Therapeutic Action Research Articles

Flatform Konseling Virtual ; Wujud Trasformasi Edukasi Terapeutik di Fasilitas Pelayanan Kesehatan

Virtual counseling platforms provide the ability to maintain connectivity between healthcare providers and their patients. Patients can quickly receive diagnoses, enabling faster and more accurate responses to any changes in their health. This article explains the implementation and therapeutic education phases in healthcare facilities, particularly hospitals and community health centers, using virtual counseling platforms in telemedicine programs through a literature review and a descriptive approach. The policy for the therapeutic education process in virtual counseling platforms in healthcare facilities is divided into eight stages: assessing educational needs, medical record-keeping, disease diagnosis, medical equipment safety, pain management, diet and nutrition, rehabilitation techniques, and verification of understanding received. There are five therapeutic education topics: patient-oriented, disease-oriented, patient safety-oriented, rehabilitation material, and prevention material. In the virtual counseling platform, healthcare providers implement seventeen implementation actions in the therapeutic education process based on the educational phases. First, in the Pre-Interaction Phase, the implementation actions include self-evaluation, setting the stages of virtual counseling therapeutic education, and creating a written plan according to established SOPs. Second, in the Orientation Phase, implementation actions include introducing oneself, scheduling meetings (contracting), building rapport and trust, initiating a conversation, and closing the introduction session. Third, in the Working Phase, implementation actions involve increasing the patients' understanding and awareness of themselves, developing independence competencies, therapeutic actions, conducting health education, collaboration, delegation, and observation. Fourth, in the Termination Phase, implementation actions include making temporary terminations, final terminations with evaluation of actions, and contracting for follow-up care and treatment outcomes.

Acupoint catgut embedding attenuates oxidative stress and cognitive impairment in chronic cerebral ischemia by inhibiting the Ang II/AT1R/NOX axis.

Chronic cerebral ischemia (CCI) is a common neurological disorder, characterized by progressive cognitive impairment. Acupoint catgut embedding (ACE) represents a modern acupuncture form that has shown neuroprotective effects; nevertheless, its effects on CCI and the mechanisms remain largely unknown. Here, we aimed to explore the therapeutic action of ACE in CCI-induced cognitive impairment and its mechanisms. The cognitive function of CCI rats was determined using Morris water maze test, and histopathological changes in the brain were assessed through hematoxylin-eosin (HE) staining. To further explore the molecular mechanisms, the expression levels of oxidative stress markers and the Ang II/AT1R/NOX axis-associated molecules in the hippocampus were evaluated using enzyme-linked immunosorbent assay (ELISA), western blotting, and immunohistochemistry. Here, we observed that ACE treatment alleviated cognitive dysfunction and histopathological injury in CCI rats. Intriguingly, candesartan (an AT1R blocker) enhanced the beneficial effects of ACE on ameliorating cognitive impairment in CCI rats. Mechanistically, ACE treatment blocked the Ang II/AT1R/NOX pathway and subsequently suppressed oxidative stress, thus mitigating cognitive impairment in CCI. Our findings first reveal that ACE treatment could suppress cognitive impairment in CCI, which might be partly due to the suppression of Ang II/AT1R/NOX axis.

A Network Pharmacology-based Approach to Explore Potential Targets and Mechanism of Berberis aristata Focusing on its Implications for Diabetes Mellitus

Berberis aristata, a revered medicinal shrub in traditional systems like Ayurveda, holds promise in managing diabetes mellitus, a burgeoning global health concern. Through a comprehensive analysis of its bioactive compounds and their interactions with potential targets, this study elucidates the molecular mechanisms underlying its anti-diabetic effects. Screening through databases yielded 17 bioactive compounds, including rutin, quercetin, and berberine. Protein-protein interaction analysis identified 44 potential targets, with 36 genes overlapping with disease-related genes, indicating pivotal pathways in diabetes mellitus treatment. Further, pathway analysis highlighted G-protein coupled receptor signaling, calcium signaling, and neurotransmitter receptor activity as significant, with adjusted p-values. Network analysis revealed key hub genes like DRD1 and MMP2, emphasizing their central role in Berberis aristata’s therapeutic action. The findings underscore Berberis aristata’s potential as a source of novel anti-diabetic agents and offer groundwork for potential research in this field.

