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Sample records for clinical pharmacology review

  1. Citalopram--a review of pharmacological and clinical effects.

    OpenAIRE

    Bezchlibnyk-Butler, K; Aleksic, I; Kennedy, S. H.

    2000-01-01

    OBJECTIVE: To provide clinicians with a critical evaluation of citalopram, a selective serotonin reuptake inhibitor (SSRI) that has been available in Canada since March 1999. DATA SOURCES: Commercial searches (MEDLINE and BiblioTech) and an "in-house" search (InfoDrug) were used to find published English-language references for clinical and preclinical publications. There was no restriction of publication dates. Primary index terms used were: pharmacological properties, receptors, pharmacolog...

  2. Clinical Pharmacology of Furosemide in Neonates: A Review

    Directory of Open Access Journals (Sweden)

    Gian Maria Pacifici

    2013-09-01

    Full Text Available Furosemide is the diuretic most used in newborn infants. It blocks the Na+-K+-2Cl− symporter in the thick ascending limb of the loop of Henle increasing urinary excretion of Na+ and Cl−. This article aimed to review the published data on the clinical pharmacology of furosemide in neonates to provide a critical, comprehensive, authoritative and, updated survey on the metabolism, pharmacokinetics, pharmacodynamics and side-effects of furosemide in neonates. The bibliographic search was performed using PubMed and EMBASE databases as search engines; January 2013 was the cutoff point. Furosemide half-life (t1/2 is 6 to 20-fold longer, clearance (Cl is 1.2 to 14-fold smaller and volume of distribution (Vd is 1.3 to 6-fold larger than the adult values. t1/2 shortens and Cl increases as the neonatal maturation proceeds. Continuous intravenous infusion of furosemide yields more controlled diuresis than the intermittent intravenous infusion. Furosemide may be administered by inhalation to infants with chronic lung disease to improve pulmonary mechanics. Furosemide stimulates prostaglandin E2 synthesis, a potent dilator of the patent ductus arteriosus, and the administration of furosemide to any preterm infants should be carefully weighed against the risk of precipitation of a symptomatic patent ductus arteriosus. Infants with low birthweight treated with chronic furosemide are at risk for the development of intra-renal calcifications.

  3. Clinical pharmacology of fentanyl in preterm infants. A review.

    Science.gov (United States)

    Pacifici, Gian Maria

    2015-06-01

    Fentanyl is a synthetic opioid that is very important in anesthetic practice because of its relatively short time to peak analgesic effect and the rapid termination of action after small bolus doses. The objective of this survey is to review the clinical pharmacology of fentanyl in preterm infants. The bibliographic search was performed using PubMed and EMBASE databases as search engines. In addition, the books Neofax: A manual of drugs used in neonatal care and Neonatal formulary were consulted. Fentanyl is N-dealkylated by CYP3A4 into the inactive norfentanyl. Fentanyl may be administered as bolus doses or as a continuous infusion. In neonates, there is a remarkable interindividual variability in the kinetic parameters. In neonates, fentanyl half-life ranges from 317 minutes to 1266 minutes and in adults it is 222 minutes. Respiratory depression occurs when fentanyl doses are >5 μg/kg. Chest wall rigidity may occur in neonates and occasionally is associated with laryngospasm. Tolerance to fentanyl may develop after prolonged use of this drug. Significant withdrawal symptoms have been reported in infants treated with continuous infusion for 5 days or longer. Fentanyl is an extremely potent analgesic and is the opioid analgesic most frequently used in the neonatal intensive care unit.

  4. Edoxaban: a focused review of its clinical pharmacology.

    Science.gov (United States)

    Lip, Gregory Y H; Agnelli, Giancarlo

    2014-07-21

    Long-term anticoagulation treatment with warfarin has been associated with a number of limitations in clinical practice and there is a need for more convenient long-term anticoagulation treatment. One of the non-vitamin K oral anticoagulants in development is edoxaban, a factor Xa inhibitor that is administered once daily. The pharmacological properties of edoxaban have various advantages in anticoagulant therapy. Edoxaban quickly reaches peak plasma concentrations in 1.5 h, has a half-life of 10-14 h, has relatively high bioavailability of 62% and exhibits highly selective, competitive, concentration-dependent inhibition of human factor Xa. The plasma concentrations of edoxaban are also closely correlated with suppression of thrombin generation and a range of platelet activation parameters (fragment 1+2, thrombin-antithrombin complex, and β-thromboglobulin), which edoxaban has been shown to rapidly inhibit. The anticoagulant activity of edoxaban is not affected by food intake or ethnicity and a number of drug-drug interaction studies have been performed. Co-administration of edoxaban with strong P-glycoprotein inhibitors, such as dronedarone, quinidine, and verapamil requires edoxaban dose-reduction by 50% to avoid the risk of over-exposure. The exposure of edoxaban may also increase in patients with a body weight ≤60 kg and moderate renal impairment. This meant a dose-reduction strategy in patients at risk of over-exposure was utilized in Phase III clinical studies. In conclusion, the pharmacological properties of edoxaban provide rapid and specific inhibition of factor Xa, which is closely related to plasma concentrations. Given the limitations with long-term warfarin therapy, once-daily edoxaban may provide a convenient long-term alternative for patients. PMID:24810388

  5. Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents.

    Science.gov (United States)

    Miyamoto, S; Miyake, N; Jarskog, L F; Fleischhacker, W W; Lieberman, J A

    2012-12-01

    of comparable or superior efficacy and side-effect profiles to existing APDs; (2) development of novel (and presumably non-D(2)) mechanism APDs; (3) development of compounds to be used as adjuncts to APDs to augment efficacy by targeting specific symptom dimensions of schizophrenia and particularly those not responsive to traditional APD treatment. In addition, efforts are being made to determine if the products of susceptibility genes in schizophrenia, identified by genetic linkage and association studies, may be viable targets for drug development. Finally, a focus on early detection and early intervention aimed at halting or reversing progressive pathophysiological processes in schizophrenia has gained great influence. This has encouraged future drug development and therapeutic strategies that are neuroprotective. This article provides an update and critical review of the pharmacology and clinical profiles of current APDs and drugs acting on novel targets with potential to be therapeutic agents in the future.

  6. Applications of stable isotopes in clinical pharmacology

    NARCIS (Netherlands)

    Schellekens, Reinout C A; Stellaard, Frans; Woerdenbag, Herman J; Frijlink, Henderik W; Kosterink, Jos G W

    2011-01-01

    This review aims to present an overview of the application of stable isotope technology in clinical pharmacology. Three main categories of stable isotope technology can be distinguished in clinical pharmacology. Firstly, it is applied in the assessment of drug pharmacology to determine the pharmacok

  7. Review of Clinical Pharmacology of Aloe vera L. in the Treatment of Psoriasis.

    Science.gov (United States)

    Miroddi, Marco; Navarra, Michele; Calapai, Fabrizio; Mancari, Ferdinando; Giofrè, Salvatore Vincenzo; Gangemi, Sebastiano; Calapai, Gioacchino

    2015-05-01

    Aloe vera L., is a plant used worldwide as folk remedy for the treatment of various ailments, including skin disorders. Its gel is present in cosmetics, medicinal products and food supplements. Psoriasis, an immune-mediated chronic inflammatory disease, involving mainly the skin, affects about the 2-3% of general population. Conventional pharmacological treatments for psoriasis can have limited effectiveness and can cause adverse reactions. For this reason often psoriatic patients look for alternative treatments based on natural products containing Aloe vera. We conducted a systematic review of clinical trials assessing effectiveness and safety of aloe for the treatment of psoriasis. Clinical studies published in English were considered; a total of four clinical trials met inclusion criteria. Studies were also evaluated by using the Jadad scale and Consort Statement in Reporting Clinical trials of Herbal Medicine Intervention. Quality and methodological accuracy of considered studies varied considerably, and some crucial information to reproduce clinical results was missing. We conclude that administration of aloe as cutaneous treatment is generally well tolerated, as no serious side effects were reported. Results on the effectiveness of Aloe vera are contradictory; our analysis reveals the presence of methodological gaps preventing to reach final conclusions.

  8. Review of Clinical Pharmacology of Aloe vera L. in the Treatment of Psoriasis.

    Science.gov (United States)

    Miroddi, Marco; Navarra, Michele; Calapai, Fabrizio; Mancari, Ferdinando; Giofrè, Salvatore Vincenzo; Gangemi, Sebastiano; Calapai, Gioacchino

    2015-05-01

    Aloe vera L., is a plant used worldwide as folk remedy for the treatment of various ailments, including skin disorders. Its gel is present in cosmetics, medicinal products and food supplements. Psoriasis, an immune-mediated chronic inflammatory disease, involving mainly the skin, affects about the 2-3% of general population. Conventional pharmacological treatments for psoriasis can have limited effectiveness and can cause adverse reactions. For this reason often psoriatic patients look for alternative treatments based on natural products containing Aloe vera. We conducted a systematic review of clinical trials assessing effectiveness and safety of aloe for the treatment of psoriasis. Clinical studies published in English were considered; a total of four clinical trials met inclusion criteria. Studies were also evaluated by using the Jadad scale and Consort Statement in Reporting Clinical trials of Herbal Medicine Intervention. Quality and methodological accuracy of considered studies varied considerably, and some crucial information to reproduce clinical results was missing. We conclude that administration of aloe as cutaneous treatment is generally well tolerated, as no serious side effects were reported. Results on the effectiveness of Aloe vera are contradictory; our analysis reveals the presence of methodological gaps preventing to reach final conclusions. PMID:25756474

  9. Carthami flos: a review of its ethnopharmacology, pharmacology and clinical applications

    Directory of Open Access Journals (Sweden)

    Yanhua Tu

    2015-10-01

    Full Text Available ABSTRACTCarthami flos, the dried floret of Carthamus tinctorius L., Asteraceae (safflower, has been widely used in traditional Chinese medicine to treat a broad range of ailments, such as coronary heart disease, angina pectoris, gynecologic disease, stroke, and hypertension. However, although several studies on Carthami flos have been done consecutively, the results are usually scattered across various documents. This review aims to provide up-to-date information on the traditional uses, pharmacology, clinical applications, and toxicology of Carthami flos in China and thereby to provide a basis for further investigation of its use to treat dissimilar diseases. Various ethnomedical uses of Carthami flos have been documented in many ancient Chinese books. Crude extracts and isolated compounds from Carthami flos show a broad range of pharmacological properties, such as protective effects on brain tissue, on osteoblasts, and in myocardial ischemia, as well as anti-inflammatory, antithrombotic, antitumor, and antidiabetic activities. To date, safflower and safflor yellow injections have been used to treat coronary heart disease, chronic pulmonary heart disease, cerebrovascular diseases, orthopedic diseases, and diabetes mellitus. Regarding the toxicology of Carthami flos, among the side effects that have been observed are allergic reaction, spermatogenetic failure, fatty liver, and nephrotoxicity.

  10. A review on clinical management and pharmacological therapy on hereditary haemorrhagic telangiectasia (HHT).

    Science.gov (United States)

    Zarrabeitia, Roberto; Albiñana, Virginia; Salcedo, Matilde; Señaris-Gonzalez, B; Fernandez-Forcelledo, Jose-Luis; Botella, Luisa-Maria

    2010-07-01

    Hereditary Haemorrhagic Telangiectasia (HHT) or Rendu-Osler-Weber syndrome, is an autosomal dominant rare disease characterized by localized angiodysplasia. This is manifested as epistaxis, mucocutaneous and gastrointestinal telangiectases, and arteriovenous malformations in the pulmonary, cerebral or hepatic circulation. The prevalence is between 1 in 5,000 to 8,000, although it is higher in some regions. The most frequent clinical manifestation of HHT is epistaxis, normally from light to moderate from the 4(th) decade of life. However, many patients show severe epistaxis which may interfere with their quality of life. The epistaxis is due to telangiectasia on the nasal mucosa. These are focally dilated postcapilar venules, which in advanced phases show many layers of smooth muscle cells without elastic fibers, and very frequently directly connect with dilated arterioles. As a consequence of these vascular alterations, telangiectases are very sensitive to slight trauma and even to the friction with the air when breathing, which gives rise to nose bleeds. Unfortunately, there is no optimal pharmacological treatment for the epistaxis in HHT. The use of antifibrinolytic agents for the treatment of HHT has been studied recently by our group as an effective relief for nasal and gastric haemorrhages. This work represents a systematic review and the beginning of a systematic laboratory work we are now conducting in our lab to screen for "orphan drugs" as therapeutic agents in HHT. In this context, the use of hormones, immunosuppresants and anti-angiogenic agents are under preclinical study in our laboratory. PMID:19485912

  11. A Systemic Review on Aloe arborescens Pharmacological Profile: Biological Activities and Pilot Clinical Trials.

    Science.gov (United States)

    Singab, Abdel-Naser B; El-Hefnawy, Hala M; Esmat, Ahmed; Gad, Haidy A; Nazeam, Jilan A

    2015-12-01

    Since ancient times, plants and herbal preparations have been used as medicine. Research carried out in the last few decades has verified several such claims. Aloe arborescens Miller, belonging to the Aloe genus (Family Asphodelaceae), is one of the main varieties of Aloe used worldwide. The popularity of the plant in traditional medicine for several ailments (antitumor, immunomodulatory, antiinflammatory, antiulcer, antimicrobial and antifungal activity) focused the investigator's interest on this plant. Most importantly, the reported studies have shown the plant effectiveness on various cancer types such as liver, colon, duodenal, skin, pancreatic, intestinal, lung and kidney types. These multiple biological actions make Aloe an important resource for developing new natural therapies. However, the biological activities of isolated compounds such as glycoprotein, polysaccharides, enzyme and phenolics were insufficient. Considering all these, this contribution provides a systematic review outlining the evidence on the biological efficacy of the plant including the pharmacology and the related mechanisms of action, with specific attention to the various safety precautions, and preclinical and clinical studies, indicating the future research prospects of this plant. PMID:26768148

  12. Clinical pharmacology and vascular risk.

    Science.gov (United States)

    Silvestrelli, G; Corea, F; Micheli, S; Lanari, A

    2010-01-01

    Pharmacological treatment and several drugs of abuse have been associated with ischemic heart disease (IHD) and cerebrovascular diseases (CVD). However, there is a paucity of data on the independent risk of vascular disease (VD) associated with pharmacological treatment and no controlled trials demonstrating a reduction in risk with abstinence. Information about IHD and CVD-related drug abuse is mainly limited to epidemiological studies focused on urban populations. The potential link between some pharmacological treatments (estrogen, some oncologic drugs and some atypical antipsychotics) and cerebrovascular adverse events was analyzed, but disagreement about an association persists. Drugs of abuse, including cocaine, amphetamines and heroin, have been associated with an increased vascular risk. These drugs can cause abrupt changes in blood pressure, vasculitic-type changes, lead to embolization caused by infective endocarditis, and hemostatic and hematologic abnormalities that can result in increased blood viscosity and platelet aggregation. Long-term treatment strategies based on medication, psychological support, and outreach programs play an important role in treatment of drug dependency. In these last years public interest in risk factors for VD has been constantly increasing and the successful identification and management of pharmacological treatment and drug abuse can be challenging. One of the major public health issues for the future will be to focus more on new vascular risk factor recognition and management. The objective of this chapter is to review the relevance of IHD and CVD associated with various pharmacological treatments and drug abuse with focusing on ischemic disease. This chapter reports the clinical evidence of this association and analyzes the experimental role of new drugs as a growing risk factor of VD with the hypothetical new association. In conclusion, in this chapter great attention is paid to evaluating the scientific and real

  13. Treatment of post-partum depression: a review of clinical, psychological and pharmacological options

    Directory of Open Access Journals (Sweden)

    Elizabeth Fitelson

    2010-12-01

    Full Text Available Elizabeth Fitelson1, Sarah Kim4, Allison Scott Baker3, Kristin Leight21Director, 2Attending Psychiatrist, TheWomen's Program, 3Child and Adolescent Psychiatry Fellow, Division of Child Psychiatry, 4PGY-I Resident in Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY, USAAbstract: Postpartum depression (PPD is a common complication of childbearing, and has increasingly been identified as a major public health problem. Untreated maternal depression has multiple potential negative effects on maternal-infant attachment and child development. Screening for depression in the perinatal period is feasible in multiple primary care or obstetric settings, and can help identify depressed mothers earlier. However, there are multiple barriers to appropriate treatment, including concerns about medication effects in breastfeeding infants. This article reviews the literature and recommendations for the treatment of postpartum depression, with a focus on the range of pharmacological, psychotherapeutic, and other non-pharmacologic interventions. Keywords: postpartum depression, postnatal depression, lactation, antidepressant, hormone therapy, psychotherapy, bright light therapy, omega-3

  14. Thuja occidentalis (Arbor vitae: A Review of its Pharmaceutical, Pharmacological and Clinical Properties

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    Belal Naser

    2005-01-01

    Full Text Available Arbor vitae (Thuja occidentalis L. is a native European tree widely used in homeopathy and evidence-based phytotherapy. Many reviews and monographs have been published on the herbal substance's description, mode of action and clinical use. However, no comprehensive evidence-based review is available. Therefore, our aim was to search MEDLINE databases and survey manufacturers for further details or unpublished data. This review presents the botany, ethnobotany and phytochemistry, especially the different contents of essential oil (Thujone in relation to different extraction procedures of this medicinal plant. Thuja's antiviral action and immunopharmacological potential, such as stimulatory and co-stimulatory effects on cytokine and antibody production and activation of macrophages and other immunocompetent cells, have been evaluated in numerous in vitro and in vivo investigations. Although no controlled trials have been conducted on Thuja occ alone, many clinical studies have been performed with a herbal medicinal product containing a special extract of Thuja occ and other immunostimulants, demonstrating its therapeutic efficacy and safety in respiratory tract infections.

  15. A review of the pharmacology and clinical application of alfaxalone in cats.

    Science.gov (United States)

    Warne, Leon N; Beths, Thierry; Whittem, Ted; Carter, Jennifer E; Bauquier, Sébastien H

    2015-02-01

    Alfaxalone-2-hydroxpropyl-β-cyclodextrin (alfaxalone-HPCD) was first marketed for veterinary use in Australia in 2001 and has since progressively became available throughout the world, including the USA, where in 2012 Food and Drug Administration (FDA) registration was granted. Despite the growing body of published works and increasing global availability of alfaxalone-HPCD, the accumulating evidence for its use in cats has not been thoroughly reviewed. The purpose of this review is: (1) to detail the pharmacokinetic properties of alfaxalone-HPCD in cats; (2) to assess the pharmacodynamic properties of alfaxalone-HPCD, including its cardiovascular, respiratory, central nervous system, neuromuscular, hepatic, renal, haematological, blood-biochemical, analgesic and endocrine effects; and (3) to consider the clinical application of alfaxalone-HPCD for sedation, induction and maintenance of anaesthesia in cats. Based on the published literature, alfaxalone-HPCD provides a good alternative to the existing intravenous anaesthetic options for healthy cats. PMID:25582797

  16. Systematic review of clinical trials assessing pharmacological properties of Salvia species on memory, cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Miroddi, Marco; Navarra, Michele; Quattropani, Maria C; Calapai, Fabrizio; Gangemi, Sebastiano; Calapai, Gioacchino

    2014-06-01

    Salvia officinalis L. and Salvia lavandulaefolia L. have a longstanding use as traditional herbal remedies that can enhance memory and improve cognitive functions. Pharmacological actions of S. officinalis and S. lavandulaefolia on healthy subjects and on patients suffering of cognitive decline have been investigated. Aim of this review was to summarize published clinical trials assessing effectiveness and safety of S. officinalis and S. lavandulaefolia in the enhancement of cognitive performance in healthy subjects and neurodegenerative illnesses. Furthermore, to purchase a more complete view on safety of S. officinalis and S. lavandulaefolia, we collected and discussed articles regarding toxicity and adverse reactions. Eight clinical studies investigating on acute effects of S. officinalis on healthy subjects were included in the review. Six studies investigated on the effects of S. officinalis and S. lavandaeluaefolia on cognitive performance in healthy subjects. The two remaining were carried out to study the effects of sage on Azheimer's disease. Our review shows that S. officinalis and S. lavandulaefolia exert beneficial effects by enhancing cognitive performance both in healthy subjects and patients with dementia or cognitive impairment and is safe for this indication. Unfortunately, promising beneficial effects are debased by methodological issues, use of different herbal preparations (extracts, essential oil, use of raw material), lack of details on herbal products used. We believe that sage promising effects need further higher methodological standard clinical trials.

  17. Pharmacological and clinical properties of curcumin

    Directory of Open Access Journals (Sweden)

    Huang S

    2011-06-01

    Full Text Available Christopher S Beevers¹, Shile Huang²¹Department of Pharmacology, Ross University School of Medicine, Picard-Portsmouth, Commonwealth of Dominica; ²Department of Biochemistry and Molecular Biology, Louisiana State University Health Sciences Center, Shreveport, LA, USAAbstract: The polyphenol natural product curcumin has been the subject of numerous studies over the past decades, which have identified and characterized the compound's pharmacokinetic, pharmacodynamic, and clinical pharmacological properties. In in vitro and in vivo model systems, curcumin displays potent pharmacological effects, by targeting many critical cellular factors, through a diverse array of mechanisms of action. Despite this tremendous molecular versatility, however, the clinical application of curcumin remains limited due to poor pharmacokinetic characteristics in human beings. The current trend is to develop and utilize unique delivery systems, chemical derivatives, and chemical analogs to circumvent these pharmacological obstacles, in order to optimize the conditions for curcumin as a chemopreventive and chemotherapeutic agent in diseases such as cancer, diabetes, obesity, Alzheimer's disease, and inflammatory disorders. The present work seeks to review recent studies in the basic pharmacological principles and potential clinical applications of curcumin.Keywords: curcumin, pharmacological properties, signal transduction, cellular targets, cancer, inflammation

  18. Incretin-based therapies– review of the physiology, pharmacology and emerging clinical experience

    DEFF Research Database (Denmark)

    Martin, JH; Deacon, Carolyn F.; Gorrell, MD;

    2011-01-01

    in type 2 diabetes, leading to development of strategies aimed at redressing this abnormality. These strategies include pharmacological inhibition of dipeptidyl peptidase-4, the enzyme responsible for the short half-life of endogenous incretins, and administration of long-acting dipeptidyl peptidase-4...

  19. NASA 2010 Pharmacology Evidence Review

    Science.gov (United States)

    Steinberg, Susan

    2011-01-01

    In 2008, the Institute of Medicine reviewed NASA's Human Research Program Evidence in assessing the Pharmacology risk identified in NASA's Human Research Program Requirements Document (PRD). Since this review there was a major reorganization of the Pharmacology discipline within the HRP, as well as a re-evaluation of the Pharmacology evidence. This panel is being asked to review the latest version of the Pharmacology Evidence Report. Specifically, this panel will: (1) Appraise the descriptions of the human health-related risk in the HRP PRD. (2) Assess the relevance and comprehensiveness of the evidence in identifying potential threats to long-term space missions. (3) Assess the associated gaps in knowledge and identify additional areas for research as necessary.

  20. Clinical pharmacology of homoharringtonine

    Energy Technology Data Exchange (ETDEWEB)

    Savaraj, N.; Lu, K.; Dimery, I.; Feun, L.G.; Burgess, M.; Keating, M.; Loo, T.L.

    1986-12-01

    Clinical pharmacokinetics of homoharringtonine (HHT) were studied in eight patients who received uniformly labeled HHT at 3-4 mg/m2 (150 mu Ci) by continuous 6-hour infusion. The drug and metabolites were quantified by radiochemical and high-performance liquid chromatographic techniques. Computerized nonlinear least-square regression and curve stripping were used to characterize HHT and total (/sup 3/H)HHT equivalent pharmacokinetics. Unchanged HHT in the plasma declined biphasically, with an alpha-half-life of 0.5 +/- 0.1 hours and a beta-half-life of 9.3 +/- 1.4 hours. The total clearance of HHT was 177.4 +/- 27.7 ml X hour-1 X kg-1, and the apparent volume of distribution, estimated from the area under the drug concentration versus time curve, was 2.4 +/- 0.4 L X kg-1. Correspondingly, the total (/sup 3/H)HHT equivalent disappeared from the plasma in a triphasic manner. Compared with the pharmacokinetic parameters of unchanged HHT, the terminal half-life of total /sup 3/H was 67.5 +/- 7.5 hours, 7.4 times longer; the total clearance was 30.9 +/- 3.1 ml X hour-1 X kg-1, 5.5 times slower; but the volume of distribution by area was 2.7 +/- 0.1 L X kg-1, nearly the same. The 72-hour cumulative urinary excretion of total tritium was 28.2% of the administered dose and only 38.3% of this resided in unchanged HHT. Thus, urinary excretion was not a major route of elimination of HHT. Moreover, HHT underwent extensive metabolism; one major and two minor unidentified products were detected in both plasma and urine.

  1. An agenda for UK clinical pharmacology

    OpenAIRE

    Coleman, Jamie J.; McDowell, Sarah E

    2012-01-01

    The internet and the World Wide Web have changed the ways that we function. As technologies grow and adapt, there is a huge potential for the internet to affect drug research and development, as well as many other aspects of clinical pharmacology. We review some of the areas of interest to date and discuss some of the potential areas in which internet-based technology can be exploited.

  2. Clinical pharmacology review of opicapone for the treatment of Parkinson's disease.

    Science.gov (United States)

    Fabbri, Margherita; Rosa, Mario M; Ferreira, Joaquim J

    2016-10-01

    Two catechol-O-methyl transferase inhibitors are currently used as add-on therapy to levodopa for the amelioration of end-of-dose motor fluctuations in Parkinson's disease patients: entacapone, which has moderate efficacy and requires multiple dosing, and tolcapone, which has a poor safety profile. Opicapone (OPC) is a novel, long-acting, peripherally selective, once daily, third-generation catechol-O-methyl transferase inhibitor. Two Phase III clinical trials demonstrated OPC efficacy in reducing OFF-time by an average of about 60 min daily compared with placebo, without increasing ON-time with troublesome dyskinesias, with a good drug safety profile. In June 2016, the European Commission granted a marketing authorization valid throughout the European Union for OPC, indicated as adjunctive of levodopa decarboxylase inhibitors in adult patients with Parkinson's disease and end-of-dose motor fluctuations.

  3. Prostaglandins: pharmacology and clinical application.

    Science.gov (United States)

    Karim, S M; Hillier, K

    1974-01-01

    Prostaglandin research has been 1 of the most stimulating features of biomedical investigation in the past decade. Interest developed at a time of expanding knowledge of hormonal and neurohormonal behavior and research work received a tremendous impetus in the early 1960s with the elucidation in Sweden of the chemical structures of prostaglandins, followed by the discovery of their biosynthetic pathways. The original findings of large amounts of prostaglandin in the male accessory genital glands and their secretions, and subsequent discovery in the menstrual and amniotic fluids linked these substances with human production. As a result of further investigation, clinical applications of prostaglandins for the induction of labor and termination of early unwanted pregnancies have been developed. Apart from the functions of the prostaglandins in the reproductive area, they have been shown to have a widespread distribution in the body and produce many different pharmacological effects. Prostaglandins are thought to be involved in the regulation of blood pressure and through their vascular effects have therapeutic potential in the treatment of hypertension and peripheral vascular disease. Through their bronchodilator effect, some prostaglandins may become useful in the treatment of asthma. PMID:4611742

  4. Review of Rhubarbs: Chemistry and Pharmacology

    Institute of Scientific and Technical Information of China (English)

    ZHENG; Qing-xia; WU; Hai-feng; GUO; Jian; NAN; Hai-jiang; CHEN; Shi-lin; YANG; Jun-shan; XU; Xu-dong

    2013-01-01

    Rhubarb is a perennial herb belonging to the genus Rheum L. (Polygonaceae). Rhei Radix et Rhizoma (rhubarb roots and rhizomes) is one of the most popular Chinese materia medica and has been widely used for strong laxative function. About 200 compounds with six different types of skeletons (anthraquinone, anthrone, stilbene, flavonoids, acylglucoside, and pyrone) have so far been isolated from eighteen species of the genus Rheum L. These constituents showed extensive pharmacological activities including cathartic, diuretic, anticancer, hepatoprotective, anti-inflammatory, and analgesic effects, as well as toxicological effects. Chemical fingerprint, LC-MS, and other analytical techniques have been used for the quality control of rhubarb. This comprehensive review summarizes the researches into the isolation, pharmacological activities, and phytochemical analysis reported since investigations began in the late 1940s. In addition, pharmacokinetic studies and clinical application of rhubarb are also discussed in present paper.

  5. Review of Rhubarbs: Chemistry and Pharmacology

    Institute of Scientific and Technical Information of China (English)

    ZHENG Qing-xia; WU Hai-feng; GUO Jian; NAN Hai-jiang; CHEN Shi-lin; YANG Jun-shan; XU Xu-dong

    2013-01-01

    Rhubarb is a perennial herb belonging to the genus Rheum L.(Polygonaceae).Rhei Radix et Rhizoma (rhubarbroots and rhizomes) is one of the most popular Chinese materia medica and has been widely used for strong laxative function.About 200 compounds with six different types of skeletons (anthraquinone,anthrone,stilbene,flavonoids,acylglucoside,and pyrone) have so far been isolated from eighteen species of the genus Rheum L These constituents showed extensive pharmacological activities including cathartic,diuretic,anticancer,hepatoprotective,anti-inflammatory,and analgesic effects,as well as toxicological effects.Chemical fingerprint,LC-MS,and other analytical techniques have been used for the quality control of rhubarb.This comprehensive review summarizes the researches into the isolation,pharmacological activities,and phytochemical analysis reported since investigations began in the late 1940s.In addition,pharmacokinetic studies and clinical application of rhubarb are also discussed in present paper.

  6. Chlorhexidine--pharmacology and clinical applications.

    Science.gov (United States)

    Lim, K-S; Kam, P C A

    2008-07-01

    Chlorhexidine is a widely used skin antisepsis preparation and is an ingredient in toothpaste and mouthwash. It is an especially effective antiseptic when combined with alcohol. Its antimicrobial effects persist because it is binds strongly to proteins in the skin and mucosa, making it an effective antiseptic ingredient for handwashing, skin preparation for surgery and the placement of intravascular access. Catheters impregnated with chlorhexidine and antimicrobial agents can reduce the incidence of catheter-related bloodstream infections. Contact dermatitis related to chlorhexidine is not common in health care workers. The incidence of contact dermatitis to chlorhexidine in atopic patients is approximately 2.5 to 5.4%. Acute hypersensitivity reactions to chlorhexidine are often not recognised and therefore may be underreported. This review discusses the pharmacology, microbiology, clinical applications and adverse effects of chlorhexidine.

  7. The clinical pharmacology of ageing

    OpenAIRE

    Swift, C G

    2003-01-01

    The ageing of populations and individuals continues to be as vital, yet to some extent as neglected, a topic in pharmacology and therapeutics as was first realised about 30 years ago. In parallel with the realisation of the predicted demographic shifts in both the developed and developing world, there have since been major developments in the basic biological concepts of ageing, in the physiology of ageing, in the study of pathogenetic mechanisms underlying a variety of age-associated disorde...

  8. Efforts and success world-wide in the field of clinical pharmacology. A personal review on the occasion of Folke Sjöqvist's 80th birthday.

    Science.gov (United States)

    Orme, Michael

    2013-05-01

    In this personal review I describe my early expectations and experiences when I first came to work with Prof. Folke Sjöqvist as a training fellow in the early 1970s. At that time Prof. Sjöqvist and his unit had already earned an international reputation, and in the following decades this success has been magnified many times. Although a description of the research performed by Prof. Sjöqvist during his long career is not the main objective of this article, it is clear that the research carried out in his unit has been instrumental in the development of his international reputation. Over an 18-year period from 1994 onwards, some 272 papers bearing the name of Folke Sjöqvist have been cited over 13,000 times, with an average of over 50 citations per paper. In terms of training clinical pharmacologists from around the world, at the last count 112 individuals from 37 different countries have received a substantial part of their training in his unit. As another measure of his world-wide success, 33 individuals from 18 different countries who received a substantial part of their training in his unit between 1968 and 1996 have gone on to become professors of clinical pharmacology. Prof. Sjöqvist has been requested to consult on various aspects of clinical pharmacology in 15 different countries, from Russia to Spain and from Egypt to Latvia. Here I describe the long-term involvement that Prof. Sjöqvist has had with IUPHAR (now the International Union of Basic and Clinical Pharmacology) and with institutions such as the World Health Organisation (WHO). In particular, I recount his role in the long-term saga involved in updating the original WHO manifesto on clinical pharmacology published in 1970 up to the eventual success of the new manifesto published by WHO in 2012. Finally, I briefly describe the international honours that have been bestowed on Prof. Sjöqvist, including various prizes, designated lectureships and honorary Doctorates (5). Taken together, these

  9. Systematic Review of Randomized Clinical Trials on Safety and Efficacy of Pharmacological and Nonpharmacological Treatments for Retinitis Pigmentosa

    Directory of Open Access Journals (Sweden)

    Marta Sacchetti

    2015-01-01

    Full Text Available Aims. Several treatments have been proposed to slow down progression of Retinitis pigmentosa (RP, a hereditary retinal degenerative condition leading to severe visual impairment. The aim of this study is to systematically review data from randomized clinical trials (RCTs evaluating safety and efficacy of medical interventions for the treatment of RP. Methods. Randomized clinical trials on medical treatments for syndromic and nonsyndromic RP published up to December 2014 were included in the review. Visual acuity, visual field, electroretinogram, and adverse events were used as outcome measures. Results. The 19 RCTs included in this systematic review included trials on hyperbaric oxygen delivery, topical brimonidine tartrate, vitamins, docosahexaenoic acid, gangliosides, lutein, oral nilvadipine, ciliary neurotrophic factor, and valproic acid. All treatments proved safe but did not show significant benefit on visual function. Long term supplementation with vitamin A showed a significantly slower decline rate in electroretinogram amplitude. Conclusions. Although all medical treatments for RP appear safe, evidence emerging from RCTs is limited since they do not present comparable results suitable for quantitative statistical analysis. The limited number of RCTs, the poor clinical results, and the heterogeneity among studies negatively influence the strength of recommendations for the long term management of RP patients.

  10. Clinical pharmacology of novel anticancer drug formulations

    NARCIS (Netherlands)

    Stuurman, F.E.

    2013-01-01

    Studies outlined in this thesis describe the impact of drug formulations on pharmacology of anticancer drugs. It consists of four parts and starts with a review describing the mechanisms of low oral bioavailability of anti-cancer drugs and strategies for improvement of the bioavailability. The major

  11. Angioedema: Clinical Presentations and Pharmacological Management.

    Science.gov (United States)

    Collins-Yoder, Angela Smith

    2016-01-01

    Angioedema (AE) is a unique clinical presentation of an unchecked release of bradykinin. The origin of this clinical presentation can be either genetic or acquired. The outcome within the patient is subcutaneous swelling of the lower layers of the epidermis. Symptoms are most often localized to the upper airway or the gastrointestinal tract. A typical course resolves in 5 to 7 days, but in some patients, the clinical manifestations exist up to 6 weeks. Hereditary AE is rare and genetically linked, and typically, the patient has episodes for many years before diagnosis. Episodes of acquired AE may be drug induced, triggered by a specific allergen, or idiopathic. Angioedema can elicit the need for critical care interventions, for advanced airway management, or unnecessary abdominal surgery. The treatment for these patients is evolving as new pharmacological agents are developed. This article addresses subtypes of AE, triggers, pharmacology, and information for interdisciplinary team planning of individualized case management. PMID:27258954

  12. Clinical pharmacology considerations in biologics development

    Institute of Scientific and Technical Information of China (English)

    Liang ZHAO; Tian-hua REN; Diane D WANG

    2012-01-01

    Biologics,including monoclonal antibodies (mAbs) and other therapeutic proteins such as cytokines and growth hormones,have unique characteristics compared to small molecules.This paper starts from an overview of the pharmacokinetics (PK) of biologics from a mechanistic perspective,the determination of a starting dose for first-in-human(FIH) studies,and dosing regimen optimisation for phase Ⅱ/Ⅲ clinical trials.Subsequently,typical clinical pharmacology issues along the corresponding pathways for biologics development are summarised,including drug-drug interactions,QTc prolongation,immunogenicity,and studies in specific populations.The relationships between the molecular structure of biologics,their pharmacokinetic and pharmacodynamic characteristics,and the corresponding clinical pharmacology strategies are summarised and depicted in a schematic diagram.

  13. Clinical pharmacology training in India: Status and need

    Directory of Open Access Journals (Sweden)

    Nilima A Kshirsagar

    2013-01-01

    Full Text Available Clinical pharmacologists undertake many tasks, and this makes defining a curriculum challenging. This is especially so under the changing circumstances in developing countries, where clinical pharmacology has an expanding role. The clinical pharmacologist may be responsible for conducting ethical clinical trials, supporting the needs of the generic drug industry, providing access to safe, effective and affordable medicines, guiding their rational use, achieving millennium development goals, and supervising medicines management standards for hospital accreditation. Clinical pharmacologists, including those in developing countries, have a great opportunity to contribute to public health and the growth of pharmaceutical industry, but at present, less clinical research is undertaken and fewer clinical trials are done than might be expected. Here we review clinical pharmacology training in India, consider the needs of different professionals contributing to clinical research and medicines utilization, and suggest ways in which current programs can be modified and new programs started. The conclusions are relevant to clinical pharmacology in both the developing and the developed world.

  14. 2013 Pharmacology Risk SRP Status Review Comments to Chief Scientist. The Risk of Clinically Relevant Unpredicted Effects of Medication

    Science.gov (United States)

    2014-01-01

    On December 5, 2013, the Pharmacology Risk SRP, participants from the JSC, HQ, the NSBRI, and NRESS participated in a WebEx/teleconference. The purpose of the call (as stated in the Statement of Task) was to allow the SRP members to: 1. Receive an update by the HRP Chief Scientist or Deputy Chief Scientist on the status of NASA's current and future exploration plans and the impact these will have on the HRP. 2. Receive an update on any changes within the HRP since the 2012 SRP meeting. 3. Receive an update by the Element or Project Scientist(s) on progress since the 2012 SRP meeting. 4. Participate in a discussion with the HRP Chief Scientist, Deputy Chief Scientist, and the Element regarding possible topics to be addressed at the next SRP meeting.

  15. Pharmacology and clinical pharmacology of methylarginines used as inhibitors of nitric oxide synthases.

    Science.gov (United States)

    Kittel, Anja; Maas, Renke

    2014-01-01

    The methylarginines asymmetric dimethylarginine (ADMA) and monomethylarginine (L-NMMA) are endogenously formed inhibitors of nitric oxide synthases (NOS), which have extensively been investigated as risk markers and used as pharmacological tools to study the L-arginine-nitric oxide (NO) pathway in vitro and in vivo. It is the aim of the present review to summarize the clinical and experimental data on the pharmacological properties that are of relevance when planning and conducting experiments and clinical studies involving methylarginines. Key pharmacodynamic and pharmacokinetic data including IC50 values of ADMA and L-NMMA for NOS isoforms and transport proteins, as well as metabolism by dimethylarginine dimethylaminohydrolases (DDAH1 and DDAH2) and alanine-glyoxylate aminotransferase 2 (AGXT2) are discussed.

  16. A pharmacologic review of anaphylaxis.

    Science.gov (United States)

    Yunker, Nancy S; Wagner, Bradley J

    2014-01-01

    Anaphylaxis occurs in the surgical population and may have devastating consequences. Anaphylaxis and anaphylactoid reactions are immediate hypersensitivity reactions that are most commonly precipitated by medications, insect stings, and foods. In the surgical population, 47.4% of immediate hypersensitivity reactions were precipitated by neuromuscular blocking agents, followed by latex and antibiotics in 20% and 18.1% of cases, respectively. Initial treatment consists of removing the precipitating trigger, administering epinephrine, and correct patient positioning. Secondary prevention measures should be instituted to prevent future occurrences. All health care professionals should have an understanding of the clinical presentation and medical management of anaphylaxis to improve patient outcomes. PMID:25461639

  17. Side effects of a dopamine agonist therapy for Parkinson’s disease: a mini-review of clinical pharmacology

    Science.gov (United States)

    Borovac, Josip Anđelo

    2016-01-01

    Dopamine agonists (DA) are therapeutic agents that are commonly used in the treatment of Parkinson’s disease (PD). They can reduce undesired motor fluctuations and delay the administration of levodopa therapy. However, this drug family is associated with specific side effects that can significantly diminish the quality of life among PD patients. Some of them impose significant risks for individuals who have a history of cardiovascular diseases, psychosis, and depression, or those older patients who suffer from renal or hepatic insufficiency. Various pharmacokinetic and pharmacodynamic considerations need to be taken into account when administering DA therapy. The goal of this review is to provide a comprehensive, up-to-date overview of DA therapeutic modalities for PD. PMID:27505015

  18. Echinacea species (Echinacea angustifolia (DC.) Hell., Echinacea pallida (Nutt.) Nutt.,Echinacea purpurea (L.) Moench): a review of their chemistry, pharmacology and clinical properties.

    Science.gov (United States)

    Barnes, Joanne; Anderson, Linda A; Gibbons, Simon; Phillipson, J David

    2005-08-01

    This paper reviews the chemistry, pharmacology and clinical properties of Echinacea species used medicinally. The Echinacea species Echinacea angustifolia, Echinacea pallida and Echinacea purpurea have a long history of medicinal use for a variety of conditions, particularly infections, and today echinacea products are among the best-selling herbal preparations in several developed countries. Modern interest in echinacea is focused on its immunomodulatory effects, particularly in the prevention and treatment of upper respiratory tract infections. The chemistry of Echinacea species is well documented, and several groups of constituents, including alkamides and caffeic acid derivatives, are considered important for activity. There are, however, differences in the constituent profile of the three species. Commercial echinacea samples and marketed echinacea products may contain one or more of the three species, and analysis of samples of raw material and products has shown that some do not meet recognized standards for pharmaceutical quality. Evidence from preclinical studies supports some of the traditional and modern uses for echinacea, particularly the reputed immunostimulant (or immunomodulatory) properties. Several, but not all, clinical trials of echinacea preparations have reported effects superior to those of placebo in the prevention and treatment of upper respiratory tract infections. However, evidence of efficacy is not definitive as studies have included different patient groups and tested various different preparations and dosage regimens of echinacea. On the basis of the available limited safety data, echinacea appears to be well tolerated. However, further investigation and surveillance are required to establish the safety profiles of different echinacea preparations. Safety issues include the possibility of allergic reactions, the use of echinacea by patients with autoimmune diseases and the potential for echinacea preparations to interact with

  19. Sumatriptan transdermal iontophoretic patch (NP101-Zelrix™: review of pharmacology, clinical efficacy, and safety in the acute treatment of migraine

    Directory of Open Access Journals (Sweden)

    Vikelis M

    2012-09-01

    Full Text Available Michail Vikelis,1 Dimos D Mitsikostas,2 Alan M Rapoport31Glyfada Headache Center, Glyfada, Greece; 2Neurology Department, Athens Naval Hospital, Athens, Greece; 3The David Geffen School of Medicine at UCLA, Los Angeles, CA, USAAbstract: Migraine is a chronic, painful, and often disabling primary headache disorder, typically presenting with recurrent attacks that may be accompanied by a variety of neurological, gastrointestinal, and autonomic symptoms. Gastrointestinal symptoms in association with migraine including, nausea, vomiting, and gastroparesis, affect a large proportion of migraine sufferers. These symptoms may result in delays or inconsistencies in the absorption of oral treatments. Hence, the necessity for an innovative, non-invasive, parenteral delivery formulation for quick and effective treatment of migraine attacks is evident. Iontophoresis utilizes minimal amounts of electrical potential to support the fast transfer of ionized medication transdermally and into the general circulation. Two pharmacokinetic clinical trials have shown that iontophoretic delivery of sumatriptan through the skin produces quick and reproducible therapeutic plasma concentrations. A randomized, double-blind, multicenter, phase III study demonstrated superior efficacy versus placebo and excellent tolerability, with no triptan-related adverse events. The proportion of patients that were pain-free at 2 h post-treatment was 18% for the sumatriptan patch vs 9% for placebo (P = 0.0092; number needed to treat = 11.1. Upon approval from the Food and Drug Administration and other regulatory authorities, the iontophoretic transdermal delivery of sumatriptan will be a good choice for patients experiencing poor absorption of oral medication often associated with migraine and/or for those with intolerable triptan-related adverse events.Keywords: iontophoretic patch, migraine, migraine treatment, sumatriptan, transdermal patch

  20. Clinical pharmacology: special safety considerations in drug development and pharmacovigilance.

    Science.gov (United States)

    Atuah, Kwame N; Hughes, Dyfrig; Pirmohamed, Munir

    2004-01-01

    The dose of a drug is a major determinant of its safety, and establishing a safe dose of a novel drug is a prime objective during clinical development. The design of pre-marketing clinical trials precludes the representation of important subpopulations such as children, the elderly and people with co-morbidities. Therefore, postmarketing surveillance (PMS) activities are required to monitor the safety profile of drugs in real clinical practice. Furthermore, individual variations in pharmacogenetic profiles, the immune system, drug metabolic pathways and drug-drug interactions are also important factors in the occurrence of adverse drug reactions. Thus, the safety of a drug is a major clinical consideration before and after it is marketed. A multidisciplinary approach is required to enhance the safety profile of drugs at all stages of development, including PMS activities. Clinical pharmacology encompasses a range of disciplines and forms the backbone of drug safety consideration during clinical drug development. In this review we give an overview of the clinical drug development process and consider its limitations. We present a discussion of several aspects of clinical pharmacology and their application to enhancing drug safety. Pharmacokinetic-pharmacodynamic modelling provides a method of predicting a clinically safe dose; consideration of drug pharmacokinetics in special populations may enhance safe therapeutics in a wider spectrum of patients, while pharmacogenetics provides the possibility of genotype-specific therapeutics. Pharmacovigilance activities are also discussed. Given the complex nature and unpredictability of type B reactions, PMS activities are crucial in managing the risks drugs pose to the general population. The various aspects of clinical pharmacology discussed make a strong case for this field as the backbone of optimising and promoting safe development and use of drugs. PMID:15154826

  1. Radioimmunoassay in basic and clinical pharmacology

    Energy Technology Data Exchange (ETDEWEB)

    Patrono, C.; Peskar, B.A.

    1987-01-01

    The subject of the book is the development, validation and application of radioimmunoassay (RIA) techniques for the measurement of a variety of substances in animal and human body fluids. The book discusses methodological and conceptual issues related to the main classes of mediators of drug action and to drugs themselves, as assayed by this particular analytical technique. A number of introductory chapters provide basic information concerning production and characterization of antibodies, labeling techniques, statistical aspects and validation criteria, insight into problems related to the development and validation of RIA for the newly discovered mediator(s). In the following chapters, the emphasis is placed on the technical details relevant to each class of compounds and on specific aspects of their applications to basic and/or clinical pharmacological studies. New developments in this area, such as monoclonal antibodies and non-radioactive labeling techniques, are also covered.

  2. Clinical Pharmacology and Pharmacokinetics of Levetiracetam

    Directory of Open Access Journals (Sweden)

    Chanin Clark Wright

    2013-12-01

    Full Text Available Status epilepticus and acute repetitive seizures still pose a management challenge despite the recent advances in the field of epilepsy. Parenteral formulations of old anticonvulsants are still a cornerstone in acute seizure management and are approved by the FDA. Intravenous levetiracetam, a second generation anticonvulsant, is approved by the FDA as an adjunctive treatment in patients 16 years or older when oral administration is not available. Data have shown that it has a unique mechanism of action, linear pharmacokinetics and no known drug interactions with other anticonvulsants. In this paper, we will review the current literature about the pharmacology and pharmacokinetics of intravenous levetiracetam and the safety profile of this new anticonvulsant in acute seizure management of both adults and children.

  3. Clinical relevance of pharmacological and physiological data in intrathecal baclofen therapy

    NARCIS (Netherlands)

    Heetla, Herre W; Staal, Michael; Proost, Johannes H; van Laar, Teus

    2014-01-01

    Objective: To review all pharmacological and physiological data available on intrathecal baclofen (ITB) therapy and to evaluate its use in clinical practice and future research. Data Sources: PubMed was searched for relevant anatomic, physiological, and pharmacological data available on ITB. Study S

  4. Phytochemical and pharmacological review of Lagenaria sicereria.

    Science.gov (United States)

    Prajapati, Rakesh P; Kalariya, Manisha; Parmar, Sachin K; Sheth, Navin R

    2010-10-01

    Lagenaria siceraria (Molina) standley (LS) (Family: Cucurbitaceae) is an annual herbaceous climbing plant with a long history of traditional medicinal uses in many countries, especially in tropical and subtropical regions. Since ancient times the climber has been known for its curative properties, and has been utilized for treatment of various ailments, including jaundice, diabetes, ulcer, piles, colitis, insanity, hypertension, congestive cardiac failure (CCF), and skin diseases. Its fruit pulp is used both as an emetic and purgative, and for its cooling, diuretic, antibilious, and pectoral properties. Boiled in oil this pulp is used to treat rheumatism and insomnia. A wide range of chemical compounds including sterols, terpenoids, flavonoids, and saponins have been isolated from the species. Its extracts have been found to possess various pharmacological activities. Below, we give a comprehensive review of its ethnomedical uses, chemical constituents, and pharmacological profile as a medicinal plant. Particular attention is given to its analgesic, anti-inflammatory, antihyperlipidemic, diuretic, hepatoprotective, anthelmintic, and antibacterial effects so that its potential uses in pharmaceutics can be better evaluated. PMID:21731373

  5. Phytochemical and pharmacological review of Lagenaria sicereria

    Directory of Open Access Journals (Sweden)

    Rakesh P Prajapati

    2010-01-01

    Full Text Available Lagenaria siceraria (Molina standley (LS (Family: Cucurbitaceae is an annual herbaceous climbing plant with a long history of traditional medicinal uses in many countries, especially in tropical and subtropical regions. Since ancient times the climber has been known for its curative properties, and has been utilized for treatment of various ailments, including jaundice, diabetes, ulcer, piles, colitis, insanity, hypertension, congestive cardiac failure (CCF, and skin diseases. Its fruit pulp is used both as an emetic and purgative, and for its cooling, diuretic, antibilious, and pectoral properties. Boiled in oil this pulp is used to treat rheumatism and insomnia. A wide range of chemical compounds including sterols, terpenoids, flavonoids, and saponins have been isolated from the species. Its extracts have been found to possess various pharmacological activities. Below, we give a comprehensive review of its ethnomedical uses, chemical constituents, and pharmacological profile as a medicinal plant. Particular attention is given to its analgesic, anti-inflammatory, antihyperlipidemic, diuretic, hepatoprotective, anthelmintic, and antibacterial effects so that its potential uses in pharmaceutics can be better evaluated.

  6. PHARMACOLOGICAL EFFECTS OF CAROTENOIDS: A REVIEW

    Directory of Open Access Journals (Sweden)

    Sumita S. Kadia

    2012-01-01

    Full Text Available Vitamin A is an essential vitamin which is required in the vision process, epithelial maintenance, mucous secretion and reproduction obtained from carotenoids. Carotenoids have been considered to provide benefits in age-related diseases, against some forms of cancer (in especial lung cancer, strokes, macular degeneration, and cataracts. Till date, more than 600 carotenoids are known and 50 of them are consumed in meals to be transformed into the essential nutrient vitamin A. After their absorption, these carotenoids are metabolized by an oxidative rupture to retinal, retinoic acid and small quantities of breakdown products and are transported by plasma lipoproteins. Carotenes are mainly associated with low-density lipoproteins, while xanthophylls show a uniform distribution between the low- and high-density lipoproteins. The present review provides an insight into the recent status of pharmacological aspects of carotenoids.

  7. Cyclooxygenase inhibitors: From pharmacology to clinical read-outs.

    Science.gov (United States)

    Patrignani, Paola; Patrono, Carlo

    2015-04-01

    Acetylsalicylic acid (aspirin) is a prototypic cyclooxygenase (COX) inhibitor. It was synthesized serendipitously from a natural compound, i.e., salicylic acid, with known analgesic activity. This chemical modification, obtained for the first time in an industrial environment in 1897, endowed aspirin with the unique capacity of acetylating and inactivating permanently COX-isozymes. Traditional nonsteroidal anti-inflammatory drugs (tNSAIDs) were developed to mimic the pharmacological effects of aspirin, using aspirin-sensitive experimental models of pain and inflammation as the template for screening new chemical entities. Among the tNSAIDs, some were endowed with moderate COX- selectivity (e.g., diclofenac), but no studies of sufficient size and duration were performed to show any clinically relevant difference between different members of the class. Similarly, no serious attempts were made to unravel the mechanisms involved in the shared therapeutic and toxic effects of tNSAIDs until the discovery of COX-2. This led to characterizing their main therapeutic effects as being COX-2-dependent and their gastrointestinal (GI) toxicity as being COX-1-dependent, and provided a rationale for developing a new class of selective COX-2 inhibitors, the coxibs. This review will discuss the clinical pharmacology of tNSAIDs and coxibs, and the clinical read-outs of COX-isozyme inhibition. This article is part of a Special Issue entitled "Oxygenated metabolism of PUFA: analysis and biological relevance." PMID:25263946

  8. Clinical pharmacology of bruceantin by radioimmunoassay

    Energy Technology Data Exchange (ETDEWEB)

    Fong, K.L.L.; Ho, D.H.W.; Benjamin, R.S.; Brown, N.S.; Bedikian, A.; Yap, B.S.; Wiseman, C.L.; Bodey, G.P.; Kramer W.

    1982-01-01

    During the phase Y clinical trial of a new antitumor agent, bruceantin, the pharmacology was studied in 18 cancer patients. The drug was infused i.v. for 3 h at doses ranging from 1 to 3.6 mg/m/sup 2/ per for 5. The plasma drug disappearance curves were biphasic, with a fast initial half-life of less than 15 min. The second half-life varied from 0.7 to 38 h among different patients and was not dose-related. The difference between the tsub(1/2..beta..) on day 1 and that on day 5 was not significant. In patients with normal liver function, the mean plasma concentration at the end of infusion was 22 ng/ml, and the value of the area under the concentration x time curve (AUC) was 111 (ng/ml)h. In contrast, in patients with abnormal liver function the corresponding values were 115 ng/ml and 830 (ng/ml)h, respectively. In addition, these patients had a slower elimination half-life of 10.9 h and a decreased total clearance of 157 ml/min/m/sup 2/, as compared with 2.6 h and 671 ml/min/m/sup 2/, respectively, for the normal group. All these differences were statistically significant. Patients with abnormal liver function developed more severe toxicity, including fever, severe nausea, vomiting, and hypotension. Two patients with severe hepatic dysfunction received a reduced dose and developed no toxicity. These results demonstrated the importance of the effects of liver dysfunction on drug disposition and showed that the dosage should be reduced in patients with hepatic dysfunction.

  9. Acanthopanax senticosus: review of botany, chemistry and pharmacology.

    Science.gov (United States)

    Huang, Linzhang; Zhao, Hongfang; Huang, Baokang; Zheng, Chengjian; Peng, Wei; Qin, Luping

    2011-02-01

    Acanthopanax senticosus (Rupr. et Maxim) Harms (Araliaceae), also called Siberian Ginseng, Eleutherococcus senticosus, and Ciwujia in Chinese, is a widely used traditional Chinese herb that could invigorate qi, strengthen the spleen, and nourish kidney in the theory of Traditional Chinese Medicine. With high medicinal value, Acanthopanax senticosus (AS, thereafter) is popularly used as an "adaptogen" like Panax ginseng. In recent decades, a great number of chemical, pharmacological, and clinical studies on AS have been carried out worldwide. Several kinds of chemical compounds have been reported, including triterpenoid saponins, lignans, coumarins, and flavones, among which, phenolic compounds such as syringin and eleutheroside E, were considered to be the most active components. Considerable pharmacological experiments both in vitro and in vivo have persuasively demonstrated that AS possessed anti-stress, antiulcer, anti-irradiation, anticancer, anti-inflammatory and hepatoprotective activities, etc. The present review is an up-to-date and comprehensive analysis of the botany, chemistry, pharmacology, toxicity and clinical trials of AS. PMID:21434569

  10. Garcinia mangostana L.: a phytochemical and pharmacological review.

    Science.gov (United States)

    Obolskiy, Dmitriy; Pischel, Ivo; Siriwatanametanon, Nisarat; Heinrich, Michael

    2009-08-01

    Garcinia mangostana L. (mangosteen, Clusiaceae) has a long history of use as a medical plant, mostly in Southeast Asia. This is a review of the phytochemistry and pharmacology of mangosteen. Traditionally mangosteen is famous for its antiinflammatory properties and is used in the treatment of skin infections and wounds. Other applications include the therapy of various conditions such as dysentery, different urinary disorders, cystitis and gonorrhoea. This review highlights the development of this botanical drug into a widely used nutraceutical. Products derived from G. mangostana are now distributed increasingly all over the world. This has given rise to a concomitant increase in research on the phytochemical constituents and biological activity of mangosteen. Central to the biological activity of the species are xanthones which are reviewed in detail. A comprehensive assessment of the biological activities of individual xanthones as well as extracts of G. mangostana is included. In addition, its potential in terms of developing novel drug leads is assessed. Products containing its fruits are now sold widely as 'liquid botanical supplements', but evidence for the health benefits of these products is still lacking. As shown here, a serious weakness in our knowledge is the lack of clinical data and it is not yet clear to what extent the findings about pharmacological activities are of potential clinical relevance.

  11. Lonicerae Japonicae Flos and Lonicerae Flos: A Systematic Pharmacology Review

    Directory of Open Access Journals (Sweden)

    Yujie Li

    2015-01-01

    Full Text Available Lonicerae japonicae flos, a widely used traditional Chinese medicine (TCM, has been used for several thousand years in China. Chinese Pharmacopeia once included Lonicerae japonicae flos of Caprifoliaceae family and plants of the same species named Lonicerae flos in general in the same group. Chinese Pharmacopeia (2005 Edition lists Lonicerae japonicae flos and Lonicerae flos under different categories, although they have the similar history of efficacy. In this study, we research ancient books of TCM, 4 main databases of Chinese academic journals, and MEDLINE/PubMed to verify the origins and effects of Lonicerae japonicae flos and Lonicerae flos in traditional medicine and systematically summarized the research data in light of modern pharmacology and toxicology. Our results show that Lonicerae japonicae flos and Lonicerae flos are similar pharmacologically, but they also differ significantly in certain aspects. A comprehensive systematic review and a standard comparative pharmacological study of Lonicerae japonicae flos and Lonicerae flos as well as other species of Lonicerae flos support their clinical safety and application. Our study provides evidence supporting separate listing of Lonicerae japonicae flos and Lonicerae flos in Chinese Pharmacopeia as well as references for revision of relevant pharmacopeial records dealing with traditional efficacy of Lonicerae japonicae flos and Lonicerae flos.

  12. ASPECTS OF THE AMLODIPINE PLEIOTROPY IN BIOCHEMISTRY, PHARMACOLOGY AND CLINICS

    Directory of Open Access Journals (Sweden)

    Rasma Vitolina, Aivars Krauze, Gunars Duburs and Astrida Velena*

    2012-05-01

    Full Text Available Amlodipine is the third generation calcium antagonist, 1,4-dihydropyridine derivative with the prolonged duration of the antihypertensive action, especially blocking L-type Ca2+ ion channels. It promotes beneficial therapeutic effect by coronary and other blood vessel diseases and thus delays development of the atherosclerosis. It has several known trade names, the most mentioned is Norvasc. Amlodipine is well tolerated in the clinics, it could be used in combinations with other drugs – diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, statins. Amlodipine at nanomolar concentrations binds to the voltage-dependent L-type calcium channels. It possesses optimal lipophylicity. Amlodipine also influences the NO-dependent metabolic processes, stimulates NO synthesis and prolongs NO action duration. Results of the studies of the amlodipine pharmacological and clinical properties are summarized in several reviews. The present review contains opinion from the scientific works of the last decades about the multisided or pleiotropic amlodipine mechanisms of action, it contains information about sometimes controversial clinical studies of the amlodipine vaso- and cardioprotective activity.

  13. 76 FR 38668 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2011-07-01

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice and... April 13, 2010, Advisory Committee for Pharmaceutical Science and Clinical Pharmacology...

  14. 76 FR 3912 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2011-01-21

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice and... how to optimally utilize mechanistic biomarkers and apply clinical pharmacology tools, such...

  15. A Review of the Medicinal Uses and Pharmacology of Ashitaba.

    Science.gov (United States)

    Caesar, Lindsay K; Cech, Nadja B

    2016-09-01

    Angelica keiskei Koidzumi, or ashitaba, is a popular botanical medicine in Japan containing diverse bioactive components including prenylated chalcones, linear and angular coumarins, and flavanones. This review provides an overview of the current knowledge of ashitaba metabolites and their biological activities to prioritize future studies. Ashitaba is purported to possess cytotoxic, antidiabetic, antioxidative, anti-inflammatory, antihypertensive, and antimicrobial properties. Although many in vitro studies have been conducted on ashitaba's chemical constituents, the in vivo efficacy and clinical relevance of this plant has yet to be confirmed for most of these activities. Here we describe the chemical composition of ashitaba and present the pharmacological effects of this botanical as supported by the current literature. The experimental results demonstrate promise for the medical use of ashitaba, but considerable work needs to be done to understand the mechanisms of action of its metabolites. Additionally, in vivo and clinical trials as well as additional studies on less abundant bioactive compounds are warranted.

  16. Clinical review

    DEFF Research Database (Denmark)

    Hjortrup, Peter Buhl; Haase, Nicolai; Wetterslev, Mik;

    2013-01-01

    Neutrophil gelatinase-associated lipocalin (NGAL) may be an early marker of acute kidney injury (AKI), but elevated NGAL occurs in a wide range of systemic diseases. Because intensive care patients have high levels of comorbidity, our objective was to conduct a systematic review of the literature...

  17. Cocos nucifera (L.) (Arecaceae): A phytochemical and pharmacological review.

    Science.gov (United States)

    Lima, E B C; Sousa, C N S; Meneses, L N; Ximenes, N C; Santos Júnior, M A; Vasconcelos, G S; Lima, N B C; Patrocínio, M C A; Macedo, D; Vasconcelos, S M M

    2015-11-01

    Cocos nucifera (L.) (Arecaceae) is commonly called the "coconut tree" and is the most naturally widespread fruit plant on Earth. Throughout history, humans have used medicinal plants therapeutically, and minerals, plants, and animals have traditionally been the main sources of drugs. The constituents of C. nucifera have some biological effects, such as antihelminthic, anti-inflammatory, antinociceptive, antioxidant, antifungal, antimicrobial, and antitumor activities. Our objective in the present study was to review the phytochemical profile, pharmacological activities, and toxicology of C. nucifera to guide future preclinical and clinical studies using this plant. This systematic review consisted of searches performed using scientific databases such as Scopus, Science Direct, PubMed, SciVerse, and Scientific Electronic Library Online. Some uses of the plant were partially confirmed by previous studies demonstrating analgesic, antiarthritic, antibacterial, antipyretic, antihelminthic, antidiarrheal, and hypoglycemic activities. In addition, other properties such as antihypertensive, anti-inflammatory, antimicrobial, antioxidant, cardioprotective, antiseizure, cytotoxicity, hepatoprotective, vasodilation, nephroprotective, and anti-osteoporosis effects were also reported. Because each part of C. nucifera has different constituents, the pharmacological effects of the plant vary according to the part of the plant evaluated.

  18. Cocos nucifera (L. (Arecaceae: A phytochemical and pharmacological review

    Directory of Open Access Journals (Sweden)

    E.B.C. Lima

    2015-01-01

    Full Text Available Cocos nucifera (L. (Arecaceae is commonly called the “coconut tree” and is the most naturally widespread fruit plant on Earth. Throughout history, humans have used medicinal plants therapeutically, and minerals, plants, and animals have traditionally been the main sources of drugs. The constituents of C. nucifera have some biological effects, such as antihelminthic, anti-inflammatory, antinociceptive, antioxidant, antifungal, antimicrobial, and antitumor activities. Our objective in the present study was to review the phytochemical profile, pharmacological activities, and toxicology of C. nucifera to guide future preclinical and clinical studies using this plant. This systematic review consisted of searches performed using scientific databases such as Scopus, Science Direct, PubMed, SciVerse, and Scientific Electronic Library Online. Some uses of the plant were partially confirmed by previous studies demonstrating analgesic, antiarthritic, antibacterial, antipyretic, antihelminthic, antidiarrheal, and hypoglycemic activities. In addition, other properties such as antihypertensive, anti-inflammatory, antimicrobial, antioxidant, cardioprotective, antiseizure, cytotoxicity, hepatoprotective, vasodilation, nephroprotective, and anti-osteoporosis effects were also reported. Because each part of C. nucifera has different constituents, the pharmacological effects of the plant vary according to the part of the plant evaluated.

  19. Achieving the World Health Organization's vision for clinical pharmacology.

    Science.gov (United States)

    Martin, Jennifer H; Henry, David; Gray, Jean; Day, Richard; Bochner, Felix; Ferro, Albert; Pirmohamed, Munir; Mörike, Klaus; Schwab, Matthias

    2016-02-01

    Clinical pharmacology is a medical specialty whose practitioners teach, undertake research, frame policy, give information and advice about the actions and proper uses of medicines in humans and implement that knowledge in clinical practice. It involves a combination of several activities: drug discovery and development, training safe prescribers, providing objective and evidence-based therapeutic information to ethics, regulatory and pricing bodies, supporting patient care in an increasingly subspecialized arena where co-morbidities, polypharmacy, altered pharmacokinetics and drug interactions are common and developing and contributing to medicines policies for Governments. Clinical pharmacologists must advocate drug quality and they must also advocate for sustainability of the Discipline. However for this they need appropriate clinical service and training support. This Commentary discusses strategies to ensure the Discipline is supported by teaching, training and policy organizations, to communicate the full benefits of clinical pharmacology services, put a monetary value on clinical pharmacology services and to grow the clinical pharmacology workforce to support a growing clinical, academic and regulatory need. PMID:26466826

  20. PHYTO-PHARMACOLOGICAL REVIEW OF ARGYREIA NERVOSA

    Directory of Open Access Journals (Sweden)

    A. Krishnaveni

    2011-02-01

    Full Text Available Herbal medicines are the significant and reliable sources for treating various diseases. Argyreia nervosa is traditionally used in wound healing, syphilius,diuretics,rheumatic affections, leucohorrhoea.,cerebral disorders, ulcers, as anti-tumour and to prevent contraception.Phytoconstituents such as flavanoids, steroids, ergoline alkaloids and triterpenoids were identified. Pharmacological studies proved its anticonvulsant, immunomodulatory, hypotensive, anti- inflammatory and nootropic effect.The present form of article highlights the phytochemical and pharmacological studies including traditional practice of Argyreia nervosa have been carried out so far.

  1. PHYTO-PHARMACOLOGICAL REVIEW OF ARGYREIA NERVOSA

    OpenAIRE

    Krishnaveni, A; T. Sant Rani

    2011-01-01

    Herbal medicines are the significant and reliable sources for treating various diseases. Argyreia nervosa is traditionally used in wound healing, syphilius,diuretics,rheumatic affections, leucohorrhoea.,cerebral disorders, ulcers, as anti-tumour and to prevent contraception.Phytoconstituents such as flavanoids, steroids, ergoline alkaloids and triterpenoids were identified. Pharmacological studies proved its anticonvulsant, immunomodulatory, hypotensive, anti- inflammatory and no...

  2. 77 FR 42746 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2012-07-20

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice...

  3. 78 FR 58314 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2013-09-23

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice...

  4. 76 FR 38188 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2011-06-29

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice...

  5. 77 FR 41790 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2012-07-16

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice...

  6. 78 FR 58315 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2013-09-23

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice...

  7. 75 FR 10488 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2010-03-08

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice...

  8. 75 FR 11551 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2010-03-11

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice...

  9. TRIBULUS TERRESTRIS LINN.: A PHYTO-PHARMACOLOGICAL REVIEW

    Directory of Open Access Journals (Sweden)

    Prajapati PK

    2013-08-01

    Full Text Available Plants have a significant role in maintaining human health and improving quality of life. gokshura  (Tribulus terrestris Linn. one of such plants, is mentioned in Ayurvedic texts for  various therapeutic properties like balya (strengthening, brimhana (nutritive, rasayana (rejuvenator, mootrala (diuretic, shothahara (anti-inflammatory, vajikarana (aphrodisiac etc. and useful in the management of mutrakrichhra (dysurea, ashmari (renal calculi etc. It is a perennial plant, grown predominantly in India and Africa. Its extract contains alkaloids, saponins, resins, flavanoids and nitrates. Considering its therapeutic values, a review has been done to gather information on different aspects of gokshura. Besides Ayurvedic references, the present paper also emphasizes on recent researches carried out on this plant for its clinical and pharmacological evaluation.

