has created, and to tackle this global healthcare crisis efficiently.
Debnath Puja Sangita, Ruhullah Shahriar Kazi, Mahmood Hasan Choudhury, Ahsan Monira, Sangita Debnath Puja, Kazi Ruhullah Shahriar, Choudhury Mahmood Hasan, Monira Ahsan
Pharmacology & Pharmacy, Volume 11, pp 137-146; doi:10.4236/pp.2020.117013

Methanolic extract of the leaves of Bridelia stipularis was studied. From this study, we isolated three known flavonoids. They were identified as 7-O-methyl luteolin, apigenin and 5, 7, 2’, 5’ tetrahydroxyflavone by NMR spectroscopic studies. All of them are first time documented for this plant. Different solvent fractions were subjected to in vitro antioxidant and cytotoxicity studies. Both apigenin and ethyl acetate soluble fraction of Bridelia stipularis showed strong antioxidant activity having IC50 value of 8.005, 8.77 μg/mL respectively. Chloroform soluble fraction of Bridelia stipularis exerted the highest toxicity to brine shrimp and petroleum ether soluble fraction showed moderate toxicity having LC50 value of 1.05, 1.71 μg/mL respectively.
Nargis Sultana Chowdhury, Farhana Farjana, Hossain Sohrab
Pharmacology & Pharmacy, Volume 11, pp 350-361; doi:10.4236/pp.2020.1112028

The objective of this study is to isolate, identify and investigate the pharmacological activities of the endophytic fungi from an aquatic plant Aponogeton undulatus Roxb. (A. undulatus). Endophytic fungi were isolated and identified based on morphological characters. The molecular identification of the fungal isolates was performed using by analyzing the DNA sequence based on mega BLAST program. Spectrums of antibacterial and antifungal activities were studied by Agar diffusion methods. Extracts of the endophytic fungal strains isolated from the plant A. undulatus were screened for probable cytotoxic activities using brine shrimp lethality bioassay. Six endophytic fungi, namely AULE-1, AULE-2, AULE-3, AURE-1, AURE-3 and AURE-4 were isolated and purified from the leaves and roots of the plant such as strains AULE-1 as Trichooderma sp., AULE-2 as Carvularia sp. AULE-3 as Penicillium sp. strains AURE-1 and AURE-4 as Fusarium sp. and AURE-3 as Mucor sp. Strain AURE-4 was further identified as Fusarium solani. At 300 μg/disc concentration, six ethyl acetate extracts of endophytic fungi of the plant A. undulates showed moderate to significant activities against most of the test bacteria and pathogenic fungi. The strain AURE-4 exhibited strong cytotoxic activities (10.18 μg/mL) compared to the standard antitumor agent vincristine sulphate and this positive result suggests that fungal extracts may contain antitumor or pesticidal compounds. This is the first study to report the isolation, identification, antimicrobial and cytotoxic properties of endophytic fungi of Aponogeton undulatus Roxb. in Bangladesh.
Joseph V. Pergolizzi, Jo Ann Le Quang, Robert Taylor, Peter Magnusson, Megan Nalamachu, Claudio Pergolizzi, Virginia Bingol, Domenico Foti, Charles Wollmuth, Sumiyo Umeda-Raffa, et al.
Pharmacology & Pharmacy, Volume 11, pp 306-315; doi:10.4236/pp.2020.1111025

Abdulmalik Alqurshi
Pharmacology & Pharmacy, Volume 11, pp 316-329; doi:10.4236/pp.2020.1111026

Background: Inappropriate disposal practices of medicinal products by households can harm nature. Alternatively, passing unused medications to friends and family members can have undesirable consequences as the quality of the product is in question. Objective: To investigate the disposal and recycling practices of medicinal products by households in Saudi Arabia. Methods: A cross-sectional questionnaire designed to investigate disposal and recycling practices aimed at households in Saudi Arabia. Phone interviews were conducted with healthcare providers from hospitals and community pharmacies as well as medical charity representatives. A thorough search (Jun-September 2020) for disposal and recycling policies was performed on the Saudi Food and Drug Authority (SFDA) and the Ministry of Health websites. Results: More than 900 participants were included in this study. Approximately 40% of respondents claimed to follow the SFDA recommendations for the disposal of unwanted medications in the wastebasket, whilst ≥6% preferred disposal via the toilet. On the other hand, 10% and 5% of households donated their unwanted over-the-counter and prescription-only medication products, respectively, to a person in need, without referring to healthcare professionals. Interviews with healthcare providers and medical charities revealed no drug take-back programs were currently available for households. The SFDA website provides a brief guide on the disposal of unwanted or expired medication. Conclusions: The absence of a clear drug disposal policy for households has created a gap allowing incorrect disposal practices that may lead to harming patients and/or the environment. The launching of drug take-back programs may lead to the provision of a clear consensus of governing bodies and healthcare providers on patient guidance for a safe drug disposal policy.
Karla Dumancela, Eduardo Mayorga, Javier Santamaría- Aguirre
Pharmacology & Pharmacy, Volume 11, pp 118-126; doi:10.4236/pp.2020.116011