Improved Anti-nociceptive, Anti-pyretic and Anti-inflammatory Effects of Orally Administered Liposome-encapsulated Piroxicam

Piroxicam, a nonsteroidal anti-inflammatory drug, has been shown with low oral bioavailability and delayed onset of its therapeutic effects. In this work, a promising nano/liposomal drug delivery system was exploited to improve the in vivo therapeutic efficacies of piroxicam. The current liposome-encapsulated piroxicam formulation effectively boosted and prolonged peripherally mediated anti-nociceptive activities in tests for abdominal writhing induced by acetic acid (inhibition of pain 70.19% was in mice treated with 30 mg/kg liposome-encapsulated piroxicam), paw licking induced by formalin (81.36% inhibition when compared to free unencapsulated piroxicam), and hyperalgesia induced by carrageenan (55.8% inhibition when compared to free unencapsulated piroxicam). Even lower dose of liposomes-encapsulated piroxicam was also significantly inhibit Brewer’s yeast-induced hyperthermia. Carrageenan-induced paw-edema test and cotton pellet-induced granuloma test revealed that liposomes-encapsulated piroxicam had significantly more potent acute and chronic anti-inflammatory effects than piroxicam, even if lower drug dosages were used to treat animals. A better modulation in the generation of inflammatory mediators (nitric oxide, tumour necrosis factor-α, interleukin-1β, and interleukin-10) at 18.02% (TNFa), 23.97% (IL-1β) and 10.27% (IL-10) inhibition when compared to 30mg/kg free piroxicam group respectively. was ascribed to the higher in vivo therapeutic actions. Present nano-encapsulated piroxicam also significantly enhanced the inhibition of cyclooxgenase-2 (total percentage inhibition was increased by 18.25% and 19.22% at drug dosage of 3 and 30 mg/kg, respectively), but not cyclooxgenase-1 enzyme. In conclusion, present study showed that liposomal drug formulation was able to improve the in vivo therapeutic effects of orally administered piroxicam.

Folate-Modified Curcumin-Loaded Nanoparticles for Overcoming Delivery Challenges in Cancer Treatment: A Narrative Review.

Curcumin, as an anti-tumor agent, is not widely used in cancer treatment due to the lack of effective levels of its metabolites in cancerous tissue. Addressing the barriers to the carrier and delivery of drugs to the specific sites of therapeutic action while reducing side effects is a priority. Folate receptor expression is high in malignant and low in normal cells. Folate as a targeted ligand could selectively target cancer cells. Thus, this narrative review aimed to provide an overview of the studies that have investigated the different types of folate-modified curcumin as a carrier and deliverer and their structural properties that enhance therapeutic drug efficacy. A literature search was performed using PubMed, Scopus, Web of Science, and Google Scholar databases. Thirty-eight preclinical studies addressing this topic were identified. The findings of the current review have shown that folate-modified nanoparticles containing curcumin as a promising therapeutic approach can be effective in improving different types of cancers. In vitro studies have shown a higher cellular uptake and cytotoxicity effect, higher cell inhibition, and anti-proliferation with a lower dosage of curcumin. In vivo studies have shown more tumor suppression and smaller tumor volume without toxicity after the administration of folate-modified nanoparticles containing curcumin. Future clinical trials are needed to confirm the beneficial effect of folate-modified curcumin as a new drug delivery platform for cancer treatment.

