Side Effects Of Pharmacotherapy Research Articles

Cystic Fibrosis: An Updated Comprehensive Review of Literature with Pediatric Dentistry Perspectives

Cystic fibrosis (CF) is a genetic disorder, inherited in an autosomal recessive manner. It affects the multiple organs or organ systems of human body including mainly respiratory, digestive, and renal systems. CF patients may have various orodental problems either directly by the primary disease of CF or indirectly by comorbidities, its complications and by side effects of pharmacotherapies. The optimization of oral health by meticulous dental care is essential aspect and hence must be an integral part of the multidisciplinary management in such patients with CF. Thus, general and pediatric dentist need to remain updated with the pathophysiology of the disease, its medical treatment, and its adverse effects on oral health in order to manage such CF-affected individuals with best scientific evidence-based approach of dentistry. Therefore, the current article has comprehensively reviewed the existing current literature regarding CF to describe its pathophysiology (etiology), clinical features, screening/diagnostic modalities, and management strategies along with its detailed orodental implications of CF and dental management aspects. Moreover, an overview/outline of dental care of CF patients in age-wise manner has been illustrated in this article. The relevant and recent scientific literature for the comprehensive review has been searched using the suitable keywords or its combinations/Boolean operators in different electronic databases (PubMed-Medline, Web of Science, Scopus, and Google Scholar) and, thus, included the topic-related articles published in English literature till 2022. Furthermore, the articles related to orodental implications and the dental management of the CF with the perspectives of pediatric dentistry was also searched and included for review.

The use of antioxidant medicine as an adjunctive therapy in late-onset schizophrenia spectrum disorders

BACKGROUND. Imbalance in the activity of neurotransmitter systems, mitochondrial impairment, and oxidative stress are potential neurobiological factors in the schizophrenia development.
 AIM. To test the hypothesis about the possibility of a subgroup selection from patients with late-onset schizophrenia spectrum disorders, for which the use of ethylmethylhydroxypyridine succinate as an adjunctive to antipsychotic therapy would be the most effective in relation to symptoms that are relatively more pronounced in patients of this subgroup.
 MATERIAL AND METHODS. 43 patients (women and men) aged 4578 years with late-onset (after 40 years) schizophrenia spectrum disorders were examined using clinical psychopathological, psychometric, biochemical and statistical research methods. Enzymatic activities of cytochrome C-oxidase, glutamate dehydrogenase, glutathione reductase and glutathione-S-transferase were assessed in blood cells twice (on a patient admission to the hospital and after a 28-day treatment course).
 RESULTS. Criteria for a patient assignment to the subgroup for ethylmethylhydroxypyridine succinate prescription were: more prominent side effects of pharmacotherapy, predominance of anxiety-hypochondriac symptoms and a lesser severity of psychosis. Before the treatment starting, the subgroup to which ethylmethylhydroxypyridine succinate was prescribed significantly differed in the activity of platelet glutamate dehydrogenase (p=0.031), glutathione-S-transferase (p=0.005), and erythrocyte glutathione reductase (p=0.045). As a result of the treatment course, the severity of symptoms by which the patients receiving ethylmethylhydroxypyridine succinate significantly differed before the starting the treatment, became undistinguished from those in the rest examined patients. After the treatment course, no significant differences in enzymatic activities were found in patients treated with ethylmethylhydroxypyridine succinate from those in other patients.
 CONCLUSION. This study confirmed the clinical validity of using a medicine with antioxidant properties as an adjunctive therapy to the main treatment in the selected subgroup of patients.

Changes in the Polysomnographic Measures in Patients of Chronic Insomnia on Drug Therapy Vs Mindful Awareness

