scholarly journals Interaction of Carbamazepine with Herbs, Dietary Supplements, and Food: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Sophia Yui Kau Fong ◽  
Qiong Gao ◽  
Zhong Zuo
Keyword(s):  
Systematic Review ◽  
Drug Interactions ◽  
Dietary Supplements ◽  
Dietary Supplement ◽  
Plasma Concentrations ◽  
Inclusion Criteria ◽  
First Line ◽  
Pharmacodynamic Interaction ◽  
Herbal Products ◽  
Therapeutic Outcomes

Background. Carbamazepine (CBZ) is a first-line antiepileptic drug which may be prone to drug interactions. Systematic review of herb- and food-drug interactions on CBZ is warranted to provide guidance for medical professionals when prescribing CBZ.Method. A systematic review was conducted on six English databases and four Chinese databases.Results. 196 out of 3179 articles fulfilled inclusion criteria, of which 74 articles were reviewed and 33 herbal products/dietary supplement/food interacting with CBZ were identified. No fatal or severe interactions were documented. The majority of the interactions were pharmacokinetic-based (80%). Traditional Chinese medicine accounted for most of the interactions (n=17), followed by food (n=10), dietary supplements (n=3), and other herbs/botanicals (n=3). Coadministration of 11 and 12 of the studied herbal products/dietary supplement/food significantly decreased or increased the plasma concentrations of CBZ. Regarding pharmacodynamic interaction, Xiao-yao-san, melatonin, and alcohol increased the side effects of CBZ while caffeine lowered the antiepileptic efficacy of CBZ.Conclusion. This review provides a comprehensive summary of the documented interactions between CBZ and herbal products/food/dietary supplements which assists healthcare professionals to identify potential herb-drug and food-drug interactions, thereby preventing potential adverse events and improving patients’ therapeutic outcomes when prescribing CBZ.

scholarly journals Update on the drug-food interactions

2014 ◽  
Vol 1 (2) ◽  
pp. 100-106
Author(s):  
Hafid Bahri ◽  
◽  
Abdelkader Douaoui ◽  
Moufida Gharbi ◽  
Djamila Amroun
Keyword(s):  
Drug Interactions ◽  
Renal Clearance ◽  
Enzyme Inhibitor ◽  
Plasma Concentrations ◽  
Public Health Problem ◽  
Therapeutic Index ◽  
Major Public Health Problem ◽  
Urine Ph ◽  
Pharmacodynamic Interaction ◽  
The Impact

Drug interactions are a major public health problem, which partly attributed to some 10,000 deaths/year in Canada. Besides the interactions between two drugs, drug interactions are also due to the effect of other substances such as foods or nutrients. The drug-food interaction will be pharmacokinetic (affecting the absorption, distribution, metabolism, and elimination) or pharmacodynamic interaction. It is in the intestine that food may have the greatest impact with mainly a change in the amount of drugs absorbed that may be clinically significant for some drugs with narrow therapeutic index (cyclosporine, phenytoin, theophylline, etc.). The absorption of the drug in the presence of food will be determined by the particular physicochemical properties of the drug but also by the impact of food on one of the parameters determining the absorption such as: modified gastric acidity and emptying, the fat content of the food, the use of common transport between the drug and nutrients, chemical reactions between elements and drugs. Fasting situations or malnutrition can affect the distribution of drugs by increasing the free drug fraction, involving sometimes the risk of overdose. Diet affects drug metabolism by changing the activity of cytochrome P450. Most often is described the increase by grapefruit juice (enzyme inhibitor) of plasma concentrations of some drugs (cyclosporine, some statins, and calcium antagonists). Other foods (garlic, smoked meats and fish, caffeine) may increase metabolism. Diet can influence two stages of renal clearance (glomerular filtration - tubular reabsorption) by modifying urine pH or renal clearance. Pharmacodynamic interactions are also monitored, especially foods rich in vitamin k or tyramine with antivitamins K or MAOIs. Finally, health professionals must mobilize against these interactions, including through patient information.