There are many natural sources to obtain pharmaceutical grade starch, one of which is banana (Musa × paradisiaca L.); nevertheless, the use of native starch has certain disadvantages compared to modified starches, whose disintegrating properties are better. In this study, starch extracted from rejected fruits of Musa × paradisiaca L., was modified by acetylation, under the following optimized experimental conditions: 130 mL acetic anhydride, 3 mL sodium hydroxide 50% p/v for each 15 grams of native starch, at 123℃ during 3 hours. The reaction resulted in a modified green banana starch with twice as much swelling capacity compared to unmodified (native) starch; acetylation was verified by infrared spectroscopy and degree of substitution of acetyl groups by back titration. The dissolution profiles of Ibuprofen tablets made with banana modified starch and commercial disintegrant, have no differences according with their similarity factor, f2. It is concluded that it is feasible to use green banana starch modified through acetylation as a pharmaceutical disintegrant.
E. Russell Vickers
Pharmacology & Pharmacy, Volume 11, pp 105-117; doi:10.4236/pp.2020.116010

There is extensive worldwide use for the social consumption of alcohol. Abuse of alcohol causes substantial personal, psychological and medical health issues. In addition, there are significant national economic costs from lost productivity. However, there are limited pharmaceutical drugs for the treatment of alcohol overuse. Historically, many cultures have used herbs and other natural compounds to reduce problematic alcohol induced behaviour but the evidence is anecdotal. This study investigated if a natural compound formula (RM88) that was developed could reduce blood alcohol concentration (BAC) in a controlled case series. Thirteen subjects (5 males, 8 females, age range 18 to 85 years) completed 16 paired sessions of alcohol only versus RM88 with alcohol. Subjects consumed one to three standard drinks of beer, wine or spirits (14.7 to 29.4 gm alcohol). Measurements were made by a fuel cell breathalyzer for a period of 90 minutes. Summated BAC showed a reduction in 94% (15/16) of paired test sessions (BAC reduction range 23% - 79%, mean 50.9% ± 16.5%, p = 0.0005). Data normalized to 20 gm alcohol (two standard drinks) showed a significance of p = 0.00026. One subject on prednisone and hydroxychloroquine drugs had increased BAC from RM88. The average reductions of BAC for the beverages were spirits 34% (n = 3), beer 36% (n = 3), and wine 52% (n = 10). RM88 showed that this combination of natural compounds was very effective in reducing maximal peak concentrations of alcohol.
Eduardo Mansilla, Ricardo Rangel Martínez, Gustavo Horacio Marín, Idiberto Zotarelli Filho, Elsa Rivas, Jaime Rivas, Katherine Athayde Teixeira De Carvalho, Mohammad Reza Dayer, Alí Samadikuchaksaraei
Pharmacology & Pharmacy, Volume 11, pp 85-104; doi:10.4236/pp.2020.116009

Noritake Hirota, Noboru Okamura
Pharmacology & Pharmacy, Volume 11, pp 55-70; doi:10.4236/pp.2020.114006

A questionnaire survey was conducted employing pharmacists at 350 Japanese Federation of Democratic Medical Institutions (Min-Iren) member pharmacies, evaluating the challenges related to registering as a Health Support Pharmacy (HSP). Completed responses were received from 193 pharmacies (55.1%). Fifty-five (28.5%) of these pharmacies were approved as meeting the HSP criteria. Some difficulties encountered in registering as an HSP included the preparation of the numerous required documents and placing a health support pharmacist. The obstacles that prevented pharmacists from registering were physical, including “placement of two or more health support pharmacists” and “placement of the required over-the-counter drugs (OTCs).” Based on these, 51.8% of supervising pharmacists stated the opinion that the government should “loosen current criteria.” However, a survey conducted among the 724 participant pharmacists, working in a pharmacy, showed no significant difference in their answering tendencies depending on whether or not they worked at an HSP. This could be attributed to the effort that Min- Iren pharmacies have been putting into health support and primary care functions. Overall, 64.5% of pharmacists working at HSPs were proud that the pharmacy they worked had HSP status. The present survey revealed the physical obstacles of HSP registration. Conformity to the criteria of HSP is essential for performing their fundamental functions as pharmacies. The relaxation of the criteria is anticipated.
Jamie L. McConaha, Phillip Lunney, Jan M. Kitzen, Joseph V. Pergolizzi Jr., Robert Taylor, Robert B. Raffa
Pharmacology & Pharmacy, Volume 11, pp 127-136; doi:10.4236/pp.2020.116012

The rise in “vaping”-associated deaths in the United States raises serious concerns. A justification for some level of risk is that e-cigarettes might provide a “reverse-gateway” from smoking traditional cigarettes to a less-harmful alternative. But are users actually smokers? We developed an electronic on-line survey to gather data regarding e-cigarette usage in a target study population of pharmacy students. The survey was created using Google Forms to collect the responses anonymously. We surveyed medical-savvy healthcare students about their e-cigarette use, and whether or not their healthcare providers were aware of their e-cigarette use. Although nearly one-fourth of a convenience sampling of 134 pharmacy-student respondents (23.9%) reported using e-cigarettes, only 2.0% reported prior regular cigarette use, 28% used cartridges containing nicotine and only 11.2% had tried and wanted to quit. The majority (64.1%) reported that their healthcare providers did not ask about such use, and respondents did not volunteer this information. The results of this pilot survey reveal a significant e-cigarette use among health-aware pharmacy students, and they do not support the notion that the respondents do so to quit smoking. The observation that most of the students’ healthcare providers did not inquire about their e-cigarette use, coupled with the finding that users did not volunteer their vaping behavior, suggests that the information should be included when getting a medical history. Further research is needed to determine what behavioral factors may play a role in this type of decision-making among student healthcare professionals.
Jiuli Hu, Junhui Hu
Pharmacology & Pharmacy, Volume 11, pp 79-84; doi:10.4236/pp.2020.116008

