Trends in Pharmaceutical Sciences
Volume:5 Issue: 1, Mar 2019

Patients undergoing Carotid Artery Stenting (CAS) may encounter serious complications including Intracranial hemorrhage (ICH). ICH after carotid re-vascularization has been usually attributed to cerebral hyperperfusion syndrome (CHS) and it is reported as a significant cause of mortality and morbidity. Factors mentioned as risk factors for ICH after carotid intervention are preoperative hypertension, renal failure, bilateral carotid disease or contralateral carotid occlusion, impaired cerebrovascular reserve, female gender, age, nonselective admission, increased Charlson comorbidities score. In this study, we report two cases of ICH after CAS in patients receiving dual antiplatelet regimen plus omega-3 fatty acids before and after carotid intervention. It seems that administration of omega 3 with other antiplatelets could augment inhibition of platelet aggregation and may increase the risk of ICH in patients undergoing CAS especially in those with several risk factors for ICH. These findings are important because of the wide availability of omega-3 supplements as an over-the-counter (OTC) drug and the propensity for usage of it in alternative medicine.

Hydrogels are cross-linked polymers with hydrophilic groups which enable them to absorb large amounts of water. Hydrogel based delivery systems have been used for delivery of different types of active pharmaceuticals. Although hydrogels have numerous capability and advantages in drug delivery including biocompatibility, low toxicity and good swelling behavior but depending on chemical moieties of the gel forming polymers and route of administration some limitations would appear in delivery of active pharmaceutical using hydrogel as delivery vehicle. Development of successful hydrogel based delivery system is possible upon knowledge about the hydrogels forming polymers physiochemical properties and understanding the influencing factors which control the swelling behaviors, hydrophilicity, biodegradability, biocompatibility and targetability of the selected polymer. In this review at first classification of the hydrogel with different approaches including chemical moieties, crosslinking agent behaviors and release controller mechanism was performed and limitations arise from each category was described and finally different approaches to overcome each of this limitation was proposed.

Transdermal drug delivery (TDD) is an attractive approach to minimize the limitations encountered by other drug administration routes such as oral and parenteral. Apart from specialized devices fabricated for modifying the barrier properties of the stratum corneum such as iontophoresis, sonophoresis and microneedles, there are several passive methods applied through physicochemical manipulations in drug formulation, including prodrugs, ion-pairs, supersaturated solutions, inclusion complexes, eutectic mixtures, ionic liquids and use of chemical penetration enhancers. More recently, colloidal carriers due to their small size, high specific surface area, unique structural and biochemical features, are suggested for the skin penetration enhancement through transcellular or shunt routes. This review considers challenges and achievements of colloidal TDD systems, either used alone or in combination with other techniques, with a special concern about lipid-based vesicular nanocarriers including liposomes, niosomes, transfersomes, pharmacosomes, ethosomes, catesomes, and invasomes. Undoubtedly, understanding interplay between physicochemical properties and the underlying mechanisms of skin penetration enhancement is a prerequisite for optimized TDD applications.

To develop and evaluate a sensitive, accurate, rapid and reproducible high performance liquid chromatography analytical method for concurrent assay of simvastatin, a hyperlipidemia controlling agent, and citicoline, a psychostimulant agent, a C18 column (Eurosphar 100-5, 150 mm × 4.6 mm) used as a reversed stationary phase and mobile phase was water (previously adjusted with phosphoric acid to a pH of 5.5), methanol and acetonitrile (20:20:60) with the flow rate 1.0 ml/min. The ultraviolet detector was set at 247 nm. A linear correlation between each concentration and its own AUC within concentration ranges of 15 to 100 g/ml for citicoline and 7.5 to 50 g/ml for simvastatin with a correlation coefficient 0.9969 for citicoline and 0.994 for simvastatin were produced. The within and between-day precision and accuracy were both in acceptable ranges. The outcomes of these tests show an accurate, rapid and robust HPLC-UV method for successful analysis of both simvastatin and citicoline simultaneously.