scholarly journals Clinical effectiveness of first-line chemoradiation for adult patients with locally advanced non-small cell lung cancer: a systematic review

2013 ◽  
Vol 17 (6) ◽  
pp. 1-99 ◽  
Author(s):  
T Brown ◽  
G Pilkington ◽  
A Boland ◽  
J Oyee ◽  
C Tudur Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Advanced Nsclc ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Clinical Effectiveness ◽  
Adult Patients ◽  
Inclusion Criteria ◽  
Stage Iiia ◽  
First Line ◽  
Locally Advanced Nsclc

BackgroundThe National Institute for Health and Clinical Excellence has issued guidelines on the treatment of non-small cell lung cancer (NSCLC) and recommends that patients with stage IIIA–IIIB disease who are not amenable to surgery be treated with potentially curative chemoradiation (CTX-RT). This review was conducted as part of a larger systematic review of all first-line chemotherapy (CTX) and CTX-RT treatments for patients with locally advanced or metastatic NSCLC. However, it was considered that patients with potentially curable disease (e.g. stage IIIA) are different from those with advanced disease, who are suitable for palliative treatment only, and therefore the results should be reported separately.ObjectiveTo evaluate the clinical effectiveness of first-line CTX in addition to radiotherapy (RT) (CTX-RT vs CTX-RT) for adult patients with locally advanced NSCLC who are suitable for potentially curative treatment.Data sourcesThree electronic databases (MEDLINE, EMBASE and The Cochrane Library) were searched from January 1990 to September 2010.Review methodsInclusion criteria comprised adult patients with locally advanced NSCLC, trials that compared any first-line CTX-RT therapy (induction, sequential, concurrent and consolidation) and outcomes of overall survival (OS) and/or progression-free survival (PFS). The results of clinical data extraction and quality assessment were summarised in tables and with narrative description. Direct meta-analyses using OS data were undertaken where possible: sequential CTX-RT compared with concurrent CTX-RT; sequential CTX-RT compared with concurrent/consolidation CTX-RT; and sequential CTX-RT compared with concurrent CTX-RT with or without consolidation. There were not sufficient data to perform meta-analysis on PFS.ResultsOf the 240 potentially relevant studies that were published post 2000, 19 met the inclusion criteria and compared CTX-RT with CTX-RT. The results from the OS meta-analysis comparing sequential CTX-RT with concurrent CTX-RT appear to show an OS advantage for concurrent CTX-RT arms over sequential arms; this result is not statistically significant [hazard ratio (HR) 0.79; 95% confidence interval (CI) 0.50 to 1.25)]. The results from the OS meta-analysis comparing sequential CTX-RT with concurrent/consolidation CTX-RT appear to show a statistically significant OS advantage for concurrent/consolidation CTX-RT treatment over sequential treatment (HR 0.68; 95% CI 0.55 to 0.83). The results from the OS meta-analysis comparing sequential CTX-RT with concurrent CTX-RT with or without consolidation appear to show a statistically significant OS advantage for concurrent CTX-RT with or without consolidation over sequential treatment (HR 0.72; 95% CI 0.61 to 0.84).LimitationsThis report provides a summary and critical appraisal of a comprehensive evidence base of CTX-RT trials; however, it is possible that additional trials have been reported since our last literature search. It is disappointing that the quality of the research in this area does not meet the accepted quality standards regarding trial design and reporting.ConclusionsThis review identified that the research conducted in the area of CTX-RT was generally of poor quality and suffered from a lack of reporting of all important clinical findings, including OS. The 19 trials included in the systematic review were too disparate to form any conclusions as to the effectiveness of individual CTX agents or types of RT. The focus of primary research should be good methodological quality; appropriate allocation of concealment and randomisation, and comprehensive reporting of key outcomes, will enable meaningful synthesis and conclusions to be drawn.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals Medication Consumption Patterns and Polypharmacy among Community-Dwelling Elderly in Lomé (Togo) in 2017