  10. Systematic review of pharmacological treatments in fragile X syndrome

    Directory of Open Access Journals (Sweden)

    Tejada Maria-Isabel

    2009-10-01

    Full Text Available Abstract Background Fragile X syndrome (FXS is considered the most common cause of inherited mental retardation. Affected people have mental impairment that can include Attention Deficit and/or Hyperactivity Disorder (ADHD, autism disorder, and speech and behavioural disorders. Several pharmacological interventions have been proposed to treat those impairments. Methods Systematic review of the literature and summary of the evidence from clinical controlled trials that compared at least one pharmacological treatment with placebo or other treatment in individuals with diagnosis of FXS syndrome and assessed the efficacy and/or safety of the treatments. Studies were identified by a search of PubMed, EMBASE and the Cochrane Databases using the terms fragile X and treatment. Risk of bias of the studies was assessed by using the Cochrane Collaboration criteria. Results The search identified 276 potential articles and 14 studies satisfied inclusion criteria. Of these, 10 studies on folic acid (9 with crossover design, only 1 of them with good methodological quality and low risk of bias did not find in general significant improvements. A small sample size trial assessed dextroamphetamine and methylphenidate in patients with an additional diagnosis of ADHD and found some improvements in those taking methylphenidate, but the length of follow-up was too short. Two studies on L-acetylcarnitine, showed positive effects and no side effects in patients with an additional diagnosis of ADHD. Finally, one study on patients with an additional diagnosis of autism assessed ampakine compound CX516 and found no significant differences between treatment and placebo. Regarding safety, none of the studies that assessed that area found relevant side effects, but the number of patients included was too small to detect side effects with low incidence. Conclusion Currently there is no robust evidence to support recommendations on pharmacological treatments in patients with

  11. Pharmacological and clinical overview of cloperastine in treatment of cough

    Directory of Open Access Journals (Sweden)

    Maria Antonietta Catania

    2011-03-01

    Full Text Available Maria Antonietta Catania1, Salvatore Cuzzocrea1,21Department of Clinical and Experimental Medicine and Pharmacology, School of Medicine, University of Messina; 2IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, ItalyAbstract: Cough constitutes an impressive expression of the normal defense mechanisms of the respiratory system. Productive cough associated with catarrh is an important protective system for the lung because it favors the upward movement of secretions and foreign bodies to the larynx and mouth. Cough may also appear without bronchial secretions, as dry cough, which may be persistent when inflammatory disease is chronic or when, in the early stages of respiratory disease, bronchial secretions are not yet fluid. Sometimes bronchitis-induced cough does not significantly affect quality of life, whilst in other cases cough may become so intense as to impair daily activities severely, resulting in permanent disability. This type of cough is one of the most frequent reasons for seeking medical advice. The use of cough suppressants may be appropriate for reaching a precise diagnosis and when dry cough is persistent. Cloperastine has been investigated in various types of cough and, unlike codeine, has been shown to possess dual activity. It also acts as a mild bronchorelaxant and has antihistaminic activity, without acting on the central nervous system or the respiratory center. Here we review the preclinical and clinical evidence of the efficacy and tolerability of cloperastine.Keywords: cough, cloperastine, inflammation, bronchitis

  12. Pharmacogenetics : the science of predictive clinical pharmacology

    OpenAIRE

    Fenech, Anthony G; Grech, Godfrey

    2014-01-01

    The study of pharmacogenetics has expanded from what were initially casual family-based clinical drug response observations, to a fully-fledged science with direct therapeutic applications, all within a time-span of less than 60 years. A wide spectrum of polymorphisms, located within several genes, are now recognised to influence the pharmacokinetics and pharmacodynamics of the majority of drugs within our therapeutic armamentarium. This information forms the basis for the new development of ...

  13. Pharmacological Potential of Matricaria recutita-A Review

    Directory of Open Access Journals (Sweden)

    Vikas Gupta

    2010-01-01

    Full Text Available Matricaria recutita, once it has been called as Marticaria chamomilla, Chamomilla recutita, and Chamomilum nobile family Asteraceae. The main constituents of this plant include the terpenoids α-bisabolol and its oxides and azulenes, including chamazulene. Matricaria recutita shows different pharmacological activities like anti-inflammatory, anti- cancer, treatment of stress and depression, anti-allergic etc. This review focuses on the detailed chemical constituents, pharmacological activities of different parts of this plant.

  14. Pharmacological Potential of Matricaria recutita-A Review

    OpenAIRE

    Vikas Gupta; Payal Mittal; Parveen Bansal; SUKHBIR L. KHOKRA; Dhirender Kaushik

    2010-01-01

    Matricaria recutita, once it has been called as Marticaria chamomilla, Chamomilla recutita, and Chamomilum nobile family Asteraceae. The main constituents of this plant include the terpenoids α-bisabolol and its oxides and azulenes, including chamazulene. Matricaria recutita shows different pharmacological activities like anti-inflammatory, anti- cancer, treatment of stress and depression, anti-allergic etc. This review focuses on the detailed chemical constituents, pharmacological activities...

  15. Topical corticosteroids: clinical pharmacology and therapeutic use.

    Science.gov (United States)

    Miller, J A; Munro, D D

    1980-02-01

    The development of topical corticosteroids has enabled many dermatoses to be more effectively treated than previously, but there is also no doubt that misuse of these preparations can lead to troublesome local effects and potentially serious systemic problems. The most effective assay for comparing different compounds has been their vasoconstrictive activity, and this on the whole correlates well with clinical effect. To be effective, corticosteroid must be absorbed and the importance of concentration, occlusion, the type of vehicle, added penetrants such as urea and the anatomical site, on the amount of absorption and therefore on clinical activity has been demonstrated. Ointments have been shown to be more effective than creams but because of the considerable choice of potencies now available most dermatologists tend to prescribe the different formulations according to the wishes of the patient. For the same reason, dilution of the commercially marketed preparations is now not generally recommended. The main therapeutic activity of topical corticosteroids is their nonspecific anti-inflammatory effect, thought to be primarily a result of their action on the chemical mediators of inflammation. They have also been shown to be antimitotic which may well be relevant not only to the treatment of scaling dermatoses but also to their dermal thinning effect resulting from inhibition of fibroblasts. Combinations of corticosteroids with antibacterial and antifungal agents have been shown to be very effective in flexural eruptions and secondarily infected dermatoses. As a general rule, the use of topical corticosteroids in outpatients, unless badly misused, is not associated with any significant risk of adrenal axis suppression, but care must be exercised as to the amount prescribed, especially if large areas of the body are to be treated with highly potent preparations. Certain groups such as young children and patients with liver failure, and certain anatomical sites such

  16. Pharmacological therapy for acromegaly: a critical review.

    Science.gov (United States)

    Muller, Alex F; Van Der Lely, Aart Jan

    2004-01-01

    The treatment of acromegaly has changed considerably over the last few decades. In the late 1970s, the introduction of the dopamine receptor agonists made it possible to reduce growth hormone (GH) secretion by somatotropinomas for the first time. Thereafter, the introduction of the somatostatin analogues in the early 1980s had major implications. Recently, the first data on the use of genetically engineered human GH receptor (GHR) antagonists that block GH actions have become available. These GHR antagonists reduce both the biochemical abnormalities of acromegaly, as well as improve clinical signs and symptomatology. In this article we firstly review available data on dopamine agonists. Currently these compounds should be considered in patients with a mixed GH-prolactin secreting pituitary adenoma and/or those in whom pre-treatment insulin-like growth factor (IGF)-I concentrations are below 750 microg/L. We then discuss the somatostatin analogues. These compounds are capable of achieving biochemical control of GH and IGF-I in 50-60% of patients and tumour shrinkage in some 30%. In particular, candidates for treatment with these compounds are those patients who have undergone an unsuccessful transsphenoidal operation or who await the therapeutic effect of external pituitary irradiation. In selected patients primary medical therapy with somatostatin analogues is certainly a feasible option. To date, pegvisomant is the only available member of a new class of drugs that was especially designed to block the GHR. Pegvisomant is the most effective treatment for normalising IGF-I concentrations and appears to have a good safety profile. However, liver function tests should be regularly monitored and tumour size should be closely followed. Finally, we propose a treatment algorithm for acromegaly.

  17. MR arthrography: pharmacology, efficacy and safety in clinical trials

    Energy Technology Data Exchange (ETDEWEB)

    Schulte-Altedorneburg, G.; Gebhard, M.; Wohlgemuth, W.A.; Fischer, W.; Zentner, J.; Bohndorf, K. [Department of Radiology, Klinikum Augsburg, Stenglinstrasse 2, 86156 Augsburg (Germany); Wegener, R.; Balzer, T. [Clinical Development Diagnostics and Radiopharmaceuticals II, Schering AG, Berlin (Germany)

    2003-01-01

    A meta-analysis was carried out of clinical trials published between 1987 and 2001 in respect of the clinical pharmacology and safety as well as the diagnostic efficacy of gadolinium-DTPA (Gd-DTPA) for direct intra-articular injection before MRI examination.Design. Scientific papers (clinical, postmortem and experimental studies) and information from the manufacturer regarding intra-articular injection of Gd-DTPA that addressed questions of mode of action, optimal concentration and dose, elimination and safety were reviewed. Clinical studies were classified according to their study design. The sensitivity, specificity and accuracy of MR arthrography (MRA) were compared with a ''gold standard'' (arthroscopy, arthrotomy) and other radiological evidence for different joints.Results. Fifty-two clinical studies of the overall 112 studies addressed aspects of diagnostic efficacy of MRA in patients or in healthy volunteers. The shoulder was the most assessed joint (29 of 52 studies). Good (>80%) or even excellent (90-100%) sensitivity, specificity and accuracy were found for MRA in most indications, especially for the shoulder and knee joints and induced extension of rotator cuff lesions, labrum abnormalities and postoperative meniscal tears. Two millimoles per liter has proven to be the best concentration for intra-articular administration of Gd-DTPA. After passive complete diffusion from the joint within 6-24 h, complete and rapid renal elimination takes place after intra-articular injection. Local safety proved to be excellent after intra-articular administration of Gd-DTPA. Regarding systemic tolerance almost no side effects have been reported, but the same safety considerations apply for intra-articular administration of Gd-DTPA as for intravenous injection.Conclusions. The diagnostic efficacy of intra-articular MRA in most clinical conditions affecting major joints is greater than that of plain MRI. In some diagnostic problems MRA achieves almost

  18. [Clinical pharmacology and the selection of drugs].

    Science.gov (United States)

    Stanulović, M

    1989-01-01

    Yugoslavia has a modern drug legislature and a selective drug market. With about 910 substances and 1250 brand names the number of drugs is among the lowest among the European countries. Most products on the market satisfy high criteria of safety to efficacy ratio. Still, the regional health insurance authorities of the Federal republics of Serbia and of Croatia limited the number of drugs to be reimbursed by the insurance scheme. The reason for this move and its justification is given by--the inertia of the complicated procedure of withdrawal from the market of a drug which is obsolete or considered today not possess the ascribed efficacy, existence of unjustly high expectations regarding the efficacy of certain drugs by both the medical profession and the layman and which lead to overprescribing (i.e. vitamin combinations, laxatives and drugs, cerebrovascular insufficiency), and--the responsibility of the public health administration for setting priorities in spending of the available funds. The allocation of funds available for medicinal drugs have been without any kind of regulation and control until now. The introduction of limitations in the reimbursement of price for certain drugs is the first measure initiated to stimulate the optimal use of drugs. As the optimal drug use is considered the therapy with the most favorable safety/efficacy and cost/efficiency ratios. The other measures available and which ought to be initiated are those based on the drug utilization studies. The prescriptions are already computerized im most settings, so the feedback of information ot the prescribing physicians could be possible after adequate analysis of the data. The team of clinical pharmacologist already active in drug utilization studies is available and ready to meet the challenge of improving therapeutic practices. PMID:2642196

  19. Extending worldwide clinical pharmacology education through a pricing approach.

    Science.gov (United States)

    Ameer, Barbara

    2005-09-01

    Financial instruments, such as professional membership fees, are part of the science and technology policy toolkit for creating an environment conducive to developing an international health knowledge network. To minimize a hurdle to global knowledge exchange in clinical pharmacology, the American College of Clinical Pharmacology reevaluated fees for its international members. Secondary market research was conducted on salary data available from US-based multinational firms. Salary comparisons for the same position based in the United States and in a developing economy were used to generate an index ratio. Applying this ratio, a tiered-membership fee structure was constructed for the approximately 120 countries where gross national income meets the World Bank classification of "developing economy." The index ratio serves as a paradigm for structuring fees across a variety of programs. With the implementation of an adjusted dues structure, information and networks of colleagues are now more accessible to clinical pharmacologists in developing economies.

  20. PHARMACOLOGICAL ACTIVITIES OF SPERMACOCE HISPIDA LINN: A REVIEW

    Directory of Open Access Journals (Sweden)

    Vinayak Meti

    2013-02-01

    Full Text Available Spermacoce hispida Linn is one of the important plant belonging to the family of Rubiaceae and is commonly used herb in siddha medicine. This review supports all updated information on its chemical constituents, pharmacological activities, traditional uses and scientific approach. The plant extracts contains phytochemical constituents such as of saponins, tannins, phenolics, steroids, essential oils, flavonoids and terpenoids. The chemical entities of this plant have been used as an antidiabetic, anti-hypertensive, hepatoprotective, anti-inflammatory, antihyperlipidaemic, analgesic, antifungal, anticancer and antioxidant properties. This review is studied for the further development of various formulations for their traditional use and pharmacological activities.

  1. [Clinical-pharmacological aspects to accelerate the development process from the preclinical to the clinical phase/1st communication: The contribution of clinical pharmacology].

    Science.gov (United States)

    Kuhlmann, Jochen

    2004-01-01

    To improve the transition from research to development a critical evaluation of the individual project by research and disease area teams is required to include input from pharmacology, toxicology, pharmacokinetics, galenics, clinical pharmacology, clinical as well as regulatory experts and marketing. Decisions on the individual development strategy should be made prior to the start of development and all projects should be reviewed at predefined stages throughout the product development life cycle. This ensures consistency of decision-making not only during the development of individual products but throughout the entire development pipeline. Studies in the exploratory stage of drug development should be designed for decision making in contrast to later clinical trials in the confirmatory stage that require power for proof-of-safety and proof-of-efficacy. The more thorough and profound studies have been carried out during this exploratory stage of drug development, the earlier a decision can be made on the continuation or discontinuation of further development, thus saving development time and money and assessing and considerably reducing the risk for the patients and increasing the success rate of the project in the later confirmatory effectiveness trial with an adequate number of subjects receiving the new therapy under typical conditions of use. Strategies which may be helpful to improve the quality of decisions in drug discovery and drug development are: discovery experiments should be done to critically evaluate the compound, the "killer" experiments should be done as early as possible, continuous effort on preclinical disease models is necessary to improve predictability of efficacy in patients ("humanized" research): genomic technology should be used to identify novel, disease-related targets and to characterise preclinical test systems, improvement of knowledge and experience concerning the relevance of new technologies for the clinical picture; genotyping

  2. [Clinical-pharmacological aspects to accelerate the development process from the preclinical to the clinical phase/1st communication: The contribution of clinical pharmacology].

    Science.gov (United States)

    Kuhlmann, Jochen

    2004-01-01

    To improve the transition from research to development a critical evaluation of the individual project by research and disease area teams is required to include input from pharmacology, toxicology, pharmacokinetics, galenics, clinical pharmacology, clinical as well as regulatory experts and marketing. Decisions on the individual development strategy should be made prior to the start of development and all projects should be reviewed at predefined stages throughout the product development life cycle. This ensures consistency of decision-making not only during the development of individual products but throughout the entire development pipeline. Studies in the exploratory stage of drug development should be designed for decision making in contrast to later clinical trials in the confirmatory stage that require power for proof-of-safety and proof-of-efficacy. The more thorough and profound studies have been carried out during this exploratory stage of drug development, the earlier a decision can be made on the continuation or discontinuation of further development, thus saving development time and money and assessing and considerably reducing the risk for the patients and increasing the success rate of the project in the later confirmatory effectiveness trial with an adequate number of subjects receiving the new therapy under typical conditions of use. Strategies which may be helpful to improve the quality of decisions in drug discovery and drug development are: discovery experiments should be done to critically evaluate the compound, the "killer" experiments should be done as early as possible, continuous effort on preclinical disease models is necessary to improve predictability of efficacy in patients ("humanized" research): genomic technology should be used to identify novel, disease-related targets and to characterise preclinical test systems, improvement of knowledge and experience concerning the relevance of new technologies for the clinical picture; genotyping

  3. Children with schizophrenia: clinical picture and pharmacological treatment.

    Science.gov (United States)

    Masi, Gabriele; Mucci, Maria; Pari, Cinzia

    2006-01-01

    these clinical patterns, such as multidimensionally impaired disorder and multiple complex developmental disorder. In the context of a multimodal approach, including behavioral, social, scholastic and familial interventions, a pharmacological treatment is usually the core treatment. Available experience from the few controlled studies, open studies and case reports on pharmacotherapy in children with schizophrenia aged <12 years is critically analysed in this review, with particular reference to the use of atypical antipsychotics in clinical practice. To date, the major evidence supports the efficacy of risperidone and olanzapine, while clozapine seems an effective option in treatment-refractory cases. Published experience with newer atypical antipsychotics (quetiapine, ziprasidone, aripiprazole) is still lacking in this age range. Safety data (namely extrapyramidal symptoms, weight gain, hyperprolactinaemia, haematological adverse effects, seizures, hepatotoxicity, metabolic effects, neuroleptic malignant syndrome and cardiovascular effects) are reviewed and discussed, along with strategies for management.

  4. Children with schizophrenia: clinical picture and pharmacological treatment.

    Science.gov (United States)

    Masi, Gabriele; Mucci, Maria; Pari, Cinzia

    2006-01-01

    these clinical patterns, such as multidimensionally impaired disorder and multiple complex developmental disorder. In the context of a multimodal approach, including behavioral, social, scholastic and familial interventions, a pharmacological treatment is usually the core treatment. Available experience from the few controlled studies, open studies and case reports on pharmacotherapy in children with schizophrenia aged <12 years is critically analysed in this review, with particular reference to the use of atypical antipsychotics in clinical practice. To date, the major evidence supports the efficacy of risperidone and olanzapine, while clozapine seems an effective option in treatment-refractory cases. Published experience with newer atypical antipsychotics (quetiapine, ziprasidone, aripiprazole) is still lacking in this age range. Safety data (namely extrapyramidal symptoms, weight gain, hyperprolactinaemia, haematological adverse effects, seizures, hepatotoxicity, metabolic effects, neuroleptic malignant syndrome and cardiovascular effects) are reviewed and discussed, along with strategies for management. PMID:16999454

  5. The Pharmacological Importance of Benincasa hispida. A review

    Directory of Open Access Journals (Sweden)

    Ali Esmail Al-Snafi

    2014-12-01

    Full Text Available Benincasa hispida was probably native in Japan and Java, cultivated more or less throughout warm countries. It was a popular vegetable crop widely used for nutritional and medicinal purposes. Phytochemical analysis showed that the major constituents of Benincasa hispida fruits are volatile oils , flavonoids, glycosides, sacchrides, proteins, carotenes, vitamins, minerals, ß-sitosterin and uronic acid. The pharmacological studies revealed that the plant exerted many pharmacological activities , including central nervous effects ( anxiolytic , muscle relaxant , antidepressant , in the treatment of Alzheimer's disease and to minimize opiates withdrawal signs, antioxidant, anti-inflammatory, analgesic, antiasthmatic, diuretic , nephroprotective , antidiabetic , hypolipidemic and antimicrobial effects . This review was designed to highlight the chemical constituents and pharmacological effects of Benincasa hispida.

  6. Pharmacological enhancement of exposure-based treatment in PTSD: a qualitative review

    Directory of Open Access Journals (Sweden)

    Rianne A. de Kleine

    2013-10-01

    Full Text Available There is a good amount of evidence that exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD. Notwithstanding its efficacy, there is room for improvement, since a large proportion of patients does not benefit from treatment. Recently, an interesting new direction in the improvement of exposure therapy efficacy for PTSD emerged. Basic research found evidence of the pharmacological enhancement of the underlying learning and memory processes of exposure therapy. The current review aims to give an overview of clinical studies on pharmacological enhancement of exposure-based treatment for PTSD. The working mechanisms, efficacy studies in PTSD patients, and clinical utility of four different pharmacological enhancers will be discussed: D-cycloserine, MDMA, hydrocortisone, and propranolol.

  7. Comorbidity issues in the pharmacological treatment of pathological gambling: a critical review

    Directory of Open Access Journals (Sweden)

    Hollander Eric

    2005-10-01

    Full Text Available Abstract Background Pathological Gambling (PG is an impulse control disorder often comorbid with other psychopathology, particularly bipolar spectrum disorders, attention deficit/hyperactivity disorder, obsessive-compulsive disorder (OCD and substance abuse. This paper reviews the published literature on the pharmacological management of PG, highlighting how clinical and subclinical comorbid psychopathology influences the choice of pharmacological treatment. Methods Using Medline, the authors reviewed relevant articles published on this topic from1995 to 2005, focusing on the best-designed studies for inclusion. Results Much of the literature on PG-treatment presupposes different theories regarding this disorder. Data suggest the utility of differentiating the pharmacotherapy of pathological gamblers in light of their comorbid profile, specifically assessing for comorbid bipolar, ADHD, OCD, and substance abuse disorders. Conclusion Decisions about pharmacological treatment of PG should take into account current and previous comorbid disorders which influence treatment selection.

  8. Bryophyllum pinnatum and Related Species Used in Anthroposophic Medicine: Constituents, Pharmacological Activities, and Clinical Efficacy.

    Science.gov (United States)

    Fürer, Karin; Simões-Wüst, Ana Paula; von Mandach, Ursula; Hamburger, Matthias; Potterat, Olivier

    2016-07-01

    Bryophyllum pinnatum (syn. Kalanchoe pinnata) is a succulent perennial plant native to Madagascar that was introduced in anthroposophic medicine in the early 20th century. In recent years, we conducted a large collaborative project to provide reliable data on the chemical composition, pharmacological properties, and clinical efficacy of Bryophyllum. Here, we comprehensively review the phytochemistry, as well as the pharmacological and clinical data. As to the pharmacology, special emphasis is given to properties related to the use in anthroposophic medicine as a treatment for "hyperactivity diseases", such as preterm labor, restlessness, and sleep disorders. Studies suggesting that B. pinnatum may become a new treatment option for overactive bladder syndrome are also reviewed. Tolerability is addressed, and toxicological data are discussed in conjunction with the presence of potentially toxic bufadienolides in Bryophyllum species. The few data available on two related species with medicinal uses, Bryophyllum daigremontianum and Bryophyllum delagoense, have also been included. Taken together, current data support the use of B. pinnatum for the mentioned indications, but further studies are needed to fully understand the modes of action, and to identify the pharmacologically active constituents. PMID:27220081

  9. 77 FR 1696 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2012-01-11

    ... Pharmacology; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. This notice... Science and Clinical Pharmacology. General Function of the Committee: To provide advice and... pharmacology aspects of pediatric clinical trial design and dosing to optimize pediatric drug development....

  10. Approach to pharmacological and clinical applications of Anisi aetheroleum

    Institute of Scientific and Technical Information of China (English)

    Khaled; Mohamed; Mohamed; Koriem

    2015-01-01

    Anisi aetheroleum is the oil obtained from Pimpinella anisuin L.(P.anisuin) by steam distillation.P.anisuin seeds were air-dried,and then the dry seeds were crushed,pulverized,and weighed in sequence for anise oil preparation.P.anisuin is one of the oldest medicinal plants that belong to family Apiaceae.The fruit of P.anisuin is harvested in August and September.P.anisuin is widespread in Asia,Africa and Europe.Local names of P.anisuin include anise,anisoon,roomy,saunf,sweet cumin and yansoon.The anise oil odour is aromatic while the oil tastes sweet.The average daily dose of Anisi aetheroleum is 0.3 g.transAnethole is the major ingredient of the anise oil.Anisi aetheroleum also displays a protective action against neurotoxicity.In addition.Anisi aetheroleum increases glucose absorption and reduces urine output in the rat.The plant oil have pharmacological(antimicrobial,hepatoprotective.anticonvulsant,anti-inflammatory,antispasmodic,bronchodilator.estrogenic,expectorant and insecticidal) effects and clinical effects on nausea,constipation,menopausal period,virus,diabetes,obesity and sedative action.Owing to the wide application of Anisi aetheroleum in pharmacological and clinical fields,it is recommended for more clinical trails to discover a new medication from the active constituents of the plant oil in the future to treat human diseases especially chronic ones.

  11. Ocimum Basilicum: A Review on Phytochemical and Pharmacological Studies

    Directory of Open Access Journals (Sweden)

    S. Khair-ul-Bariyah

    2012-06-01

    Full Text Available Ocimum basilicum is a common herb that is known for its ornamental and therapeutic importance. The chemical constituents which have been isolated from the plant include terpenoids, alkaloids, flavonoids, tannins, saponin glycosides and ascorbic acid. It has been reported to be hepatoprotective, immunomodulatory, antihyperglycemic, hypolipidemic, antitoxic, anti-inflammatory, antibacterial and antifungal. The present review is aimed to cover the phytochemical study and pharmacological investigations on this important medicinal herb.

  12. PHARMACOLOGICAL ACTIVITIES OF SPERMACOCE HISPIDA LINN: A REVIEW

    OpenAIRE

    Vinayak Meti; Chandrashekar K; Shishir Mishra

    2013-01-01

    Spermacoce hispida Linn is one of the important plant belonging to the family of Rubiaceae and is commonly used herb in siddha medicine. This review supports all updated information on its chemical constituents, pharmacological activities, traditional uses and scientific approach. The plant extracts contains phytochemical constituents such as of saponins, tannins, phenolics, steroids, essential oils, flavonoids and terpenoids. The chemical entities of this plant have been used as an antidiabe...

  13. Nelumbo Nucifera (Lotus: A Review on Ethanobotany, Phytochemistry and Pharmacology

    Directory of Open Access Journals (Sweden)

    Nishkruti R Mehta*, Ekta P Patel Pragnesh V Patani, Biren Shah

    2013-12-01

    Full Text Available Nelumbo nucifera Gaertn (Nymphaeaceae, a perennial aquatic plant, has been used as a medicinal herb in China and India. It has been recorded in the most famous medicinal book in China for more than 400 years. Different part of plant (leaves, seeds, flower, and rhizome can be used in traditional system of medicine. In traditional system of medicine, the different parts of plant is reported to possess beneficial effects as in for the treatment of pharyngopathy, pectoralgia, spermatorrhoea, leucoderma, smallpox, dysentery, cough, haematemesis, epistaxis, haemoptysis, haematuria, metrorrhagia, hyperlipidaemia, fever, cholera, hepatopathy and hyperdipsia. Following the traditional claims for the use of N.nucifera as cure of numerous diseases considerable efforts have been made by researchers to verify it’s utility through scientific pharmacological screenings. The pharmacological studies have shown that N.nucifera posseses various notable pharmacological activities like amti-ischemic, antioxidant, anticancer, antiviral, antiobesity, lipolytic, hypocholestemic, antipyretic, hepatoprotective, hypoglycaemic, antidiarrhoeal, antifungal, antibacterial, anti-inflammatory and diuretic activities. A wide variety of phytoprinciples have been isolated from the plant. The present review is an effort to consolidate traditional, ethnobotanic, phytochemical and pharmacological information available on N.nucifera.

  14. Clinically and pharmacologically relevant interactions of antidiabetic drugs.

    Science.gov (United States)

    May, Marcus; Schindler, Christoph

    2016-04-01

    Patients with type 2 diabetes mellitus often require multifactorial pharmacological treatment due to different comorbidities. An increasing number of concomitantly taken medications elevate the risk of the patient experiencing adverse drug effects or drug interactions. Drug interactions can be divided into pharmacokinetic and pharmacodynamic interactions affecting cytochrome (CYP) enzymes, absorption properties, transporter activities and receptor affinities. Furthermore, nutrition, herbal supplements, patient's age and gender are of clinical importance. Relevant drug interactions are predominantly related to sulfonylureas, thiazolidinediones and glinides. Although metformin has a very low interaction potential, caution is advised when drugs that impair renal function are used concomitantly. With the exception of saxagliptin, dipeptidyl peptidase-4 (DPP-4) inhibitors also show a low interaction potential, but all drugs affecting the drug transporter P-glycoprotein should be used with caution. Incretin mimetics and sodium-glucose cotransporter-2 (SGLT-2) inhibitors comprise a very low interaction potential and are therefore recommended as an ideal combination partner from the clinical-pharmacologic point of view. PMID:27092232

  15. Tinospora crispa (L.) Hook. f. & Thomson: A Review of Its Ethnobotanical, Phytochemical, and Pharmacological Aspects

    OpenAIRE

    Ahmad, Waqas; Jantan, Ibrahim; Bukhari, Syed N. A.

    2016-01-01

    Tinospora crispa (L.) Hook. f. & Thomson (Menispermaceae), found in the rainforests or mixed deciduous forests in Asia and Africa, is used in traditional medicines to treat numerous health conditions. This review summarizes the up-to-date reports about the ethnobotany, phytochemistry, pharmacological activities, toxicology, and clinical trials of the plant. It also provides critical assessment about the present knowledge of the plant which could contribute toward improving its prospect as a s...

  16. Tinospora crispa (L.) Hook. f. & Thomson: A review of its ethnobotanical, phytochemical and pharmacological aspects

    OpenAIRE

    Ibrahim eJantan; Waqas eAhmad; SYED NASIR ABBAS eBUKHARI

    2016-01-01

    Tinospora crispa (L.) Hook. f. & Thomson (Menispermaceae), found in the rainforests or mixed deciduous forests in Asia and Africa, is used in traditional medicines to treat numerous health conditions. This review summarizes the up-to-date reports about the ethnobotany, phytochemistry, pharmacological activities, toxicology and clinical trials of the plant. It also provides critical assessment about the present knowledge of the plant which could contribute towards improving its prospect as a ...

  17. Phytochemical, Ethnobotanical and Pharmacological Profile of Lagenaria siceraria: - A Review

    Directory of Open Access Journals (Sweden)

    Amit Kumar

    2012-09-01

    Full Text Available In traditional systems of medicine, different parts (leaves, stem, flower, root, seeds and even whole plant of lagenaria siceraria (known as lauki in Hindi, has been used in the ointment for ailment of various diseases throughout India. The fruit of cultivated lagenaria siceraria is the good source of different nutrients components like protein, fat, fibre, carbohydrates, calcium, magnesium. The plant has also been suggested to possess antioxidant activity, laxative, cardioprotective, diuretic, hepatoprotective, hypolipidemic, central nervous system stimulant, anthelmentic, antihypertensive, immunosuppressive analgesic, adaptogenic and free radical scavenging activity. This work reviews the pharmacological evidence of extracts of plants from the lagenaria siceraria, giving an overview of the most studied biological effects and the known phytochemical composition. Although more studies are necessary, lagenaria siceraria exhibits proven potential to become of important pharmacological interest.

  18. Aerva lanata: A review on phytochemistry and pharmacological aspects

    Directory of Open Access Journals (Sweden)

    Manoj Goyal

    2011-01-01

    Full Text Available Aerva lanata (L. A. L. Juss. ex Schultes. (Amaranthaceae locally known as ′bui′ is an erect or prostrate undershrub with a long tap-root and many wolly-tomentose branches, found in the wild, throughout India. In traditional medicine the plant is used in cough, strangury (slow to be and painful discharge of urine, headache and urolithiasis. The photochemical constituents present in the plant include alkaloids (ervine, methylervine, ervoside, aervine, methylaervine, aervoside, ervolanine, and aervolanine, flavanoids (kaempferol, quercetin, isorhamnetin, persinol, persinosides A and B, methyl grevillate, lupeol, lupeol acetate benzoic acid, β-sitosteryl acetate and tannic acid. Pharmacological studies reported diuretic, anti-inflammatory, hypoglycemic, anti-diabetic, antiparasitic, antimicrobial, hepoprotective, anti-urolithiasis, antiasthmatic, antifertility and hypolipidemic properties of Aerva lanata. This review article includes the detailed exploration of the morphology, phytochemistry, and pharmacological aspects of Aerva lanata in an attempt to provide a direction for further research.

  19. Ocimum sanctum: a review on the pharmacological properties

    Directory of Open Access Journals (Sweden)

    Siva M.

    2016-06-01

    Full Text Available Herbal medicine, the backbone of traditional medicine in many countries have played an important role in curing the diseases of humans since ancient time. Medicinal plants are great source of bioactive compounds and chemical structures that have potential beneficial effects. The present review compiles information on ethnopharmacologically useful information and pharmacological properties of Ocimum sanctum. Ocimum sanctum (OS has many medicinal properties like antioxidant, antidiabetic, antiulcer, anticancer, antibacterial, antifungal and other. The phytochemicals compounds of Ocimum, alkaloids, flavonoids, phenolics, essential oils, tannins and saponins play an important role in herbal medicine. Bioactive compounds of Ocimum responsible for its various medicinal properties and their effects at the molecular level need to be investigated in more detail. Furthermore, pharmacological properties of bioactive compounds in Ocimum sanctum are required to confirm the ethnomedicinal claims of Ocimum sanctum for pharmaceutical therapeutic applications. [Int J Basic Clin Pharmacol 2016; 5(3.000: 558-565

  20. Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

    Directory of Open Access Journals (Sweden)

    Crippa José AS

    2012-01-01

    Full Text Available Abstract Background Cannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition. Objective To review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis. Methods A search was performed on the Pubmed, Lilacs, and Scielo online databases by combining the terms cannabis, intoxication, psychosis, anxiety, and treatment. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review. Results The reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol. Conclusion Although scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil.

  1. From Traditional Usage to Pharmacological Evidence: A Systematic Mini-Review of Spina Gleditsiae.

    Science.gov (United States)

    Gao, Jiayu; Yang, Xiao; Yin, Weiping

    2016-01-01

    Spina Gleditsiae is an important herb with various medicinal properties in traditional and folk medicinal systems of East Asian countries. In China through the centuries, it has been traditionally used as a source of drugs for anticancer, detoxication, detumescence, apocenosis, and antiparasites effects. Recently, an increasing number of studies have been reported regarding its chemical constituents and pharmacological activities. To further evidence the traditional use, phytochemicals, and pharmacological mechanisms of this herb, a systematic literature review was performed herein for Spina Gleditsiae. The review approach consisted of searching several web-based scientific databases including PubMed, Web of Science, and Elsevier using the keywords "Spina Gleditsiae", "Zao Jiao Ci", and "Gleditsia sinensis". Based on the proposed criteria, 17 articles were evaluated in detail. According to the reviewed data, it is quite evident that Spina Gleditsiae contains a number of bioactive phytochemical components, which account for variety medicinal values including anticancer, anti-inflammatory, antiatherogenic, antimicrobial, antiallergic, and antivirus activities. The phytochemical and pharmacological studies reviewed herein strongly underpin a fundamental understanding of herbal Spina Gleditsiae and support its ongoing clinical uses in China. The further phytochemical evaluation, safety verification, and clinical trials are expected to progress Spina Gleditsiae-based development to finally transform the traditional TCM herb Spina Gleditsiae to the valuable authorized drug. PMID:27433183

  2. Considerations for clinical pharmacology studies for biologics in emerging markets.

    Science.gov (United States)

    Damle, Bharat; White, Robert; Wang, Huifen Faye

    2015-03-01

    Registration of innovative biologics in Emerging Markets (EMs) poses many opportunities and challenges. The BRIC-MT countries (Brazil, Russia, India, China, Mexico, and Turkey) that are the fastest growing markets and regulators in these countries have imposed certain requirements, including the need for local clinical studies, for registration of biologics. The regulatory landscape in these countries is rapidly evolving, which necessitates an up-to-date understanding of such requirements. There is growing evidence which suggests that race, after accounting for body weight differences, may not influence the pharmacokinetics of biologics to the same extent that it does for small molecules. Thus, the requirements for clinical pharmacology trials in EMs are driven mainly by regulatory needs set forth by local Ministry of Health. In addition to the clinical Phase I to III studies done in the global program that supports registration in large geographies, countries such as China require local single and multiple dose Phase I studies. Participating in global studies with clinical sites within their country may be sufficient for some markets, while other regulators may be satisfied with a Certificate of Pharmaceutical Product. This paper discusses the current requirements for registration of innovative biologics in key EMs. PMID:25707959

  3. CNS pharmacology and clinical therapeutic effects of oxiracetam.

    Science.gov (United States)

    Itil, T M; Menon, G N; Songar, A; Itil, K Z

    1986-01-01

    Oxiracetam, a new substance found to be a nootropic in experimental pharmacological studies, was tested in three clinical trials: a single rising dose tolerance and dose-finding study with quantitative pharmaco-electroencephalogram (pharmaco-EEG) and quantitative pharmacopsychology in healthy volunteers; a dose-finding study, at three dose levels for 3 months, with quantitative pharmaco-EEG in mild to moderate dementia patients; and a safety and efficacy study with increasing dosages for 12 weeks with subjective and objective tests in elderly patients with dementia. In single and repeated oral dosages up to 2,400 mg, oxiracetam is a safe compound. According to HZI Data Bank Classification Systems, oxiracetam is a vigilance-enhancing compound with some effects on spontaneous memory. The therapeutic effect of oxiracetam can be discriminated from placebo, and in comparison with piracetam, oxiracetam exhibits greater improvement in memory factor. PMID:3594458

  4. CNS pharmacology and clinical therapeutic effects of oxiracetam.

    Science.gov (United States)

    Itil, T M; Menon, G N; Songar, A; Itil, K Z

    1986-01-01

    Oxiracetam, a new substance found to be a nootropic in experimental pharmacological studies, was tested in three clinical trials: a single rising dose tolerance and dose-finding study with quantitative pharmaco-electroencephalogram (pharmaco-EEG) and quantitative pharmacopsychology in healthy volunteers; a dose-finding study, at three dose levels for 3 months, with quantitative pharmaco-EEG in mild to moderate dementia patients; and a safety and efficacy study with increasing dosages for 12 weeks with subjective and objective tests in elderly patients with dementia. In single and repeated oral dosages up to 2,400 mg, oxiracetam is a safe compound. According to HZI Data Bank Classification Systems, oxiracetam is a vigilance-enhancing compound with some effects on spontaneous memory. The therapeutic effect of oxiracetam can be discriminated from placebo, and in comparison with piracetam, oxiracetam exhibits greater improvement in memory factor.

  5. 75 FR 8368 - Advisory Committee for Pharmaceutical Science and Clinical Pharmacology; Notice of Meeting

    Science.gov (United States)

    2010-02-24

    ... Science and Clinical Pharmacology. General Function of the Committee: To provide advice and... examines the genetic differences that influence a person's responses, both beneficial and harmful,...

  6. A review on dronedarone:Pharmacological, pharmacodynamic and pharmacokinetic profile

    Institute of Scientific and Technical Information of China (English)

    Farah Iram; Sadaf Ali; Aftab Ahmad; Shah Alam Khan; Asif Husain

    2016-01-01

    Dronedarone, a benzofuran containing chemical compound, is a derivative of amiodarone which is classified as a Class III antiarrhythmic agent. It is prescribed to the cardiovas-cular patients who have paroxysmal or persistent atrial fibrillation to lower the chances of hospitalization. Amiodarone, sotalol, procainamide dofetilide, quinidine, ibutilide, fle-cainide, and propafenone are the other useful medicinal products used to treat atrial fibrillation or cardiac arrhythmia. Dronedarone was approved for clinical use in atrial fibrillation by the Food and Drug Administration in 2009. The generic name for drone-darone is Multaq (Sanofi Aventis). This article briefly highlights the important pharma-cological, pharmacodynamic and pharmacokinetic properties of dronedarone.

  7. Chemistry and pharmacology of 4-hydroxylonchocarpin: a review.

    Science.gov (United States)

    Kuete, Victor; Noumedem, Jaures A K; Nana, Frederic

    2013-06-01

    4-hydroxylonchocarpin (LCP) or 2',4-dihydroxy-3',4'-(2,2-dimethylchromene) chalcone is a chalcone of the class flavonoid, with a molecular weight of 322 g/mol mostly isolated in the family Moraceae and Leguminosae. LCP was reported to have a variety of pharmacological activities such as antibacterial, antifungal, anticancer, anti-reverse transcriptase, antitubercular, antimalarial, anti-inflammatory, ornitnine decarboxylase activity and antioxidant. The hemisynthesis of the compound has been described. The present review was undertaken to bring out together the knowledge on LCP, and can serve as the start point for future research and valorization accomplishments.

  8. A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults.

    Science.gov (United States)

    Skapinakis, Petros; Caldwell, Deborah; Hollingworth, William; Bryden, Peter; Fineberg, Naomi; Salkovskis, Paul; Welton, Nicky; Baxter, Helen; Kessler, David; Churchill, Rachel; Lewis, Glyn

    2016-01-01

    BACKGROUND Obsessive-compulsive disorder (OCD) is a relatively common and disabling condition. OBJECTIVES To determine the clinical effectiveness, acceptability and cost-effectiveness of pharmacological and psychological interventions for the treatment of OCD in children, adolescents and adults. DATA SOURCES We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Trials Registers, which includes trials from routine searches of all the major databases. Searches were conducted from inception to 31 December 2014. REVIEW METHODS We undertook a systematic review and network meta-analysis (NMA) of the clinical effectiveness and acceptability of available treatments. Outcomes for effectiveness included mean differences in the total scores of the Yale-Brown Obsessive-Compulsive Scale or its children's version and total dropouts for acceptability. For the cost-effectiveness analysis, we developed a probabilistic model informed by the results of the NMA. All analyses were performed using OpenBUGS version 3.2.3 (members of OpenBUGS Project Management Group; see www.openbugs.net ). RESULTS We included 86 randomised controlled trials (RCTs) in our systematic review. In the NMA we included 71 RCTs (54 in adults and 17 in children and adolescents) for effectiveness and 71 for acceptability (53 in adults and 18 in children and adolescents), comprising 7643 and 7942 randomised patients available for analysis, respectively. In general, the studies were of medium quality. The results of the NMA showed that in adults all selective serotonin reuptake inhibitors (SSRIs) and clomipramine had greater effects than drug placebo. There were no differences between SSRIs, and a trend for clomipramine to be more effective did not reach statistical significance. All active psychological therapies had greater effects than drug placebo. Behavioural therapy (BT) and cognitive therapy (CT) had greater effects than psychological placebo, but cognitive-behavioural therapy (CBT) did not

  9. Relaxin for the Treatment of Acute Decompensated Heart Failure: Pharmacology, Mechanisms of Action, and Clinical Evidence.

    Science.gov (United States)

    Ng, Tien M H; Goland, Sorel; Elkayam, Uri

    2016-01-01

    Acute heart failure remains a major cause of morbidity, and its treatment requires an increasing investment of the health care system. Whereas success in treating chronic heart failure has been achieved over the last decades, several pharmacological approaches for acute heart failure have been introduced but have failed to demonstrate any clinical benefit. Serelaxin is a recombinant human relaxin-2 vasoactive peptide that causes systemic and renal vasodilation. Data suggest that the clinical benefits may be attributable to a potential combination of multiple actions of serelaxin, including improving systemic, cardiac, and renal hemodynamics, and protecting cells and organs from damage via neurohormonal, anti-inflammatory, antiremodeling, antifibrotic, anti-ischemic, and proangiogenic effects. Recently, a number of clinical trials have demonstrated that serelaxin infusion over 48 hours improved dyspnea with more rapid relief of congestion during the first days after admission for heart failure. In addition, administration of serelaxin diminished cardiac, renal, and hepatic damage, which were associated with improved long-term mortality. Available data support substantial clinical benefits and significant promise for serelaxin as a treatment option for patients with acute heart failure. This review focuses on the pharmacology and mechanisms of action of serelaxin and provides a detailed discussion of the clinical evidence for this novel therapy in acute heart failure. PMID:26331289

  10. Pharmacology of dextromethorphan: Relevance to dextromethorphan/quinidine (Nuedexta®) clinical use.

    Science.gov (United States)

    Taylor, Charles P; Traynelis, Stephen F; Siffert, Joao; Pope, Laura E; Matsumoto, Rae R

    2016-08-01

    Dextromethorphan (DM) has been used for more than 50years as an over-the-counter antitussive. Studies have revealed a complex pharmacology of DM with mechanisms beyond blockade of N-methyl-d-aspartate (NMDA) receptors and inhibition of glutamate excitotoxicity, likely contributing to its pharmacological activity and clinical potential. DM is rapidly metabolized to dextrorphan, which has hampered the exploration of DM therapy separate from its metabolites. Coadministration of DM with a low dose of quinidine inhibits DM metabolism, yields greater bioavailability and enables more specific testing of the therapeutic properties of DM apart from its metabolites. The development of the drug combination DM hydrobromide and quinidine sulfate (DM/Q), with subsequent approval by the US Food and Drug Administration for pseudobulbar affect, led to renewed interest in understanding DM pharmacology. This review summarizes the interactions of DM with brain receptors and transporters and also considers its metabolic and pharmacokinetic properties. To assess the potential clinical relevance of these interactions, we provide an analysis comparing DM activity from in vitro functional assays with the estimated free drug DM concentrations in the brain following oral DM/Q administration. The findings suggest that DM/Q likely inhibits serotonin and norepinephrine reuptake and also blocks NMDA receptors with rapid kinetics. Use of DM/Q may also antagonize nicotinic acetylcholine receptors, particularly those composed of α3β4 subunits, and cause agonist activity at sigma-1 receptors. PMID:27139517

  11. Traditional uses, phytochemistry and pharmacology of Tecomella undulata- A review

    Institute of Scientific and Technical Information of China (English)

    Mahendra Jain; Rakhee Kapadia; Ravirajsinh Navalsinh Jadeja; Menaka Chanu Thounaojam; Ranjitsinh Vijaysinh Devkar; Shri Hari Mishra

    2012-01-01

    The aim of the present review is to present comprehensive information of the traditional uses, phytochemistry and pharmacology of Tecomella undulata (Family, Bignoniaceae) and to discuss future scope of research. Tecomella undulata (TU) is commonly known as desert teak (ver. Rohiro) and is traditionally for treating liver and spleen diseases, tumours, conjunctivitis, hepatosplenomegaly, syphilis, gonorrhea, hepatitis, as a blood purifier and in wound healing. Compounds such as naphthaquinone derivative, iridoid glucoside, phytosterol, fatty alcohol, flavonols, flavonoid glucoside and triterpenoids have been reported from TU. Anti HIV, anti bacterial, anti microbial, immune modulator, analgesic and hepatoprotective activities have been reported from its various aerial parts. In the present review, attempts have been made to compile research reports on TU, to assess current research trends with possible future avenues of research.

  12. PHARMACOLOGICAL POTENTIALS OF MORINGA OLEIFERA LAM.: A REVIEW

    Directory of Open Access Journals (Sweden)

    Subrata Kumar Biswas et al.

    2012-01-01

    Full Text Available The aim of this literature review was to provide advance research information for the future scientists to discover new drug molecules from the medicinal plant, Moringa oleifera Lam. (Moringaceae. The plant provides a rich and rare combination of zeatin, quercetin, beta-sitosterol and kaempferol. In addition to its high nutritional value, Moringa oleifera Lam is very important for its medicinal value. Various parts of this plant such as leaves, roots, seed, bark, fruit, flowers and immature pods act as cardiac and circulatory stimulants, possess antitumor, antipyretic, anti-inflammatory, antiulcer, antispasmodic, diuretic, antihypertensive, cholesterol lowering, antioxidant, antidiabetic, hepatoprotective, antibacterial and antifungal activities, and are being employed for the treatment of different ailments in the indigenous system of medicine. This review gives the scientific information regarding pharmacological potentials of Moringa oleifera Lam. (Moringaceae.

  13. PHARMACOLOGICAL AND PHARMACEUTICAL PROFILE OF DARUNAVIR: A REVIEW

    Directory of Open Access Journals (Sweden)

    Jain Ankita

    2013-04-01

    Full Text Available Treatment of human immunodeficiency virus (HIV infection involves a combination of several antiviral agents belonging to different pharmacological classes. Darunavir is a second-generation protease inhibitor. It used to treat HIV infection. Darunavir, formerly known as TMC114.Darunavir is available in the market under the trade names- Prezista®. Darunavir was designed to form robust interactions with the protease enzyme from many strains of HIV, including strains with multiple resistance mutations to second generation protease inhibitor. Darunavir is also used with small dose of ritonavir,that is darunavir is available in combination form. Combination therapy is the current standard of care for antiretroviral therapy. Since combinations of antiretroviral agents may be synergistic, additive, or antagonistic, it is important to test the developmental compounds which are used in combination with all the currently prescribed antiretroviral drugs. This combination is referred to as highly active antiretroviral therapy (HAART. This paper reviews the pharmacological and pharmaceutical properties of Darunavir. Darunavir could be an attractive target for the generic industries.

  14. Pharmacology and biochemistry ofPolygonatum verticillatum:A review

    Institute of Scientific and Technical Information of China (English)

    Saboon; Yamin Bibi; Muhammad Arshad; Sidra Sabir; Muhammad Shoaib Amjad; Ejaz Ahmed; Sunbal Khalil Chaudhari

    2016-01-01

    Polygonatum verticillatum (Linn.) All. syn.Convallaria verticillata Linn. is a valuable medicinal plant, distributed in the temperate Himalaya at the elevations 2 400 to 2 800 m. It is a perennial rhizomatous herb and contains various pharmacologically important secondary metabolites among which the most important areα-bulnesene, linalyl acetate, eicosadienoic, pentacosane, piperitone, docasane, diosgenin, santonin and calarene. It also possesses antimalarial, antipyretic, anti-inflammatory, anticonvulsant, lipoxygenase, urease inhibition, diuretic, tracheorelaxant, antidiarrheal, antispasmodic, antinociceptive, antifungal, antibacterial and bronchodilator activities. The plant also got importance in traditional systems of medicine due to its broad therapeutic potential especially of its rhizome. But in the past few years, over exploitation of plant parts caused the decline in the frequency of this species due to which it became threatened, endangered and vulnerable in different parts of the world. So efforts are being made in certain regions of the world for bothex-situ and in-situ conservation. This paper briefly reviewed the botanical, traditional, phytochemical, pharmacological and conservation related aspects of this plant.

  15. Pharmacology and biochemistry of Polygonatum verticillatum: A review

    Directory of Open Access Journals (Sweden)

    Saboon

    2016-05-01

    Full Text Available Polygonatum verticillatum (Linn. All. syn. Convallaria verticillata Linn. is a valuable medicinal plant, distributed in the temperate Himalaya at the elevations 2400 to 2800 m. It is a perennial rhizomatous herb and contains various pharmacologically important secondary metabolites among which the most important are α-bulnesene, linalyl acetate, eicosadienoic, pentacosane, piperitone, docasane, diosgenin, santonin and calarene. It also possesses antimalarial, antipyretic, anti-inflammatory, anticonvulsant, lipoxygenase, urease inhibition, diuretic, tracheorelaxant, antidiarrheal, antispasmodic, antinociceptive, antifungal, antibacterial and bronchodilator activities. The plant also got importance in traditional systems of medicine due to its broad therapeutic potential especially of its rhizome. But in the past few years, over exploitation of plant parts caused the decline in the frequency of this species due to which it became threatened, endangered and vulnerable in different parts of the world. So efforts are being made in certain regions of the world for both ex-situ and in-situ conservation. This paper briefly reviewed the botanical, traditional, phytochemical, pharmacological and conservation related aspects of this plant.

  16. Mimusops elengi: A Review on Ethnobotany, Phytochemical and Pharmacological Profile

    Directory of Open Access Journals (Sweden)

    Prasad V. Kadam

    2012-09-01

    Full Text Available The present review is an attempt to highlight the various ethno botanical and traditional uses as well as phytochemical and pharmacological reports on Mimusops elengi to which commonly known as Bakul and Spanish cherry, belonging to Sapotaceae family. It is a large ornamental evergreen tree cultivated in India and generally reared in gardens for the sake of its fragrant flowers. In the traditional Indian system of medicine, the ayurveda and in various folk system of medicine, the bark, fruit and seeds of Mimusops elengi possess several medicinal properties such as astringent, tonic, and febrifuge. Chemical studies have shown that, Bark contain tannin, some caoutchoue, wax, starch and ash and Flower contain volatile oil as well as Seeds contain fixed fatty oil. Preclinical studies have shown that Mimusops elengi or some part of its phytochemicals possess Analgesic, Antibiotic, Antihyperlipidemic, Anti-inflammatory, Antimicrobial, Antoxidant, Antipyretic, Cytotoxic, Congestive enhancing, Gingival bleeding, Gastic ulcer, Hypotensive activity

  17. Pharmacological treatment of ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    Boulos, Pauline; Dougados, Maxime; Macleod, Stuart M; Hunsche, Elke

    2005-01-01

    The purpose of this study was to review the evidence regarding the efficacy and safety of pharmacological therapies currently available for the treatment of ankylosing spondylitis (AS).A literature search using MEDLINE from 1966 through to April 2005 and a hand search of abstracts from the American College of Rheumatology (ACR) meetings for 2001 through to 2004 were performed. References of articles retrieved were also searched. The MEDLINE search yielded 570 citations and 157 abstracts from ACR were identified. Eighty-four studies were randomised controlled trials (RCTs); 53 fulfilled the inclusion criteria (pharmacological treatment of AS and RCT) and were included in this review. Statistical pooling of data was not performed because of the disparate outcome measures used. Eight RCTs found nonselective NSAIDs and two RCTs found cyclo-oxygenase (COX)-2-selective NSAIDs to be superior to placebo for relief of pain and improvement in physical function. Twenty-nine RCTs showed comparable efficacy and safety between nonselective NSAIDs. One RCT showed no difference between methylprednisolone 1g and 375 mg. Seven RCTs assessing the efficacy of sulfasalazine (sulphasalazine) and two RCTs of methotrexate provided contradictory evidence as to their benefit for treatment of AS. One RCT showed intravenous pamidronate 60 mg to be more effective than 10mg intravenously for the treatment of axial pain. All six RCTs of anti-tumour necrosis factor (TNF)-alpha agents demonstrated superiority to placebo for the treatment of axial and peripheral symptoms. Nonselective as well as COX-2-selective NSAIDs can be used for pain control in patients with AS. Other proven treatment options include sulfasalazine for the treatment of peripheral joint symptoms, while limited evidence supports the use of pamidronate or methotrexate, which require further studies. Anti-TNFalpha agents have been found very effective for the treatment of both peripheral and axial symptoms in patients with AS, but

  18. Berberine: New Insights from Pharmacological Aspects to Clinical Evidences in the Management of Metabolic Disorders.

    Science.gov (United States)

    Caliceti, Cristiana; Franco, Placido; Spinozzi, Silvia; Roda, Aldo; Cicero, Arrigo F G

    2016-01-01

    Berberine is a quaternary ammonium salt from the protoberberine group of isoquinoline alkaloids found in such plants as gender Berberis. Berberine is recognised to improve glucose and lipid metabolism disorders and preliminary clinical evidences suggest the ability of berberine to reduce endothelial inflammation improving vascular health, even in patients already affected by cardiovascular diseases, suggesting a possible interesting role of berberine and its metabolites in clinical practice. However, its physicochemical properties, pharmacokinetic, and metabolism are not fully elucidated and contradictory data have been reported. This review provides a summary regarding the pharmacological and biological features of berberine, with a focus on berberine as well as their pharmacologically active metabolites and the different mechanisms underlying their activities in order to clarify the correct use of berberine supplementation, alone or in association with other nutraceuticals, for the management of metabolic disorders associated to increased cardiovascular disease risk. A particular attention has also been given to the available clinical trials assessing its short- and middle- term use tolerability, safety and efficacy in various conditions, such as dyslipidaemia, impaired fasting glucose, metabolic syndrome and type 2 diabetes. PMID:27063256

  19. Wrightia tinctoria R. Br.-a review on its ethnobotany, pharmacognosy and pharmacological profile

    Institute of Scientific and Technical Information of China (English)

    Mahendra S Khyade; Nityanand P Vaikos

    2014-01-01

    Different parts of Wrightia tinctoria R. Br. (Apocynaceae) (W. tinctoria), have been extensively used in Indian systems of medicine such as Ayurveda, Siddha and Unani for the treatment of jaundice, malaria, psoriasis and many other ailments. The present review has been primed to describe the existing data on the information on the traditional uses, botany, pharmacognosy, phytochemical constituents, pharmacological activities and toxicology of W. tinctoria. The information was gathered via electronic search (using Google Scholar, NOPR, Pubmed, Elsevier, Medline Plus and Web of Science) and library search for the books on traditional medicine as well as the articles published in peer-reviewed journals. The plant is rich in compounds containing alkaloids, saponins, indoxy yielding O-glycoside(s), phenolics, flavonoids, isatin tryptanthrin, anthranillate, rutin, β-isatin, tryptophan, indigotin, indirubin, wrightial and sterols. The vast number of literature found in database revealed that the extracts of different parts of W. tinctoria showed significant pharmacological actions. Clinical studies indicated a broad range of applications in the treatment of psoriasis and other skin diseases. We suggest that there is a need for further investigations to isolate active principles that confer pharmacological action. Therefore, identification of such active compound is useful for producing safer drugs in the treatments of various ailments.

  20. Wrightia tinctoria R. Br.-a review on its ethnobotany, pharmacognosy and pharmacological profile

    Directory of Open Access Journals (Sweden)

    Mahendra S. Khyade

    2014-10-01

    Full Text Available Different parts of Wrightia tinctoria R. Br. (Apocynaceae (W. tinctoria, have been extensively used in Indian systems of medicine such as Ayurveda, Siddha and Unani for the treatment of jaundice, malaria, psoriasis and many other ailments. The present review has been primed to describe the existing data on the information on the traditional uses, botany, pharmacognosy, phytochemical constituents, pharmacological activities and toxicology of W. tinctoria. The information was gathered via electronic search (using Google Scholar, NOPR, Pubmed, Elsevier, Medline Plus and Web of Science and library search for the books on traditional medicine as well as the articles published in peer-reviewed journals. The plant is rich in compounds containing alkaloids, saponins, indoxy yielding O-glycoside(s, phenolics, flavonoids, isatin tryptanthrin, anthranillate, rutin, β-isatin, tryptophan, indigotin, indirubin, wrightial and sterols. The vast number of literature found in database revealed that the extracts of different parts of W. tinctoria showed significant pharmacological actions. Clinical studies indicated a broad range of applications in the treatment of psoriasis and other skin diseases. We suggest that there is a need for further investigations to isolate active principles that confer pharmacological action. Therefore, identification of such active compound is useful for producing safer drugs in the treatments of various ailments.

  1. The mollusks in zootherapy: traditional medicine and clinical-pharmacological importance

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    Eraldo Medeiros Costa Neto

    2006-09-01

    Full Text Available The use of animals as sources of medicines is a cross-cultural phenomenon that is historically ancient and geographically widespread. This article reviews the use of mollusks in traditional medicine and discusses the clinical and pharmacological importance of these invertebrates. The roles that mollusks play in folk practices related to the healing and/or prevention of illnesses have been recorded in different social-cultural contexts worldwide. The clinical and therapeutic use of compounds coming from different species of mollusks is recorded in the literature. The chemistry of natural products provided by oysters, mussels, clams, sluggards, and snails has been substantially investigated, but the majority of these studies have focused on the subclasses Opistobranchia and Prosobranchia. Research into the knowledge and practices of folk medicine makes possible a better understanding of the interaction between human beings and the environment, in addition to allowing the elaboration of suitable strategies for the conservation of natural resources.

  2. Osteoarthritis year in review 2015: clinical.

    Science.gov (United States)

    Sharma, L

    2016-01-01

    The purpose of this review is to highlight clinical research in osteoarthritis (OA). A literature search was conducted using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) with the search terms "osteoarthritis [All Fields] AND treatment [All Fields]" and the following limits activated: humans, English language, all adult 19+ years, published between April 1, 2014 and April 1, 2015. A second literature search was then conducted with the search terms "osteoarthritis [All Fields] AND epidemiology [All Fields]", with the same limits. Reports of surgical outcome, case series, surgical technique, tissue sample or culture studies, trial protocols, and pilot studies were excluded. Of 1523, 150 were considered relevant. Among epidemiologic and observational clinical studies, themes included physical activity, early knee OA, and confidence/instability/falls. Symptom outcomes of pharmacologic treatments were reported for methotrexate, adalimumab, anti-nerve growth factor monoclonal antibodies, strontium ranelate, bisphosphonates, glucosamine, and chondroitin sulfate, and structural outcomes of pharmacologic treatments for strontium ranelate, recombinant human fibroblast growth factor 18, and glucosamine and chondroitin sulfate. Symptom outcomes of non-pharmacologic interventions were reported for: neuromuscular exercise, quadriceps strengthening, weight reduction and maintenance, TENS, therapeutic ultrasound, stepped care strategies, cognitive behavior therapy for sleep disturbance, acupuncture, gait modification, booster physical therapy, a web-based therapeutic exercise resource center for knee OA; hip physical therapy for hip OA; and joint protection and hand exercises for hand OA. Structure outcomes of non-pharmacologic interventions were reported for patellofemoral bracing. PMID:26707991

  3. Herrnstein's hyperbolic matching equation and behavioral pharmacology: review and critique.

    Science.gov (United States)

    Dallery, J; Soto, P L

    2004-11-01

    Behavioral pharmacologists have enlisted Herrnstein's (1970) hyperbolic matching equation to understand the behavioral effects of drugs. Herrnstein's hyperbola describes the relation between absolute response rate and reinforcement rate. The equation has two fitted parameters. The parameter k represents the asymptotic response rate, and the parameter r(e) represents the reinforcement rate necessary to obtain half the asymptotic response rate. According to one interpretation of the equation, changes in k should reflect changes in response or motoric variables, and changes in r(e) should reflect changes in reinforcer or motivational variables, or changes in reinforcement from sources extraneous to the instrumental response. We review research that has applied Herrnstein's equation to distinguish the motoric from the motivational effects of drugs, and to identify additional independent variables responsible for drug effects, such as extraneous reinforcement. The validity of inferences about drug effects depends on the consistency of how k and r(e) respond to environmental manipulations: k should change only with response or motoric variables, and r(e) should change with reinforcer or motivational variables and with the rate of extraneous reinforcement. Empirical tests of these predictions, however, have produced inconsistent results. The review suggests that Herrnstein's theory has not fulfilled its promise of identifying the behavioral mechanisms of drug action. Modifications to the equation, known as bias and sensitivity, may explain some of these inconsistent results, and the modified equation may have utility in behavioral pharmacology.

  4. PHYTOCHEMISTRY AND PHARMACOLOGY OF OXALIS CORNICULATA LINN.: A REVIEW

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    Merugu Srikanth , Tadigotla Swetha* and Veeresh B.

    2012-11-01

    Full Text Available Many herbal remedies have been employed in various medical systems for treatment and management of different diseases. The plant Oxalis corniculata Linn. has been used in different system of traditional medication for the treatment of diseases and ailments of human beings. β-sitosterol, betulin, 4-hydroxybenzoic acid, ethyl gallate, methoxyflavones, apigenin, and 7-O-β-D-glucopyranoside were previously isolated from the whole plant of Oxalis corniculata.linn. The review reveals that wide ranges of phytochemical constituents have been isolated from the plant like flavanoids, tannins, phytosterols, phenol, glycosides, fatty acids, galacto-glycerolipid and volatile oil. The leaves contain flavonoids, iso vitexine and vitexine-2”- O- beta – Dglucopyrunoside. It is rich source of essential fatty acids like palmitic acid, oleic, linoleic, linolenic and stearic acids. It has been reported that the plant contains anti-inflammatory, anxiolytic, anticonvulsant, antifungal, antiulcer, antinociceptive, anticancer, antidiabetic, hepatoprotective, hypolipedemic, abortificient, antimicrobial and wound healing properties. The current study is therefore reviewed to provide requisite phytochemical and pharmacological detail about the plant.

  5. An Endocrine Pharmacology Course for the Clinically-Oriented Pharmacy Curriculum

    Science.gov (United States)

    Rahwan, Ralf G.

    1976-01-01

    In view of trends in clinical pharmacy education, the role of the traditional basic sciences has to be reassessed. An endocrine pharmacology course comprised of 49 clock-hours and open for professional undergraduate and graduate credit is described that blends basic and applied pharmacology. (LBH)

  6. Acknowledgments to reviewers of World Journal of Gastrointestinal Pharmacology and Therapeutics

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Many reviewers have contributed their expertise and time to the peer review,a critical process to ensure the quality of World Journal of Gastrointestinal Pharmacology and Therapeutics.The editors and authors of the articles submitted to

  7. Tinospora crispa (L. Hook. f. & Thomson: A review of its ethnobotanical, phytochemical and pharmacological aspects

    Directory of Open Access Journals (Sweden)

    Ibrahim eJantan

    2016-03-01

    Full Text Available Tinospora crispa (L. Hook. f. & Thomson (Menispermaceae, found in the rainforests or mixed deciduous forests in Asia and Africa, is used in traditional medicines to treat numerous health conditions. This review summarizes the up-to-date reports about the ethnobotany, phytochemistry, pharmacological activities, toxicology and clinical trials of the plant. It also provides critical assessment about the present knowledge of the plant which could contribute towards improving its prospect as a source of lead molecules for drug discovery. The plant has been used traditionally in the treatment of jaundice, rheumatism, urinary disorders, fever, malaria, diabetes, internal inflammation, fracture, scabies, hypertension, reducing thirst, increasing appetite, cooling down the body temperature and maintaining good health. Phytochemical analyses of T. crispa revealed the presence of alkaloids, flavonoids and flavone glycosides, triterpenes, diterpenes and diterpene glycosides, cis clerodane-type furanoditerpenoids, lactones, sterols, lignans and nucleosides. Studies showed that the crude extracts and isolated compounds of T. crispa possessed a broad range of pharmacological activities such as anti-inflammatory, antioxidant, immunomodulatory, cytotoxic, antimalarial, cardioprotective and anti-diabetic activities. Most pharmacological studies were based on crude extracts of the plant and the bioactive compounds responsible for the bioactivities have not been well identified. Further investigations are required to transform the experience-based claims on the use of T. crispa in traditional medicine practices into evidence-based information. The plant extract used in pharmacological and biological studies should be qualitatively and quantitatively analyzed based on its biomarkers. There should be detail in vitro and in vivo studies on the mechanisms of action of the pure bioactive compounds and more elaborate toxicity study to ensure safety of the plant for human

  8. Tinospora crispa (L.) Hook. f. & Thomson: A Review of Its Ethnobotanical, Phytochemical, and Pharmacological Aspects

    Science.gov (United States)

    Ahmad, Waqas; Jantan, Ibrahim; Bukhari, Syed N. A.

    2016-01-01

    Tinospora crispa (L.) Hook. f. & Thomson (Menispermaceae), found in the rainforests or mixed deciduous forests in Asia and Africa, is used in traditional medicines to treat numerous health conditions. This review summarizes the up-to-date reports about the ethnobotany, phytochemistry, pharmacological activities, toxicology, and clinical trials of the plant. It also provides critical assessment about the present knowledge of the plant which could contribute toward improving its prospect as a source of lead molecules for drug discovery. The plant has been used traditionally in the treatment of jaundice, rheumatism, urinary disorders, fever, malaria, diabetes, internal inflammation, fracture, scabies, hypertension, reducing thirst, increasing appetite, cooling down the body temperature, and maintaining good health. Phytochemical analyses of T. crispa revealed the presence of alkaloids, flavonoids, and flavone glycosides, triterpenes, diterpenes and diterpene glycosides, cis clerodane-type furanoditerpenoids, lactones, sterols, lignans, and nucleosides. Studies showed that the crude extracts and isolated compounds of T. crispa possessed a broad range of pharmacological activities such as anti-inflammatory, antioxidant, immunomodulatory, cytotoxic, antimalarial, cardioprotective, and anti-diabetic activities. Most pharmacological studies were based on crude extracts of the plant and the bioactive compounds responsible for the bioactivities have not been well identified. Further investigations are required to transform the experience-based claims on the use of T. crispa in traditional medicine practices into evidence-based information. The plant extract used in pharmacological and biological studies should be qualitatively and quantitatively analyzed based on its biomarkers. There should be detail in vitro and in vivo studies on the mechanisms of action of the pure bioactive compounds and more elaborate toxicity study to ensure safety of the plant for human use. More

  9. Tinospora crispa (L.) Hook. f. & Thomson: A Review of Its Ethnobotanical, Phytochemical, and Pharmacological Aspects.

    Science.gov (United States)

    Ahmad, Waqas; Jantan, Ibrahim; Bukhari, Syed N A

    2016-01-01

    Tinospora crispa (L.) Hook. f. & Thomson (Menispermaceae), found in the rainforests or mixed deciduous forests in Asia and Africa, is used in traditional medicines to treat numerous health conditions. This review summarizes the up-to-date reports about the ethnobotany, phytochemistry, pharmacological activities, toxicology, and clinical trials of the plant. It also provides critical assessment about the present knowledge of the plant which could contribute toward improving its prospect as a source of lead molecules for drug discovery. The plant has been used traditionally in the treatment of jaundice, rheumatism, urinary disorders, fever, malaria, diabetes, internal inflammation, fracture, scabies, hypertension, reducing thirst, increasing appetite, cooling down the body temperature, and maintaining good health. Phytochemical analyses of T. crispa revealed the presence of alkaloids, flavonoids, and flavone glycosides, triterpenes, diterpenes and diterpene glycosides, cis clerodane-type furanoditerpenoids, lactones, sterols, lignans, and nucleosides. Studies showed that the crude extracts and isolated compounds of T. crispa possessed a broad range of pharmacological activities such as anti-inflammatory, antioxidant, immunomodulatory, cytotoxic, antimalarial, cardioprotective, and anti-diabetic activities. Most pharmacological studies were based on crude extracts of the plant and the bioactive compounds responsible for the bioactivities have not been well identified. Further investigations are required to transform the experience-based claims on the use of T. crispa in traditional medicine practices into evidence-based information. The plant extract used in pharmacological and biological studies should be qualitatively and quantitatively analyzed based on its biomarkers. There should be detail in vitro and in vivo studies on the mechanisms of action of the pure bioactive compounds and more elaborate toxicity study to ensure safety of the plant for human use. More

  10. Long-Term Pharmacological Treatments of Anxiety Disorders: An Updated Systematic Review.

    Science.gov (United States)

    Perna, Giampaolo; Alciati, Alessandra; Riva, Alice; Micieli, Wilma; Caldirola, Daniela

    2016-03-01

    Many aspects of long-term pharmacological treatments for anxiety disorders (AnxDs) are still debated. We undertook an updated systematic review of long-term pharmacological studies on panic disorder (PD), generalized anxiety disorder (GAD), and social anxiety disorder (SAD). Relevant studies dating from January 1, 2012 to August 31, 2015 were identified using the PubMed database and a review of bibliographies. Of 372 records identified in the search, five studies on PD and 15 on GAD were included in the review. No studies on SAD were found. Our review confirms the usefulness of long-term pharmacological treatments for PD and GAD and suggests that they can provide further improvement over that obtained during short-term therapy. Paroxetine, escitalopram, and clonazepam can be effective for long-term treatment of PD. However, further studies are needed to draw conclusions about the long-term benzodiazepine use in PD, particularly for the possible cognitive side-effects over time. Pregabalin and quetiapine can be effective for long-term treatment of GAD, while preliminary suggestions emerged for agomelatine and vortioxetine. We did not find any evidence for determining the optimal length and/or dosage of medications to minimize the relapse risk. Few investigations have attempted to identify potential predictors of long-term treatment response. Personalized treatments for AnxDs can be implemented using predictive tools to explore those factors affecting treatment response/tolerability heterogeneity, including neurobiological functions/clinical profiles, comorbidity, biomarkers, and genetic features, and to tailor medications according to each patient's unique features. PMID:26830881

  11. Prevention and treatment of traveler's diarrhea: a clinical pharmacological approach.

    Science.gov (United States)

    Scarpignato, C; Rampal, P

    1995-01-01

    Diarrhea represents a major health problem for travelers to developing countries. Although the syndrome is usually self-limited and recovery occurs in the majority of cases without any specific form of therapy, there is a need for safe and effective ways of preventing and treating it. Since the syndrome is most often caused by an infection acquired by ingesting fecally contaminated food or beverages, precautions regarding dietary habits remain the cornerstone of prophylaxis, but dietary self-restrictions do not always translate to reduced rates of diarrheal illness. Administration of probiotics (e.g. lactobacilli or Saccharomyces boulardii) and immunoprophylaxis with the newer oral cholera vaccines have been tried with promising results. Antimicrobials remain, however, the most successful form of prophylaxis, being effective in up to 90% of travelers. For those with impaired health who will take prophylaxis, systemic agents with proved efficacy should be recommended. For other otherwise healthy persons, poorly absorbed agents are preferable in order to avoid the serious, albeit rare, toxicity of systemic drugs. The key factor in the management of acute watery traveler's diarrhea, particularly in infants and young children, is the restoration of water and electrolyte balance. This does not reduce the duration of the illness but will limit dehydration and prevent acidosis. Many patients will require no additional therapy, whereas some will need pharmacologic treatment to shorten the duration of diarrhea or to relieve the accompanying symptoms, like abdominal discomfort, nausea and vomiting. A typical 3- to 5-day illness can be reduced to approximately 1 day by trimethoprim-sulfamethoxazole (TMP-SMX) combination. Some other systemic antimicrobials have been successfully used but, during the last few years, the 4-fluoroquinolone drugs have received considerable attention and have been shown to be highly effective in reducing the duration of traveler's diarrhea. These

  12. A review on phytochemical, ethnomedical and pharmacological studies on genus Sophora, Fabaceae

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    Panthati Murali Krishna

    2012-10-01

    Full Text Available Sophora is a genus of the Fabaceae family, contains about 52 species, nineteen varieties, and seven forms that are widely distributed in Asia, Oceanica, and the Pacific islands, in the family Fabaceae of herbaceous (Sophora flavescens Aiton to trees (Sophora japonica L.. More than fifteen species in this genus have a long history of use in traditional Chinese medicines. In the last decades the use of this genus in traditional Chinese drugs has led to rapid increase in the information available on active components and reported to posses various pharmacological/therapeutic properties. The paper reviews the ethnopharmacology, the biological activities and the correlated chemical compounds of genus Sophora, Fabaceae. More than 300 compounds has been isolated, among them major are quinolizidine alkaloids particularly matrine and oxymatrine and flavonoids particularly prenylated and isoprenylated flavonoids. Modern pharmacological studies and clinical studies demonstrated that these chemical constituens possess wide reaching pharmacological actions like anti oxidant, anticancer, anti-asthamatic, anti-neoplastic, antimicrobial, antiviral, antidote, anti pyretic, cardiotonic, antinflammatory, diuretic and in the treatment of skin diseases like eczema, colitis and psoriasis.