Occasional incompetence of human serum albumin (HSA) as a plasma expander is linked to severity of the underlying endothelial cell injury so that HSA can readily extravasate if structural integrity of the endothelial is compromised. Consequently, the leaking HSA may exacerbate the oncotic plasma gradient and results in capillary leak syndrome; therefore, we hypothesized that HSA modification by the covalently attaching multiple PEG (polyethylene glycol) groups would result in enhanced retention of HSA in blood circulation in animal model of acute inflammation. PEGylation of HSA was performed by maleimide-thiol chemistry. The products were characterized by polyacrylamide gel electrophoresis and size-exclusion chromatography. Extravasation of PEGylated HSA was compared to the native protein in BALB/C mice model of carrageenan-induced inflammation by histopathological evaluations. HSA was thiolated by either reaction of 2-iminothiolane (Traut’s reagent) with lysine side chains or DTT reduction of disulfide bridges for subsequent reaction with methoxyPEG-maleimide (mPEG-Mal). The PEGylation reaction was optimized in terms of pH and mPEG/HSA molar ratio, producing high conjugation yield. mPEG 5 KDa-HSA demonstrated higher osmotic pressure and more homogeneous weight distribution than mPEG 20 KDa-HSA. According to the histopathological findings, mPEG 5 KDa-HSA showed lower extravasation in comparison to native HSA in carrageenan-induced inflammation model. Conclusively, PEGylated form of HSA might lessen the need of frequent HSA administration via decreasing the capillary leakage and endow a product with improved intravascular retention.

Hyperlipidemia is one of vital complications in diabetes. The leaves of thymus daenensis Celak are being widely used to reduce hyperlipidemia in Persian folk medicine. Objective Present study is based upon the investigation of total phenol content and antioxidant activity of thymus daenensis Celak extract (Td) as well as the effect of Td on some biochemical parameters (glucose, total cholesterol, HDL, LDL and Triglyceride level) in normal and streptozotocin-induced (STZ-induced) and Triton x-100 induced hyperlipidemic male Sprague Dawley rats. Also, synergic effect of this extract with atorvastatin was evaluated in mentioned groups. Animals were divided into five groups: healthy control group (sham), diabetic and hyperlipidemic control group (STZ+ Tri), diabetic and hyperlipidemic groups treated with Td fraction (Ex 1000); diabetic and hyperlipidemic groups treated with atorvastatin (Ator 10), diabetic and hyperlipidemic groups treated with Td fraction + atorvastatin (Ex 1000 + Ator 10). Treatment of diabetic rats with Td (1000 mg/kg) significantly decreased glucose, total cholesterol, triglyceride and LDL level as compared with the diabetic hyperlipidemic control group. Nevertheless, there were no synergistic effects between Td and atorvastatin on reducing lipid indications. The total phenol content of Td was 76 mg/g and the result of nitric oxide radical scavenging assay showed IC50 of 451.14± 44.4 and 486.94± 8.91μg/ml for Td and ascorbic acid respectively. The results of this study indicate that Td is potent antioxidant and hypoallergenic, which may be proper to prevent coronary heart disease in diabetes in future clinical studies.

Medication errors may prolong hospitalization period, enhance its costs and make harmful impacts on health. Inappropriate drug history taking is a type of medication errors which may occur on admission, resulting in medication discrepancies. This work presents a report of discrepancies between the drug history acquired by pharmacists and the drugs administered by the physicians at a teaching hospital in Shiraz, Iran. This prospective study was conducted from October 2016 to March 2017 in 7 wards of Namazi hospital affiliated to Shiraz University of Medical Sciences. Both the physicians/nurses and pharmacists obtained medication history from patients recruited in this study during the first 24 hours of their admission. The medications were classified according to the ATC classification. Totally, 103 patients were recruited and 557 medications were recorded in this study. The mean±standard deviation age of patients was 58.52±18.75 years. Comparing pharmacist drug history with medication lists obtained by nurses or physicians revealed 353 discrepancies. On average, 3.42 discrepancies were identified per patient (ranged from 0 to 12). Most (85.8%) of medication discrepancies were related to omission errors. Metformin and aspirin were the most common medications involved in omission errors. The rate of medication discrepancies at admission in our hospital was high. Active contribution of pharmacists and providing accurate medication histories at the time of hospital admission can be considered as possible solutions for this problem.