Several Categories Of Drugs Research Articles

ANTIHYPERTENSIVES IN ORAL SUB MUCOSAL FIBROSIS

Oral submucous brosis is a common pre-malignant condition affecting the oral mucosa with more prevalence among Indian population. Various treatment modalities have been elucidated in order to alleviate the symptoms associated with OSMF. Currently oral Anti hypertensive has been proved to have benecial result in treating OSMF because of its anti-inammatory, brinolytic, immunomodulatory and rheologic modifying property. Several categories of drugs have been used in the treatment of OSMF but their effectiveness leaves much to be desired and no treatment regimen has afforded denitive cure. While Oral administration limits the concentration of drugs in lesional tissue and increases the potential for side effects, the Intralesional injections are associated with signicant mechanical injury and non compliance on the patient’s part because of the accompanying discomfort and pain. The present study was done to evaluate the effectiveness of oral antihypertensives in the management of OSMF Very few studies across world have showed that anti hypertensive drugs showed signicant improvement in mouth opening, reduction in burning sensation. Hence anti hypertensive can be a good alternative in the management of OSMF for whom intralesional steroids or hyaluronidase are contraindicated, for those who cannot make frequent visit and to avoid pain due to injection. And most importantly anti hypertensive is cost effective and more compliant to the patient.

Antihypertensives in oral submucous fibrosis

Oral submucous fibrosis is a common pre-malignant condition affecting the oral mucosa with more prevalence among Indian population. Various treatment modalities have been elucidated in order to alleviate the symptoms associated with OSMF. Currently oral Anti-hypertensive has been proved to have beneficial result in treating OSMF because of its anti-inflammatory, fibrinolytic, immunomodulatory and rheologic modifying property. Several categories of drugs have been used in the treatment of OSMF but their effectiveness leaves much to be desired and no treatment regimen has afforded definitive cure. While Oral administration limits the concentration of drugs in lesional tissue and increases the potential for side effects, the Intralesional injections are associated with significant mechanical injury and noncompliance on the patient’s part because of the accompanying discomfort and pain. The present study was done to evaluate the effectiveness of oral antihypertensives in the management of OSMF. Very few studies across world have showed that anti-hypertensive drugs showed significant improvement in mouth opening, reduction in burning sensation. Hence anti-hypertensive can be a good alternative in the management of OSMF for whom intralesional steroids or hyaluronidase are contraindicated, for those who cannot make frequent visit and to avoid pain due to injection.

Drug Interactions of H2 Receptor Antagonists-Ranitidine: A Review

Ranitidine has OTC drug status as well as it is an essential drug by WHO, hence it is popularly selling drug from community and hospital pharmacy. Many prescription and nonprescription drugs were found having drug interaction with ranitidine which may lead to either drug toxicity or therapy failure. This review compiles potential drug interactions of ranitidine with several categories of drugs along with effective measures. Ranitidine is in a group of drugs called histamine-2 blockers. H2 receptor antagonists continue to be prescribed usually for acid –peptic disease. Their safety record finally led to their availability as “Over the Counter” drugs. Histamine is a naturally-occurring chemical that stimulates cells in the stomach (parietal cells) to produce acid. H2-blockers inhibit the action of histamine on the cells, thus reducing the production of acid by the stomach. Ranitidine hydrochloride is prescribed for conditions such as gastroesophageal reflux disease (GERD), ulcers, Zollinger-Ellison syndrome, erosive esophagitis, upper gastrointestinal bleeding, heartburn, and other conditions where reduction of gastric secretion and acid output is desirable.

Patent perspectives for corticosteroids based ophthalmic therapeutics.

Eye inflammation, if untreated at right time poses the risk of vision loss. Several categories of drugs are available in the global market, but corticosteroids are still used for the treatment of ocular inflammation including anterior/ posterior uveitis, age related macular degeneration (AMD) and post cataract surgery inflammation. Although corticosteroids have well-documented side effects as compared to non steroidal anti-inflammatory drugs (NSAIDs), but they are still regarded as better anti-inflammatory agents for treating ocular inflammations. The prime concern with conventional formulations such as (ophthalmic solutions, suspensions, ointments) is low drug bioavailability due to precorneal barrier of the eye, tear turnover and rapid drainage of drug via nasolacrimal drainage and drug induced systemic toxicity. To overcome these limitations, various novel formulations of corticosteroids have been explored. These include nanoparticles, solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC), nanomicelles, in-situ gels, iontophoresis, liposomes, nanoemulsions, microemulsions and ocular implants for the effective ophthalmic delivery of the corticosteroids. Topical nanocarriers have also been demonstrated to be promising vectors with potential application in the ophthalmic therapeutics. This review summarizes the clinical findings and patents on various corticosteroids as ocular pharmacotherapeutics.