  13. Pain and psychiatry: a critical analysis and pharmacological review

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    Presta Silvio

    2006-11-01

    Full Text Available Abstract Pain is one of the most difficult medical problems to diagnose and treat and can be a common symptom of several psychiatric disorders. Pain-related issues are heterogeneous and often underestimated or misinterpreted, with the result that psychiatric interventions, which might have been beneficial from the outset, are often delayed or requested only as a last measure. Several problems arise from the definition, classification and assessment of pain, when documented according to the different scales which are commonly used, since these attempt to cover a multitude of analytical requirements, without really succeeding. An area of constant debate regards the connection between pain and various psychiatric disorders, and the difficulty in the classification of pain disorders within the currently existing framework. The pharmacological treatment of pain is complex and implies a variety of different compounds, from opioids to psychotropic medications like antidepressants and anticonvulsivants. This paper explores the mutual and reciprocal influence between pain and psychiatric disorders reviewing the latest developments in the definition, assessment and treatment of pain, with special emphasis on the impact of pain on psychiatric disorders (and vice versa, and on the use of psychotropic drugs in the treatment of pain syndromes.

  14. Eryngium creticum – ethnopharmacology, phytochemistry and pharmacological activity. A review

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    Małgorzata Kikowska

    2016-06-01

    Full Text Available Abstract Eryngium creticum Lam. (E. cyaneum Sibth. & Sm., E. syriacum Lam., Saniculoideae, Apiaceae is of great importance in the traditional Greco – Arab medicine. This study was carried out in order to contribute to the ethnopharmacological knowledge of this medicinal species. This review describes the botanical characterization and distribution, as well as critically assesses the phytochemical properties and biological activities of E. creticum, a species that has been used in traditional medicine for many decades. Possible trends and perspectives for future research of this plant are discussed, as well. E. creticum has been found to contain several chemical constituents, mostly sesquiterpenes, monoterpenes, aldehydes, coumarins, sitosterols and sugars. Eryngo with its bioactive compounds possesses a wild range of biological activities. It was reported that in traditional medicine E. creticum was applied mainly as the remedy for snake and scorpion bites. Some published studies have shown a broad spectrum of biological and pharmacological activities, including anti-snake and anti-scorpion venom, as well as antibacterial, antifungal and antileishmanial effects. Other have indicated antihyperglycemic, hypoglycemic and antioxidant activities of this species. The in vitro studies and in vivo models have provided a simple bioscientific explanation for its various ethnopharmacological uses.

  15. Phytochemical and ethno-pharmacological profile of Crataeva nurvala Buch-Hum (Varuna):A review

    Institute of Scientific and Technical Information of China (English)

    Atanu Bhattacharjee; Shastry Chakrakodi Shashidhara; Aswathanarayana

    2012-01-01

    Crataeva nurvala Buch-Hum (Varuna) is well known traditional Indian medicinal plant used to treat various ailments in particular urolithiasis. During last two decades, numerous ethno-pharmacological and scientific reports have been cited in the literature to support its multi-directional therapeutic potential. The plant is rich in alkaloids, saponins, triterpenes, tannins, flavanoid glycosides, glucosinolates and phytosterols. The review emphasizes primarily on folkloric uses, biological activities of isolated compounds, pharmacological activities of the extracts, clinical studies and safety profile of Crataeva nurvala to provide a comprehensive data for researchers to hit upon new chemical entity responsible for its claimed traditional uses.

  16. Systematic Review of Pharmacological Properties of the Oligodendrocyte Lineage

    Science.gov (United States)

    Marinelli, Carla; Bertalot, Thomas; Zusso, Morena; Skaper, Stephen D.; Giusti, Pietro

    2016-01-01

    Oligodendrogenesis and oligodendrocyte precursor maturation are essential processes during the course of central nervous system development, and lead to the myelination of axons. Cells of the oligodendrocyte lineage are generated in the germinal zone from migratory bipolar oligodendrocyte precursor cells (OPCs), and acquire cell surface markers as they mature and respond specifically to factors which regulate proliferation, migration, differentiation, and survival. Loss of myelin underlies a wide range of neurological disorders, some of an autoimmune nature—multiple sclerosis probably being the most prominent. Current therapies are based on the use of immunomodulatory agents which are likely to promote myelin repair (remyelination) indirectly by subverting the inflammatory response, aspects of which impair the differentiation of OPCs. Cells of the oligodendrocyte lineage express and are capable of responding to a diverse array of ligand-receptor pairs, including neurotransmitters and nuclear receptors such as γ-aminobutyric acid, glutamate, adenosine triphosphate, serotonin, acetylcholine, nitric oxide, opioids, prostaglandins, prolactin, and cannabinoids. The intent of this review is to provide the reader with a synopsis of our present state of knowledge concerning the pharmacological properties of the oligodendrocyte lineage, with particular attention to these receptor-ligand (i.e., neurotransmitters and nuclear receptor) interactions that can influence oligodendrocyte migration, proliferation, differentiation, and myelination, and an appraisal of their therapeutic potential. For example, many promising mediators work through Ca2+ signaling, and the balance between Ca2+ influx and efflux can determine the temporal and spatial properties of oligodendrocytes (OLs). Moreover, Ca2+ signaling in OPCs can influence not only differentiation and myelination, but also process extension and migration, as well as cell death in mature mouse OLs. There is also evidence

  17. Alepidea amatymbica Eckl. & Zeyh.: A Review of Its Traditional Uses, Phytochemistry, Pharmacology, and Toxicology

    Directory of Open Access Journals (Sweden)

    O. A. Wintola

    2014-01-01

    Full Text Available Alepidea amatymbica is an important medicinal plant in Southern Africa with a long history of traditional use for the management of conditions like colds, coughs, sore throat, influenza, asthma, and abdominal cramps. Despite the much acclaimed traditional uses of the plant, there is a dearth of scientific information on the review of this plant. Hence, this review is aimed at providing information on the botany, phytochemistry, pharmacology, and toxicology of A. amatymbica. This review uses all the synonyms of the plant obtained from the plant list. Google scholar, Science Direct, PubMed, and Scopus were made use of in addition to the University of Fort Hare’s online databases. All the phytochemical studies on Alepidea amatymbica obtained from the literature reported the presence of kaurene-type diterpenoids and their derivatives. Pharmacological areas identified on A. amatymbica fresh and dried extract include antibacterial, antifungal, sedative, astringent, antimalarial, anti-inflammatory, antihelminthes, antihypertensive, anti-HIV, and diuretic activities. Literature search on A. amatymbica revealed the use of cell line, brine shrimps, and rats for the determination of the toxicity in the plant. Clinical trials and product development to fully exploit the medicinal value are also required to validate its folklore use in traditional medicine.

  18. Traditional uses, fermentation, phytochemistry and pharmacology of Phellinus linteus: A review.

    Science.gov (United States)

    Chen, Hua; Tian, Ting; Miao, Hua; Zhao, Ying-Yong

    2016-09-01

    Medicinal mushroom Phellinus linteus ("Sanghuang" in Chinese, ) is a famous fungus which is widely used in China, Korea, and other Asian countries. As a traditional Chinese medicine with a 2000-year long history, medicinal applications of Phellinus linteus mainly include treating hemorrhage, hemostasis and diseases related to female menstruation according to Chinese clinical empirical practice. A number of studies reported Phellinus linteus possessed good therapeutic effects on various ailments including tumor, diabetes, inflammation, obesity, etc. The present paper comprehensively reviewed the traditional uses, fermentation, constituent and pharmacology of Phellinus linteus based on scientific literature as well as critical analysis of the research. This review aimed to provide latest information and new foundations and directions for further investigations on Phellinus linteus. All available information about Phellinus linteus was supplied by library database and electronic search (CNKI, Google Scholar, ScienceDirect, Web of Science, PubMed, etc.). Some local and ancient books as well as brilliant scholars were also important information resources. Improvement of fermentation techniques promoted the production of Phellinus linteus. Studies of constituents showed the main chemical composition of Phellinus linteus included polysaccharides, flavones, triterpenes, aromatic acids, amino acids, etc. and polysaccharides were found to account for the largest proportion. Pharmacological researches revealed Phellinus linteus possessed a variety of biological activities including anti-cancer, immuno-regulation, anti-diabetes, anti-oxidation and anti-inflammation. Based on these summarized information, this review was presented to provide helpful references and beneficial directions for future studies of Phellinus linteus. PMID:27343366

  19. Traditional uses, fermentation, phytochemistry and pharmacology of Phellinus linteus: A review.

    Science.gov (United States)

    Chen, Hua; Tian, Ting; Miao, Hua; Zhao, Ying-Yong

    2016-09-01

    Medicinal mushroom Phellinus linteus ("Sanghuang" in Chinese, ) is a famous fungus which is widely used in China, Korea, and other Asian countries. As a traditional Chinese medicine with a 2000-year long history, medicinal applications of Phellinus linteus mainly include treating hemorrhage, hemostasis and diseases related to female menstruation according to Chinese clinical empirical practice. A number of studies reported Phellinus linteus possessed good therapeutic effects on various ailments including tumor, diabetes, inflammation, obesity, etc. The present paper comprehensively reviewed the traditional uses, fermentation, constituent and pharmacology of Phellinus linteus based on scientific literature as well as critical analysis of the research. This review aimed to provide latest information and new foundations and directions for further investigations on Phellinus linteus. All available information about Phellinus linteus was supplied by library database and electronic search (CNKI, Google Scholar, ScienceDirect, Web of Science, PubMed, etc.). Some local and ancient books as well as brilliant scholars were also important information resources. Improvement of fermentation techniques promoted the production of Phellinus linteus. Studies of constituents showed the main chemical composition of Phellinus linteus included polysaccharides, flavones, triterpenes, aromatic acids, amino acids, etc. and polysaccharides were found to account for the largest proportion. Pharmacological researches revealed Phellinus linteus possessed a variety of biological activities including anti-cancer, immuno-regulation, anti-diabetes, anti-oxidation and anti-inflammation. Based on these summarized information, this review was presented to provide helpful references and beneficial directions for future studies of Phellinus linteus.

  20. Trials of Pharmacological Interventions for Tourette Syndrome: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Karen Waldon

    2013-01-01

    Full Text Available Introduction: Gilles de la Tourette Syndrome (GTS is a childhood-onset hyperkinetic movement disorder defined by the chronic presence of multiple motor tics and at least one vocal tic and often complicated by co-morbid behavioural problems. The pharmacological treatment of GTS focuses on the modulation of monoaminergic pathways within the cortico-striato-thalamo-cortical circuitry. This paper aims to evaluate the efficacy and safety profiles of pharmacological agents used in the treatment of tics in patients with GTS, in order to provide clinicians with an evidence-based rationale for the pharmacological treatment in GTS.

  1. Two Traditional Chinese Medicines Curcumae Radix and Curcumae Rhizoma: An Ethnopharmacology, Phytochemistry, and Pharmacology Review

    Science.gov (United States)

    Zhou, Yang; Xie, Meng; Song, Yan; Wang, Wenping; Zhao, Haoran; Tian, Yuxin; Wang, Yan; Bai, Shaojuan; Zhao, Yichen; Chen, Xiaoyi; She, Gaimei

    2016-01-01

    Curcumae Rhizoma, known as Ezhu (Chinese: 莪术), and Curcumae Radix, known as Yujin (Chinese: 郁金), are different plant parts coming from three same species according to China Pharmacopoeia. Actually, they are used in different ways in TCM clinical treatment. Curcumae Rhizoma is mainly used as antitumor drug, while Curcumae Radix has been used as antidepressant and cholagogue. Curcumae Rhizoma and Curcumae Radix are confused in variety and source, even in clinical trials by some nonprofessional workers. So it is important for us to make them clear. This review is aimed at summarizing the ethnopharmacology, phytochemical, and pharmacological differences between Curcumae Radix and Curcumae Rhizoma by SciFinder, CNKI, and so on, to use them exactly and clearly. Further studies on Curcumae Rhizoma and Curcumae Radix can lead to the development of new drugs and therapeutics for various diseases on the basis of the TCM theory. PMID:27057197

  2. Periodic Review Sessions Contribute to Student Learning across the Disciplines in Pharmacology

    Science.gov (United States)

    Barry, Orla P.; O' Sullivan, Eleanor; McCarthy, Marian

    2015-01-01

    Background: The teaching of the discipline of pharmacology is in constant flux. In order to meet the challenges of teaching pharmacology effectively we investigated a new teaching and learning strategy. Aim: Our aim was to investigate whether structured periodic review sessions (RS) could improve teaching and learning for students in a…

  3. Phyto-Pharmacology of Ziziphus jujuba Mill- A plant review

    Directory of Open Access Journals (Sweden)

    R T Mahajan

    2009-01-01

    Full Text Available Herbs have always been the natural form of medicine in India. Medicinal plants have curative properties due to presence of various complex chemical substances of different composition which contain secondary metabolites such as alkaloids, flavonoids, terpenoids, saponin and phenolic compounds distributed in different parts of the plants. Ziziphus jujuba Mill, a member of the family Rhamnaceae, commonly known as Bor, is used traditionally as tonic and aphrodisiac and sometimes as Hypnotic-sedative and Anxiolytic, anticancer (Melanoma cells, Antifungal, Antibacterial, Antiulcer, Anti-inflammatory, Cognitive, Antispastic, Antifertility/contraception, Hypotensive and Antinephritic, Cardiotonic, Antioxidant, Immunostimulant, and Wound healing properties. It possesses allied compounds viz. Ascorbic acid, thiamine, riboflavin-bioflavonoids and Pectin A and various chemical substances like Mauritine-A; Amphibine-H; Jubanine-A; Jubanine-B; Mucronine-D and Nummularine-B. Sativanine-E. Frangufoline, Ziziphine-A to Q, betulinic acid colubrinic acid, alphitolic acid, 3-O-cis-p-coumaroylalphitolic acid, 3-O-transp-coumaroylalphitolic acid, 3-O-cis-p-coumaroylmaslinic acid, 3-O-trans-pcoumaroylmaslinic acid, oleanolic acid, betulonic acid, oleanonic acid, zizyberenalic acid and betulinic acid, jujubosides A, B, A1 B1 and C and acetyljujuboside B and the protojujubosides A, B and B1, saponin, ziziphin, from the dried leaves of Z. jujube - 3-O-a-L-rhamnopyranosyl (1-2-a-arabinopyranosyl-20-O- (2,3-di-O-acetyl-a-L-rhamnopyranosyl jujubogenin. Saponin from leaves and stem are 3-O- ((2-O- alpha - D - furopyranosyl - 3-O- beta - D -glucopyranosyl - alpha - L - arabinopyranosyl jujubogenin and (6′′′-sinapoylspinosin, 6′′′-feruloylspinosin and 6′′′-p-coumaroylspinosin. The present review discusses photo-chemistry, pharmacology, medicinal properties and biological activities of Za jujuba and its usage in different ailments.

  4. The Hedyotis diffusa Willd. (Rubiaceae: A Review on Phytochemistry, Pharmacology, Quality Control and Pharmacokinetics

    Directory of Open Access Journals (Sweden)

    Rui Chen

    2016-05-01

    Full Text Available Hedyotis diffusa Willd (H. diffusa is a well-known Chinese medicine with a variety of activities, especially its anti-cancer effect in the clinic. Up to now, 171 compounds have been reported from H. diffusa, including 32 iridoids, 26 flavonoids, 24 anthraquinones, 26 phenolics and their derivatives, 50 volatile oils and 13 miscellaneous compounds. In vitro and in vivo studies show these phytochemicals and plant extracts to exhibit a range of pharmacological activities of anti-cancer, antioxidant, anti-inflammatory, anti-fibroblast, immunomodulatory and neuroprotective effects. Although a series of methods have been established for the quality control of H. diffusa, a feasible and reliable approach is still needed in consideration of its botanical origin, collecting time and bioactive effects. Meanwhile, more pharmacokinetics researches are needed to illustrate the characteristics of H. diffusa in vivo. The present review aims to provide up-to-date and comprehensive information on the phytochemistry, pharmacology, quality control and pharmacokinetic characteristics of H. diffusa for its clinical use and further development.

  5. The Hedyotis diffusa Willd. (Rubiaceae): A Review on Phytochemistry, Pharmacology, Quality Control and Pharmacokinetics.

    Science.gov (United States)

    Chen, Rui; He, Jingyu; Tong, Xueli; Tang, Lan; Liu, Menghua

    2016-01-01

    Hedyotis diffusa Willd (H. diffusa) is a well-known Chinese medicine with a variety of activities, especially its anti-cancer effect in the clinic. Up to now, 171 compounds have been reported from H. diffusa, including 32 iridoids, 26 flavonoids, 24 anthraquinones, 26 phenolics and their derivatives, 50 volatile oils and 13 miscellaneous compounds. In vitro and in vivo studies show these phytochemicals and plant extracts to exhibit a range of pharmacological activities of anti-cancer, antioxidant, anti-inflammatory, anti-fibroblast, immunomodulatory and neuroprotective effects. Although a series of methods have been established for the quality control of H. diffusa, a feasible and reliable approach is still needed in consideration of its botanical origin, collecting time and bioactive effects. Meanwhile, more pharmacokinetics researches are needed to illustrate the characteristics of H. diffusa in vivo. The present review aims to provide up-to-date and comprehensive information on the phytochemistry, pharmacology, quality control and pharmacokinetic characteristics of H. diffusa for its clinical use and further development. PMID:27248992

  6. Platycladus orientalis leaves: a systemic review on botany, phytochemistry and pharmacology.

    Science.gov (United States)

    Shan, Ming-Qiu; Shang, Jing; Ding, An-Wei

    2014-01-01

    Platycladus orientalis leaves (Cebaiye) have been used for thousands of years as traditional Chinese medicine (TCM). According to the theory of TCM, they are categorized as a blood-cooling and hematostatic herb. In clinical practice, they were usually prescribed with heat-clearing herbs to reinforce the efficacy of hemostasis. The review provides the up-to-date information from 1980 to present that is available on the botany, processing research, phytochemistry, pharmacology and toxicology of the leaves. The information is collected from scientific journals, books, theses and reports via library and electronic search (Google Scholar, Pubmed and CNKI). Through literature reports, we can find that the leaves show a wide spectrum of pharmacological activities, such as anti-inflammatory, antioxidant, antimicrobial, disinsection, anticancer, diuretic, hair growth-promoting, neuroprotective and antifibrotic activities. Diterpene and flavonoids would be active constituents in P. orientalis leaves. Many studies have provided evidence for various traditional uses. However, there is a great need for additional studies to elucidate the mechanism of blood-cooling and hematostatic activity of the leaves. Therefore, the present review on the botany, traditional uses, phytochemistry and toxicity has provided preliminary information for further studies of this herb. PMID:24871649

  7. PTSD and comorbid AUD: a review of pharmacological and alternative treatment options

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    Ralevski E

    2014-03-01

    Full Text Available Elizabeth Ralevski, Lening A Olivera-Figueroa, Ismene Petrakis Yale University School of Medicine, Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA Background: Although posttraumatic stress disorder (PTSD and alcohol use disorders (AUD frequently co-occur there are no specific treatments for individuals diagnosed with these comorbid conditions. The main objectives of this paper are to review the literature on pharmacological options for PTSD and comorbid AUD, and to summarize promising behavioral and alternative interventions for those with these dual diagnoses. Methods: We conducted a comprehensive search on PsycINFO and MEDLINE/PubMed databases using Medical Subject Headings terms in various combinations to identify articles that used pharmacotherapy for individuals with dual diagnoses of PTSD and AUD. Similar strategies were used to identify articles on behavioral and alternative treatments for AUD and PTSD. We identified and reviewed six studies that tested pharmacological treatments for patients with PTSD and comorbid AUD. Results: The literature on treatment with US Food and Drug Administration approved medications for patients with dual diagnosis of PTSD and AUD is very limited and inconclusive. Promising evidence indicates that topiramate and prazosin may be effective in reducing PTSD and AUD symptoms in individuals with comorbidity. Seeking safety has had mixed efficacy in clinical trials. The efficacy of other behavioral and alternative treatments (mindfulness-based, yoga, and acupuncture is more difficult to evaluate since the evidence comes from small, single studies without comparison groups. Conclusion: There is a clear need for more systematic and rigorous study of pharmacological, behavioral, and alternative treatments for patients with dual diagnoses of PTSD and AUD. Keywords: dual diagnosis, PTSD, AUD, pharmacotherapy

  8. Review of systematic reviews about the efficacy of non-pharmacological interventions to improve sleep quality in insomnia

    NARCIS (Netherlands)

    Niet, G.J. De; Tiemens, B.G.; Kloos, M.W.; Hutschemaekers, G.J.M.

    2009-01-01

    Background Insomnia is a very common condition in various populations. Non-pharmacological interventions might offer (safe) alternatives for hypnotics. Aim To evaluate the evidence for efficacy from systematic reviews about non-pharmacological interventions to improve sleep quality in insomnia by a

  9. Rehmannia glutinosa: review of botany, chemistry and pharmacology.

    Science.gov (United States)

    Zhang, Ru-Xue; Li, Mao-Xing; Jia, Zheng-Ping

    2008-05-01

    Rehmannia glutinosa, a widely used traditional Chinese herb, belongs to the family of Scrophulariaceae, and is taken to nourish Yin and invigorate the kidney in traditional Chinese medicine (TCM) and has a very high medicinal value. In recent decades, a great number of chemical and pharmacological studies have been done on Rehmannia glutinosa. More than 70 compounds including iridoids, saccharides, amino acid, inorganic ions, as well as other trace elements have been found in the herb. Studies show that Rehmannia glutinosa and its active principles possess wide pharmacological actions on the blood system, immune system, endocrine system, cardiovascular system and the nervous system. Currently, the effective monomeric compounds or active parts have been screened for the pharmacological activity of Rehmannia glutinosa and the highest quality scientific data is delivered to support the further application and exploitation for new drug development. PMID:18407446

  10. Trapa bispinosa Roxb.: A Review on Nutritional and Pharmacological Aspects

    Directory of Open Access Journals (Sweden)

    Prafulla Adkar

    2014-01-01

    protein content of the water chestnut kernel, Trapa bispinosa are reported. In this paper, the recent reports on nutritional, phytochemical, and pharmacological aspects of Trapa bispinosa Roxb, as a medicinal and nutritional food, are reviewed.

  11. Attitudes toward pharmacological cognitive enhancement-a review

    NARCIS (Netherlands)

    Schelle, K.J.; Faulmüller, N.S.; Caviola, L.; Hewstone, M.

    2014-01-01

    A primary means for the augmentation of cognitive brain functions is "pharmacological cognitive enhancement" (PCE). The term usually refers to the off-label use of medical substances to improve mental performance in healthy individuals. With the final aim to advance the normative debate taking place

  12. The pharmacologic and clinical effects of medical cannabis.

    Science.gov (United States)

    Borgelt, Laura M; Franson, Kari L; Nussbaum, Abraham M; Wang, George S

    2013-02-01

    Cannabis, or marijuana, has been used for medicinal purposes for many years. Several types of cannabinoid medicines are available in the United States and Canada. Dronabinol (schedule III), nabilone (schedule II), and nabiximols (not U.S. Food and Drug Administration approved) are cannabis-derived pharmaceuticals. Medical cannabis or medical marijuana, a leafy plant cultivated for the production of its leaves and flowering tops, is a schedule I drug, but patients obtain it through cannabis dispensaries and statewide programs. The effect that cannabinoid compounds have on the cannabinoid receptors (CB(1) and CB(2) ) found in the brain can create varying pharmacologic responses based on formulation and patient characteristics. The cannabinoid Δ(9) -tetrahydrocannabinol has been determined to have the primary psychoactive effects; the effects of several other key cannabinoid compounds have yet to be fully elucidated. Dronabinol and nabilone are indicated for the treatment of nausea and vomiting associated with cancer chemotherapy and of anorexia associated with weight loss in patients with acquired immune deficiency syndrome. However, pain and muscle spasms are the most common reasons that medical cannabis is being recommended. Studies of medical cannabis show significant improvement in various types of pain and muscle spasticity. Reported adverse effects are typically not serious, with the most common being dizziness. Safety concerns regarding cannabis include the increased risk of developing schizophrenia with adolescent use, impairments in memory and cognition, accidental pediatric ingestions, and lack of safety packaging for medical cannabis formulations. This article will describe the pharmacology of cannabis, effects of various dosage formulations, therapeutics benefits and risks of cannabis for pain and muscle spasm, and safety concerns of medical cannabis use.

  13. Acknowledgments to reviewers of World Journal of Gastrointestinal Pharmacology and Therapeutics

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Many reviewers have contributed their expertise and time to the peer review,a critical process to ensure the quality of World Journal of Gastrointestinal Pharmacology and Therapeutics.The editors and authors of the articles submitted to the journal are grateful to the following reviewers for evaluating the articles(including those published in this issue and those rejected for this issue)

  14. Acknowledgments to reviewers of World Journal of Gastrointestinal Pharmacology and Therapeutics

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of World Journal of Gastrointestinal Pharmacology and Therapeutics. The editors and authors of the articles submitted to the journal are grateful to the following reviewers for evaluating the articles (including those published in this issue and those rejected for this issue)

  15. Acknowledgments to reviewers of World Journal of Gastrointestinal Pharmacology and Therapeutics

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of World Journal of Gastrointestinal Pharmacology and Therapeutics. The editors and authors of the articles submitted to the journal are grateful to the following reviewers for evaluating the articles (including those published in this issue

  16. Pharmacological Review on Centella asiatica: A Potential Herbal Cure-all.

    Science.gov (United States)

    Gohil, Kashmira J; Patel, Jagruti A; Gajjar, Anuradha K

    2010-09-01

    In recent times, focus on plant research has increased all over the world. Centella asiatica is an important medicinal herb that is widely used in the orient and is becoming popular in the West. Triterpenoid, saponins, the primary constituents of Centella asiatica are manly believed to be responsible for its wide therapeutic actions. Apart from wound healing, the herb is recommended for the treatment of various skin conditions such as leprosy, lupus, varicose ulcers, eczema, psoriasis, diarrhoea, fever, amenorrhea, diseases of the female genitourinary tract and also for relieving anxiety and improving cognition. The present review attempts to provide comprehensive information on pharmacology, mechanisms of action, various preclinical and clinical studies, safety precautions and current research prospects of the herb. At the same time, studies to evaluate the likelihood of interactions with drugs and herbs on simultaneous use, which is imperative for optimal and safe utilization of the herb, are discussed. PMID:21694984

  17. Pharmacological review on Centella asiatica: A potential herbal cure-all

    Directory of Open Access Journals (Sweden)

    Gohil Kashmira

    2010-01-01

    Full Text Available In recent times, focus on plant research has increased all over the world. Centella asiatica is an important medicinal herb that is widely used in the orient and is becoming popular in the West. Triterpenoid, saponins, the primary constituents of Centella asiatica are manly believed to be responsible for its wide therapeutic actions. Apart from wound healing, the herb is recommended for the treatment of various skin conditions such as leprosy, lupus, varicose ulcers, eczema, psoriasis, diarrhoea, fever, amenorrhea, diseases of the female genitourinary tract and also for relieving anxiety and improving cognition. The present review attempts to provide comprehensive information on pharmacology, mechanisms of action, various preclinical and clinical studies, safety precautions and current research prospects of the herb. At the same time, studies to evaluate the likelihood of interactions with drugs and herbs on simultaneous use, which is imperative for optimal and safe utilization of the herb, are discussed.

  18. Foeniculum vulgare Mill: a review of its botany, phytochemistry, pharmacology, contemporary application, and toxicology.

    Science.gov (United States)

    Badgujar, Shamkant B; Patel, Vainav V; Bandivdekar, Atmaram H

    2014-01-01

    Foeniculum vulgare Mill commonly called fennel has been used in traditional medicine for a wide range of ailments related to digestive, endocrine, reproductive, and respiratory systems. Additionally, it is also used as a galactagogue agent for lactating mothers. The review aims to gather the fragmented information available in the literature regarding morphology, ethnomedicinal applications, phytochemistry, pharmacology, and toxicology of Foeniculum vulgare. It also compiles available scientific evidence for the ethnobotanical claims and to identify gaps required to be filled by future research. Findings based on their traditional uses and scientific evaluation indicates that Foeniculum vulgare remains to be the most widely used herbal plant. It has been used for more than forty types of disorders. Phytochemical studies have shown the presence of numerous valuable compounds, such as volatile compounds, flavonoids, phenolic compounds, fatty acids, and amino acids. Compiled data indicate their efficacy in several in vitro and in vivo pharmacological properties such as antimicrobial, antiviral, anti-inflammatory, antimutagenic, antinociceptive, antipyretic, antispasmodic, antithrombotic, apoptotic, cardiovascular, chemomodulatory, antitumor, hepatoprotective, hypoglycemic, hypolipidemic, and memory enhancing property. Foeniculum vulgare has emerged as a good source of traditional medicine and it provides a noteworthy basis in pharmaceutical biology for the development/formulation of new drugs and future clinical uses. PMID:25162032

  19. A Comprehensive Review of Punica granatum (Pomegranate) Properties in Toxicological, Pharmacological, Cellular and Molecular Biology Researches

    Science.gov (United States)

    Rahimi, Hamid Reza; Arastoo, Mohammad; Ostad, Seyed Nasser

    2012-01-01

    Punica granatum (Pg), commonly known as pomegranate (Pg), is a member of the monogeneric family, Punicaceae, and is mainly found in Iran which is considered to be its primary centre of origin. Pg and its chemical components possess various pharmacological and toxicological properties including antioxidant, anti-inflammatory (by inhibiting pro-inflammatory cytokines), anti-cancer and anti-angiogenesis activities. They also show inhibitory effects on invasion/motility, cell cycle, apoptosis, and vital enzymes such as cyclooxygenase (COX), lipooxygenase (LOX), cytochrome P450 (CYP450), phospholipase A2 (PLA2), ornithine decarboxylase (ODC), carbonic anhydrase (CA), 17beta-hydroxysteroid dehydrogenase (17β-HSDs) and serine protease (SP). Furthermore, they can stimulate cell differentiation and possess anti-mutagenic effects. Pg can also interfere with several signaling pathways including PI3K/AKT, mTOR, PI3K, Bcl-X, Bax, Bad, MAPK, ERK1/2, P38, JNK, and caspase. However, the exact mechanisms for its pharmacological and toxicological properties remain to be unclear and need further evaluation. These properties strongly suggest a wide range use of Pg for clinical applications. This review will discuss the areas for which Pg has shown therapeutic properties in different mechanisms. PMID:24250463

  20. Foeniculum vulgare Mill: A Review of Its Botany, Phytochemistry, Pharmacology, Contemporary Application, and Toxicology

    Directory of Open Access Journals (Sweden)

    Shamkant B. Badgujar

    2014-01-01

    Full Text Available Foeniculum vulgare Mill commonly called fennel has been used in traditional medicine for a wide range of ailments related to digestive, endocrine, reproductive, and respiratory systems. Additionally, it is also used as a galactagogue agent for lactating mothers. The review aims to gather the fragmented information available in the literature regarding morphology, ethnomedicinal applications, phytochemistry, pharmacology, and toxicology of Foeniculum vulgare. It also compiles available scientific evidence for the ethnobotanical claims and to identify gaps required to be filled by future research. Findings based on their traditional uses and scientific evaluation indicates that Foeniculum vulgare remains to be the most widely used herbal plant. It has been used for more than forty types of disorders. Phytochemical studies have shown the presence of numerous valuable compounds, such as volatile compounds, flavonoids, phenolic compounds, fatty acids, and amino acids. Compiled data indicate their efficacy in several in vitro and in vivo pharmacological properties such as antimicrobial, antiviral, anti-inflammatory, antimutagenic, antinociceptive, antipyretic, antispasmodic, antithrombotic, apoptotic, cardiovascular, chemomodulatory, antitumor, hepatoprotective, hypoglycemic, hypolipidemic, and memory enhancing property. Foeniculum vulgare has emerged as a good source of traditional medicine and it provides a noteworthy basis in pharmaceutical biology for the development/formulation of new drugs and future clinical uses.

  1. O tratamento farmacológico do transtorno bipolar: uma revisão sistemática e crítica dos aspectos metodológicos dos estudos clínicos modernos The pharmacological treatment of bipolar disorder: a systematic and critical review of the methodological aspects of modern clinical trials

    Directory of Open Access Journals (Sweden)

    Elie Cheniaux

    2011-03-01

    Full Text Available OBJETIVO: Revisar sistematicamente os principais estudos clínicos sobre o tratamento farmacológico do transtorno bipolar e fazer uma análise crítica de seus aspectos metodológicos. MÉTODO: Realizou-se uma busca nas bases de dados Medline, ISI e PsycINFO, utilizando-se os seguintes termos de busca: "bipolar", "randomized", "placebo" e "controlled". Foram selecionados estudos clínicos randomizados, duplo-cegos e controlados por placebo sobre o tratamento farmacológico do transtorno bipolar. Além disso, de acordo com os nossos critérios, as amostras deveriam ser de no mínimo 100 pacientes e a substância testada deveria ser usada como monoterapia. RESULTADOS: 34 artigos se adequaram aos critérios de seleção. Todas as substâncias atualmente indicadas para mania, depressão bipolar e para o tratamento de manutenção foram mais eficazes que o placebo em pelo menos um estudo. Todavia, esses estudos tiveram amostras altamente selecionadas, altas taxas de abandono e baixas taxas de resposta clínica. CONCLUSÃO: Os modernos estudos clínicos sobre o tratamento farmacológico do transtorno bipolar apresentam algumas importantes limitações metodológicas. Assim, seus resultados devem ser considerados com cautela.OBJECTIVE: To review systematically the main clinical trials on the pharmacological treatment of bipolar disorder and to make a critical analysis of their methodological aspects. METHOD: A search in Medline, ISI and PsycINFO databases was conducted, using the following search terms: "bipolar", "randomized", "placebo" e "controlled". Randomized, double-blind, placebo-controlled clinical trials on the pharmacological treatment of bipolar disorder were selected. Besides, according to our criteria, samples had to consist of at least 100 patients and experimental drug had to be used as monotherapy. RESULTS: 34 articles met our selection criteria. All drugs currently indicated for mania, bipolar depression and maintenance treatment of

  2. Clinical Pharmacology of Alpha-1 Blockers Improving Drug-profile through Novel Formulations.

    Science.gov (United States)

    Nerurkar, Rajan P; Ved, Jignesh K

    2014-09-01

    Clinical pharmacology is an essential consideration in chronic therapies, and may play a significant role in modifying the pharmacological characteristics of drug formulations. Improvement in drug formulations may ensure their safe and effective use over a period of time. This has been particularly observed with α-1 adrenergic blockers in hypertension management. Advancements in formulations like prazosin GITS, have resulted in improvement in tolerability profile and smoother, more effective blood pressure control, which reasonably translate into improvement in patient compliance and better clinical outcomes.

  3. A REVIEW OF FISH MODEL IN EXPERIMENTAL PHARMACOLOGY

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    Pandey Govind

    2011-09-01

    Full Text Available Recognizing differences in the physiology of fish is essential to understanding the problems associated with drug approval for the aquatic environment. A wide variety of experiments and the use of drugs in fish have been elucidated in various literatures. Antibacterial, antiparasitic and anaesthetic drugs, besides the pharmacokinetic and pharmacodynamic parameters have been well experimented on the fish. Several groups of drugs, such as tetracyclines, penicillins, macrolides, quinolones, sulfonamides, immunostimulants, anticancer agents, herbal drugs and vaccines, have been successfully experimented or used in fish. Hence, fish is also used as a new model organism for different experimental studies of pharmacology and toxicology. The potential for the application of research findings to both human and environmental health issues makes fish species attractive and valuable alternative models in various diseases, including cancer, and pharmacological and toxicological research. Zebrafish has emerged as a major model organism in the developmental genetics, neurophysiology or biomedical research.

  4. Clinical pharmacology of non opioid analgesics in neonates.

    Science.gov (United States)

    Allegaert, K; de Hoon, J; Van Overmeire, B; Devlieger, H

    2005-01-01

    An integrated approach of neonatal analgesia starts with the systematic evaluation of pain and should be followed by effective interventions, mainly based on the appropriate (i.e. safe and effective) administration of analgesics. In contrast to the more potent opioids, data on the pharmacokinetics and -dynamics of non-opioid analgesics in this specific population are still rare or even lacking. We therefore evaluated various aspects of developmental pharmacology of non-opioid analgesics (paracetamol, ibuprofen, acetylsalicyl acid) in neonates. We first performed a single dose propacetamol study in preterm and term neonates. Based on these preliminary findings, a repeated dose administration scheme was developed and tested and maturational aspects from preterm till teenage were documented. Although non-selective COX-inhibitors might be effective in the treatment of postoperative or inflammatory pain syndromes in neonates, potential efficacy should be balanced against the drugs' safety profile. Neonatal renal clearance strongly depends on glomerular filtration rate (GFR) and GFR itself strongly depends on the vaso-dilatative of prostaglandins on the afferent arterioli. We therefore evaluated the impact of the administration of ibuprofen or acetylsalicylic acid on renal clearance in preterm infants and hereby used amikacin clearance as a surrogate marker. We hereby documented the negative effect of ibuprofen on glomerular filtration rate in preterm infants up to 34 weeks and we were able to show that ibuprofen and acetylsalicylic acid had an equal impact on the glomerular filtration rate. PMID:16408826

  5. CLINICAL PHARMACOLOGY OF A NEW COMPLEX HEPATOPROTECTIVE PREPARATION

    Directory of Open Access Journals (Sweden)

    Semenenko M. P.

    2016-05-01

    Full Text Available This article presents the results of the studies of the influence of a new complex hepatoprotective preparation on the basic system of the body, the mechanism of occurrence and manifestation of its biological effects, the dependence of this action from the components that are parts of the preparation, the dose, as well as the regularity of manifestation of possible side effects. The effect of the different doses of the preparation (1% and 2% on the average daily weight gain and morphological and biochemical indices of the birds’ blood was studied. The conducted research determined a stimulatory influence of the preparation on the growth, development and safety of broiler chickens. The new hepatoprotector exhibits the properties aimed on revitalizing the erythro- and hematopoiesis and magnification of the cellular immunity against the exogenous influence. The use of the preparation helps to improve liver function and reduce the toxic load on hepatocytes, which manifests an increase in a number of metabolic parameters, such as total protein, glucose, calcium, phosphorus. We have noted an expressed hepatoprotective effect on the enzyme activity of AST and the remission of the cytolytic syndrome of the experimental chickens. Thereby it was found out that the complex hepatoprotective preparation has a pronounced pharmacological activity, providing a significant impact on the energy of the broiler chickens’ growth and their safety, morphological and biochemical indices of the blood and metabolic processes in the body of the bird

  6. Therapeutic and pharmacological potential of Foeniculum vulgare Mill: a review

    Directory of Open Access Journals (Sweden)

    Kooti Wesam

    2015-01-01

    Full Text Available Introduction: Fennel (Foeniculum vulgare Mill is one of the oldest spice plants which, due to its economic importance and significant pharmaceutical industry applications, is considered as one of the world’s most important medicinal plants. The purpose of this study is to investigate and collect scientific reports such as morphological characteristics, phytochemical compounds and evaluation of the therapeutic properties of this valuable medicinal plant that have been published. Methods: In order to gather the information the keywords Fennel and Foeniculum vulgare mill, therapeutic, and pharmacology have been searched until January 1, 2015 from journals accessible in databases such as ScienceDirect, Scopus, EBSCO, Medline, PubMed, Embase, SID and Iran Medex. Results: The results showed that this plant has various pharmacological properties including antioxidant, anti-cancer activity, anti-inflammatory, antifungal, anti-bacterial and estrogenic effects which are probably due to the presence of aromatic compounds such as anethole, estragole and fenshon. Conclusion: Fennel possesses various pharmacological properties and the fennel bioactive molecules play an important role in human health, hence, it might be used for different drug productions.

  7. Special issue of clinical pharmacology: advances and applications in new protein therapeutics modulating tumor immunity

    Directory of Open Access Journals (Sweden)

    Frankel AE

    2013-11-01

    Full Text Available Arthur E Frankel Department of Internal Medicine, Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA Until recent decades, the role of the immune system in harnessing tumor growth was based on anecdotal observations of increased cancers in immune-compromised patients, the benefits of graft-versus-leukemia in allogeneic stem cell transplants, and the limited but reproducible anticancer activity of several lymphokines, including interferon and interleukin (IL-2. Vaccine studies and infusions of "activated" lymphocytes yielded variable clinical responses and disease control. An improved understanding of the molecular and cell mechanisms of the innate and adaptive immune system in cancer-bearing animals and the discovery of an immune-suppressive tumor microenvironment then led to development and testing of a battery of new drug and cell-based approaches to trigger antitumor immunity. This issue of Clinical Pharmacology: Advances and Applications highlights some of the new protein-based compounds that are radically changing the cancer therapeutic landscape. The purpose of this collection of reviews is to inform the readership regarding the importance of the seismic change in cancer therapeutics and stimulate efforts to find novel niches and combinations of agents similar to recent advances in the application of cancer pathway inhibitors.

  8. [Transdermal buprenorphine: a current overview of pharmacological and clinical data].

    Science.gov (United States)

    Faymonville, M E; Libbrecht, D

    2008-11-01

    Our understanding of the pathophysiologic mechanisms of chronic pain progresses; the complexity of the problem justifies our need for new molecules and new ways of administration that will help to further optimise and better individualize our pharmacologic therapies. Whereas acute pain can be considered an alarm signal, chronic pain constitutes, per se, a syndrome that requires a meticulous selection of the analgesic drug(s). Since pain is permanent, the continuous administration of the analgesic is recommended rather than an on demand administration. Transdermic modes of administration are of value for the treatment of chronic pain because they allow a progressive delivery of the active compound together with the maintenance of stable plasma levels of the drug. Buprenorphine is a semi-synthetic opioid that is available in the sublingual, injectable, or transdermic forms. The matrix patch of buprenorphine represents a major asset for the treatment of chronic pain, whether it be cancerous in origin, or not. Its efficacy and safety have been clearly demonstrated in randomised double blind trials as well as in post-marketing surveillance observations. Buprenorphine, administered as a transdermal therapeutic system, induces a dose-related pain relief, whatever the nature of the pain and the age of the patient. Buprenorphine also exerts an analgesic action on neuropathic pain. It differs from other opioids by its affinity as a partial agonist on mu and kappa receptors, and as a complete agonist of ORL-1 receptors. Therefore, transdermal buprenorphine will be useful to all physicians having to control severe pain by powerful opioids. PMID:19112993

  9. The Antihyperglycemic Effects of Rhizoma Coptidis and Mechanism of Actions: A Review of Systematic Reviews and Pharmacological Research

    Directory of Open Access Journals (Sweden)

    Hui Wang

    2014-01-01

    Full Text Available Rhizoma Coptidis (Huang Lian in Chinese pinyin is among the most widely used traditional Chinese herbal medicines and has a profound history of more than 2000 years of being used as a therapeutic herb. The antidiabetic effects of Rhizoma Coptidis have been extensively investigated in animal experiments and clinical trials and its efficacy as a promising antihyperglycemic agent has been widely discussed. In the meantime, findings from modern pharmacological studies have contributed the majority of its bioactivities to berberine, the isoquinoline alkaloids component of the herb, and a number of experiments testing the antidiabetic effects of berberine have been initiated. Therefore, we conducted a review of the current evidence profile of the antihyperglycemic effects of Rhizoma Coptidis as well as its main component berberine and the possible mechanism of actions, in order to summarize research evidence in this area and identify future research directions.

  10. Pediatric Clinical Pharmacology and Child Health:A Canadian Perspective

    Institute of Scientific and Technical Information of China (English)

    Stuart Macleod

    2011-01-01

    @@ Introduction Canadian academic centres and children's hospitals have had a longstanding interest in the improvement of drug therapy for children through research conducted across the four pillars of activity identified as being of critical importance by the Canadian Institutes of Health Research(viz,basic research,clinical research,population health research,applied health and policy research)[1].

  11. Integrating historical clinical and financial data for pharmacological research

    Directory of Open Access Journals (Sweden)

    Deshmukh Vikrant G

    2011-11-01

    Full Text Available Abstract Background Retrospective research requires longitudinal data, and repositories derived from electronic health records (EHR can be sources of such data. With Health Information Technology for Economic and Clinical Health (HITECH Act meaningful use provisions, many institutions are expected to adopt EHRs, but may be left with large amounts of financial and historical clinical data, which can differ significantly from data obtained from newer systems, due to lack or inconsistent use of controlled medical terminologies (CMT in older systems. We examined different approaches for semantic enrichment of financial data with CMT, and integration of clinical data from disparate historical and current sources for research. Methods Snapshots of financial data from 1999, 2004 and 2009 were mapped automatically to the current inpatient pharmacy catalog, and enriched with RxNorm. Administrative metadata from financial and dispensing systems, RxNorm and two commercial pharmacy vocabularies were used to integrate data from current and historical inpatient pharmacy modules, and the outpatient EHR. Data integration approaches were compared using percentages of automated matches, and effects on cohort size of a retrospective study. Results During 1999-2009, 71.52%-90.08% of items in use from the financial catalog were enriched using RxNorm; 64.95%-70.37% of items in use from the historical inpatient system were integrated using RxNorm, 85.96%-91.67% using a commercial vocabulary, 87.19%-94.23% using financial metadata, and 77.20%-94.68% using dispensing metadata. During 1999-2009, 48.01%-30.72% of items in use from the outpatient catalog were integrated using RxNorm, and 79.27%-48.60% using a commercial vocabulary. In a cohort of 16304 inpatients obtained from clinical systems, 4172 (25.58% were found exclusively through integration of historical clinical data, while 15978 (98% could be identified using semantically enriched financial data. Conclusions

  12. Review on Natural Coumarin Lead Compounds for Their Pharmacological Activity

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    K. N. Venugopala

    2013-01-01

    Full Text Available Coumarin (2H-1-benzopyran-2-one is a plant-derived natural product known for its pharmacological properties such as anti-inflammatory, anticoagulant, antibacterial, antifungal, antiviral, anticancer, antihypertensive, antitubercular, anticonvulsant, antiadipogenic, antihyperglycemic, antioxidant, and neuroprotective properties. Dietary exposure to benzopyrones is significant as these compounds are found in vegetables, fruits, seeds, nuts, coffee, tea, and wine. In view of the established low toxicity, relative cheapness, presence in the diet, and occurrence in various herbal remedies of coumarins, it appears prudent to evaluate their properties and applications further.

  13. Acknowledgments to reviewers of World Journal of Gastrointestinal Pharmacology and Therapeutics

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Many reviewers have contributed their expertise and time to the peer review,a critical process to ensure the quality of World Journal of Gastrointestinal Pharmacology and Therapeutics.The editors and authors of the articles submitted to the journal are grateful to the following

  14. Acknowledgments to reviewers of World Journal of Gastrointestinal Pharmacology and Therapeutics

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Many reviewers have contributed their expertise and time to the peer review,a critical process to ensure the quality of World Journal of Gastrointestinal Pharmacology and Therapeutics.The editors and authors of the articles submitted to the journal are grateful to the following

  15. Pharmacological treatment of opioid-induced hyperalgesia: a review of the evidence.

    Science.gov (United States)

    Ramasubbu, Chitra; Gupta, Anita

    2011-01-01

    Opioids are commonly used to treat moderate to severe pain. Opioid-induced hyperalgesia is a paradoxical response to opioid agonists resulting in an increased perception of pain rather than an antinociceptive effect. Even though there is a debate regarding its clinical relevance, it is becoming a challenge in both acute and chronic pain settings. The study of opioid-induced hyperalgesia is an emerging field with multiple challenges faced by investigators with regard to defining the diagnosis and characterizing the findings. The objective of this study was to review the preliminary evidence related to the treatment and management of opioid-induced hyperalgesia. Lack of data, small patient numbers, short-term follow-up, and variations in study design limited the review. With the literature on this subject being sparse, this study attempts to provide a preliminary look at the available data and to set the stage for an eventual meta-analysis. Case reports in the literature have shown success with various pharmacological interventions. Possible treatment regimens include ketamine, dextromethorphan, and nonsteroidal anti-inflammatory drugs (NSAIDs), opioid switching, amantadine, buprenorphine, α(2) agonists, and methadone. These agents are briefly discussed in this paper. Further well-designed, placebo-controlled trials are needed to assess the effectiveness of the interventions investigated in this review.

  16. Clinical and pharmacological management of endodontic flare-up

    OpenAIRE

    Harikaran Jayakodi; Sivakumar Kailasam; Karthick Kumaravadivel; Boopathi Thangavelu; Sabeena Mathew

    2012-01-01

    Knowledge of the causes of and mechanisms behind interappointment pain in endodontics is of utmost importance for the clinician to properly prevent or manage this undesirable condition. The causative factors of interappointment pain encompass mechanical, chemical, and microbial injuries to the pulp or periradicular tissues, which are induced or exacerbated during root canal treatment. This review article underlines the various treatment modalities for relief of pain and swelling in such situa...

  17. Pharmacological management of chronic lower back pain: a review of cost effectiveness.

    Science.gov (United States)

    Haas, Marion; De Abreu Lourenco, Richard

    2015-06-01

    Lower back pain is one of the most prevalent musculoskeletal conditions in the developed world and accounts for significant health services use. The American College of Physicians and the American Pain Society have published a joint clinical guideline that recommends providing patients with information on prognosis and self-management, the use of medications with proven benefits and, for those who do not improve, consideration be given to the use of spinal manipulation (for acute lower back pain only), interdisciplinary rehabilitation, exercise, acupuncture, massage, yoga, cognitive behavioural therapy or relaxation. The purpose of this review was to evaluate published economic evaluations of pharmacological management for chronic lower back pain. A total of seven studies were eligible for inclusion in there view. The quality of the economic evaluations undertaken in the included studies was not high. This was primarily because of the nature of the underlying clinical evidence, most of which did not come from rigorous randomised controlled trials (RCTs), and the manner in which it was incorporated into the economic evaluations. All studies provided reasonable information about what aspects of healthcare and other resource use were identified, measured and valued. However, the reporting of total costs was not uniform across studies. Measures of pain and disability were the most commonly collected outcomes measures. Two studies collected information on quality of life directly from participants while two studies modelled this information based on the literature. Future economic evaluations of interventions for chronic lower back pain, including pharmacological interventions, should be based on the results of well-conducted RCTs where the measurement of costs and outcomes such as quality of life and quality-adjusted life-years is included in the trial protocol, and which have a follow-up period sufficient to capture meaningful changes in both costs and outcomes. In

  18. International Union of Basic and Clinical Pharmacology. XCIV. Adhesion G protein-coupled receptors

    DEFF Research Database (Denmark)

    Hamann, Jörg; Aust, Gabriela; Araç, Demet;

    2015-01-01

    and Clinical Pharmacology Committee on Receptor Nomenclature and Drug Classification, proposes a unified nomenclature for Adhesion GPCRs. The new names have ADGR as common dominator followed by a letter and a number to denote each subfamily and subtype, respectively. The new names, with old and alternative...

  19. Clinical and pharmacological management of endodontic flare-up

    Directory of Open Access Journals (Sweden)

    Harikaran Jayakodi

    2012-01-01

    Full Text Available Knowledge of the causes of and mechanisms behind interappointment pain in endodontics is of utmost importance for the clinician to properly prevent or manage this undesirable condition. The causative factors of interappointment pain encompass mechanical, chemical, and microbial injuries to the pulp or periradicular tissues, which are induced or exacerbated during root canal treatment. This review article underlines the various treatment modalities for relief of pain and swelling in such situations, including premedication, drainage establishment, relief of occlusion, and intracanal and systemic medication.

  20. Placebo response of non-pharmacological and pharmacological trials in major depression: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    André Russowsky Brunoni

    Full Text Available BACKGROUND: Although meta-analyses have shown that placebo responses are large in Major Depressive Disorder (MDD trials; the placebo response of devices such as repetitive transcranial magnetic stimulation (rTMS has not been systematically assessed. We proposed to assess placebo responses in two categories of MDD trials: pharmacological (antidepressant drugs and non-pharmacological (device- rTMS trials. METHODOLOGY/PRINCIPAL FINDINGS: We performed a systematic review and meta-analysis of the literature from April 2002 to April 2008, searching MEDLINE, Cochrane, Scielo and CRISP electronic databases and reference lists from retrieved studies and conference abstracts. We used the keywords placebo and depression and escitalopram for pharmacological studies; and transcranial magnetic stimulation and depression and sham for non-pharmacological studies. All randomized, double-blinded, placebo-controlled, parallel articles on major depressive disorder were included. Forty-one studies met our inclusion criteria - 29 in the rTMS arm and 12 in the escitalopram arm. We extracted the mean and standard values of depression scores in the placebo group of each study. Then, we calculated the pooled effect size for escitalopram and rTMS arm separately, using Cohen's d as the measure of effect size. We found that placebo response are large for both escitalopram (Cohen's d - random-effects model - 1.48; 95%C.I. 1.26 to 1.6 and rTMS studies (0.82; 95%C.I. 0.63 to 1. Exploratory analyses show that sham response is associated with refractoriness and with the use of rTMS as an add-on therapy, but not with age, gender and sham method utilized. CONCLUSIONS/SIGNIFICANCE: We confirmed that placebo response in MDD is large regardless of the intervention and is associated with depression refractoriness and treatment combination (add-on rTMS studies. The magnitude of the placebo response seems to be related with study population and study design rather than the intervention

  1. Jatropha gossypiifolia L. (Euphorbiaceae: A Review of Traditional Uses, Phytochemistry, Pharmacology, and Toxicology of This Medicinal Plant

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    Juliana Félix-Silva

    2014-01-01

    Full Text Available Jatropha gossypiifolia L. (Euphorbiaceae, widely known as “bellyache bush,” is a medicinal plant largely used throughout Africa and America. Several human and veterinary uses in traditional medicine are described for different parts and preparations based on this plant. However, critical reviews discussing emphatically its medicinal value are missing. This review aims to provide an up-to-date overview of the traditional uses, as well as the phytochemistry, pharmacology, and toxicity data of J. gossypiifolia species, in view of discussing its medicinal value and potential application in complementary and alternative medicine. Pharmacological studies have demonstrated significant action of different extracts and/or isolated compounds as antimicrobial, anti-inflammatory, antidiarrheal, antihypertensive, and anticancer agents, among others, supporting some of its popular uses. No clinical trial has been detected to date. Further studies are necessary to assay important folk uses, as well as to find new bioactive molecules with pharmacological relevance based on the popular claims. Toxicological studies associated with phytochemical analysis are important to understand the eventual toxic effects that could reduce its medicinal value. The present review provides insights for future research aiming for both ethnopharmacological validation of its popular use and its exploration as a new source of herbal drugs and/or bioactive natural products.

  2. Alternative pharmacological strategies for adult ADHD treatment: a systematic review.

    Science.gov (United States)

    Buoli, Massimiliano; Serati, Marta; Cahn, Wiepke

    2016-01-01

    Adult Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition associated with high disability and frequent comorbidity. Current standard pharmacotherapy (methylphenidate and atomoxetine) improves ADHD symptoms in the short-term, but poor data were published about long-term treatment. In addition a number of patients present partial or no response to methylphenidate and atomoxetine. Research into the main database sources has been conducted to obtain an overview of alternative pharmacological approaches in adult ADHD patients. Among alternative compounds, amphetamines (mixed amphetamine salts and lisdexamfetamine) have the most robust evidence of efficacy, but they may be associated with serious side effects (e.g. psychotic symptoms or hypertension). Antidepressants, particularly those acting as noradrenaline or dopamine enhancers, have evidence of efficacy, but they should be avoided in patients with comorbid bipolar disorder. Finally metadoxine and lithium may be particularly suitable in case of comorbid alcohol misuse or bipolar disorder. PMID:26693882

  3. Pharmacological Treatments in Gambling Disorder: A Qualitative Review

    Directory of Open Access Journals (Sweden)

    Matteo Lupi

    2014-01-01

    Full Text Available Gambling disorder (GD is a psychiatric condition associated with both social and family costs; DSM-5 currently includes GD among addictive disorders. Despite the high burden of this condition, to date there are no treatment guidelines approved by Food and Drug Administration (FDA. Purpose of this paper is to offer a qualitative overview about the different pharmacologic agents used for the treatment of GD. Our analysis, conducted on a final selection of 75 scientific papers, demonstrates that a variety of pharmaceutical classes have been utilised, with different results. Published data, although limited by brief duration of the studies and small number of enrolled subjects, shows mixed evidence for serotonergic antidepressants, opioid antagonists, and mood stabilizers. Other compounds, such as glutamatergic agents and psychostimulants, deserve further studies.

  4. Pharmacological basis and clinical evidence of dabigatran therapy

    Directory of Open Access Journals (Sweden)

    Redondo Santiago

    2011-12-01

    Full Text Available Abstract Dabigatran is an emerging oral anticoagulant which is a direct inhibitor of thrombin activity. It has been approved in the European Union and the United States of America for the prevention of thrombosis after major orthopedic surgery. It has also been approved by the American Food and Drug Administration and the European Medicines Agency for the prevention of stroke in chronic atrial fibrillation. Dabigatran provides a stable anticoagulation effect without any need to perform periodical laboratory controls. Of note, there is a growing amount of clinical evidence which shows its safety and efficacy. For these reasons, dabigatran may suppose a revolution in oral anticoagulation. However, two important limitations remain. First, it is contraindicated in patients with end-stage renal disease. Second, there is no evidence of the prevention of thrombosis in mechanical heart valves.

  5. Review of systematic reviews about the efficacy of non-pharmacological interventions to improve sleep quality in insomnia.

    Science.gov (United States)

    De Niet, Gerrit J; Tiemens, Bea G; Kloos, Margot W; Hutschemaekers, Giel Jm

    2009-12-01

    Background  Insomnia is a very common condition in various populations. Non-pharmacological interventions might offer (safe) alternatives for hypnotics. Aim  To evaluate the evidence for efficacy from systematic reviews about non-pharmacological interventions to improve sleep quality in insomnia by a systematic review of systematic reviews and meta-analyses. Search strategy  Search strategies were conducted in the Database of Abstracts of Reviews of Effects (2002-July 2008), The Cochrane Database of Systematic Reviews (2000-July 2008) and PubMed (1950-July 2008). Sleep quality was the outcome measure of interest. Selection criteria  Systematic reviews about the efficacy of one or more non-pharmacological interventions for insomnia, concerning both adult and elderly populations, were included. Reviews that included studies performed among populations suffering with severe neurological or cognitive impairments or with addictive disorders were excluded. Data analysis  Relevant data were extracted. The quality of the reviews found was appraised by using the Overview Quality Assessment Questionnaire. The evidence was appraised and divided into six classes. Results and conclusions  Sixteen reviews about 17 interventions were included. Six reviews were of adequate methodological quality. Of these, only one provided an effect size: a moderate effect was found for music-assisted relaxation. Weak evidence indicating a large effect was found for multicomponent cognitive behavioural therapy, progressive muscle relaxation, stimulus control and 'behavioural only'. Weak evidence indicating a moderate effect was found for paradoxical intention. Finally, weak evidence indicating a moderate to large effect was found for relaxation training. Because of the lack of sufficient methodological quality and the lack of calculated effect sizes, most of the included reviews were not suitable for drawing rigorous conclusions about the effect of non-pharmacological interventions on

  6. Acknowledgments to reviewers of World Journal of Gastrointestinal Pharmacology and Therapeutics

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of World Journal of Gastrointestinal Pharmacology and Therapeutics.The editors and authors of the articles submitted to the journal are grateful to the following reviewers for evaluating the articles (including those published in this issue and those rejected for this issue) during the last editing time period.

  7. A Blended Learning Course Design in Clinical Pharmacology for Post-graduate Dental Students.

    Science.gov (United States)

    Rosenbaum, Paul-Erik Lillholm; Mikalsen, Oyvind; Lygre, Henning; Solheim, Einar; Schjøtt, Jan

    2012-01-01

    Postgraduate courses in clinical pharmacology are important for dentists to be updated on drug therapy and information related to their clinical practice, as well as knowledge of relevant adverse effects and interactions. A traditional approach with classroom delivery as the only method to teaching and learning has shortcomings regarding flexibility, individual learning preferences, and problem based learning (PBL) activities compared to online environments. This study examines a five week postgraduate course in clinical pharmacology with 15 hours of lectures and online learning activities, i.e. blended course design. Six postgraduate dental students participated and at the end of the course they were interviewed. Our findings emphasize that a blended learning course design can be successfully used in postgraduate dental education. Key matters for discussion were time flexibility and location convenience, change in teacher's role, rein-forced learning strategies towards professional needs, scarcity in online communication, and proposed future utilization of e-learning components. PMID:23248716

  8. Pharmacological Effects of Mangiferin

    Institute of Scientific and Technical Information of China (English)

    WEI Zhi-quan; DENG Jia-gang; YAN Li

    2011-01-01

    Mango leaves have been widely used in the clinical practice for thousands of years in traditional Chinese medicine.Mangiferin,an effective constituent in the mango leaves,has multiple pharmacological actions involved in some basic pathological processes,such as inflammation,oxidative injury,tumor growth,micro-organism infections,metabolic regulations,and immunological regulations.The pharmacological effects of mangiferin from some published data are reviewed in this article.

  9. Pharmacologic doses of nicotinamide in the treatment of inflammatory skin conditions: a review.

    Science.gov (United States)

    Niren, Neil M

    2006-01-01

    Various skin disorders with an inflammatory component often have been treated with steroids and/or oral antibiotics. However, long-term use of these agents has drawbacks: steroids may induce numerous serious side effects such as hypertension, immunosuppression, and osteoporosis, and overuse of oral antibiotics may contribute to the development of bacterial resistance, as well as to a host of nuisance side effects such as diarrhea, yeast infections, and photosensitivity. As a result, alternative oral treatments, such as nicotinamide, have been investigated. During the past 50 years, many clinical reports have identified nicotinamide as a beneficial agent in the treatment of a variety of inflammatory skin disorders; what's more, its exceptional safety profile at pharmacologic doses makes it a potentially ideal long-term oral therapy for patients with inflammatory skin diseases. A recent large study evaluating nicotinamide for the treatment of acne or rosacea has confirmed the potential benefits of oral nicotinamide as an alternative approach to managing inflammatory lesions associated with acne vulgaris and acne rosacea. This article reviews the substantial number of reports published over the past 50 years that document the clinical utility and safety of oral and topical formulations of nicotinamide for the treatment of a variety of inflammatory skin conditions.

  10. Gamma-hydroxybutyrate (GHB): a scoping review of pharmacology, toxicology, motives for use, and user groups.

    Science.gov (United States)

    Brennan, Rebekah; Van Hout, Marie Claire

    2014-01-01

    Gamma hydroxybutyrate (GHB) is a central nervous system depressant with euphoric and relaxant effects. Documentation of GHB prevalence and the underreporting of abuse remains problematic, given the availability of GHB and its precursors γ-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) and the ease of synthesis from kits available on the Internet. The continued abuse of and dependence on GHB, and associated fatalities, present an on-going public health problem. As the drug GHB remains an underresearched topic, a scoping review was chosen as a technique to map the available literature into a descriptive summarized account. PRISMA was used to assist in data retrieval, with subsequent data charting into three key themes (pharmacology and toxicology, outcomes, and user groups). Administered orally, GHB is dose-dependent and popular for certain uses (therapeutic, body enhancement, sexual assault) and amongst user sub groups (recreational party drug users, homosexual men). Despite the low prevalence of use in comparison to other club drugs, rising abuse of the drug is associated with dependence, withdrawal, acute toxicity, and fatal overdose. Clinical diagnosis and treatment is complicated by the co-ingestion of alcohol and other drugs. Limitations of the scoping review and potential for further research and harm reduction initiatives are discussed.

  11. [Discussion on strengthening yin of chinese herbs with bitter-flavor clinical traditional Chinese pharmacology noun terminology standardization research].

    Science.gov (United States)

    Liu, Xiao-Mei; Bao; Zhaorigetu; Zhuang, Xin-Ying; Que, Ling; Tian, Chang-Jiang

    2013-10-01

    Clinical traditional Chinese pharmacology is the subject that study of basic theory of traditional Chinese medicine, property of Chinese materia medica and clinical application. The study on the standardization research of the terminology of clinical traditional Chinese pharmacology is an important premise and foundation to standardization, modernization and internationalization, informationization construction of clinical traditional Chinese pharmacology and is also the important content of the subject construction. To provide some exploring ideas for clinical traditional Chinese pharmacology noun terminology standardization, this article elaborates the concept of strengthening Yin with bitter-flavor herbs in several aspects, such as connotation and the historical origin, the clinical application in the traditional, modern clinic application, and the modern basic research and so on.

  12. [Discussion on strengthening yin of chinese herbs with bitter-flavor clinical traditional Chinese pharmacology noun terminology standardization research].