Invasive candidiasis was the most common nosocomial fungal infection with high morbidity and mortality, which is mainly occurring in immunodeficiency and critical patients. Echinocandins were recommended as first-line drugs for the treatment and prevention of invasive candidiasis. In our study, we aimed to optimize the dosage of Rezafungin against Candida spp. based on pharmacokinetic/pharmacodynamics (PK/PD) analysis. We collected the published data about pharmacokinetic parameters of rezafungin and the MIC distribution of Candida spp. on rezafungin. Monte Carlo simulation was used to calculate probability of target attainment and a cumulative fraction of response to assess the best dosing regimen. The optimal dosage regimen for C. albicans and C. glabrata was 50 mg IV, and the optimal dosage regimen for C. parapsilosis was 100 mg IV. Lastly, rezafungin has an excellent antifungal effect on C. albicans, C. glabrata and C. parapsilosis.
John F. Peppin, Joseph V. Pergolizzi Jr., Albert Dahan, Robert B. Raffa
Pharmacology & Pharmacy, Volume 11, pp 362-372; doi:10.4236/pp.2020.1112029

The “opioid crisis” has had a tremendous impact not only on its victims, but also on the practice of medicine, pain patients, and society in general. Unfortunately, efforts to “stem the tide” have not been successful at reducing overdose deaths. Counterbalancing the many ardent efforts to eliminate overdose deaths (such as the current widespread availability and use of opioid-receptor antagonists such as naloxone) is influx of the illicit fentanoids (i.e., fentanyl and analogs). In addition to their high-potency, the fentanoids differ in surprising ways from more “traditional” opioids such as morphine and heroin. This uniqueness contributes to a reduced effectiveness of opioid receptor antagonists in the treatment of opioid overdose. Further greatly complicating overdose treatment is polysubstance abuse (e.g., an opioid plus a benzodiazepine). The non-opioid in the combination is not responsive to an opioid-recep- tor antagonist, which imparts additional challenges. Thus, the new reality introduces complications that negatively impact efforts to reverse “opioid” overdose. New approaches to improve outcomes in individuals who experience respiratory depression due to fentanoid-induced or polysubstance-induced over- dose are needed. Approaches that harmonize with the new reality, perhaps something like a non-opioid “agnostic” pharmacologic ventilatory stimulant, would provide a welcome addition to the current choices.
M. Mohamed Sumeia, Mark Christensen John, Leblanc Nicole, Sumeia M. Mohamed, John Mark Christensen, Nicole Leblanc
Pharmacology & Pharmacy, Volume 11, pp 39-53; doi:10.4236/pp.2020.113005

Atenolol diffusion through synthetic membrane, cloned human epidermis, and cat ear skin was performed utilizing a Franz diffusion cell. Transdermal drug diffusion enhancers’ ethanol, glycerol, propylene glycol, polysorbate 80 and Dimethyl isosorbide (DMI) were added to the topical formulations and tested for their ability to enhance drug permeation through the test membranes. Topical formulation with penetration enhancers showed a rapid burst of atenolol diffusion for the first two hours (35.5 to 40 μg/ml) followed by a zero-order sustained diffusion of 2.7 μg/cm2/h of atenolol for up to twenty-four hours after application to test membranes. Increased atenolol flux through different test membranes was greatest for synthetic membrane. The topical application of the optimized atenolol formulation to cat skin containing permeation enhancers aided transdermal atenolol drug delivery to treat cats with hypertrophic obstructive cardiomyopathy. The optimum topical formulation demonstrated two fluxes through cat skin, the burst flux (15.7 μg/cm2/h) and a sustained flux (2.7 μg/cm2/h). Measured atenolol concentrations in cats at 3, 6 and 12 hours after transdermal atenolol application were 432.7 ng/ml ± 323.3, 262.4 ng/ml ± 150.1, and 253.3 ng/ml ± 133.6 respectively. Six of 7 cats achieved therapeutic serum atenolol levels (260 ng/ml) for at least one time point. Five of 7 cats had therapeutic serum atenolol concentrations 3 hours post-atenolol. At the 6 hours post-atenolol time point, only 2 had a therapeutic serum atenolol concentration while at 12 hours post-atenolol dosing, 4 of 7 cats had therapeutic serum atenolol concentrations. Transdermal atenolol administered at 25 mg q12h resulted in clinically therapeutic serum atenolol concentrations in the majority of healthy cats. The optimum transdermal formulation enabled good drug delivery feasible for transdermal application in a clinical trial in cats.
Ying Wang, Jingyi Zhao, Yinhui Yao, Junhui Hu, Jiuli Hu, Xu Xiao, Yanwu Zhao
Pharmacology & Pharmacy, Volume 11, pp 29-37; doi:10.4236/pp.2020.112004

Dalbavancin is a novel semi-synthetic glycopeptide antibiotic. In this study, we aimed to optimize the dosage regimen of dalbavancin in patients with hepatic or renal impairment by Mote Carlo simulation. Pharmacokinetic parameters and microbiological data were collected about dalbavancin. 10,000 patients with renal or hepatic impairment analyzed by Crystal Ball to calculate probability of target attainment (PTA) and cumulative fraction of response (CFR). We found that all bacterial PTA and CFR were more than 90% for dalbavancin in patients with hepatic or renal impairment, except for Enterococcus faecium. There is no need to adjust the dosage regimen of dalbavancin in patients with hepatic or renal impairment.
Xianjun Long, Bo Liu, Zuren Peng, Ping Qiu, Xuechun Yang, Yuanxiang Yang, Meili Wang, Songmao Yin, Xingchu Gong
Pharmacology & Pharmacy, Volume 11, pp 188-195; doi:10.4236/pp.2020.118017