The essential roles of protein–protein interaction in sigma-1 receptor functions

The essential roles of protein–protein interaction in sigma-1 receptor functions

Wound healing in pre‐tibial injuries – an observation study

Pre-tibial lacerations are complex wounds affecting a primarily aged population, with poor healing and a potentially significant impact on social well-being. Management of these wounds has changed little in 20 years, despite significant advances in wound care. A retrospective observational study was undertaken to observe current wound care practice and to assess the effect of various medical factors on wound healing time on 24 elderly patients throughout their wound journey. Wound length was found to be substantively and significantly associated with wound healing time, with a reduction in instantaneous healing rate of about 30% for every increase of 1 cm in wound length. Hence, longer wounds are associated with longer wound healing times. Prescription of several categories of drugs, including those for ischaemic heart disease (IHD), hypertension, respiratory disease or asthma; and the age of the patient were not significantly associated with wound healing times, although substantive significance could be inferred in the case of prescription for IHD and asthma. Despite the small sample size, this study identified a clear association between healing and length of wound. Neither the comorbidities nor prescriptions explored showed any significant association although some seem to be more prevalent in this patient group. The study also highlighted other issues that require further exploration including the social and economic impact of these wounds.

Successful treatment of SUNCT syndrome with divalproex sodium extended-release

Introduction: Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is a primary rare headache. This syndrome is known to be refractory to pharmacotherapy. Various treatments have been tried for SUNCT syndrome, generally of little benefit. Objective: To report a case of SUNCT syndrome who was successfully treated with divalproex sodium extended-release (DVPX ER) and to review the literature about of drugs used in this treatment. Patient and Method: The authors report a case of a 61 year-old man, suffering from SUNCT syndrome, who was successfully treated with DVPX ER. We review the literature about several categories of drugs that are used in the treatment to this syndrome. Conclusion: SUNCT syndrome is clinically well identified, but it is poorly treated. This is first report of SUNCT syndrome responsive to DVPX ER.

Treating postmenopausal osteoporosis in women at increased risk of fracture – critical appraisal of bazedoxifene: a review

Several categories of drugs to treat osteoporosis exist in the form of bisphosphonates, strontium, parathyroid hormone, and selective estrogen receptor modulators (SERM). Advantages and disadvantages exist for each category as some patients may, for example, not tolerate bisphosphonates for gastrointestinal side effects, and especially in women in whom osteoporosis is frequent, several options for treatment are needed. The objectives of this review were to critically appraise the effects of bazedoxifene on risk of fractures especially in women at high risk of fractures. A systematic literature search was conducted for studies, especially randomized controlled trials with fractures as end-points. Bazedoxifene is a new member of the SERM group. The literature search identified one randomized controlled trial with fractures as end-point. This was a 3-year randomized double-blind placebo controlled trial in which 7492 postmenopausal women aged 55 to 85 years were randomly allocated to 1) bazedoxifene (20 [n = 1886] or 40 [n = 1872] mg/day); 2) raloxifene (60 mg/day, n = 1849); or 3) placebo (n = 1885). The risk of vertebral fractures decreased with both 20 (HR 0.58, 95% CI 0.38 to 0.89) and 40 (HR 0.63, 95% CI 0.42 to 0.96) mg of bazedoxifene per day compared to placebo. There was no reduction in non-vertebral fractures. A subgroup of women with a priori high risk of fractures was identified post hoc. In this subgroup there was a reduction in the risk of non-vertebral fractures with the 20 mg dose of bazedoxifene compared to placebo (HR 0.50, 95% CI 0.28 to 0.90). In the 40 mg bazedoxifene group no significant reduction in non-vertebral fractures was seen in this subgroup (HR 0.70, 95% CI 0.40 to 1.20). In general post-hoc defined subgroup analyses should be interpreted with caution. However, the results indicate that bazedoxifene may be effective in preventing vertebral fractures in postmenopausal women with osteoporosis.

Early preclinical studies of discriminable sedative and hallucinogenic drug effects

One important technique in behavioral pharmacology is to train laboratory animals to discriminate between a psychoactive drug effect and a nondrug condition. Tests with different drugs have identified several categories of drugs that have different discriminable effects. The two authors describe and discuss the early research on discriminable effects of sedative and hallucinogenic drugs and their acquaintance with each other at Yale University prior to their early and frequent publications on discriminable drug effects. Herb Barry studied sedative drugs primarily and Jim Appel studied hallucinogenic drugs. Sedative drugs include ethyl alcohol, barbiturates, and benzodiazepines. Their discriminable effects are largely attributable to the activation of an inhibitory neurotransmitter, gamma-amino butyric acid. Alcohol has the most pervasive effect in accordance with the high dose required to alter behavior. Hallucinogenic drugs include lysergic acid diethylamide and mescaline. They increase the activity of the neurotransmitter 5-hydroxytryptamine and, perhaps, dopamine in the central nervous system (CNS). In spite of their relatively low concentrations in the brain, both of these neurotransmitters have many important behavioral effects. Various sedative drugs cause a discriminable decrease in the function of the CNS. Different types of sedatives can be discriminated from each other. Indole and phenylethylamine hallucinogens have potent discriminative stimulus properties, which are related to the actions of biogenic amine neurotransmitters in the CNS.

Drug-induced thrombotic thrombocytopenic purpura/hemolytic uremic syndrome: a concise review.