    Science.gov (United States)

    Liu, Xiao-Mei; Bao; Zhaorigetu; Zhuang, Xin-Ying; Que, Ling; Tian, Chang-Jiang

    2013-10-01

    Clinical traditional Chinese pharmacology is the subject that study of basic theory of traditional Chinese medicine, property of Chinese materia medica and clinical application. The study on the standardization research of the terminology of clinical traditional Chinese pharmacology is an important premise and foundation to standardization, modernization and internationalization, informationization construction of clinical traditional Chinese pharmacology and is also the important content of the subject construction. To provide some exploring ideas for clinical traditional Chinese pharmacology noun terminology standardization, this article elaborates the concept of strengthening Yin with bitter-flavor herbs in several aspects, such as connotation and the historical origin, the clinical application in the traditional, modern clinic application, and the modern basic research and so on. PMID:24490579

  13. Prescribing knowledge in the light of undergraduate clinical pharmacology and therapeutics teaching in India: views of first-year postgraduate students

    Directory of Open Access Journals (Sweden)

    Upadhyaya P

    2012-06-01

    Full Text Available Prerna Upadhyaya,1 Vikas Seth,2 Monika Sharma,1 Mushtaq Ahmed,1 Vijay Vasant Moghe,1 Zafar Yab Khan,1 Vinay Kumar Gupta,1 Shipra Vikram Jain,1 Utkarsh Soni,1 Manohar Bhatia,1 Kumar Abhijit,1 Jaswant Goyal11Department of Pharmacology, Mahatma Gandhi Medical College, Jaipur, 2Department of Pharmacology, Hind Institute of Medical Sciences, Lucknow, IndiaObjectives: The study aimed to review the prescribing knowledge of first-year postgraduate doctors in a medical college in India, using the principles of good prescribing, to suggest strategies to improve rational prescribing, and to recommend what curriculum planners can do to accomplish this objective.Methods: Fifty first-year postgraduate doctors were asked to fill in a structured questionnaire that sought information regarding their undergraduate training in clinical pharmacology and therapeutics, prescribing habits, and commonly consulted drug information sources. Also, the questionnaire assessed any perceived deficiencies in their undergraduate clinical pharmacology teaching and sought feedback regarding improvement in the teaching.Results: Eighty-eight percent of residents said that they were taught prescription writing in undergraduate pharmacology teaching; 48% of residents rated their prescribing knowledge at graduation as average, 28% good, 4% excellent, 14% poor, and 4% very poor; 58% felt that their undergraduate training did not prepare them to prescribe safely, and 62% felt that their training did not prepare them to prescribe rationally. Fifty-eight percent of residents felt that they had some specific problems with writing a prescription during their internship training, while 92% thought that undergraduate teaching should be improved. Their suggestions for improving teaching methods were recorded.Conclusions: This study concludes that efforts are needed to develop a curriculum that encompasses important aspects of clinical pharmacology and therapeutics along with incorporation of

  14. ORIGINAL ARTICLE: Identification of Practical Pharmacology Skills Useful for Good Clinical Practice

    Directory of Open Access Journals (Sweden)

    V. Shilpa, R. Divya

    2012-07-01

    Full Text Available Background: Awareness about animal ethics is increasing everywhere. This increased awareness coupled with strict regulations discouraging the use of animals for routine experiments have tied the hands of many pharmacologists. They are now forced to develop alternative experiments without using animals. At present, there is acute need to come out with more innovative and useful practical exercises for pharmacology practical sessions. In this background, the present study was undertaken to develop the much-needed alternative experiments. Aims and Objective: To identify new pharmacological practical skills useful for good clinical practice. Material and Methods: A pre-tested questionnaire was administered to 110 doctors of different categories like house surgeons, postgraduate students, assistant professors and professors who are working in a tertiary care hospital. They were asked to give their suggestions regarding new pharmacology practical skills useful for good clinical practice. Statistical analysis: Responses of the participants to the questions asked were tabulated and analyzed. Suggestions given by them were listed out and studied. Results: Use of emergency drugs, dosage calculation, drugs used in pregnancy, case discussions and prescription writing exercises received a lot of support from the participants. Research methodology, cost calculation, animal experiments and interpretation of data of animal experiments did not receive support from the participants. Suggestions given by the participants regarding useful pharmacological skills belonged to the areas like therapeutics, safe use of drugs, recent advances, analysis of information given by the medical representatives and analyzing articles in journals for knowing the efficacy of drugs. Conclusion: Exercises relevant to the clinical practice, as identified in this study, can be introduced as practical pharmacology exercises. Steps are to be taken to highlight the importance of research

  15. Clinical review on RIT

    International Nuclear Information System (INIS)

    Full text of publication follows. Radioimmunotherapy (RIT) has been in use for more than 20 years and has progressed significantly with the discovery of new molecular targets, the development of new stable chelates, the humanization of monoclonal antibodies (MAbs), and the use of pre-targeting techniques. Today, 2 products targeting the CD20 antigen are approved in the treatment of B lymphoma: 131-tositumomab (Bexxar) and 90Y-ibritumomab tiuxetan (Zevalin). RIT can be applied in clinical practice for patients with relapsed or refractory follicular lymphoma (FL) or as consolidation after induction chemotherapy in front-line treatment in FL patients. Hematological toxicity is the major side effect of RIT and depends on bone marrow involvement and prior treatment. High-dose treatment, RIT as consolidation, RIT in first-line treatment, fractionated RIT and use of new humanized MAbs, in particular targeting CD22, showed promising results in B lymphoma. Targeting of antigens other than CD20 appears particularly interesting in the context of consolidation therapy after rituximab-based therapy. In other hemopathies, such as multiple myeloma (MM), RIT efficacy has been suggested in preclinical studies. Syndecan-1 is expressed in all MM and preclinical studies showed promising results using 213Bi-labeled anti-CD138. In solid tumors, more resistant to radiations and less accessible to large molecules such as MAbs, clinical efficacy remains limited. However, RIT used in minimal or small-size metastatic disease has shown promising clinical efficacy. Pre-targeting approaches have shown potential in increasing the therapeutic index of radiolabeled antibodies. Recently, a phase II clinical trial showed efficacy of anti-CEA pre targeted 131I-RIT in 42 progressive medullary thyroid carcinoma patients. Disease control according RECIST criteria (objective response + stabilization) was observed in 32 patients (76.2%), including one durable CR of at least 40 months and 31 durable

  16. A REVIEW ON PHYTOCHEMICAL AND PHARMACOLOGICAL OF EUCALYPTUS GLOBULUS: A MULTIPURPOSE TREE

    OpenAIRE

    Hardel Danendra kumar; Sahoo Laxmidhar

    2011-01-01

    The phytochemical and pharmacological studies reported in the present review confirm the therapeutic value of Eucalyptus globulus. The results of the above studies support the use of these plants for human and animal disease therapy and reinforce the importance of the ethnobotanical approach as a potential source of bioactive substances.

  17. Hibiscus sabdariffa L. - A phytochemical and pharmacological review

    OpenAIRE

    Da-Costa-Rocha, I.; Pischel, I; Heinrich, M.; Bonnlaender, B.; H. Sievers

    2014-01-01

    Hibiscus sabdariffa L. (Hs, roselle; Malvaceae) has been used traditionally as a food, in herbal drinks, in hot and cold beverages, as a flavouring agent in the food industry and as a herbal medicine. In vitro and in vivo studies as well as some clinical trials provide some evidence mostly for phytochemically poorly characterised Hs extracts. Extracts showed antibacterial, anti-oxidant, nephro- and hepato-protective, renal/diuretic effect, effects on lipid metabolism (anti-cholesterol), anti-...

  18. COMPREHENSIVE REVIEW ON ETHANOBOTANICAL USES, PHYTOCHEMISTRY AND PHARMACOLOGICAL PROPERTIES OF MELIA AZEDARACH LINN.

    Directory of Open Access Journals (Sweden)

    SABIRA SULTANA, HAFIZ MUHAMMAD ASIF, NAVEED AKHTAR, MUHAMMAD WAQAS, SAIF UR REHMAN

    2014-05-01

    Full Text Available Medicinal plants, since times immemorial, have been used in virtually all cultures for therapeutic purposes. The widespread use of herbal remedies and healthcare preparations obtained from commonly used traditional herbs and medicinal plants have been traced to the occurrence of natural products with medicinal properties. In the present review, an attempt has been made to collect the botanical, phytochemical, ethnomedicinal, pharmacological and toxicological information on Melia azedarach L. which is used traditionally as an anthelmintic, diuretic, emmenagouge, expectorant, vermifuge, used in piles, used as astringent, used in hysteria, leprosy, and in scrofula. Medicinally it has been shown to possess various pharmacological activities like antifungal, anti-malarial, antibacterial, hepatoprotective, anti-oxidant, anti-fertility, anthelmintic, antipyretic and cytotoxic activities. The available literature on the M. azedarach L. revealed that this plant contains many phytochemical constituents including alkaloids, terpenoids, saponins, glycosides, phenolic compounds, flavonoids and rutins. The aim of this article is to review those medicinal and pharmacological properties of M. azedarach which have been or still are being learned. The present review is therefore, an effort to give a detailed survey of the literature on its traditional, phytochemical and pharmacological properties.

  19. Pharmacological Preventions of Brain Injury Following Experimental Germinal Matrix Hemorrhage: an Up-to-Date Review.

    Science.gov (United States)

    Tang, Jun; Tao, Yihao; Jiang, Bing; Chen, Qianwei; Hua, Feng; Zhang, John; Zhu, Gang; Chen, Zhi

    2016-02-01

    Germinal matrix hemorrhage (GMH) is defined as the rupture of immature blood vessels in the subependymal zone of premature infants with significant mortality and morbidity. Considering the notable social and ecological stress brought by GMH-induced brain injury and sequelae, safe and efficient pharmacological preventions are badly needed. Currently, several appropriate animal models are available to mimic the clinical outcomes of GMH in human patients. In the long run, hemorrhagic strokes are the research target. Previously, we found that minocycline was efficient to alleviate GMH-induced brain edema and posthemorrhagic hydrocephalus (PHH) in rats, which may be closely related to the activation of cannabinoid receptor 2 (CB2R). However, how the two molecules correlate and the underlined molecular pathway remain unknown. To extensively understand current experimental GMH treatment, this literature review critically evaluates existing therapeutic strategies, potential treatments, and potentially involved molecular mechanisms. Each strategy has its own advantages and disadvantages. Some of the mechanisms are still controversial, requiring an increasing number of animal experiments before the therapeutic strategy would be widely accepted.

  20. PUNICA GRANATUM: A REVIEW ON PHARMACOLOGICAL AND THERAPEUTIC PROPERTIES

    Directory of Open Access Journals (Sweden)

    Neelam Arun* and D. P. Singh

    2012-05-01

    Full Text Available A wide range of medicinal plant parts is used as raw drugs and they possess varied medicinal properties. The different parts used as raw drugs include root, stem, flower, fruit, twigs exudates and modified plant organs. The Punica granatum is a native shrub of occidental Asia and Mediterranean Europe that has a rich history of traditional use in medicine. For centuries, the barks, leaves, flowers, fruits, and seeds of this plant have been used to treat various diseases. The aim of this present review is to throw light on the therapeutic utility of various parts of pomegranate.

  1. Hibiscus sabdariffa L. - a phytochemical and pharmacological review.

    Science.gov (United States)

    Da-Costa-Rocha, Inês; Bonnlaender, Bernd; Sievers, Hartwig; Pischel, Ivo; Heinrich, Michael

    2014-12-15

    Hibiscus sabdariffa L. (Hs, roselle; Malvaceae) has been used traditionally as a food, in herbal drinks, in hot and cold beverages, as a flavouring agent in the food industry and as a herbal medicine. In vitro and in vivo studies as well as some clinical trials provide some evidence mostly for phytochemically poorly characterised Hs extracts. Extracts showed antibacterial, anti-oxidant, nephro- and hepato-protective, renal/diuretic effect, effects on lipid metabolism (anti-cholesterol), anti-diabetic and anti-hypertensive effects among others. This might be linked to strong antioxidant activities, inhibition of α-glucosidase and α-amylase, inhibition of angiotensin-converting enzymes (ACE), and direct vaso-relaxant effect or calcium channel modulation. Phenolic acids (esp. protocatechuic acid), organic acid (hydroxycitric acid and hibiscus acid) and anthocyanins (delphinidin-3-sambubioside and cyanidin-3-sambubioside) are likely to contribute to the reported effects. More well designed controlled clinical trials are needed which use phytochemically characterised preparations. Hs has an excellent safety and tolerability record. PMID:25038696

  2. The Cerebrospinal Fluid in Severe Pain Conditions : Clinical, Pharmacological and Proteomic Aspects

    OpenAIRE

    Bäckryd, Emmanuel

    2015-01-01

    The treatment of both cancer pain and non-cancer chronic pain is still suboptimal. The overall aim of this PhD thesis was to conduct translational pain research at the interface between clinical pain medicine and the field of human proteomics, using the practice of intrathecal analgesia at our institution as a starting point. Hence, the cerebrospinal fluid (CSF) is at the centre of the present dissertation, both as a target for infusing analgesics (Papers I and II – clinical and pharmacologic...

  3. Medicinal uses, phytochemistry and pharmacology of Picralima nitida (Apocynaceae) in tropical diseases:A review

    Institute of Scientific and Technical Information of China (English)

    Osayemwenre Erharuyi; Abiodun Falodun; Peter Langer

    2014-01-01

    Picralima nitida Durand and Hook, (fam. Apocynaceae) is a West African plant with varied applications in African folk medicine. Various parts of the plant have been employed ethnomedicinally as remedy for fever, hypertension, jaundice, dysmenorrheal, gastrointestinal disorders and malaria. In order to reveal its full pharmacological and therapeutic potentials, the present review focuses on the current medicinal uses, phytochemistry, pharmacological and toxicological activities of this species. Literature survey on scientific journals, books as well as electronic sources have shown the isolation of alkaloids, tannins, polyphenols and steroids from different parts of the plant, pharmacological studies revealed that the extract or isolated compounds from this species posses analgesic, anti-inflammatory, hypoglyceamic, hypotensive, antiplasmodial, antimicrobial, antiulcer and antitumorigenic activities. Results from various scientific investigations to date have revealed the potential of the extract from the plant or isolated compounds for use in the treatment and prevention of various kinds of human diseases. However, further studies on the extracts and pure compounds from this species is required to completely assess its phytochemical, pharmacological and toxicological profile as well as the mechanism of action behind these pharmacological activities exhibited by the compounds isolated from this species.

  4. Non-pharmacological strategies to decrease anxiety in cardiac catheterization: integrative review

    Directory of Open Access Journals (Sweden)

    Natany da Costa Ferreira

    2015-12-01

    Full Text Available ABSTRACT Objective: to identify and review the literature on non-pharmacological strategies used for reducing anxiety in patients receiving cardiac catheterization. Method: this study was an integrative literature review. The research was conducted using the databases LILACS, SciELO, Medline (through BVS and PubMed and Scopus. Studies were analyzed according to their objective, method, instruments used for evaluating patients' anxiety, and the results obtained. Results: the most used strategy for reducing anxiety in patients receiving cardiac catheterization was music therapy. However, no study identifying the most appropriate time for this intervention (before, during and/or after the procedure was found. Other strategies identified in this review were educational videos, massage, and palm therapy. Conclusion: the results found suggest that anxiety can be reduced using non-pharmacological strategies.

  5. Ocular Syphilis: a Clinical Review.

    Science.gov (United States)

    Woolston, Sophie L; Dhanireddy, Shireesha; Marrazzo, Jeanne

    2016-11-01

    While ocular syphilis is not a new phenomenon, recent increased rates of new diagnoses, especially in human immunodeficiency virus (HIV)-infected persons and men who have sex with men, have sparked a new interest in an old disease. This article will review the clinical presentation, diagnosis, and treatment of ocular syphilis, and provide guidance on management. PMID:27686678

  6. A review of the pharmacological effects of Arctium lappa (burdock).

    Science.gov (United States)

    Chan, Yuk-Shing; Cheng, Long-Ni; Wu, Jian-Hong; Chan, Enoch; Kwan, Yiu-Wa; Lee, Simon Ming-Yuen; Leung, George Pak-Heng; Yu, Peter Hoi-Fu; Chan, Shun-Wan

    2011-10-01

    Arctium lappa, commonly known as burdock, is being promoted/recommended as a healthy and nutritive food in Chinese societies. Burdock has been used therapeutically in Europe, North America and Asia for hundreds of years. The roots, seeds and leaves of burdock have been investigated in view of its popular uses in traditional Chinese medicine (TCM). In this review, the reported therapeutic effects of the active compounds present in the different botanical parts of burdock are summarized. In the root, the active ingredients have been found to "detoxify" blood in terms of TCM and promote blood circulation to the skin surface, improving the skin quality/texture and curing skin diseases like eczema. Antioxidants and antidiabetic compounds have also been found in the root. In the seeds, some active compounds possess anti-inflammatory effects and potent inhibitory effects on the growth of tumors such as pancreatic carcinoma. In the leaf extract, the active compounds isolated can inhibit the growth of micro-organisms in the oral cavity. The medicinal uses of burdock in treating chronic diseases such as cancers, diabetes and AIDS have been reported. However, it is also essential to be aware of the side effects of burdock including contact dermatitis and other allergic/inflammatory responses that might be evoked by burdock.

  7. "Êxtase": revisão farmacológica "Ecstasy": a pharmacological review

    Directory of Open Access Journals (Sweden)

    Maristela Ferigolo

    1998-10-01

    Full Text Available Neste estudo fez-se uma revisão bibliográfica sobre a 3,4- metilenodioximetan-fetamina (MDMA, mais conhecida como "êxtase", uma droga em expansão de abuso entre os jovens. Descreve-se o histórico, desde sua síntese até seu uso inicial como auxiliar em psicoterapia e, mais recentemente, como droga de abuso. Apresenta-se o perfil de uso em outros países, tentando prever o possível padrão de uso no Brasil, onde já se iniciou o abuso. O detalhamento sobre a farmacocinética da MDMA visa a justificar as conseqüências sobre a atividade farmacológica e toxicológica. Resumem-se as manifestações clínicas de toxicidade a curto e a médio prazo, descrevendo-se os efeitos na intoxicação grave com o "êxtase". São apresentados os estudos dos mecanismos de ação no sentido de justificar seus efeitos tóxicos psíquicos e físicos, detalhar os mecanismos pelos quais a droga é auto-administrada e as possibilidades terapêuticas para reverter os efeitos.A literature review on 3,4 methylenedioxymethanphetaneine (MDMA,. known as ecstasy, a drug with increased use among youngsters is presented. The history from its synthesis, up to its use as an adjunct to psychotherapy and, more recently, as a drug of abuse, is described. The possible pattern of abuse in several countries is reviewed with the objective of predicting what might happen in Brazil, where some reports of abuse have already appeared. The pharmacokinetics of MDMA is also reviewed to explain the consequences for pharmacological activity, toxicology and adverse effects. The clinical outcome of both short and middle-term intoxication is summarized and the clinical symptoms of severe intoxication with ecstasy, are described. The studies undertaken on its mechanism of action are detailed to explain its toxic psychiatric and physical side effects, to explain the mechanism of self-administration of the drug and to propose a therapeutic possibility of treating intoxication.

  8. Thiopurine treatment in inflammatory bowel disease: clinical pharmacology and implication of pharmacogenetically guided dosing.

    Science.gov (United States)

    Teml, Alexander; Schaeffeler, Elke; Herrlinger, Klaus R; Klotz, Ulrich; Schwab, Matthias

    2007-01-01

    This review summarises clinical pharmacological aspects of thiopurines in the treatment of chronic inflammatory bowel disease (IBD). Current knowledge of pharmacogenetically guided dosing is discussed for individualisation of thiopurine therapy, particularly to avoid severe adverse effects. Both azathioprine and mercaptopurine are pro-drugs that undergo extensive metabolism. The catabolic enzyme thiopurine S-methyltransferase (TPMT) is polymorphically expressed, and currently 23 genetic variants have been described. On the basis of an excellent phenotype-genotype correlation for TPMT, genotyping has become a safe and reliable tool for determination of a patient's individual phenotype. Thiopurine-related adverse drug reactions are frequent, ranging from 5% up to 40%, in both a dose-dependent and -independent manner. IBD patients with low TPMT activity are at high risk of developing severe haematotoxicity if pharmacogenetically guided dosing is not performed. Based on several cost-benefit analyses, assessment of TPMT activity is recommended prior to thiopurine therapy in patients with IBD. The underlying mechanisms of azathioprine/mercaptopurine-related hepatotoxicity, pancreatitis and azathioprine intolerance are still unknown. Although the therapeutic response appears to be related to 6-thioguanine nucleotide (6-TGN) concentrations above a threshold of 230-260 pmol per 8 x 10(8) red blood cells, at present therapeutic drug monitoring of 6-TGN can be recommended only to estimate patients' compliance.Drug-drug interactions between azathioprine/mercaptopurine and aminosalicylates, diuretics, NSAIDs, warfarin and infliximab are discussed. The concomitant use of allopurinol without dosage adjustment of azathioprine/mercaptopurine leads to clinically relevant severe haematotoxicity due to elevated thiopurine levels. Several studies indicate that thiopurine therapy in IBD during pregnancy is safe. Thus, azathioprine/mercaptopurine should not be withdrawn in strictly

  9. [Clinical-pharmacological aspects to accelerate the development process from the preclinical to the clinical phase/2nd communication: promising strategies].

    Science.gov (United States)

    Kuhlmann, Jochen

    2004-01-01

    To improve the transition from research to development a critical evaluation of the individual project by research and disease area teams is required to include input from pharmacology, toxicology, pharmacokinetics, galenics, clinical pharmacology, clinical as well as regulatory experts and marketing. Decisions on the individual development strategy should be made prior to the start of development and all projects should be reviewed at predefined stages throughout the product development life cycle. This ensures consistency of decision-making not only during the development of individual products but throughout the entire development pipeline. Studies in the exploratory stage of drug development should be designed for decision making in contrast to later clinical trials in the confirmatory stage that require power for proof-of-safety and proof-of-efficacy. The more thorough and profound studies have been carried out during this exploratory stage of drug development, the earlier a decision can be made on the continuation or discontinuation of further development, thus saving development time and money and assessing and considerably reducing the risk for the patients and increasing the success rate of the project in the later confirmatory effectiveness trial with an adequate number of subjects receiving the new therapy under typical conditions of use. Strategies which may be helpful to improve the quality of decisions in drug discovery and drug development are: discovery experiments should be done to critically evaluate the compound, the "killer" experiments should be done as early as possible, continuous effort on preclinical disease models is necessary to improve predictability of efficacy in patients ("humanized" research): genomic technology should be used to identify novel, disease-related targets and to characterise preclinical test systems, improvement of knowledge and experience concerning the relevance of new technologies for the clinical picture, genotyping

  10. [Clinical-pharmacological aspects to accelerate the development process from the preclinical to the clinical phase/2nd communication: promising strategies].

    Science.gov (United States)

    Kuhlmann, Jochen

    2004-01-01

    To improve the transition from research to development a critical evaluation of the individual project by research and disease area teams is required to include input from pharmacology, toxicology, pharmacokinetics, galenics, clinical pharmacology, clinical as well as regulatory experts and marketing. Decisions on the individual development strategy should be made prior to the start of development and all projects should be reviewed at predefined stages throughout the product development life cycle. This ensures consistency of decision-making not only during the development of individual products but throughout the entire development pipeline. Studies in the exploratory stage of drug development should be designed for decision making in contrast to later clinical trials in the confirmatory stage that require power for proof-of-safety and proof-of-efficacy. The more thorough and profound studies have been carried out during this exploratory stage of drug development, the earlier a decision can be made on the continuation or discontinuation of further development, thus saving development time and money and assessing and considerably reducing the risk for the patients and increasing the success rate of the project in the later confirmatory effectiveness trial with an adequate number of subjects receiving the new therapy under typical conditions of use. Strategies which may be helpful to improve the quality of decisions in drug discovery and drug development are: discovery experiments should be done to critically evaluate the compound, the "killer" experiments should be done as early as possible, continuous effort on preclinical disease models is necessary to improve predictability of efficacy in patients ("humanized" research): genomic technology should be used to identify novel, disease-related targets and to characterise preclinical test systems, improvement of knowledge and experience concerning the relevance of new technologies for the clinical picture, genotyping

  11. Ficus deltoidea Jack: A Review on Its Phytochemical and Pharmacological Importance

    Directory of Open Access Journals (Sweden)

    Hamidun Bunawan

    2014-01-01

    Full Text Available Ficus deltoidea Jack (Moraceae has had a long history of use in traditional medicine among the Malays to alleviate and heal ailments such as sores, wounds, and rheumatism and as an after-birth tonic and an antidiabetic drug. Modern pharmacological studies demonstrated that this plant has a wide variety of beneficial attributes for human health. Despite its importance, a review of this species has not been published in the scientific literature to date. Here, we review and summarize the historic and current literature concerning the botany, traditional uses, phytochemistry, pharmacological effects, and toxicity of this wonder plant. This summary could be beneficial for future research aiming to exploit the therapeutic potential of this useful, medicinal species.

  12. The Hedyotis diffusa Willd. (Rubiaceae): A Review on Phytochemistry, Pharmacology, Quality Control and Pharmacokinetics

    OpenAIRE

    Rui Chen; Jingyu He; Xueli Tong; Lan Tang; Menghua Liu

    2016-01-01

    Hedyotis diffusa Willd (H. diffusa) is a well-known Chinese medicine with a variety of activities, especially its anti-cancer effect in the clinic. Up to now, 171 compounds have been reported from H. diffusa, including 32 iridoids, 26 flavonoids, 24 anthraquinones, 26 phenolics and their derivatives, 50 volatile oils and 13 miscellaneous compounds. In vitro and in vivo studies show these phytochemicals and plant extracts to exhibit a range of pharmacological activities of anti-cancer, antioxi...

  13. Prevention of fatigue and insomnia in shift workers—a review of non-pharmacological measures

    OpenAIRE

    Richter, Kneginja; Acker, Jens; Adam, Sophia; Niklewski, Guenter

    2016-01-01

    Background Excessive fatigue and insomnia are common among shift workers and can lead to negative effects such as reduced work performance, processing errors, accidents at work, absenteeism, reduced quality of life, and symptoms of depression. Moreover, work in rotating shifts can be a risk factor for different somatic and psychiatric diseases and may contribute to poor health, especially in elder adults and women. This review aims to show non-pharmacological preventive measures against fatig...

  14. COMPREHENSIVE REVIEW ON ETHANOBOTANICAL USES, PHYTOCHEMISTRY AND PHARMACOLOGICAL PROPERTIES OF MELIA AZEDARACH LINN.

    OpenAIRE

    SABIRA SULTANA, HAFIZ MUHAMMAD ASIF, NAVEED AKHTAR, MUHAMMAD WAQAS, SAIF UR REHMAN

    2014-01-01

    Medicinal plants, since times immemorial, have been used in virtually all cultures for therapeutic purposes. The widespread use of herbal remedies and healthcare preparations obtained from commonly used traditional herbs and medicinal plants have been traced to the occurrence of natural products with medicinal properties. In the present review, an attempt has been made to collect the botanical, phytochemical, ethnomedicinal, pharmacological and toxicological information on Melia azedarach L. ...

  15. Foeniculum vulgare Mill: A Review of Its Botany, Phytochemistry, Pharmacology, Contemporary Application, and Toxicology

    OpenAIRE

    Shamkant B. Badgujar; Patel, Vainav V.; Bandivdekar, Atmaram H.

    2014-01-01

    Foeniculum vulgare Mill commonly called fennel has been used in traditional medicine for a wide range of ailments related to digestive, endocrine, reproductive, and respiratory systems. Additionally, it is also used as a galactagogue agent for lactating mothers. The review aims to gather the fragmented information available in the literature regarding morphology, ethnomedicinal applications, phytochemistry, pharmacology, and toxicology of Foeniculum vulgare. It also compiles available scienti...

  16. Folk uses and pharmacological properties of Casearia sylvestris: a medicinal review

    OpenAIRE

    Paulo Michel P Ferreira; Costa-Lotufo, Leticia V.; Manoel O. Moraes; Francisco W.A. Barros; Aline M. A. MARTINS; Alberto J. Cavalheiro; Vanderlan S. Bolzani; Andre G. Santos; Claudia Pessoa

    2011-01-01

    Folk uses and scientific investigations have highlighted the importance of Casearia sylvestris extracts and their relevant bioactive potential. The aim of this work was to review the pharmacological properties of C. sylvestris, emphasizing its anti-ulcer, anti-inflammatory, anti-ophidian and antitumor potentialities. Ethanolic extracts and essential oil of their leaves have antiulcerogenic activity and reduce gastric volume without altering the stomach pH, which corroborates their consumption...

  17. Wrightia tinctoria R. Br.-a review on its ethnobotany, pharmacognosy and pharmacological profile

    OpenAIRE

    Mahendra S. Khyade; Nityanand P. Vaikos

    2014-01-01

    Different parts of Wrightia tinctoria R. Br. (Apocynaceae) (W. tinctoria), have been extensively used in Indian systems of medicine such as Ayurveda, Siddha and Unani for the treatment of jaundice, malaria, psoriasis and many other ailments. The present review has been primed to describe the existing data on the information on the traditional uses, botany, pharmacognosy, phytochemical constituents, pharmacological activities and toxicology of W. tinctoria. The information was g...

  18. Pharmacological and Other Interventions for Head and Neck Cancer Pain: a Systematic Review

    Directory of Open Access Journals (Sweden)

    Patrick B. Trotter

    2012-12-01

    Full Text Available Objectives: Pain is a common complication in head and neck cancer. The aim of this paper is to evaluate the evidence from randomised control trials investigating pharmacological and non-pharmacological methods of pain management in head and neck cancer. Material and Methods: Medline, Embase and the Cochrane library databases were searched. Squamous cell carcinomas of the head and neck excluding nasopharyngeal and salivary gland cancers were included. The limits were “human” and “randomised clinical trials”. A quality assessment was carried out. Results: 13 studies were included with a total of 644 participants. The primary outcome for most of these papers was pain control post-treatment. Levels of bias varied between the studies. Majority (12 out of the 13 studies reported intervention to be superior to the control or standard therapy in pain management. Only 46% of the studies were carried out on an intention to treat basis. Two studies reported high dropout rates, with one at 66%. Conclusions: There is insufficient evidence from randomised clinical trials to suggest an optimal pharmacological intervention for head and neck cancer pain post-treatment. Further high quality randomised clinical trials should be conducted to develop an optimal management strategy for head and neck cancer pain.

  19. Phytochemistry and pharmacology of ornamental gingers, Hedychium coronarium and Alpinia purpurata:a review

    Institute of Scientific and Technical Information of China (English)

    Eric Wei Chiang Chan; Siu Kuin Wong

    2015-01-01

    In this review, the phytochemistry and pharmacology of two ornamental gingers, Hedychium coronarium (butterfly ginger) and Alpinia purpurata (red ginger), are updated, and their botany and uses are described. Flowers of H. coronarium are large, showy, white, yel ow or white with a yel ow centre and highly fragrant. Inflorescences of A. purpurata are erect spikes with attractive red or pink bracts. Phytochemical investigations on the rhizomes of H. coronarium generated research interest global y. This resulted in the isolation of 53 labdane-type diterpenes, with little work done on the leaves and flowers. Pharmacological properties of H. coronarium included antioxidant, antibacterial, antifungal, cytotoxic, chemopreventive, anti-al ergic, larvicidal, anthelminthic, analgesic, anti-inflammatory, anti-urolithiatic, anti-angiogenic, neuro-pharmacological, fibrinogenolytic, coagulant and hepatoprotective activities. On the contrary, little is known on the phytochemistry of A. purpurata with pharmacological properties of antioxidant, antibacterial, larvicidal, cytotoxic and vasodilator activities reported in the leaves and rhizomes. There is much disparity in terms of research effort within and between these two ornamental gingers.

  20. The influence of clinical and pharmacological factors on enuresis treatment with imipramine.

    OpenAIRE

    Fernández de Gatta, M M; P. Galindo; Rey, F.; Gutierrez, J; Tamayo, M; García, M. J.; Domínguez-Gil, A

    1990-01-01

    1. The aim of this study has been to evaluate the response to imipramine treatment in enuretic children through the use of a series of clinical and pharmacological variables and by applying a multivariate (principal components) analysis technique. 2. The study was carried out on 146 children whose ages ranged from 5 to 14 years, and who received variable doses of imipramine (12.5 to 100 mg day-1). 3. The quantitative variables analyzed were: drug dosage, serum levels of imipramine and its met...

  1. International Union of Basic and Clinical Pharmacology. XC. multisite pharmacology: recommendations for the nomenclature of receptor allosterism and allosteric ligands.

    Science.gov (United States)

    Christopoulos, Arthur; Changeux, Jean-Pierre; Catterall, William A; Fabbro, Doriano; Burris, Thomas P; Cidlowski, John A; Olsen, Richard W; Peters, John A; Neubig, Richard R; Pin, Jean-Philippe; Sexton, Patrick M; Kenakin, Terry P; Ehlert, Frederick J; Spedding, Michael; Langmead, Christopher J

    2014-10-01

    Allosteric interactions play vital roles in metabolic processes and signal transduction and, more recently, have become the focus of numerous pharmacological studies because of the potential for discovering more target-selective chemical probes and therapeutic agents. In addition to classic early studies on enzymes, there are now examples of small molecule allosteric modulators for all superfamilies of receptors encoded by the genome, including ligand- and voltage-gated ion channels, G protein-coupled receptors, nuclear hormone receptors, and receptor tyrosine kinases. As a consequence, a vast array of pharmacologic behaviors has been ascribed to allosteric ligands that can vary in a target-, ligand-, and cell-/tissue-dependent manner. The current article presents an overview of allostery as applied to receptor families and approaches for detecting and validating allosteric interactions and gives recommendations for the nomenclature of allosteric ligands and their properties.

  2. Clinical Pharmacology of Paracetamol in Neonates: A Review

    Directory of Open Access Journals (Sweden)

    Gian Maria Pacifici, MD, PhD

    2015-12-01

    Paracetamol clearance is lower in neonates than in children and adults. After metabolic conversion, paracetamol is subsequently eliminated by the renal route. The main metabolic conversions are conjugation with glucuronic acid and with sulphate. In the urine of neonates sulphated paracetamol concentration is higher than the glucuronidated paracetamol level, suggesting that sulfation prevails over glucuronidation in neonates. A loading dose of 20 mg/kg followed by 10 mg/kg every 6 hours of intravenous paracetamol is suggested to achieve a compartment concentration of 11 mg/L in late preterm and term neonates. Aiming for the same target concentration, oral doses are similar with rectal administration of 25 to 30 mg/kg/d in preterm neonates of 30 weeks’ gestation, 45 mg/kg/d in preterm infants of 34 weeks’ gestation, and 60 mg/kg/d in term neonates are suggested. The above-mentioned paracetamol doses for these indications (pain, fever are well tolerated in neonates, but do not result in a significant increase in liver enzymes, and do not affect blood pressure and have limited effects on heart rate. In contrast, the higher doses suggested in extreme preterm neonates to induce closure of the patent ductus arteriosus have not yet been sufficiently evaluated regarding efficacy or safety. Moreover, focussed pharmacovigilance to explore the potential causal association between paracetamol exposure during perinatal life and infancy and subsequent atopy is warranted.

  3. A review of the chemical and pharmacological aspects of the genus marrubium.

    Science.gov (United States)

    Meyre-Silva, Christiane; Cechinel-Filho, Valdir

    2010-01-01

    The genus Marrubium (Lamiaceae) is comprised of about forty species, distributed in Europe, Asia and Brazil. Some species are traditionally used to treat various diseases, including asthma, pulmonary infections, inflammation and hypotension, as cholagogues and sedative agents, and for pain relief. A literature review on the chemical and biological aspects of these plants indicates antimicrobial activity against gram positive bacteria, analgesic properties, and anti-hypertensive, antidiabetic, antioxidant properties, among others, particularly related to the presence of diterpenes, sterols, phenylpropanoids and flavonoids. This review shows the main chemical and pharmacological aspects of the genus Marrubium, with emphasis on M. vulgare, which grows in Brazil and has been studied by us and other authors.

  4. Pharmacologic Comparison of Clinical Neutral Endopeptidase Inhibitors in a Rat Model of Acute Secretory Diarrhea.

    Science.gov (United States)

    Griggs, David W; Prinsen, Michael J; Oliva, Jonathan; Campbell, Mary A; Arnett, Stacy D; Tajfirouz, Deena; Ruminski, Peter G; Yu, Ying; Bond, Brian R; Ji, Yuhua; Neckermann, Georg; Choy, Robert K M; de Hostos, Eugenio; Meyers, Marvin J

    2016-05-01

    Racecadotril (acetorphan) is a neutral endopeptidase (NEP) inhibitor with known antidiarrheal activity in animals and humans; however, in humans, it suffers from shortcomings that might be improved with newer drugs in this class that have progressed to the clinic for nonenteric disease indications. To identify potentially superior NEP inhibitors with immediate clinical utility for diarrhea treatment, we compared their efficacy and pharmacologic properties in a rat intestinal hypersecretion model. Racecadotril and seven other clinical-stage inhibitors of NEP were obtained or synthesized. Enzyme potency and specificity were compared using purified peptidases. Compounds were orally administered to rats before administration of castor oil to induce diarrhea. Stool weight was recorded over 4 hours. To assess other pharmacologic properties, select compounds were orally administered to normal or castor oil-treated rats, blood and tissue samples collected at multiple time points, and active compound concentrations determined by mass spectroscopy. NEP enzyme activity was measured in tissue homogenates. Three previously untested clinical NEP inhibitors delayed diarrhea onset and reduced total stool output, with little or no effect on intestinal motility assessed by the charcoal meal test. Each was shown to be a potent, highly specific inhibitor of NEP. Each exhibited greater suppression of NEP activity in intestinal and nonintestinal tissues than did racecadotril and sustained this inhibition longer. These results suggest that newer clinical-stage NEP inhibitors originally developed for other indications may be directly repositioned for treatment of acute secretory diarrhea and offer advantages over racecadotril, such as less frequent dosing and potentially improved efficacy. PMID:26907621

  5. Otostegia persica (Lamiaceae: A review on its ethnopharmacology, phytochemistry, and pharmacology

    Directory of Open Access Journals (Sweden)

    Zahra Sadeghi

    2014-02-01

    Full Text Available Abstract Objective: The current study summarizes the updated information concerning the ethnopharmacology, Phytochemistry, and pharmacology of Otostegia persica Boiss. (Lamiaceae, an endemic medicinal plant in south and southeast of Iran. Materials and Methods: Information was collected through bibliographic investigation from scientific journals, books, theses, reports, and electronic search (databases SCOPUS, Google Scholar, Web of Science, and Science Direct. Moreover, documentation from unpublished resources and ethnobotanical surveys has been used. The present review covers the literature available from 2003 to 2013. Results: In traditional systems of medicine, this plant is reputed for treating diabetes, arthritis, gastric discomfort, headache, rheumatism, sedative activities, regulating blood pressure, and hyperlipidemia. Phytochemical screening of active components and mineral element evaluation of this species have been reported. Several types of diterpenoids and flavonols including morin, kaempferol, and quercetin are identified from the plant. Most of the pharmacological activity of this plant resides in its flavonoid fraction which causes antimicrobial and antioxidant activities. Various pharmacological studies on O. persica show antimicrobial, antioxidant, anti-inflammatory, anti-diabetic, anti-aphid, and hepatoprotective activities. Conclusion: Being an endemic plant of Iran, this species is an important medicinal herb which can be used for various purposes. This review might be helpful for scientists and researchers to find new chemical entities responsible for its claimed traditional uses and discover new lead compounds for diseases mentioned.

  6. Medicinal Uses, Phytochemistry, and Pharmacology of Origanum onites (L.): A Review.

    Science.gov (United States)

    Tepe, Bektas; Cakir, Ahmet; Sihoglu Tepe, Arzuhan

    2016-05-01

    Origanum onites L., known as Turkish oregano, has great traditional, medicinal, preservative, and commercial importance. It is used for the treatment of several kinds of ailments, such as gastrointestinal disorders, diabetes, high cholesterol, leukemia, bronchitis, etc. In this review, traditional use, phytochemistry, and pharmacology of O. onites reported between 1988 and 2014 were discussed. This review was prepared based on literature survey on scientific journals and books from libraries and electronic sources, such as Web of Science, PubMed, Scopus, Google Scholar, etc. All databases were searched up to June 2014. Several different classes of terpenoids, triterpene acids, phenolic acids, hydroquinones, flavonoids, hydrocarbons, sterols, pigments, fatty acids, tocopherols, and inorganic compounds were detected mainly in the aerial parts of this plant. Pharmacological studies revealed that extracts obtained from several solvents and individual compounds exhibited antimicrobial, antiviral, antioxidant, insecticidal, anticancer, hepatoprotective, genotoxic, antidiabetic, cholinesterase inhibitory, anti-inflammatory, analgesic activities, etc. O. onites, in general, exhibited remarkable activity potential in almost all test systems. The results of toxicity studies indicated that O. onites did not show any significant toxicity and mutagenicity on Drosophila and Salmonella. Toxicity of the extracts/essential oils and also individual compounds should be evaluated on mammalian cells to ensure their safety. The bioactivity of individual compounds aside from terpenoids should also be assessed in detail. Additionally, mode of action for the bioactive compounds should be evaluated to understand the complex pharmacological effects of these phytochemicals. PMID:27062715

  7. Traditional uses, phytochemistry and pharmacology of Clerodendron glandulosum Coleb-a review

    Institute of Scientific and Technical Information of China (English)

    Ravirajsinh N Jadeja; Menaka C Thounaojam; Thouchom Brojendro Singh; Ranjitsinh V Devkar; AV Ramachandran

    2012-01-01

    Present review for the first time provides a complete botanical description and information on ethnomedicinal uses of Clerodendron glandulosum.Coleb (CG;Fam, Verbenaceae). Recent studies conducted from our laboratory provide pharmacological evidence for its anti-hypertensive, anti-diabetic and anti-obesity potentials. Further, its beneficial potential in preventing in vitro and in vivo non-alcoholic steatohepatitis and atherosclerosis and potent hepatoprotective and free radical scavenging abilities along with its acute and sub-chronic toxicological evaluations are also reported from our laboratory. In keeping with its traditional uses, CG extract was capable of ameliorating experimentally induced hypertension, diabetes and obesity. Its beneficial potential against NASH induced oxidative stress and atherosclerosis can be attributed to its potent free radical scavenging potential. Non-toxic nature of CG leaf extract further provides added merit to its reported pharmacological properties. The present review summarizes the pioneering scientific evidence for the pharmacological effects of CG against related metabolic disorders like hypertension, diabetes and obesity along with anti oxidant potential and beneficial effects against non alcoholic steatohepatitis.

  8. Escitalopram—translating molecular properties into clinical benefit: reviewing the evidence in major depression

    OpenAIRE

    Leonard, Brian; Taylor, David

    2010-01-01

    The majority of currently marketed drugs contain a mixture of enantiomers; however, recent evidence suggests that individual enantiomers can have pharmacological properties that differ importantly from enantiomer mixtures. Escitalopram, the S-enantiomer of citalopram, displays markedly different pharmacological activity to the R-enantiomer. This review aims to evaluate whether these differences confer any significant clinical advantage for escitalopram over either citalopram or other frequent...

  9. Melastoma malabathricum (L. Smith Ethnomedicinal Uses, Chemical Constituents, and Pharmacological Properties: A Review

    Directory of Open Access Journals (Sweden)

    S. Mohd. Joffry

    2012-01-01

    Full Text Available Melastoma malabathricum L. (Melastomataceae is one of the 22 species found in the Southeast Asian region, including Malaysia. Considered as native to tropical and temperate Asia and the Pacific Islands, this commonly found small shrub has gained herbal status in the Malay folklore belief as well as the Indian, Chinese, and Indonesian folk medicines. Ethnopharmacologically, the leaves, shoots, barks, seeds, and roots of M. malabathricum have been used to treat diarrhoea, dysentery, hemorrhoids, cuts and wounds, toothache, and stomachache. Scientific findings also revealed the wide pharmacological actions of various parts of M. malabthricum, such as antinociceptive, anti-inflammatory, wound healing, antidiarrheal, cytotoxic, and antioxidant activities. Various types of phytochemical constituents have also been isolated and identifed from different parts of M. malabathricum. Thus, the aim of the present review is to present comprehensive information on ethnomedicinal uses, phytochemical constituents, and pharmacological activities of M. malabathricum.

  10. Prescription Writing in Small Groups as a Clinical Pharmacology Educational Intervention: Perceptions of Preclerkship Medical Students.

    Science.gov (United States)

    James, Henry; Tayem, Yasin I Y; Al Khaja, K A J; Veeramuthu, Sindhan; Sequeira, Reginald P

    2016-08-01

    Medical students do not perform well in writing prescriptions, and the 3 variables-learner, teacher, and instructional method-are held responsible to various degrees. The objective of this clinical pharmacology educational intervention was to improve medical students' perceptions, motivation, and participation in prescription-writing sessions. The study participants were second-year medical students of the College of Medicine and Medical Sciences of the Arabian Gulf University, Bahrain. Two prescription-writing sessions were conducted using clinical case scenarios based on problems the students had studied as part of the problem-based learning curriculum. At the end of the respiratory system subunit, the training was conducted in small groups, each facilitated by a tutor. At the end of the cardiovascular system subunit, the training was conducted in a traditional large-group classroom setting. Data were collected with the help of a questionnaire at the end of each session and a focus group discussion. A majority of the students (95.3% ± 2.4%) perceived the small-group method better for teaching and learning of all aspects of prescription writing: analyzing the clinical case scenario, applying clinical pharmacology knowledge for therapeutic reasoning, using a formulary for searching relevant prescribing information, and in writing a complete prescription. Students also endorsed the small-group method for better interaction among themselves and with the tutor and for the ease of asking questions and clarifying doubts. In view of the principles of adult learning, where motivation and interaction are important, teaching and learning prescription writing in small groups deserve a serious consideration in medical curricula. PMID:26677798

  11. Pharmacologic Agents That Promote Airway Clearance in Hospitalized Subjects: A Systematic Review.

    Science.gov (United States)

    Sathe, Nila A; Krishnaswami, Shanthi; Andrews, Jeff; Ficzere, Cathy; McPheeters, Melissa L

    2015-07-01

    Pharmacologic agents to promote mucus clearance may reduce the sequelae of obstructive secretions. We systematically reviewed comparative studies of pharmacologic agents for mucus clearance in hospitalized or postoperative subjects without cystic fibrosis and over 12 months of age. We searched MEDLINE and other databases from January 1970 to July 2014 to identify relevant literature. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers also independently extracted data regarding subject and intervention characteristics and outcomes and assigned overall quality ratings. The 9 studies meeting review criteria included 5 randomized controlled trials, 3 crossover randomized controlled trials, and one retrospective cohort study. Studies were small and together included a total of 379 subjects (mean of 42 subjects per study). N-acetylcysteine, heparin plus N-acetylcysteine, albuterol, ipratropium bromide, and saline were assessed. Studies reported no benefit of studied agents on expectoration, pulmonary function, and atelectasis and little effect on changes in sputum volume, weight, or viscosity. Adverse effects of agents were not consistently reported. Nausea was reported in 2 studies of N-acetylcysteine (one paper reported 2 experiments and did not clearly identify in which experiment adverse effects occurred), 3 studies reported that there were no adverse events, and 3 studies did not address adverse effects at all. Further research with clearly characterized populations and interventions is needed to understand the potential benefits and adverse effects of mucoactive agents. PMID:25944943

  12. Erythrina variegata Linn: A review on morphology, phytochemistry, and pharmacological aspects

    Directory of Open Access Journals (Sweden)

    A Kumar

    2010-01-01

    Full Text Available This review gives an account of the current knowledge on the morphology, phytochemistry, and pharmacological aspects of Erythrina variegata. E. variegata also called Erythrina indica is a thorny deciduous tree growing to 60 feet tall. A wide range of chemical compounds have been isolated, mainly alkaloids, flavonoids, triterpenoids, and lectin. Different parts of the plant have been used in traditional medicine as nervine sedative, collyrium in opthalmia, antiasthmatic, antiepileptic, antiseptic, and as an astringent. The alkaloids extracted from the leaves of E. variegata are reported to have anti-inflammatory and analgesic activity. Isoflavonoids isolated from E. variegata having antibacterial and anthelmintic activity. E. variegata shows several other characteristic pharmacological effects like neuromuscular blocking, smooth muscle relaxant, CNS depressant, and hydrocholeretic, which are consistent with the reported uses of the plant extracts in the indigenous system of medicine. Hence the present article includes the detailed exploration of morphology, phytochemistry, and pharmacological aspects of E. variegata in an attempt to provide a direction for further research.

  13. Phytol a Natural Diterpenoid with Pharmacological Applications on Central Nervous System: A Review.

    Science.gov (United States)

    Pereira Costa, Jessica; da Silva Oliveira, Johanssy; Mario Rezende Junior, Luis; de Freitas, Rivelilson Mendes

    2014-01-01

    Phytol (3,7,11,15-tetramethylhexadec-2-en-1-ol), a diterpene member of long and ramified chain of unsaturated acyclic alcohols. The objective of study was to conduct a systematic review of this diterpene and its pharmaceutical applications in Nervous System diseases in humans and/or rodents. Periodicals bases, such as ScienceDirect and PubMed, were used, as well as technological basis of European Patent Office, World Intellectual Property Organization, United States Patent and Trademark Office, Derwent Innovations Index(®), Latin American Bank of Patents and data base of Instituto Nacional de Propriedade Industrial (INPI-National Institute of Industrial Property). The software EndNote-X5 was utilized as reference with the keywords: phytol, anxiolytic, antidepressant and anticonvulsant and their correlations in English, Spanish and Portuguese from January 2003 to June 2014. There are many publications on phytol in international literature. However, there is a reduced number of articles related to pharmacological activities proposed here. In reference to technological bases, patents present a wide range of pharmacological and commercial applications as cosmetics, hypolipodemic, anxiolytic and antidepressant. Therefore, it is necessary to explore phytol molecules, which present high pharmacological potential from scientific and technological points of view, in search of transference of technologies to generate economical and industrial growth. PMID:27099143

  14. A review on the pharmacological and toxicological aspects of Datura stramonium L.

    Institute of Scientific and Technical Information of China (English)

    Bhakta Prasad Gaire; Lalita Subedi

    2013-01-01

    Datura stramonium L.,a wild-growing plant of the Solanaceae family,is widely distributed and easily accessible.It contains a variety of toxic tropane alkaloids such as atropine,hyoscamine,and scopolamine.In Eastern medicine,especially in Ayurvedic medicine,D.stramonium has been used for curing various human ailments,including ulcers,wounds,inflammation,rheumatism and gout,sciatica,bruises and swellings,fever,asthma and bronchitis,and toothache.A few previous studies have reported on the pharmacological effects of D.stramonium; however,complete information regarding the pharmacology,toxicity,ethnobotany and phytochemistry remains unclear.Ethnomedicinally,the frequent recreational abuse of D.stramonium has resulted in toxic syndromes.D.stramonium,in the form of paste or solution to relieve the local pain,may not have a deleterious effect; however,oral and systemic administration may lead to severe anticholinergic symptoms.For this reason,it is very important for individuals,mainly young people,to be aware of the toxic nature and potential risks associated with the use of this plant.This comprehensive review of D.stramonium includes information on botany,phytochemistry,pharmacology,toxicology and ethnomedicinal uses.

  15. Phytol a Natural Diterpenoid with Pharmacological Applications on Central Nervous System: A Review.

    Science.gov (United States)

    Pereira Costa, Jessica; da Silva Oliveira, Johanssy; Mario Rezende Junior, Luis; de Freitas, Rivelilson Mendes

    2014-01-01

    Phytol (3,7,11,15-tetramethylhexadec-2-en-1-ol), a diterpene member of long and ramified chain of unsaturated acyclic alcohols. The objective of study was to conduct a systematic review of this diterpene and its pharmaceutical applications in Nervous System diseases in humans and/or rodents. Periodicals bases, such as ScienceDirect and PubMed, were used, as well as technological basis of European Patent Office, World Intellectual Property Organization, United States Patent and Trademark Office, Derwent Innovations Index(®), Latin American Bank of Patents and data base of Instituto Nacional de Propriedade Industrial (INPI-National Institute of Industrial Property). The software EndNote-X5 was utilized as reference with the keywords: phytol, anxiolytic, antidepressant and anticonvulsant and their correlations in English, Spanish and Portuguese from January 2003 to June 2014. There are many publications on phytol in international literature. However, there is a reduced number of articles related to pharmacological activities proposed here. In reference to technological bases, patents present a wide range of pharmacological and commercial applications as cosmetics, hypolipodemic, anxiolytic and antidepressant. Therefore, it is necessary to explore phytol molecules, which present high pharmacological potential from scientific and technological points of view, in search of transference of technologies to generate economical and industrial growth.

  16. Effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depression: a systematic review (METACHRON

    Directory of Open Access Journals (Sweden)

    von Wolff Alessa

    2010-11-01

    Full Text Available Abstract Background Chronic depressions represent a substantial part of depressive disorders and are associated with severe consequences. Several studies were performed addressing the effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depressions. Yet, a systematic review comparing the effectiveness of multiple treatment options and considering all subtypes of chronic depressions is still missing. Methods/Design Aim of this project is to summarize empirical evidence on efficacy and effectiveness of treatments for chronic depression by means of a systematic review. The primary objectives of the study are to examine, which interventions are effective; to examine, if any differences in effectiveness between active treatment options exist; and to find possible treatment effect modifiers. Psychotherapeutic, pharmacological, and combined treatments will be considered as experimental interventions and no treatment, wait-list, psychological/pharmacological placebo, treatment as usual, and other active treatments will be seen as comparators. The population of patients will include adults with chronic major depression, dysthymia, double depression, or recurrent depression without complete remission between episodes. Outcomes of the analyses are depressive symptoms, associated consequences, adverse events, and study discontinuation. Only randomized controlled trials will be considered. Discussion Given the high prevalence and serious consequences of chronic depression and a considerable amount of existing primary studies addressing the effectiveness of different treatments the present systematic review may be of high relevance. Special attention will be given to the use of current methodological standards. Findings are likely to provide crucial information that may help clinicians to choose the appropriate treatment for chronically depressed patients.

  17. A Pharmacological Primer of Biased Agonism

    OpenAIRE

    Andresen1, Bradley T.

    2011-01-01

    Biased agonism is one of the fastest growing topics in G protein-coupled receptor pharmacology; moreover, biased agonists are used in the clinic today: carvedilol (Coreg®) is a biased agonist of beta-adrenergic receptors. However, there is a general lack of understanding of biased agonism when compared to traditional pharmacological terminology. Therefore, this review is designed to provide a basic introduction to classical pharmacology as well as G protein-coupled receptor signal transductio...

  18. Pharmacologic Therapies in Anticoagulation.

    Science.gov (United States)

    Ferreira, Joana Lima; Wipf, Joyce E

    2016-07-01

    Anticoagulants are beneficial for prevention and treatment of venous thromboembolism and stroke prevention in atrial fibrillation. The development of target-specific oral anticoagulants is changing the landscape of anticoagulation therapy and created growing interest on this subject. Understanding the pharmacology of different anticoagulants is the first step to adequately treat patients with best available therapy while avoiding serious bleeding complications. This article reviews the pharmacology of the main anticoagulant classes (vitamin K antagonists, direct oral anticoagulants, and heparins) and their clinical indications based on evidence-based data currently available in the literature. PMID:27235611

  19. Streblus asper Lour. (Shakhotaka: A Review of its Chemical, Pharmacological and Ethnomedicinal Properties

    Directory of Open Access Journals (Sweden)

    Subha Rastogi

    2006-01-01

    Full Text Available Streblus asper Lour is a small tree found in tropical countries, such as India, Sri Lanka, Malaysia, the Philippines and Thailand. Various parts of this plant are used in Ayurveda and other folk medicines for the treatment of different ailments such as filariasis, leprosy, toothache, diarrhea, dysentery and cancer. Research carried out using different in vitro and in vivo techniques of biological evaluation support most of these claims. This review presents the botany, chemistry, traditional uses and pharmacology of this medicinal plant.

  20. Non-pharmacological care for patients with generalized osteoarthritis: design of a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Cornelissen Jessica

    2010-07-01

    Full Text Available Abstract Background Non-pharmacological treatment (NPT is a useful treatment option in the management of hip or knee osteoarthritis. To our knowledge however, no studies have investigated the effect of NPT in patients with generalized osteoarthritis (GOA. The primary aim of this study is to compare the effectiveness of two currently existing health care programs with different intensity and mode of delivery on daily functioning in patients with GOA. The secondary objective is to compare the cost-effectiveness of both interventions. Methods/Design In this randomized, single blind, clinical trial with active controls, we aim to include 170 patients with GOA. The experimental intervention consist of six self-management group sessions provided by a multi-disciplinary team (occupational therapist, physiotherapist, dietician and specialized nurse. The active control group consists of two group sessions and four sessions by telephone, provided by a specialized nurse and physiotherapist. Both therapies last six weeks. Main study outcome is daily functioning during the first year after the treatment, assessed on the Health Assessment Questionnaire. Secondary outcomes are health related quality of life, specific complaints, fatigue, and costs. Illness cognitions, global perceived effect and self-efficacy, will also be assessed for a responder analysis. Outcome assessments are performed directly after the intervention, after 26 weeks and after 52 weeks. Discussion This article describes the design of a randomized, single blind, clinical trial with a one year follow up to compare the costs and effectiveness of two non-pharmacological interventions with different modes of delivery for patients with GOA. Trial registration Dutch Trial Register NTR2137

  1. ALOE VERA: A REVIEW OF ITS CLINICAL EFFECTIVENESS

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    Malik Itrat

    2013-08-01

    Full Text Available Aloe vera has been used for over five thousand years. Throughout history, it has been considered a magical plant, almost a panacea, capable of remedying many of mankind’s ailments. It is only in the last 20 years, after a series of proven research, that we can highlight the characteristics of this plant, whose secrets have been hidden behind a blanket of botanical and pharmacological puzzles that only today begin to yield some answers. The Aloe vera plant and its clinical uses are briefly reviewed in this article.

  2. Epoetin zeta in the management of anemia associated with chronic kidney disease, differential pharmacology and clinical utility

    Directory of Open Access Journals (Sweden)

    Davis-Ajami ML

    2014-04-01

    Full Text Available Mary Lynn Davis-Ajami,1 Jun Wu,2 Katherine Downton,3 Emilie Ludeman,3 Virginia Noxon4 1Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA; 2South Carolina College of Pharmacy, University of South Carolina, Greenville, SC, USA; 3Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA; 4Department of Clinical Pharmacy and Outcomes Science, South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA Abstract: Epoetin zeta was granted marketing authorization in October 2007 by the European Medicines Agency as a recombinant human erythropoietin erythropoiesis-stimulating agent to treat symptomatic anemia of renal origin in adult and pediatric patients on hemodialysis and adults on peritoneal dialysis, as well as for symptomatic renal anemia in adult patients with renal insufficiency not yet on dialysis. Currently, epoetin zeta can be administered either subcutaneously or intravenously to correct for hemoglobin concentrations ≤10 g/dL (6.2 mmol/L or with dose adjustment to maintain hemoglobin levels at desired levels not in excess of 12 g/dL (7.5 mmol/L. This review article focuses on epoetin zeta indications in chronic kidney disease, its use in managing anemia of renal origin, and discusses its pharmacology and clinical utility. Keywords: biosimilar, chronic kidney disease, epoetin alfa, erythropoiesis, renal anemia, Retacrit®

  3. PIRIFORMIS SYNDROME: A CLINICAL REVIEW

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    Samarjit

    2013-04-01

    Full Text Available ABSTRACT: Piriformis Syndrome is a cause for Low back pain whi ch is most of the times misdiagnosed as it may mimic with various other con ditions. Abnormal condition of the Piriformis muscle such as hypertrophy, inflammation, or anatomic variations may lead to this condition. Reported incidence rates for Piriformis S yndrome among patients with low back pain vary widely, from 5% to 36%. Etiology of Piriformis Syndrome is also variable. It can be primary due to anatomical problems or secondary due to vario us other causes like trauma, local ischemia, limb-length discrepancy etc. Diagnosis of Piriformis Syndrome is complex. History with various clinical tests along with MRI, EMG (El ectromyography and Diagnostic blocks may help to diagnose this condition. Here is a review of Piriformis syndrome for better understanding of the problem so that the diagnosis a nd management are appropriate. KEY WORDS:Piriformis Syndrome.

  4. [How to write a good clinical review?].

    Science.gov (United States)

    Krause, B J; Khan, C; Antoch, G

    2015-01-01

    Clinical reviews are an important part of the medical literature offering the reader condensed information on a specific topic. In radiology and nuclear medicine most clinical reviews have a subjective character as they have been written in a rather narrative way. Based on their low level of evidence these narrative reviews are frequently not being considered for establishment of clinical guidelines. The aim of this paper is to aid the reader in writing a good clinical review by highlighting the different aspects of a systematic review. PMID:25774019

  5. [How to write a good clinical review?].

    Science.gov (United States)

    Krause, B J; Khan, C; Antoch, G

    2015-01-01

    Clinical reviews are an important part of the medical literature offering the reader condensed information on a specific topic. In radiology and nuclear medicine most clinical reviews have a subjective character as they have been written in a rather narrative way. Based on their low level of evidence these narrative reviews are frequently not being considered for establishment of clinical guidelines. The aim of this paper is to aid the reader in writing a good clinical review by highlighting the different aspects of a systematic review.

  6. A review on ethnobotany, phytochemistry and pharmacology of Fumaria indica (Fumitory)

    Institute of Scientific and Technical Information of China (English)

    Prakash Chandra Gupta; Nisha Sharma; Ch V Rao

    2012-01-01

    Fumaria indica (Hausskn.) Pugsley (Fumariaceae), known as “Fumitory”, is an annual herb found as a common weed all over the plains of India and Pakistan. The whole plant is widely used in traditional and folkloric systems of medicine. In traditional systems of medicine, the plant is reputed for its anthelmintic, diuretic, diaphoretic, laxative, cholagogue, stomachic and sedative activities and is used to purify blood and in liver obstruction in ethnopharmacology. The whole plant is ascribed to possess medicinal virtues in Ayurvedic and Unani systems of medicine and is also used in preparation of important Ayurvedic medicinal preparations and polyherbal liver formulations. The review reveals that phytochemical constituents of wide range have been separated from the plants and it possesses important pharmacological activities like smooth muscle relaxant, spasmogenic and spasmolytic, analgesic, anti-inflammatory, neuropharmacological and antibacterial activities. The separation of hepatoprotective and antifungal constituents from this plant was also reported newly. This review highlights the traditional, ethnobotanical, phytochemical, pharmacological information available on Fumaria indica, which might be helpful for scientists and researchers to find out new chemical entities responsible for its claimed traditional uses.

  7. A review of the chemical and pharmacological aspects of the genus marrubium.

    Science.gov (United States)

    Meyre-Silva, Christiane; Cechinel-Filho, Valdir

    2010-01-01

    The genus Marrubium (Lamiaceae) is comprised of about forty species, distributed in Europe, Asia and Brazil. Some species are traditionally used to treat various diseases, including asthma, pulmonary infections, inflammation and hypotension, as cholagogues and sedative agents, and for pain relief. A literature review on the chemical and biological aspects of these plants indicates antimicrobial activity against gram positive bacteria, analgesic properties, and anti-hypertensive, antidiabetic, antioxidant properties, among others, particularly related to the presence of diterpenes, sterols, phenylpropanoids and flavonoids. This review shows the main chemical and pharmacological aspects of the genus Marrubium, with emphasis on M. vulgare, which grows in Brazil and has been studied by us and other authors. PMID:20942795

  8. Trace Amines and the Trace Amine-Associated Receptor 1: Pharmacology, Neurochemistry and Clinical Implications

    Directory of Open Access Journals (Sweden)

    Yue ePei

    2016-04-01

    Full Text Available Biogenic amines are a collection of endogenous molecules that play pivotal roles as neurotransmitters and hormones. In addition to the classical biogenic amines resulting from decarboxylation of aromatic acids, including dopamine (DA, norepinephrine, epinephrine, serotonin (5-HT and histamine, other biogenic amines, present at much lower concentrations in the central nervous system (CNS, and hence referred to as trace amines (TAs, are now recognized to play significant neurophysiological and behavioural functions. At the turn of the century, the discovery of the trace amine-associated receptor 1 (TAAR1, a phylogenetically conserved G protein-coupled receptor that is responsive to both TAs, such as β-phenylethylamine, octopamine and tyramine, and structurally-related amphetamines, unveiled mechanisms of action for TAs other than interference with aminergic pathways, laying the foundations for deciphering the functional significance of TAs and its mammalian CNS receptor, TAAR1. Although its molecular interactions and downstream targets have not been fully elucidated, TAAR1 activation triggers accumulation of intracellular cAMP, modulates PKA and PKC signalling and interferes with the β-arrestin2-dependent pathway via G protein-independent mechanisms. TAAR1 is uniquely positioned to exert direct control over DA and 5-HT neuronal firing and release, which has profound implications for understanding the pathophysiology of, and therefore designing more efficacious therapeutic interventions for, a range of neuropsychiatric disorders that involve aminergic dysregulation, including Parkinson’s disease, schizophrenia, mood disorders and addiction. Indeed, the recent development of novel pharmacological tools targeting TAAR1 has uncovered the remarkable potential of TAAR1-based medications as new generation pharmacotherapies in neuropsychiatry. This review summarizes recent developments in the study of TAs and TAAR1, their intricate neurochemistry and

  9. Trace Amines and the Trace Amine-Associated Receptor 1: Pharmacology, Neurochemistry, and Clinical Implications.

    Science.gov (United States)

    Pei, Yue; Asif-Malik, Aman; Canales, Juan J

    2016-01-01

    Biogenic amines are a collection of endogenous molecules that play pivotal roles as neurotransmitters and hormones. In addition to the "classical" biogenic amines resulting from decarboxylation of aromatic acids, including dopamine (DA), norepinephrine, epinephrine, serotonin (5-HT), and histamine, other biogenic amines, present at much lower concentrations in the central nervous system (CNS), and hence referred to as "trace" amines (TAs), are now recognized to play significant neurophysiological and behavioral functions. At the turn of the century, the discovery of the trace amine-associated receptor 1 (TAAR1), a phylogenetically conserved G protein-coupled receptor that is responsive to both TAs, such as β-phenylethylamine, octopamine, and tyramine, and structurally-related amphetamines, unveiled mechanisms of action for TAs other than interference with aminergic pathways, laying the foundations for deciphering the functional significance of TAs and its mammalian CNS receptor, TAAR1. Although, its molecular interactions and downstream targets have not been fully elucidated, TAAR1 activation triggers accumulation of intracellular cAMP, modulates PKA and PKC signaling and interferes with the β-arrestin2-dependent pathway via G protein-independent mechanisms. TAAR1 is uniquely positioned to exert direct control over DA and 5-HT neuronal firing and release, which has profound implications for understanding the pathophysiology of, and therefore designing more efficacious therapeutic interventions for, a range of neuropsychiatric disorders that involve aminergic dysregulation, including Parkinson's disease, schizophrenia, mood disorders, and addiction. Indeed, the recent development of novel pharmacological tools targeting TAAR1 has uncovered the remarkable potential of TAAR1-based medications as new generation pharmacotherapies in neuropsychiatry. This review summarizes recent developments in the study of TAs and TAAR1, their intricate neurochemistry and

  10. Efficacy of Raynaud's phenomenon and digital ulcer pharmacological treatment in systemic sclerosis patients: a systematic literature review.

    Science.gov (United States)

    García de la Peña Lefebvre, Paloma; Nishishinya, María Betina; Pereda, Claudia Alejandra; Loza, Estíbaliz; Sifuentes Giraldo, Walter Alberto; Román Ivorra, José Andrés; Carreira, Patricia; Rúa-Figueroa, Iñigo; Pego-Reigosa, Jose María; Muñoz-Fernández, Santiago

    2015-09-01

    To evaluate the efficacy of current treatments for the Raynaud phenomenon (RP) in patients with systemic sclerosis (SSc), a systematic literature search was performed using Medline, EMBASE, and Cochrane Central Register of Controlled Trials (from 1961 to October 2011). We included meta-analyses, systematic reviews, clinical trials, and high-quality cohort studies published in English or Spanish. Patient populations had to include adults diagnosed with limited cutaneous or diffuse SSc who had associated RP and/or digital ulcers under pharmacological treatment. Efficacy of treatments was evaluated based on: number of RP episodes, RP severity, episode-free time, ulcer improvement/healing, and appearance of new ulcers. We used the Jadad scale of methodological quality to evaluate the quality of randomized clinical trials, and the 2009 Oxford Centre for Evidence-Based Medicine classification for other studies. Of a total of 1617 studies identified, only 27 fulfilled inclusion criteria. Drugs received the following grade recommendations: Grade A for nifedipine, nicardipine, quinapril, IV iloprost, bosentan, tadalafil, and MQx-503; Grade B for beraprost, cicaprost, DMSO, cyclofenil, and atorvastatin; and Grade C for misoprostol, prazosin, OPC-2826, enalapril, sildenafil, antioxidant, and stanazolol. Calcium channel blockers, prostanoids, tadalafil, and bosentan received the highest recommendation level for their effectiveness. However, most systematic reviews reviewed just a handful of studies with small sample sizes and short follow-ups. Our review shows that the existing evidence on the efficacy of RP treatment in SSc patients is inconclusive which calls for further research, especially in the form of prospective studies of high quality with long-term follow-ups.

  11. Clinically Relevant Pharmacological Strategies That Reverse MDMA-Induced Brain Hyperthermia Potentiated by Social Interaction.

    Science.gov (United States)

    Kiyatkin, Eugene A; Ren, Suelynn; Wakabayashi, Ken T; Baumann, Michael H; Shaham, Yavin

    2016-01-01

    MDMA-induced hyperthermia is highly variable, unpredictable, and greatly potentiated by the social and environmental conditions of recreational drug use. Current strategies to treat pathological MDMA-induced hyperthermia in humans are palliative and marginally effective, and there are no specific pharmacological treatments to counteract this potentially life-threatening condition. Here, we tested the efficacy of mixed adrenoceptor blockers carvedilol and labetalol, and the atypical antipsychotic clozapine, in reversing MDMA-induced brain and body hyperthermia. We injected rats with a moderate non-toxic dose of MDMA (9 mg/kg) during social interaction, and we administered potential treatment drugs after the development of robust hyperthermia (>2.5 °C), thus mimicking the clinical situation of acute MDMA intoxication. Brain temperature was our primary focus, but we also simultaneously recorded temperatures from the deep temporal muscle and skin, allowing us to determine the basic physiological mechanisms of the treatment drug action. Carvedilol was modestly effective in attenuating MDMA-induced hyperthermia by moderately inhibiting skin vasoconstriction, and labetalol was ineffective. In contrast, clozapine induced a marked and immediate reversal of MDMA-induced hyperthermia via inhibition of brain metabolic activation and blockade of skin vasoconstriction. Our findings suggest that clozapine, and related centrally acting drugs, might be highly effective for reversing MDMA-induced brain and body hyperthermia in emergency clinical situations, with possible life-saving results. PMID:26105141

  12. A Review on Pharmacological Properties of Zingerone (4-(4-Hydroxy-3-methoxyphenyl)-2-butanone).

    Science.gov (United States)

    Ahmad, Bilal; Rehman, Muneeb U; Amin, Insha; Arif, Ahmad; Rasool, Saiema; Bhat, Showkat Ahmad; Afzal, Insha; Hussain, Ishraq; Bilal, Sheikh; Mir, Manzoor ur Rahman

    2015-01-01

    Humans have been using natural products for medicinal use for ages. Natural products of therapeutic importance are compounds derived from plants, animals, or any microorganism. Ginger is also one of the most commonly used condiments and a natural drug in vogue. It is a traditional medicine, having some active ingredients used for the treatment of numerous diseases. During recent research on ginger, various ingredients like zingerone, shogaol, and paradol have been obtained from it. Zingerone (4-(4-hydroxy-3-methoxyphenyl)-2-butanone) is a nontoxic and inexpensive compound with varied pharmacological activities. It is the least pungent component of Zingiber officinale. Zingerone is absent in fresh ginger but cooking or heating transforms gingerol to zingerone. Zingerone closely related to vanillin from vanilla and eugenol from clove. Zingerone has potent anti-inflammatory, antidiabetic, antilipolytic, antidiarrhoeic, antispasmodic, and so forth properties. Besides, it displays the property of enhancing growth and immune stimulation. It behaves as appetite stimulant, anxiolytic, antithrombotic, radiation protective, and antimicrobial. Also, it inhibits the reactive nitrogen species which are important in causing Alzheimer's disease and many other disorders. This review is written to shed light on the various pharmacological properties of zingerone and its role in alleviating numerous human and animal diseases. PMID:26106644

  13. A Review on Pharmacological Properties of Zingerone (4-(4-Hydroxy-3-methoxyphenyl-2-butanone

    Directory of Open Access Journals (Sweden)

    Bilal Ahmad

    2015-01-01

    Full Text Available Humans have been using natural products for medicinal use for ages. Natural products of therapeutic importance are compounds derived from plants, animals, or any microorganism. Ginger is also one of the most commonly used condiments and a natural drug in vogue. It is a traditional medicine, having some active ingredients used for the treatment of numerous diseases. During recent research on ginger, various ingredients like zingerone, shogaol, and paradol have been obtained from it. Zingerone (4-(4-hydroxy-3-methoxyphenyl-2-butanone is a nontoxic and inexpensive compound with varied pharmacological activities. It is the least pungent component of Zingiber officinale. Zingerone is absent in fresh ginger but cooking or heating transforms gingerol to zingerone. Zingerone closely related to vanillin from vanilla and eugenol from clove. Zingerone has potent anti-inflammatory, antidiabetic, antilipolytic, antidiarrhoeic, antispasmodic, and so forth properties. Besides, it displays the property of enhancing growth and immune stimulation. It behaves as appetite stimulant, anxiolytic, antithrombotic, radiation protective, and antimicrobial. Also, it inhibits the reactive nitrogen species which are important in causing Alzheimer’s disease and many other disorders. This review is written to shed light on the various pharmacological properties of zingerone and its role in alleviating numerous human and animal diseases.

