Principles of Pharmacology

2013 ◽  
Author(s):  
Graham Brack ◽  
Penny Franklin ◽  
Jill Caldwell
Keyword(s):  
Patient Safety ◽  
Adverse Effects ◽  
Renal Impairment ◽  
Drug Interactions ◽  
Point Of View ◽  
The Body ◽  
Detailed Knowledge ◽  
Inflammatory Drug ◽  
Anti Inflammatory ◽  
Compromised Patients

From the previous chapters you will see that understanding the pharmacological aspects of the drugs you are administering is vital to keeping your patients safe. Nurses need to understand the pharmacodynamics of a medicine, or how it actually works within the body, since this will need to be explained to patients and carers. For example, how will you ensure that a patient understands the importance of taking their treatment for hypertension (especially if they are experiencing no symptoms) if you are unable to explain how the medicine will be working? Similarly, your understanding of the pharmacokinetics (the absorption, distribution, metabolism, and excretion) of individual medicines is vital to ensure compromised patients are not administered inappropriate medicines. For example, you would question the prescribing of a non-steroidal anti-inflammatory drug (NSAID) to a patient with significant renal impairment, because the kidney is essential to the elimination of NSAIDs so the drug could accumulate if the kidneys are not functioning properly. From the point of view of ensuring patient safety, you will need to understand the principles of drug interactions so that you can understand how two medicines (or food and medicine) could interact and be alert to signs that this may be happening. There are several good textbooks dealing with the uses and actions of individual medicines, including interactions. However, these will not be discussed here because at this stage of your career you are not expected to have a detailed knowledge of particular medicines, but rather an understanding of the key principles. As nurses, we are concerned with how the body handles medicines (pharmacokinetics) so that we can see how this may be affected by age, genetics, or illness, and how the actions of medicines may conflict with one another or produce toxicity because their effects are additive. Equally, we need to look at occasions in which two medicines produce the same response by two different routes; such interactions can be beneficial to the patient and avoid having to give large doses of a single medicine because the same result can be achieved with smaller doses of two medicines, thereby reducing the risk of adverse effects.

Non-Steroidal Anti-Inflammatory Drugs: Usage and Co-prescription with Other Potentially Interacting Drugs in Elderly: a Cross-sectional Study

2019 ◽  
Author(s):  
Nuru Abdu ◽  
Samuel Teweldemedhin ◽  
Asmerom Mosazghi ◽  
Luwam Asfaha ◽  
Makda Teshale ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Protective Agents ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Introduction: Globally, non-steroidal anti-inflammatory drugs (NSAIDs) usage in the elderly with chronic pain has been reported as frequent. Though it is fundamental in maintaining their quality of life, the risk of polypharmacy, drug interactions and adverse effects is of paramount importance as the elderly usually require multiple medications for their co-morbidities. If prescriptions are not appropriately monitored and managed, they are likely to expose patients to serious drug interactions and potentially fatal adverse effects. Thus, the objective of the study was to assess the appropriateness of NSAIDs use and incidence of NSAIDs related potential interactions in elderly. Methods: A descriptive cross-sectional study was conducted among elderly out-patients (aged 60 and above) who visited three hospitals in Asmara between August 22 and September 29, 2018. The sampling design was two-stage random sampling and data was collected using a questionnaire, exit interview and by abstracting information from patients’ clinical cards. Descriptive and analytical statistics including chi-square test and logistic regression were employed using SPSS. Results: A total of 285 elderly respondents were enrolled in the study with similar male to female ratio. One in four of all respondents were chronic NSAIDs users, of which 74.6% were not prescribed prophylactic gastro-protective agents (GPAs). About 20% of the elderly were involved in polypharmacy and nearly all of the encountered potential NSAIDs related interactions (n=322) with prescribed drugs were moderate. Diabetes and hypertension were significantly associated with chronic NSAIDs use (OR=3, 95% CI: 1.54, 5.84; OR=9.99, 95% CI: 4.46, 22.38) and incidence of drug interactions (OR=3.95, 95%CI: 1.92, 8.13; OR=3.12, 95%CI: 1.81, 5.33) while diabetes and cardiac problem were significantly associated with incidence of polypharmacy (OR=4.33, 95% CI: 2.36, 7.96; OR=3.56, 95% CI: 1.05, 12.11). Conclusion: Though the overall reflection of prescription pattern of NSAIDs during the study period was almost satisfactory, gastro-protective agents were poorly prescribed as a prophylaxis.

scholarly journals Animal Models of Inflammation for Screening of Anti-inflammatory Drugs: Implications for the Discovery and Development of Phytopharmaceuticals