Background:- Modern day 24*7 lifestyle is witnessing an increase in people with insomnia like neverbefore. The deep and restoring sleep like a baby seems to have vanished from our hectic lifestyles ,andsleep disorders like insomnia have crept in involving people across all ages and sections of society. In thegiven scenario it remains a matter of concern that most primary physicians are not trained in the variousmodalities which could be used for the treatment of insomnia. In the absence of required knowledge ininsomnia management hypnotic medication remain the preferred treatment for insomnia . The present studywas undertaken with a view to study the effectiveness of mindfulness based relaxation therapy vs hypnoticmedication for the treatment of insomnia.Methods :- A cross sectional study was conducted on 100 patients suffering from insomnia in two groups,pharmacotherapy (PCT) group and Mindfulness based stress reduction (MBSR) group. MBSR a programof mindfulness meditation training consisting of one hour long class daily which includes training inprogressive muscular exercises, breathing exercises, standing, sitting and walking meditations. Homepractice expectations were 30 minutes of medication per day and following an attitude of mindfulnessthrough out the day during the four week follow.Result :- The study showed comparable results on all sleep parameters for both groups. There was asignificant increase in total sleep time in both groups, the increase was more with drug group compare tothe MBSR group.Conclusion :- While the time commitment associated with participating in and practicing a behavioralintervention such as MBSR is more than with medication, our results suggest that this is not a deterrent tomost of our participants. Given patient preferences, the side effects of pharmacotherapy, evidence of theefficacy of MBSR and the potential positive benefits of meditation that go beyond management of insomniasymptoms.

Microemulsion-Based Media in Nose-to-Brain Drug Delivery.

Nose-to-brain drug delivery has recently attracted enormous attention as an alternative to other delivery routes, including the most popular oral one. Due to the unique anatomical features of the nasal cavity, drugs administered intranasally can be delivered directly to the central nervous system. The most important advantage of this approach is the ability to avoid the blood–brain barrier surrounding the brain and blocking the entry of exogenous substances to the central nervous system. Moreover, selective brain targeting could possibly avoid peripheral side effects of pharmacotherapy. The challenges associated with nose-to-brain drug delivery are mostly due to the small volume of the nasal cavity and insufficient drug absorption from nasal mucosa. These issues could be minimized by using a properly designed drug carrier. Microemulsions as potential drug delivery systems offer good solubilizing properties and the ability to enhance drug permeation through biological membranes. The aim of this review is to summarize the current status of the research focused on microemulsion-based systems for nose-to-brain delivery with special attention to the most extensively investigated neurological and psychiatric conditions, such as neurodegenerative diseases, epilepsy, and schizophrenia.

Smoking cessation knowledge, attitude and practices among tuberculosis physicians: A qualitative study.

INTRODUCTIONSmoking cessation interventions within tuberculosis (TB) care are feasible, effective and efficient for increasing smoking cessation rates. We aimed to assess TB physicians’ smoking cessation knowledge, attitude, and practices (KAP).METHODSWe conducted a qualitative study with 21 TB physicians and utilized directed deductive content analysis with predefined knowledge, attitude, and practice categories. Physicians’ practice was analyzed using the ABC approach (Ask, Brief advice, and Cessation support).RESULTSPhysicians acknowledged the importance of quitting for improved treatment outcomes and decreased risk of TB relapse. Physicians revealed presumed drug interactions, possible side effects of pharmacotherapy, and reluctance to take additional medications as challenges of smoking cessation interventions. Physicians asked about smoking behavior and provided a brief quitting advice to TB patients; however, implementation of cessation support was limited due to poor knowledge of evidence-based cessation methods and the absence of formal tobacco dependence treatment algorithms within TB care.CONCLUSIONSTB physicians’ KAP on smoking cessation was limited. Interventions targeting physicians’ knowledge and skills, and formalization of tobacco dependence treatment within TB care, are core for improving their smoking cessation practices in Armenia.

ASSESSMENT OF KNOWLEDGE, COMFORT LEVEL, AND CLINICAL PRACTICES OF MEDICINE RESIDENTS REGARDING THE TOPIC OF SMOKING CESSATION AND HARM REDUCTION: ARE WE TRAINING OUR RESIDENTS WELL ENOUGH?