  14. Andrographis paniculata (Burm. f. Wall. ex Nees: A Review of Ethnobotany, Phytochemistry, and Pharmacology

    Directory of Open Access Journals (Sweden)

    Md. Sanower Hossain

    2014-01-01

    Full Text Available As aboriginal sources of medications, medicinal plants are used from the ancient times. Andrographis paniculata is one of the highly used potential medicinal plants in the world. This plant is traditionally used for the treatment of common cold, diarrhoea, fever due to several infective cause, jaundice, as a health tonic for the liver and cardiovascular health, and as an antioxidant. It is also used to improve sexual dysfunctions and serve as a contraceptive. All parts of this plant are used to extract the active phytochemicals, but the compositions of phytoconstituents widely differ from one part to another and with place, season, and time of harvest. Our extensive data mining of the phytoconstituents revealed more than 55 ent-labdane diterpenoids, 30 flavonoids, 8 quinic acids, 4 xanthones, and 5 rare noriridoids. In this review, we selected only those compounds that pharmacology has already reported. Finally we focused on around 46 compounds for further discussion. We also discussed ethnobotany of this plant briefly. Recommendations addressing extraction process, tissue culture, and adventitious rooting techniques and propagation under abiotic stress conditions for improvement of phytoconstituents are discussed concisely in this paper. Further study areas on pharmacology are also proposed where needed.

  15. A review of standard pharmacological therapy for adult asthma – Steps 1 to 5.

    Science.gov (United States)

    Patel, Mitesh; Shaw, Dominick

    2015-05-01

    The aim of pharmacological therapy for asthma is to improve symptoms and lung function and minimize the risk of asthma attacks. The intensity of treatment is based on the level of asthma control and the potential risk of future deterioration. In the British asthma guidelines, treatments are divided into steps 1 to 5, with each step signifying a need for an increase in therapy in response to symptoms or to prevent exacerbations. Treatments comprise of inhaled or systemic medications. Inhaled therapy includes short-acting and long-acting medication to improve symptoms and inhaled corticosteroids that reduce airway inflammation. Systemic treatments include medications that act on specific biological pathways, such as the leukotriene or immunoglobulin E pathways, or systemic corticosteroids. In choosing a particular therapy, treatment benefits are balanced by the potential risks of medication-related adverse effects. This review will provide a practical guide to the key pharmacological therapies for adult asthma at steps 1 to 5 based on British guidelines and consider future options for new treatments.

  16. The Hill equation: a review of its capabilities in pharmacological modelling.

    Science.gov (United States)

    Goutelle, Sylvain; Maurin, Michel; Rougier, Florent; Barbaut, Xavier; Bourguignon, Laurent; Ducher, Michel; Maire, Pascal

    2008-12-01

    The Hill equation was first introduced by A.V. Hill to describe the equilibrium relationship between oxygen tension and the saturation of haemoglobin. In pharmacology, the Hill equation has been extensively used to analyse quantitative drug-receptor relationships. Many pharmacokinetic-pharmacodynamic models have used the Hill equation to describe nonlinear drug dose-response relationships. Although the Hill equation is widely used, its many properties are not all well known. This article aims at reviewing the various properties of the Hill equation. The descriptive aspects of the Hill equation, in particular mathematical and graphical properties, are examined, and related to Hill's original work. The mechanistic aspect of the Hill equation, involving a strong connection with the Guldberg and Waage law of mass action, is also described. Finally, a probabilistic view of the Hill equation is examined. Here, we provide some new calculation results, such as Fisher information and Shannon entropy, and we introduce multivariate probabilistic Hill equations. The main features and potential applications of this probabilistic approach are also discussed. Thus, within the same formalism, the Hill equation has many different properties which can be of great interest for those interested in mathematical modelling in pharmacology and biosciences.

  17. Clinacanthus nutans: A review of the medicinal uses, pharmacology and phytochemistry.

    Science.gov (United States)

    Alam, Ariful; Ferdosh, Sahena; Ghafoor, Kashif; Hakim, Abdul; Juraimi, Abdul Shukor; Khatib, Alfi; Sarker, Zaidul I

    2016-04-01

    Clinacanthus nutans Lindau is known as snake grass belonging to the Acanthaceae family. This plant has diverse and potential medicinal uses in traditional herbal medicine for treating skin rashes, insects and snake bites, lesions caused by herpes simplex virus, diabetes, and gout in Malaysia, Indonesia, Thailand and China. Phytochemical investigations documented the varied contents of bioactive compounds from this plant namely flavonoids, glycosides, glycoglycerolipids, cerebrosides and monoacylmonogalatosylglycerol. The pharmacological experiment proved that various types of extracts and pure compounds from this species exhibited a broad range of biological properties such as anti-inflammatory, antiviral, antioxidant, and anti-diabetic activities. The findings of toxicity study showed that extracts from this plant did not show any toxicity thus it can be used as strong therapeutic agents for specific diseased conditions. However, further experiments on chemical components and their mode of action showing biological activities are required to elucidate the complete phytochemical profile and assess to confirm their suitability for future drugs. This review summarizes the medicinal uses, phytochemistry and pharmacology of this plant in order to explore its therapeutic potential and gaps necessitating for prospected research work. PMID:27086161

  18. A Humanized Clinically Calibrated Quantitative Systems Pharmacology Model for Hypokinetic Motor Symptoms in Parkinson's Disease.

    Science.gov (United States)

    Roberts, Patrick; Spiros, Athan; Geerts, Hugo

    2016-01-01

    The current treatment of Parkinson's disease with dopamine-centric approaches such as L-DOPA and dopamine agonists, although very successful, is in need of alternative treatment strategies, both in terms of disease modification and symptom management. Various non-dopaminergic treatment approaches did not result in a clear clinical benefit, despite showing a clear effect in preclinical animal models. In addition, polypharmacy is common, sometimes leading to unintended effects on non-motor cognitive and psychiatric symptoms. To explore novel targets for symptomatic treatment and possible synergistic pharmacodynamic effects between different drugs, we developed a computer-based Quantitative Systems Pharmacology (QSP) platform of the closed cortico-striatal-thalamic-cortical basal ganglia loop of the dorsal motor circuit. This mechanism-based simulation platform is based on the known neuro-anatomy and neurophysiology of the basal ganglia and explicitly incorporates domain expertise in a formalized way. The calculated beta/gamma power ratio of the local field potential in the subthalamic nucleus correlates well (R (2) = 0.71) with clinically observed extra-pyramidal symptoms triggered by antipsychotics during schizophrenia treatment (43 drug-dose combinations). When incorporating Parkinsonian (PD) pathology and reported compensatory changes, the computer model suggests a major increase in b/g ratio (corresponding to bradykinesia and rigidity) from a dopamine depletion of 70% onward. The correlation between the outcome of the QSP model and the reported changes in UPDRS III Motor Part for 22 placebo-normalized drug-dose combinations is R (2) = 0.84. The model also correctly recapitulates the lack of clinical benefit for perampanel, MK-0567 and flupirtine and offers a hypothesis for the translational disconnect. Finally, using human PET imaging studies with placebo response, the computer model predicts well the placebo response for chronic treatment, but not for acute

  19. Pharmacological management of sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Fletcher, J.R.

    1985-01-01

    Systemic sepsis continues to be the most-difficult management problem in caring for the combat casualty. The complications of sepsis pervade all areas of injury to soldiers in the field, whether it is mechanical (missiles), thermal (burns), chemical, biological, or radiation injury. With the advent of tactical nuclear weapons, the problem of sepsis will be much higher in future wars than has previously been experienced through the world. The purpose of this chapter is a) to review the data suggesting pharmacological agents that may benefit the septic patient, and b) to emphasize the adjunctive therapies that should be explored in clinical trials. The pharmacological management of sepsis remains controversial. Most of the drugs utilized clinically treat the symptoms of the disease and are not necessarily directed at fundamental mechanisms that are known to be present in sepsis. A broad data base is emerging, indicating that NSAID should be used in human clinical trials. Prostaglandins are sensitive indicators of cellular injury and may be mediators for a number of vasoactive chemicals. Opiate antagonists and calcium channel blockers require more in-depth data; however, recent studies generate excitement for their potential use in the critically ill patient. Pharmacological effects of antibiotics, in concert with other drugs, suggest an entirely new approach to pharmacological treatment in sepsis. There is no doubt that new treatment modalities or adjunctive therapies must be utilized to alter the poor prognosis of severe sepsis that we have observed in the past 4 decades.

  20. Preliminary study on combined pharmacological and laser treatment in optic pit serous maculopathy after literature review.

    Science.gov (United States)

    Nebbioso, M; Dapoto, L; Lenarduzzi, F; Belcaro, G; Malagola, R

    2012-12-01

    The pit of the optic nerve head (ON) is a rare congenital defect that sometimes presents itself with a maculopathy of various neuroretinal layers for unknown reason. This study was focused, before and after pharmacological and parasurgical treatment, on the structural and functional visual assessment in a patient with optic pit maculopathy (OPM). In order to achieve this the latest generation of hi-tech diagnostic tests were used, such as Spectral-Domain Optical Coherence Tomography (SD-OCT), Visual Evoked Potentials (VEP), full-field Electroretinography (ERG), multifocal ERG (mfERG), Microperimetry (MP-1), Standard Automated Perimetry (SAP), Fluorescein Angiography (FA) and Indocyanine Green Angiography (ICG). The research was conducted through a review of past and recent literature. PMID:23241936

  1. Plant profile, phytochemistry and pharmacology of Cordia dichotoma (Indian cherry): a review.

    Science.gov (United States)

    Jamkhande, Prasad G; Barde, Sonal R; Patwekar, Shailesh L; Tidke, Priti S

    2013-12-01

    More than half of the world's population relies on the traditional medicine and major role of the traditional medicine including the use of plant extract and their active constituents. Among them, Cordia dichotoma Forst., a small to moderate size plant of family Boragenaceae, commonly called bhokar, lasura, gonda, Indian cherry and shlesmataka. Plant parts such as leaves, fruit, bark and seed have been reported for possessing antidiabetic, antiulcer, anti-inflammatory, immune-modulator and analgesic activity. Screening of fruit, leaves and seed shows the presence of pyrrolizidine alkaloids, coumarins, flavonoids, saponins, terpenes and sterols. Present review focuses on details of geographical distribution, physicochemical parameters, phytoconstituents and pharmacological properties of Cordia dichotoma reported so far.

  2. Plant profile, phytochemistry and pharmacology of Cordia dichotoma (Indian cherry):A review

    Institute of Scientific and Technical Information of China (English)

    Prasad G Jamkhande; Sonal R Barde; Shailesh L Patwekar; Priti S Tidke

    2013-01-01

    More than half of the world’s population relies on the traditional medicine and major role of the traditional medicine including the use of plant extract and their active constituents. Among them, Cordia dichotoma Forst., a small to moderate size plant of family Boragenaceae, commonly called bhokar, lasura, gonda, Indian cherry and shlesmataka. Plant parts such as leaves, fruit, bark and seed have been reported for possessing antidiabetic, antiulcer, anti-inflammatory, immune-modulator and analgesic activity. Screening of fruit, leaves and seed shows the presence of pyrrolizidine alkaloids, coumarins, flavonoids, saponins, terpenes and sterols. Present review focuses on details of geographical distribution, physicochemical parameters, phytoconstituents and pharmacological properties of Cordia dichotoma reported so far.

  3. Plant profile, phytochemistry and pharmacology of Cordia dichotoma (Indian cherry: A review

    Directory of Open Access Journals (Sweden)

    Prasad G. Jamkhande

    2013-12-01

    Full Text Available More than half of the world's population relies on the traditional medicine and major role of the traditional medicine including the use of plant extract and their active constituents. Among them, Cordia dichotoma Forst., a small to moderate size plant of family Boragenaceae, commonly called bhokar, lasura, gonda, Indian cherry and shlesmataka. Plant parts such as leaves, fruit, bark and seed have been reported for possessing antidiabetic, antiulcer, anti-inflammatory, immune-modulator and analgesic activity. Screening of fruit, leaves and seed shows the presence of pyrrolizidine alkaloids, coumarins, flavonoids, saponins, terpenes and sterols. Present review focuses on details of geographical distribution, physicochemical parameters, phytoconstituents and pharmacological properties of Cordia dichotoma reported so far.

  4. Porphyra Species: A Mini-Review of Its Pharmacological and Nutritional Properties.

    Science.gov (United States)

    Cao, Jin; Wang, Jianping; Wang, Shicheng; Xu, Ximing

    2016-02-01

    Porphyra sensu lato belongs to Bangiales, the most genetically diverse order of red algae. Porphyra or Pyropia is widely cultivated in East Asian countries, such as China, Japan, and Korea. Dried Porphyra contains numerous nutritional and biofunctional compounds, including proteins, minerals, dietary fiber, polyunsaturated fatty acids, carotenoids, saccharides, and mycosporine-like amino acids. In addition, the compound is most abundant in Porphyra, such as polysaccharides and phycobiliproteins, and demonstrates various immunomodulating, anticancer, antihyperlipidemic, and antioxidative activities. This review summarizes our current knowledge concerning the pharmacologically active substances found in Porphyra species. The biological activities and potential applications of certain carbohydrates, proteins, peptides, and other small molecules purified from Porphyra are also described, and possible areas for future studies are discussed.

  5. Pharmacological potentials of Cassia auriculata and Cassia fistula plants: A review.

    Science.gov (United States)

    Kainsa, Sushma; Kumar, Praveen; Rani, Poonam

    2012-05-01

    People are using herbal medicines from centuries for safety, efficacy, cultural acceptability and lesser side effects. Plant and plant products have utilized with varying success to cure and prevent diseases throughout history. Therapeutically interesting and important drugs can be developed from plant sources which are used in traditional systems of medicines. Indian traditional system of medicine is based on empirical knowledge of observations and the experience over millennia and more than 5000 plants are used by different ethnic communities in India. Cassia is an indigenous medicinal plant genus, in which Cassia auriculata have large biodiversity in south India and Cassia fistula in north India. The present communication constitutes a review on the medicinal properties and pharmacological actions of Cassia auriculata and Cassia fistula used in Indian traditional medicine. These plants are known to contain various active principles of therapeutic value and to posses' biological activity against a number of diseases.

  6. A review on phytochemical and pharmacological investigations of miswak (Salvadora persica Linn

    Directory of Open Access Journals (Sweden)

    Jamal Akhtar

    2011-01-01

    Full Text Available The miswak is a natural toothbrush made from the twigs of the Salvadora persica (Salvadoraceae. Its use predates the inception of Islam and is frequently advocated in the Hadith (the traditions relating to the life of Prophet Muhammad PBUH . In addition to strengthening the gums, it prevents tooth decay, eliminating toothaches and halt further increase in decay that has already set in. It creates a fragrance in the mouth, eliminates bad odor, improves the sense of taste, and causes the teeth to glow and shine. The other parts of the tree have therapeutic values as corrective, deobstruent, liver tonic, diuretic, analgesic, anthelmintic, astringent, lithontriptic, carminative, diuretic, aphrodisiac, and stomachic. The present review is therefore an effort to give detailed survey of the literature on phytochemistry and pharmacological activities of miswak.

  7. Corn Silk (Stigma Maydis in Healthcare: A Phytochemical and Pharmacological Review

    Directory of Open Access Journals (Sweden)

    Shuhaimi Mustafa

    2012-08-01

    Full Text Available Corn silk (Stigma maydis is an important herb used traditionally by the Chinese, and Native Americans to treat many diseases. It is also used as traditional medicine in many parts of the world such as Turkey, United States and France. Its potential antioxidant and healthcare applications as diuretic agent, in hyperglycemia reduction, as anti-depressant and anti-fatigue use have been claimed in several reports. Other uses of corn silk include teas and supplements to treat urinary related problems. The potential use is very much related to its properties and mechanism of action of its plant’s bioactive constituents such as flavonoids and terpenoids. As such, this review will cover the research findings on the potential applications of corn silk in healthcare which include its phytochemical and pharmacological activities. In addition, the botanical description and its toxicological studies are also included.

  8. Phytochemical and pharmacological studies of Vaj Turki (Acorus calamus Linn. & Unani Description– A Review

    Directory of Open Access Journals (Sweden)

    Nadir Shahzad

    2015-10-01

    Full Text Available Vaj Turki (Acorus calamus Linn. is a marshy perennial herb and rhizomes which has been traditionally used as medicine, against different diseases viz; Nisyan (dementia, Zofe Dimagh (Alzheimers disease, Humma (fever, Zeequn Nafs (asthama, Sual Muzmin (chronic cough, Ziabetus (ziabetes, Dyslipidemia, Quroohe Muzmina (chronic ulcer and mainly for digestive problems such as Dyspepsia (Zofe Hazm, Sue Hazm and Tukhma. A large number of chemical constituents such as phenyl propanoids, sesquiterpenes, monoterpenes as well as xanthone glycosides, flavones, lignans, steroids obtained from the Vaj have been proved to show various pharmacological activities such as antioxidant, immunomodulator, anti-inflammatory, nootropic, antipyretic, anti-asthamatic, hypoglycaemic, hepato-protective, cardioprotective, cytotoxic activity etc. The aim of this review is to provide information regarding Unani description in classical texts and scientific studies at current scenario which will motivate the research scholars on the basis of current scientific updates in their field of research.

  9. Balanites aegyptiaca (L. Del. (Hingot: A review of its traditional uses, phytochemistry and pharmacological properties

    Directory of Open Access Journals (Sweden)

    Yadav J

    2010-01-01

    Full Text Available Balanites aegyptiaca is an evergreen, woody, true xerophytic tree of tremendous medicinal importance. It belongs to the family Balanitaceae and is distributed throughout the drier parts of India. B. aegyptiaca has been used in a variety of folk medicines in India and Asia. Various parts of the plant are used in Ayurvedic and other folk medicines for the treatment of different ailments such as syphilis, jaundice, liver and spleen problems, epilepsy, yellow fever and the plant also has insecticidal, antihelminthic, antifeedant, molluscicidal and contraceptive activities. Research has been carried out using different in vitro and in vivo techniques of biological evaluation to support most of these claims. This review presents the traditional uses, phytochemistry and pharmacological properties of this medicinal plant.

  10. Recurrent Obscure Gastrointestinal Bleeding: Dilemmas and Success with Pharmacological Therapies. Case Series and Review

    Directory of Open Access Journals (Sweden)

    Majid Almadi

    2009-01-01

    Full Text Available The present article describes three difficult cases of recurrent bleeding from obscure causes, followed by a review of the pitfalls and pharmacological management of obscure gastrointestinal bleeding. All three patients underwent multiple investigations. An intervening complicating diagnosis or antiplatelet drugs may have compounded long-term bleeding in two of the cases. A bleeding angiodysplasia was confirmed in one case but was aggravated by the need for anticoagulation. After multiple transfusions and several attempts at endoscopic management in some cases, long-acting octreotide was associated with decreased transfusion requirements and increased hemoglobin levels in all three cases, although other factors may have contributed in some. In the third case, however, the addition of low-dose thalidomide stopped bleeding for a period of at least 23 months.

  11. PATHORCHUR (COLEUS AROMATICUS: A REVIEW OF THE MEDICINAL EVIDENCE FOR ITS PHYTOCHEMISTRY AND PHARMACOLOGY PROPERTIES

    Directory of Open Access Journals (Sweden)

    Om Prakash Rout

    2012-12-01

    Full Text Available Coleus aromaticus Benth., (Fam. Lamiaceae, syn. Coleus amboinicus Lour. Spreng or Plectranthus ambonicus Lour, is commonly known as Indian/ country borage and ‘Pathorchur’ in Hindi and Bengali. It is recorded in the Indian system of medicine as one of the sources of Pashanabheda. It is large succulent aromatic perennial herb, shrubby below, hispidly villous or tomentose. It is found throughout India, Ceylon and Moluccas. The leaves of the plant are bitter, acrid and were being widely used traditionally for various purposes. The plant has been worked out very well and isolated several chemical constituents and had shown various biological properties. This review is an effort to compile all the information reported on its macroscopic, microscopic features, nutritional content, phytochemistry, pharmacology and therapeutic uses.

  12. European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

    DEFF Research Database (Denmark)

    Roessner, Veit; Plessen, Kerstin J; Rothenberger, Aribert;

    2011-01-01

    provide the first comprehensive overview of all reports on pharmacological treatment options for TS through a MEDLINE, PubMed, and EMBASE search for all studies that document the effect of pharmacological treatment of TS and other tic disorders between 1970 and November 2010. We present a summary...

  13. Evolving paradigms in clinical pharmacology and therapeutics for the treatment of Duchenne muscular dystrophy.

    Science.gov (United States)

    Huard, J; Mu, X; Lu, A

    2016-08-01

    Progressive muscle weakness and degeneration due to the lack of dystrophin eventually leads to the loss of independent ambulation by the middle of the patient's second decade, and a fatal outcome due to cardiac or respiratory failure by the third decade. More specifically, loss of sarcolemmal dystrophin and the dystrophin-associated glycoprotein (DAG) complex promotes muscle fiber damage during muscle contraction. This process results in an efflux of creatine kinase (CK), an influx of calcium ions, and the recruitment of T cells, macrophages, and mast cells to the damaged muscle, causing progressive myofiber necrosis. For the last 20 years, the major goal in the development of therapeutic approaches to alleviate muscle weakness in DMD has been centered on the restoration of dystrophin or proteins that are analogous to dystrophin, such as utrophin, through a variety of modalities including cell therapy, gene therapy, gene correction, and the highly promising techniques utilizing CRISPR/Cas9 technology. Despite the development of new therapeutic options, there still exist numerous challenges that we must face with regard to these new strategies and, consequently, we still do not have any feasible options available to ultimately slow the progression of this devastating disease. The purpose of this article is to highlight the current knowledge and advancements in the evolving paradigms in clinical pharmacology and therapeutics for this devastating musculoskeletal disease. PMID:27071500

  14. Evaluation of impact of teaching clinical pharmacology and rational therapeutics to medical undergraduates and interns

    Science.gov (United States)

    Desai, Mira K; Panchal, Jigar R; Shah, Samdih; Iyer, Geetha

    2016-01-01

    Objectives: To find out the impact of teaching clinical pharmacology and rational therapeutics (CPT) to medical undergraduates (UGs) and interns. Materials and Methods: This cross-sectional, prospective study was conducted on three UGs batches and interns using two pretested validated structured questionnaires, modified from the work of Tobaiqy et al. The study was approved by the Institutional Ethics Committee. ANOVA and Chi-square test were used for statistical analysis. The value of P < 0.05 was considered statistically significant. Results: A total of 379 UGs and 96 interns participated in this study. Mean knowledge score of interns was significantly reduced as compared to UGs (P < 0.0001). A significant increase in confidence for unsupervised prescribing of nonsteroidal anti-inflammatory drugs (99%), oral rehydration salt, iron salts was perceived among interns as compared to UGs (P < 0.05). However, 63.5% confessed problems in selection of drugs, drug–drug interactions, prescribing in special patient population. Although they were confident prescribing fixed dose combination for adult patients (89.5%), majority were hesitant to prescribe opioids (77%), steroids (76%), vaccines (75%), and antihypertensives (62%). Conclusion: The theoretical CPT teaching transfers knowledge to UGs; however, it is not retained in internship and does not adequately prepare interns to prescribe safe and rational drugs. PMID:27563589

  15. The influence of clinical and pharmacological factors on enuresis treatment with imipramine.

    Science.gov (United States)

    Fernández de Gatta, M M; Galindo, P; Rey, F; Gutierrez, J; Tamayo, M; García, M J; Domínguez-Gil, A

    1990-11-01

    1. The aim of this study has been to evaluate the response to imipramine treatment in enuretic children through the use of a series of clinical and pharmacological variables and by applying a multivariate (principal components) analysis technique. 2. The study was carried out on 146 children whose ages ranged from 5 to 14 years, and who received variable doses of imipramine (12.5 to 100 mg day-1). 3. The quantitative variables analyzed were: drug dosage, serum levels of imipramine and its metabolite desipramine, the relationship between them both, the duration of treatment, age and weight. 4. The qualitative variables were: compliance, presence of side-effects, enuretic and/or psychiatric antecedents, intelligence quotient (I.Q.), the existence (or absence) of related pathologies, sex, and the type of enuresis. 5. The response to treatment was quantified by means of the percentage of decrease in frequency of enuresis as compared with the initial frequency. 6. The results obtained show that the variables which are most associated with the reduction of enuresis are, in decreasing order: the dosage of imipramine administered, the duration of treatment, compliance and the level/dose ratio for the sum of the drug and metabolite levels. PMID:2271368

  16. Clinical management of alcohol withdrawal: A systematic review

    Directory of Open Access Journals (Sweden)

    Shivanand Kattimani

    2013-01-01

    Full Text Available Alcohol withdrawal is commonly encountered in general hospital settings. It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on pharmacological management of alcohol withdrawal in humans with no limit on the date of publication. Articles not relevant to clinical management were excluded based on the titles and abstract available. Full-text articles were obtained from this list and the cross-references. There were four meta-analyses, 9 systematic reviews, 26 review articles and other type of publications like textbooks. Alcohol withdrawal syndrome is a clinical diagnosis. It may vary in severity. Complicated alcohol withdrawal presents with hallucinations, seizures or delirium tremens. Benzodiazepines have the best evidence base in the treatment of alcohol withdrawal, followed by anticonvulsants. Clinical institutes withdrawal assessment-alcohol revised is useful with pitfalls in patients with medical comorbidities. Evidence favors an approach of symptom-monitored loading for severe withdrawals where an initial dose is guided by risk factors for complicated withdrawals and further dosing may be guided by withdrawal severity. Supportive care and use of vitamins is also discussed.

  17. Factors associated with clinical inertia: an integrative review

    Directory of Open Access Journals (Sweden)

    Aujoulat I

    2014-05-01

    Full Text Available Isabelle Aujoulat,1 Patricia Jacquemin,1 Ernst Rietzschel,2 André Scheen,3 Patrick Tréfois,4 Johan Wens,5 Elisabeth Darras,1 Michel P Hermans6 1Université Catholique de Louvain, Institute of Health and Society, Brussels, 2Ghent University, Department of Cardiovascular Diseases and Department of Public Health, Faculty of Medicine and Health Sciences, Ghent, 3University of Liège, Division of Diabetes, Nutrition and Metabolic Disorders and Clinical Pharmacology Unit, CHU Liège, Liège, 4Société Scientifique de Médecine Générale, Brussels, 5University of Antwerp, Faculty of Medicine and Health Sciences, Primary and Interdisciplinary Care Antwerp, 6Université Catholique de Louvain, Institute of Experimental and Clinical Research and Cliniques Universitaires Saint-Luc, Department of Endocrinology and Nutrition, Brussels, Belgium Abstract: Failure to initiate or intensify therapy according to evidence-based guidelines is increasingly being acknowledged as a phenomenon that contributes to inadequate management of chronic conditions, and is referred to as clinical inertia. However, the number and complexity of factors associated with the clinical reasoning that underlies the decision-making processes in medicine calls for a critical examination of the consistency of the concept. Indeed, in the absence of information on and justification of treatment decisions that were made, clinical inertia may be only apparent, and actually reflect good clinical practice. This integrative review seeks to address the factors generally associated with clinical inaction, in order to better delineate the concept of true clinical inertia. Keywords: clinical inertia, evidence-based medicine, clinical decision, integrative review, concept clarification, physician adherence to guidelines

  18. Pharmacological targeting of dopamine D3 receptors: Possible clinical applications of selective drugs.

    Science.gov (United States)

    Pich, Emilio Merlo; Collo, Ginetta

    2015-09-01

    Dopamine D3 receptors have been pharmacologically engaged in humans since the development of the first antipsychotics and ergot-derivative dopamine (DA) agonists, even without knowing it. These agents were generally non-selective, developed primarily to target D2 receptors. In the last 10 years the understanding of the clinical implication of D3 receptors has been progressing also due to the identification of D3 gene polymorphisms, the use of more selective PET ligands such as [(11)C]-(+)-PHNO and the learning regarding the clinical use of the D3-preferential D2/D3 agonists ropinirole and pramipexole. A new specific neuroplasticity role of D3 receptor regarding dendrite arborisation outgrowth in dopaminergic neurons was also proposed to support, at least in part, the slowing of disease observed in subjects with Parkinson׳s Disease treated with DA agonists. Similar mechanisms could be at the basis of the antidepressant-like effects observed with DA agonists when co-administered with standard of care. Severe adverse event occurring with the use of anti-parkinsonian DA agonists in predisposed subjects, i.e., impulse control disorders, are now suggested to be putatively related to overactive D3 receptors. Not surprisingly, blockade of D3 receptors was proposed as treatment for addictive disorders, a goal that could be potentially achieved by repositioning buspirone, an anxiolytic drug with D3-preferential antagonistic features, or with novel selective D3 antagonists or partial agonists currently in development for schizophrenia. At the moment ABT-925 is the only selective D3 antagonist tested in schizophrenic patients in Phase II, showing an intriguing cognitive enhancing effects supported by preclinical data. Finally, exploratory pharmacogenetic analysis suggested that ABT-925 could be effective in a subpopulation of patients with a polymorphism on the D3 receptor, opening to a possible personalised medicine approach. PMID:26298833

  19. Clinical pharmacology study of cariprazine (MP-214) in patients with schizophrenia (12-week treatment)

    Science.gov (United States)

    Nakamura, Tadakatsu; Kubota, Tomoko; Iwakaji, Atsushi; Imada, Masayoshi; Kapás, Margit; Morio, Yasunori

    2016-01-01

    Purpose Cariprazine is a potent dopamine D3-preferring D3/D2 receptor partial agonist in development for the treatment of schizophrenia, bipolar mania, and depression. Pharmacokinetics of cariprazine and the two clinically relevant metabolites (desmethyl- and didesmethyl-cariprazine) was evaluated in a clinical pharmacology study. Methods This was a multicenter, randomized, open-label, parallel-group, fixed-dose (3, 6, or 9 mg/day) study of 28-week duration (≤4-week observation, 12-week open-label treatment, and 12-week follow-up). Once-daily cariprazine was administered to 38 adult patients with schizophrenia. The pharmacokinetics of cariprazine, metabolites, and total active moieties (sum of cariprazine and two metabolites) was evaluated; efficacy and safety were also assessed. Results Steady state was reached within 1–2 weeks for cariprazine and desmethyl-cariprazine, 4 weeks for didesmethyl-cariprazine, and 3 weeks for total active moieties. Cariprazine and desmethyl-cariprazine levels decreased >90% within 1 week after the last dose, didesmethyl-cariprazine decreased ~50% at 1 week, and total active moieties decreased ~90% within 4 weeks. Terminal half-lives of cariprazine, desmethyl-cariprazine, and didesmethyl-cariprazine ranged from 31.6 to 68.4, 29.7 to 37.5, and 314 to 446 hours, respectively. Effective half-life (calculated from time to steady state) of total active moieties was ~1 week. Incidence of treatment-emergent adverse events was 97.4%; 15.8% of patients discontinued due to adverse events. No abnormal laboratory values or major differences from baseline in extrapyramidal symptoms were observed. Conclusion Cariprazine and its active metabolites reached steady state within 4 weeks, and exposure was dose proportional over the range of 3–9 mg/day. Once-daily cariprazine was generally well tolerated in adult patients with schizophrenia. PMID:26834462

  20. Crown lengthening: a clinical review.

    Science.gov (United States)

    Talbot, T R; Briggs, P F; Gibson, M T

    1993-09-01

    The use of crown lengthening surgery as an adjunct to restorative therapy was first suggested by Rosen and Gitnick. This technique is designed to increase the clinical crown heights of teeth requiring restoration following extensive wear through attrition, abrasion and erosion. This loss of tooth tissue and resulting clinical crown height may be localized to a few teeth or affect the entire dentition. This clinical problem is reflected by the increasing number of reports of treatment of the worn dentition.

  1. A Systematic Review of Pharmacological Treatments of Pain Following Spinal Cord Injury

    Science.gov (United States)

    Teasell, Robert W.; Mehta, Swati; Aubut, Jo-Anne L.; Foulon, Brianne; Wolfe, Dalton L.; Hsieh, Jane T.C.; Townson, Andrea F.; Short, Christine

    2011-01-01

    Objective To conduct a systematic review of published research on the pharmacological treatment of pain after spinal cord injury (SCI). Data Sources Medline, CINAHL, EMBASE and PsycINFO databases were searched for articles published 1980 to June 2009 addressing the treatment of pain post SCI. Randomized controlled trials (RCTs) were assessed for methodological quality using the PEDro assessment scale, while non-RCTs were assessed using the Downs and Black evaluation tool. A level of evidence was assigned to each intervention using a modified Sackett scale. Study Selection The review included randomized controlled trials and non-randomized controlled trials which included prospective controlled trials, cohort, case series, case-control, pre-post and post studies. Case studies were included only when there were no other studies found. Data Extraction Data extracted included the PEDro or Downs and Black score, the type of study, a brief summary of intervention outcomes, type of pain, type of pain scale and the study findings.. Data Synthesis Articles selected for this particular review evaluated different interventions in the pharmacological management of pain post SCI. 28 studies met inclusion criteria: there were 21 randomized controlled trials of these 19 had Level 1 evidence. Treatments were divided into five categories: anticonvulsants, antidepressants, analgesics, cannabinoids and antispasticity medications. Conclusions Most studies did not specify participants’ types of pain; hence making it difficult to identify the type of pain being targeted by the treatment. Anticonvulsant and analgesic drugs had the highest levels of evidence and were the drugs most often studied. Gabapentin and pregabalin had strong evidence (five Level 1 RCTs) for effectiveness in treating post-SCI neuropathic pain, as did intravenous analgesics (lidocaine, ketamine and morphine) but the latter only had short term benefits. Tricyclic antidepressants only showed benefit for neuropathic

  2. Pharmacological versus microvascular decompression approaches for the treatment of trigeminal neuralgia: clinical outcomes and direct costs

    Directory of Open Access Journals (Sweden)

    Almeida A

    2011-08-01

    therapies, while after MDV surgery several patients showed important side effects. Data reinforce that, (1 TN patients should be carefully evaluated before choosing therapy for pain control, (2 different pharmacological approaches are available to initiate pain control at low costs, and (3 criteria for surgical interventions should be clearly defined due to important side effects, with the initial higher costs being strongly reduced with time.Keywords: trigeminal neuralgia, carbamazepine, gabapentin associated with ropivacaine, microvascular decompression, clinical outcomes, direct costs 

  3. A review on phyto‑pharmacological potentials of Euphorbia thymifolia L.

    Directory of Open Access Journals (Sweden)

    Prashant Y Mali

    2013-01-01

    Full Text Available Euphorbia thymifolia L. (Euphorbiaceae is a small branched, hispidly pubescent, prostate annual herb, commonly known as laghududhika or choti-dudhi. The leaves, seeds and fresh juice of whole plant are used in worm infections, as stimulant, astringent. It is also used in bowel complaints and in many more diseases therapeutically. The present work is an extensive review of published literature concerning phytochemical and pharmacological potential of E. thymifolia. Data was searched and designed using various review modalities manually and using electronic search engines with reference to all aspects of E. thymifolia and was arranged chronologically. Complete information of the plant has been collected from the various books and journals since the last 32 years, internet databases, etc., were searched. Compiled data reflects the safety and therapeutic efficacy of the plant. This will be helpful for researchers to focus on the priority areas of research yet to be explored and in scientific use of the plant for its wide variety of traditional therapeutic claims and also as to find out new chemical entities responsible for its claimed traditional activities.

  4. Clinical diagnosis and management in early Huntington's disease: a review

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    Schiefer J

    2015-03-01

    Full Text Available Johannes Schiefer,1,* Cornelius J Werner,1,* Kathrin Reetz1,2 1Euregional Huntington Center, 2Jülich Aachen Research Alliance (JARA – Translational Brain Medicine, Department of Neurology, RWTH Aachen University, Aachen, Germany *These authors contributed equally to this work Abstract: This review focuses on clinical diagnosis and both pharmacological and nonpharmacological therapeutic options in early stages of the autosomal dominant inherited neurodegenerative Huntington's disease (HD. The available literature has been reviewed for motor, cognitive, and psychiatric alterations, which are the three major symptom domains of this devastating progressive disease. From a clinical point of view, one has to be aware that the HD phenotype can vary highly across individuals and during the course of the disease. Also, symptoms in juvenile HD can differ substantially from those with adult-onset of HD. Although there is no cure of HD and management is limited, motor and psychiatric symptoms often respond to pharmacotherapy, and nonpharmacological approaches as well as supportive care are essential. International treatment recommendations based on study results, critical statements, and expert opinions have been included. This review is restricted to symptomatic and supportive approaches since all attempts to establish a cure for the disease or modifying therapies have failed so far. Keywords: Neurodegeneration, clinical picture, early symptoms, therapy, treatment

  5. A systematic review on the effectiveness of pharmacological interventions for chronic non-specific low-back pain

    OpenAIRE

    Kuijpers, T; van Middelkoop, M.; Rubinstein, S.M.; Ostelo, R.; Verhagen, A.; Koes, B W; van Tulder, M. W

    2010-01-01

    The objective of this review was to determine the effectiveness of pharmacological interventions [i.e., non-steroid anti-inflammatory drugs (NSAIDs), muscle relaxants, antidepressants, and opioids] for non-specific chronic low-back pain (LBP). Existing Cochrane reviews for the four interventions were screened for studies fulfilling the inclusion criteria. Then, the literature searches were updated. Only randomized controlled trials on adults (≥18 years) with chronic (≥12 weeks) non-specific L...

  6. Acetylsalicylic acid (ASA) - How much, how often, and when? A clinical-pharmacological perspective.

    Science.gov (United States)

    Loew, Dieter; Belz, Gustav G

    2016-08-01

    The dose of acetylsalicylic acid (ASA) commonly used in the prevention and treatment of arteriosclerotic angiopathies is equal to or less than 100 mg daily. This choice of dose is predominantly based on molecular-pharmacological findings showing an inhibition in synthesis of the prothrombotic thromboxane (TXB2) and an irreversible inhibition in blood platelet aggregation. However, an analysis of ASA dose-effect relationships for doses of 50 - 500 mg (PO and IV) shows that doses of ASA up to 100 mg daily produce only a small or moderate inhibition in collagen/epinephrine-induced platelet aggregation and have no significant effect on the important platelet factors, PF3 and PF4. Doses of ASA 300 - 500 mg, on the other hand, inhibit platelet aggregation almost completely and, in addition, produce a 50 - 70% inhibition in PF3 and PF4 lasting at least 24 hours. There is also evidence that doses of ASA above 100 mg daily markedly inhibit thromboxane synthesis for up to 24 hours and that doses of 500 mg daily produce a clinically relevant inhibition in platelet adhesion to vessel walls for up 72 hours and prevent procoagulatory shape changes for up to 12 hours. These findings suggest that a dose of ≥ 300 mg at intervals of 2 - 3 days would be more appropriate for primary and secondary prophylaxis of arteriosclerotic angiopathies and that the benefit-risk ratio would be greater because of the increased availability of mucoprotective prostaglandins, PGI2 (prostacyclin) and the gastroprotective, PGE2. Our viewpoint, predominantly based on findings with biomarkers, could serve as a basis for further randomized controlled studies.

  7. A new generation of antipsychotics: pharmacology and clinical utility of cariprazine in schizophrenia

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    Caccia S

    2013-08-01

    Full Text Available Silvio Caccia, Roberto William Invernizzi, Alessandro Nobili, Luca Pasina IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy Abstract: Cariprazine is a potential antipsychotic awaiting approval from the US Food and Drug Administration. It is a dopamine D2- and D3-receptor partial agonist, with higher affinity for D3 receptors, as opposed to the D2 antagonism of most older antipsychotic agents. Like most lipophilic antipsychotics, it undergoes extensive hepatic metabolism by cytochrome P450 (CYP, mainly the highly variable 3A4, with the formation of active metabolites. However, the parent compound – particularly its active didesmethyl derivative – is cleared very slowly, with elimination half-lives in schizophrenic patients ranging from 2–5 days for cariprazine to 2–3 weeks for didesmethyl-cariprazine. Exposure to the latter was several times that for cariprazine, although didesmethyl-cariprazine did not reach steady state within the 3 weeks of 12.5 mg/day dosing. Preliminary information on its therapeutic role comes from press releases and a few abstracts presented at scientific meetings. In short-term controlled trials, it was more effective than placebo in reducing positive and negative symptoms of schizophrenia, with an effective dose range of 1.5–12 mg/day. Although cariprazine was associated with a higher incidence of akathisia and extrapyramidal side effects than placebo, it did not cause weight gain, metabolic abnormalities, prolactin increase, or corrected QT prolongation. Similarly, cariprazine's efficacy and tolerability for the treatment of bipolar disorder (manic/mixed and depressive episodes was established in the dose range of 3–12 mg/day, although again no long-term data are available. Well-designed clinical trials, mainly direct "head-to-head" comparisons with other second-generation antipsychotic agents, are needed to define the therapeutic role and safety profile of cariprazine in schizophrenia and

  8. Pharmacologic sensitivity of paclitaxel to its delivery vehicles drives distinct clinical outcomes of paclitaxel formulations.

    Science.gov (United States)

    Li, Yan; Chen, Nianhang; Palmisano, Maria; Zhou, Simon

    2015-04-01

    Paclitaxel, an effective antitumor agent, is formulated in various vehicles serving as carriers to deliver the hydrophobic paclitaxel to tissue. The approved formulations in the U.S. are paclitaxel formulated in Cremophor EL (currently known as Kolliphor EL) and nanoparticle albumin-bound paclitaxel (nab-paclitaxel). Despite having the same active ingredient (paclitaxel), different formulations produce distinct products with unique efficacy and safety profiles. A semimechanistic model was developed to describe the pharmacologic sensitivity of paclitaxel under different formulations. Circulating paclitaxel concentration data from patients treated with nab-paclitaxel or Cremophor EL-paclitaxel were analyzed in NONMEM using a semimechanistic model with simultaneous disposition of paclitaxel-carrier complexes and the total paclitaxel released from the complexes. The key factors driving paclitaxel exposure in circulation and peripheral tissues were explored via sensitivity analysis. The rapid decline of total paclitaxel concentration following intravenous administration of nab-paclitaxel and Cremophor EL-paclitaxel was attributed to rapid tissue distribution of the paclitaxel-carrier complexes, with minor contribution of free and protein-bound paclitaxel. Distribution of nab-paclitaxel to peripheral tissue was 4-fold faster and 10-fold more extensive than that of Cremophor EL-paclitaxel micelles, resulting in distinct tissue paclitaxel profiles. Sensitivity analyses showed the plasma paclitaxel-time profile was insensitive to the rapid rates of tissue distribution and decomposition of paclitaxel-carrier complexes but that the tissue distribution profile of paclitaxel was highly sensitive. Tissue distribution of paclitaxel is carrier complex system-dependent. Different delivery systems result in distinct tissue paclitaxel profiles but similar paclitaxel concentration-time profiles in plasma or blood, rendering the paclitaxel plasma profile a poor surrogate for its

  9. A review of clinical guidelines.

    LENUS (Irish Health Repository)

    Andrews, E J

    2012-02-03

    BACKGROUND: Clinical guidelines are increasingly used in patient management but few clinicians are familiar with their origin or appropriate application. METHODS: A Medline search using the terms \\'clinical guidelines\\' and \\'practice guidelines\\' was conducted. Additional references were sourced by manual searching from the bibliographies of articles located. RESULTS AND CONCLUSION: Clinical guidelines originated in the USA in the early 1980s, initially as a cost containment exercise. Significant improvements in the process and outcomes of care have been demonstrated following their introduction, although the extent of improvement varies considerably. The principles for the development of guidelines are well established but many published guidelines fall short of these basic quality criteria. Guidelines are only one aspect of improving quality and should be used within a wider framework of promoting clinical effectiveness. Understanding their limitations as well as their potential benefits should enable clinicians to have a clearer view of their place in everyday practice.

  10. A Review of the Pharmacological Effects of the Dried Root of Polygonum cuspidatum (Hu Zhang and Its Constituents

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    Huan Zhang

    2013-01-01

    Full Text Available Traditional Chinese medicine (TCM has been widely used in China for thousands of years to treat and prevent diseases. TCM has been proven safe and effective, and it is being considered as one of the important types of complementary and alternative medicine and receives increasing attention worldwide. The dried root of Polygonum cuspidatum Sieb. et Zucc. (also known as “Hu Zhang” in Chinese is one of the medicinal herbs listed in the Pharmacopoeia of the People's Republic of China. Hu Zhang is widely distributed in the world. It can be found in Asia and North America and is used as folk medicine in countries such as Japan and Korea. In China, Hu Zhang is usually used in combination with other TCM herbs. The therapeutic uses of those Hu Zhang-containing TCM prescriptions or formulations are for treating cough, hepatitis, jaundice, amenorrhea, leucorrhea, arthralgia, burns and snake bites. Recent pharmacological and clinical studies have indicated that Hu Zhang has antiviral, antimicrobial, anti-inflammatory, neuroprotective, and cardioprotective functions. This review gives a summary of the reported therapeutic effects of the active compounds and the different extracts of Hu Zhang.

  11. Pharmacological Treatment of Sleep Disturbance in Developmental Disabilities: A Review of the Literature

    Science.gov (United States)

    Hollway, Jill A.; Aman, Michael G.

    2011-01-01

    Sleep disturbance is a common problem in children with developmental disabilities. Effective pharmacologic interventions are needed to ameliorate sleep problems that persist when behavior therapy alone is insufficient. The aim of the present study was to provide an overview of the quantity and quality of pharmacologic research targeting sleep in…

  12. Therapeutic significance and pharmacological activities of antidiarrheal medicinal plants mention in Ayurveda: A review.

    Science.gov (United States)

    Mishra, Ashish; Seth, Ankit; Maurya, Santosh Kumar

    2016-01-01

    Diarrhea is a serious problem affecting 3-5 billion people per year around the world, especially children of below 5 years. 70% of the world population uses traditional and indigenous medicine for their primary health care. The facts of these indigenous remedies are passed verbally and sometimes as documents. Since ancient time, Ayurveda is the main system of healing in South East Asian countries. Indian literature from ayurvedic texts and other books claim the potency of several plants in the treatment of diarrhea. As the global prospective of ayurvedic medicine is increasing, interest regarding the scientific basis of their action is parallely increasing. Researchers are doing experiments to establish the relation between the claimed action and observed pharmacological activities. In the present article, an attempt was made to compile the scientific basis of medicinal plants used to cure diarrhea in Ayurveda. Literature was collected via electronic search (PubMed, ScienceDirect, Medline, and Google Scholar) from published articles that reports antidiarrheal activity of plants that were mentioned in Ayurveda classics. A total of 109 plant species belonging to 58 families were reported for their antidiarrheal activity. Several Indian medicinal plants have demonstrated promising antidiarrheal effects, but the studies on the antidiarrheal potentials of these plants are not taken beyond proof of concept stage. It is hoped that the article would stimulate future clinical studies because of the paucity of knowledge in this area. PMID:27366356

  13. Therapeutic significance and pharmacological activities of antidiarrheal medicinal plants mention in Ayurveda: A review

    Science.gov (United States)

    Mishra, Ashish; Seth, Ankit; Maurya, Santosh Kumar

    2016-01-01

    Diarrhea is a serious problem affecting 3-5 billion people per year around the world, especially children of below 5 years. 70% of the world population uses traditional and indigenous medicine for their primary health care. The facts of these indigenous remedies are passed verbally and sometimes as documents. Since ancient time, Ayurveda is the main system of healing in South East Asian countries. Indian literature from ayurvedic texts and other books claim the potency of several plants in the treatment of diarrhea. As the global prospective of ayurvedic medicine is increasing, interest regarding the scientific basis of their action is parallely increasing. Researchers are doing experiments to establish the relation between the claimed action and observed pharmacological activities. In the present article, an attempt was made to compile the scientific basis of medicinal plants used to cure diarrhea in Ayurveda. Literature was collected via electronic search (PubMed, ScienceDirect, Medline, and Google Scholar) from published articles that reports antidiarrheal activity of plants that were mentioned in Ayurveda classics. A total of 109 plant species belonging to 58 families were reported for their antidiarrheal activity. Several Indian medicinal plants have demonstrated promising antidiarrheal effects, but the studies on the antidiarrheal potentials of these plants are not taken beyond proof of concept stage. It is hoped that the article would stimulate future clinical studies because of the paucity of knowledge in this area. PMID:27366356

  14. A Review on the taxonomy, ethnobotany, chemistry and pharmacology of Oroxylum indicum vent

    Directory of Open Access Journals (Sweden)

    Harminder

    2011-01-01

    Full Text Available Oroxylum indicum Vent. (O. indicum is a tree commonly called Indian trumpet tree found in tropical countries, such as India, Japan, China, Sri Lanka, Malaysia. The chemical constituents obtained from different parts of plant include baicalein-7-O-diglucoside (Oroxylin B, baicalein-7-O-glucoside, chrysin, apegenin, prunetin, sitosterol, oroxindin, biochanin-A, ellagic acid, baicalein and its 6- and 7-glucuronides, scutellarein, tetuin, antraquinone and aloe-emodin. Various parts of the plant are used in Ayurveda and folk medicine for the treatment of different ailments such as cancer, diarrhea, fever, ulcer and jaundice. Recent in vivo and in vitro studies have indicated its antiinflammatory, antiulcer, hepatoprotective, anticancer, antioxidant, photocytotoxic, antiproliferative, antiarthritic, antimicrobial, antimutagenic and immunostimulant properties. Exhaustive literature survey reveals that there are some activities which are still not proven scientifically. This article is an attempt to compile an up-to-date and comprehensive review on O. indicum covering its traditional and folk medicinal uses, phytochemistry and pharmacology.

  15. Medical record review for clinical pertinence.

    Science.gov (United States)

    Lewis, K S

    1991-08-01

    This clinical pertinence review process described was in effect for seven months, after which the author terminated affiliation with the hospital. Despite resistance by many physicians, this monthly review process focused the medical staff's attention on good documentation practices. To the author's knowledge, the plan is still in use.

  16. Lifestyle-oriented non-pharmacological treatments for fibromyalgia: a clinical overview and applications with home-based technologies

    Directory of Open Access Journals (Sweden)

    Friedberg F

    2012-10-01

    Full Text Available Fred Friedberg,1 David A Williams,2 William Collinge31Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, New York; 2Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, 3Collinge and Associates, Kittery, Maine, USAAbstract: Fibromyalgia (FM is a persistent and disabling widespread pain condition often accompanied by chronic fatigue, cognitive problems, sleep disturbance, depression, anxiety, and headache. To date, the most thoroughly studied non-pharmacological approaches to managing FM are those with a focus on changing patient activities and beliefs that affect the illness. These interventions are intended to facilitate enduring improvement in pain and functional status. Lifestyle-oriented treatments include patient education, aerobic or other physical exercise, and cognitive-behavioral therapy (CBT. These interventions in FM can be delivered in medical or behavioral health care settings by trained professionals, through patient-oriented treatment manuals, or via remote-access technologies. Non-pharmacological treatments, in particular exercise and CBT, have yielded effect sizes and cost–benefit ratios comparable to medications. This paper describes lifestyle-oriented non-pharmacological treatments for FM and highlights selected literature reviews of these interventions. In addition, behavioral and practical issues are addressed that may affect these non-pharmacological treatments, including patient expectations, participant burden, and treatment availability. Recommendations are made to facilitate these interventions and potentially improve outcomes. In particular, the increasing availability of convenient home-based mobile technologies to deliver these non-pharmacological treatments is described.Keywords: cognitive-behavior therapy, exercise, education, mobile technology

  17. Establishing a clinical pharmacology fellowship program for physicians, pharmacists, and pharmacologists: a newly accredited interdisciplinary training program at the Ohio State University

    Directory of Open Access Journals (Sweden)

    Kitzmiller JP

    2014-06-01

    Full Text Available Joseph P Kitzmiller,1,4 Mitch A Phelps,2 Marjorie V Neidecker,3 Glen Apseloff41Center for Pharmacogenomics, Colleges of Medicine and of Engineering, The Ohio State University Medical Center, 2Colleges of Pharmacy and Medicine, Pharmacoanalytic Shared Resources Laboratory, The Ohio State University, 3Colleges of Medicine, Nursing, and Pharmacy, The Ohio State University, 4Department of Pharmacology, The Ohio State University College of Medicine, Columbus, OH, USAAbstract: Studying the effect of drugs on humans, clinical pharmacologists play an essential role in many academic medical and research teams, within the pharmaceutical industry and as members of government regulatory entities. Clinical pharmacology fellowship training programs should be multidisciplinary and adaptable, and should combine didactics, applied learning, independent study, and one-on-one instruction. This article describes a recently developed 2 year clinical pharmacology fellowship program – one of only nine accredited by the American Board of Clinical Pharmacology – that is an integrative, multi faceted, adaptable method for training physicians, pharmacists, and scientists for leadership roles in the pharmaceutical industry, in academia, or with regulatory or accreditation agencies. The purpose of this article is to provide information for academic clinicians and researchers interested in designing a similar program, for professionals in the field of clinical pharmacology who are already affiliated with a fellowship program and may benefit from supplemental information, and for clinical researchers interested in clinical pharmacology who may not be aware that such training opportunities exist. This article provides the details of a recently accredited program, including design, implementation, accreditation, trainee success, and future directions.Keywords: clinical pharmacology education, clinical pharmacology fellowship

  18. Phyto - chemistry and pharmacology of shankapushpi - four varieties.

    Science.gov (United States)

    Aulakh, G S; Narayanan, S; Mahadevan, G

    1988-01-01

    Pharmacognosy, Pharmacology, Clinical studies and photochemistry of the four plants, viz., Convolvulus pluricaulis, Evolvulus alsinoides, Canscora decussate and Clitoria ternatea commonly used as the drug Shankapushphi have been reviewed here. PMID:22557606

  19. Folk uses and pharmacological properties of Casearia sylvestris: a medicinal review

    Directory of Open Access Journals (Sweden)

    Paulo Michel P. Ferreira

    2011-12-01

    Full Text Available Folk uses and scientific investigations have highlighted the importance of Casearia sylvestris extracts and their relevant bioactive potential. The aim of this work was to review the pharmacological properties of C. sylvestris, emphasizing its anti-ulcer, anti-inflammatory, anti-ophidian and antitumor potentialities. Ethanolic extracts and essential oil of their leaves have antiulcerogenic activity and reduce gastric volume without altering the stomach pH, which corroborates their consumption on gastrointestinal disorders. Leaf water extracts show phospholipase A2 inhibitory activity that prevents damage effects on the muscular tissue after toxin inoculation. This antiphospholipasic action is probably related to the use as an anti-inflammatory, proposing a pharmacological blockage similar to that obtained with non-steroidal anti-inflammatory drugs on arachidonic acid and cyclooxygenase pathways. Bioguided-assay fractionations lead to the identification of secondary metabolites, especially the clerodane diterpenes casearins (A-X and casearvestrins (A-C, compounds with a remarkable cytotoxic and antitumor action. Therefore, the C. sylvestris shrub holds a known worldwide pharmacological arsenal by its extensive folk utilization, exciting searches for new molecules and a better comprehension about biological properties.Usos populares e pesquisas científicas têm destacado a importância dos extratos da planta Casearia sylvestris e seu grande potencial bioativo. Neste trabalho, objetiva-se revisar as propriedades farmacológicas de C. sylvestris, enfatizando sua potencialidade antiulcerogênica, antiinflamatória, antiofídica e antitumoral. O extrato etanólico e o óleo essencial das folhas possuem atividade antiulcerogênica promissora, diminuindo o volume gástrico sem alterar o pH estomacal, corroborando sua aplicação contra dores gastrointestinais. Já os extratos aquosos das folhas têm atividade inibitória contra fosfolipase A2 presente

  20. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: protocol for a systematic review and network meta-analysis of randomized controlled trials

    OpenAIRE

    Catalá López, Ferrán; Hutton, Brian; Núñez Beltrán, Amparo; Mayhew, Alain D.; Matthew J Page; Ridao, Manuel; Tobías, Aurelio; Catalá, Miguel A; Tabarés Seisdedos, Rafael; Moher, David

    2015-01-01

    Background Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of children and adolescents, with a significant impact on health services and the community in terms of economic and social burdens. The objective of this systematic review will be to evaluate the comparative efficacy and safety of pharmacological and non-pharmacological treatments in children and adolescents with ADHD. Methods Searches involving PubMed/MEDLINE and the Cochrane Da...

  1. PRESENTING CLINICAL-PHARMACOLOGY AND THERAPEUTICS - A PROBLEM-BASED APPROACH FOR CHOOSING AND PRESCRIBING DRUGS

    NARCIS (Netherlands)

    DEVRIES, TPGM

    1993-01-01

    As a guide to the rational choice and prescribing of drugs a normative (ideal) problem-solving model has been developed. This model combines medical problem solving and decision analysis, practical medical aspects, and pharmacological facts and basic principles. It consists of a set of actions or st

  2. Reducing medication errors and increasing patient safety: case studies in clinical pharmacology.

    Science.gov (United States)

    Benjamin, David M

    2003-07-01

    Today, reducing medication errors and improving patient safety have become common topics of discussion for the president of the United States, federal and state legislators, the insurance industry, pharmaceutical companies, health care professionals, and patients. But this is not news to clinical pharmacologists. Improving the judicious use of medications and minimizing adverse drug reactions have always been key areas of research and study for those working in clinical pharmacology. However, added to the older terms of adverse drug reactions and rational therapeutics, the now politically correct expression of medication error has emerged. Focusing on the word error has drawn attention to "prevention" and what can be done to minimize mistakes and improve patient safety. Webster's New Collegiate Dictionary has several definitions of error, but the one that seems to be most appropriate in the context of medication errors is "an act that through ingnorance, deficiency, or accident departs from or fails to achieve what should be done." What should be done is generally known as "the five rights": the right drug, right dose, right route, right time, and right patient. One can make an error of omission (failure to act correctly) or an error of commission (acted incorrectly). This article now summarizes what is currently known about medication errors and translates the information into case studies illustrating common scenarios leading to medication errors. Each case is analyzed to provide insight into how the medication error could have been prevented. "System errors" are described, and the application of failure mode effect analysis (FMEA) is presented to determine the part of the "safety net" that failed. Examples of reengineering the system to make it more "error proof" are presented. An error can be prevented. However, the practice of medicine, pharmacy, and nursing in the hospital setting is very complicated, and so many steps occur from "pen to patient" that there

  3. International Union of Basic and Clinical Pharmacology. XCVI. Pattern recognition receptors in health and disease.

    Science.gov (United States)

    Bryant, Clare E; Orr, Selinda; Ferguson, Brian; Symmons, Martyn F; Boyle, Joseph P; Monie, Tom P

    2015-01-01

    Since the discovery of Toll, in the fruit fly Drosophila melanogaster, as the first described pattern recognition receptor (PRR) in 1996, many families of these receptors have been discovered and characterized. PRRs play critically important roles in pathogen recognition to initiate innate immune responses that ultimately link to the generation of adaptive immunity. Activation of PRRs leads to the induction of immune and inflammatory genes, including proinflammatory cytokines and chemokines. It is increasingly clear that many PRRs are linked to a range of inflammatory, infectious, immune, and chronic degenerative diseases. Several drugs to modulate PRR activity are already in clinical trials and many more are likely to appear in the near future. Here, we review the different families of mammalian PRRs, the ligands they recognize, the mechanisms of activation, their role in disease, and the potential of targeting these proteins to develop the anti-inflammatory therapeutics of the future.

  4. Huntington's disease: a clinical review

    Directory of Open Access Journals (Sweden)

    Roos Raymund AC

    2010-12-01

    Full Text Available Abstract Huntington disease (HD is a rare neurodegenerative disorder of the central nervous system characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia. Prevalence in the Caucasian population is estimated at 1/10,000-1/20,000. Mean age at onset of symptoms is 30-50 years. In some cases symptoms start before the age of 20 years with behavior disturbances and learning difficulties at school (Juvenile Huntington's disease; JHD. The classic sign is chorea that gradually spreads to all muscles. All psychomotor processes become severely retarded. Patients experience psychiatric symptoms and cognitive decline. HD is an autosomal dominant inherited disease caused by an elongated CAG repeat (36 repeats or more on the short arm of chromosome 4p16.3 in the Huntingtine gene. The longer the CAG repeat, the earlier the onset of disease. In cases of JHD the repeat often exceeds 55. Diagnosis is based on clinical symptoms and signs in an individual with a parent with proven HD, and is confirmed by DNA determination. Pre-manifest diagnosis should only be performed by multidisciplinary teams in healthy at-risk adult individuals who want to know whether they carry the mutation or not. Differential diagnoses include other causes of chorea including general internal disorders or iatrogenic disorders. Phenocopies (clinically diagnosed cases of HD without the genetic mutation are observed. Prenatal diagnosis is possible by chorionic villus sampling or amniocentesis. Preimplantation diagnosis with in vitro fertilization is offered in several countries. There is no cure. Management should be multidisciplinary and is based on treating symptoms with a view to improving quality of life. Chorea is treated with dopamine receptor blocking or depleting agents. Medication and non-medical care for depression and aggressive behavior may be required. The progression of the disease leads to a complete dependency in daily life, which

  5. Estetrol review: profile and potential clinical applications.

    Science.gov (United States)

    Coelingh Bennink, H J T; Holinka, C F; Diczfalusy, E

    2008-01-01

    In this review paper, the existing information on the human fetal steroid estetrol (E4) has been summarized. In the past, E4 was considered as a weak estrogen and interest disappeared. However, recent new research has demonstrated that E4 is a potent, orally bioavailable, natural human fetal selective estrogen receptor modulator, since it acts in the rat as an estrogen on all tissues investigated except breast tumor tissue, where it has estrogen antagonistic properties in the presence of estradiol. Based on its safety data, its pharmacokinetic properties, its pharmacological profile and the results of first human studies, E4 may be suitable as a potential drug for human use in applications such as hormone replacement therapy (vaginal atrophy, hot flushes), contraception and osteoporosis. Additional areas worth exploring are the treatment of breast and prostate cancer, hypoactive sexual desire disorder and topical use (wrinkles) in women, auto-immune diseases, migraine, cardiovascular applications and the treatment of selected obstetric disorders. PMID:18464023

  6. Brinzolamide ophthalmic suspension: a review of its pharmacology and use in the treatment of open angle glaucoma and ocular hypertension

    OpenAIRE

    Michele Iester

    2008-01-01

    Michele IesterClinica Oculistica, University of Genoa, ItalyAbstract: Brinzolamide is a white powder commercially formulated as a 1% ophthalmic suspension to reduce intraocular pressure (IOP). Pharmacologically, brinzolamide is a highly specific, non-competitive, reversible, and effective inhibitor of carbonic anhydrase II (CA-II), able to suppress formation of aqueous humor in the eye and thus to decrease IOP. Several clinical trials have evaluated its safety and the most commonly ocular adv...

  7. Pediatric Clinical Pharmacology of Voriconazole: Role of Pharmacokinetic/Pharmacodynamic Modeling in Pharmacotherapy.

    Science.gov (United States)

    Kadam, Rajendra S; Van Den Anker, Johannes N

    2016-09-01

    Voriconazole is a potent antifungal agent used for the treatment of invasive fungal infections caused by Aspergillus and Candida species in adult and pediatric patients. Voriconazole has a narrow therapeutic index and a large intra- and inter-individual pharmacokinetics (PK) variability. Several factors including non-linear PK, age, body weight, cytochrome P450 2C19 genotype, concomitant drugs, liver function, and food are responsible for the large variability in voriconazole PK. A combination of a narrow therapeutic index with a large PK variability results in treatment failure in many patients at clinically recommended doses. There is an urgent need to establish an optimal dosing regimen for pediatric patients 60 %) treatment failure rates. Therapeutic drug monitoring is commonly used in clinical practice to optimize the voriconazole dosing regimens in pediatric patients, but it is associated with several practical limitations. Implementation of a PK model-guided individualized dose selection will help in reducing the PK variability and will improve therapeutic outcomes. In this review, we have summarized the covariates influencing the PK of voriconazole in adult and pediatric patients, emphasizing that the clearance of voriconazole is significantly different between adult and pediatric patients owing to developmental changes in the major clearance pathways. Moreover, we have provided the limitations of the current dosing regimens and have proposed a new dosing method using a PK model-guided dose individualization of voriconazole in pediatric patients.

  8. The Experiences of and Attitudes toward Non-Pharmacological Interventions for Attention-Deficit/hyperactivity Disorder Used in School Settings: A Systematic Review and Synthesis of Qualitative Research

    Science.gov (United States)

    Moore, Darren A.; Gwernan-Jones, Ruth; Richardson, Michelle; Racey, Daniel; Rogers, Morwenna; Stein, Ken; Thompson-Coon, Jo; Ford, Tamsin J.; Garside, Ruth

    2016-01-01

    School-based non-pharmacological interventions are an important part of the treatment of attention-deficit/hyperactivity disorder (ADHD). We aimed to systematically review qualitative literature relating to the experience of and attitudes towards school-based non-pharmacological interventions for ADHD. Systematic searches of 20 electronic…

  9. "Hemicrania continua": a clinical review.

    Science.gov (United States)

    Bordini, C; Antonaci, F; Stovner, L J; Schrader, H; Sjaastad, O

    1991-01-01

    Hemicrania continua (HC) is a headache entity completely responsive to indomethacin. Since 1984, 18 cases have been described, 15 females and 3 males, i.e. a F:M ratio of 5.0. The finding of a female preponderance, like that in chronic paroxysmal hemicrania, is a new observation. HC is, in general, a unilateral headache in the sense that it sets in on one side and subsequently sticks to this side. In two cases, both sides might possibly be involved, when the pain was at its maximum. In another (somewhat dubious) case the headache was bilateral. The pain was continuous from the beginning in 8 of 18 cases (early stage ratio continuous: non-continuous = 0.8). Over time, the headache developed a continuous character in 16 of the 18 cases, producing a "continuous: non-continuous ratio" of 8:1. The intensity of pain generally was moderate and was not reported as excruciatingly severe by any patient. The autonomic involvement from a clinical point of view, was clearly less pronounced than that of other unilateral headaches, such as cluster headache and chronic paroxysmal hemicrania.

  10. Review of the traditional uses, phytochemistry, pharmacology and toxicology of giant fennel (Ferula communis L. subsp. communis

    Directory of Open Access Journals (Sweden)

    Maryam Akaberi

    2015-11-01

    Full Text Available Ferula communis L., subsp. communis, namely giant fennel, has extensively been used in traditional medicine for a wide range of ailments. Fresh plant materials, crude extracts and isolated components of F. communis showed a wide spectrum of in vitro and in vivo pharmacological properties including antidiabetic, antimicrobial, antiproliferative, and cytotoxic activities. The present paper, reviews the traditional uses, botany, phytochemistry, pharmacology and toxicology of F. communis in order to reveal its therapeutic potential and future research opportunities. A bibliographic literature search was conducted in different scientific databases and search engines including Scopus, Cochrane Library, Embase, Google Scholar, Pubmed, SciFinder, and Web of science. Phytochemical studies have led to the isolation of different compounds such as sesquiterpenes from F. communis. This plant has two different chemotypes, the poisonous and non-poisonous chemotypes. Each chemotype is endowed with various constituents and different activities. The poisonous chemotype exhibits anticoagulant and cytotoxic activities with sesquiterpene coumarins as major constituents, while the non-poisonous one exhibits estrogenic and cytotoxic effects with daucane sesquiterpene esters as the main compounds. In addition, although various pharmacological properties have been reported for F. communis, anti-microbial activities of the plant have been investigated in most studies. Studies revealed that F. communis exhibits different biological activities, and contains various bioactive compounds. Although, antibacterial and cytotoxic activities are the two main pharmacological effects of this plant, further studies should focus on the mechanisms underlying these actions, as well as on those biological activities that have been reported traditionally.

  11. 聚卡波非钙的药理及临床研究%Progress on pharmacology and clinical research of calcium polycarbophil

    Institute of Scientific and Technical Information of China (English)

    韩振杰; 袁耀宗

    2012-01-01

    通过文献回顾,评价聚卡波非钙治疗肠易激综合征及其他原因所致便秘的药理作用、药动学、临床研究和安全性.本品为高分子聚合物,临床试验显示其对肠易激综合症及其他原因引起的便秘具有很好的疗效,主要的不良反应为消化道症状.%By literature review, pharmacology, pharmacokinetics, clinical study, and safety of calcium polycarbophil in the treatment of constipation in irritable bowel syndrome and others were evaluated in the paper. As a polymer, calcium polycarbophil has a positive effect on IBS and other constipation. The main adverse drug reaction is the digestive system symptoms.

  12. Targeting poly(ADP-ribose)polymerase1 in neurological diseases: A promising trove for new pharmacological interventions to enter clinical translation.

    Science.gov (United States)

    Sriram, Chandra Shekhar; Jangra, Ashok; Kasala, Eshvendar Reddy; Bodduluru, Lakshmi Narendra; Bezbaruah, Babul Kumar

    2014-10-01

    The highly conserved abundant nuclear protein poly(ADP-ribose)polymerase1 (PARP1) functions at the center of cellular stress response and is mainly implied in DNA damage repair mechanism. Apart from its involvement in DNA damage repair, it does sway multiple vital cellular processes such as cell death pathways, cell aging, insulator function, chromatin modification, transcription and mitotic apparatus function. Since brain is the principal organ vulnerable to oxidative stress and inflammatory responses, upon stress encounters robust DNA damage can occur and intense PARP1 activation may result that will lead to various CNS diseases. In the context of soaring interest towards PARP1 as a therapeutic target for newer pharmacological interventions, here in the present review, we are attempting to give a silhouette of the role of PARP1 in the neurological diseases and the potential of its inhibitors to enter clinical translation, along with its structural and functional aspects. PMID:25049175

  13. The use of benzodiazepines in the aged patient: clinical and pharmacological considerations.

    Science.gov (United States)

    Dailly, Eric; Bourin, Michel

    2008-04-01

    Benzodiazepines are widely used to treat anxiety and insomnia in elderly patients. The interest of this prescription is discussed in this article. The discussion is based on the pharmacological properties and adverse effects of benzodiazepines in the elderly subjects. The conclusions are that benzodiazepines should be rarely prescribed in elderly people; many patients treated by benzodiazepines should be withdrawn and other therapeutic strategies than benzodiazepines should be considered to treat anxiety and insomnia in the elderly patients.