The change of drug quality of Yuxingcao injection after formulation is considered as one of the causes for adverse reactions. In this study, orthogonal experimental design was used to investigate the influencing factors on the pH stability of Yuxingcao injection. Two methods of accelerated tests were carried out in the experiments. The results showed that using Tween 80 as the solubilizer could significantly decrease the pH value of Yuxingcao injection after accelerated tests. There was no significant difference in the pH value after the accelerated tests when the other 6 factors varied, including the type of liquid processed, the dosage of activated carbon, heating temperature, reagents for pH adjustment, pH value range after adjustment, and sterilization conditions. In order to improve the quality stability of Yuxingcao injection, the quality of Tween 80 should be strictly controlled to minimize the change of pH value of Yuxingcao injection.
Froylán Ibarra-Velarde, Yolanda Vera-Montenegro, Yazmín Acala-Canto, Irene Cruz-Mendoza
Pharmacology & Pharmacy, Volume 11, pp 174-187; doi:10.4236/pp.2020.118016

The acaricidal efficiency of fipronil alone and fipronil + methoprene compared to commercial fipronil and commercial fipronil + methoprene, applied by the epicutaneous route (spot-on) in dogs naturally infested with ticks, was assessed. Thirty dogs infested with high loads of ticks were used. On day 0, the dogs were divided into 5 groups of 6 animals each. Each animal was duly identified for individual and group monitoring. Treatments were made based on body weight according to manufacturer’s instructions. Group 1 (G1) received 10.0% fipronil at a single dose of a pipette applied by epicutaneous route in the base of the neck. G2 received 10% fipronil + 10% methoprene in single application similarly to G1. G3 was treated with 9.8% commercial fipronil as before mentioned. G4 received commercial 9.8% fipronil + 9.8% methoprene applied as in previous groups. G5 served as an infected untreated control. Animals were examined by thumb tick counts on days 0 (Treatment day), 3, 7, 14, 21 and 28. Efficacy was measured as a percentage of tick reduction in the treated groups relative to the untreated control. Results indicated an overall efficacy of 88.2%, 93%, 90.4% and 99.3%, respectively. There was no significant statistical difference between the treated groups (P ly and in full development. It is concluded that the combined formulations of fipronil + methoprene compared to fipronil applied alone, showed an additive effect against Rhipicephalus sanguineus ticks in naturally infested dogs kept in captivity.
Moushumi Tabassoom Salam, Ashim Kumar, Akito Hata, Hiromu Kondo, Abdus Salam, Mir Imam Ibne Wahed, Rafiqul Islam Khan, Ranjan Kumar Barman
Pharmacology & Pharmacy, Volume 11, pp 159-173; doi:10.4236/pp.2020.118015

This investigation was undertaken to enhance the solubility and consequent antibacterial activity of cefuroxime axetil (CA), a β-lactamase-stable broad spectrum second generation cephalosporin through solid dispersion (SD) technique. For this purpose, CA loaded SDs (CSDs) were prepared by solvent evaporation method using different concentrations of microcrystalline cellulose (MCC) as carrier. The CSDs were characterized by in-vitro dissolution study, thermal analysis (DSC), crystallinity (PXRD), interactions (FTIR) and morphology (SEM). Among the formulations, CSD-2 showed the highest dissolution rate which was 2.59-fold higher than pure CA with a drug-carrier (CA: MCC) ratio of 1:3. Enhanced dissolution rate was attributed to conversion of drug from crystalline to amorphous state during preparation of SDs, which was validated by DSC, PXRD, FTIR and SEM analyses. Antibacterial activity of CSD-2 against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922) showed 1.94- and 6.75-fold higher relative zone of inhibition (RZOI), respectively than pure CA. CSD-2 has been found to be the most effective optimized formulation in terms of both enhanced dissolution rate and antibacterial activity. Thus, it can be an effective alternative to conventional dosage forms of CA. However, further investigations are needed to validate its pharmacokinetic properties, in-vivo antibacterial efficacy and safety before recommending as a novel formulation
Jiuli Hu, Zhu Xiaoqin, Chanchan Hu, Rui Wang, Yanwu Zhao, Xiaoqin Zhu
Pharmacology & Pharmacy, Volume 11, pp 299-305; doi:10.4236/pp.2020.1111024

Introduction: The prevalence of Klebsiella pneumoniae has rapidly increased in recent years and the distribution differed greatly by region, We aimed to study the relationship between antibiotic resistance and K. pneumoniae, especially carbapenem-resistant Klebsiella pneumoniae (CRKP) in our tertiary hospitals from 2014 to 2018. Methodology: The antibiotic consumption data of K. pneumoniae were expressed as the defined daily dose (DDD) per 100 inpatient days (DDDs). K. pneumoniae which isolated from clinical samples in hospital between January 2014 and December 2018 were retrospectively analyzed, and the correlation between antibiotic resistance rate and antibiotic frequency was analyzed. Results: From 2014 to 2018, a total of 2295 strains of K. pneumoniae were isolated, with the detection rates of 8.2%, 9.2%, 11.9%, 13.4% and 14.0%. There were 423 strains of CRKP, with the detection rates of 7.5%, 5.8%, 17.8% 24.2% and 25.2% respectively. K. pneumoniae showed different degrees of resistance to antibiotics and showed an increasing trend year by year to carbapenems. The resistance rate of imipenem was 2.5%, 2.8%, 9.9%, 12.3%, 13.4%, and the resistance rate of meropenem was 2.0%, 3.0%, 8.8%, 12.6%, 12.7%, respectively. The resistance rate of most other drugs decreased. The DDDs values of cefoperazone/sulbactam, piperacillin-tazobactam and gentamicin showed a strong positive correlation with K. pneumoniae drug resistance rate (r > 0.8, P 0.05). Conclusions: The detection rate of K. pneumoniae and CRKP increased year by year, which was closely related to the dose of antibiotics. Strengthening the management of antimicrobial drugs and standardising the use of antimicrobial prescriptions were of great significance for delaying the emergence of drug-resistant bacteria.
Baraa G. Alani, Ameer H. Alwash, Ismail T. Ibrahim
Pharmacology & Pharmacy, Volume 11, pp 251-281; doi:10.4236/pp.2020.1110022

