Avicenna Journal of Pharmaceutical Research
Volume:1 Issue: 2, Dec 2020

In this study which was conducted in Besat hospital (Hamadan, Iran), the therapeutic drug monitoring (TDM) of vancomycin (VAN) was carried out based on the quantification of VAN trough in intensive care unit (ICU) patients.

The study population was selected from ICU patients treated by intravenous VAN. To determine VAN trough, blood samples were taken from patients before the fourth dose. Then, trough concentrations were determined by newly developed high-performance liquid chromatography (HPLC) and compared with the conventional method of immunoassay. Twenty patients were included based on the aim of the study.

The mean value of the trough for the studied patients was 26.31±18.05 μg/mL. For 16 (80%) patients, trough levels were found to be less than 10 μg/mL. For 12 (60%) patients, creatinine clearance was less than 90 mL/min and more than 120 mL/min. The mean value of creatinine clearance for the studied patients was 95.49± 25.74 mL/min. Based on the results, there was a significant relationship between VAN trough concentration and creatinine clearance (P=0.045).

In general, the HPLC method is more sensitive than immunoassay for the determination of VAN in plasma samples. However, VAN dosing based on creatinine clearance is not enough for achieving the goal trough level but measuring the creatinine clearance and trough concentration are considered as vital aspects for the TDM of VAN.

The objective of the present study was to design a porous osmotic pump-based drug delivery system for the controlled release of captopril (Cap) which can maintain a constant therapeutic concentration, thus reducing dose-related side effects and dosing frequency.

The study evaluated in vitro drug release for the controlled porosity osmotic pump tablet (CPOPT) of Cap. This in vitro drug release study investigated the influence of the tablet formulation variables such as the amount of mannitol, hydroxypropylmethylcellulose K4M (HPMCK4M), and polyvinyl pyrrolidone (PVP K-30) in the core and the concentration of cellulose acetate and polyethylene glycol 400 (PEG-400) in the coating solution.

It was found that the drug release was mostly affected by the amount of mannitol, HPMCK4M, and PVP K-30 in the core and the amount of cellulose acetate and PEG-400 in the coating solution.

In general, the objective of the study was established by coating the core tablet containing osmotic and pore-forming agents. Therefore, the CPOPT of Cap could be a safe, effective, stable, and promising preparation in the future.

One of the major causes of failure in root canal treatment is microorganisms like Enterococcus faecalis.

This study aimed to examine the effectiveness of triple antibiotic paste (TAP) containing ciprofloxacin, metronidazole, and minocycline in comparison with modified TAP (MTAP) containing metronidazole, ciprofloxacin, and clindamycin and calcium hydroxide on Enterococcus strains isolated from root canal of tooth associated with pre-apical lesion. Moreover, we evaluated the E. faecalis resistance and antibiotic susceptibility. To do so, 25 patients with previous failure of endodontic treatment were enrolled in this study.

The antimicrobial effect of MTAP10%, MTAP1%, TAP10%, TAP1%, and CaOH was significantly better than the positive control group (P <0.05). There was no significant difference between antimicrobial effect of TAP1% and MTAP1%, and CaOH was the least effective one. The antimicrobial effect of TAP10% was significantly better than MTAP10% (P = 0.007). Out of 11 E. faecalis samples, 1 sample was resistant to MTAP1% and MTAP10%, though it was sensitive to other drugs; meanwhile, it showed the highest sensitivity to TAP10%.

TAP10% was the most effective choice followed by MTAP10%, but calcium hydroxide was not effective compared to other choices. Thus, MTAP might be a good choice for root canal medicament instead of TAP

Foeniculum vulgare (Fennel) has a wide range of applications. Previous studies revealed the presence of different compounds in the essential oil (EO) of fennel fruit (FF). Matrix metalloproteinase-13 (MMP-13) participates in several human biological processes including the degradation of extracellular matrix proteins, activation or degradation of some significant regulatory proteins, and tumor cell invasion. Furthermore, the up-regulation of MMP-13 is associated with many disorders such as tooth caries and periodontitis, as well as the degradation of enamel and tissues around the implant and Alzheimer’s disease. Therefore, the aims of the present study were to investigate the compounds of the EO of FF (EOFF) from the Hamedan district, along with performing molecular docking analysis to assess the binding affinity of four compounds originated from F. vulgare with the MMP-13. Finally, the study focused on evaluating the pharmacokinetic and toxicity characteristics of the compounds.

Hydrodistillation method was used for obtaining the EO from FF. Then, gas chromatographymass spectrometry was applied to identify the components of the EO. Molecular docking analysis was carried out using AutoDock software. Eventually, the pharmacokinetic and toxicity features of compounds were evaluated using bioinformatics webservers.

The results revealed the presence of fourteen compounds, among which e-anethole (86.86%), fenchone (743%), estragole (165%), and thymol (1.21%) were the main components. Based on the results, thymol, fenchone, e-anethole, and estragole could potentially bind to the MMP-13 active site, respectively.

Regardless of several studies on the chemical constituents of EOFF, the subject has its own pharmacognostical importance. According to computational studies, EOFF has the potential for study on several human disorders such as cancer, tooth decay, and Alzheimer’s disease.