  14. Pharmacological treatment of painful HIV-associated sensory neuropathy: a systematic review and meta-analysis of randomised controlled trials.

    Directory of Open Access Journals (Sweden)

    Tudor J C Phillips

    Full Text Available BACKGROUND: Significant pain from HIV-associated sensory neuropathy (HIV-SN affects ∼40% of HIV infected individuals treated with antiretroviral therapy (ART. The prevalence of HIV-SN has increased despite the more widespread use of ART. With the global HIV prevalence estimated at 33 million, and with infected individuals gaining increased access to ART, painful HIV-SN represents a large and expanding world health problem. There is an urgent need to develop effective pain management strategies for this condition. METHOD AND FINDINGS: OBJECTIVE: To evaluate the clinical effectiveness of analgesics in treating painful HIV-SN. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline, Cochrane central register of controlled trials, www.clinicaltrials.gov, www.controlled-trials.com and the reference lists of retrieved articles. SELECTION CRITERIA: Prospective, double-blinded, randomised controlled trials (RCTs investigating the pharmacological treatment of painful HIV-SN with sufficient quality assessed using a modified Jadad scoring method. REVIEW METHODS: Four authors assessed the eligibility of articles for inclusion. Agreement of inclusion was reached by consensus and arbitration. Two authors conducted data extraction and analysis. Dichotomous outcome measures (≥ 30% and ≥ 50% pain reduction were sought from RCTs reporting interventions with statistically significant efficacies greater than placebo. These data were used to calculate RR and NNT values. RESULTS: Of 44 studies identified, 19 were RCTs. Of these, 14 fulfilled the inclusion criteria. Interventions demonstrating greater efficacy than placebo were smoked cannabis NNT 3.38 95%CI(1.38 to 4.10, topical capsaicin 8%, and recombinant human nerve growth factor (rhNGF. No superiority over placebo was reported in RCTs that examined amitriptyline (100mg/day, gabapentin (2.4 g/day, pregabalin (1200 mg/day, prosaptide (16 mg/day, peptide-T (6 mg/day, acetyl-L-carnitine (1g

  15. Molecular targets of Chinese herbs: a clinical study of hepatoma based on network pharmacology

    Science.gov (United States)

    Gao, Li; Wang, Xiao-dong; Niu, Yang-yang; Duan, Dan-dan; Yang, Xue; Hao, Jian; Zhu, Cui-hong; Chen, Dan; Wang, Ke-xin; Qin, Xue-mei; Wu, Xiong-zhi

    2016-01-01

    Traditional Chinese medicine (TCM) has been used to treat tumors for years and has been demonstrated to be effective. However, the underlying molecular mechanisms of herbs remain unclear. This study aims to ascertain molecular targets of herbs prolonging survival time of patients with advanced hepatocellular carcinoma (HCC) based on network pharmacology, and to establish a research method for accurate treatment of TCM. The survival benefit of TCM treatment with Chinese herbal medicine (CHM) was proved by Kaplan–Meier method and Cox regression analysis among 288 patients. The correlation between herbs and survival time was performed by bivariate correlation analysis. Network pharmacology method was utilized to construct the active ingredient-target networks of herbs that were responsible for the beneficial effects against HCC. Cox regression analysis showed CHM was an independent favorable prognostic factor. The median survival time was 13 months and the 5-year overall survival rates were 2.61% in the TCM group, while there were 6 months, 0 in the non-TCM group. Correlation analysis demonstrated that 8 herbs closely associated with prognosis. Network pharmacology analysis revealed that the 8 herbs regulated multiple HCC relative genes, among which the genes affected proliferation (KRAS, AKT2, MAPK), metastasis (SRC, MMP), angiogenesis (PTGS2) and apoptosis (CASP3) etc. PMID:27143508

  16. Application of a utility analysis to evaluate a novel assessment tool for clinically oriented physiology and pharmacology.

    Science.gov (United States)

    Cramer, Nicholas; Asmar, Abdo; Gorman, Laurel; Gros, Bernard; Harris, David; Howard, Thomas; Hussain, Mujtaba; Salazar, Sergio; Kibble, Jonathan D

    2016-09-01

    Multiple-choice questions are a gold-standard tool in medical school for assessment of knowledge and are the mainstay of licensing examinations. However, multiple-choice questions items can be criticized for lacking the ability to test higher-order learning or integrative thinking across multiple disciplines. Our objective was to develop a novel assessment that would address understanding of pathophysiology and pharmacology, evaluate learning at the levels of application, evaluation and synthesis, and allow students to demonstrate clinical reasoning. The rubric assesses student writeups of clinical case problems. The method is based on the physician's traditional postencounter Subjective, Objective, Assessment and Plan note. Students were required to correctly identify subjective and objective findings in authentic clinical case problems, to ascribe pathophysiological as well as pharmacological mechanisms to these findings, and to justify a list of differential diagnoses. A utility analysis was undertaken to evaluate the new assessment tool by appraising its reliability, validity, feasibility, cost effectiveness, acceptability, and educational impact using a mixed-method approach. The Subjective, Objective, Assessment and Plan assessment tool scored highly in terms of validity and educational impact and had acceptable levels of statistical reliability but was limited in terms of acceptance, feasibility, and cost effectiveness due to high time demands on expert graders and workload concerns from students. We conclude by making suggestions for improving the tool and recommend deployment of the instrument for low-stakes summative assessment or formative assessment.

  17. Application of a utility analysis to evaluate a novel assessment tool for clinically oriented physiology and pharmacology.

    Science.gov (United States)

    Cramer, Nicholas; Asmar, Abdo; Gorman, Laurel; Gros, Bernard; Harris, David; Howard, Thomas; Hussain, Mujtaba; Salazar, Sergio; Kibble, Jonathan D

    2016-09-01

    Multiple-choice questions are a gold-standard tool in medical school for assessment of knowledge and are the mainstay of licensing examinations. However, multiple-choice questions items can be criticized for lacking the ability to test higher-order learning or integrative thinking across multiple disciplines. Our objective was to develop a novel assessment that would address understanding of pathophysiology and pharmacology, evaluate learning at the levels of application, evaluation and synthesis, and allow students to demonstrate clinical reasoning. The rubric assesses student writeups of clinical case problems. The method is based on the physician's traditional postencounter Subjective, Objective, Assessment and Plan note. Students were required to correctly identify subjective and objective findings in authentic clinical case problems, to ascribe pathophysiological as well as pharmacological mechanisms to these findings, and to justify a list of differential diagnoses. A utility analysis was undertaken to evaluate the new assessment tool by appraising its reliability, validity, feasibility, cost effectiveness, acceptability, and educational impact using a mixed-method approach. The Subjective, Objective, Assessment and Plan assessment tool scored highly in terms of validity and educational impact and had acceptable levels of statistical reliability but was limited in terms of acceptance, feasibility, and cost effectiveness due to high time demands on expert graders and workload concerns from students. We conclude by making suggestions for improving the tool and recommend deployment of the instrument for low-stakes summative assessment or formative assessment. PMID:27445277

  18. A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder.

    Science.gov (United States)

    Briars, Leslie; Todd, Timothy

    2016-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common psychological diagnosis in children. This disorder impacts children and adolescents in all areas of life, including academic performance, extracurricular activities, and social interactions. ADHD can continue into adulthood where unemployment and substance abuse has been described. Although behavioral therapy is recommended for all patients with ADHD, medication management typically is initiated soon after diagnosis. Psychostimulants remain the primary medication of choice. This review focuses on the clinical use of psychostimulant medication in children and adolescents. The pharmacodynamic and pharmacokinetic differences between the newest long-acting formulations as well as commonly encountered adverse drug reactions, with suggested management strategies, will be highlighted. Non-stimulant therapy with atomoxetine or alpha2-adrenergic agonists is also reviewed. These agents may be warranted for patients who cannot tolerate psychostimulant therapy or have a comorbid condition. Finally, the 8-year multimodal treatment study results are also discussed. PMID:27453697

  19. Review on medicinal uses, pharmacological, phytochemistry and immunomodulatory activity of plants.

    Science.gov (United States)

    Akram, M; Hamid, A; Khalil, A; Ghaffar, A; Tayyaba, N; Saeed, A; Ali, M; Naveed, A

    2014-01-01

    Since ancient times, plants have been an exemplary source of medicine. Researchers have discovered some important compounds from plants. The present work constitutes a review of the medicinal plants whose immunomodulant activity has been proven. We performed PUBMED, EMBASE, Google scholar searches for research papers of medicinal plants having immunomodulant activity. Medicinal plants used by traditional physicians or reported as having immunomodulant activity include Acacia concocinna, Camellia sinensis, Lawsonia inermis Linn, Piper longum Linn, Gelidium amansii, Petroselinum crispum, Plantago major and Allium sativum. Immunomodulant activities of some of these medicinal plants have been investigated. The medicinal plants documented have immunomodulant activity and should be further investigated via clinical trial. PMID:25280022

  20. 交叉过敏的临床药学干预%Clinical Pharmacological Intervention on Cross Allergy

    Institute of Scientific and Technical Information of China (English)

    严磊; 寿军; 周权; 王华芬

    2012-01-01

    OBJECTIVE To promote the clinical awareness of cross allergy and prevent the occurrence of medical errors. METHODS Prescribing information on cross allergy in "Contraindications" was derived from a software. Records of drug counseling, cases of medical errors and near misses in an online reporting system were analyzed. Data mining was performed. Clinical pharmacological interventions were conducted and the effects were evaluated. RESULTS Besides 27 kinds of drugs within pharmacologically similar class involving cross allergy, there were seven kinds of drugs with complete different pharmacological effects. Similarity in chemical structures was the main case of cross allergy. Excipients were related with cross allergy. Prescribing information in some drugs had unscientific descriptions on cross allergy associated contraindications, lacking clinical value in guiding safe use of medication. There were difference in descriptions on cross allergy in some drugs within pharmacologically similar clas, and some domestic and imported products. The problem of cross allergy of drugs involving different pharmacological effects was dangerous and not easy to be detected. After pharmacological interventions, awareness was greatly increased and the occurrence rate of medical errors and similar mistake decreased by 97%. CONCLISION Severe potential safety hazard might exist if more attentions are not paid to cross allergy aspect. The comprehensive pharmacological interventions are very effective. Applications of information technology and data maintenance are pivotal for continuous quality improvement in cross allergy aspect.%目的 促进临床医护人员对药物交叉过敏的意识,防范用药失误发生.方法 对药物说明书禁忌症中有关交叉过敏的描述进行信息分析和数据挖掘.对药物咨询、用药失误和近似错误在线呈报系统记录进行分析.实施临床药学综合性干预措施,并评估干预效果.结果 除药理作用相似的27

  1. Establishing a clinical pharmacology fellowship program for physicians, pharmacists, and pharmacologists: a newly accredited interdisciplinary training program at the Ohio State University.

    Science.gov (United States)

    Kitzmiller, Joseph P; Phelps, Mitch A; Neidecker, Marjorie V; Apseloff, Glen

    2014-01-01

    Studying the effect of drugs on humans, clinical pharmacologists play an essential role in many academic medical and research teams, within the pharmaceutical industry and as members of government regulatory entities. Clinical pharmacology fellowship training programs should be multidisciplinary and adaptable, and should combine didactics, applied learning, independent study, and one-on-one instruction. This article describes a recently developed 2 year clinical pharmacology fellowship program - one of only nine accredited by the American Board of Clinical Pharmacology - that is an integrative, multi faceted, adaptable method for training physicians, pharmacists, and scientists for leadership roles in the pharmaceutical industry, in academia, or with regulatory or accreditation agencies. The purpose of this article is to provide information for academic clinicians and researchers interested in designing a similar program, for professionals in the field of clinical pharmacology who are already affiliated with a fellowship program and may benefit from supplemental information, and for clinical researchers interested in clinical pharmacology who may not be aware that such training opportunities exist. This article provides the details of a recently accredited program, including design, implementation, accreditation, trainee success, and future directions.

  2. Establishing a clinical pharmacology fellowship program for physicians, pharmacists, and pharmacologists: a newly accredited interdisciplinary training program at the Ohio State University.

    Science.gov (United States)

    Kitzmiller, Joseph P; Phelps, Mitch A; Neidecker, Marjorie V; Apseloff, Glen

    2014-01-01

    Studying the effect of drugs on humans, clinical pharmacologists play an essential role in many academic medical and research teams, within the pharmaceutical industry and as members of government regulatory entities. Clinical pharmacology fellowship training programs should be multidisciplinary and adaptable, and should combine didactics, applied learning, independent study, and one-on-one instruction. This article describes a recently developed 2 year clinical pharmacology fellowship program - one of only nine accredited by the American Board of Clinical Pharmacology - that is an integrative, multi faceted, adaptable method for training physicians, pharmacists, and scientists for leadership roles in the pharmaceutical industry, in academia, or with regulatory or accreditation agencies. The purpose of this article is to provide information for academic clinicians and researchers interested in designing a similar program, for professionals in the field of clinical pharmacology who are already affiliated with a fellowship program and may benefit from supplemental information, and for clinical researchers interested in clinical pharmacology who may not be aware that such training opportunities exist. This article provides the details of a recently accredited program, including design, implementation, accreditation, trainee success, and future directions. PMID:25018660

  3. A Review of Botanical Characteristics, Traditional Usage, Chemical Components, Pharmacological Activities, and Safety of Pereskia bleo (Kunth DC

    Directory of Open Access Journals (Sweden)

    Sogand Zareisedehizadeh

    2014-01-01

    Full Text Available Pereskia bleo, a leafy cactus, is a medicinal plant native to West and South America and distributed in tropical and subtropical areas. It is traditionally used as a dietary vegetable, barrier hedge, water purifier, and insect repellant and for maintaining health, detoxification, prevention of cancer, and/or treatment of cancer, hypertension, diabetes, stomach ache, muscle pain, and inflammatory diseases such as dermatitis and rheumatism. The aim of this paper was to provide an up-to-date and comprehensive review of the botanical characteristics, traditional usage, phytochemistry, pharmacological activities, and safety of P. bleo. A literature search using MEDLINE (via PubMed, Science direct, Scopus and Google scholar and China Academic Journals Full-Text Database (CNKI and available eBooks and books in the National University of Singapore libraries in English and Chinese was conducted. The following keywords were used: Pereskia bleo, Pereskia panamensis, Pereskia corrugata, Rhodocacus corrugatus, Rhodocacus bleo, Cactus panamensis, Cactus bleo, Spinach cactus, wax rose, Perescia, and Chinese rose. This review revealed the association between the traditional usage of P. bleo and reported pharmacological properties in the literature. Further investigation on the pharmacological properties and phytoconstituents of P. bleo is warranted to further exploit its potentials as a source of novel therapeutic agents or lead compounds.

  4. AN UPDATED REVIEW ON MOLECULAR GENETICS, PHYTOCHEMISTRY, PHARMACOLOGY AND PHYSIOLOGY OF BLACK NIGHTSHADE (SOLANUM NIGRUM

    Directory of Open Access Journals (Sweden)

    Ashwani Kumar*, S. Sagwal, Niketa and S. Rani

    2012-09-01

    Full Text Available This article reviews, connected the gap between the folkloric use of Solanum nigrum and the results of evidence based experiments. Although Solanum nigrum is a rich source of one of plants most dreaded toxins solanine, it has appreciably monstrated its potential as a reservoir of antioxidants having hepatoprotective, anti-tumor, cytostatic, anti-convulsant, anti-ulcerogenic and anti-inflammatory.effects. The review encompasses in-vitro, in vivo and clinical studies done on Solanum nigrum, while examining.whether or not correct scientific measures have been taken in generating experimental evidences for its traditional uses. This review would afford research scientist to know how much is known and what is left undone in the investigation of Solanum nigrum. The compounds considered in this revieware flavonoids and other phenolics, alkaloids (especially indole terpenoid and purine alkaloids, essential oils and other terpenoids, cannabinoids, lucosinolates and isothiocyanates, and compounds having human hormone activity. The review concludes with a discussion of the possible evolutionary mechanisms that have led to the evolution of UV-B regulation of secondary metabolite accumulation. Many Ayurveda philosophers and healers praised about the properties of this plant and utilized in various disorders. Here, a review made on the screening of Solanum nigrum for various activities. It is found that the drug is very potential and can be used for various applications as mentioned in Ayurveda. Black nightshade grows as a weed, found in the dry parts of India and other parts of the world. It has a medicinal usage and has been used as a traditional folk medicine for treating various ailments such as pain, fever and liver disorders. Generally, black nightshade is very rich in nutritive values, which are capable of supplying minerals, vitamins, hormones and proteins. This herb elaborates a wide variety of medicinal properties such as anticancer, antioxidant

  5. A review on medicinal importance, pharmacological activity and bioanalytical aspects of beta-carboline alkaloid ‘‘Harmine’’

    Institute of Scientific and Technical Information of China (English)

    K Patel; M Gadewar; R Tripathi; SK Prasad; Dinesh Kumar Patel

    2012-01-01

    Harmine, a beta-carboline alkaloid, is widely distributed in the plants, marine creatures, insects, mammalians as well as in human tissues and body fluids. Harmine was originally isolated from seeds of Peganum harmal in 1847 having a core indole structure and a pyridine ring. Harmine has various types of pharmacological activities such as antimicrobial, antifungal, antitumor, cytotoxic, antiplasmodial, antioxidaant, antimutagenic, antigenotoxic and hallucinogenic properties. It acts on gamma-aminobutyric acid type A and monoamine oxidase A or B receptor, enhances insulin sensitivity and also produces vasorelaxant effect. Harmine prevents bone loss by suppressing osteoclastogenesis. The current review gives an overview on pharmacological activity and analytical techniques of harmine, which may be useful for researcheres to explore the hidden potential of harmine and and will also help in developing new drugs for the treatment of various diseases.

  6. CRATAEVA TAPIA LINN. - AN IMPORTANT MEDICINAL PLANT: A REVIEW OF ITS TRADITIONAL USES, PHYTOCHEMISTRY AND PHARMACOLOGICAL PROPERTIES

    Directory of Open Access Journals (Sweden)

    Priyanka Sharma*, Darshana Patil and Avinash Patil

    2013-02-01

    Full Text Available Medicinal plants, since times immemorial, have been used in virtually all cultures as a source of medicine. Interest in herbal drugs is growing due to their efficiency, low toxicity and absence/minimal side effects. Crataeva tapia L. (Family-Capparaceae is a branched tree, commonly called as ‘Varuna’. The plant has been reported to possess several medicinal uses which include anti-inflammatory, anti-oxidant, anti-arthritic, anti-fertility, anti-mycotic, anti-diabetic, anti-microbial, anti-diarrhoeal, wound healing, anti-helminthic, urolithic property, nephrolithic, hepatoprotective and cardio protective. Given the importance of the tree the present review illustrates the medicinal uses of the plant along with its pharmacognostic characteristics, phytochemistry, pharmacological actions and commercial uses. The innumerable medicinal properties and pharmacological studies establish a scientific basis for therapeutic use of this plant.

  7. A review on medicinal importance, pharmacological activity and bioanalytical aspects of beta-carboline alkaloid “Harmine”

    Directory of Open Access Journals (Sweden)

    K Patel

    2012-08-01

    Full Text Available Harmine, a beta-carboline alkaloid, is widely distributed in the plants, marine creatures, insects, mammalians as well as in human tissues and body fluids. Harmine was originally isolated from seeds of Peganum harmal in 1847 having a core indole structure and a pyridine ring. Harmine has various types of pharmacological activities such as antimicrobial, antifungal, antitumor, cytotoxic, antiplasmodial, antioxidaant, antimutagenic, antigenotoxic and hallucinogenic properties. It acts on gamma–aminobutyric acid type A and monoamine oxidase A or B receptor, enhances insulin sensitivity and also produces vasorelaxant effect. Harmine prevents bone loss by suppressing osteoclastogenesis. The current review gives an overview on pharmacological activity and analytical techniques of harmine, which may be useful for researcheres to explore the hidden potential of harmine and and will also help in developing new drugs for the treatment of various diseases.

  8. International Union of Basic and Clinical Pharmacology. LXXIX. Cannabinoid receptors and their ligands

    DEFF Research Database (Denmark)

    Pertwee, R G; Howlett, A C; Abood, M E;

    2010-01-01

    or channel. However, it does identify certain pharmacological targets that should be investigated further as potential CB(3) receptors or channels. These include TRP vanilloid 1, which possibly functions as an ionotropic cannabinoid receptor under physiological and/or pathological conditions, and some...... deorphanized GPCRs. Also discussed are 1) the ability of CB(1) receptors to form heteromeric complexes with certain other GPCRs, 2) phylogenetic relationships that exist between CB(1)/CB(2) receptors and other GPCRs, 3) evidence for the existence of several as-yet-uncharacterized non-CB(1), non-CB(2...

  9. 交叉过敏的临床药学干预%Clinical pharmacological intervention on cross allergy

    Institute of Scientific and Technical Information of China (English)

    刘玉根

    2013-01-01

    Objective To strengthen the clinical awareness of cross allergy and to reduce the incidence rate of incorrect uses of medicines.Methods The previous records of medication counseling,incorrect uses of medicines,and approximation errors in the online reporting system were analyzed.Data mining was performed.Prescribing information on cross allergy in "contraindications" was derived from a software.Clinical pharmacological interventions were conducted and the effects were evaluated.Results Similarity in chemical structures was the main cause of cross allergy.Besides 27 kinds of medications within pharmacologically similar class involving cross allergy,there were seven sorts with complete different pharmacological effects.Prescribing information on some medications had unscientific descriptions on cross allergy associated contraindications,lacking clinical value in guiding safe use of medication.There were difference in descriptions on cross allergy in some drugs within pharmacologically similar class,and some domesic and imported products.After pharmacological interventions,awareness was greatly increased; the occurrence rate of incorrect uses of medicines and approximation errors decreased.Conclusions Comprehensive pharmacological interventions is of very important significance in cross allergy.%目的 提高医务人员对于临床药物交叉过敏的防范意识,降低用药差错的发生率.方法 对用药咨询、用药失误以及近似错误的在线报告系统的以往记录进行统计分析,对药品说明书中禁忌症项关于交叉过敏症状的描述进行数据挖掘以及信息分析,并对医院实行临床药学干预的效果进行评估.结果 药物的化学结构相似是造成交叉过敏的主要因素.临床上易发生交叉过敏的药物除了27类药理作用相似的同类药品外,还有7类涉及多种药理作用类别的药物.有部分药物的禁忌症与交叉过敏有关的描述缺乏科学性,没有临床指导意义,部

  10. Clinical Applications of Saffron (Crocus sativus) and its Constituents: A Review.

    Science.gov (United States)

    Moshiri, M; Vahabzadeh, M; Hosseinzadeh, H

    2015-06-01

    Commonly known as saffron, Crocus sativus L and its active components have shown several useful pharmacological effects such as anticonvulsant, antidepressant, anti-inflammatory, antitumor, radical scavenger effects, learning and memory improving effects, etc. There has been an increasing body of data on saffron use in medical databases within the last 20 years. In the current review, the strengths and weaknesses of some of the clinical trials about different pharmacological effects of saffron will be discussed C. sativus extract has been studied in 8 anti-depressant clinical trials in comparison to placebo or some antidepressant drugs, in which saffron showed effectiveness as an antidepressant drug. Clinical trials on anti-Alzheimer effect of saffron demonstrated that it was more effective than the placebo, and as effective as donepezil. 2 clinical trials on antipruritic and complexion promoter in skin care effects of saffron both confirmed that saffron was more efficient than the placebo. In another clinical trial, it was proved that in addition to the weight loss treatment, saffron could reduce snacking frequency. Clinical trials conducted on women with premenstrual syndrome showed that saffron could reduce suffering symptoms more than the placebo and similar to standard treatments.Furthermore, additional clinical trials on effects of saffron on erection dysfunction, allergies, cardiovascular and immune system as well as its safety, toxicity and human pharmacokinetics are reviewed herein.

  11. Otostegia persica (Lamiaceae): A review on its ethnopharmacology, phytochemistry, and pharmacology

    OpenAIRE

    Zahra Sadeghi; Maryam Akaberi; Jafar Valizadeh

    2014-01-01

    Abstract Objective: The current study summarizes the updated information concerning the ethnopharmacology, Phytochemistry, and pharmacology of Otostegia persica Boiss. (Lamiaceae), an endemic medicinal plant in south and southeast of Iran. Materials and Methods: Information was collected through bibliographic investigation from scientific journals, books, theses, reports, and electronic search (databases SCOPUS, Google Scholar, Web of Science, and Science Direct). Moreover, documentation from...

  12. Pharmacological and clinical evidence of nevirapine immediate- and extended-release formulations

    Directory of Open Access Journals (Sweden)

    Ena J

    2012-11-01

    Full Text Available Javier Ena, Concepción Amador, Conxa Benito, Francisco PasquauHIV Unit, Hospital Marina Baixa, Villajoyosa, SpainAbstract: We reviewed the current information available on nevirapine immediate- and extended-release formulations and its role in single-dose and combination antiretroviral therapy. Nevirapine was approved in 1996 and was the first non-nucleoside reverse-transcriptase inhibitor available for the treatment of HIV-1 infection. Nevirapine has demonstrated good efficacy and a well-characterized safety profile. A major drawback is the low genetic barrier, allowing the emergence of resistance in the presence of single mutations in the reverse-transcriptase gene. This shortcoming is particularly relevant when nevirapine is administered in a single dose to prevent mother-to-child transmission of HIV-1 infection, compromising the efficacy of future non-nucleoside reverse transcriptase–inhibitor regimens. Studies published recently have probed the noninferiority of nevirapine compared to ritonavir-boosted atazanavir with both tenofovir disoproxil fumarate and emtricitabine in antiretroviral treatment–naïve patients. In 2011, a new formulation of nevirapine (nevirapine extended release that allowed once-daily dosing was approved by the Food and Drug Administration and by the European Medicines Agency. VERxVe, a study comparing nevirapine extended release with nevirapine immediate release in antiretroviral treatment–naïve patients, and TRANxITION, a study carried out in antiretroviral treatment–experienced patients who switched therapy from nevirapine immediate release to nevirapine extended release, provided data on the noninferiority of the new formulation of nevirapine compared with nevirapine immediate release in terms of efficacy and safety. Nevirapine extended release will further increase the durability and persistence of nevirapine-containing antiretroviral therapy, allowing once-daily dosing regimens.Keywords: nevirapine

  13. A review of objective structured practical examination (OSPE in pharmacology at a rural medical college

    Directory of Open Access Journals (Sweden)

    Rushikesh P. Deshpande

    2013-10-01

    Full Text Available Background: 1. To evaluate the attitudes of undergraduate medical students towards objectively structured practical examination (OSPE component of Pharmacology practical examination. 2. To investigate any gender differences and any influence of medium of instruction in school on these attitudes. Methods: The scores of 40 undergraduate medical students were analysed at S R T R Government Medical College, Ambajogai, Maharashtra, India. A Likert scale containing 9 items was used to assess the attitudes of students towards OSPE in Pharmacology. Student perspectives regarding the OSPE were obtained by asking them to respond to a questionnaire. Results: The study revealed that the OSPE was an acceptable tool in Pharmacology practical examination. The overall mean attitude score was 3.99. The response of male students towards OSPE (4.2 was more favourable as compared to that of female students (3.9 Students strongly agreed that OPSE covers wide range of skills and it is a good form of examination and learning experience. Majority of students were in favour of continuing OSPE as a method for examination in Pharmacology. Conclusions: OSPE was found to be a valuable tool to check the depth of understanding of undergraduate students. OSPE can be used as an index of the learning attitude of students. The present study is a small step in a direction of changing the traditional patterns of practical examination to a more objective and reliable way of evaluation in Pharmacology. It will help in modifying teaching-learning strategies so that both, the teachers as well as the students can gain maximum advantage. [Int J Basic Clin Pharmacol 2013; 2(5.000: 629-633

  14. Peer review practicalities in clinical medicine

    Directory of Open Access Journals (Sweden)

    Matthew J Metcalfe

    2010-10-01

    Full Text Available Matthew J Metcalfe1, MAL Farrant2, JM Farrant31Department of Vascular Surgery, Imperial College NHS Trust, St Mary’s Hospital, London, UK; 2Department of Anaesthesia, Poole Hospital NHS Foundation Trust, Poole Hospital, Dorset, UK; 3Department of Radiology, Royal Free Hampstead NHS Trust, Royal Free Hospital, London, UKAbstract: Peer review processes in teaching requires a reviewer to observe a teacher’s practice in a planned manner. Conversation between the two enables the teacher to reflect on their own teaching, promoting self-improvement. Although a central part of the teaching process, and despite its crucial role in continuing professional development, peer review is not widely practiced in hospital settings. This article explains the process and its benefits. Practical implementations of the process in busy clinical settings are suggested. Its evaluation and incorporation into undergraduate learning and postgraduate clinical practice are described. With enthusiastic support for colleagues and allowances for its implementation, it should become part of the regular teaching practice, improving the quality of teaching delivered.Keywords: teaching, education, clinical practice, peer review

  15. Pharmacologically screened aphrodisiac plant-A review of current scientific literature

    Institute of Scientific and Technical Information of China (English)

    Patel DK; Kumar R; Prasad SK; Hemalatha S

    2011-01-01

    Substances which are used to treat sexual dysfunction or to improve sexual behavior and satisfaction in humans and animals are called ‘aphrodisiac’. Uses of plant material to treat sexual disorder is a long back history in the different system of medicine and it was practiced by different type of vaidyas and traditional healer in almost all the countries in the world, like China, India, Egypt, Rome and Greek. Even though there was an unavailability of the scientific data, these substances have been used as aphrodisiac. During the historic times Lytta vesicatoria,Tribulus terrestris, Ptychopetalum olacoides, Crocus sativus, Bufo marinus, Myristica fragrans, Theobroma cocao and other plants have been investigated for its aphrodisiac activity by in vivo and in vitro model. Even though the study showed positive response to a particular substance, there is always a need to run the clinical trial before administering the tested drug in human being. The present review article summarizes the plant material which has been tested for its aphrodisiac activity in different experimental model (in vitro, in vivo on animal models, or in human clinical trials) and comply its claim in the different system of medicine. A brief overview about the data of percentage study in the last eighteen years duration on aphrodisiac activity of plant material was done on the basis of the CAB abstract database.

  16. [Clinical aspects of pharmacological treatment of diabetic neuropathy - cooperation with neurologists and diabetologists].

    Science.gov (United States)

    Janíčková Žďárská, Denisa; Kvapil, Milan

    2016-03-01

    The development and progression of symptomatic diabetic neuropathy (SDN) is linked to hyperglycemia. The effort to improve compensation of diabetes mellitus during therapy is therefore very important. This is where the cooperation between the diabetologist and neurologist within therapy plays an important role. The pharmaco-logical therapy of symptomatic sensitive peripheral diabetic neuropathy is difficult and with a less than satisfactory effect. A variety of active substances is used in symptomatic therapy, primarily designed for intervention in other pathological conditions. The recommended guidelines include antidepressants, anticonvulsants, opiates and their derivatives. However this therapy brings with it a relatively high incidence of adverse effects which detract from patients adherence to treatment. Very good results are reached by the therapy with thioctacid. PMID:27180665

  17. 护理药理学教学改革探讨%Pharmacological action and clinical

    Institute of Scientific and Technical Information of China (English)

    覃梦岚

    2015-01-01

    Through finding the problems encountered in nursing pharmacology teaching, from rational use of materials, training of teachers team, teaching skills and memory, enrich the teaching means, to achieve the goal of emotion etc. five aspects put forward and to explore the effective methods of teaching reform, provides the reference for other teachers.%文章通过寻找护理药理学教学中遇到的问题,从合理使用教材、培养师资团队、传授技巧记忆、充实教学手段、实现情感目标等5个方面提出和探讨行之有效的教学改革方法,为其他教师提供参考。

  18. Experimental and Clinical Pharmacology of Andrographis paniculata and Its Major Bioactive Phytoconstituent Andrographolide

    Directory of Open Access Journals (Sweden)

    Thanasekaran Jayakumar

    2013-01-01

    Full Text Available Andrographis paniculata (Burm. F Nees, generally known as “king of bitters,” is an herbaceous plant in the family Acanthaceae. In China, India, Thailand, and Malaysia, this plant has been widely used for treating sore throat, flu, and upper respiratory tract infections. Andrographolide, a major bioactive chemical constituent of the plant, has shown anticancer potential in various investigations. Andrographolide and its derivatives have anti-inflammatory effects in experimental models asthma, stroke, and arthritis. In recent years, pharmaceutical chemists have synthesized numerous andrographolide derivatives, which exhibit essential pharmacological activities such as those that are anti-inflammatory, antibacterial, antitumor, antidiabetic, anti-HIV, antifeedant, and antiviral. However, what is noteworthy about this paper is summarizing the effects of andrographolide against cardiovascular disease, platelet activation, infertility, and NF-κB activation. Therefore, this paper is intended to provide evidence reported in relevant literature on qualitative research to assist scientists in isolating and characterizing bioactive compounds.

  19. A Narrative Review of Pharmacologic and Non-pharmacologic Interventions for Disorders of Consciousness Following Brain Injury in the Pediatric Population

    OpenAIRE

    Evanson, Nathan K.; Paulson, Andrea L.; Kurowski, Brad G.

    2016-01-01

    Traumatic brain injury (TBI) is the most common cause of long-term disability in the United States. A significant proportion of children who experience a TBI will have moderate or severe injuries, which includes a period of decreased responsiveness. Both pharmacological and non-pharmacological modalities are used for treating disorders of consciousness after TBI in children. However, the evidence supporting the use of potential therapies is relatively scant, even in adults, and overall, there...

  20. A Systematic Review of the Botanical, Phytochemical and Pharmacological Profile of Dracaena cochinchinensis, a Plant Source of the Ethnomedicine “Dragon’s Blood”

    Directory of Open Access Journals (Sweden)

    Jia-Yi Fan

    2014-07-01

    Full Text Available “Dragon’s blood” is the name given to a deep red resin obtained from a variety of plant sources. The resin extracted from stems of Dracaena cochinchinensis is one such source of “dragon’s blood”. It has a reputation for facilitating blood circulation and dispersing blood stasis. In traditional Chinese medicine, this resinous medicine is commonly prescribed to invigorate blood circulation for the treatment of traumatic injuries, blood stasis and pain. Modern pharmacological studies have found that this resinous medicine has anti-bacterial, anti-spasmodic, anti-inflammatory, analgesic, anti-diabetic, and anti-tumor activities, while it is also known to enhance immune function, promote skin repair, stop bleeding and enhance blood circulation. Various compounds have been isolated from the plant, including loureirin A, loureirin B, loureirin C, cochinchinenin, socotrin-4'-ol, 4',7-dihydroxyflavan, 4-methylcholest-7-ene-3-ol, ethylparaben, resveratrol, and hydroxyphenol. The present review summarizes current knowledge concerning the botany, phytochemistry, pharmacological effects, toxicology studies and clinical applications of this resinous medicine as derived from D. cochinchinenesis.

  1. Postural orthostatic tachycardia syndrome: a clinical review.

    Science.gov (United States)

    Johnson, Jonathan N; Mack, Kenneth J; Kuntz, Nancy L; Brands, Chad K; Porter, Coburn J; Fischer, Philip R

    2010-02-01

    Postural orthostatic tachycardia syndrome was defined in adult patients as an increase >30 beats per minute in heart rate of a symptomatic patient when moving from supine to upright position. Clinical signs may include postural tachycardia, headache, abdominal discomfort, dizziness/presyncope, nausea, and fatigue. The most common adolescent presentation involves teenagers within 1-3 years of their growth spurt who, after a period of inactivity from illness or injury, cannot return to normal activity levels because of symptoms induced by upright posture. Postural orthostatic tachycardia syndrome is complex and likely has numerous, concurrent pathophysiologic etiologies, presenting along a wide spectrum of potential symptoms. Nonpharmacologic treatment includes (1) increasing aerobic exercise, (2) lower-extremity strengthening, (3) increasing fluid/salt intake, (4) psychophysiologic training for management of pain/anxiety, and (5) family education. Pharmacologic treatment is recommended on a case-by-case basis, and can include beta-blocking agents to blunt orthostatic increases in heart rate, alpha-adrenergic agents to increase peripheral vascular resistance, mineralocorticoid agents to increase blood volume, and serotonin reuptake inhibitors. An interdisciplinary research approach may determine mechanistic root causes of symptoms, and is investigating novel management plans for affected patients.

  2. Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence.

    Science.gov (United States)

    Sinclair, Julia M A; Chambers, Sophia E; Shiles, Celia J; Baldwin, David S

    2016-07-01

    Alcohol use disorders (AUD) cause significant morbidity and mortality worldwide, but pharmacological treatments for them are underused, despite evidence of efficacy. Acamprosate, naltrexone, nalmefene and disulfiram are all approved in one or more region for the treatment of AUD. Baclofen currently has a temporary indication in France. Safety considerations for using psychopharmacological treatments in this patient group include the impact of concurrent alcohol consumption at high levels; multiple physical comorbidities that may interfere with pharmacological effects, distribution and metabolism; and concomitant medication for the treatment of comorbid physical and psychiatric conditions. The five drugs, including an extended-release injectable suspension of naltrexone, have different safety profiles that need to be balanced with the treatment objective (initiation or continuation of abstinence, or reduction of drinking), individual patient preferences and comorbid conditions. Appropriate treatment will be based on the unique risk-benefit profile in each case. PMID:27023898

  3. Zingiber zerumbet (L. Smith: A Review of Its Ethnomedicinal, Chemical, and Pharmacological Uses

    Directory of Open Access Journals (Sweden)

    N. J. Yob

    2011-01-01

    Full Text Available Zingiber zerumbet Sm., locally known to the Malay as “Lempoyang,” is a perennial herb found in many tropical countries, including Malaysia. The rhizomes of Z. zerumbet, particularly, have been regularly used as food flavouring and appetizer in various Malays' cuisines while the rhizomes extracts have been used in Malay traditional medicine to treat various types of ailments (e.g., inflammatory- and pain-mediated diseases, worm infestation and diarrhea. Research carried out using different in vitro and in vivo assays of biological evaluation support most of these claims. The active pharmacological component of Z. zerumbet rhizomes most widely studied is zerumbone. This paper presents the botany, traditional uses, chemistry, and pharmacology of this medicinal plant.

  4. Pharmacological and methodological aspects of the separation-induced vocalization test in guinea pig pups; a systematic review and meta-analysis.

    Science.gov (United States)

    Groenink, Lucianne; Verdouw, P Monika; Bakker, Brenda; Wever, Kimberley E

    2015-04-15

    The separation-induced vocalization test in guinea pig pups is one of many that has been used to screen for anxiolytic-like properties of drugs. The test is based on the cross-species phenomenon that infants emit distress calls when placed in social isolation. Here we report a systematic review and meta-analysis of pharmacological intervention in the separation-induced vocalization test in guinea pig pups. Electronic databases were searched for original research articles, yielding 32 studies that met inclusion criteria. We extracted data on pharmacological intervention, animal and methodological characteristics, and study quality indicators. Meta-analysis showed that the different drug classes in clinical use for the treatment of anxiety disorders, have comparable effects on vocalization behaviour, irrespective of their mechanism of action. Of the experimental drugs, nociception (NOP) receptor agonists proved very effective in this test. Analysis further indicated that the commonly used read-outs total number and total duration of vocalizations are equally valid. With regard to methodological characteristics, repeated testing of pups as well as selecting pups with moderate or high levels of vocalization were associated with larger treatment effects. Finally, reporting of study methodology, randomization and blinding was poor and Egger's test for small study effects showed that publication bias likely occurred. This review illustrates the value of systematic reviews and meta-analyses in improving translational value and methodological aspects of animal models. It further shows the urgent need to implement existing publication guidelines to maximize the output and impact of experimental animal studies.

  5. A review on biological, nutraceutical and clinical aspects of French maritime pine bark extract.

    Science.gov (United States)

    Maimoona, Alya; Naeem, Ismat; Saddiqe, Zeb; Jameel, Khalid

    2011-01-27

    Bark extract of Pinus pinaster has a long history of ethnomedicinal use and is available commercially as herbal dietary supplement with proprietary name pycnogenol. It is used as a food supplement to overcome many degenerative disorders. Rohdewald (2002) wrote the first comprehensive review of extract highlighting its antioxidative nature and its role in different diseases. Later, Watson (2003) and Gulati (2005) in their reviews about cardiovascular health, described the extract as a best neutraceutical agent in this regard. The objective of this paper is to review the current research on this extract in terms of extraction methods, its pharmacological, toxicological and nutraceutical effects and clinical studies. Web sites of Google Scholar, Pubmed and Medline were searched for articles written in English and published in peer-reviewed journals from 2006 to 2009 and sixty-nine research articles were extracted. Of these, two are about extraction advancement and analysis while the rest relate to its clinical, biological and nutraceutical aspects. PMID:21044675

  6. A review of objective structured practical examination (OSPE) in pharmacology at a rural medical college

    OpenAIRE

    Rushikesh P Deshpande; Vijay M. Motghare; Sudhir L. Padwal; Chetanraj G. Bhamare; Suvarna S. Rathod; Rakesh R. Pore

    2013-01-01

    Background: 1. To evaluate the attitudes of undergraduate medical students towards objectively structured practical examination (OSPE) component of Pharmacology practical examination. 2. To investigate any gender differences and any influence of medium of instruction in school on these attitudes. Methods: The scores of 40 undergraduate medical students were analysed at S R T R Government Medical College, Ambajogai, Maharashtra, India. A Likert scale containing 9 items was used to assess the a...

  7. Deep vein thrombosis: a clinical review

    Directory of Open Access Journals (Sweden)

    Kesieme EB

    2011-04-01

    Full Text Available Emeka Kesieme1, Chinenye Kesieme2, Nze Jebbin3, Eshiobo Irekpita1, Andrew Dongo11Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 2Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Nigeria; 3Department of Surgery, University of Port Harcourt Teaching Hospital, Port-Harcourt, NigeriaBackground: Deep vein thrombosis (DVT is the formation of blood clots (thrombi in the deep veins. It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.Aim: To present an update on the causes and management of DVT.Methods: A review of publications obtained from Medline search, medical libraries, and Google.Results: DVT affects 0.1% of persons per year. It is predominantly a disease of the elderly and has a slight male preponderance. The approach to making a diagnosis currently involves an algorithm combining pretest probability, D-dimer testing, and compression ultrasonography. This will guide further investigations if necessary. Prophylaxis is both mechanical and pharmacological. The goals of treatment are to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome.Conclusion: DVT is a potentially dangerous condition with a myriad of risk factors. Prophylaxis is very important and can be mechanical and pharmacological. The mainstay of treatment is anticoagulant therapy. Low-molecular-weight heparin, unfractionated heparin, and vitamin K antagonists have been the treatment of choice. Currently anticoagulants specifically targeting components of the common pathway have been recommended for prophylaxis. These include fondaparinux, a selective indirect factor Xa inhibitor and the new oral selective direct thrombin inhibitors (dabigatran and selective

  8. The Prediabetic Period: Review of Clinical Aspects

    Directory of Open Access Journals (Sweden)

    Sang Youl Rhee

    2011-04-01

    Full Text Available Hyperglycemia that does not satisfy the diagnostic criteria for diabetes mellitus (DM is generally called prediabetes (preDM. The global prevalence of preDM has been increasing progressively in the past few decades, and it has been established that preDM status is a strong risk factor for DM and cardiovascular disease. Currently, preDM status is classified into two subtypes: impaired fasting glucose and impaired glucose tolerance. Currently, preDM is not regarded as an independent clinical entity, but only as a risk factor for others. In this article, we review various clinical aspects of preDM in terms of the working definition, changes in criteria over the years, epidemiology, and pathophysiological characteristics, and its clinical significance in current medicine.

  9. PHARMACOLOGICAL IMPORTANCE OF CITRUS FRUITS

    OpenAIRE

    Amita Tomar *, Mridula Mall and Pragya Rai

    2013-01-01

    This paper reviews the pharmacological importance of citrus fruits. Citrus fruits are used for various pharmacological importance. According to literature the citrus fruit possess anti-cancer, antimicrobial, antioxidant, antiulcer, anti-inflammatory, and hypolipidemic and hepatoprotective properties.

  10. Clinical pharmacology of analgesic medicines in older people: impact of frailty and cognitive impairment.

    Science.gov (United States)

    McLachlan, Andrew J; Bath, Sally; Naganathan, Vasi; Hilmer, Sarah N; Le Couteur, David G; Gibson, Stephen J; Blyth, Fiona M

    2011-03-01

    Pain is highly prevalent in frail older people who often have multiple co-morbidities and multiple medicines. Rational prescribing of analgesics in frail older people is complex due to heterogeneity in drug disposition, comorbid medical conditions, polypharmacy and variability in analgesic response in this population. A critical issue in managing older people with pain is the need for judicious choice of analgesics based on a comprehensive medical and medication history. Care is needed in the selection of analgesic medicine to avoid drug-drug or drug-disease interactions. People living with dementia and cognitive impairment have suboptimal pain relief which in part may be related to altered pharmacodynamics of analgesics and challenges in the systematic assessment of pain intensity in this patient group. In the absence of rigorously controlled trials in frail older people and those with cognitive impairment a pharmacologically-guided approach can be used to optimize pain management which requires a systematic understanding of the pharmacokinetics and pharmacodynamics of analgesics in frail older people with or without changes in cognition. PMID:21284694

  11. Differential pharmacology and clinical utility of empagliflozin in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Munir KM

    2016-04-01

    Full Text Available Kashif M Munir,1 Stephen N Davis2 1Division of Endocrinology, Diabetes, and Nutrition, Center for Diabetes and Endocrinology, 2Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA Abstract: With rates of obesity and diabetes rising across the world, effective therapies to treat hyperglycemia and its associated comorbidities continue to be in demand. Empagliflozin is a highly selective sodium glucose transporter-2 inhibitor that improves serum glucose levels by inducing glucosuria. Taken orally, it is rapidly absorbed with linear pharmacokinetics consistent in Asian and Caucasian populations. Empagliflozin treatment demonstrates consistent reductions in hemoglobin A1c, fasting plasma glucose, body weight, and blood pressure in individuals with type 2 diabetes. Improvements in glycemic control and metabolic end points are evident with empagliflozin monotherapy, as add-on to oral hypoglycemics or add-on to insulin. The nonglycemic effects of empagliflozin with consistent improvements in blood pressure, body weight, and waist circumference provide additional rationale for use in patients with type 2 diabetes. Moreover, treatment with empagliflozin has recently shown significant reductions in both microvascular and macrovascular complications of diabetes. Keywords: empagliflozin, type 2 diabetes, pharmacology, blood pressure, body weight, hemoglobin A1c, glucose

  12. ITI-007 in the treatment of schizophrenia: from novel pharmacology to clinical outcomes.

    Science.gov (United States)

    Davis, Robert E; Correll, Christoph U

    2016-06-01

    ITI-007 is an investigational drug being developed for schizophrenia and other neuropsychiatric/neurodegenerative diseases. ITI-007 has a unique pharmacological profile, combining potent 5-HT2a receptor antagonism with cell-type-specific dopamine and glutamate receptor modulation, plus serotonin reuptake inhibition. At dopamine-D2 receptors, ITI-007 acts as a post-synaptic antagonist and pre-synaptic partial agonist. Additionally, ITI-007 stimulates phosphorylation of glutamatergic NMDA-NR2B receptors, downstream of dopamine-D1 receptor intracellular signaling. Based on a large, placebo and risperidone controlled, Phase-II trial, ITI-007 60 mg was shown to be effective in reducing symptoms in patients with acutely exacerbated schizophrenia. The antipsychotic efficacy of ITI-007 60 mg in this patient population was confirmed in a recently completed Phase III study. ITI-007 was associated with minimal safety risk compared to risperidone (Phase II study) or placebo (both studies) for neuromotor disturbances, prolactin changes, weight gain and metabolic abnormalities. A second 6-week, placebo and risperidone-controlled Phase-III trial in acutely exacerbated schizophrenia is ongoing. PMID:27042868

  13. Managing cancer-related fatigue in men with prostate cancer: a systematic review of non-pharmacological interventions.

    Science.gov (United States)

    Larkin, David; Lopez, Violeta; Aromataris, Edoardo

    2014-10-01

    The aim of this systematic review was to synthesize the best available evidence informing the effectiveness of non-pharmacological interventions for managing cancer-related fatigue in men treated for prostate cancer. This review considered experimental studies that included men with prostate cancer (regardless of staging, previous treatment or comorbidities), aged 18 years and over who were undergoing any treatment, or had completed any treatment for prostate cancer within the previous 12 months. Three interventions were identified for the management of cancer-related fatigue in men with prostate cancer. Evidence from five studies including 447 participants demonstrates the effectiveness of physical activity, both aerobic and resistance exercise, and from three studies including 153 participants suggesting the benefits of psychosocial interventions including education and cognitive behavioural therapy. Health professionals require knowledge of a range of effective interventions aimed at reducing cancer-related fatigue in men with prostate cancer and should incorporate those interventions into their patient management. Although physical activity appears to show the greatest benefit, other non-pharmacological interventions such as education and cognitive behavioural therapy have demonstrated benefit and should also be considered as a strategy in treating this debilitating side effect of cancer and its treatment. PMID:24237792

  14. Acknowledgments to reviewers of World Journal of Gastrointestinal Pharmacology and Therapeutics

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    We acknowledge our sincere thanks to our reviewers. Many reviewers have contributed their expertise and time to the peer review, a critical process to ensure the quality of our World Series Journals. Both the editors of the journals and authors of the manuscripts submitted to the journals are grateful to the following reviewers for

  15. Clinical Characteristics and Pharmacological Treatment of Psychotic Patients Attending the Mental Health Services of the Pediatric Hospital of Cienfuegos

    Directory of Open Access Journals (Sweden)

    Beatriz Sabina Roméu

    2016-06-01

    Full Text Available Background: the mental health services of the Pediatric Hospital of Cienfuegos receive all patients in the province that need to be hospitalized. Among them, children and adolescents functioning at the psychotic level are of great clinical and social importance. Objective: to describe the clinical characteristics and pharmacological treatment of psychotic patients treated in the mental health services. Methods: a case series study of 35 psychotic patients admitted to the mental health unit of the Pediatric Hospital of Cienfuegos was conducted between 2008 and 2012. Demographic variables, in addition to variables related to clinical data and pharmacotherapeutic aspects were analyzed. Results: sixty five point seven percent of patients were adolescents and 77.1% were of urban origin. The most common diagnoses were acute and transient psychotic disorder and schizophrenia. Sixty three percent had a family history of psychiatric disorder. Forty percent were treated with trifluoperazine and an equal percent took haloperidol. Psychotic symptoms were controlled in 58% of patients during the first weeks. Conclusion: white adolescent patients from urban areas with a family history of psychiatric illness predominated. They received regular psychiatric attention and experienced the symptoms for a short time before being treated. The most frequently prescribed medications were typical antipsychotic drugs, which caused adverse reactions in a third of the patients. In the first few weeks, psychotic symptoms were controlled in most patients, although half of them experienced a recurrence of symptoms, which evolved into conditions with worse prognosis.

  16. Pharmacologic Evidence to Support Clinical Decision Making for Peripartum Methadone Treatment

    Science.gov (United States)

    Bogen, D. L.; Perel, J. M.; Helsel, J. C.; Hanusa, B. H.; Romkes, M.; Nukui, T.; Friedman, C. R.; Wisner, K. L.

    2012-01-01

    Rationale Limited pharmacological data are available to guide methadone treatment during pregnancy and postpartum. Objectives Study goals were to: 1) Characterize changes in methadone dose across childbearing, 2) Determine enantiomer-specific methadone withdrawal kinetics from steady-state during late pregnancy, 3) Assess enantiomer-specific changes in methadone level/dose (L/D) ratios across childbearing, and 4) Explore relationships between CYP2B6, CYP2C19 and CYP3A4 single nucleotide polymorphisms and maternal dose, plasma concentration and L/D. Methods Methadone dose changes and timed plasma samples were obtained for women on methadone (n=25) followed prospectively from third trimester of pregnancy to three months postpartum. Results Participants were primarily white, Medicaid insured and multiparous. All women increased their dose from first to end of second trimester (mean peak increase=23 mg/day); 71% of women increased from second trimester to delivery (mean peak increase=19 mg/day). Half took a higher dose 3 months postpartum than at delivery despite significantly larger clearance during late pregnancy. Third trimester enantiomer-specific methadone half-lives (range R-methadone 14.7-24.9 hours; S-methadone 8.02-18.9 hours) were about half of those reported in non-pregnant populations. In 3 women with weekly 24-hour methadone levels after delivery, L/D increased within 1-2 weeks after delivery. Women with the CYP2B6 Q172 variant GT genotype have consistently higher L/D values for S-methadone across both pregnancy and postpartum. Conclusions Most women require increases in methadone dose across pregnancy. Given the shorter half-life and larger clearances during pregnancy, many pregnant women may benefit from split methadone dosing. L/D increases quickly after delivery and doses should be lowered rapidly after delivery. PMID:22926004

  17. Early Clinical Detection of Pharmacologic Response in Insulin Action in a Nondiabetic Insulin-Resistant Population

    Directory of Open Access Journals (Sweden)

    Sudha S. Shankar, MD

    2015-12-01

    Conclusions: Significant changes in insulin action across multiple insulin-sensitive tissues can be detected within 2 weeks of initiation of insulin-sensitizing therapy with pioglitazone in obese patients with nondiabetic insulin resistance. ClinicalTrials.gov identifier: NCT01115712.

  18. The matching quality of experimental and control interventions in blinded pharmacological randomised clinical trials

    DEFF Research Database (Denmark)

    Bello, Segun; Wei, Maoling; Hilden, Jørgen;

    2016-01-01

    Background: Blinding is a pivotal method to avoid bias in randomised clinical trials. In blinded drug trials, experimental and control interventions are often designed to be matched, i.e. to appear indistinguishable. It is unknown how often matching procedures are inadequate, so we decided...

  19. Current status and future prospects of therapeutic drug monitoring and applied clinical pharmacology in antiretroviral therapy.

    NARCIS (Netherlands)

    Boffito, M.; Acosta, E.; Burger, D.M.; Fletcher, C.V.; Flexner, C.; Garaffo, R.; Gatti, G.; Kurowski, M.; Perno, C.F.; Peytavin, G.; Regazzi, M.; Back, D.

    2005-01-01

    The consensus of current international guidelines for the treatment of HIV infection is that data on therapeutic drug monitoring (TDM) of non-nucleoside reverse transcriptase inhibitors and protease inhibitors provide a framework for the implementation of TDM in certain defined scenarios in clinical

  20. Pharmacological approach to acute pancreatitis

    DEFF Research Database (Denmark)

    Bang, U.C.; Semb, S.; Nøjgaard, Camilla;

    2008-01-01

    The aim of the present review is to summarize the current knowledge regarding pharmacological prevention and treatment of acute pancreatitis (AP) based on experimental animal models and clinical trials. Somatostatin (SS) and octreotide inhibit the exocrine production of pancreatic enzymes and may...... be useful as prophylaxis against post endoscopic retrograde cholangiopancreatography pancreatitis (PEP). The protease inhibitor gabexate mesilate (GM) is used routinely as treatment to AP in some countries, but randomized clinical trials and a meta-analysis do not support this practice. Nitroglycerin (NGL...

  1. Clinical Aspects of Feline Retroviruses: A Review

    Directory of Open Access Journals (Sweden)

    Katrin Hartmann

    2012-10-01

    Full Text Available Feline leukemia virus (FeLV and feline immunodeficiency virus (FIV are retroviruses with global impact on the health of domestic cats. The two viruses differ in their potential to cause disease. FeLV is more pathogenic, and was long considered to be responsible for more clinical syndromes than any other agent in cats. FeLV can cause tumors (mainly lymphoma, bone marrow suppression syndromes (mainly anemia, and lead to secondary infectious diseases caused by suppressive effects of the virus on bone marrow and the immune system. Today, FeLV is less commonly diagnosed than in the previous 20 years; prevalence has been decreasing in most countries. However, FeLV importance may be underestimated as it has been shown that regressively infected cats (that are negative in routinely used FeLV tests also can develop clinical signs. FIV can cause an acquired immunodeficiency syndrome that increases the risk of opportunistic infections, neurological diseases, and tumors. In most naturally infected cats, however, FIV itself does not cause severe clinical signs, and FIV-infected cats may live many years without any health problems. This article provides a review of clinical syndromes in progressively and regressively FeLV-infected cats as well as in FIV-infected cats.

  2. Discovery and resupply of pharmacologically active plant-derived natural products: A review

    Science.gov (United States)

    Linder, Thomas; Wawrosch, Christoph; Uhrin, Pavel; Temml, Veronika; Wang, Limei; Schwaiger, Stefan; Heiss, Elke H.; Rollinger, Judith M.; Schuster, Daniela; Breuss, Johannes M.; Bochkov, Valery; Mihovilovic, Marko D.; Kopp, Brigitte; Bauer, Rudolf; Dirsch, Verena M.; Stuppner, Hermann

    2016-01-01

    Medicinal plants have historically proven their value as a source of molecules with therapeutic potential, and nowadays still represent an important pool for the identification of novel drug leads. In the past decades, pharmaceutical industry focused mainly on libraries of synthetic compounds as drug discovery source. They are comparably easy to produce and resupply, and demonstrate good compatibility with established high throughput screening (HTS) platforms. However, at the same time there has been a declining trend in the number of new drugs reaching the market, raising renewed scientific interest in drug discovery from natural sources, despite of its known challenges. In this survey, a brief outline of historical development is provided together with a comprehensive overview of used approaches and recent developments relevant to plant-derived natural product drug discovery. Associated challenges and major strengths of natural product-based drug discovery are critically discussed. A snapshot of the advanced plant-derived natural products that are currently in actively recruiting clinical trials is also presented. Importantly, the transition of a natural compound from a “screening hit” through a “drug lead” to a “marketed drug” is associated with increasingly challenging demands for compound amount, which often cannot be met by re-isolation from the respective plant sources. In this regard, existing alternatives for resupply are also discussed, including different biotechnology approaches and total organic synthesis. While the intrinsic complexity of natural product-based drug discovery necessitates highly integrated interdisciplinary approaches, the reviewed scientific developments, recent technological advances, and research trends clearly indicate that natural products will be among the most important sources of new drugs also in the future. PMID:26281720

  3. Suprofen: the pharmacology and clinical efficacy of a new non-narcotic peripheral analgesic.

    Science.gov (United States)

    Tolman, E L; Rosenthale, M E; Capetola, R J; McGuire, J L

    1984-08-01

    Suprofen is a potent, peripherally-acting, non-narcotic analgesic agent. The mechanism of action of the compound involves inhibition of prostaglandin biosynthesis and, perhaps, direct antagonism of the peripheral, pain inducing actions of prostaglandins, bradykinin and other pain mediators. Suprofen at a dose of 200 mg appears to be equal or greater in efficacy as an analgesic modality than those of ibuprofen, propoxyphene, naproxen and diflunisal or a combination of 650 mg aspirin plus 60 mg codeine. Its clinical utility has been amply demonstrated in the treatment of a number of types of pain including general and orthopedic surgery, episiotomy, post-partum pain, dysmenorrhea, dental pain and musculoskeletal disorders. Suprofen represents a new class of orally effective nonnarcotic analgesics with potential for effective clinical use in the treatment of pain.

  4. Overview on Pharmacological and Clinical Study of Earthworm%地龙的药理与临床研究概况

    Institute of Scientific and Technical Information of China (English)

    孙姹; 张长林

    2011-01-01

    This article summarizes the pharmacological effect and clinical application of earthworm, in order to provide the reference for the further research and development of earthworm.%为进一步研究和开发地龙,本文对地龙的药理作用及临床研究的进展做一综述.

  5. Effective use of real-life events as tools for teaching-learning clinical pharmacology in a problem-based learning curriculum

    Directory of Open Access Journals (Sweden)

    Henry James

    2015-01-01

    Full Text Available Aim: This paper describes how in a problem-based learning (PBL medical curriculum, having identified the learning outcomes, problems can be developed from real-life events for teaching-learning clinical pharmacology topics for which PBL cases might be inadequate. Such problems can be very interesting and educational. Methodology: Using the story of the development and withdrawal of rofecoxib (Vioxx ® , we developed a problem for undergraduate medical students to address important issues related to clinical pharmacology and therapeutics such as new drug development, preclinical testing, clinical trials, adverse drug reactions, professionalism, and critical appraisal of literature. These topics would otherwise be difficult to address in patient-based problems. Results: The evaluation of the problem based on pooled feedback from 57 tutorial groups, each comprising 8-10 students, collected over 5 years, supported the effectiveness of the problem. Conclusion: A systematic approach described in this paper can be used for the development and validation of educational material for introducing focal topics of pharmacology/clinical pharmacology integrated with other disciplines in innovative medical (and other health profession curricula.

  6. 治疗偏头痛药物那拉曲坦的药理与临床研究%Progress in pharmacological and clinical studies of naratriptan for migraine

    Institute of Scientific and Technical Information of China (English)

    刘宇; 刘东

    2012-01-01

    那拉曲坦是高选择性5-羟色胺(5-HT1D/1B)受体激动剂,临床用于偏头痛的治疗,本文结合现有文献,对其药理作用、药动学、临床研究、安全性等内容进行了综述.%Naratriptan is a highly selective agonists at the 5-HTID and 5-HT1B receptors for migraine. In this review, the pharmacological mechanism, pharmacokinetics, clinical trials, safety of naratriptan were summarized.

  7. Trends in qualifying biomarkers in drug safety. Consensus of the 2011 meeting of the Spanish Society of Clinical Pharmacology.

    Directory of Open Access Journals (Sweden)

    José A.G. eAgúndez

    2012-01-01

    Full Text Available In this paper we discuss the consensus view on the use of qualifying biomarkers in drug safety, raised within the frame of the XXIV meeting of the Spanish Society of Clinical Pharmacology held in Málaga (Spain in October, 2011.The widespread use of biomarkers as surrogate endpoints is a goal that scientists have long been pursuing. Thirty years ago, when molecular pharmacogenomics evolved, we anticipated that these genetic biomarkers would soon obviate the routine use of drug therapies in a way that patients should adapt to the therapy rather than the opposite. This expected revolution in routine clinical practice never took place as quickly nor with the intensity as initially expected.The concerted action of operating multicenter networks holds great promise for future studies to identify biomarkers related to drug toxicity and to provide better insight into the underlying pathogenesis. Today some pharmacogenomic advances are already widely accepted, but pharmacogenomics still needs further development to elaborate more precise algorithms and many barriers to implementing individualized medicine exist. We briefly discuss our view about these barriers and we provide suggestions and areas of focus to advance in the field.

  8. The Genus Alpinia:A Review of Its Phytochemistry and Pharmacology

    Institute of Scientific and Technical Information of China (English)

    Wei-Jie Zhang; Jian-Guang Luo; Ling-Yi Kong

    2016-01-01

    Genus Alpinia consists of over 250 species, which are widely distributed in south and southeast Asia. Many plants of genus Alpinia have been used for thousands of years to treat digestive system diseases and as anti-inflammatory drugs. Phytochemical research on this genus has led to the isolation of different kinds of diarylheptanoids, terpenes triterpenoids, phenylbutanoids, lignans, and flavonoids. Experimental evidences revealed that both the crude extracts and pure constituents isolated from the genus Alpinia exhibit a wide range of bioactivities such as anti-cancer, anti-oxidant, anti-bacterial, anti-viral, cardiovascular, and digestive system protective effects. Here, we summarize the phytochemistry and pharmacology investigation of the genus Alpinia, which can provide reference for further research and drug development.

  9. Review on pharmacological pain management in trauma patients in (pre-hospital) emergency medicine in the Netherlands.

    Science.gov (United States)

    Dijkstra, B M; Berben, S A A; van Dongen, R T M; Schoonhoven, L

    2014-01-01

    Pain is one of the main complaints of trauma patients in (pre-hospital) emergency medicine. Significant deficiencies in pain management in emergency medicine have been identified. No evidence-based protocols or guidelines have been developed so far, addressing effectiveness and safety issues, taking the specific circumstances of pain management of trauma patients in the chain of emergency care into account. The aim of this systematic review was to identify effective and safe initial pharmacological pain interventions, available in the Netherlands, for trauma patients with acute pain in the chain of emergency care. Up to December 2011, a systematic search strategy was performed with MeSH terms and free text words, using the bibliographic databases CINAHL, PubMed and Embase. Methodological quality of the articles was assessed using standardized evaluation forms. Of a total of 2328 studies, 25 relevant studies were identified. Paracetamol (both orally and intravenously) and intravenous opioids (morphine and fentanyl) proved to be effective. Non-steroidal anti-inflammatory drugs (NSAIDs) showed mixed results and are not recommended for use in pre-hospital ambulance or (helicopter) emergency medical services [(H)EMS]. These results could be used for the development of recommendations on evidence-based pharmacological pain management and an algorithm to support the provision of adequate (pre-hospital) pain management. Future studies should address analgesic effectiveness and safety of various drugs in (pre-hospital) emergency care. Furthermore, potential innovative routes of administration (e.g., intranasal opioids in adults) need further exploration. PMID:23737462

  10. Clinical trials in zirconia: a systematic review.

    Science.gov (United States)

    Al-Amleh, B; Lyons, K; Swain, M

    2010-08-01

    Zirconia is unique in its polymorphic crystalline makeup, reported to be sensitive to manufacturing and handling processes, and there is debate about which processing method is least harmful to the final product. Currently, zirconia restorations are manufactured by either soft or hard-milling processes, with the manufacturer of each claiming advantages over the other. Chipping of the veneering porcelain is reported as a common problem and has been labelled as its main clinical setback. The objective of this systematic review is to report on the clinical success of zirconia-based restorations fabricated by both milling processes, in regard to framework fractures and veneering porcelain chipping. A comprehensive review of the literature was completed for in vivo trials on zirconia restorations in MEDLINE and PubMed between 1950 and 2009. A manual hand search of relevant dental journals was also completed. Seventeen clinical trials involving zirconia-based restorations were found, 13 were conducted on fixed partial dentures, two on single crowns and two on zirconia implant abutments, of which 11 were based on soft-milled zirconia and six on hard-milled zirconia. Chipping of the veneering porcelain was a common occurrence, and framework fracture was only observed in soft-milled zirconia. Based on the limited number of short-term in vivo studies, zirconia appears to be suitable for the fabrication of single crowns, and fixed partial dentures and implant abutments providing strict protocols during the manufacturing and delivery process are adhered to. Further long-term prospective studies are necessary to establish the best manufacturing process for zirconia-based restorations. PMID:20406352

  11. Pharmacology and clinical application of S(+)-ketamine%右氯胺酮的药理学特点和临床应用

    Institute of Scientific and Technical Information of China (English)

    刘丝濛; 岳云

    2016-01-01

    背景 右氯胺酮在欧洲已广泛使用,与常见的消旋氯胺酮比较,具有药效更强、可控性更好、副作用更少等优势. 目的 对右氯胺酮的药理学特点和目前的临床研究进行综述,为进一步研究和应用于临床提供参考. 内容 通过与常见的消旋氯胺酮比较,阐述右氯胺酮在药效、可控性、副作用等方面的优势.围术期小剂量应用右氯胺酮可减少术后额外镇痛药的用量,延长术后镇痛的时间,提高镇痛质量. 趋向 右氯胺酮可能在一些临床应用中取代消旋氯胺酮.%Background S (+)-ketamine has been widely used in Europe,which has higher efficacy,better controllability,and less adverse effects compared to the racemic mixture.Objective This article reviews the pharmacology and current clinical researches of S(+)-ketamine in order to provide a reference for its clinical application.Content S(+)-ketamine has higher efficacy,better controllability,and less adverse effects compared to the racemic mixture.Small-dose S(+)-ketamine used in perioperative period can prolong analgesic time,reduce postoperative analgesic need,and improve analgesic quality.Trend S (+)-ketamine is likely to replace the racemic mixture in some clinical applications.

  12. Sleep and Children with Cerebral Palsy: A Review of Current Evidence and Environmental Non-Pharmacological Interventions

    Directory of Open Access Journals (Sweden)

    Risha Dutt

    2015-02-01

    Full Text Available Between 23%–46% of children with cerebral palsy experience sleep problems. Many of the sensory-motor and cognitive features of cerebral palsy (such as immobility, pain, and seizures act as predisposing factors for sleep problems in this population. This paper presents the background related to the etiology and consequences of sleep problems in children with cerebral palsy. The relationship between pain and sleep is emphasized, as the risk of pain is highly prevalent in children with cerebral palsy. The review concludes with a discussion of the evidence-base for environmental non-pharmacological interventions based on light, temperature, sound and bedding to promote sleep for children with cerebral palsy.

  13. Pharmacological Analyses of Protein Kinases Regulating Egg Maturation in Marine Nemertean Worms: A Review and Comparison with Mammalian Eggs

    Directory of Open Access Journals (Sweden)

    Alicia Marquardt

    2010-08-01

    Full Text Available For development to proceed normally, animal eggs must undergo a maturation process that ultimately depends on phosphorylations of key regulatory proteins. To analyze the kinases that mediate these phosphorylations, eggs of marine nemertean worms have been treated with pharmacological modulators of intracellular signaling pathways and subsequently probed with immunoblots employing phospho-specific antibodies. This article both reviews such analyses and compares them with those conducted on mammals, while focusing on how egg maturation in nemerteans is affected by signaling pathways involving cAMP, mitogen-activated protein kinases, Src-family kinases, protein kinase C isotypes, AMP-activated kinase, and the Cdc2 kinase of maturation-promoting factor.