Chloroquine (CQ) was and still considered as the most common agent in the treatment and prophylaxis of malaria, it also possesses many different pharmacological and biological activities that make it able to be used as a therapy or adjuvant therapy for many types of diseases. CQ exhibits anticancer activity alone or as adjuvants with other agents against many kinds of tumors. Its activities also were approved as an anti-inflammatory agent in rheumatoid and other autoimmune diseases like systemic lupus and rheumatic arthritis. Its’ important role in the improvement of many metabolic disorders like hypertension, hyperglycemia, and lipid profile disturbances was also established. CQ can act against different microbial infections such as many types of viruses, bacteria and fungus by different mechanisms of action. Furthermore, its dermatological role in the treatment of many skin diseases was demonstrated. Recently, CQ showed a very responsive role in curing and prevention of the covoid-19 virus. This review summarizes intensively the multiple therapeutic applications of CQ and discusses the possible mechanisms of action for these applications.
Abdulqader Abdulrazzaq, Simon Kennedy
Pharmacology & Pharmacy, Volume 11, pp 331-349; doi:10.4236/pp.2020.1112027

The recent acknowledgment of the paracrine role of perivascular adipose tissue (PVAT) in vascular modulation has been supported by many studies investigating major arteries in several animal models and humans. The influence of PVAT on the functional activity of the vascular bed has been a matter of debate, whether it is an anticontractile effect with protective roles or a pro-contractile effect, investigations are underway to address this obscurity. In this investigation, we have studied the effects of vasoconstrictors, phenylephrine and noradrenaline, and vasorelaxants, carbachol and s-nitroso-n- acetylpenicillamine (SNAP), on subclavian and iliac rings with and without PVAT attached; and concentration-response curves were constructed accordingly. Levels of nitric oxide (NO) generated due to activation of the enzyme adenosine monophosphate-activated protein kinase (AMPK) by 5-Aminoimi- dazole-4-carboxamide-1-β-D-ribofuranoside (AICAR) were measured in sub- clavian and iliac PVAT conditioned media. Additionally, Haematoxylin and Eosin staining was performed to analyze and compare the histological characteristics of both arteries. Subclavian and iliac rings with PVAT attached showed stronger contraction to phenylephrine and noradrenaline than that of rings without PVAT attached. At the same time, relaxation tests reported lower relaxation percentages in subclavian and iliac rings with PVAT attached compared to rings without PVAT attached in response to carbachol and SNAP. PVAT treated with AICAR generated higher levels of NO compared to levels of untreated PVAT. Conclusions drawn were the pro-contractile effects demonstrated by the PVAT especially in high concentrations of drugs used. In addition, histology analysis revealed characteristics of white adipose tissue in both PVATs.
Tanja Gmeiner, Jasna Grzelj, Borut Strukelj, Luka Stopar, Pij Bogomir Marko
Pharmacology & Pharmacy, Volume 11, pp 373-401; doi:10.4236/pp.2020.1112030

Immense changes have been introduced in psoriasis treatment, including successful systemic treatment of inflammation and education of psoriatic patients. The focus of this review is the latest developments in the understanding of the aetiopathogenesis of psoriasis, the significance of its comorbidities, treatment possibilities and long-term management using the latest insight provided by pharmacogenetics and identification of biomarkers. The successful control of the disease leads to reduction of myocardial infarction and long-term cardiovascular risk but is usually achieved after various therapeutic attempts until the best-matched treatment for the individual is identified. There is a high unmet medical need for revealing biomarkers associated with disease prognosis, comorbidities, response to therapy and adverse effects. More studies have to be performed for identification and validation of biomarkers and implementation of personalized medicine into clinical practice.
Robert B. Raffa, Joseph V. Pergolizzi Jr., Robert Taylor
Pharmacology & Pharmacy, Volume 11, pp 1-8; doi:10.4236/pp.2020.111001

Many therapeutic drugs are racemates; i.e. they are chiral molecules consisting of “left”- and “right-handed” enantiomers (stereoisomers that are mirror images of each other, and are non-superimposable). In some cases, both enantiomers of the drug contribute to some extent (or equally) to the therapeutic effect; in other cases they contribute not at all. The same is true for the adverse effects of racemate drugs: the adverse effects of a racemate drug can be greater-than, less-than, or equal to one or the other enantiomer. An unusual situation arises when a drug consists of “atropisomers”, stereoisomers arising because of hindered rotation about a single chemical bond. We summarize the concept of atropisomerism, and give examples.
Yuka Miyachi, Chika Nakayama, Takashi Horiba, Tomoaki Hino, Kazuyo Nagashiba, Miki Kato, Masafumi Ohnishi, Hiroko Saito, Masato Isogai, Nami Sugiura, et al.
Pharmacology & Pharmacy, Volume 11, pp 9-16; doi:10.4236/pp.2020.111002