Effects of psilocybin on uncertain punishment learning

Psilocybin may provide a useful treatment for mood disorders including anxiety and depression but its mechanisms of action for these effects are not well understood. While recent preclinical work has begun to assess psilocybin’s role in affective behaviors through innate anxiety or fear conditioning, there is scant evidence for its role in conflict between reward and punishment. The current study was designed to determine the impact of psilocybin on the learning of reward-punishment conflict associations, as well as its effects after learning, in male and female rats. We utilized a chained schedule of reinforcement that involved execution of safe and risky reward-guided actions under uncertain punishment. Different patterns of behavioral suppression by psilocybin emerged during learning versus after learning of risky action-reward associations. Psilocybin increased behavioral suppression in female rats as punishment associations were learned. After learning, psilocybin decreased behavioral suppression in both sexes. Thus, psilocybin produces divergent effects on action suppression during approach-avoidance conflict depending on when the conflict is experienced. This observation may have implications for its therapeutic mechanism of action.

Sunitinib-mediated inhibition of STAT3 in skeletal muscle and spinal cord does not affect the disease in a mouse model of ALS

Variability in disease onset and progression is a hallmark of amyotrophic lateral sclerosis (ALS), both in sporadic and genetic forms. Recently, we found that SOD1-G93A transgenic mice expressing the same amount of mutant SOD1 but with different genetic backgrounds, C57BL/6JOlaHsd and 129S2/SvHsd, show slow and rapid muscle wasting and disease progression, respectively. Here, we investigated the different molecular mechanisms underlying muscle atrophy. Although both strains showed similar denervation-induced degradation of muscle proteins, only the rapidly progressing mice exhibited early and sustained STAT3 activation that preceded atrophy in gastrocnemius muscle. We therefore investigated the therapeutic potential of sunitinib, a tyrosine kinase inhibitor known to inhibit STAT3 and prevent cancer-induced muscle wasting. Although sunitinib treatment reduced STAT3 activation in the gastrocnemius muscle and lumbar spinal cord, it did not preserve spinal motor neurons, improve neuromuscular impairment, muscle atrophy and disease progression in the rapidly progressing SOD1-G93A mice. Thus, the effect of sunitinib is not equally positive in different diseases associated with muscle wasting. Moreover, given the complex role of STAT3 in the peripheral and central compartments of the neuromuscular system, the present study suggests that its broad inhibition may lead to opposing effects, ultimately preventing a potential positive therapeutic action in ALS.

From Perspective of Hippocampal Plasticity: Function of Antidepressant Chinese Medicine Xiaoyaosan.

The hippocampus is one of the most commonly studied brain regions in the context of depression. The volume of the hippocampus is significantly reduced in patients with depression, which severely disrupts hippocampal neuroplasticity. However, antidepressant therapies that target hippocampal neuroplasticity have not been identified as yet. Chinese medicine (CM) can slow the progression of depression, potentially by modulating hippocampal neuroplasticity. Xiaoyaosan (XYS) is a CM formula that has been clinically used for the treatment of depression. It is known to protect Gan (Liver) and Pi (Spleen) function, and may exert its antidepressant effects by regulating hippocampal neuroplasticity. In this review, we have summarized the association between depression and aberrant hippocampal neuroplasticity. Furthermore, we have discussed the researches published in the last 30 years on the effects of XYS on hippocampal neuroplasticity in order to elucidate the possible mechanisms underlying its therapeutic action against depression. The results of this review can aid future research on XYS for the treatment of depression.

The longevity-associated BPIFB4 gene guarantees vascular homeostasis and immune protection through platelets.