The present study was performed to investigate the protective effects of propofol against cisplatin-induced pulmonary toxicity in rats.

A total of 20 male Wistar rats weighing 180-250 g were divided into four groups of control, the cisplatin-intoxicated group intraperitoneally (IP) injected with cisplatin (7 mg/kg/d for a week), the propofol group (10 mg/kg/d, IP), and the protected group receiving propofol (10 mg/kg/d, IP) poisoned by cisplatin. Then, the biomarkers of total antioxidant capacity (TAC), catalase (CAT) activity, and lipid peroxidation (LPO) were measured in homogeneous lung tissues.

The data revealed the evidence of oxidative stress in the lung tissue of cisplatin-intoxicated rats as indicated by an increase in the level of LPO compared with propofol and protected groups (P<0.05). Moreover, TAC decreased in the cisplatin group while it increased in the propofol group compared to cisplatin and protected groups (P<0.05). No significant difference was observed between the groups regarding CAT (P>0.05). Protection with propofol ameliorated the oxidative stress induced by cisplatin in the lung tissue because of the reduction of LPO.

According to these results, it seems that propofol provides a remarkable protection against cisplatin-induced oxidative pulmonary damage mediated by its antioxidant properties.

Internal reference pricing (IRP) is one of the pharmaceutical pricing approaches, which is widely favored by health policymakers in different countries as a cost-containment tool for managing medicine expenditure. Evidence related to the implementation of this method confirms its usefulness in reducing pharmaceutical costs. Accordingly, the purpose of this study was to calculate potential changes in pharmaceutical expenditure using the IRP method for products belonging to three pharmaceutical categories in the pharmaceutical system of Iran.

This routine data study assessed the potential effect of IRP in three pharmaceutical categories including statins, non-steroidal anti-inflammatory drugs, and proton pump inhibitors (PPIs). Two scenarios for reference groups (levels 4 and 5 of the ATC code) and four scenarios for the reference price (i.e., the minimum, median, mean, and the mean of three minimum prices in the reference group) were considered in this regard, and the price and sales data source was the report published by the Iranian Food and Drug Administration. Then, cost changes were calculated with each hypothetical scenario. It was assumed that other intervening factors remain unchanged, including consumers and prescribers’ behavior.

Based on the results, the two largest potential saving effects belonged to the minimum price scenario and the mean of the scenario of the three minimum prices, respectively. However, the results showed that the consequence of using a price scenario other than the minimum price as the reference price is highly related to the details of the distribution of prices in the related reference group. In addition, appropriate decisions regarding outlier products (e.g., imported products) might have extremely important effects on the result, especially for the mean price scenario. The minimum price scenario concomitant with a premium for superior products can also be considered, but part of it is outside the scope of this study and requires independent research.

Thus if an appropriate scenario is selected for the reference price and group, the IRP method has the potential to reduce the costs of medicines. Therefore, pharmaceutical policymakers must pay enough attention to the details of planning this system and the needed procedure for updating the details of this system.

Nowadays, many people believe in traditional medicines and use them for different diseases. Knowledge of medicinal plants and traditional medicine has been practiced for centuries through trial and error, and many important treatments for the disease have been passed down from one generation to the next. Ephedra is a valuable plant and has been used to treat diseases since ancient times. Accordingly, this study aims to comprehensively introduce Ephedra distachya L. in traditional medicine.

In this review study, databases such as Google Scholar, SID, Scopus, and books on medicinal plants in Persian and English languages were searched to collect data. The keywords included “ephedra”, “traditional medicine”, “goat’s beard”, and “medicinal plants”.

Many resources highlighted the importance of using ephedra due to its useful properties. Experimental studies in traditional medicine show the effect of this plant in the prevention of diseases, such as asthma and bronchitis.

Considering the beneficial effects of ephedra and scientific evidence about its effects, further studies are needed to better understand the use of this plant in traditional medicine.

In this minireview, we evaluated the studies that underlie the usage and suggestion of antivirals for the treatment of coronavirus disease 2019 (COVID-19). Until now, there has been no known curative treatment for COVID-19. However, many clinical trials have used antiviral medicines including remdesivir, lopinavir (LPV), ritonavir (RTV), ribavirin, favipiravir (FPV), oseltamivir, umifenovir, and nitazoxanide. Using remdesivir in patients with severe COVID-19 has improved respiratory symptoms, making the remdesivir one of the specific drugs suggested for the treatment of severe COVID-19. It has been shown that triple antiviral therapy (LPV, RTV, and ribavirin) can improve symptoms and consequently shorten the duration of viral shedding and hospital stay. However, the results of treatment with oseltamivir, umifenovir, and a combination of LPV and RTV were not different from the results of treatment with standard care in the time to clinical improvement. FPV showed better therapeutic responses to COVID-19 in terms of disease progression and viral clearance. Future clinical studies should evaluate the effect of antiviral agents for the treatment of COVID-19 outbreak. Therefore, it is suggested that highly active antiviral drugs should be used in combination with other therapeutic approaches for the treatment of COVID-19.