SESSION TITLE: Tobacco Cessation and Prevention Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Our study aimed to assess and compare the knowledge of Internal medicine (IM) and Family medicine (FM) residents regarding smoking cessation counseling, prescribing pharmacological drugs, and familiarity with the concept of harm reduction. METHODS: This study is a cross-sectional study conducted at large community hospital. All current IM residents from Postgraduate Year-1 (PGY-1) to Postgraduate Year-4 (PGY-4) and FM residents from Postgraduate Year-1 (PGY-1) to Postgraduate Year-3 (PGY-3) were included. A 20-question data collection form was developed. The questionnaire was created using the ©SurveyPlanet tool and was sent to all participants via email. RESULTS: Out of 79 participants (57 IM and 22 FM), only 44 participants (55.6%) ( 10 in FM and 34 in IM) completed the questionnaire. Residents demonstrated below-average understanding (18%) of the basic concepts of the 5-A model, stages of behavior change, and evidence-based guidelines regarding adequate time spent and the resulting outcome. Assessment of pharmacotherapy side effects showed that residents are least aware of Varenicline (25%, n=11) side effects, compared to Nicotine (61%, n=27) and bupropion (84%, n=37). Only 13.6% (n=6) are aware of evidence-based practice for using pharmacotherapy in patients with coronary artery disease (CAD). 86% of the residents spend 1-5 minutes on smoking cessation, and 63 % recognized the lack of time as the most significant barrier to counseling. 50% of residents blamed a lack of awareness of available resources as the biggest hurdle to quitting smoking, and despite this, only 45% has ever used a QUIT SMOKING helpline. FM residents seem to be more familiar with QUIT SMOKING helplines (70% vs 38%) and harm reduction models (81% vs 72%) compared to IM. Cutting down was the most common harm reduction model amongst both groups (68%). CONCLUSIONS: Our study clearly demonstrated that both IM and FM residents need more education and formal training about clinical practice guidelines regarding smoking cessation. It can be achieved by arranging educational lectures and placing the summarized guidelines on the hospital’s clinical decision support page. It is crucial to make the discussion about smoking cessation a routine part of the resident’s assessment and encourage them to formulate a plan to address the issue. CLINICAL IMPLICATIONS: Residents are one of the most critical parts of the healthcare team. Their knowledge, approach, and attitude towards actively smoking patients can make a huge difference in helping patients quit or reduce smoking. Focused resident education in this regard will improve their knowledge and understanding of the subject, which in turn can help us achieve a higher smoking cessation rate. DISCLOSURES: No relevant relationships by Ahmad Arslan, source=Web Response No relevant relationships by Bilal Lashari, source=Web Response No relevant relationships by nayab Nadeem, source=Web Response No relevant relationships by Ahmad Raza, source=Web Response No relevant relationships by Umer Shoukat, source=Web Response

Important players in carcinogenesis as potential targets in cancer therapy: an update.

The development of cancer is a problem that has accompanied mankind for years. The growing number of cases, emerging drug resistance, and the need to reduce the serious side effects of pharmacotherapy are forcing scientists to better understand the complex mechanisms responsible for the initiation, promotion, and progression of the disease. This paper discusses the modulation of the particular stages of carcinogenesis by selected physiological factors, including: acetylcholine (ACh), peroxisome proliferator-activated receptors (PPAR), fatty acid-binding proteins (FABPs), Bruton’s tyrosine kinase (Btk), aquaporins (AQPs), insulin-like growth factor-2 (IGF-2), and exosomes. Understanding their role may contribute to the development of more effective and safer therapies based on new binding sites.

Anti-tuberculosis activity in the presence of drug resistance as a rationale for prospect use of thiosonide

Objective. To provide in vitro and in vivo experimental evaluation of the efficacy and tolerability of treatment for multidrugresistant tuberculosis (MDR-TB) with an innovative drug thiosonide. Material and Methods. The study was performed using M. tuberculosis cultures sensitive to therapy and resistant to isoniazid and rifampicin. A series of experiments using C57Bl/6 mice infected with M. tuberculosis resistant to polychemotherapy (PCT) was performed. The efficacy of treatment of experimental drug-resistant tuberculosis using standard mono- and polychemotherapy regimens with and without drug thiosonide was evaluated. Results. The study demonstrated in vitro anti-tuberculosis activity of thiosonide including the activity against M. tuberculosis strains resistant to isoniazid and rifampicin. The ability of thiosonide to increase the survival rate of mice infected with MDRTB compared with survival in the presence of traditional chemotherapy was shown. The calculated index of the effectiveness of therapy with the use of anti-tuberculosis drug thiosonide revealed its ability to improve the treatment of experimental MDR-TB. An increase in the mass of experimental animals was observed in the case of therapy with thiosonide, which indicates good drug tolerability. Conclusions. Thiosonide, added to the experimental MDR-TB polychemotherapy regimen, increased the treatment efficiency while reducing the number and severity of side effects of pharmacotherapy. This fact makes it possible to consider thiosonide as a promising drug for MDR-TB treatment.