It is the responsibility of pharmacists to ensure the safety of patients as pharmacist’s professional duties expand into diverse directions. In recent years, the use of automated dispensing systems has increased; however, the inspection by pharmacists is the most important step in the prevention of medical errors. Comparing the inspection of hospital and community pharmacists may lead to an increased awareness of incident countermeasures. Therefore, eye tracking was performed for hospital and community pharmacists who conduct inspection, and the results revealed the factors that affect dispensing errors. One of the factors was the size of the dispensing space, especially if the space was small and the items needed were not easily accessible. In addition, differences in the inspection procedures among pharmacists were presumed to lead to possible dispensing errors due to oversights. Moreover, it was suggested that any subsequent work would flow more smoothly if a pharmacist checked the prescription and medication history management records at the beginning. Furthermore, it was thought that keeping a history of checks, such as recording any prescription checks in writing, would speed up finding the cause in the unlikely event that a dispensing error occurred. Accordingly, creating an environment in which one can concentrate without distractions during the inspections can lead to the prevention of dispensing error.
Ying Wang, Jingyi Zhao, Junhui Hu, Xinhong Zhao, Yinhui Yao
Pharmacology & Pharmacy, Volume 11, pp 17-28; doi:10.4236/pp.2020.111003

Invasive fungal infections (IFI) have recently become increasingly more prevalent, resulting in an increased risk of morbidity and mortality. Both Candida spp. and Aspergillus spp. are major causes of IFI. In this study, we aimed to evaluate the cumulative fraction of response of various dosage regimens of posaconazole against nine Candida spp. and six Aspergillus spp. in both children and adults. Monte Carlo simulation (MCS) was performed to optimize selection of posaconazole dosage regimens. For children, a dosage regimen of 120 mg/m2 posaconazole tid was sufficient to treat fungal infections caused by all six Aspergillus spp. and six of the nine Candida spp. (but was not effective against C. glabrata, C. guilliermondii and C. krusei). In contrast, a 400 mg dosage regimen of posaconazole bid achieved the target pharmacokinetic/pharmacodynamics (PK/PD) parameters against all six Aspergillus spp. and eight of the nine Candida spp. (but was not effective against C. glabrata) in the adults. Dosage regimens of 50 mg bid, 100 mg bid, or 200 mg bid were not effective. Posaconazole dosage regimens are likely to achieve their desired PK/PD targets against Candida spp. and Aspergillus spp. in both children and adults.
Ying Wang, Jingyi Zhao, Yinhui Yao, Junhui Hu, Jiuli Hu, Xu Xiao, Yanwu Zhao
Pharmacology & Pharmacy, Volume 11, pp 71-78; doi:10.4236/pp.2020.115007

The objective of this study was to investigate the probability of target attainment of various posaconazole dosing regimens against Mucorales species in patients with mucormycosis. According to pharmacokinetic/pharmacodynamic parameters of posaconazole in adults, the dosage regimen of posaconazole for mucormycosis included 50, 100, 200 and 400 mg orally q12h. Monte Carlo Simulation analysed the published parameters of pharmacokinetics and the MIC values of mucormycosis in Mucorales species. The results showed that posaconazole did not affect Rhizopus arrhizus and Mucor sp. The optimal dosage of posaconazole for Rhizopus microsporus and Rhizomucor pusillus was 400 mg orally q12h and the best dosage regimen for Lichtheimia corymbifera was 200 mg orally q12h. The antifungal activity of posaconazole against mucormycosis was different, and the dosage regimen needs to adjust according to fungal species.
Linda Garcés-Ramírez, Oscar O. Morales-Dionisio, Gonzalo Flores, José Luna-Muñoz, Fidel De La Cruz
Pharmacology & Pharmacy, Volume 11, pp 235-250; doi:10.4236/pp.2020.119021

Four immobility responses (IR): elicited by clamping, bandaging, grasping and inversion, and their modification by potassium and spironolactone was studied in old Wistar rats (body weight, 500 g). When undrugged, only clamping and grasping, but not bandaging and inversion induced an IR in rats. Potassium and spironolactone significantly enhanced the duration of IR induced by clamping but not by grasping. They also induced an immobility response by bandaging, but not by inversion. The data suggest that IR induced by clamping and bandaging are somehow related to changes in the potassium serum levels. Consequently, such a relationship may be a suitable model to study some forms of paralysis in human beings which are related to changes in the potassium serum levels.
Debnath Puja Sangita, Mahmood Hasan Choudhury, Ahsan Monira, Sangita Debnath Puja, Choudhury Mahmood Hasan, Monira Ahsan
Pharmacology & Pharmacy, Volume 11, pp 147-157; doi:10.4236/pp.2020.117014

The stem bark of Baccaurea ramiflora was studied. Four aldehydes named as 3 methoxy 4 hydroxy-cinnamaldehyde (coniferyl aldehyde); 3, 4, 5 trimethoxy cinnamaldehyde; 3, 4, 5 trimethoxy benzaldehyde and 3,4 dimethoxy benzaldehyde) (veratraldehyde) have been isolated and then identified by NMR spectroscopy. All of them are first time reported for this plant. Here in vitro biological investigations include antioxidant and cytotoxicity study. Among all fractions, the chloroform soluble fraction exhibited strong free radical scavenging activity having IC50 value of 12.87 μg/ml compared to BHT (IC50 value 5.64 μg/ml). On the contrary, aqueous soluble fraction exhibited most toxicity towards brine shrimp compared with vincristine sulphate having LC50 value of 1.44 and 0.9258 μg/ml respectively.
Wei-Hsi Chen, Chyng-Yann Shiue
Pharmacology & Pharmacy, Volume 11, pp 282-298; doi:10.4236/pp.2020.1110023