Beyond their activity in hemostasis and thrombosis, recent advances attribute platelets a pro-youthful role capable to attenuate immune senescence and age-related neuroinflammation. Previous studies from our group associated a polymorphic haplotype variant in the BPIFB4 gene (LAV-BPIFB4) with exceptional longevity. Transfer of the LAV-BPIFB4 in preclinical models has proved strategic to cope with frailty conditions, aging-related events, e.g., cardiovascular ones, and immune dysfunction mainly through a favorable conditioning of the immune system. However, whether platelets participate in LAV-BPIFB4 therapeutic action is currently unknown.Herein, we discovered that platelets were instrumental in boosting the favorable health outcomes of the systemic AAV-LAV-BPIFB4 gene transfer in vivo, as the α-CD42b platelet depletion completely abolished the vascular protective action of LAV-BPIFB4 and suppressed its pro-resolutive CD206 + anti-/CD86 + pro-inflammatory Ly6C + monocyte skewing to LPS stimulation. Of note, this is associated with a huge drop in the protective levels of BPIFB4 in the plasma of AAV-LAV-BPIFB4-injected C57BL/6 mice, indicating that plasma circulating platelets may be a reservoir of the BPIFB4 protein. Indeed, we noticed that BPIFB4 was released by human platelets, a process that is amplified in LAV-allele carrier donors. Accordingly, lentivirus-mediated overexpression of human LAV-BPIFB4 isoform, but not WT-BPIFB4 isoform was able in leading differentiated megakaryocytes to release more platelet-like-particles enriched for BPIFB4. In addition, in vitro, the M2 macrophage polarization increased when releasate from platelets, and even more from LAV pre-stimulated once, was added in monocyte cell culture. Our data suggest that platelet release of BPIFB4 and of yet-to-be-determined unidentified factors mediates the therapeutic efficacy of LAV-BPIFB4 treatment.

A Review of Darchini (Cinnamomum zeylanicum) in Unani Medicine with Therapeutic Benefits and other Pharmacological potential

Darchini (Cinnamomum zeylanicum) is a bark of a cinnamon plant that belongs to the Lauraceae family. Cinnamon is a rich tasting and aromatic spice used by different cultures worldwide. Recently, many phytochemicals were discovered and obtained from Darchini. Numerous experimental research using these phytochemical components have established several therapeutic actions. In addition, it possesses useful medicinal properties and is considered a remedy for indigestion, flatulency, depletion of innate heat, respiratory diseases, diabetes, cardiovascular diseases, and neurological disorders. A manual literature search of classical Unani manuscripts was carried out to acquire information on temperament (Mizaj), pharmacological activities and medicinal applications of Darchini. In addition, all accessible material on phytochemical, physiochemical and pharmacological studies have been collected using an extensive review of internet sources such PubMed, Google Scholar and Science Direct. The aim of this review article is to further highlight the discovered pharmacological effect and medicinal values of Cinnamomum zeylanicum as per the Unani literature as well as scientific research. Based on scientific studies regarding its phytochemical components, it is beneficial for various ailments. Darchini also has a beneficial effect on some gynaecological disorders such as amenorrhoea, dysmenorrhoea, leucorrhoea, menorrhagia, prolapse, and vaginosis. However, there is need to conduct experimental and clinical study to validate their effectiveness and safety in humans. Keywords: Cinnamomum zeylanicum, Darchini, Gynaecological disorders Phytochemicals, Unani system of medicine

Practical or Cultural: American Medical Perceptions of Acupuncture from the Boom of the 1820s to ‘Acupuncture Fever’ of the 1970s

In the United States today, acupuncture and Chinese medicine are so connected that the terms are almost interchangeable. Yet, when acupuncture first came to prominence in the American medical community in the 1820s, it was seen as a European innovation and associated with physicians in Paris and London. In contrast to the cultural models of therapeutic action so prevalent today, medical manuals and textbooks of the nineteenth century tended to classify acupuncture as a form of “practical medicine,” an empirically effective technique without a definitive theoretical basis. This paper traces a genealogy of the different ways in which acupuncture has historically been recognized in the United States. Particular attention is paid to the period of “acupuncture fever” in the 1970s, the appearance of acupuncture in American medical texts in the late nineteenth century, and the initial wave of discourse around acupuncture in the 1820s. This paper demonstrates an ongoing historical tension between framing acupuncture in terms of a complex system of cultural concepts and framing it as a simple and practical therapy whose efficacy is most clearly felt in the space of the clinical encounter.