Ranking Self-reported Gastrointestinal Side Effects of Pharmacotherapy in Sarcoidosis

BackgroundClinical manifestations of sarcoidosis vary widely, depending on the intensity of the inflammation and the organ systems affected. So far, no curative treatment exists; the disease can only be suppressed. All treatment options cause side effects affecting quality of life. The aim of this study was to establish and rank the prevalence of self-reported gastrointestinal side effects of drugs used in the treatment of sarcoidosis.MethodsA cross-sectional web-based anonymous survey about complaints and side effects was conducted among sarcoidosis patients in the Netherlands, United Kingdom, and United States of America.ResultsOf the participants, 70% were being treated with one or more drugs. The most important reported side effect was weight gain, associated with increased appetite among prednisone users (as monotherapy as well as in combination with other drugs). Methotrexate (MTX) users especially experienced nausea, with monotherapy as well as combination therapy. Vomiting and weight loss were most prominent among azathioprine and mycophenolate mofetil (MMF) users, whereas diarrhoea was frequently mentioned by MMF and MTX users. The reported side effects of hydroxychloroquine were generally rather mild.ConclusionThe current study ranked the gastrointestinal side effects associated with pharmacotherapy in sarcoidosis patients. Pharmacotherapy does have multiple gastrointestinal side effects. The strongest association between a reported side effect and drug use was that of weight gain associated with increased appetite among prednisone users. It would therefore be useful for future research to look further into dietary interventions to counter these side effects and reduce their burden.

Citrus limon (L.) Burm f. Essential Oil Has Anxiolytic and Sedative Properties by Modulating GABAA-Receptors

The high prevalence of anxiety disorders associated with pharmacotherapy side effects have motivated the search for new pharmacological agents. Species from Citrus genus, such as Citrus limon (sicilian lemon), have been used in folk medicine as a potential therapy to minimize emotional disorders. In order to searching for new effective treatments with fewer side effects, the present study evaluated the anxiolytic mechanism of action and the hypnotic-sedative activity from the Citrus limon fruit's peels essential oil (CLEO). Adults male Swiss mice were submitted to barbiturate-induced sleep test; elevated plus-maze (EPM) and light-dark box (LDB) (evaluation of the mechanism of action); rotarod; and catalepsy tests. CLEO oral treatment decreased latency and increased the sleep total time; moreover it induced in animals an increased the number of entries and percentage of time spent into open arms of the EPM; an increased the number of transitions and the percentage of time into light compartment in the LDB; which were only antagonized by flumazenil pretreatment, with no injury at motor function. Thus, results suggest that CLEO treatment induced an anxiolytic behavior suggestively modulated by the benzodiazepine binding site of the GABAA receptor or by an increase of GABAergic neurotransmission, without cause impairment in the motor coordination.

Polymorphic variants of xenobiotic metabolism genes and body mass index in schizophrenia patients receiving antipsychotic therapy

The use of atypical antipsychotic drugs has made metabolic disorders one of the most common side effect of pharmacotherapy for schizophrenic patients. The aim of this study was to assess the contribution of polymorphic variants of genes of the P450 cytochrome system to changes in body mass index in patients with schizophrenia. As a result of the study, we did not identify significant associations of genotypes and alleles of the studied polymorphic variants of the CYP2D6, CYP1A2, CYP2C19 genes with weight gain in patients with schizophrenia of Russian nationality of the Siberian region receiving antipsychotic therapy and can revealed neither protective nor predisposing effects. Metabolic syndrome and, increase in body weight especially, are complex side effect, and further studies is needed to increase successful exploration and identification of the genetic component and assess contribution.

Safety profile of pharmacotherapy in paitionts with non-alcogolic fatty liver disease

NAFLD is a leader among chronic liver diseases worldwide. Polymorbidity of such patients requires the appointment of different groups of drugs. The quality of pharmacological correction, which is determined in achieving the desired therapeutic effect and the absence of adverse reactions of the therapy, depends on the functional state of the liver. In diseases of the liver clearance of drugs is reduced, and the period of their half-life increases. Thus, drugs with high hepatic extraction may increase the risk of overdose. In this connection, prior to therapy, laboratory and instrumental control of liver function is necessary to reduce the risk of its drug damage, side effects of pharmacotherapy and prevention of complications.