A high performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) analytical method was developed to determine the identity of impurities resulting from the synthesis of N,N-dimethyl-2-(2-amino-4-fluorophenylthio)benzyl-amine (F-ADAM), as well as its metabolic products by rat liver microsomes. 18F-ADAM is an important positive electron emission ligand commonly employed as a radio-imaging agent for serotonin transporter (SERT) in the brain. F-ADAM and its derivatives were separated using HPLC on a C4-phenyl column with an ammonium formate aqueous buffer/acetonitrile programmed mobile phase. Synthetic contaminants and metabolic products were identified using fragmentation spectra obtained by tandem mass spectrometry. We show that F-ADAM is unstable in methanol, and propose the use of acetonitrile to generate optimal chromatogram. A Cl-substituted species was found to be the major impurity resulting from the F-ADAM synthetic process. The metabolic products of F-ADAM by rat liver microsomes were characterized by oxidization of the sulfur moiety to sulfoxide, demethylation of the dimethylamine moiety, and oxidative defluorination/deamination. These results elucidate the by-products of F-ADAM synthetic and metabolic processes, and provide direction for the application of this imaging agent to biosystems properly.
Robert B. Raffa, , Robert Taylor, Robert P. James, Mark Pirner
Pharmacology & Pharmacy, Volume 10, pp 1-10; doi:10.4236/pp.2019.101001

Heather Marie Pol
Pharmacology & Pharmacy, Volume 10, pp 11-20; doi:10.4236/pp.2019.101002

As diabetes becomes more prevalent throughout the United States, there is an increased demand for healthcare providers and healthcare resources. Pharmacists have started to collaborate with primary care providers, and through this collaboration, pharmacists are able to augment patient care and provide additional resources to diabetic patients. This essay reviews the effect of one clinic that incorporates pharmacist interventions as an addition to established patient care teams, and evaluates the effect that the pharmacist interventions have on patient hemoglobin A1C%. While this essay provides data to show the positive benefits of pharmacist intervention on diabetes patients and A1C% goals, additional data and research are needed to demonstrate how pharmacists are a necessary addition to patient care teams.
Shiori Ando, Arisu Sato, Michinori Funato, Kazuki Ohuchi, Satoshi Inagaki, Shinsuke Nakamura, Masamitsu Shimazawa, Hideo Kaneko, Hideaki Hideaki Hara
Pharmacology & Pharmacy, Volume 10, pp 159-168; doi:10.4236/pp.2019.104014

Anawara Begum, Abul Hossen, Ayasha Akter Moly, Mahbubur Rahman Bhuiyan, Shahed-Al-Mahmud Shahed-Al-Mahmud
Pharmacology & Pharmacy, Volume 10, pp 177-193; doi:10.4236/pp.2019.104016

Background: Thunbergia erecta (Acanthaceae) is the most abundant medicinal plant in different parts of Bangladesh where it is known as “nilghonta”. It has been used as traditional medicine for insomnia, depression and anxiety management. However, no scientific evidence of T. erecta belonging to neuropharmacological activity has been reported. The aim of present study was to investigate in vivo sedative and anxiolytic activities of methanol extract from the leaves of T. erecta in Swiss Albino mice. Methods: Sedative activity of METE was investigated using open field, hole cross and thiopental sodium-induced sleeping time test model whereas anxiolytic activity was screened by elevated-plus maze, light-dark box, hole-board and marble-burying test method in mice at 200 and 400 mg/kg doses. The acute toxicity study and phytochemical analysis of METE also carried out. Diazepam used as the positive control for the following behavioral pharmacology test. Results: METE exhibited significant (p T. erecta contains phytoconstituents that possess sedative and anxiolytic activity which traditionally used in insomnia, depression and anxiety management.
Milon Kumar Ghosh, Mir Imam Ibne Wahed, Ashraf Ali, Ranjan Kumar Barman
Pharmacology & Pharmacy, Volume 10, pp 343-355; doi:10.4236/pp.2019.107028

S. M. Mushiur Rahman, Sohel Rana, Nahinul Islam, Alok Kumer, Mehedi Hassan, Tonmoy Kumar Biswas, Atikullah
Pharmacology & Pharmacy, Volume 10, pp 283-297; doi:10.4236/pp.2019.106023

In indigenous or folk medicine, Euphorbia hirta is a very popular herb and used as a palliative to treat various ailments including intestinal parasites, diarrhoea, vomiting, amoebic dysentery, asthma, bronchitis, emphysema, coughs, kidney stones, menstrual problems etc. The objective of this study is to evaluate the anxiolytic and sedative-like effects of the methanol extract from the leaves of Euphorbia hirta (Euphorbiaceae). Methanolic extract of Euphorbia hirta was evaluated for its CNS depression effect using mice behavioral models such as, elevated plus maze and hole board test for its anxiolytic potential where hole cross and pentobarbital-induced sleeping time tests were performed for its sedative properties, respectively. The test group received three different doses of the MEHL (100 mg/kg, 200 mg/kg and 300 mg/kg) orally. The positive control group received diazepam (1 mg/kg) orally where the negative control group received distilled water (10 ml/kg) orally. In elevated plus maze test, the extract exhibited significant (p d the number of open arm entry and time spent in open arm by mice compared to control group. In addition, the number of head dips and hole crosses significantly (p Euphorbia hirta has potential anxiolytic and sedative-like activity in the animal behavioral models. And the findings represent a rational explanation for its use in traditional medicine for the management of neurological disorder.
Abdul Mannan
Pharmacology & Pharmacy, Volume 10, pp 298-308; doi:10.4236/pp.2019.106024