Burst firing in Output-Defined Parallel Habenula Circuit Underlies the Antidepressant Effects of Bright Light Treatment.

Research highlights the significance of increased bursting in lateral habenula (LHb) neurons in depression and as a focal point for bright light treatment (BLT). However, the precise spike patterns of LHb neurons projecting to different brain regions during depression, their roles in depression development, and BLT's therapeutic action remain elusive. Here, LHb neurons are found projecting to the dorsal raphe nucleus (DRN), ventral tegmental area (VTA), and median raphe nucleus (MnR) exhibit increased bursting following aversive stimuli exposure, correlating with distinct depressive symptoms. Enhanced bursting in DRN-projecting LHb neurons is pivotal for anhedonia and anxiety, while concurrent bursting in LHb neurons projecting to the DRN, VTA, and MnR is essential for despair. Remarkably, reducing bursting in distinct LHb neuron subpopulations underlies the therapeutic effects of BLT on specific depressive behaviors. These findings provide valuable insights into the mechanisms of depression and the antidepressant action of BLT.

Therapeutic potential of Gudadyavaleha in the management of Bronchial Asthma: A review

Asthma is a chronic disease, characterized by reversible airway obstruction, airway inflammation and hyper-reactivity. No ideal preventive measure has yet been found. Gudadyavaleha is an Ayurvedic polyherbal formulation which is explained in the context of swasa (Dysponea) Prakaran in Vaidya Chintamani.This review was carried out to get thorough idea related to its composition, method of preparation, Properties of each ingredient in the preparation and its mode of action and therapeutic uses. Guda (Jaggery), Dadima phala twak (Punica granatum), Draksha (Vitis vinifera), Pippali (Piper longum Linn.), Sunthi (Zingiber officinale), Matulunga (Citrus medica), Madhu (Honey) are the ingredients of Gudadyavaleha. This review examines the potential role of Gudadyavaleha in asthma management, exploring its pharmacological properties, mechanisms of action, and existing evidence from both traditional knowledge and contemporary research and evidence supporting the anti-asthmatic potential. On the basis of the therapeutic actions of drugs in the formulation and present evidences it can be suggested that Gudayavaleha has therapeutic potential in the management of swas roga (bronchial asthma).

Studies on the mechanisms of action of MR33317

MR33317 was synthesized as an acetylcholinesterase-inhibitor and an agonist at brain 5-HT4-receptors. MR33317 might be used to treat Morbus Alzheimer. This therapeutic action of MR33317 might be based on MR33317´s dual synergistic activity. We tested the hypothesis that MR33317 also stimulates 5-HT4-receptors in the heart. MR33317 (starting at 10 nM) increased force of contraction and beating rate in isolated atrial preparations from mice with cardiac confined overexpression of the human 5-HT4-serotonin receptor (5-HT4-TG) but was inactive in wild type mouse hearts (WT). Only in the presence of the phosphodiesterase III-inhibitor cilostamide, MR33317 raised force of contraction under isometric conditions in isolated paced (1 Hz) human right atrial preparations (HAP). This increase in force of contraction in human atrium by MR33317 was attenuated by 10 µM tropisetron or GR125487. These data suggest that MR33317 is an agonist at human 5-HT4-serotonin receptors in the human atrium. Clinically, one would predict that MR33317 may lead to atrial fibrillation.

Pro-angiogenic Terbium Hydroxide Nanorods Improve Critical Limb Ischemia in Part by Amelioration of Ischemia-Induced Endothelial Injury.