Neuromodulation for Pain Management.

Pain is a salient and complex sensory experience with important affective and cognitive dimensions. The current definition of pain relies on subjective reports in both humans and experimental animals. Such definition lacks basic mechanistic insights and can lead to a high degree of variability. Research on biomarkers for pain has previously focused on genetic analysis. However, recent advances in human neuroimaging and research in animal models have begun to show the promise of a circuit-based neural signature for pain. At the treatment level, pharmacological therapy for pain remains limited. Neuromodulation has emerged as a specific form of treatment without the systemic side effects of pharmacotherapies. In this review, we will discuss some of the current neuromodulatory modalities for pain, research on newer targets, as well as emerging possibility for an integrated brain-computer interface approach for pain management.

Effectiveness of Transcranial Direct Current Stimulation on Worry, Anxiety, and Depression in Generalized Anxiety Disorder: A Randomized, Single-Blind Pharmacotherapy and Sham-Controlled Clinical Trial

Background: Due to low adherence to treatment and side effects of pharmacotherapy, using new brain stimulation, such as transcranial direct current stimulation (tDCS) in patients with anxiety disorders are available. Objectives: The present research was performed to evaluate the efficacy of tDCS and compare it with pharmacotherapy on reduction of worry, depression, and anxiety in a group of Iranian patients with generalized anxiety disorder (GAD). Methods: This study was a quasi-experimental research. A total of 18 patients (46% females and 64% males) with GAD were randomly assigned either to tDCS, pharmacotherapy or sham conditions. Stimulation was delivered over the contralateral deltoid at 2 m/A during 20 minutes in 10 sessions of 4 weeks. Symptoms were assessed by a 7-item GAD scale, HARS, HDRS, and PSWQ in pre-test, post-test and follow up assessment (2 months later). Analysis of variance with repeated measure was used to analyze the data. Results: The results showed that both tDCS and pharmacotherapy were effective in reducing worry symptoms, also the pharmacotherapy group compared with the tDCS group and sham condition was more effective in treating of worry. Anxiety symptoms were reduced by both tDCS and pharmacotherapy and the difference between the 2 methods was not significant. Finally, the effectiveness of tDCS therapy on reducing depressive symptoms was more significant than pharmacotherapy. Conclusions: The tDCS is a promising treatment for generalized anxiety disorder, especially in depressive and worry symptoms.

Remote Ischemic Conditioning: A Novel Non-Invasive Approach to Prevent Post-Stroke Depression.

Post-stroke depression (PSD) is a common neuropsychiatric complication of stroke. However, due to the high expense and side effects of pharmacotherapy and the difficult-to-achieve of psychotherapy, the prevention and treatment of PSD are still far from satisfaction. Inflammation hypothesis is now playing an essential role in the pathophysiological mechanism of PSD, and it may be a new preventive and therapeutic target. Remote ischemic conditioning (RIC) is a non-invasive and easy-to-use physical strategy, which has been used to protect brain (including ischemic and hemorrhagic stroke), heart and many other organs in clinical trials. The underlying mechanisms of RIC include anti-inflammation, anti-oxidative stress, immune system regulation and other potential pathways. Our hypothesis is that RIC is a novel approach to prevent PSD. The important implications of this hypothesis are that: (1) RIC could be widely used in clinical practice to prevent PSD if our hypothesis were verified; and (2) RIC would be thoroughly explored to test its effects on other neurobehavioral disorders (e.g., cognitive impairment).

Lecture of the specialization cycle on reflexology "Using Reflexotherapy in Gynecology"

Improvements direction loop "Specialization reflex" lectures on "The use of acupuncture in gynecology" would help solve at least two problems: the decline of pharmacological burden on patients and thus minimizing possible complications and side effects of pharmacotherapy. On the other hand, the structure used in acupuncture treatment measures will undoubtedly increase the effectiveness of treatment of a wide range of pathological conditions in obstetrics and gynecology. Among the diseases in which treatment RT should take its rightful place, you can specify such as miscarriage, vomiting in pregnancy, preeclampsia, menstrual irregularities, algomenorrhea, endometriosis, premenstrual syndrome, pelvic pain, menopausal syndrome.