An extensive variety of drugs have been associated with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (TTP/HUS). Although a direct causal effect has usually not been proven, the cumulative evidence linking several drugs with TTP/HUS is strong. This paper reviews several categories of drugs including antineoplastics, immunotherapeutics and anti-platelet agents that have been reported to induce TTP/HUS. The pathogenesis of drug-induced TTP/HUS and the effectiveness of treatment regimens are also reviewed. A consensus on diagnostic criteria to accurately and consistently diagnose drug-induced TTP is needed.

Epidural Anesthesia

The spinal cord can be affected by several categories of drugs: local anesthetics, opiate agonist, alpha 2 adrenergic agonists, and ketamine. The mechanism of action, side effects, and usefulness of these injections vary with the type of drug used.

Effects of Antihypertensive Therapy on Diastolic Dysfunction in Left Ventricular Hypertrophy

In systemic hypertension, a certain degree of impairment of left ventricular diastolic function is often detectable, and is the consequence of two factors: elevated afterload and left ventricular hypertrophy. The goal of improving diastolic dysfunction can thus be achieved by lowering blood pressure and by inducing a regression in left ventricular hypertrophy. A reduction in blood pressure by intravenous administration of verapamil has proved capable of enhancing left ventricular filling properties in patients with hypertension. This finding has not been corroborated, however, in midterm protocols using an array of drugs (beta-blockers, dihydropyridines, diltiazem, and diuretics). Reduction in left ventricular mass can be achieved by several categories of drugs, and it has been shown that a decrease in mass is accompanied by an improvement in the early diastolic filling pattern. The kind of drug used to accomplish mass reduction seems to be irrelevant as far as the improvement in diastolic function is concerned. The pattern of left ventricular hypertrophy, however, might play a role in influencing the outcome on diastolic mechanics of left ventricular mass decrease.

Deleterious Effects of Drugs on the Developing Nervous System

In the past two decades, several categories of drugs have emerged as serious neuroteratogens. These include vitamin A congeners, isotretinoin and etretinate, certain antiepileptic drugs, especially trimethadione, and valproic acid. Other antiepileptic drugs have low teratogenic potential and variably affect the developing CNS. When multiple antiepileptics are administered during pregnancy, however, the risk to the fetus increases considerably.

Calcium antagonists and heat-induced hepatic injury.

Several laboratories have demonstrated the value of the isolated perfused rat liver as a suitable model for heat-induced hepatic injury in vivo. Membrane changes caused by perfusion of rat livers at 42 degrees C for 90 min were similar to those induced by toxic chemicals or hypoxia. In an evaluation of several categories of drugs reported to reduce cell injury, calcium antagonists (nifedipine, dantrolene, and verapamil), were evaluated for their therapeutic potential for heat injury. Isolated rat livers were perfused at 42 degrees C for 90 min with and without calcium antagonists. Livers were also perfused at 37 degrees C. Potassium and transaminase leakage, bile production and ultrastructure were used to evaluate their responses. Neither of the three calcium antagonists significantly improved any of the functional parameters measured. However, dantrolene produced dilated or vesicular rough endoplasmic reticulum in the heated livers. These changes suggest selective intracellular action on endoplasmic reticulum of heated livers. Ring-shaped mitochondria and vesicular endoplasmic reticulum were observed in the heated, verapamil-treated livers, but these could not be quantitatively distinguished from controls. Nifedipine did not appear to alter intracellular membranes, but did increase bile production.

Effect of thymosin immunostimulation with and without corticosteroid immunosuppression on chimpanzee hepatitis B carriers

Carriers of hepatitis B surface antigen (HBsAg) are at a high personal risk of developing chronic hepatitis, cirrhosis, and primary hepatocellular carcinoma, and they pose a potential health threat to others. Accordingly, erradication of the carrier state is an important therapeutic goal. Several categories of drugs have been evaluated for this purpose, with, at best, limited success. The immune stimulants constitute a drug group considered to have potential benefit, since altered cell-mediated immunity (CMI) appears to have a pathogenic role in the perpetuation of the carrier state. One such immune stimulant is the thymic hormone, thymosin, which is known to enhance suppressor T-cell activity. We therefore examined its possible therapeutic role by evaluating its effect on four chronic HBsAg- and hepatitis B e antigen (HBeAg)-positive chimpanzees. After baseline biochemical, serological, immunological, and histochemical studies were conducted, all four chimpanzees received parenteral thymosin for a period of 10-14 weeks; two of them were pretreated for 4 weeks with corticosteroids. All four were then reevaluated in the same manner at regular intervals during the 14-week period. Neither immunosuppression nor immunostimulation significantly affected biochemical, serological, or histological measures. Indices of CMI were altered, however: both T4 and T8 cells increased with thymosin treatment, although the T4/T8 ratio declined because of the relatively greater increase of the T8 than of the T4 cells. Thymosin did not affect the mitogen assays. Thus, while immunostimulation with thymosin did slightly alter CMI, it had no affect on the HBsAg carrier state or on measures of chronic hepatitis, even when preceded by corticosteroid immunosuppression.