Critical limb ischemia (CLI) refers to a severe condition resulting from gradual obstruction in the supply of blood, oxygen, and nutrients to the limbs. The most promising clinical solution to CLI is therapeutic angiogenesis. This study explored the potency of pro-angiogenic terbium hydroxide nanorods (THNR) for treatment of CLI, with a major focus on their impact on ischemia-induced maladaptive alterations in endothelial cells as well as on vascularization in ischemic limbs. This study demonstrated that, in hypoxia-exposed endothelial cells, THNR improve survival and promote proliferation, migration, restoration of nitric oxide production, and regulation of vascular permeability. Based on molecular studies, these attributes of THNR can be traced to the stimulation of PI3K/AKT/eNOS signaling pathways. Besides, Wnt/GSK-3β/β-catenin signaling pathways may also play a role in the therapeutic actions of THNR. Furthermore, in the murine model of CLI, THNR administration can integrally re-establish blood perfusion with concomitant reduction of muscle damage and inflammation. Additionally, improvement of locomotor activities and motor coordination in ischemic limbs in THNR treated mice is also evident. Overall, the study demonstrates that THNR have the potential to be developed as an efficacious and cost-effective alternative clinical therapy for CLI, using a nanomedicine approach.

Controversies in COVID-19 pandemic: the case of convalescent plasma

The SARS-CoV-2 pandemic has caused an unprecedented health and social crisis worldwide. In this paper we summarized the different therapeutic actions planned from the two sides of the Atlantic Ocean (USA and Europe) to fight the initial phase of COVID-19 pandemic, with an emphasis on passive immunotherapies such as convalescent plasma and anti-Spike monoclonal antibodies. The lessons derived from the critical analysis of that period could drive our treatment decisions for the next pandemics.

Effect of Marham-i-Bāsalīqūn on Cervical Erosion (Qurūḥ al-Raḥim)): A Randomized Comparative Clinical Study

Background and Objective: Cervical erosion (Qurūḥ al-Raḥim) is one of the most frequent gynecological conditions seen in clinical practice. Therefore, the objective of the current study was to assess the impact of the topical application of Marham-i-Bāsalīqūn in Qurūḥ al- Raḥim. Material and Method: A randomized comparative clinical study was carried out at the Institute Hospital in Bengaluru. Diagnosed cases (n=40) of cervical erosion were randomly assigned to test (n=20) and control (n=20) groups. A total of 6 g ointment of Marham-i-Bāsalīqūn (test drug) and tested Unani formulation (control drug) was applied with an applicator per vaginum over the eroded area of the cervix daily once at bedtime for 14 days. A single dose of the antibiotic regimen (azithromycin-1g and cefixime-400 mg) was administered orally in both groups. Subjective parameters like vaginal discharge, pruritus vulvae, low back ache, lower abdominal pain, and postcoital bleeding were assessed during the trial. The main outcome measure was an improvement in the cervical erosion grading score. The inference was executed with appropriate statistical analysis. Result: Improvement in the cervical erosion grading score was achieved in 50% and 40% of patients in the control and test groups, respectively, after 2 weeks of treatment with P<0.0001, which was considered highly significant. A highly significant improvement in subjective parameters was observed during the trial with P<0.0001. Conclusion: Considering the high prevalence of cervical erosion among women of reproductive age group, effective treatment and safe strategies are highly recommended. Marham-i-Bāsalīqūn is cost-effective and has several therapeutic actions that can help to promote the healing of erosion and relieve the associated symptoms. The clinical trial was registered at the Clinical Trial Registry of India (CTRI) with registration number CTRI/2022/02/040419.

Study protocol for "Psilocybin in patients with fibromyalgia: brain biomarkers of action".

