Does Hypertensive Patients are More Susceptible to the Risk of Drug-Drug Interactions?

Drug-Drug Interactions (DDIs) are the main problem among patients treated with multidrug therapy. Cardiovascular Diseases (CVD) consider the main cause of all morbidities and mortalities in universal. The major cause of CVDs death is hypertension. Clinical trials have reported that the treatment of hypertension minimizes CVD cases and all reason of mortality. Hypertensive patients are especially suspectable to DDIs due to their age, polypharmacy, comorbid conditions, long hospital stay and the presence of a drug therapy for other comorbid conditions that arise as a complication of long‑term hypertension. This article reviews different case studies evaluating DDIs in hypertensive elderly patients with polypharmacy. The most generally prescribed drug group that observed mostly in all case studies are: antihypertensives, Non-Steroidal Anti-Inflammatory Drug (NSAIDs), antidiabetics, antibiotics, antihistaminic, cardiac glycosides, calcium supplements, antimicrobial, Central Nervous System (CNS) depressant, thiazide diuretics, Lipid lowering drug, antigout, anticoagulants, analgesics, antibacterial and antianxiety. DDIs checker tool used in different case studies are REAX-Micromedex, Beers Criteria, Lexi-Interact software and Medscape checker software. The common interacting drug pairs among the antihypertensive drugs were atenolol-amlodipine, furosemide-telmisartan, furosemide-enalapril, furosemide-atenolol and metoprolol-amlodipine. Both pharmacokinetics and pharmacodynamics type of DDIs were found in most cases but with different rates. The severity of DDIs was mainly significant and moderate. The prevalence of DDIs was differ from case to case depend on drug pair used and clinical disorder in each case. The majority of DDIs can be addressed through the dosage adjustment and lab monitoring of patient. This is particularly significant in the case of accompanying medication with various groups of antihypertensive drugs.

Antioxidant Properties of Plant Extracts

There is a continued interest to screen plant extracts for their antioxidant properties, in light of the fact that antioxidant activities parallel anticancer activities, amongst their ability to combat other diseases. Cancer is one of the diseases that has a high mortality status in developed countries and is on the rise in developing countries. Plant extracts have been tested for their antimicrobial, anticancer, Antidiabetic, insect repellant and a range of other biological activities. Since 1990s, antioxidant research has expanded significantly, due to its potential benefits in disease prevention and health promotion. Guyana, a country located on the mainland of South America and whose rich diverse flora needs continual screening for plants with a range of pharmaceutical and medicinal activities of which, antioxidant is one. In addition, the isolation of known and unknown natural antioxidants may contribute to novel drug discovery. This article is a mini review of plants/plant extracts that have exhibited antioxidant properties.

Complexation and Interaction Study of Antibiotic Cifixime with Essential Metals by Spectrophotometric Method

This research work designates of interaction and complexation studies of Cefixime with essential metal. Cefixime involved the third generation drug of penicillin. In vitro analysis, Cefixime must be interacted with metal like Mg2+ and Mn2+. At pH 7.4, this study was done in different ratios of cefixime with metal and antacid both at room temperature 25°C. By this study, it is investigated that drug Cefixime is complexed with metal as well as antacid which is confirmed by jobs plot. This experiment was carried out by using ultra violet spectrophotometer. The microbial sensitivity test is important to know whether there is any change in the effectivity of Cefixime after the interaction with metals. There was a remarkable change in the effectivity of Cefixime and its complexes. This research work confirms that there was interaction between Cefixime with Metals like Mg2+ and Mn2+ which was confirmed by Jobs plot method by spectrophotometric assay.

Appropriate Use of Doxycycline for Skin and Soft Tissue Infection after Foot and Ankle Surgery: A Brief Review and Case Presentation

This paper aims to provide a concise review of doxycycline, including a case report that provides an exemplar of a short-term application of this drug to a patient who developed skin and soft tissue infection of the lower extremity after elective surgery. Doxycycline appears to be benign but research suggests that it does have notable side effects and contraindications. A short duration of treatment is recommended after the risks and benefits of Doxycycline are carefully considered, and after the therapeutic guidelines provided by CDC, IDSA and WHO are reviewed. Studies have shown that Doxycycline is effective; however, it is not appropriate for every patient and increased reports of overuse have become a serious problem. Doxycycline should be used on organisms that are sensitive or suspected to be sensitive to it. Synthesis of the literature also suggests that dose and duration needs to be careful examined. When used in outpatient therapy, use of Doxycycline prevents extended hospital stays, thus potentially reducing hospital-acquired infections and reduced costs for the hospital and the patient. Although it does have a broad antimicrobial coverage, patients should be transitioned to a narrow therapy following the discovery of sensitivity results.

Stress Degradation Studies on Bimatoprost and Development of Validated Stability Indicating Densitometric RP-TLC and HPLC Methods

Simple, sensitive and accurate stability-indicating densitometric RP-TLC and RP HPLC-UV methods were developed and validated for analysis of Bimatoprost (BMT). Stress stability studies were performed using hydrolytic (acid & alkai) and oxidative degradation products and conformed using LC-MS. Structure elucidation and pathway of degradation were presented. Both methods were based on reversed phase thin-layer and liquid chromatographic separation of BMT from hydrolytic and oxidative degradation products. Acetonitrile, water and 33% ammonia (4:5:1, by volume) and acetonitrile –water (40:60, v/v) at 30◦C were used as mobile phases for separation of BMT from degradation products using RP TLC and HPLC methods respectively. Quantification was achieved at 220 nm for both methods. The linear ranges were 0.5-6.0 μg/band and 5 – 100 μg /mL with mean recoveries ± RSD%, of 98.72 ± 0. 31% and 99.25 ± 0.59% for the two methods respectively. The specificity of HPLC method was further assured by peak purity. The proposed methods are rapid with retention time less than 6 min. The methods met ICH regulatory requirements. The two methods were successfully applied for the quantification of BMT in drug substance and ophthalmic solution with acceptable accuracy and precisions; the label claim percentages were 93.145 ± 0.89 and 95.35 + 0.65 for densitometric RP-TLC and RP HPLC-UV methods respectively. The research work has a great value for quality control and stability studies of BMT.

Features of Clinical Use of Albumin. Problems and Ways of Decision Solutions

The advantages of albumin over less costly alternative fluids continue to be debated. Many scientific articles were devoted to the clinical analysis of the use of albumin in acute illness as well as its comparison with other fluid regimens. However, the lack of fundamental knowledge about the physical and chemical properties of commercial albumin generates many unpromising discussions about the effectiveness of the use of albumin among practitioners and medical scientists. The manuscript provides information about the different variants of commercial albumin, the mechanisms of their action, indications and contraindications to use. The main purpose of this article is to objectively show the failure of generalizing conclusions and recommendations on the clinical use of commercial albumin, taking into account its various physical and chemical characteristics. To date, all studies should be conducted either in the form of a comparative analysis of a specific clinical effect, or within the framework of studies of only one brand of albumin. Otherwise, generalizing the conclusions, the recommendations on the use of different forms of albumin are not correct and generate a lot of useless of the discussions. The presented information is based on fundamental knowledge of physical and chemical properties of commercial albumin. This manuscript is not only educational information, but also is scientific guide for clinicians.