  14. A HUMANIZED CLINICALLY CALIBRATED QUANTITATIVE SYSTEMS PHARMACOLOGY MODEL FOR HYPOKINETIC MOTOR SYMPTOMS IN PARKINSON’S DISEASE

    Directory of Open Access Journals (Sweden)

    Hugo eGeerts

    2016-02-01

    Full Text Available The current treatment of Parkinson’s disease with dopamine-centric approaches such as L-DOPA and dopamine agonists, although very succesfull, is in need of alternative treatment strategies, both in terms of disease modification and symptom management. Various non-dopaminergic treatment approaches did not result in a clear clinical benefit, despite showing a clear effect in preclinical animal models. In addition, polypharmacy is common, sometimes leading to unintended effects on non-motor symptoms such as in cognitive and psychiatric domains. To explore novel targets for symptomatic treatment and possible synergistic pharmacodynamic effects between different drugs, we developed a Quantitative Systems Pharmacology (QSP platform of the closed cortico-striatal-thalamic-cortical basal ganglia loop of the dorsal motor circuit. This mechanism-based simulation platform is based on the known neuro-anatomy and neurophysiology of the basal ganglia and explicitly incorporates domain expertise in a formalized way. The calculated beta/gamma power ratio of the local field potential in the subthalamic nucleus correlates well (R2=0.71 with clinically observed extra-pyramidal symptoms triggered by antipsychotics during schizophrenia treatment (43 drug-dose combinations. When incorporating Parkinsonian (PD pathology and reported compensatory changes, the computer model suggests a major increase in b/g ratio (corresponding to bradykinesia and rigidity from a dopamine depletion of 70% onwards. The correlation between the outcome of the QSP model and the reported changes in UPDRS III Motor Part for 22 placebo-normalized drug-dose combinations is R2=0.84. The model also correctly recapitulates the lack of clinical benefit for perampanel, MK-0567 and flupirtine and offers a hypothesis for the translational disconnect. Finally, using human PET imaging studies with placebo response, the computer model predicts well the placebo response for chronic treatment, but not

  15. A Humanized Clinically Calibrated Quantitative Systems Pharmacology Model for Hypokinetic Motor Symptoms in Parkinson’s Disease

    Science.gov (United States)

    Roberts, Patrick; Spiros, Athan; Geerts, Hugo

    2016-01-01

    The current treatment of Parkinson’s disease with dopamine-centric approaches such as L-DOPA and dopamine agonists, although very successful, is in need of alternative treatment strategies, both in terms of disease modification and symptom management. Various non-dopaminergic treatment approaches did not result in a clear clinical benefit, despite showing a clear effect in preclinical animal models. In addition, polypharmacy is common, sometimes leading to unintended effects on non-motor cognitive and psychiatric symptoms. To explore novel targets for symptomatic treatment and possible synergistic pharmacodynamic effects between different drugs, we developed a computer-based Quantitative Systems Pharmacology (QSP) platform of the closed cortico-striatal-thalamic-cortical basal ganglia loop of the dorsal motor circuit. This mechanism-based simulation platform is based on the known neuro-anatomy and neurophysiology of the basal ganglia and explicitly incorporates domain expertise in a formalized way. The calculated beta/gamma power ratio of the local field potential in the subthalamic nucleus correlates well (R2 = 0.71) with clinically observed extra-pyramidal symptoms triggered by antipsychotics during schizophrenia treatment (43 drug-dose combinations). When incorporating Parkinsonian (PD) pathology and reported compensatory changes, the computer model suggests a major increase in b/g ratio (corresponding to bradykinesia and rigidity) from a dopamine depletion of 70% onward. The correlation between the outcome of the QSP model and the reported changes in UPDRS III Motor Part for 22 placebo-normalized drug-dose combinations is R2 = 0.84. The model also correctly recapitulates the lack of clinical benefit for perampanel, MK-0567 and flupirtine and offers a hypothesis for the translational disconnect. Finally, using human PET imaging studies with placebo response, the computer model predicts well the placebo response for chronic treatment, but not for acute

  16. Pharmacology and clinical potential of vortioxetine in the treatment of major depressive disorder

    Directory of Open Access Journals (Sweden)

    Alvarez E

    2014-07-01

    Full Text Available Enric Alvarez,1,2 Victor Perez,4,2 Francesc Artigas3,2 1Department of Psychiatry, Hospital de Sant Pau, Universitat Autonoma de Barcelona, Institut de Recerca Biomedica Sant Pau, Barcelona, Spain; 2Ministry of Science and Innovation, CIBERSAM, Madrid, Spain; 3Institut d’Investigacions Biomediques de Barcelona, CSIC, Barcelona, Spain; 4Institut de Neuropsiquiatria I Adiccions, Universitat Autonoma de Barcelona, Hospital del Mar, Barcelona, Spain Abstract: Vortioxetine is a new multimodal action antidepressant with two types of action: serotonin transporter (SERT blockade and a strong affinity for several serotoninergic receptors. It is an antagonist of the 5-HT3 and 5-HT7 receptors, a partial agonist of 5-HT1B, and an agonist of 5-HT1A. Its combined action on SERT and four subtypes of serotoninergic receptors increases the extracellular concentration of serotonin, dopamine, and noradrenaline. Twelve ­clinical trials have been carried out, nine of which had positive results versus placebo. When active comparators were included in the study design, no significant differences were found except in one study in which the efficacy of vortioxetine was superior to the comparator (agomelatine in depression resistant to selective serotonin reuptake inhibitors (SSRI/serotonin–norepinephrine reuptake inhibitors (SNRI treatment. Tolerability studies indicate that the drug does not cause any important problems on blood tests, vital signs, or on electrocardiography. The lack of weight gain and induction of metabolic syndrome and the lack of significant changes in the QTc are especially important. The incidence rate of sexual dysfunction is low and similar to placebo in various trials. Similarly, cognitive function remains intact with vortioxetine. Keywords: depression, clinical trial, efficacy

  17. Epidemiological, clinical and pharmacological aspects of headache in a university undergraduate population in Palestine.

    Science.gov (United States)

    Sweileh, W M; Sawalha, A F; Zyoud, S H; Al-Jabi, S W; Shamseh, F F B; Khalaf, H S

    2010-04-01

    Headache is one of the most common complaints in clinical practice. Few studies regarding headache in university students have been conducted in the Middle East. The objective of this study was to explore the prevalence, clinical characteristics, triggering factors and treatment options of headaches in university undergraduate students in Palestine/Middle East. Data were collected by interviewing a sample of 1900 students. The Headache Assessment Quiz was used to measure quality and severity of headache and to collect data on triggering factors and symptom management. A total of 1808 (95.2%) reported having at least one headache episode in the previous year. A positive family history of headache was found in 40% of students. The prevalence rate of frequent headache (tow or more episodes/month) was found in 1096 (60.9%) students; 613 women (55.9%). Of those having frequent headaches, 228 (20.8%) experienced moderate to severe episodes, 341 (31.2%) had pulsating, throbbing and pounding pain, and 274 (25%) had unilateral pain. The most common triggering factors among students with frequent headaches were: tension/stress (78.2%) and sleep deprivation (75.4%). Less than 5% of students sought medical assistance during headache episodes. Most students (79.1%) reported self-therapy with a single analgesic (53.4%), herbs (10.2%) or combination (15.5%), while 20.9% reported using no medication of any type to decrease pain. Paracetamol (48.5%) followed by ibuprofen (4.9%) were the most commonly used non-prescription analgesic drugs. Headache is a prevalent symptom in the college age population. Further research is needed to determine the prevalence of specific types of headaches. Healthcare providers are required to educate this population as well as to assist students in properly diagnosing and treating headache types. PMID:19673913

  18. Ceftazidime–avibactam: an evidence-based review of its pharmacology and potential use in the treatment of Gram-negative bacterial infections

    Directory of Open Access Journals (Sweden)

    Lagacé-Wiens P

    2014-01-01

    Full Text Available Philippe Lagacé-Wiens,1,2 Andrew Walkty,1,2 James A Karlowsky1,2 1Clinical Microbiology, Diagnostic Services Manitoba, 2Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada Abstract: Avibactam (NXL104, AVE1330A is a semi-synthetic, non-β-lactam, β-lactamase inhibitor that is active against Ambler class A, class C, and some class D serine β-lactamases. In this review, we summarize the in vitro data, pharmacology, mechanisms of action and resistance, and clinical trial data relating to the use of this agent combined with ceftazidime for the treatment of Gram-negative bacterial infections. The addition of avibactam to ceftazidime improves its in vitro activity against Enterobacteriaceae and Pseudomonas aeruginosa. Avibactam does not improve the activity of ceftazidime against Acinetobacter spp., Burkholderia spp., or most anaerobic Gram-negative rods. Pharmacodynamic data indicate that ceftazidime–avibactam is bactericidal at concentrations achievable in human serum. Animal studies demonstrate that ceftazidime–avibactam is effective in ceftazidime-resistant Gram-negative septicemia, meningitis, pyelonephritis, and pneumonia. Limited clinical trials published to date have reported that ceftazidime–avibactam is as effective as therapy with a carbapenem in complicated urinary tract infection and complicated intra-abdominal infection (combined with metronidazole including infection caused by cephalosporin-resistant Gram-negative isolates. Safety and tolerability of ceftazidime–avibactam in clinical trials has been excellent, with few serious drug-related adverse events reported. Given the abundant clinical experience with ceftazidime and the significant improvement that avibactam provides in its activity against contemporary β-lactamase-producing Gram-negative pathogens, it is likely this new combination agent will play a role in the empiric treatment of complicated

  19. Developmental intervention: a pediatric clinical review.

    Science.gov (United States)

    Casey, P H; Bradley, R H; Caldwell, B M; Edwards, D R

    1986-08-01

    We have attempted to review developmental intervention for pediatricians in a way that is of clinical relevance to primary care pediatricians. In so doing, we chose not to evaluate certain topics such as therapeutic intervention for handicapped children or center-based educational programs because these have been adequately addressed elsewhere. It is clear that pediatricians have a unique and important role to play in developmental intervention for the following reasons: pediatricians have easy and routinely accepted access to infants and families in the prenatal, perinatal, and preschool periods: pediatricians possess a socially accepted role of authority; and pediatricians can integrate understanding of the child's health and developmental status within the context of the family and social environment to make clinical interpretation regarding the child's developmental status and prognosis. Pediatricians are thus in the best position to convince parents of their impact on their child's development. The following general roles have been identified for pediatricians. First, pediatricians should be aware of the child's biologic status and family environmental situation and the relative degree of risk for developmental problems. This clinical awareness, in combination with the use of appropriate screening instruments of the child's development and family environment, will allow clinical judgment regarding the frequency and type of child health supervision, the need for further diagnostic evaluation, and the need for referral to intervention programs and other resources. Second, the pediatrician should develop an approach for developmental intervention for all children, whatever their degree of biological risk. This review of medical, educational, and psychological literature demonstrate the following recurring important themes as goals for primary intervention: Improve parental understanding of normal child development and developmental expectations. Assist parent

  20. The Genus Luehea (Malvaceae-Tiliaceae): Review about Chemical and Pharmacological Aspects

    Science.gov (United States)

    de Morais, Selene Maia; Colares, Aracélio Viana

    2016-01-01

    Popularly known as “açoita-cavalo” (whips-horse), Luehea species (Malvaceae-Tilioideae) are native to America and are used in folk medicine as anti-inflammatory, antidiarrheal, antiseptic, expectorant, and depurative and against skin infections. Although there are studies showing the chemical constituents of some species, the active substances have not been properly identified. A systematic study was carried out through a computer search of data on CAPES journals, SciELO, ISI Bireme, PubMed, ScienceDirect, ScienceDomain Medline, and Google Scholar from published articles using key words: Luehea, açoita-cavalo, and Malvaceae. Luehea divaricata was the species with the highest number of studies observed. Triterpenes (9), flavonoids (6), and steroids (4), including saponins, organic acids (4), and one lignan, are the main types of secondary metabolites registered and the most cited flavonoids were rutin and quercetin and among triterpenes there was maslinic acid, which might be associated with the popular indication of its anti-inflammatory action. The vitexin, a C-glycosylated flavone, isolated from three different species, is cited as a possible taxonomic marker of the genus. Studies confirm in part the medicinal uses of plants named as “açoita-cavalo” species. Some pharmacological activities, not assigned to the species of the genus Luehea by populations, were observed in laboratory experiments.

  1. Holoptelea integrifolia (Roxb. Planch: A Review of Its Ethnobotany, Pharmacology, and Phytochemistry

    Directory of Open Access Journals (Sweden)

    Showkat Ahmad Ganie

    2014-01-01

    Full Text Available Holoptelea integrifolia (Ulmaceae is a versatile medicinal plant used in various indigenous systems of medicine for curing routine healthcare maladies. It is traditionally used in the treatment and prevention of several ailments like leprosy, inflammation, rickets, leucoderma, scabies, rheumatism, ringworm, eczema, malaria, intestinal cancer, and chronic wounds. In vitro and in vivo pharmacological investigations on crude extracts and isolated compounds showed antibacterial, antifungal, analgesic, antioxidant, anti-inflammatory, anthelmintic, antidiabetic, antidiarrhoeal, adaptogenic, anticancer, wound healing, hepatoprotective, larvicidal, antiemetic, CNS depressant, and hypolipidemic activities. Phytochemical analysis showed the presence of terpenoids, sterols, saponins, tannins, proteins, carbohydrates, alkaloids, phenols, flavonoids, glycosides, and quinines. Numerous compounds including Holoptelin-A, Holoptelin-B, friedlin, epifriedlin, β-amyrin, stigmasterol, β-sitosterol, 1, 4-napthalenedione, betulin, betulinic acid, hexacosanol, and octacosanol have been identified and isolated from the plant species. The results of several studies indicated that H. integrifolia may be used as an effective therapeutic remedy in the prevention and treatment of various ailments. However, further studies on chemical constituents and their mechanisms in exhibiting certain biological activities are needed. In addition, study on the toxicity of the crude extracts and the compounds isolated from this plant should be assessed to ensure their eligibility to be used as source of modern medicines.

  2. Clinical and pharmacologic aspects of blinatumomab in the treatment of B-cell acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Portell CA

    2013-04-01

    Full Text Available Craig A Portell, Candice M Wenzell, Anjali S Advani Leukemia Program, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA Abstract: Acute lymphoblastic leukemia (ALL in adults remains a challenging disease to treat, and novel therapies are needed. Precursor-B ALL comprises 80% of cases, and the CD19 antigen is expressed in nearly all precursor-B ALL patients. Bispecific T-cell-engaging antibodies are novel bioengineered proteins. The bispecific T-cell-engaging antibody blinatumomab engages polyclonal T cells to CD19-expressing B cells. By binding to both CD3 and CD19, blinatumomab physically brings these T cells in close proximity to malignant B cells and potentiates T-cell-induced cytotoxic cell kill. Blinatumomab requires continuous intravenous infusion due to its short half-life, the need for continuous exposure for the drug to exert sufficient efficacy, and lessened toxicity. A phase II trial of B-cell ALL patients with persistent or relapsed minimal residual disease demonstrated an 80% rate of complete molecular remission. Cytokine-release syndrome and central nervous system events, such as seizures and encephalopathy, are reversible toxicities. Promising results in B-cell ALL with minimal residual disease have led to further evaluation of this drug in newly diagnosed and relapsed B-cell ALL. Keywords: blinatumomab, B-cell acute lymphoblastic leukemia, CD19, BiTE antibodies

  3. Pharmacology, toxicology, clinical efficacy, and adverse effects of calcium polycarbophil, an enteral hydrosorptive agent.

    Science.gov (United States)

    Danhof, I E

    1982-01-01

    Calcium polycarbophil is the calcium salt of polyacrylic acid crosslinked with divinyl glycol. It is chemically and physiologically inert. In dilute alkali it possesses marked hydrophilic capacity (60 to 100 times its weight), which is the basis for its therapeutic use. In daily dosages of 4 to 5 g in adults, it appears to be quite safe, is non-toxic, does not interfere with digestion or absorption, and does not cause gastrointestinal irritation. It appears to be effective in the treatment of both constipation and diarrhea due to functional or organic causes. Several days of continuous use are necessary before effectiveness becomes apparent. Clinical studies, of which there are relatively few, range from uncontrolled, unblinded evaluations of an almost anecdotal nature to well controlled, double-blind, crossover studies. Additional carefully controlled studies on dietary influences, exercise, and patient compliance would be helpful. Adverse effects, which are minimal, include epigastric fullness or heaviness, abdominal distention and bloating, and flatulence. As with all bulk-forming agents, calcium polycarbophil should not be used by persons who have stenotic lesions of the gastrointestinal tract.

  4. AARC Clinical Practice Guideline: Effectiveness of Pharmacologic Airway Clearance Therapies in Hospitalized Patients.

    Science.gov (United States)

    Strickland, Shawna L; Rubin, Bruce K; Haas, Carl F; Volsko, Teresa A; Drescher, Gail S; O'Malley, Catherine A

    2015-07-01

    Aerosolized medications are used as airway clearance therapy to treat a variety of airway diseases. These guidelines were developed from a systematic review with the purpose of determining whether the use of these medications to promote airway clearance improves oxygenation and respiratory mechanics, reduces ventilator time and ICU stay, and/or resolves atelectasis/consolidation compared with usual care. Recombinant human dornase alfa should not be used in hospitalized adult and pediatric patients without cystic fibrosis. The routine use of bronchodilators to aid in secretion clearance is not recommended. The routine use of aerosolized N-acetylcysteine to improve airway clearance is not recommended. Aerosolized agents to change mucus biophysical properties or promote airway clearance are not recommended for adult or pediatric patients with neuromuscular disease, respiratory muscle weakness, or impaired cough. Mucolytics are not recommended to treat atelectasis in postoperative adult or pediatric patients, and the routine administration of bronchodilators to postoperative patients is not recommended. There is no high-level evidence related to the use of bronchodilators, mucolytics, mucokinetics, and novel therapy to promote airway clearance in these populations. PMID:26113566

  5. Topical antioxidants in radiodermatitis: a clinical review.

    Science.gov (United States)

    Kodiyan, Joyson; Amber, Kyle T

    2015-09-01

    Radiation-induced skin toxicity is the most prevalent side effect of radiation therapy. Not only does it have a significant effect on patients' quality of life, but it also results in poor follow-up and early termination of radiotherapy treatment. Several skin care practices and topical applications have been studied in the field of radiodermatitis, including skin washing, topical steroids, and mechanical skin barriers. Aside from these methods, many patients turn to complementary and alternative medicine for the prevention and treatment of radiodermatitis. Many of these alternative therapies are topically applied antioxidants. While the rationale behind the use of antioxidants in treating radiodermatitis is strong, clinical studies have been far less consistent. Even in large scale randomised controlled trials, findings have been limited by the inconsistent use of topical vehicles and placebos. In this article, the authors review the role of topical antioxidants to better help the practitioner navigate through different available skin directed antioxidants.

  6. Escitalopram--translating molecular properties into clinical benefit: reviewing the evidence in major depression.

    LENUS (Irish Health Repository)

    Leonard, Brian

    2010-08-01

    The majority of currently marketed drugs contain a mixture of enantiomers; however, recent evidence suggests that individual enantiomers can have pharmacological properties that differ importantly from enantiomer mixtures. Escitalopram, the S-enantiomer of citalopram, displays markedly different pharmacological activity to the R-enantiomer. This review aims to evaluate whether these differences confer any significant clinical advantage for escitalopram over either citalopram or other frequently used antidepressants. Searches were conducted using PubMed and EMBASE (up to January 2009). Abstracts of the retrieved studies were reviewed independently by both authors for inclusion. Only those studies relating to depression or major depressive disorder were included. The search identified over 250 citations, of which 21 studies and 18 pooled or meta-analyses studies were deemed suitable for inclusion. These studies reveal that escitalopram has some efficacy advantage over citalopram and paroxetine, but no consistent advantage over other selective serotonin reuptake inhibitors. Escitalopram has at least comparable efficacy to available serotonin-norepinephrine reuptake inhibitors, venlafaxine XR and duloxetine, and may offer some tolerability advantages over these agents. This review suggests that the mechanistic advantages of escitalopram over citalopram translate into clinical efficacy advantages. Escitalopram may have a favourable benefit-risk ratio compared with citalopram and possibly with several other antidepressant agents.

  7. Assessing clinical trials of Internet addiction treatment: a systematic review and CONSORT evaluation.

    Science.gov (United States)

    King, Daniel L; Delfabbro, Paul H; Griffiths, Mark D; Gradisar, Michael

    2011-11-01

    Although there is ongoing debate concerning the clinical status of Internet addiction, and the quality of the extant literature in this emerging field is not optimal, several clinical trials of both pharmacological and psychological treatments for Internet addiction have been published in recent years. A systematic review investigating the reporting quality of eight treatment studies is presented. Reporting quality was defined according to the 2010 Consolidating Standards of Reporting Trials (CONSORT) statement. An evaluation of the reviewed studies highlighted several key limitations, including (a) inconsistencies in the definition and diagnosis of Internet addiction, (b) a lack of randomization and blinding techniques, (c) a lack of adequate controls or other comparison groups, and (d) insufficient information concerning recruitment dates, sample characteristics, and treatment effect sizes. It is concluded that improvements in future studies' design and reporting would be of significant benefit to both researchers and clinicians, and to the overall positioning of Internet addiction in the behavioral addiction field.

  8. Occupational Therapy clinical documentation: a literature review

    Directory of Open Access Journals (Sweden)

    Carla Simon Benevides Panzeri

    2013-12-01

    Full Text Available Occupational therapy clinical documentation comprises all recorded information about a client/patient/user, from forwarding to discharge, and it may integrate the patient’s record or serve as support for the exclusive practice of occupational therapy. In Brazil, despite being a mandatory and routine practice, little scientific-technical material on the subject is available for the support of professionals. This study aimed to identify, through literature review, information for greater understanding and support to the practice of professional activity. The data were analyzed and presented according to the different themes identified, seeking common, complementary and divergent points on each theme. Twelve articles were included in the study. The information obtained addressed themes such as registration methods, perception and attitudes of professionals, communication and language, quality, and others. It was possible to achieve a preliminary approach to the subject and have an overview of aspects related to occupational therapy clinical documentation, but some segmented information and several weaknesses were found

  9. A review on phytochemical, pharmacological, and pharmacognostical profile of Wrightia tinctoria: Adulterant of kurchi

    Directory of Open Access Journals (Sweden)

    Rajani Srivastava

    2014-01-01

    Full Text Available Wrightia tinctoria R. Br. belongs to family Apocynaceae commonly called as Sweet Indrajao, Pala Indigo Plant, Dyer′s Oleander. "Jaundice curative tree" in south India. Sweet Indrajao is a small, deciduous tree with a light gray, scaly smooth bark. Native to India and Burma, Wrightia is named after a Scottish physician and botanist William Wright (1740-1827. Sweet Indrajao is called dhudi (Hindi because of its preservative nature. The juice of the tender leaves is used efficaciously in jaundice. Crushed fresh leaves when filled in the cavity of decayed tooth relieve toothache. In Siddha system of medicine, it is used for psoriasis and other skin diseases. Oil 777 prepared out of the fresh leaves of the plant has been assigned to analgesic, anti-inflammatory, and anti-pyretic activities and to be effective in the treatment of psoriasis. The plant is reported to contain presence of flavanoid, glycoflavones-iso-orientin, and phenolic acids. The various chemical constituents isolated from various parts of the plant are reported as 3,4-Seco-lup-20 (29-en-3-oic acid, lupeol, stigmasterol and campetosterol, Indigotin, indirubin, tryptanthrin, isatin, anthranillate and rutin Triacontanol, Wrightial, cycloartenone, cycloeucalenol, β-amyrin, Alpha-Amyrin, and β-sitosterol, 14α-methylzymosterol. Four uncommon sterols, desmosterol, clerosterol, 24-methylene-25-methylcholesterol, and 24-dehydropollinastanol, were isolated and identified in addition to several more common phytosterols. The Triterpinoids components of the leaves and pods of Wrightia tinctoria also isolated. This article intends to provide an overview of the chemical constituents present in various parts of the plants and their pharmacological actions and pharmacognostical evaluation.

  10. A review on phytochemical, pharmacological, and pharmacognostical profile of Wrightia tinctoria: Adulterant of kurchi.

    Science.gov (United States)

    Srivastava, Rajani

    2014-01-01

    Wrightia tinctoria R. Br. belongs to family Apocynaceae commonly called as Sweet Indrajao, Pala Indigo Plant, Dyer's Oleander. "Jaundice curative tree" in south India. Sweet Indrajao is a small, deciduous tree with a light gray, scaly smooth bark. Native to India and Burma, Wrightia is named after a Scottish physician and botanist William Wright (1740-1827). Sweet Indrajao is called dhudi (Hindi) because of its preservative nature. The juice of the tender leaves is used efficaciously in jaundice. Crushed fresh leaves when filled in the cavity of decayed tooth relieve toothache. In Siddha system of medicine, it is used for psoriasis and other skin diseases. Oil 777 prepared out of the fresh leaves of the plant has been assigned to analgesic, anti-inflammatory, and anti-pyretic activities and to be effective in the treatment of psoriasis. The plant is reported to contain presence of flavanoid, glycoflavones-iso-orientin, and phenolic acids. The various chemical constituents isolated from various parts of the plant are reported as 3,4-Seco-lup-20 (29)-en-3-oic acid, lupeol, stigmasterol and campetosterol, Indigotin, indirubin, tryptanthrin, isatin, anthranillate and rutin Triacontanol, Wrightial, cycloartenone, cycloeucalenol, β-amyrin, Alpha-Amyrin, and β-sitosterol, 14α-methylzymosterol. Four uncommon sterols, desmosterol, clerosterol, 24-methylene-25-methylcholesterol, and 24-dehydropollinastanol, were isolated and identified in addition to several more common phytosterols. The Triterpinoids components of the leaves and pods of Wrightia tinctoria also isolated. This article intends to provide an overview of the chemical constituents present in various parts of the plants and their pharmacological actions and pharmacognostical evaluation.

  11. May spa therapy be a valid opportunity to treat hand osteoarthritis? A review of clinical trials and mechanisms of action

    Science.gov (United States)

    Fortunati, Nicola Angelo; Fioravanti, Antonella; Seri, Gina; Cinelli, Simone; Tenti, Sara

    2016-01-01

    Osteoarthritis (OA) is the most common form of arthritis and its current treatment includes non-pharmacological and pharmacological modalities. Spa therapy represents a popular treatment for many rheumatic diseases. The aim of this review was to summarize the currently available information on clinical effects and mechanisms of action of spa therapy in OA of the hand. We conducted a search of the literature to extract articles describing randomized clinical trials (RCTs) in hand OA published in the period 1952-2015. We identified three assessable articles reporting RCTs on spa therapy in hand OA. Data from these clinical trials support a beneficial effect of spa therapy on pain, function and quality of life in hand OA. Spa therapy seems to have a role in the treatment of hand OA. However, additional RCTs are necessary to clarify the mechanisms of action and the effects of the application of thermal treatments.

  12. Functionalized formazans: A review on recent progress in their pharmacological activities

    Directory of Open Access Journals (Sweden)

    Ahmad S. Shawali

    2015-05-01

    Full Text Available This review provides an up to date information about the diverse pharmaceutical activities of formazans. The bibliography includes 97 references which have been published during the period from 1980 to 2013. The covered biological activities of the title compounds include antioxidant, anticonvulsant, therapeutic, anthelmintic, anti-tubercular, antiviral, anti-inflammatory, anticancer, anti-HIV, antimicrobial, antiparkinsonian, cardiovascular and antiproliferative activities.

  13. Review of clinical studies of Polygonum multiflorum Thunb. and its isolated bioactive compounds

    Directory of Open Access Journals (Sweden)

    Guy-Armel Bounda

    2015-01-01

    Full Text Available Polygonum multiflorum Thunb. (PMT, officially listed in the Chinese Pharmacopoeia, is one of the most popular perennial Chinese traditional medicines known as He shou wu in China and East Asia, and as Fo-ti in North America. Mounting pharmacological studies have stressed out its key benefice for the treatment of various diseases and medical conditions such as liver injury, cancer, diabetes, alopecia, atherosclerosis, and neurodegenerative diseases as well. International databases such as PubMed/Medline, Science citation Index and Google Scholar were searched for clinical studies recently published on P. multiflorum. Various clinical studies published articles were retrieved, providing information relevant to pharmacokinetics-pharmacodynamics analysis, sleep disorders, dyslipidemia treatment, and neurodegenerative diseases. This review is an effort to update the clinical picture of investigations ever carried on PMT and/or its isolated bio-compounds and to enlighten its therapeutic assessment.

  14. Ethnobotany, phytochemistry and pharmacological potential ofVitex negundo L. (five-leaved chaste tree):An updated review

    Institute of Scientific and Technical Information of China (English)

    Lubna Abidin; Aftab Ahmad; Shokat Rasool Mir; Mohd Mujeeb; Shah Alam Khan

    2015-01-01

    In the past two decades, a shift in paradigm has been observed in the development of new drugs from the plants for the treatment of diseases. Many scientists are focusing on the evidence based use of medicinal plants to develop pharmacotherapy for various human ailments. An important medicinal plant that has caught the attention of researchers all over the globe is Vitex negundo Linn. This plant is commonly used in various traditional systems of medicine like Ayurveda, Chinese, Siddha and Unani to treat various diseases and has been the subject of extensive research studies lately. Its roots and leaves are widely used in various disorders and illnesses such as skin eczema, ringworm, liver disorders, spleen enlargement, rheumatic pain, gout, abscess, backache etc. Seeds are also used as folklore medicine in bronchitis, eye disorders, female reproductive disorders, cold, dropsy, malarial fever and as demulcent. The current article is an effort to compile an updated review to disseminate knowledge and information among the scientific fraternity covering the progress made in the pharmacology and phytochemistry of this useful medicinal plant. This review on a very important traditional medicine,Vitex negundo L. can serve as a reference to the scientific community for their future research on this plant.

  15. Methoxetamine, a novel psychoactive substance with serious adverse pharmacological effects: a review of case reports and preclinical findings.

    Science.gov (United States)

    Zanda, Mary T; Fadda, Paola; Chiamulera, Cristiano; Fratta, Walter; Fattore, Liana

    2016-09-01

    An increasing number of novel psychoactive substances are currently available and sold as 'legal highs' or 'research chemicals' accompanied by the indication that they are 'not for human consumption'. Among those that have emerged in the last few years, methoxetamine (MXE) owes its wide popularity to its easy access on the Internet and its reputation of being a 'safe' drug. MXE is an arylcyclohexylamine with a chemical structure analogous to ketamine and phencyclidine, and similar noncompetitive glutamate N-methyl D-aspartate receptor antagonist properties. Yet, very recent preclinical data highlighted a stimulatory effect of MXE on dopamine neurotransmission within the mesolimbic pathway. The aim of this review is to provide an updated review of the behavioral and toxicological effects of MXE as well as the latest findings on its pharmacology that might explain sought effects and frequent occurrence of adverse effects. In light of the growing number of intoxications induced by MXE, knowledge of its short-term and long-term effects is urgently needed. However, the hypothetical rapid antidepressant activity of MXE suggested by its chemical analogy with ketamine and supported by recent preclinical findings deserves further investigation. PMID:27128862

  16. Pharmacological interventions for phantom limb pain

    Institute of Scientific and Technical Information of China (English)

    FANG Jun; LIAN Yan-hong; XIE Kang-jie; CAI Shu-nü

    2013-01-01

    Objective To review the mechanisms and current clinical application of pharmacological interventions for phantom limb pain.Data sources Both Chinese and English language literatures were searched using MEDLINE (1982-2011),Pubmed (1982-2011) and the Index of Chinese Language Literature (1982-2011).Study selection Data from published articles about pharmacological management of phantom limb pain in recent domestic and foreign literature were selected.Data extraction Data were mainly extracted from 96 articles which are listed in the reference section of this review.Results By reviewing the mechanisms and current clinical application of pharmacological interventions for phantom limb pain,including anticonvulsants,antidepressants,local anaesthetics,N-methyl-D-aspartate receptor antagonists,non-steroidal anti-inflammatory drugs,tramadol,opioids,calcitonin,capsaicin,beta-adrenergic blockers,clonidine,muscle relaxants,and emerging drugs,we examined the efficacy and safety of these medications,outlined the limitations and future directions.Conclusions Although there is lack of evidence-based consensus guidelines for the pharmacological management of phantom limb pain,we recommend tricyclic antidepressants,gabapentin,tramadol,opioids,local anaesthetics and N-methyl-D-aspartate receptor antagonists as the rational options for the treatment of phantom limb pain.

  17. Who needs pharmacologic therapy?

    Directory of Open Access Journals (Sweden)

    Christopher Porterfield; Rohit Malhotra

    2014-06-01

    Full Text Available Treatment of atrial fibrillation has evolved significantly in the last ten years, with ablation becoming a far more common form of treatment for this most common of arrhythmias. However, while ablation has become more common, certain populations derive continued benefit from the use of pharmacologic therapy for treatment. We review the use of pharmacologic therapy and novel considerations for treatment of atrial fibrillation.

  18. The pharmacology of psilocybin.

    Science.gov (United States)

    Passie, Torsten; Seifert, Juergen; Schneider, Udo; Emrich, Hinderk M

    2002-10-01

    Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) is the major psychoactive alkaloid of some species of mushrooms distributed worldwide. These mushrooms represent a growing problem regarding hallucinogenic drug abuse. Despite its experimental medical use in the 1960s, only very few pharmacological data about psilocybin were known until recently. Because of its still growing capacity for abuse and the widely dispersed data this review presents all the available pharmacological data about psilocybin.

  19. Clinical pharmacology of levosimendan.

    Science.gov (United States)

    Antila, Saila; Sundberg, Stig; Lehtonen, Lasse A

    2007-01-01

    Levosimendan has been developed for the treatment of decompensated heart failure and is used intravenously when patients with heart failure require immediate initiation of drug therapy. It increases cardiac contractility and induces vasodilatation. The pharmacokinetics of levosimendan are linear at the therapeutic dose range of 0.05-0.2 microg/kg/minute. The short half-life (about 1 hour) of the parent drug, levosimendan, enables fast onset of drug action, although the effects are long-lasting due to the active metabolite OR-1896, which has an elimination half-life of 70-80 hours in patients with heart failure (New York Heart Association functional class III-IV). Although levosimendan is administered intravenously, it is excreted into the small intestine and reduced by intestinal bacteria to an amino phenolpyridazinone metabolite (OR-1855). This metabolite is further metabolised by acetylation to N-acetylated conjugate (OR-1896). The circulating metabolites OR-1855 and OR-1896 are formed slowly, and their maximum concentrations are seen on average 2 days after stopping a 24-hour infusion. The haemodynamic effects after levosimendan seem to be similar between fast and slow acetylators despite the fact that the enzyme N-acetyltransferase-2, which is responsible for the metabolism of OR-1855 to OR-1896, is polymorphically distributed in the population. Levosimendan reduces peripheral vascular resistance and has direct contractility-enhancing effects on the failing left ventricle. It also improves indices of diastolic function and seems to improve the function of stunned myocardium. Despite an improvement in ventricular function, levosimendan does not increase myocardial oxygen uptake significantly. An increase in coronary blood flow and a reduction in coronary vascular resistance have been observed. Levosimendan reduces plasma brain natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) levels substantially, and a decrease in plasma endothelin-1 has been observed. Levosimendan also exerts beneficial effects on proinflammatory cytokines and apoptosis mediators. The effects of a 24-hour levosimendan infusion on filling pressure, ventricular function and BNP, as well as NT-proBNP, last for at least 7 days.

  20. Flupirtine: Clinical pharmacology.

    Science.gov (United States)

    Harish, S; Bhuvana, K; Bengalorkar, Girish M; Kumar, Tn

    2012-04-01

    Flupirtine is neither an opioid nor a non steroidal anti-inflammatory drug (NSAID) producing its analgesic action through blockade of glutamate N-methyl-D-aspartate receptor. It is devoid of adverse effects of routinely used analgesic drugs, but is equally efficacious in reducing pain sensation. It has a distinctive mechanism of action, exerting a dual therapeutic effect with both analgesic and muscle relaxant properties that has utility in the treatment of pain, including that associated with muscle tension. PMID:22557738

  1. Flupirtine: Clinical pharmacology

    OpenAIRE

    Harish, S; K Bhuvana; Girish M Bengalorkar; T N Kumar

    2012-01-01

    Flupirtine is neither an opioid nor a non steroidal anti-inflammatory drug (NSAID) producing its analgesic action through blockade of glutamate N-methyl-D-aspartate receptor. It is devoid of adverse effects of routinely used analgesic drugs, but is equally efficacious in reducing pain sensation. It has a distinctive mechanism of action, exerting a dual therapeutic effect with both analgesic and muscle relaxant properties that has utility in the treatment of pain, including that associated wit...

  2. Flupirtine : Clinical pharmacology

    Directory of Open Access Journals (Sweden)

    S Harish

    2012-01-01

    Full Text Available Flupirtine is neither an opioid nor a non steroidal anti-inflammatory drug (NSAID producing its analgesic action through blockade of glutamate N-methyl-D-aspartate receptor. It is devoid of adverse effects of routinely used analgesic drugs, but is equally efficacious in reducing pain sensation. It has a distinctive mechanism of action, exerting a dual therapeutic effect with both analgesic and muscle relaxant properties that has utility in the treatment of pain, including that associated with muscle tension.

  3. Intern’s knowledge of clinical pharmacology and therapeutics at Puducherry: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nitya S

    2013-10-01

    Full Text Available Background: Internship is the intermediate period between under-graduation and general practice. The dexterity of health professional relies upon prescribing practices. Clinical pharmacology and therapeutics (CPT is a crucial discipline for interns to acquire safe and rational prescription of drugs. Cultivating sound knowledge about CPT during under graduation is, henceforth, mandatory. Aims and objectives: 1.To assess whether the undergraduate CPT teaching and internship training had prepared interns adequately for safe and rational prescription. 2.To assess the awareness and reporting of adverse drug reaction (ADR. Methods: 110 interns were enrolled after obtaining informed written consent. A structured questionnaire was given to them including basic demographic information, undergraduate CPT teaching, experience of ADR and any deficiency in the under-graduate CPT teaching. Results: Response rate was 91 % in which 53 were males and 47 females. 81 considered themselves aware of CPT. 56% & 57% interns were able to prescribe drug safely and rationally respectively. Without supervision, they were confident to prescribe antacids (93%, vitamins and minerals (90%, NSAIDS (85%, antihistamines (82%, antibiotics (75%, antiemetics (62% and antiasthmatics (52%. Only 22% had reported ADR and opined that it could lead to hospitalization (51%, prolonged hospital stay (33%, morbidity (16% and death (21%. According to interns, the topics where more emphasis needed were ADR, dosage calculation, pediatric and emergency medicine and therapeutic drug monitoring during undergraduate CPT teaching. Conclusion: CPT teaching should be improved at undergraduate level for safe and rational prescribing including ADR monitoring, ADR reporting and dosage calculation. [Int J Basic Clin Pharmacol 2013; 2(5.000: 622-628

  4. A Chemical Proteomics Approach for the Search of Pharmacological Targets of the Antimalarial Clinical Candidate Albitiazolium in Plasmodium falciparum Using Photocrosslinking and Click Chemistry

    OpenAIRE

    Diana Marcela Penarete-Vargas; Anaïs Boisson; Serge Urbach; Hervé Chantelauze; Suzanne Peyrottes; Laurent Fraisse; Vial, Henri J

    2014-01-01

    Plasmodium falciparum is responsible for severe malaria which is one of the most prevalent and deadly infectious diseases in the world. The antimalarial therapeutic arsenal is hampered by the onset of resistance to all known pharmacological classes of compounds, so new drugs with novel mechanisms of action are critically needed. Albitiazolium is a clinical antimalarial candidate from a series of choline analogs designed to inhibit plasmodial phospholipid metabolism. Here we developed an origi...

  5. A mini-review on Biginelli adducts with notable pharmacological properties

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    Ângelo de Fátima

    2015-05-01

    Full Text Available Since the disclosure of Biginelli reaction by the chemist Pietro Biginelli, functionalized 3,4-dihydropyrimidin-2(1H-ones/thiones (DHPMs have emerged as prototypes for the design of compounds with a broad variety of biological activities. This mini-review describes over 100 Biginelli adducts demonstrated to be promising anticancer, inhibitors of calcium channel, anti-inflammatory, antimicrobial and antioxidant agents. Thus, this compilation presents the most notable in vitro and in vivo results for such fascinating class of organic compounds.

  6. Fragile X syndrome: A review of clinical management.

    Science.gov (United States)

    Lozano, Reymundo; Azarang, Atoosa; Wilaisakditipakorn, Tanaporn; Hagerman, Randi J

    2016-08-01

    The fragile X mental retardation 1 gene, which codes for the fragile X mental retardation 1 protein, usually has 5 to 40 CGG repeats in the 5' untranslated promoter. The full mutation is the almost always the cause of fragile X syndrome (FXS). The prevalence of FXS is about 1 in 4,000 to 1 in 7,000 in the general population although the prevalence varies in different regions of the world. FXS is the most common inherited cause of intellectual disability and autism. The understanding of the neurobiology of FXS has led to many targeted treatments, but none have cured this disorder. The treatment of the medical problems and associated behaviors remain the most useful intervention for children with FXS. In this review, we focus on the non-pharmacological and pharmacological management of medical and behavioral problems associated with FXS as well as current recommendations for follow-up and surveillance. PMID:27672537

  7. A Review of New Pharmacologic Treatments for Patients With Chronic Heart Failure With Reduced Ejection Fraction.

    Science.gov (United States)

    Nguyen, Elaine; Weeda, Erin R; White, C Michael

    2016-08-01

    Heart failure (HF) impacts an estimated 5.7 million Americans, and its prevalence is projected to increase to more than 8 million Americans in the next 15 years. Key clinical trials have established an evidence-based foundation for treatment of heart failure with reduced ejection fraction (HFrEF). Ivabradine and sacubitril/valsartan, which inhibit the f-channel and the angiotensin receptor and neprilysin, respectively, were recently approved by the Food and Drug Administration for HFrEF. In systolic heart failure, treatment with the If inhibitor ivabradine significantly reduced the combined endpoint of cardiovascular mortality or heart failure hospital admission vs placebo (P trial, sacubitril/valsartan significantly reduced the combined endpoint of cardiovascular death or heart failure hospitalization vs enalapril (P trials and their interplay with guideline-directed medical therapy. Ivabradine and sacubitril/valsartan increase pharmacotherapy options for the treatment of HFrEF but are not yet first-line agents. Clinical application will be better defined in the coming years as practitioners increase their familiarity with ivabradine and sacubitril/valsartan. PMID:26626162

  8. Triptans in migraine: a comparative review of pharmacology, pharmacokinetics and efficacy.

    Science.gov (United States)

    Tfelt-Hansen, P; De Vries, P; Saxena, P R

    2000-12-01

    Triptans are a new class of compounds developed for the treatment of migraine attacks. The first of the class, sumatriptan, and the newer triptans (zolmitriptan, naratriptan, rizatriptan, eletriptan, almotriptan and frovatriptan) display high agonist activity at mainly the serotonin 5-HT1B and 5-HT1D receptor subtypes. As expected for a class of compounds developed for affinity at a specific receptor, there are minor pharmacodynamic differences between the triptans. Sumatriptan has a low oral bioavailability (14%) and all the newer triptans have an improved oral bioavailability and for one, risatriptan, the rate of absorption is faster. The half-lives of naratriptan, eletriptan and, in particular, frovatriptan (26 to 30h) are longer than that of sumatriptan (2h). These pharmacokinetic improvements of the newer triptans so far seem to have only resulted in minor differences in their efficacy in migraine. Double-blind, randomised clinical trials (RCTs) comparing the different triptans and triptans with other medication should ideally be the basis for judging their place in migraine therapy. In only 15 of the 83 reported RCTs were 2 triptans compared, and in 11 trials triptans were compared with other drugs. Therefore, in all placebo-controlled randomised clinical trials, the relative efficacy of the triptans was also judged by calculating the therapeutic gain (i.e. percentage response for active minus percentage response for placebo). The mean therapeutic gain with subcutaneous sumatriptan 6mg (51%) was more than that for all other dosage forms of triptans (oral sumatriptan 100mg 32%; oral sumatriptan 50mg 29%: intranasal sumatriptan 20mg 30%; rectal sumatriptan 25mg 31%; oral zolmitriptan 2.5mg 32%; oral rizatriptan 10mg 37%; oral eletriptan 40mg 37%; oral almotriptan 12.5mg 26%). Compared with oral sumatriptan 100mg (32%), the mean therapeutic gain was higher with oral eletriptan 80mg (42%) but lower with oral naratriptan 2.5mg (22%) or oral frovatriptan 2.5mg (16

  9. Interns' knowledge of clinical pharmacology and therapeutics after undergraduate and on-going internship training in Nigeria: a pilot study

    Directory of Open Access Journals (Sweden)

    Senbanjo Idowu O

    2009-07-01

    Full Text Available Abstract Background A sound knowledge of pathophysiology of a disease and clinical pharmacology and therapeutics (CPT of a drug is required for safe and rational prescribing. The aim of this study was therefore to assess how adequately the undergraduate CPT teaching had prepared interns in Nigeria for safe and rational prescribing and retrospectively, to know how they wanted the undergraduate curriculum to be modified so as to improve appropriate prescribing. The effect of internship training on the prescribing ability of the interns was also sought. Methods A total of 100 interns were randomly selected from the Lagos State University Teaching Hospital (LASUTH, Ikeja; Lagos University Teaching Hospital (LUTH, Idiaraba; General Hospital Lagos (GHL; the EKO Hospital, Ikeja; and Havana Specialist Hospital, Surulere. A structured questionnaire was the instrument of study. The questionnaire sought information about the demographics of the interns, their undergraduate CPT teaching, experience of adverse drug reactions (ADRs and drug interactions since starting work, confidence in drug usage and, in retrospect; any perceived deficiencies in their undergraduate CPT teaching. Results The response rate was 81%. All the respondents graduated from universities in Nigeria. The ability of the interns to prescribe rationally (66, 81.4% and safely (47, 58% was provided by undergraduate CPT teaching. Forty two (51.8% respondents had problems with prescription writing. The interns would likely prescribe antibiotics (71, 87.6%, nonsteroidal analgesics (66, 81.4%, diuretics (55, 67.9%, sedatives (52, 62.9%, and insulin and oral hypoglycaemics (43, 53% with confidence and unsupervised. The higher the numbers of clinical rotations done, the more confident were the respondents to prescribe unsupervised (χ2 = 19.98, P 2 = 11.57, P 2 = 11.25, P Conclusion Undergraduate CPT teaching in Nigeria appears to be deficient. Principles of rational prescribing, drug dose

  10. Conus venom peptide pharmacology.

    Science.gov (United States)

    Lewis, Richard J; Dutertre, Sébastien; Vetter, Irina; Christie, MacDonald J

    2012-04-01

    Conopeptides are a diverse group of recently evolved venom peptides used for prey capture and/or defense. Each species of cone snails produces in excess of 1000 conopeptides, with those pharmacologically characterized (≈ 0.1%) targeting a diverse range of membrane proteins typically with high potency and specificity. The majority of conopeptides inhibit voltage- or ligand-gated ion channels, providing valuable research tools for the dissection of the role played by specific ion channels in excitable cells. It is noteworthy that many of these targets are found to be expressed in pain pathways, with several conopeptides having entered the clinic as potential treatments for pain [e.g., pyroglutamate1-MrIA (Xen2174)] and one now marketed for intrathecal treatment of severe pain [ziconotide (Prialt)]. This review discusses the diversity, pharmacology, structure-activity relationships, and therapeutic potential of cone snail venom peptide families acting at voltage-gated ion channels (ω-, μ-, μO-, δ-, ι-, and κ-conotoxins), ligand-gated ion channels (α-conotoxins, σ-conotoxin, ikot-ikot, and conantokins), G-protein-coupled receptors (ρ-conopeptides, conopressins, and contulakins), and neurotransmitter transporters (χ-conopeptides), with expanded discussion on the clinical potential of sodium and calcium channel inhibitors and α-conotoxins. Expanding the discovery of new bioactives using proteomic/transcriptomic approaches combined with high-throughput platforms and better defining conopeptide structure-activity relationships using relevant membrane protein crystal structures are expected to grow the already significant impact conopeptides have had as both research probes and leads to new therapies. PMID:22407615

  11. Plant profile, phytochemistry and pharmacology of Avartani (Helicteres isora Linn.):A review

    Institute of Scientific and Technical Information of China (English)

    Nirmal Kumar; Anil Kumar Singh

    2014-01-01

    Plants are used as medicine since ancient time, in organized (Ayurveda, Unani & Siddha) and unorganized (folk, native & tribal) form. In these systems, drugs are described either in Sanskrit or vernacular languages. Avartani (Helicteres isora Linn.) is a medicinal plant which is used in several diseases. It is commonly known as Marodphali, Marorphali, Enthani etc. due to screw like appearance of its fruit. Avartani is used as a folk medicine to treat snake bite, diarrhoea and constipation of new born baby. In the research, antioxidant, hypolipidaemic, antibacterial and antiplasmid activities, cardiac antioxidant, antiperoxidative potency, brain-antioxidation potency, anticancer activity, antinociceptive activity, hepatoprotective activity, anti-diarrheal activity and wormicidal activity in this plant were reviewed.

  12. Pharmacological potentials of phenolic compounds from Prosopis spp.-a review

    Institute of Scientific and Technical Information of China (English)

    Dhananjaya Seturaman Prabha; Hans-Uwe Dahms; Prabha Malliga

    2014-01-01

    The shrub Prosopsis juliflora (Sw.) DC. revealed several medicinal properties due to its different chemical compounds such as alkaloids, flavonoids, terpenoids, saponins and phenolic compounds distributed in different parts of the plant body, such as woody parts (roots, stem, branches and bark) as well as leaves and pollen have been used for the extraction of medically active substances. Prosopsis juliflora containing a diverse group of secondary metabolites has unique and multifactorial medicinal properties. The utilization of this abundant resource provides a viable option for producing bioactive natural products that may serve as lead substances for the chemical and pharmaceutical industries. This review highlights accessible bioactive sources from this plant that are of potential interest for industrial applications.

  13. Dolutegravir – a review of the pharmacology, efficacy, and safety in the treatment of HIV

    Directory of Open Access Journals (Sweden)

    Kandel CE

    2015-07-01

    Full Text Available Christopher E Kandel,1 Sharon L Walmsley1,21Department of Medicine, University of Toronto, Toronto, ON, Canada; 2Division of Infectious Diseases, University Health Network, Toronto, ON, CanadaAbstract: Dolutegravir is the newest integrase strand transfer inhibitor to be approved for the treatment of human immunodeficiency virus (HIV infection. Dolutegravir is equivalent or superior to existing treatment regimens in both treatment-naïve and treatment-experienced patients including those with previous raltegravir or elvitegravir failure. The consistent efficacy coupled with excellent tolerability and infrequent drug–drug interactions makes the co-formulation of dolutegravir with two nucleotide reverse-transcriptase inhibitors an attractive treatment option. This review summarizes the pharmacokinetics, adverse event profile, and efficacy of dolutegravir in the treatment of HIV.Keywords: patient-reported outcomes, integrase inhibitor, antiretroviral therapy

  14. A critical review of pharmacological significance of Hydrogen Sulfide in hypertension

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    Ashfaq Ahmad

    2015-01-01

    Full Text Available In the family of gas transmitters, hydrogen sulfide (H 2 S is yet not adequately researched. Known for its rotten egg smell and adverse effects on the brain, lungs, and kidneys for more than 300 years, the vasorelaxant effects of H 2 S on blood vessel was first observed in 1997. Since then, research continued to explore the possible therapeutic effects of H 2 S in hypertension, inflammation, pancreatitis, different types of shock, diabetes, and heart failure. However, a considerable amount of efforts are yet needed to elucidate the mechanisms involved in the therapeutic effects of H 2 S, such as nitric oxide-dependent or independent vasodilation in hypertension and regression of left ventricular hypertrophy. More than a decade of good repute among researchers, H 2 S research has certain results that need to be clarified or reevaluated. H 2 S produces its response by multiple modes of action, such as opening the ATP-sensitive potassium channel, angiotensin-converting enzyme inhibition, and calcium channel blockade. H 2 S is endogenously produced from two sulfur-containing amino acids L-cysteine and L-methionine by the two enzymes cystathionine γ lyase and cystathionine β synthase. Recently, the third enzyme, 3-mercaptopyruvate sulfur transferase, along with cysteine aminotransferase, which is similar to aspartate aminotransferase, has been found to produce H 2 S in the brain. The H 2 S has interested researchers, and a great deal of information is being generated every year. This review aims to provide an update on the developments in the research of H 2 S in hypertension amid the ambiguity in defining the exact role of H 2 S in hypertension because of insufficient number of research results on this area. This critical review on the role of H 2 S in hypertension will clarify the gray areas and highlight its future prospects.

  15. Medetomidine sedation in dogs and cats: a review of its pharmacology, antagonism and dose.

    Science.gov (United States)

    Cullen, L K

    1996-09-01

    Medetomidine is a relatively new sedative analgesic in dogs and cats but some precautions are required when using it. It is a potent alpha 2-adrenoceptor agonist and stimulates receptors centrally to produce dose-dependent sedation and analgesia and receptors centrally and peripherally to cause marked bradycardia and decrease the cardiac output. While hypotension occurs frequently, higher doses of the sedative can raise the blood pressure due to an affect on peripheral receptors. Slowing of the respiratory rate is a frequent effect of medetomidine with some dogs showing signs of cyanosis. Other actions that follow medetomidine use are slowing of gastrointestinal motility, hypothermia, changes to endocrine function and, occasionally, vomiting and muscle twitching. The clinical use of medetomidine in dogs and cats is discussed. Recommended dose rates are presented along with precautions that should be taken when it is used alone for sedation, as an anaesthetic premedicant or in combination with ketamine, propofol or opioids. Hypoxaemia occurs frequently in dogs given medetomidine and propofol. The actions of medetomidine can be rapidly reversed with the specific alpha 2-adrenoceptor antagonist, atipamezole, which is an advantage because undesirable and sedative actions of medetomidine can be terminated. PMID:8885463

  16. 抗惊厥新药依佐加滨的药理与临床评价%Pharmacology and clinical evaluation of a new anticonvulsant, ezogabine

    Institute of Scientific and Technical Information of China (English)

    王来海; 张瑞岭; 张萍

    2012-01-01

    依佐加滨是首个治疗癫痫的神经元钾离子通道开放剂,己于2011年6月13日被美国FDA批准用于成人惊厥部分发作的治疗.其作用机制并未完全阐明,可能是通过稳定神经元钾离子通道使其保持“开放”状态,降低其若奋性而产生抗惊厥作用.其常见的不良反应有眩晕、嗜睡、乏力、意识错乱等.本文对依佐加滨的药理作用、药代动力学、药物相互作用、临床评价和安全性等进行介绍.%Ezogabine is the first neuronal potassium channel opener developed for the treatment of epilepsy. It was approved by the U. S. Food and Drug Administration on June 13, 2011 as an add-on medication to treat seizures associated with epilepsy in adults. The mechanism by which ezogabine exerts its therapeutic effects has not been fully elucidated. The drug may act as an anticonvulsant by reducing excitability through the stabilization of neuronal potassium channels in an "open" state. Studies indicate that ezogabine enhances transmembrane potassium currents mediated by the KCNQ family ion channels. By activating KCNQ channels, ezogabine is thought to stabilize the resting membrane potential and reduce brain excitability. The most common adverse effects were dizziness, drowsiness, fatigue and confusion, etc. The pharmacology, pharmaeokinetics, clinical evaluation, safety and drug interactions of ezogabine were reviewed in this paper.

  17. Clinical review: Statins and trauma--a systematic review.

    Science.gov (United States)

    Jansen, Jan O; Lord, Janet M; Thickett, David R; Midwinter, Mark J; McAuley, Daniel F; Gao, Fang

    2013-01-01

    Statins, in addition to their lipid-lowering properties, have anti-inflammatory actions. The aim of this review is to evaluate the effect of pre-injury statin use, and statin treatment following injury. MEDLINE, EMBASE, and CENTRAL databases were searched to January 2012 for randomised and observational studies of statins in trauma patients in general, and in patients who have suffered traumatic brain injury, burns, and fractures. Of 985 identified citations, 7 (4 observational studies and 3 randomised controlled trials (RCTs)) met the inclusion criteria. Two studies (both observational) were concerned with trauma patients in general, two with patients who had suffered traumatic brain injury (one observational, one RCT), two with burns patients (one observational, one RCT), and one with fracture healing (RCT). Two of the RCTs relied on surrogate outcome measures. The observational studies were deemed to be at high risk of confounding, and the RCTs at high risk of bias. Three of the observational studies suggested improvements in a number of clinical outcomes in patients taking statins prior to injury (mortality, infection, and septic shock in burns patients; mortality in trauma patients in general; mortality in brain injured patients) whereas one, also of trauma patients in general, showed no difference in mortality or infection, and an increased risk of multi-organ failure. Two of three RCTs on statin treatment in burns patients and brain injured patients showed improvements in E-selectin levels and cognitive function. The third, of patients with radial fractures, showed no acceleration in fracture union. In conclusion, there is some evidence that pre-injury statin use and post-injury statin treatment may have a beneficial effect in patients who have suffered general trauma, traumatic brain injury, and burns. However, these studies are at high risk of confounding and bias, and should be regarded as 'hypothesisgenerating'. A well-designed RCT is required to

  18. Brazilin from Caesalpinia sappan heartwood and its pharmacological activities:A review

    Institute of Scientific and Technical Information of China (English)

    Nilesh; P; Nirmal; Mithun; S; Rajput; Rangabhatla; G.S.V.Prasad; Mehraj; Ahmad

    2015-01-01

    Caesalpinia sappan L.(CS) is a plant of Leguminosae family,commonly known as Brazil or Sappan wood.CS is distributed in Southeast Asia and its dried heartwood has been used as traditional ingredient of food or beverages and has a wide variety of medicinal properties.Higher extraction yield of CS wood was achieved with 95% ethanol for 2 h.Chemical constituent’s investigation of sappan wood resulled in the isolation of various structural types of phenolic components including one xanihone,one coumarin,three chalcones,two flavones three homoisoflavonoids and brazilin.Brazilin[(6a S-cis)-7,11b-dihydrobcnz[b]indeno[1.2-d]pyran-3.6a.9.10(6H)- tetroll.a major and active compound found in CS heartwood.Most of the folkloric uses of brazilin were validated by the scientific studies such as antioxidant,antibacterial,anti-inflammatory,anti-photoaging.hypoglycemic,vasorelaxant,hepatoproteetive and anti-acne activity.CS heartwood extract is safe and did not produce any acute or subacute toxicity in both male and female rats.Brazilin is the safe natural compound having potential to develop as a medicinal compound with application in food,beverage,cosmetics and pharmaceutical industries to screen its clinical use in modern medicine.The information gained could provide the important and potential approach for pharmaceutical researcher to implicate the knowledge of brazilin in the formulation of new drug and to reveal therapeutic and gaps requiring future research opportunities.More studies are needed to evaluate the potential application of brazilin as preservative and coloring agent in food processing industries.

  19. Brazilin from Caesalpinia sappan heartwood and its pharmacological activities:A review

    Institute of Scientific and Technical Information of China (English)

    Nilesh P Nirmal; Mithun S Rajput; Rangabhatla GSV Prasad; Mehraj Ahmad

    2015-01-01

    Caesalpinia sappan L. (CS) is a plant of Leguminosae family, commonly known as Brazil or Sappan wood. CS is distributed in Southeast Asia and its dried heartwood has been used as traditional ingredient of food or beverages and has a wide variety of medicinal properties. Higher extraction yield of CS wood was achieved with 95% ethanol for 2 h. Chemical constituent’s investigation of sappan wood resulted in the isolation of various structural types of phenolic components including one xanthone, one coumarin, three chalcones, two flavones three homoisoflavonoids and brazilin. Brazilin [(6a S-cis)-7, 11b-dihydrobenz[b]indeno[1,2-d] pyran-3,6a,9,10(6H)-tetrol], a major and active compound found in CS heartwood. Most of the folkloric uses of brazilin were validated by the scientific studies such as antioxidant, antibacterial, anti-inflammatory, anti-photoaging, hypoglycemic, vasorelaxant, hepatoprotective and anti-acne activity. CS heartwood extract is safe and did not produce any acute or subacute toxicity in both male and female rats. Brazilin is the safe natural compound having potential to develop as a medicinal compound with application in food, beverage, cosmetics and pharmaceutical industries to screen its clinical use in modern medicine. The information gained could provide the important and potential approach for pharmaceutical researcher to implicate the knowledge of brazilin in the formulation of new drug and to reveal therapeutic and gaps requiring future research opportunities. More studies are needed to evaluate the potential application of brazilin as preservative and coloring agent in food processing industries.

  20. Tamarindus indica L.: A review of traditional uses, phytochemistry and pharmacology

    Directory of Open Access Journals (Sweden)

    De Caluwé, Emmy

    2010-01-01

    Full Text Available Tamarind (Tamarindus indica, Fabaceae, a tropical fruit found in Africa and Asia is highly valued for its pulp. Tamarind fruit pulp has a sweet acidic taste due to a combination of high contents of tartaric acid and reducing sugars. The pulp is used for seasoning, in prepared foods, to flavour confections, curries and sauces, and as a major ingredient in juices and other beverages. Commercial tamarind-based drinks are available from many countries. Vitamin B content is quite high; carotene and vitamin C contents are low. Presence of tannins and other dyeing matters in the seed testa make the whole seed unsuitable for consumption, but they become edible after soaking and boiling in water. Tamarind kernel powder is an important sizing material in textile, paper and juteindustries. Seeds are gaining importance as an alternative source of proteins, and are besides rich in some essential minerals. Seed pectin can form gels over a wide pH range. Leaves and flowers can be eaten as vegetables, and are prepared in a variety of dishes. They are used to make curries, salads, stews and soups. Tamarind leaves are a fair source of vitamin C and α-carotene; mineral content is high, particularly P, K, Ca and Mg. Anti-oxidant, anti-inflammatory, anti-microbial and anti-fungal activity has been documented from several plant parts. Tamarind is also extensively used in traditional medicine. The traditional uses, its phytochemistry and pharmacognosy is reviewed to provided with a particular orientation to its value in sub-Sahara Africa.

  1. Lixivaptan – an evidence-based review of its clinical potential in the treatment of hyponatremia

    Directory of Open Access Journals (Sweden)

    Bowman BT

    2013-07-01

    Full Text Available Brendan T Bowman, Mitchell H Rosner Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USA Abstract: Hyponatremia is the most common electrolyte abnormality seen in clinical practice. Most cases of euvolemic or hypervolemic hyponatremia involve arginine vasopressin (AVP. AVP leads to a concentrated urine and negative free water clearance. Given this primary role of AVP, antagonizing its effect through blockade of its receptor in the distal tubule is an attractive therapeutic target. Lixivaptan is a newer, non-peptide, vasopressin type 2 receptor antagonist. Recent studies have demonstrated efficacy. This review summarizes the clinical pharmacology and data for this new agent. Keywords: vasopressin, hyponatremia, heart failure, lixivaptan, therapy, outcomes

  2. Orofacial pain of cardiac origin: Review literature and clinical cases

    OpenAIRE

    López-López, José; Garcia-Vicente, Laia; Jané-Salas, Enric; Estrugo-Devesa, Albert; Chimenos-Küstner, Eduardo; Roca-Elias, Josep

    2012-01-01

    The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin. Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature. Study Design: Description of clinical cases and review of clinical cases. Resu...

  3. Brinzolamide ophthalmic suspension: a review of its pharmacology and use in the treatment of open angle glaucoma and ocular hypertension

    Directory of Open Access Journals (Sweden)

    Michele Iester

    2008-10-01

    Full Text Available Michele IesterClinica Oculistica, University of Genoa, ItalyAbstract: Brinzolamide is a white powder commercially formulated as a 1% ophthalmic suspension to reduce intraocular pressure (IOP. Pharmacologically, brinzolamide is a highly specific, non-competitive, reversible, and effective inhibitor of carbonic anhydrase II (CA-II, able to suppress formation of aqueous humor in the eye and thus to decrease IOP. Several clinical trials have evaluated its safety and the most commonly ocular adverse events are blurred vision (3%–8%, ocular discomfort (1.8%–5.9%, and eye pain (0.7%–4.0%. Brinzolamide has been introduced to treat ocular hypertension and primary open-angle glaucoma. In some clinical studies it has been estimated that brinzolamide reduced IOP by was about 18%. Brinzolamide can be added to beta-blockers and prostaglandins. In the latter combination, because prostaglandin derivatives improve the uveoscleral outflow but also increase the activity of CA in ciliary epithelium with a secondary increase in aqueous humor secretion, and slightly reduce the efficacy of prostaglandin analogues, theoretically topical CA inhibitors (CAI decrease IOP by inhibiting CA-II, thus improving prostaglandin efficacy as well as lowering IOP. Brinzolamide could have a secondary possible effect on ocular flow too. Some clinical studies showed a mild improvement of ocular blood flow. Theoretically, CAI could give rise to metabolic acidosis, with secondary vasodilatation and improvement of blood flow. Systemic acidosis can occur in the setting of oral CAI therapy, and local acidosis within ocular tissues is theoretically possible with topical CAI therapy, with the potential for a local increase in ocular blood flow. In conclusion, topical CAI treatment has efficacy in IOP-lowering ranging from 15% to 20%. From published data, brinzolamide can be used as first-line medication, even if other medications have a higher efficacy, with few side effects and it is a

  4. Non-pharmacological management of orthostatic hypotension after spinal cord injury: a critical review of the literature

    OpenAIRE

    Gillis, Jason; Wouda, Matthijs; Hjeltnes, Nils

    2008-01-01

    Objectives: Identify and describe the body of literature pertaining to non-pharmacological management of orthostatic hypotension (OH) during the early rehabilitation of persons with a spinal cord injury (SCI).

  5. Pharmacological and methodological aspects of the separation-induced vocalization test in guinea pig pups; a systematic review and meta-analysis

    OpenAIRE

    Groenink, Lucianne; Verdouw, P Monika; Bakker, Brenda; Wever, Kimberley E

    2015-01-01

    The separation-induced vocalization test in guinea pig pups is one of many that has been used to screen for anxiolytic-like properties of drugs. The test is based on the cross-species phenomenon that infants emit distress calls when placed in social isolation. Here we report a systematic review and meta-analysis of pharmacological intervention in the separation-induced vocalization test in guinea pig pups. Electronic databases were searched for original research articles, yielding 32 studies ...

  6. Alzheimer´s disease: a clinical-practice-oriented review

    Directory of Open Access Journals (Sweden)

    Luísa eAlves

    2012-04-01

    Full Text Available Investigation in the field of Alzheimer´s disease (AD, the commonest cause of dementia, has been very active in recent years and it may be difficult for the clinician to keep up with all the innovations and to be aware of the implications they have in clinical practice. The authors, thus, reviewed recent literature on the theme in order to provide the clinician with an updated overview, intended to support decision-making on aspects of diagnosis and management. This article begins to focus on the concept of AD and on its pathogenesis. Afterwards, epidemiology and non-genetic risk factors are approached. Genetics, including genetic risk factors and guidelines for genetic testing, are mentioned next. Recommendations for diagnosis of AD, including recently proposed criteria, are then reviewed. Data on the variants of AD is presented. First approach to the patient is dealt with next, followed by neuropsychological evaluation. Biomarkers, namely MRI, SPECT, FDG PET, PiB PET, CSF tau and Aβ analysis, as well as available data on their diagnostic accuracy, are also discussed. Factors predicting rate of disease progression are briefly mentioned. Finally, non-pharmacological and pharmacological treatments, including established and emerging drugs, are addressed.

  7. Attributes of clinical leadership in contemporary nursing: an integrative review.

    Science.gov (United States)

    Mannix, Judy; Wilkes, Lesley; Daly, John

    2013-08-01

    Effective clinical leadership is offered as the key to healthy, functional and supportive work environments for nurses and other health professionals. However, as a concept it lacks a standard definition and is poorly understood. This paper reports on an integrative review undertaken to uncover current understandings of defining attributes of contemporary clinical leadership in nursing. Data collection involved a search of relevant electronic databases for a 10-year period. Keywords for the search were 'clinical leadership' and 'nursing'. Ten research papers met the inclusion criteria for the integrative review. Analysis of these studies indicated clinical leadership attributes had a clinical focus, a follower/team focus or a personal qualities focus; attributes necessary to sustain supportive workplaces and build the capacity and resilience of nursing workforces. The small number of research-based studies yielded for the review indicates the need for further research in the area of clinical leadership. PMID:24099222

  8. Pharmacological approach to acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Ulrich Christian Bang; Synne Semb; Camilla Nφjgaard; Flemming Bendtsen

    2008-01-01

    The aim of the present review is to summarize the current knowledge regarding pharmacological prevention and treatment of acute pancreatitis (AP)based on experimental animal models and clinical trials.Somatostatin (SS) and octreotide inhibit the exocrine production of pancreatic enzymes and may be useful as prophylaxis against Post Endoscopic retrograde cholangiopancreatography Pancreatitis (PEP). The protease inhibitor Gabexate mesilate (GM) is used routinely as treatment to AP in some countries, but randomized clinical trials and a meta-analysis do not support this practice. Nitroglycerin (NGL) is a nitrogen oxide (NO) donor, which relaxes the sphincter of Oddi.Studies show conflicting results when applied prior to ERCP and a large multicenter randomized study is warranted. Steroids administered as prophylaxis against PEP has been validated without effect in several randomized trials. The non-steroidal anti-inflammatory drugs (NSAID) indomethacin and diclofenac have in randomized studies showed potential as prophylaxis against PEP. Interleukin 10 (IL-10) is a cytokine with anti-inflammatory properties but two trials testing IL-10 as prophylaxis to PEP have returned conflicting results.Antibodies against tumor necrosis factor-alpha (TNF-α)have a potential as rescue therapy but no clinical trials are currently being conducted. The antibiotics betalactams and quinolones reduce mortality when necrosis is present in pancreas and may also reduce incidence of infected necrosis. Evidence based pharmacological treatment of AP is limited and studies on the effect of potent anti-inflammatory drugs are warranted.

  9. Pharmacological and clinical profile of recently approved second-generation antipsychotics: implications for treatment of schizophrenia in older patients.

    Science.gov (United States)

    Rado, Jeffrey; Janicak, Philip G

    2012-10-01

    Antipsychotics are frequently used in elderly patients to treat a variety of conditions, including schizophrenia. While extensively studied for their impact in younger populations, there is comparatively limited evidence about the effectiveness of these agents in older patients. Further complicating this situation are the high comorbidity rates (both psychiatric and medical) in the elderly; age-related changes in pharmacokinetics that lead to a heightened proclivity for adverse effects; and the potential for multiple, clinically relevant drug interactions. With this background in mind, we review diagnostic and treatment-related issues specific to elderly patients suffering from schizophrenia. We then focus on the potential role of the most recently approved second-generation antipsychotics, paliperidone (both the extended-release oral formulation and the long-acting injectable formulation), iloperidone, asenapine and lurasidone, given the limited clinical experience with these agents in the elderly. While there is limited data to support their safety, tolerability and efficacy in older patients with schizophrenia, each has unique characteristics that should be considered when used in this population.