Bacopa monniera Linn. or Brahmi, a plant in the family Scrophulariaceae, is used as a traditional medicine for memory improvement, dementia like anxiety, depression, epilepsy etc. for a long time in Bangladesh. This study evaluated the anxiolytic effects of the methanolic extract of B. monniera (MEBM) in animal models of anxiety. For the further tests and phytochemical screening, the whole plant of B. monniera extracted following maceration method. The extract was evaluated for anxiolytic activity using light/dark box, elevated plus maze, marble burying and rota rod tests in mice at the doses of 50, 100, and 200 mg/kg body weight. Diazepam (1.0 mg/kg), an anxiolytic drug used as standard drug. MEBM showed a strong and dose-dependent anxiolytic effects in animal models of anxiety. MEBM significantly increased the time spent in the light compartment, the latency time, and the entries of open arms in light/dark and elevated plus maze tests. In addition, MEBM also significantly decreased the number of buried marbles in marble burying test and increased the time of performance in rota rod test (p
Robert B. Raffa, Joseph V. Pergolizzi
Pharmacology & Pharmacy, Volume 10, pp 465-473; doi:10.4236/pp.2019.1011038

Treatment of health problems that accompany aging often includes pharmacotherapy. It is thus common for older adults—and, increasingly, younger adults—to be on multiple medications, either prescription or over-the-counter (OTC). With the consumption of multiple medications, drug-drug interactions (DDIs) are a concern. The site of drug-drug interactions is often at the level of drug metabolism. If a drug inhibits (or enhances) the metabolism of another, the blood level (therapeutic effect) can be decreased below the required level, or adverse effects can increase. Because most currently used drugs are metabolized via cytochrome P450-catalyzed pathways, drug discovers seek drugs that are metabolized by alternate pathways. Medicinal chemists have come upon a strategy—the incorporation of oxetane rings in the drug structure—that increases the likelihood that a drug will not be metabolized via CYP450. The same modification gives other desirable physical properties to the molecule. Although there are no guarantees that there will be fewer DDIs or an absence of other unexpected problems, the strategy could pave the way for new drugs that are safer and easier to use with concomitant medications.
Nargis Sultana Chowdhury, Sifat Jamaly, Farhana Farjana, Nadira Begum, Elina Akher Zenat
Pharmacology & Pharmacy, Volume 10, pp 94-108; doi:10.4236/pp.2019.102008

Abelmoschus is a genus of about fifteen species belongs to the family Malvaceae. The herb, popularly known as Lady’s Finger or Okra (in English) is a nutritional source used for both medicinal and culinary purposes. The plant is widely distributed from Africa to Asia, Southern Europe, and America. This comprehensive account provides a botanical description of the plant, its phytochemical constituents and pharmacological activities focusing anti-diabetic, anti-oxidant, anti-adhesive, gastro-protective, hepatoprotective, and immunomodulating actions. Most of the pharmacological effects can be explained by the constituents like tannins, terpenoids, flavonoids and glycosides present in all plant parts. However, future efforts should concentrate more on in vitro and in vivo studies and also on clinical trials in order to confirm traditional wisdom in the light of a rational phytotherapy. The present review is an overview of phytochemistry and ethnopharmacological studies that support many of the traditional ethnomedicinal uses of the plant.
Joseph V. Pergolizzi, Jo Ann LeQuang, Robert Taylor, Robert B. Raffa
Pharmacology & Pharmacy, Volume 10, pp 61-81; doi:10.4236/pp.2019.102006

The recent large increase in deaths involving opioids (whether prescription or illicit, pure or adulterated, alone or in combination with other drugs) is the manifestation of a complex, and multifaceted problem consisting of psychological, psychosocial, medical, legal, regulatory, economic, cultural, and political components, among others. Because the problem involves issues related to both supply and demand, the solution is not obvious, simple, or quick. There is no easy fix. Preventing and treating opioid misuse and abuse requires a comprehensive, time-intensive, and expensive intervention supported by public policy and support through coordinated medical, regulatory, legal, and financial guidelines and practice. But until the long-term problems can be fixed, the immediate crisis of overdose deaths can be ameliorated by making available an opioid receptor antagonist to reverse the respiratory depression that is the cause of death to those who are in the best position to administer it in time (professionals, untrained bystanders, and even fellow drug abusers). The statistics overwhelmingly demonstrate that this is a life-saving medical intervention. Yet, there is still uncertainty about this intervention, and even some opposition to it. We describe the scientific basis for the approach and the issues surrounding its use to treat accidental or intentional overdose by pain patients, recreational opioid users, and addicts. We also describe the calls to limit the number of times it should be available to a user and the limitations of its effectiveness—mainly that it only addresses the acute death crisis, not the underlying problems that led to it.
Yao Potchoo, Salou Mounerou, Rasak Soukouratou, Dossim Sika, Koumavi D. Ekouevi, Yerima Mouhoudine, Prince-David Mireille, Anoumou Y. Dagnra
Pharmacology & Pharmacy, Volume 10, pp 31-47; doi:10.4236/pp.2019.101004

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