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Fifonsi A. Gbeasor-Komlanvi ◽  
Wendpouiré I. C. Zida-Compaore ◽  
Ikpindi H. Dare ◽  
Aboudoulatif Diallo ◽  
Tchin P. Darre ◽  
...  
Keyword(s):  
Medicinal Plants ◽  
Drug Interactions ◽  
Dietary Supplements ◽  
Community Dwelling ◽  
Consumption Patterns ◽  
African Region ◽  
Self Medication ◽  
Cross Sectional ◽  
Herbal Products ◽  
Medication Consumption

Background. In the sub-Saharan African, region of the world with a fast growing aging population and where the use of herbal products is very common, there is a paucity of data on medication consumption patterns among elderly people. The objective of this study was to assess the prevalence of polypharmacy and its associated factors among community-dwelling elderly in Lomé, Togo, in 2017. Methods. A cross-sectional study was conducted from March to June 2017 in Lomé, Togo among people aged 60 years and older. The Respondent Driven Sampling method was used to recruit participants. Data on socio-demographic characteristics and medication consumption patterns, including the use of medicinal plants and dietary supplements, were collected using a standardized questionnaire during a face-to-face interview at participants’ home. Descriptive and binary logistic regression analyses were performed. Results. A total of 370 participants with median age 65 years, (IQR: 62–71) were enrolled in the study. Almost three elderly in five (57.6%) were multimorbid (had two or more chronic diseases). Conventional drugs (78.4%), medicinal plants (14.3%) and other dietary supplements (9.5%) were used by participants. The prevalence of polypharmacy was 22.7% (95% CI: 18.5–27.3%). Concurrent use of conventional drugs and medicinal plants or other dietary supplements was observed among 17.0% of participants and 67.3% reported self-medication. Multimorbidity (aOR = 4.55; 95% CI: [2.42–8.54]) and female sex (aOR = 1.86; 95% CI: [1.00–3.47]) were associated with polypharmacy. Conclusion. One elderly in five uses five or more medications in Togo. Further studies are needed to assess drug-drug interactions and herb-drug interactions among this population.

scholarly journals Pharmacokinetics of antiretroviral and tuberculosis drugs in children with HIV/TB co-infection: a systematic review

2020 ◽  
Vol 75 (12) ◽  
pp. 3433-3457
Author(s):  
Tom G Jacobs ◽  
Elin M Svensson ◽  
Victor Musiime ◽  
Pablo Rojo ◽  
Kelly E Dooley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inclusion Criteria ◽  
Older Children ◽  
First Line ◽  
Once Daily ◽  
Tb Treatment ◽  
Current State ◽  
Trough Concentrations ◽  
The Many ◽  
Treatment Use

Abstract Introduction Management of concomitant use of ART and TB drugs is difficult because of the many drug–drug interactions (DDIs) between the medications. This systematic review provides an overview of the current state of knowledge about the pharmacokinetics (PK) of ART and TB treatment in children with HIV/TB co-infection, and identifies knowledge gaps. Methods We searched Embase and PubMed, and systematically searched abstract books of relevant conferences, following PRISMA guidelines. Studies not reporting PK parameters, investigating medicines that are not available any longer or not including children with HIV/TB co-infection were excluded. All studies were assessed for quality. Results In total, 47 studies met the inclusion criteria. No dose adjustments are necessary for efavirenz during concomitant first-line TB treatment use, but intersubject PK variability was high, especially in children <3 years of age. Super-boosted lopinavir/ritonavir (ratio 1:1) resulted in adequate lopinavir trough concentrations during rifampicin co-administration. Double-dosed raltegravir can be given with rifampicin in children >4 weeks old as well as twice-daily dolutegravir (instead of once daily) in children older than 6 years. Exposure to some TB drugs (ethambutol and rifampicin) was reduced in the setting of HIV infection, regardless of ART use. Only limited PK data of second-line TB drugs with ART in children who are HIV infected have been published. Conclusions Whereas integrase inhibitors seem favourable in older children, there are limited options for ART in young children (<3 years) receiving rifampicin-based TB therapy. The PK of TB drugs in HIV-infected children warrants further research.