Lecture of the cycle of specialization in reflexology "Using reflexotherapy for craniocerebral trauma"

Improvement of the course on the topic "Reflexotherapy Specialization" of the lecture material on the topic "Use of reflexotherapy for craniocerebral traumas" would help to solve the problem of reducing the pharmacological burden on patients and, consequently, minimizing possible complications and side effects of pharmacotherapy. The theory and practice of reflexology is accelerated by a physician-clinician, which contributes to the problematic teaching methodology, which is based on the formation of problems in clinical situations, which greatly increases the activity of the students, targets them for practical activity, improves the mastering of the theoretical program. During lectures on the specialty cycle of reflexology, such problem situations are widely used, when the teacher creates a certain contradiction of real facts on the basis of generalized medical knowledge, creates a problematic situation and solves it together with the listeners.

Lecture of the cycle of specialization in reflexology «Using reflexotherapy as a part of integrated therapeutic measures in cosmetology»

Improvement of the course on the topic "Specialization on reflexology" of the lecture material on the theme "Use of reflexotherapy as part of complex therapeutic measures in cosmetology" has helped to reduce the pharmacological burden on patients and minimize the possibility of development of complications and side effects of pharmacotherapy. On the other hand, application in the structure of therapeutic measures of acupuncture will undoubtedly increase the effectiveness of therapy of a fairly wide range of pathological conditions in dermatology.

Adjuvant antioxidant therapy in varicocele infertility

Infertility affects an estimated 15% of couples globally. Male factor infertility accounts for about a half of infertility cases. About 40% of infertile men have varicocele. The aim of this study was to investigate the efficacy and safety of a complex of acetyl-L-carnitine, L-carnitine fumarate and alpha-lipoic acid (SpermActin-forte) (SA) for adjuvant antioxidant therapy after microsurgical varicocelectomy (MVE) in men with varicocele and assess its impact on the level of DNA fragmentation in sperm cells. This is an open, prospective, randomized trial comprising 114 men aged 25-45 (mean 34.1+/-12.1) years who underwent MVE. The patients were allocated to receive either adjuvant SA (n=38), SA in combination with a vitamin complex (VC) (n=38) or no adjuvant therapy (n=38). The efficacy was assessed at 3 months by testing standard semen parameters and the level of sperm DNA fragmentation. MVE led to a 21.7% increase in the progressive sperm motility compared to the baseline level. In patients receiving SA, this was by 76.7% due to active sperm motility (category A) at 3 months. MVE with concurrent supplementation of SA resulted in a 22.3% decrease in the level of sperm DNA fragmentation at 3 months. When used in the postoperative period after MVE, SA and VC resulted in a 27% increase in the sperm concentration at 3 months. There were no side effects of pharmacotherapy. The statistical significance of the change in variables was calculated using the Wilcoxon test. Critical level =0.05 was established for all criteria. Using nutraceuticals (SA) after MVE is an effective and safe adjuvant antioxidant therapy of male infertility in patients with varicocele which leads to an improvement in the basic sperm parameters (sperm concentration and motility) and a decrease in the level of sperm DNA fragmentation in the short term. Adjuvant antioxidant therapy of varicocele infertility potentiates the effects of monotherapy (both medical and surgical), leads to an increase in its effectiveness and shortens the time to pregnancy. Further studies in this field are needed to assess long-term outcomes of the treatment.

Is Mania the Hypertension of the Mood? Discussion of A Hypothesis.

: Beyond both being biphasic/bidirectional disorders (hypo)mania and essential hypertension share a surprising number of similarities and an overlap between their genetics, biological background, underlying personality and temperamental factors, precipitating factors, comorbidity and response to treatment, indicating a possibly partially shared biological background. Based on theoretical knowledge, similarities related to characteristics, manifestation and course, and the results of pharmacological studies related to the effects and side effects of pharmacotherapies used in the treatment of these two distinct disorders, the authors outline a hypothesis discussing the similar origins of these two phenomena and thus mania being the hypertension of mood in memory of Athanasios Koukopoulos, one of the greatest researchers and theoreticists of mania of all time.