Chronic pain is a leading cause of disability worldwide. Fibromyalgia is a particularly debilitating form of widespread chronic pain. Fibromyalgia remains poorly understood, and treatment options are limited or moderately effective at best. Here, we present a protocol for a mechanistic study investigating the effects of psychedelic-assisted-therapy in a fibromyalgia population. The principal focus of this trial is the central mechanism(s) of psilocybin-therapy i.e., in the brain and on associated mental schemata, primarily captured by electroencephalography (EEG) recordings of the acute psychedelic state, plus pre and post Magnetic Resonance Imaging (MRI). Twenty participants with fibromyalgia will complete 8 study visits over 8 weeks. This will include two dosing sessions where participants will receive psilocybin at least once, with doses varying up to 25mg. Our primary outcomes are 1) Lempel-Ziv complexity (LZc) recorded acutely using EEG, and the 2) the (Brief Experiential Avoidance Questionnaire (BEAQ) measured at baseline and primary endpoint. Secondary outcomes will aim to capture broad aspects of the pain experience and related features through neuroimaging, self-report measures, behavioural paradigms, and qualitative interviews. Pain Symptomatology will be measured using the Brief Pain Inventory Interference Subscale (BPI-IS), physical and mental health-related function will be measured using the 36-Item Short Form Health Survey (SF-36). Further neurobiological investigations will include functional MRI (fMRI) and diffusion tensor imaging (changes from baseline to primary endpoint), and acute changes in pre- vs post-acute spontaneous brain activity - plus event-related potential functional plasticity markers, captured via EEG. The results of this study will provide valuable insight into the brain mechanisms involved in the action of psilocybin-therapy for fibromyalgia with potential implications for the therapeutic action of psychedelic-therapy more broadly. It will also deliver essential data to inform the design of a potential subsequent RCT.

Adolescent Obesity and Type 2 Diabetes Mellitus: Synaptics and Heuristics

The adolescent population is the foundation for a Nation’s progress. Their shoulders therefore must be emboldened withhealth and dignity to ensure a developed Nation. However, the multitude of prevailing epidemics have left nostone unturnedto enfeeble their strength. Type 2 diabetes mellitus (T2DM) and obesity stand amongst the top shotguns. There is a dire needto execute preventive as well as therapeutic actions to contain the epidemic, for which one must be well versed with theattributable risk factors. In this article, we will understand the synaptics of adolescent obesity and T2DM and what strategiesare recommended by the health authorities to prevent and overcome this rising epidemic

Procedure for rapid determination of bile-tolerant gram-negative bacteria in drugs

The European Pharmacopoeia is a single reference study for the quality control of drugs. The official standards published within it provide a legal and scientific basis for quality control in the processes of drugs development, production and marketing. However, the long experience and the multitude of studies have demonstrated that medicinal forms represent unstable dispersed systems and can undergo various manifest or non-manifest changes, leading to drug incompatibilities. Along with the physico-chemical transformations, microbiological transformations can occur with the contamination of the final product with pathogenic, conditionally pathogenic or even saprophytic germs, especially medicines that do not undergo final sterilization or are not aseptically prepared. Microbial contamination of the drug can be an indicator of the production conditions; it can cause the instability of the product through the microbial decomposition of auxiliary substances, the alteration or definitive cancellation of the therapeutic effect of the active substances, the appearance of metabolites with toxic properties, especially those fractions of endotoxins on the wall cell of gram-negative bacteria with the development of allergenic, pyrogenic substances and the induction of the danger of local orgeneral infections. An important role is attributed to the group of bile-tolerant gram-negative bacteria as representatives of microorganisms that are inadmissible in one g/ml for the absence test and for the quantitative test <10 NCP/g/ml (probable number of bacteria), inadmissible in non-sterile medicinal products, herbal medicinal products for oral use and extracts used in their preparation. Due to the diversity of medicinal forms in terms of content, method of application, and therapeutic action, these preparations fulfil the indispensable conditions for the growth of microorganisms, therefore a primary concern is to avoid microbial contamination from the technological phase to the administration phase in order to prevent complications associated with bacterial infections. The given study reveals the testing of the procedure for the rapid determination of inadmissible microorganisms in non-sterile medicinal products and herbal drugs for oral use and the extracts used in their preparation, especially microorganisms of the group Enterobacteriaceae spp.