2019 ◽  
Vol 20 (18) ◽  
pp. 4367 ◽  
Author(s):  
Kalpesh R. Patil ◽  
Umesh B. Mahajan ◽  
Banappa S. Unger ◽  
Sameer N. Goyal ◽  
Sateesh Belemkar ◽  
...  
Keyword(s):  
Animal Models ◽  
Adverse Effects ◽  
Drug Development ◽  
Drug Screening ◽  
Current Therapy ◽  
Natural Sources ◽  
Inflammatory Drug ◽  
Screening Programs ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Inflammation is one of the common events in the majority of acute as well as chronic debilitating diseases and represent a chief cause of morbidity in today’s era of modern lifestyle. If unchecked, inflammation leads to development of rheumatoid arthritis, diabetes, cancer, Alzheimer’s disease, and atherosclerosis along with pulmonary, autoimmune and cardiovascular diseases. Inflammation involves a complex network of many mediators, a variety of cells, and execution of multiple pathways. Current therapy for inflammatory diseases is limited to the steroidal and non-steroidal anti-inflammatory agents. The chronic use of these drugs is reported to cause severe adverse effects like gastrointestinal, cardiovascular, and renal abnormalities. There is a massive need to explore new anti-inflammatory agents with selective action and lesser toxicity. Plants and isolated phytoconstituents are promising and interesting sources of new anti-inflammatories. However, drug development from natural sources has been linked with hurdles like the complex nature of extracts, difficulties in isolation of pure phytoconstituents, and the yield of isolated compounds in minute quantities that is insufficient for subsequent lead development. Although various in-vivo and in-vitro models for anti-inflammatory drug development are available, judicious selection of appropriate animal models is a vital step in the early phase of drug development. Systematic evaluation of phytoconstituents can facilitate the identification and development of potential anti-inflammatory leads from natural sources. The present review describes various techniques of anti-inflammatory drug screening with its advantages and limitations, elaboration on biological targets of phytoconstituents in inflammation and biomarkers for the prediction of adverse effects of anti-inflammatory drugs. The systematic approach proposed through present article for anti-inflammatory drug screening can rationalize the identification of novel phytoconstituents at the initial stage of drug screening programs.

▾Tenoxicam - yet another NSAID

1989 ◽  
Vol 27 (19) ◽  
pp. 73-74
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trials ◽  
Adverse Effects ◽  
Inflammatory Drug ◽  
Relative Safety ◽  
Anti Inflammatory

Tenoxicam (Mobiflex) is a new non-steroidal anti-inflammatory drug (NSAID) being promoted by two major companies, Roche and Glaxo (Duncan Flockhart), which have hitherto had no products in this field. It is licensed for “the relief of pain and inflammation in osteoarthritis and rheumatoid arthritis”. We have previously highlighted the balance between efficacy and risk of serious adverse effects for NSAIDs;1 the relative safety of a new NSAID is particularly difficult to quantify because of the few patients studied in clinical trials. Does tenoxicam offer any features that justify introduction of yet another NSAID?

scholarly journals Chronic Sulfasalazine Treatment in Mice Induces System xc− - Independent Adverse Effects

2021 ◽  
Vol 12 ◽  
Author(s):  
Lise Verbruggen ◽  
Lindsay Sprimont ◽  
Eduard Bentea ◽  
Pauline Janssen ◽  
Azzedine Gharib ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Therapeutic Potential ◽  
Negative Impact ◽  
Chronic Administration ◽  
Systemic Circulation ◽  
The Body ◽  
Ample Evidence ◽  
Anti Inflammatory ◽  
First Time

Despite ample evidence for the therapeutic potential of inhibition of the cystine/glutamate antiporter system xc− in neurological disorders and in cancer, none of the proposed inhibitors is selective. In this context, a lot of research has been performed using the EMA- and FDA-approved drug sulfasalazine (SAS). Even though this molecule is already on the market for decades as an anti-inflammatory drug, serious side effects due to its use have been reported. Whereas for the treatment of the main indications, SAS needs to be cleaved in the intestine into the anti-inflammatory compound mesalazine, it needs to reach the systemic circulation in its intact form to allow inhibition of system xc−. The higher plasma levels of intact SAS (or its metabolites) might induce adverse effects, independent of its action on system xc−. Some of these effects have however been attributed to system xc− inhibition, calling into question the safety of targeting system xc−. In this study we chronically treated system xc− - deficient mice and their wildtype littermates with two different doses of SAS (160 mg/kg twice daily or 320 mg/kg once daily, i.p.) and studied some of the adverse effects that were previously reported. SAS had a negative impact on the survival rate, the body weight, the thermoregulation and/or stress reaction of mice of both genotypes, and thus independent of its inhibitory action on system xc−. While SAS decreased the total distance travelled in the open-field test the first time the mice encountered the test, it did not influence this parameter on the long-term and it did not induce other behavioral changes such as anxiety- or depressive-like behavior. Finally, no major histological abnormalities were observed in the spinal cord. To conclude, we were unable to identify any undesirable system xc−-dependent effect of chronic administration of SAS.

scholarly journals Studi Penggunaan Obat pada Pasien Osteoartritis Usia Lanjut di Instalasi Rawat Jalan Rumah Sakit dr. H Koesnadi Bondowoso Tahun 2013