  10. Clinical applications: percutaneous coronary intervention - a review

    Energy Technology Data Exchange (ETDEWEB)

    Meier, B. [Swiss Cardiovascular Center Bern, Univ. Hospital, Bern (Switzerland)

    2006-07-01

    Following a brief review of the early days of coronary angiography, this article traces the development of percutaneous coronary intervention from the pioneering work of Dotter and Gruentzig up to the latest procedures for coronary angioplasty. (orig.)

  11. 抗精神病新药鲁拉西酮的药理与临床研究进展%Progress in pharmacological and clinical studies of antipsychotic drug:lurasidone

    Institute of Scientific and Technical Information of China (English)

    封宇飞

    2011-01-01

    Lurasidone is a novel psychotropic agent with high affinity for dopamine D2 and serotonin 5-HT2A receptors. Lurasidone has received accelerated approval from the FDA for the treatment of schizophrenia. A literature search was conducted using Medline with the key word lurasidone. Its pharmacology, pharmacokinetics and drug interactions, clinical study and safety were reviewed in this paper.%鲁拉西酮是一种新型抗精神病药,对多巴胺D和5-HT受体具有高度的亲和性.FDA批准其用于精神分裂症的治疗.文中通过Medline对鲁拉西酮进行文献检索,并对其药理作用、药动学、药物相互作用、临床研究和安全性进行了综述.

  12. 抗感染新药非达霉素的药理作用与临床评价%Pharmacology and clinical evaluation of the new anti-infective drug fidaxomicin

    Institute of Scientific and Technical Information of China (English)

    姜春梅; 刘洋; 王京晶; 张清; 康博欣

    2011-01-01

    Fidaxomicin (edarbi) is the antibiotic with a novel structure of macrolides for the treatment of clostridium difficile-associated diarrhea ( CDAD). Literature was searched from FDA database with the key word edarbi. The pharmacology, pharmacokinetics, clinical evaluation, safety evaluation and drug interactions of fidaxomicin were reviewed.%非达霉素( fidaxomicin)是一种新型的大环内酯类抗生素,适用于艰难梭菌相关性腹泻(clostridium difficile-associated diarrhea,CDAD)的治疗.本文参考美国FDA的相关资料,对非达霉素的药理作用、药动学、临床评价、安全性评价及药物相互作用等进行综述.

  13. Should psychosocial intervention be added to pharmacological treatment for opiate abuse/dependence? An overview of systematic reviews of the literature

    Directory of Open Access Journals (Sweden)

    Laura Amato

    2006-06-01

    Full Text Available

    Background: Opioid abuse and dependence are major health and social issues in most societies. Different interventions are available, but the majority of heroin patients relapse and these relapses are a substantial problem to their rehabilitation. Psychosocial interventions for drug addicts have been suggested as possible instruments to overcome the difficulty of maintaining a drug-free state. The aim of this paper is to provide a summary of the available evidence of effectiveness.

    Methods: We summarised the results from two systematic reviews on psychosocial interventions combined with Methadone Maintenance Treatment and Methadone or Buprenorphine Detoxification Treatment.

    Results: For detoxification treatments, the results show that benefits can be gained from adding any psychosocial treatment to any substitution detoxification treatment in terms of completion of treatment: relative risk (RR 1.68 (95% CI 1.11-2.55, and compliance (proportion of clinical absences: RR 0.48 (95% CI 0.38-0.59; for the use of heroin during treatment, the differences were not statistically significant. For maintenance treatments, there is an additional benefit to be gained in adding any psychosocial treatment to methadone maintenance treatment in relation to the use of heroin during treatment: RR 0.69(95% CI 0.53-0.91; no statistically significant additional benefit was shown in terms of treatment retention and results at follow-up.

    Conclusions: Psychosocial treatments offered in addition to pharmacological detoxification treatments are effective in terms of completion of treatment and compliance, while adding any psychosocial support to methadone maintenance significantly improves the non-use of heroin during treatment but does not improve the other outcomes considered.

  14. Pharmacological treatment of chorea in Huntington’s disease–good clinical practice versus evidence-based guideline

    OpenAIRE

    Reilmann, Ralf

    2013-01-01

    Recently, the American Academy of Neurology published an evidence-based guideline for the pharmacological treatment of chorea in Huntington’s disease. Although the progress in medical care because of the implementation of criteria of evidence-based medicine is undisputed, the guideline classifies the level of evidence for drugs to reduce chorea based on anchors in the Unified Huntington’s Disease Rating Scale-Total Motor Score chorea sum score, which were chosen arbitrarily and do not reflect...

  15. Lithium: updated human knowledge using an evidence-based approach. Part II: Clinical pharmacology and therapeutic monitoring.

    Science.gov (United States)

    Grandjean, Etienne Marc; Aubry, Jean-Michel

    2009-01-01

    After a single dose, lithium, usually given as carbonate, reaches a peak plasma concentration at 1.0-2.0 hours for standard-release dosage forms, and 4-5 hours for sustained-release forms. Its bioavailability is 80-100%, its total clearance 10-40 mL/min and its elimination half-life is 18-36 hours. Use of the sustained-release formulation results in 30-50% reductions in peak plasma concentrations without major changes in the area under the plasma concentration curve. Lithium distribution to the brain, evaluated using 7Li magnetic resonance spectroscopy, showed brain concentrations to be approximately half those in serum, occasionally increasing to 75-80%. Brain concentrations were weakly correlated with serum concentrations. Lithium is almost exclusively excreted via the kidney as a free ion and lithium clearance is considered to decrease with aging. No gender- or race-related differences in kinetics have been demonstrated. Renal insufficiency is associated with a considerable reduction in renal clearance of lithium and is considered a contraindication to its use, especially if a sodium-poor diet is required. During the last months of pregnancy, lithium clearance increases by 30-50% as a result of an increase in glomerular filtration rate. Lithium also passes freely from maternal plasma into breast milk. Numerous kinetic interactions have been described for lithium, usually involving a decrease in the drug's clearance and therefore increasing its potential toxicity. Clinical pharmacology studies performed in healthy volunteers have investigated a possible effect of lithium on cognitive functions. Most of these studies reported a slight, negative effect on vigilance, alertness, learning and short-term memory after long-term administration only. Because of the narrow therapeutic range of lithium, therapeutic monitoring is the basis for optimal use and administration of this drug. Lithium dosages should be adjusted on the basis of the serum concentration drawn

  16. Effects of feedback of information on clinical practice: a review.

    OpenAIRE

    Mugford, M; Banfield, P; O'Hanlon, M

    1991-01-01

    OBJECTIVE--To establish what is known about the role of feedback of statistical information in changing clinical practice. DESIGN--Review of 36 studies of interventions entailing the use of statistical information for audit or practice review, which used a formal research design. SUBJECTS--Papers identified from computer searches of medical and health service management publications, of which 36 describing studies of interventions designed to influence clinical care and including information ...

  17. Systematic Reviewers in Clinical Neurology Do Not Routinely Search Clinical Trials Registries.

    Directory of Open Access Journals (Sweden)

    Philip Marcus Sinnett

    Full Text Available We examined the use of clinical trials registries in published systematic reviews and meta-analyses from clinical neurology. A review of publications between January 1, 2008 and December 31, 2014 from five neuroscience journals (Annals of Neurology, Brain, Lancet Neurology, Neurology, and The Neuroscientist was performed to identify eligible systematic reviews. The systematic reviews comprising the final sample were independently appraised to determine if clinical trials registries had been included as part of the search process. Studies acknowledging the use of a trials registry were further examined to determine whether trial data had been incorporated into the analysis. The initial search yielded 194 studies, of which 78 systematic reviews met the selection criteria. Of those, five acknowledged the use of a specific clinical trials registry: four reviewed unpublished trial data and two incorporated unpublished trial data into their results. Based on our sample of systematic reviews, there was no increase in the use of trials registries in systematic review searches over time. Few systematic reviews published in clinical neurology journals included data from relevant clinical trials registries.

  18. PHARMACOLOGICAL IMPORTANCE OF CITRUS FRUITS

    Directory of Open Access Journals (Sweden)

    Amita Tomar *, Mridula Mall and Pragya Rai

    2013-01-01

    Full Text Available This paper reviews the pharmacological importance of citrus fruits. Citrus fruits are used for various pharmacological importance. According to literature the citrus fruit possess anti-cancer, antimicrobial, antioxidant, antiulcer, anti-inflammatory, and hypolipidemic and hepatoprotective properties.

  19. Investigational pharmacology for low back pain

    Directory of Open Access Journals (Sweden)

    Avinash K Bhandary

    2010-09-01

    Full Text Available Avinash K Bhandary1 , Gary P Chimes2, Gerard A Malanga3 1Department of Physical Medicine and Rehabilitation, 2Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 3New Jersey Sports Medicine Institute; Overlook Hospital; Mountainside Hospital; Rehabilitation Medicine and Electrodiagnosis, St Michael’s Medical Center; Horizon Healthcare Worker’s Compensation Services, Blue Cross and Blue Shield Worker’s Compensation, Summit, NJ, USAStudy design: Review and reinterpretation of existing literature.Objective: This review article summarizes the anatomy and pathogenesis of disease processes that contribute to low back pain, and discusses key issues in existing therapies for chronic low back pain. The article also explains the scientific rationale for investigational pharmacology and highlights emerging compounds in late development.Results/conclusion: While the diverse and complex nature of chronic low back pain continues to challenge clinicians, a growing understanding of chronic low back pain on a cellular level has refined our approach to managing chronic low back pain with pharmacology. Many emerging therapies with improved safety profiles are currently in the research pipeline and will contribute to a multimodal therapeutic algorithm in the near future. With the heterogeneity of the patient population suffering from chronic low back pain, the clinical challenge will be accurately stratifying the optimal pharmacologic approach for each patient.Keywords: low back pain, investigational, pharmacology, drugs

  20. Vitespen: a preclinical and clinical review.

    NARCIS (Netherlands)

    Wood, C.G.; Mulders, P.F.A.

    2009-01-01

    Vitespen is a heat shock protein (gp96)-peptide complex purified from resected autologous tumors, developed as a means of capturing the antigenic 'fingerprint' of a specific cancer for use as a patient-specific vaccine. Vitespen has been extensively assessed in animal models, and clinically in a ran

  1. Clinical Prediction Rules for Physical Therapy Interventions: A Systematic Review

    OpenAIRE

    Beneciuk, Jason M.; Bishop, Mark D; George, Steven Z.

    2009-01-01

    Background and Purpose: Clinical prediction rules (CPRs) involving physical therapy interventions have been published recently. The quality of the studies used to develop the CPRs was not previously considered, a fact that has potential implications for clinical applications and future research. The purpose of this systematic review was to determine the quality of published CPRs developed for physical therapy interventions.

  2. Review on clinical trials of targeted treatments in malignant mesothelioma

    DEFF Research Database (Denmark)

    Jakobsen, Jan Nyrop; Sørensen, Jens Benn

    2011-01-01

    Malignant mesothelioma (MM) is an aggressive tumor of the serosal surfaces with a poor prognosis. Advances in the understanding of tumor biology have led to the development of several targeted treatments, which have been evaluated in clinical trials. This article is a comprehensive review of all...... clinical trials evaluating the effect of targeted treatments in MM....

  3. Five Pistacia species (P. vera, P. atlantica, P. terebinthus, P. khinjuk, and P. lentiscus): a review of their traditional uses, phytochemistry, and pharmacology.

    Science.gov (United States)

    Bozorgi, Mahbubeh; Memariani, Zahra; Mobli, Masumeh; Salehi Surmaghi, Mohammad Hossein; Shams-Ardekani, Mohammad Reza; Rahimi, Roja

    2013-01-01

    Pistacia, a genus of flowering plants from the family Anacardiaceae, contains about twenty species, among them five are more popular including P. vera, P. atlantica, P. terebinthus, P. khinjuk, and P. lentiscus. Different parts of these species have been used in traditional medicine for various purposes like tonic, aphrodisiac, antiseptic, antihypertensive and management of dental, gastrointestinal, liver, urinary tract, and respiratory tract disorders. Scientific findings also revealed the wide pharmacological activities from various parts of these species, such as antioxidant, antimicrobial, antiviral, anticholinesterase, anti-inflammatory, antinociceptive, antidiabetic, antitumor, antihyperlipidemic, antiatherosclerotic, and hepatoprotective activities and also their beneficial effects in gastrointestinal disorders. Various types of phytochemical constituents like terpenoids, phenolic compounds, fatty acids, and sterols have also been isolated and identified from different parts of Pistacia species. The present review summarizes comprehensive information concerning ethnomedicinal uses, phytochemistry, and pharmacological activities of the five mentioned Pistacia species. PMID:24453812

  4. Five Pistacia species (P. vera, P. atlantica, P. terebinthus, P. khinjuk, and P. lentiscus: A Review of Their Traditional Uses, Phytochemistry, and Pharmacology

    Directory of Open Access Journals (Sweden)

    Mahbubeh Bozorgi

    2013-01-01

    Full Text Available Pistacia, a genus of flowering plants from the family Anacardiaceae, contains about twenty species, among them five are more popular including P. vera, P. atlantica, P. terebinthus, P. khinjuk, and P. lentiscus. Different parts of these species have been used in traditional medicine for various purposes like tonic, aphrodisiac, antiseptic, antihypertensive and management of dental, gastrointestinal, liver, urinary tract, and respiratory tract disorders. Scientific findings also revealed the wide pharmacological activities from various parts of these species, such as antioxidant, antimicrobial, antiviral, anticholinesterase, anti-inflammatory, antinociceptive, antidiabetic, antitumor, antihyperlipidemic, antiatherosclerotic, and hepatoprotective activities and also their beneficial effects in gastrointestinal disorders. Various types of phytochemical constituents like terpenoids, phenolic compounds, fatty acids, and sterols have also been isolated and identified from different parts of Pistacia species. The present review summarizes comprehensive information concerning ethnomedicinal uses, phytochemistry, and pharmacological activities of the five mentioned Pistacia species.

  5. Endemic mycoses in AIDS: a clinical review.

    OpenAIRE

    Wheat, J

    1995-01-01

    Histoplasmosis and coccidioidomycosis are serious opportunistic infections in patients with AIDS who reside in areas of endemicity of the United States and Central and South America. Blastomycosis, although less common, also must be recognized as an opportunistic infection in patients with AIDS. Prompt diagnosis requires knowledge of the clinical syndromes and diagnostic tests as well as a high index of suspicion. Histoplasmosis and blastomycosis respond well to antifungal treatment, but rela...

  6. Clinical review: Critical illness polyneuropathy and myopathy

    OpenAIRE

    Hermans, Greet; De Jonghe, Bernard; Bruyninckx, Frans; Berghe, Greet Van den

    2008-01-01

    Critical illness polyneuropathy (CIP) and myopathy (CIM) are major complications of severe critical illness and its management. CIP/CIM prolongs weaning from mechanical ventilation and physical rehabilitation since both limb and respiratory muscles can be affected. Among many risk factors implicated, sepsis, systemic inflammatory response syndrome, and multiple organ failure appear to play a crucial role in CIP/CIM. This review focuses on epidemiology, diagnostic challenges, the current under...

  7. Headache and sleep disorders: review and clinical implications for headache management.

    Science.gov (United States)

    Rains, Jeanetta C; Poceta, J Steven

    2006-10-01

    Review of epidemiological and clinical studies suggests that sleep disorders are disproportionately observed in specific headache diagnoses (eg, migraine, tension-type, cluster) and other nonspecific headache patterns (ie, chronic daily headache, "awakening" or morning headache). Interestingly, the sleep disorders associated with headache are of varied types, including obstructive sleep apnea (OSA), periodic limb movement disorder, circadian rhythm disorder, insomnia, and hypersomnia. Headache, particularly morning headache and chronic headache, may be consequent to, or aggravated by, a sleep disorder, and management of the sleep disorder may improve or resolve the headache. Sleep-disordered breathing is the best example of this relationship. Insomnia is the sleep disorder most often cited by clinical headache populations. Depression and anxiety are comorbid with both headache and sleep disorders (especially insomnia) and consideration of the full headache-sleep-affective symptom constellation may yield opportunities to maximize treatment. This paper reviews the comorbidity of headache and sleep disorders (including coexisting psychiatric symptoms where available). Clinical implications for headache evaluation are presented. Sleep screening strategies conducive to headache practice are described. Consideration of the spectrum of sleep-disordered breathing is encouraged in the headache population, including awareness of potential upper airway resistance syndrome in headache patients lacking traditional risk factors for OSA. Pharmacologic and behavioral sleep regulation strategies are offered that are also compatible with treatment of primary headache. PMID:17040332

  8. Melasma: a clinical and epidemiological review.

    Science.gov (United States)

    Handel, Ana Carolina; Miot, Luciane Donida Bartoli; Miot, Hélio Amante

    2014-01-01

    Melasma is a chronic acquired hypermelanosis of the skin, characterized by irregular brown macules symmetrically distributed on sun-exposed areas of the body, particularly on the face. It is a common cause of demand for dermatological care that affects mainly women (especially during the menacme), and more pigmented phenotypes (Fitzpatrick skin types III-V). Due to its frequent facial involvement, the disease has an impact on the quality of life of patients. Its pathogeny is not yet completely understood, although there are some known triggering factors such as sun exposure, pregnancy, sexual hormones, inflammatory processes of the skin, use of cosmetics, steroids, and photosensitizing drugs. There is also a clear genetic predisposition, since over 40% of patients reported having relatives affected with the disease. In this manuscript, the authors discuss the main clinical and epidemiological aspects of melasma.

  9. Key concepts of clinical trials: a narrative review.

    Science.gov (United States)

    Umscheid, Craig A; Margolis, David J; Grossman, Craig E

    2011-09-01

    The recent focus of federal funding on comparative effectiveness research underscores the importance of clinical trials in the practice of evidence-based medicine and health care reform. The impact of clinical trials not only extends to the individual patient by establishing a broader selection of effective therapies, but also to society as a whole by enhancing the value of health care provided. However, clinical trials also have the potential to pose unknown risks to their participants, and biased knowledge extracted from flawed clinical trials may lead to the inadvertent harm of patients. Although conducting a well-designed clinical trial may appear straightforward, it is founded on rigorous methodology and oversight governed by key ethical principles. In this review, we provide an overview of the ethical foundations of trial design, trial oversight, and the process of obtaining approval of a therapeutic, from its pre-clinical phase to post-marketing surveillance. This narrative review is based on a course in clinical trials developed by one of the authors (DJM), and is supplemented by a PubMed search predating January 2011 using the keywords "randomized controlled trial," "patient/clinical research," "ethics," "phase IV," "data and safety monitoring board," and "surrogate endpoint." With an understanding of the key principles in designing and implementing clinical trials, health care providers can partner with the pharmaceutical industry and regulatory bodies to effectively compare medical therapies and thereby meet one of the essential goals of health care reform. PMID:21904102

  10. Diabetes insipidus: the basic and clinical review

    Directory of Open Access Journals (Sweden)

    Muhammad Waseem Abbas

    2016-01-01

    Full Text Available Diabetes insipidus (DI is a complex disease. DI is inability of the body to conserve water. Polydipsia and polyuria are the major manifestations of DI. DI has various variants including central diabetes insipidus (due to defect in ADH secretion, nephrogenic diabetes insipidus (due to defect in ADH receptors or urea receptors, gestational diabetes insipidus (due to catabolism of ADH by placental vasopressinase and primary polydipsia (due to massive fluid intake. The cause of various variants of DI is either acquired or congenital. High plasma osmolality due to hypotonic urine excretion can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. Polyuria and polydipsia help in the diagnosis of DI. Differential diagnosis of various variants of DI can be carried out on the basis of water deprivation test, MRI and other radiological techniques. The proper management of DI is the replenishment of water loss and correction of clinical presentations produced as a result of DI, major is hypernatremia. The best management for primary polydipsia is fluid restriction while fluid intake is used for adipsic diabetes insipidus. ADH replacement therapy is widely used to treat DI. DDAVP or desmopressin is mostly preferred ADH analogue because it has less side effects and resistant to placental vasoprssinase. [Int J Res Med Sci 2016; 4(1.000: 5-11

  11. Transcatheter therapies for resistant hypertension: Clinical review

    Institute of Scientific and Technical Information of China (English)

    Adil; Lokhandwala; Abhijeet; Dhoble

    2014-01-01

    Resistant hypertension(RHTN) is a commonly encountered clinical problem and its management remains a challenging task for healthcare providers. The prevalence of true RHTN has been difficult to assess due to pseudoresistance and secondary hypertension. Atherosclerotic renal artery stenosis(RAS) has been associated as a secondary cause of RHTN. Initial studies had shown that angioplasty and stenting for RAS were a promising therapeutic option when added to optimal medical management. However, recent randomized controlled trials in larger populations have failed to show any such benefit. Sympathetic autonomic nervous system dysfunction is commonly noted in individuals with resistant hypertension. Surgical sympathectomy was the treatment of choice for malignant hypertension and it significantly improved mortality. However, postsurgical complications and the advent of antihypertensive drugs made this approach less desirable and it was eventually abandoned. Increasing prevalence of RHTN in recent decades has led to the emergence of minimally invasive interventions such as transcatheter renal denervation for better control of blood pressure. It is a minimally invasive procedure which uses radiofrequency energy for selective ablation of renal sympathetic nerves located in the adventitia of the renal artery. It is a quick procedure and has a short recovery time. Early studies in small population showed significant reduction in blood pressure. The most recent Symplicity HTN-3 study, which is the largest randomized control trial and the only one to use a sham procedure in controls, failed to show significant BP reduction at 6 mo.

  12. Hypoxic Hepatitis: A Review and Clinical Update

    Science.gov (United States)

    Waseem, Najeff; Chen, Po-Hung

    2016-01-01

    Abstract Hypoxic hepatitis (HH), also known as ischemic hepatitis or shock liver, is characterized by a massive, rapid rise in serum aminotransferases resulting from reduced oxygen delivery to the liver. The most common predisposing condition is cardiac failure, followed by circulatory failure as occurs in septic shock and respiratory failure. HH does, however, occur in the absence of a documented hypotensive event or shock state in 50% of patients. In intensive care units, the incidence of HH is near 2.5%, but has been reported as high as 10% in some studies. The pathophysiology is multifactorial, but often involves hepatic congestion from right heart failure along with reduced hepatic blood flow, total body hypoxemia, reduced oxygen uptake by hepatocytes or reperfusion injury following ischemia. The diagnosis is primarily clinical, and typically does not require liver biopsy. The definitive treatment of HH involves correction of the underlying disease state, but successful management includes monitoring for the potential complications such as hypoglycemia, hyperglycemia, hyperammonemia and hepatopulmonary syndrome. Prognosis of HH remains poor, especially for cases in which there was a delay in diagnosis. The in-hospital mortality rate is >50%, and the most frequent cause of death is the predisposing condition and not the liver injury itself. PMID:27777895

  13. Review of splanchnic oximetry in clinical medicine.

    Science.gov (United States)

    Bailey, Sean M; Mally, Pradeep V

    2016-09-01

    Global tissue perfusion and oxygenation are important indicators of physiologic function in humans. The monitoring of splanchnic oximetry through the use of near-infrared spectroscopy (NIRS) is an emerging method used to assess tissue oxygenation status. Splanchnic tissue oxygenation (SrSO2) is thought to be potentially of high value in critically ill patients because gastrointestinal organs can often be the first to suffer ischemic injury. During conditions of hypovolemia, cardiac dysfunction, or decreased oxygen-carrying capacity, blood flow is diverted toward vital organs, such as the brain and the heart at the expense of the splanchnic circulation. While monitoring SrSO2 has great potential benefit, there are limitations to the technology and techniques. SrSO2 has been found to have a relatively high degree of variability that can potentially make it difficult to interpret. In addition, because splanchnic organs only lie near the skin surface in children and infants, and energy from currently available sensors only penetrates a few centimeters deep, it can be difficult to use clinically in a noninvasive manner in adults. Research thus far is showing that splanchnic oximetry holds great promise in the ability to monitor patient oxygenation status and detect disease states in humans, especially in pediatric populations.

  14. A Review of the Receptor-Binding Properties of p-Synephrine as Related to Its Pharmacological Effects

    Directory of Open Access Journals (Sweden)

    Sidney J. Stohs

    2011-01-01

    Full Text Available Bitter orange (Citrus aurantium extract and its primary protoalkaloid p-synephrine are used widely in weight loss/weight management and sports performance products. Because of structural similarities, the pharmacological effects of p-synephrine are widely assumed to be similar to those of ephedrine, m-synephrine (phenylephrine, and endogenous amine neurotransmitters as norepinephrine and epinephrine. However, small structural changes result in the receptor binding characteristics of these amines that are markedly different, providing a plausible explanation for the paucity of adverse effects associated with the wide-spread consumption of p-synephrine in the form of dietary supplements as well as in various Citrus foods and juices. This paper summarizes the adrenoreceptor binding characteristics of p-synephrine relative to m-synephrine, norepinephrine, and other amines as related to the observed pharmacological effects.

  15. Factors associated with clinical inertia: an integrative review

    Science.gov (United States)

    Aujoulat, Isabelle; Jacquemin, Patricia; Rietzschel, Ernst; Scheen, André; Tréfois, Patrick; Wens, Johan; Darras, Elisabeth; Hermans, Michel P

    2014-01-01

    Failure to initiate or intensify therapy according to evidence-based guidelines is increasingly being acknowledged as a phenomenon that contributes to inadequate management of chronic conditions, and is referred to as clinical inertia. However, the number and complexity of factors associated with the clinical reasoning that underlies the decision-making processes in medicine calls for a critical examination of the consistency of the concept. Indeed, in the absence of information on and justification of treatment decisions that were made, clinical inertia may be only apparent, and actually reflect good clinical practice. This integrative review seeks to address the factors generally associated with clinical inaction, in order to better delineate the concept of true clinical inertia. PMID:24868181

  16. FDG PET in non-pharmacological therapy in Alzheimer's disease; cerebral metabolic increase correlates with clinical improvement after cognitive therapy

    Energy Technology Data Exchange (ETDEWEB)

    Na, Hae Ri; Kim, Yu Kyeong; Park, Seong Min; Lee, Seung Hyun; Park, Eun Kyung; Lee, Jung Seok; Kim, Sang Yun; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    In management of AD, pharmacological treatment alone using acetylcholinesterase inhibitor (AChEI) is general consensus, and provides beneficial effect to prolong their progression. Combined non-pharmacological therapy, especially cognitive therapy is recently having attention with expectation of improvement in cognitive ability. This study examined the effect of combined cognitive therapy in AD patients who were maintaining AChEI using FDG PET. Four patients (689 yrs) who diagnosed as probable Alzheimer's disease based on the NINCDS-ADRDA criteria participated in this study. 12-week cognitive therapy comprised seven fields to enhance orientation, memory, recall, visuo-motor organization, categorization and behavior modification/sequencing. They received 45-minute sessions twice per week with maintaining their previous medication. Clinical improvement was assessed by comprehensive neuropsychological tests. Two FDG PET studies were performed before cognitive therapy and in the middle of the therapy, and compared to evaluate the effect of cognitive therapy to cerebral metabolism. Two of 4 patients whose initial cognitive impairment was milder had clinical improvement after 12 weeks, the rest who were more severely impaired failed to have clinical improvement. Regional cerebral hypometabolism on initial PET was correlated with their functional status. Follow up PET of two responders demonstrated the increases in regional metabolism in the temporal and/or frontal cortex, which was associated their functional improvement. Cerebral metabolism in poor responders were minimally increased or no changed. This preliminary data suggests that cognitive therapy is potentially useful to stabilize or improve cognitive and functional performance in AD patients with relatively mild cognitive dysfunction. And FDG PET could demonstrate possible candidates for cognitive therapy and the effect of the therapy.

  17. Concurrent clinical review: using microcomputer-based DRG-software.

    Science.gov (United States)

    Huertas-Portocarrero, D; Ruiz, P P; Marmol, J P

    1988-01-01

    Since the introduction of the Prospective Payment System based on Diagnosis Related Groups (DRGs) in the U.S.A., important information technologies are arising. We discuss how Professional Review Organizations, (PROS) are forcing a better control of appropriateness and quality of medical care. Hospitals should have the internal capabilities to perform, at least, the same reviews as performed by the PROs. Concurrent Clinical Review Systems based on DRGs are a special type of information technology that take place during and even before patient hospitalization, therefore allowing an 'on line' monitoring information. Low-cost microcomputers are playing a major role in the popularization of this technology. 'Clinical Review System' is a microcomputer-based software that renders easy and feasible and otherwise complex task. An effort should be made in order to adapt the philosophy underlying this or other similar software to the European needs. PMID:10312511

  18. Systems Pharmacology in Small Molecular Drug Discovery

    Directory of Open Access Journals (Sweden)

    Wei Zhou

    2016-02-01

    Full Text Available Drug discovery is a risky, costly and time-consuming process depending on multidisciplinary methods to create safe and effective medicines. Although considerable progress has been made by high-throughput screening methods in drug design, the cost of developing contemporary approved drugs did not match that in the past decade. The major reason is the late-stage clinical failures in Phases II and III because of the complicated interactions between drug-specific, human body and environmental aspects affecting the safety and efficacy of a drug. There is a growing hope that systems-level consideration may provide a new perspective to overcome such current difficulties of drug discovery and development. The systems pharmacology method emerged as a holistic approach and has attracted more and more attention recently. The applications of systems pharmacology not only provide the pharmacodynamic evaluation and target identification of drug molecules, but also give a systems-level of understanding the interaction mechanism between drugs and complex disease. Therefore, the present review is an attempt to introduce how holistic systems pharmacology that integrated in silico ADME/T (i.e., absorption, distribution, metabolism, excretion and toxicity, target fishing and network pharmacology facilitates the discovery of small molecular drugs at the system level.

  19. Systems Pharmacology in Small Molecular Drug Discovery

    Science.gov (United States)

    Zhou, Wei; Wang, Yonghua; Lu, Aiping; Zhang, Ge

    2016-01-01

    Drug discovery is a risky, costly and time-consuming process depending on multidisciplinary methods to create safe and effective medicines. Although considerable progress has been made by high-throughput screening methods in drug design, the cost of developing contemporary approved drugs did not match that in the past decade. The major reason is the late-stage clinical failures in Phases II and III because of the complicated interactions between drug-specific, human body and environmental aspects affecting the safety and efficacy of a drug. There is a growing hope that systems-level consideration may provide a new perspective to overcome such current difficulties of drug discovery and development. The systems pharmacology method emerged as a holistic approach and has attracted more and more attention recently. The applications of systems pharmacology not only provide the pharmacodynamic evaluation and target identification of drug molecules, but also give a systems-level of understanding the interaction mechanism between drugs and complex disease. Therefore, the present review is an attempt to introduce how holistic systems pharmacology that integrated in silico ADME/T (i.e., absorption, distribution, metabolism, excretion and toxicity), target fishing and network pharmacology facilitates the discovery of small molecular drugs at the system level. PMID:26901192

  20. Agonist Replacement for Stimulant Dependence: A Review of Clinical Research

    OpenAIRE

    Stoops, William W.; Rush, Craig R.

    2013-01-01

    Stimulant use disorders are an unrelenting public health concern worldwide. Agonist replacement therapy is among the most effective strategies for managing substance use disorders including nicotine and opioid dependence. The present paper reviewed clinical data from human laboratory self-administration studies and clinical trials to determine whether agonist replacement therapy is a viable strategy for managing cocaine and/or amphetamine use disorders. The extant literature suggests that ago...

  1. The HELLP syndrome: clinical issues and management. A Review

    OpenAIRE

    Svendsen Einar; Haram Kjell; Abildgaard Ulrich

    2009-01-01

    Abstract Background The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia. The present review highlights occurrence, diagnosis, complications, surveillance, corticosteroid treatment, mode of delivery and risk of recurrence. Methods Clinical reports and reviews published between 2000 and 2008 were screened using Pub Med and C...

  2. STUDENTS’ ATTITUDE TOWARDS DIFFERENT EVALUATION METHODS IN PHARMACOLOGY

    Directory of Open Access Journals (Sweden)

    Majagi Suneel Ishwar

    2012-08-01

    Full Text Available Literature review suggests the importance and the need of students’ feedback which may be used to effectively reform evaluation methods in medical sciences. The present study has been conducted to obtain student’s attitude (perception of towards different evaluation methods of pharmacology. The sample consisted of second phase M.B.B.S (n=108 students. Students answered 115 items/questions designed according to Likert’s five point (in agreement with items scale. These items/questions assessed student’s attitude (perception of towards different constituents of evaluation methods of pharmacology like sessional exams, traditional practical exams, objective structured practical exam (OSPE, MCQs, long essays, viva voce, pharmacy practical exercise, experimental pharmacology exercise etc in relation with various aspects of pharmacology subject like understanding, retention, learning clinical applications, mechanism of action of drugs, pharmacological actions, therapeutic uses, prescribing drugs etc. Results of the present study indicated the degree to which each evaluation method like sessional/preliminary theory exams, traditional practical exams and OSPE helps to elicit different constituents of pharmacology subject (ex: mechanism of action of drugs, therapeutic uses etc and the reason for the same is discussed. Similarly usefulness of different constituents of theory exams (MCQs, long essay etc and practical exams (spotters, pharmacy exercises etc towards eliciting the understanding pharmacology is revealed. Present study indicated the merits and demerits of different evaluation methods used in pharmacology. If any reformations/changes have to be incorporated in the evaluation methods, outcomes of this study will definitely help towards improving/modifying the evaluation methods of teaching and learning of pharmacology subject.

  3. Value of 1.0-M gadolinium chelates: review of preclinical and clinical data on gadobutrol

    International Nuclear Information System (INIS)

    Several preclinical and clinical studies with the first commercially available highly concentrated Gd-chelate gadobutrol (1 mol/l) are reviewed. Physicochemical, pharmacological, and pharmacokinetic properties, safety analysis, as well as experimental and clinical efficacy studies are highlighted in comparison with 0.5-M Gd-chelates. The 1-mol gadobutrol has been proven to be safe in an examined dose range from 0.04 up to 0.5 mmol/kg body weight (b.w.). Even in patients with chronic renal impairment, including hemodialysis, gadobutrol can safely be applied at doses up to 0.3 mmol/kg b.w. For contrast-enhanced MRI in the equilibrium phase, efficacy data analysis shows comparable results to other commercially available extracellular Gd-chelates with lower Gd-concentrations (0.5 M). Studies focused on the potential benefit of a tighter bolus, such as brain perfusion imaging using T2*-effects, document the superiority of a highly concentrated Gd contrast agent. For contrast-enhanced MRA, clinical studies are still ongoing; therefore, the ultimate potential of a more compact bolus, using 1-M Gd-chelates, for contrast-enhanced MRI, has still to be analyzed, especially for time-resolved magnetic resonance angiography. (orig.)

  4. Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years.

    Science.gov (United States)

    Dos Santos, Rafael G; Osório, Flávia L; Crippa, José Alexandre S; Riba, Jordi; Zuardi, Antônio W; Hallak, Jaime E C

    2016-06-01

    To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties. Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria. Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents. However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings. PMID:27354908

  5. Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years.

    Science.gov (United States)

    Dos Santos, Rafael G; Osório, Flávia L; Crippa, José Alexandre S; Riba, Jordi; Zuardi, Antônio W; Hallak, Jaime E C

    2016-06-01

    To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties. Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria. Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents. However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings.

  6. End points in dermatologic clinical trials: A review for clinicians.

    Science.gov (United States)

    Wei, Erin X; Kirsner, Robert S; Eaglstein, William H

    2016-07-01

    Clinical trials are critical for the development of new therapies in dermatology, and their results help determine US Food and Drug Administration (FDA) approval and guide care. Of special relevance is the clinical trial efficacy end point, the metric from which statistically significant outcome is derived. Clinicians' understanding of a clinical trial's end point is necessary for critical analysis of the trial results and for applying those results to daily practice. This review provides practical knowledge and critical evaluation of end points used in treatment approvals by the FDA. The end points for actinic keratosis, acne vulgaris, atopic dermatitis, onychomycosis, and cutaneous ulcer serve as examples. PMID:26936300

  7. Systematic reviews, systematic error and the acquisition of clinical knowledge

    Directory of Open Access Journals (Sweden)

    Mickenautsch Steffen

    2010-06-01

    Full Text Available Abstract Background Since its inception, evidence-based medicine and its application through systematic reviews, has been widely accepted. However, it has also been strongly criticised and resisted by some academic groups and clinicians. One of the main criticisms of evidence-based medicine is that it appears to claim to have unique access to absolute scientific truth and thus devalues and replaces other types of knowledge sources. Discussion The various types of clinical knowledge sources are categorised on the basis of Kant's categories of knowledge acquisition, as being either 'analytic' or 'synthetic'. It is shown that these categories do not act in opposition but rather, depend upon each other. The unity of analysis and synthesis in knowledge acquisition is demonstrated during the process of systematic reviewing of clinical trials. Systematic reviews constitute comprehensive synthesis of clinical knowledge but depend upon plausible, analytical hypothesis development for the trials reviewed. The dangers of systematic error regarding the internal validity of acquired knowledge are highlighted on the basis of empirical evidence. It has been shown that the systematic review process reduces systematic error, thus ensuring high internal validity. It is argued that this process does not exclude other types of knowledge sources. Instead, amongst these other types it functions as an integrated element during the acquisition of clinical knowledge. Conclusions The acquisition of clinical knowledge is based on interaction between analysis and synthesis. Systematic reviews provide the highest form of synthetic knowledge acquisition in terms of achieving internal validity of results. In that capacity it informs the analytic knowledge of the clinician but does not replace it.

  8. Clinical use of Skype: a review of the evidence base.

    Science.gov (United States)

    Armfield, Nigel R; Gray, Leonard C; Smith, Anthony C

    2012-04-01

    Skype is a popular and free software application that allows PCs and mobile devices to be used for video communication over the Internet. We reviewed the literature to determine whether the clinical use of Skype is supported by evidence. One small (n = 7) controlled clinical trial had assessed the effect of nursing communication using Skype on elderly patients with dementia and their carers. However, we were unable to identify any large, well-designed studies which had formally evaluated the safety, clinical effectiveness, security and privacy of Skype for the routine delivery of patient care. While there were many case reports and small studies, no firm evidence either in favour of, or against the use of Skype for clinical telehealth was found. The risks and benefits of using Skype for clinical purposes are not known. PMID:22362829

  9. Pharmacology and drug distribution

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, L.R.; Weatherall, T.J.

    1979-08-01

    An overview of the pharmacology of drugs in the treatment of cancer is presented. The discussion begins with the simplest relationship of drugs and particles to one another then proceeds to demonstrate the interrelationship in a biologic system to produce a chemobiodynamic response. The basic principles of pharmacokinetics are reviewed and their correlation with investigational and standard drug therapies is discussed. Voids in the consideration of interactions between chemotherapy and radiotherapy are discussed.

  10. International Union of Basic and Clinical Pharmacology. XCV. Recent Advances in the Understanding of the Pharmacology and Biological Roles of Relaxin Family Peptide Receptors 1–4, the Receptors for Relaxin Family Peptides

    Science.gov (United States)

    Halls, Michelle L.; Bathgate, Ross A. D.; Sutton, Steve W.; Dschietzig, Thomas B.

    2015-01-01

    Relaxin, insulin-like peptide 3 (INSL3), relaxin-3, and INSL5 are the cognate ligands for the relaxin family peptide (RXFP) receptors 1–4, respectively. RXFP1 activates pleiotropic signaling pathways including the signalosome protein complex that facilitates high-sensitivity signaling; coupling to Gαs, Gαi, and Gαo proteins; interaction with glucocorticoid receptors; and the formation of hetero-oligomers with distinctive pharmacological properties. In addition to relaxin-related ligands, RXFP1 is activated by Clq-tumor necrosis factor-related protein 8 and by small-molecular-weight agonists, such as ML290 [2-isopropoxy-N-(2-(3-(trifluoromethylsulfonyl)phenylcarbamoyl)phenyl)benzamide], that act allosterically. RXFP2 activates only the Gαs- and Gαo-coupled pathways. Relaxin-3 is primarily a neuropeptide, and its cognate receptor RXFP3 is a target for the treatment of depression, anxiety, and autism. A variety of peptide agonists, antagonists, biased agonists, and an allosteric modulator target RXFP3. Both RXFP3 and the related RXFP4 couple to Gαi/Gαo proteins. INSL5 has the properties of an incretin; it is secreted from the gut and is orexigenic. The expression of RXFP4 in gut, adipose tissue, and β-islets together with compromised glucose tolerance in INSL5 or RXFP4 knockout mice suggests a metabolic role. This review focuses on the many advances in our understanding of RXFP receptors in the last 5 years, their signal transduction mechanisms, the development of novel compounds that target RXFP1–4, the challenges facing the field, and current prospects for new therapeutics. PMID:25761609

  11. International Union of Basic and Clinical Pharmacology. XCV. Recent advances in the understanding of the pharmacology and biological roles of relaxin family peptide receptors 1-4, the receptors for relaxin family peptides.

    Science.gov (United States)

    Halls, Michelle L; Bathgate, Ross A D; Sutton, Steve W; Dschietzig, Thomas B; Summers, Roger J

    2015-01-01

    Relaxin, insulin-like peptide 3 (INSL3), relaxin-3, and INSL5 are the cognate ligands for the relaxin family peptide (RXFP) receptors 1-4, respectively. RXFP1 activates pleiotropic signaling pathways including the signalosome protein complex that facilitates high-sensitivity signaling; coupling to Gα(s), Gα(i), and Gα(o) proteins; interaction with glucocorticoid receptors; and the formation of hetero-oligomers with distinctive pharmacological properties. In addition to relaxin-related ligands, RXFP1 is activated by Clq-tumor necrosis factor-related protein 8 and by small-molecular-weight agonists, such as ML290 [2-isopropoxy-N-(2-(3-(trifluoromethylsulfonyl)phenylcarbamoyl)phenyl)benzamide], that act allosterically. RXFP2 activates only the Gα(s)- and Gα(o)-coupled pathways. Relaxin-3 is primarily a neuropeptide, and its cognate receptor RXFP3 is a target for the treatment of depression, anxiety, and autism. A variety of peptide agonists, antagonists, biased agonists, and an allosteric modulator target RXFP3. Both RXFP3 and the related RXFP4 couple to Gα(i)/Gα(o) proteins. INSL5 has the properties of an incretin; it is secreted from the gut and is orexigenic. The expression of RXFP4 in gut, adipose tissue, and β-islets together with compromised glucose tolerance in INSL5 or RXFP4 knockout mice suggests a metabolic role. This review focuses on the many advances in our understanding of RXFP receptors in the last 5 years, their signal transduction mechanisms, the development of novel compounds that target RXFP1-4, the challenges facing the field, and current prospects for new therapeutics. PMID:25761609

  12. Effect of vitamin B/sub 6/ on the neurotoxicity and pharmacology of desmethylmisonidazole and misonidazole: clinical and laboratory studies

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, C.N.; Hirst, V.K.; Brown, D.M.; Halsey, J.

    1984-08-01

    The clinical usefulness of misonidazole (MISO) and desmethylmisonidazole (DMM) is severely limited by neurotoxicity. Based on theoretical considerations and on laboratory data suggesting that pyridoxine (PN) decreased MISO toxicity in mice. The authors attempted to ameliorate the clinical neuropathy of DMM using oral PN. Pharmacokinetic analysis suggested interaction of PN and DMM but no protection against neuropathy was observed. Serial experiments with C3H and BALB/c mice were done using various forms of vitamin B/sub 6/ (PN, pyridoxal, pyridoxal phosphate) administered orally and i.p. No consistent protection was observed. Dexamethasone did not alter MISO toxicity in mice, contrary to the clinical findings. They conclude that vitamin B/sub 6/ is not useful in preventing clinical neurotoxicity of MISO or DMM.

  13. Social Pharmacology: Expanding horizons

    Directory of Open Access Journals (Sweden)

    Rituparna Maiti

    2014-01-01

    Full Text Available In the current modern and global society, social changes are in constant evolution due to scientific progress (technology, culture, customs, and hygiene and produce the freedom in individuals to take decisions by themselves or with their doctors toward drug consumption. In the arena of marketed drug products which includes society, individual, administration, and pharmaceutical industry, the young discipline emerged is social pharmacology or sociopharmacology. This science arises from clinical pharmacology, and deals with different parameters, which are important in creating knowledge on marketed drugs. However, the scope of "social pharmacology" is not covered by the so-called "Phase IV" alone, but it is the science that handles the postmarketing knowledge of drugs. The social pharmacology studies the "life cycle" of any marketed pharmaceutical product in the social terrain, and evaluates the effects of the real environment under circumstances totally different in the drug development process. Therefore, there are far-reaching horizons, plural, and shared predictions among health professionals and other, for beneficial use of a drug, toward maximizing the benefits of therapy, while minimizing negative social consequences.

  14. 宽筋藤的药理作用和临床应用研究进展%Pharmacological Effects of Tinospora sinensis and Research Progress in its Clinical Application

    Institute of Scientific and Technical Information of China (English)

    吴凤荣; 曾聪彦; 戴卫波

    2014-01-01

    Tinosporasinensisis mainly used in the treatment of fractures,joint stiffness and rheumatic arthral-gia. This article made a review on the chemical composition,pharmacological effects and clinical application of Tinosporasinensisbased on web searching and manual checking on network databases and the literature both at home and abroad,so as to provide a more comprehensive reference for new product development and clinical appli-cation ofTinosporasinensis.%宽筋藤临床主要用于治疗骨折、关节僵硬、风湿痹痛等,应用较为广泛。通过检索文献和手工查阅相结合的方法查找国内外报道的有关宽筋藤的研究资料,对宽筋藤的化学成分、药理作用和临床应用情况进行综述,为宽筋藤的产品开发和临床应用提供参考。

  15. Pharmacological Effects of Tinospora sinensis and Research Progress in its Clinical Application%宽筋藤的药理作用和临床应用研究进展

    Institute of Scientific and Technical Information of China (English)

    吴凤荣; 曾聪彦; 戴卫波

    2014-01-01

    Tinosporasinensisis mainly used in the treatment of fractures,joint stiffness and rheumatic arthral-gia. This article made a review on the chemical composition,pharmacological effects and clinical application of Tinosporasinensisbased on web searching and manual checking on network databases and the literature both at home and abroad,so as to provide a more comprehensive reference for new product development and clinical appli-cation ofTinosporasinensis.%宽筋藤临床主要用于治疗骨折、关节僵硬、风湿痹痛等,应用较为广泛。通过检索文献和手工查阅相结合的方法查找国内外报道的有关宽筋藤的研究资料,对宽筋藤的化学成分、药理作用和临床应用情况进行综述,为宽筋藤的产品开发和临床应用提供参考。

  16. Clinical Presentation of Anxiety in Parkinson's Disease: A Scoping Review.

    Science.gov (United States)

    Lutz, Sara G; Holmes, Jeffrey D; Ready, Emily A; Jenkins, Mary E; Johnson, Andrew M

    2016-07-01

    Up to 40% of all individuals with Parkinson's disease (PD) are estimated to experience anxiety that interferes with daily functioning. This article describes research regarding the presentation of anxiety in PD and the influence anxiety has on participation in this population. A scoping review identified 1,635 articles, of which 49 met the inclusion criteria. This review identified that anxiety in PD is often associated with a range of clinical correlates related to demographic and clinical characteristics (age, gender, disease stage, duration, progression), motor symptoms (tremor, bradykinesia, dystonia, freezing of gait, symptom severity), treatment-related complications (on/off fluctuations, on with dyskinesia, unpredictable off), and non-motor symptoms (sleep abnormalities, fatigue, cognitive impairment, depression). These findings can be used to increase clinicians' awareness toward the specific clinical correlates linked to anxiety in PD so that mental health concerns can be detected and addressed more readily in practice. PMID:27618849

  17. Pharmacological Effects of Rosa Damascena

    OpenAIRE

    Boskabady, Mohammad Hossein; Shafei, Mohammad Naser; Saberi, Zahra; Amini, Somayeh

    2011-01-01

    Rosa damascena mill L., known as Gole Mohammadi in is one of the most important species of Rosaceae family flowers. R. damascena is an ornamental plant and beside perfuming effect, several pharmacological properties including anti-HIV, antibacterial, antioxidant, antitussive, hypnotic, antidiabetic, and relaxant effect on tracheal chains have been reported for this plant. This article is a comprehensive review on pharmacological effects of R. damascena. Online literature searches were perform...

  18. Review on pharmacological action of lumbricus to treat rheumatism%地龙治疗风湿病的药理作用研究综述

    Institute of Scientific and Technical Information of China (English)

    杨茜茜; 龚国清

    2015-01-01

    本文分析了地龙在药理方面的实验研究结果,并结合相关方面知识从中医、西医两个方面证明了地龙可以治疗风湿病的药理学成因,并且简要介绍了地龙对于治疗各种类型风湿病的临床应用与生化指标,进一步证实了地龙对于治疗风湿病的重要作用。%This paper analyzes the earthworm in the pharmacological aspects of animal experimental results, indirect from the two aspects of traditional Chinese medicine and Western medicine proved earthworm can treat rheumatism causes of pharmacology, and briefly introduces the earthworm for the treatment of various types of rheumatism clinical and biochemical indicators, which further confirmed the earthworm plays an important role in the treatment of rheumatism.

  19. Clinical effectiveness of baclofen for the treatment of alcohol dependence: a review

    Directory of Open Access Journals (Sweden)

    Brennan JL

    2013-07-01

    Full Text Available Jessica L Brennan,2 Jonathan G Leung,1 Jane P Gagliardi,3 Sarah K Rivelli,3 Andrew J Muzyk4 1Department of Hospital Pharmacy Services, Mayo Clinic, Rochester, MN, 2Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, 3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 4Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, Buies Creek, NC, USA Abstract: Baclofen, an agonist at the B subunit of gaba-aminobutyric acid receptor, possesses pharmacologic properties that may confer utility for the treatment of alcohol dependence. Research suggests that not only can it be useful in promoting maintenance of alcohol abstinence but also it may play a key role in decreasing alcohol cravings and anxiety often associated with alcohol dependence. To assess the benefit of baclofen for alcohol dependence, a review of the literature was conducted to identify published data investigating this off-label treatment. Four randomized controlled trials to date have been published and were included in this review. Although primary outcomes differ between studies, patients randomized to baclofen experience higher rates of abstinence from alcohol than those taking placebo in two of the trials. Secondary analyses indicate that baclofen is safe in patients with alcohol dependence, including those with moderate to severe liver cirrhosis, and may provide beneficial anxiolytic effects. Despite some positive data, the largest available randomized controlled trial failed to find any differences between baclofen and placebo. In all studies, individuals with severe medical comorbidities, seizure disorders, and psychiatric disorders were excluded from trials, which may limit external validity. In summary, there may be beneficial effects from using baclofen for the treatment of alcohol dependence; however, limited conclusions can be drawn from the small number of studies

  20. 儿茶素的药理作用研究综述%Review of research on pharmacological effects of catechins

    Institute of Scientific and Technical Information of China (English)

    徐先祥

    2012-01-01

    The research progress on the pharmacology of catechins and its analogues was reviewed from remarkable pharmacological activities such as antioxidation, cardioprotection, anticancer effect, antibiosis, antiviral, anti-inflammation, immunomodulation, neuroprotection, regulation of glucose and lipid metabolism and so on. It is indicated that catechins has the important medical care application value,future studies on catechins might focus on chiral resolutions and their interactions with metallic ions and proteins in vivo.%对儿茶素及其类似化合物所具有的抗氧化、保护心血管、抗肿瘤、抗菌、抗病毒、抗炎、免疫调节、神经保护、调节糖脂代谢等药理作用进行了综述,指出其具有重要的医疗保健应用价值,儿茶素类的手性研究及其体内与金属离子、蛋白质等物质的相互作用将是今后研究开发的重点.

  1. Pharmacological Research Review of Osthole from Duhuo%独活活性成分蛇床子素的药理学研究进展

    Institute of Scientific and Technical Information of China (English)

    姚丽; 冯红玄; 霍红; 刘秉义; 于楠

    2012-01-01

    Duhuo which is used widely by traditional medicine doctors exerts a broad spectrum of pharmacological activities and is considered to have potential therapeutic applications. Osthole ,7 - methoxy - 8 - ( 3 - methyl - 2 - butenyl) coumarin( Figure 1) ,is the major bio - activity compound of Duhuo. In this paper,we reviewed all the references related to Osthole in recent 20 years to summarize its pharmacological activities, thus maybe establish a solid theory foundation for Osthole application and provide a very promising natural lead compound for new drug discovery.%独活是具有千年药用历史的古老中药,其主要活性成分为蛇床子素(7-甲氧基-8-异戊烯基香豆素),具有广泛的药理作用.综述近20年国内外关于蛇床子素药理学研究进展,为蛇床子素临床应用奠定坚实的理论基础,并为创新药物研发提供一个可行的先导化合物.

  2. Neuropharmacological Aspects of Crocus sativus L.: A Review of Preclinical Studies and Ongoing Clinical Research.

    Science.gov (United States)

    Singh, Damanpreet

    2015-01-01

    Crocus sativus L. (Iridaceae) is an important member of the genus Crocus having high medicinal value. Its dried stigmas, known as "saffron" are being widely used form past many centuries as a food additive, coloring agent, flavoring agent and a potential source of traditional medicine. The stigmas along with other botanical parts of Crocus sativus are being extensively used in ethnomedical treatment of varied central nervous system diseases. In line with its ethnomedical importance, several preclinical studies have been carried out to validate its traditional uses, identify active principle(s), understand pharmacological basis of therapeutic action and explore novel medicinal uses. The bioactive components of Crocus sativus have been found to modulate several synaptic processes via direct/indirect interplay with neurotransmitter receptor functions, interaction with neuronal death/survival pathways and alteration in neuronal proteins expression. Many clinical studies proving beneficial effect of Crocus sativus in depressive disorders, Alzheimer's disease and some other neurological abnormalities have also been carried out. Based on the vast literature reports available, an attempt has been made to comprehend the fragmented information on neuropharmacological aspects, chemistry and safety of Crocus sativus. Although the plant has been well explored, but still a large scope of future preclinical and clinical research exist to explore its potential in neurological diseases, that has been discussed in depth in the present review.

  3. The Pharmacological Potential of Mushrooms

    Directory of Open Access Journals (Sweden)

    Ulrike Lindequist

    2005-01-01

    Full Text Available This review describes pharmacologically active compounds from mushrooms. Compounds and complex substances with antimicrobial, antiviral, antitumor, antiallergic, immunomodulating, anti-inflammatory, antiatherogenic, hypoglycemic, hepatoprotective and central activities are covered, focusing on the review of recent literature. The production of mushrooms or mushroom compounds is discussed briefly.

  4. Review of current and evolving clinical indications forendoscopic ultrasound

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    For the first several years after its development,endoscopic ultrasound (EUS) was primarily limited toidentification of pancreatic malignancies. Since thistime, the field of EUS has advanced at a tremendousspeed in terms of additional clinical diagnostic andtherapeutic uses. The combination of ultrasound withendoscopy provides a unique interventional modalitythat is a minimally invasive alternative to various surgicalinterventions. Given the expanding recommendedindications for EUS, this article will serve to review themost common uses with supporting evidence, while alsoexploring innovative endeavors that may soon becomecommon clinical practice.

  5. Bach flower remedies: a systematic review of randomised clinical trials.

    Science.gov (United States)

    Ernst, Edzard

    2010-01-01

    Bach flower remedies continue to be popular and its proponents make a range of medicinal claims for them. The aim of this systematic review was to critically evaluate the evidence for these claims. Five electronic databases were searched without restrictions on time or language. All randomised clinical trials of flower remedies were included. Seven such studies were located. All but one were placebo-controlled. All placebo-controlled trials failed to demonstrate efficacy. It is concluded that the most reliable clinical trials do not show any differences between flower remedies and placebos. PMID:20734279

  6. A Humanized Clinically Calibrated Quantitative Systems Pharmacology Model for Hypokinetic Motor Symptoms in Parkinson’s Disease

    OpenAIRE

    Roberts, Patrick; Spiros, Athan; Geerts, Hugo

    2016-01-01

    The current treatment of Parkinson’s disease with dopamine-centric approaches such as L-DOPA and dopamine agonists, although very successful, is in need of alternative treatment strategies, both in terms of disease modification and symptom management. Various non-dopaminergic treatment approaches did not result in a clear clinical benefit, despite showing a clear effect in preclinical animal models. In addition, polypharmacy is common, sometimes leading to unintended effects on non-motor cogn...

  7. Clinical correlates of common corneal neovascular diseases: a literature review

    Institute of Scientific and Technical Information of China (English)

    Nizar; Saleh; Abdelfattah; Mohamed; Amgad; Amira; A; Zayed; Hamdy; Salem; Ahmed; E; Elkhanany; Heba; Hussein; Nawal; Abd; El-Baky

    2015-01-01

    A large subset of corneal pathologies involves the formation of new vessels(neovascularization), leading to compromised visual acuity. This article aims to review the clinical causes and presentations of corneal neovascularization(CNV) by examining the mechanisms behind common CNV-related corneal pathologies, with a particular focus on herpes simplex stromal keratitis,contact lenses-induced keratitis and CNV secondary to keratoplasty. Moreover, we reviewed CNV in the context of different types of corneal transplantation and keratoprosthesis, and summarized the most relevant treatment available so far.

  8. Dietary sodium intake and asthma: an epidemiological and clinical review.

    Science.gov (United States)

    Mickleborough, T D; Fogarty, A

    2006-12-01

    The changes in diet associated with the development of a more affluent lifestyle have been considered one of the environmental factors that may have contributed to the rise in the prevalence of asthma over the past few decades, and dietary sodium has been considered to be a dietary constituent which may be implicated in this phenomenon. The data presented in this review demonstrate that adoption of a low sodium diet for a period of 2-5 weeks may improve lung function and decrease bronchial reactivity in adults with asthma, while sodium loading appears to have a detrimental effect. Similarly, a low sodium diet maintained for 1-2 weeks decreases bronchoconstriction in response to exercise in individuals with asthma. There is no data as to the longer-term effect of a low sodium diet on either the prevalence or severity of asthma or on exercise-induced bronchoconstriction. As a low sodium diet has other beneficial health effects, it can be considered as a therapeutic option for adults with asthma, although it should be considered as an adjunctive intervention to supplement optimal pharmacological management of asthma and not as an alternative. If the relationship between higher sodium intake and increased prevalence and severity of asthma is causal, then there are potential population benefits for asthma as well as cardiovascular disease to be derived from public health measures to reduce sodium consumption. PMID:17109669

  9. UNANI DRUGS IN THE MANAGEMENT OF CARDIOVASCULAR DISEASES: A REVIEW ON PHARMACOLOGICAL STUDIES ON ARJUN AND ZAFRAN

    Directory of Open Access Journals (Sweden)

    Rabbani Syed Arman

    2013-06-01

    Full Text Available Cardiovascular diseases (CVDs are the leading cause of death and disability in the world. They have emerged as a major health threat in develop¬ing countries contrary to the prior belief that they were confined primarily to industrialized nations. The global burden of disease due to cardiovascular diseases is escalating, principally due to a sharp rise in the developing countries which are experiencing rapid health transition. An estimated 17.3 million people died from CVDs in 2008 and over 80% of CVD deaths take place in low and middle income countries. By 2030, almost 23.6 million people will die from CVDs. Therefore, finding ways to reduce the mortality of cardiovascular disease remains an important public health goal. Traditional Medicines have been an integral part of the healthcare system since time immemorial. WHO reports indicate that around eighty percent of the global population still relies on botanical drugs and several herbal medicines have advanced to clinical use in modern times. Unani occupies an important place in the rich traditional heritage of indigenous systems of medicine in India and contributes significantly to the health care. The core of treatment in Unani System of Medicine is based on drugs of herbal, mineral and animal origin. The ancient classical literature of Unani has mention of numerous drugs possessing cardioprotective and cardiotonic activity, Arjun (Terminalia arjuna and Zafran (Crocus sativus are two of them. The Unani physicians have been using these drugs successfully since ages and this is possible only by inherent quality and safety standards specified in the system.With the advent of new techniques and recent upsurge towards scientific exploration of traditional medicines, empirical data substantiating their safety and efficacy has been generated and had led to better understanding of their role to prevent and cure diseases. The aim of this paper is to review and highlight the work done on Arjun

  10. Prevention of cardiovascular disease guided by total risk estimations - challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2011-11-03

    This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the \\'treat-to-target\\' paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and \\'real-world\\' populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources.

  11. Competing designs for phase I clinical trials: a review.

    Science.gov (United States)

    Rosenberger, William F; Haines, Linda M

    2002-09-30

    Phase I clinical trials are typically small, uncontrolled studies designed to determine a maximum tolerated dose of a drug which will be used in further testing. Two divergent schools have developed in designing phase I clinical trials. The first defines the maximum tolerated dose as a statistic computed from data, and hence it is identified, rather than estimated. The second defines the maximum tolerated dose as a parameter of a monotonic dose-response curve, and hence is estimated. We review techniques from both philosophies. The goal is to present these methods in a single package, to compare them from philosophical and statistical grounds, to hopefully clear up some common misconceptions, and to make a few recommendations. This paper is not a review of simulation studies of these designs, nor does it present any new simulations comparing these designs.

  12. Clinical review: Respiratory mechanics in spontaneous and assisted ventilation

    OpenAIRE

    Grinnan, Daniel C; Truwit, Jonathon Dean

    2005-01-01

    Pulmonary disease changes the physiology of the lungs, which manifests as changes in respiratory mechanics. Therefore, measurement of respiratory mechanics allows a clinician to monitor closely the course of pulmonary disease. Here we review the principles of respiratory mechanics and their clinical applications. These principles include compliance, elastance, resistance, impedance, flow, and work of breathing. We discuss these principles in normal conditions and in disease states. As the sev...

  13. Clinical applications of nuclear magnetic resonance spectroscopy: a review

    International Nuclear Information System (INIS)

    The advantages and present limitations of the clinical applications of nuclear magnetic resonance spectroscopy are reviewed in outline, with passing references to skeletal muscular studies, in particular a group of children with advanced Duchenne dystrophy, and the applications to the study of cerebral metabolism of neonates, excised kidneys, biopsy studies of breast and axillary lymph node samples, and NMR spectroscopy performed during chemotherapy of a secondary rhabdomyosarcoma in the skin. (U.K.)

  14. Pharmacology of Heparin and Related Drugs.

    Science.gov (United States)

    Mulloy, Barbara; Hogwood, John; Gray, Elaine; Lever, Rebecca; Page, Clive P

    2016-01-01

    Heparin has been recognized as a valuable anticoagulant and antithrombotic for several decades and is still widely used in clinical practice for a variety of indications. The anticoagulant activity of heparin is mainly attributable to the action of a specific pentasaccharide sequence that acts in concert with antithrombin, a plasma coagulation factor inhibitor. This observation has led to the development of synthetic heparin mimetics for clinical use. However, it is increasingly recognized that heparin has many other pharmacological properties, including but not limited to antiviral, anti-inflammatory, and antimetastatic actions. Many of these activities are independent of its anticoagulant activity, although the mechanisms of these other activities are currently less well defined. Nonetheless, heparin is being exploited for clinical uses beyond anticoagulation and developed for a wide range of clinical disorders. This article provides a "state of the art" review of our current understanding of the pharmacology of heparin and related drugs and an overview of the status of development of such drugs.

  15. Review of rank-based procedures for multicenter clinical trials.

    Science.gov (United States)

    Rashid, M Mushfiqur; McKean, Joseph W; Kloke, John D

    2013-01-01

    This article reviews nonparametric alternatives to the mixed model normal theory analysis for the analyses of multicenter clinical trials. Under a mixed model, the traditional analysis is based on maximum likelihood theory under normal errors. This analysis, though, is not robust to outliers. Robust, rank-based, Wilcoxon-type procedures are reviewed for a multicenter clinical trial for the mixed model but without the assumption of normality. These procedures retain the high efficiency of Wilcoxon methods for simple location problems and are based on a fitting criterion which is robust to outliers in response space. A simple weighting scheme can be employed so that the procedures are robust to outliers in factor (design) space as well as response space. These rank-based analyses offer a complete analysis, including estimation of fixed effects and their standard errors, and tests of linear hypotheses. Both rank-based estimates of contrasts and individual treatment effects are reviewed. We illustrate the analyses using real data from a clinical trial. PMID:24138428

  16. Review on chemistry and pharmacology of Rabdosia rubescens%冬凌草的化学和药理作用研究

    Institute of Scientific and Technical Information of China (English)

    高世勇; 王珑

    2014-01-01

    To introduce the results of researching the chemical composition , pharmacological effects, anti-tumor mechanisms and clinical application of Rabdosia rubescens , this paper summarized the research on Rabdosia rubescens at home and abroad systematically by a lot of literature .It showed that Rabdosia rubescens contained some chemical compositions , inclu-ding terpenoids, alkaloids, steroids, flavonoids, volatile oils, amino acids, organic acids, monosaccharides , and has some pharmacological effects , such as anti-tumor, anti-inflamma-tory, immune-enhancing, anti-oxidation,anti-mutation and anti-hypertension.The anti-tumor mechanisms are shown as follows: repression of cell cycle , decrease of telomerase activity , inhibition of cell membrane sodium pump activity , inducing tumor cell apoptosis and reversal of multidrug resistance .In clinical , it has effect on esophageal cancer , gastric cardia canc-er, liver cancer , breast cancer and other cancers . This paper showed that Rabdosia rubescens has extensive pharmacological effects and good anticancer activity .%介绍冬凌草的化学成分、药理作用、抗肿瘤机制、临床应用等方面的研究成果。通过文献系统地介绍了国内外目前关于冬凌草的研究。研究发现冬凌草中含有萜类、生物碱、甾体、黄酮、挥发油、氨基酸、有机酸、单糖等化学成分,并具有抗肿瘤、抗菌消炎、免疫增强、抗氧化、抗突变、降压等药理作用,而其抗肿瘤机制包括阻遏细胞周期、下调端粒酶活性、抑制细胞膜钠泵活性、诱导肿瘤细胞凋亡、逆转多药耐药等,在临床上对食管癌、贲门癌、肝癌、乳腺癌等多种癌症均具有疗效。表明冬凌草具有广泛的药理作用和良好的抗癌活性。

  17. Practical clinical considerations of luting cements: A review.

    Science.gov (United States)

    Lad, Pritam P; Kamath, Maya; Tarale, Kavita; Kusugal, Preethi B

    2014-02-01

    The longevity of fixed partial denture depends on the type of luting cement used with tooth preparation. The clinician's understating of various cements, their advantages and disadvantages is of utmost importance. In recent years, many luting agents cements have been introduced claiming clinically better performance than existing materials due to improved characteristics. Both conventional and contemporary dental luting cements are discussed here. The various agents discussed are: Zinc phosphate, Zinc polycarboxylate, Zinc oxide-eugenol, Glass-ionomer, Resin modified GIC, Compomers and Resin cement. The purpose of this article is to provide a discussion that provides a clinical perspective of luting cements currently available to help the general practitioner make smarter and appropriate choices. How to cite the article: Lad PP, Kamath M, Tarale K, Kusugal PB. Practical clinical considerations of luting cements: A review. J Int Oral Health 2014;6(1):116-20. PMID:24653615

  18. Statistical challenges for central monitoring in clinical trials: a review.

    Science.gov (United States)

    Oba, Koji

    2016-02-01

    Recently, the complexity and costs of clinical trials have increased dramatically, especially in the area of new drug development. Risk-based monitoring (RBM) has been attracting attention as an efficient and effective trial monitoring approach, which can be applied irrespectively of the trial sponsor, i.e., academic institution or pharmaceutical company. In the RBM paradigm, it is expected that a statistical approach to central monitoring can help improve the effectiveness of on-site monitoring by prioritizing and guiding site visits according to central statistical data checks, as evidenced by examples of actual trial datasets. In this review, several statistical methods for central monitoring are presented. It is important to share knowledge about the role and performance capabilities of statistical methodology among clinical trial team members (i.e., sponsors, investigators, data managers, monitors, and biostatisticians) in order to adopt central statistical monitoring for assessing data quality in the actual clinical trial. PMID:26499195

  19. E-textiles in Clinical Rehabilitation: A Scoping Review

    Directory of Open Access Journals (Sweden)

    Amanda Fleury

    2015-02-01

    Full Text Available Electronic textiles have potential for many practical uses in clinical rehabilitation. This scoping review appraises recent and emerging developments of textile-based sensors with applications to rehabilitation. Contributions published from 2009 to 2013 are appraised with a specific focus on the measured physiological or biomechanical phenomenon, current measurement practices, textile innovations, and their merits and limitations. While fabric-based signal quality and sensor integration have advanced considerably, overall system integration (including circuitry and power has not been fully realized. Validation against clinical gold standards is inconsistent at best, and feasibility with clinical populations remains to be demonstrated. The overwhelming focus of research and development has been on remote sensing but the opportunity for textile-mediated feedback to the wearer remains unexplored. Recommendations for future research are provided.

  20. 小分子抑制剂瑞戈非尼的药理和临床概述%The progress on pharmacological and clinical research of small molecule inhibitors regorafenib

    Institute of Scientific and Technical Information of China (English)

    王明森; 刘正平; 侯良玉; 张菊红; 张建强

    2015-01-01

    Pharmacology,pharmacokinetics,clinical study and safety of regorafenib in the treatment of colorectal cancer and gastrointestinal stromal tumors were reviewed in the paper. The main refeience to foreign - related registration and clini-cal data of regorafenib. Clinical trials showed the Overall Survival(OS)and Progression - Free - Survival(PFS)was sig-nificantly increased in patients treated with regorafenib. The most serious adverse drug reactions in patients receiving Stivar-ga were severe liver injury,haemorrhage and gastrointestinal perforation. The most frequently observed adverse drug reactions (≥30% )in patients receiving Stivarga were asthenia/ fatigue,decreased appetite and food intake,hand foot skin reaction, diarrhoea,weight loss,hypertension and dysphonia.%本文综述了瑞戈非尼治疗结肠直肠癌和胃肠道间质瘤的药理、药动学、临床研究和安全性信息。主要参考国外有关的瑞格菲尼的注册和临床资料。临床试验表明瑞戈非尼能使患者的总生存期、无进展生存期获得明显提高。接受治疗的患者中最严重的药物不良反应是严重肝损伤、出血和胃肠道穿孔,最常见的不良反应(≥30%)为虚弱/疲乏、食欲减退、食物摄入量减少、手足皮肤反应、腹泻、消瘦、高血压和发音障碍。