2018 ◽  
Vol 6 (3) ◽  
pp. 408
Author(s):  
Ema Rachmawati ◽  
Putu Setia Pratama ◽  
Afifah Machlaurin
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Elderly People ◽  
Bone Disease ◽  
Organ Function ◽  
Inflammatory Drug ◽  
Keywords Osteoarthritis ◽  
Anti Inflammatory ◽  
To Receive ◽  
Degenerative Processes

  Osteoarthritis (OA) is a degenerative bone disease that begin by loss of articulary cartilage (joint). The disease most commonly affects the elder or adult people. Elderly people experiencing degenerative processes in which decreasing organ function. The organ degeneration causes several diseases resulting the patients to receive multi drug for the treatment and causing polypharmacy, thus will increase the risk of drug interactions. This study was conducted to determine the treatment for osteoarthritis and drug interactions that occur in patients with osteoarthritis. The method used was total sampling using the descriptive-retrospective approach. The sample was elderly osteoarthritis patients in outpatient installation which were treated in RSD dr. H Koesnadi Bondowoso during January to December 2013. In this study we found that the main treatment for osteoarthritis was non steroidal anti inflammatory drug (NSAID) that use to relief pain. From 108 samples of elderly osteoarthritis patients, we found that 17 patients (15.74%) indicating the potential for drug interactions.   Keywords: osteoarthritis, outpatient age above 60 years, NSAID, drug interaction  

scholarly journals Combination of oxymatrine and diammonium glycyrrhizinate significantly mitigates mice allergic contact dermatitis induced by dinitrofluorobenzene

2019 ◽  
Vol 244 (13) ◽  
pp. 1111-1119
Author(s):  
Hui-juan Shi ◽  
Hong-bin Song ◽  
Qiong Gao ◽  
Jia-wei Si ◽  
Qian Zou
Keyword(s):  
Contact Dermatitis ◽  
Adverse Effects ◽  
Allergic Contact Dermatitis ◽  
The Body ◽  
Plasma Sodium ◽  
Serum Ige ◽  
Body Weights ◽  
Anti Inflammatory ◽  
Allergic Contact ◽  
Inflammatory Infiltrates

This study investigated the safety and effect of oxymatrine (OMT) and/or diammonium glycyrrhizinate (DG) on allergic contact dermatitis (ACD) induced by 1-fluoro-2,4-dinitrofluorobenzene (DNFB) in ICR mice. Mice were topically smeared with vehicle (control) or DNFB on their ear and skin to induce ACD. The mice were randomized and injected with saline as the model, treated intraperitoneally with dexamethasone (DEX), 45 or 90 mg·kg−1 OMT and/or DG daily beginning one day post the first smearing for two weeks. The body weights, the severity of ear and skin inflammation, the levels of serum IgE, IL-4, and IFNγ, creatinine and urea as well as plasma sodium and potassium in individual mice were measured. In comparison with the control group, the model group did not change the body weights, but developed severe skin and ear inflammation with increased ear thickness, accompanied by many inflammatory infiltrates in the lesions and high levels of serum IgE, IL-4, and IFNγ. Combination of OMT and DG prevented the OMT- or DG-altered body weights in mice. While treatment with either OMT or DG moderately reduced the skin and ear inflammation, their thickness and inflammatory infiltrates, combination of OMT and DG further significantly increased their anti-inflammatory effects in mice. A similar pattern of inhibitory effect on the levels of serum IgE, IL-4, and IFNγ was observed in the different groups of mice. Combination of OMT and DG also prevented the OMT-, DG-, or DEX-altered plasma sodium or potassium levels in mice. Therefore, combination of OMT and DG significantly increased anti-inflammatory effects on ACD induced by DNFB in mice and attenuated DG- or OMT-related adverse effects. Impact statement Diammonium glycyrrhizinate (DG) and oxymatrine (OMT) have similar anti-inflammatory, anti-allergic, anti-tumor, immunomodulatory, and other pharmacological properties. Our previous study has shown that when DG and OMT are combined, DG can attenuate both high-dose (347.44 mg·kg−1) and regular-dose (90 mg·kg−1) OMT-induced mortality and adverse effects (such as body weight loss and hyponatremia). Furthermore, OMT can similarly attenuate the adverse effects (such as body weight gain, hypernatremia, and hypokalemia) induced by regular dose (90 mg·kg−1) of DG. Accordingly, we tested whether combination of OMT and DG would increase anti-inflammatory activities and reduce their adverse effect in a mouse model of allergic contact dermatitis (ACD) induced by 1-fluoro-2,4-dinitrofluorobenzene (DNFB). Our findings indicated that combination of OMT and DG significantly increased anti-inflammatory effects on ACD induced by DNFB in ICR mice and attenuated adverse effects of DG or OMT alone.

scholarly journals Systematic Review of Nonsteroidal Anti-Inflammatory Drug-Induced Adverse Effects in Dogs

2013 ◽  
Vol 27 (5) ◽  
pp. 1011-1019 ◽  
Author(s):  
B.P. Monteiro-Steagall ◽  
P.V.M. Steagall ◽  
B.D.X. Lascelles
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Drug Induced ◽  
Inflammatory Drug ◽  
Anti Inflammatory
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