scholarly journals Pharmacologic Treatment of Idiopathic Chilblains (Pernio): A Systematic Review

2021 ◽  
pp. 120347542199513
Author(s):  
Michelle Pratt ◽  
Farhan Mahmood ◽  
Mark G. Kirchhof
Keyword(s):  
Systematic Review ◽  
Pharmacologic Therapy ◽  
Pharmacologic Treatment ◽  
Inclusion Criteria ◽  
First Line ◽  
Therapeutic Trials ◽  
Preventative Measures ◽  
Topical Minoxidil ◽  
Study Population ◽  
Topical Glyceryl Trinitrate

Idiopathic chilblains is a cold-induced inflammatory condition that causes significant morbidity. When preventative measures alone are inadequate, oral nifedipine is generally recommended as first-line pharmacologic therapy. Given the natural course of this spontaneously remitting/relapsing condition, controls are needed to critically appraise studies and determine the value of treatments. We report a systematic review of placebo-controlled or comparative therapeutic trials for the treatment of idiopathic chilblains. Our search of PubMed, Embase, and Cochrane databases, identified 11 studies that met our inclusion criteria for a combined study population n = 576. Therapies included nifedipine, pentoxifylline, tadalafil, topical glyceryl trinitrate (GTN), topical minoxidil, diltiazem, corticosteroids, and vitamin D. There was moderate evidence to support the use of nifedipine and pentoxifylline in the treatment of severe or refractory cases of idiopathic chilblains, while other therapies had inadequate evidence or nonsignificant results compared to placebo.

Importance of Dietary Supplements to the Health

2020 ◽  
Vol 16 ◽  
Author(s):  
Amarnath Mishra ◽  
Arvind K. Singh Chandel ◽  
Dixit V. Bhalani ◽  
Richa Shrivastava
Keyword(s):  
Amino Acids ◽  
Fatty Acids ◽  
Dietary Supplements ◽  
Dietary Supplement ◽  
Dosage Forms ◽  
Recommended Dose ◽  
Herbal Products ◽  
Other Substances ◽  
Enzyme Supplement

: The term “dietary supplement” defines a comprehensive and diverse category of products that are essential to our health but those are absent or insufficient into the diet that may be needed to take separately, requirement of dietary supplements are varies at different stages of life such as infant, child-adult, pregnancy, lactation, and geriatrics. Dietary supplements are not medicines, nor should they be considered a substitute for food. USFDA defines dietary supplements in part as a product taken by mouth that contains a “dietary ingredients.” Nutritional ingredients comprise vitamins, minerals, amino acids, and herbs or botanicals, in addition to other substances that can be considered to supplement the diet. The market flooded with various dosage forms of dietary supplements such as capsules, tablets, powders, energy bars, liquids, etc. These include Vitamin, Mineral, Herbal Products containing extracts from herbs as well as algae and fungi, Concentrate, metabolite, constituent, or extract, Enzyme supplement, Essential amino, and fatty acids. This chapter describes the importance of the dietary supplement, source, disease arises by deficiency, and recommended dose for different groups.

Anaphylactic Reaction to a Dietary Supplement Containing Willow Bark

2003 ◽  
Vol 37 (6) ◽  
pp. 832-835 ◽  
Author(s):  
Joseph I Boullata ◽  
Patrick J McDonnell ◽  
Cynthia D Oliva
Keyword(s):  
Weight Loss ◽  
Adverse Effects ◽  
Dietary Supplements ◽  
Dietary Supplement ◽  
Anaphylactic Reaction ◽  
Medication History ◽  
Herbal Products ◽  
Initial Symptoms ◽  
History Of ◽  
Willow Bark

OBJECTIVE: To report a case of anaphylaxis resulting from the use of a willow bark–containing dietary supplement in a patient with a history of an aspirin allergy. CASE SUMMARY: A 25-year-old white woman presented to the emergency department of a community teaching hospital with anaphylaxis requiring epinephrine, diphenhydramine, methylprednisolone, and volume resuscitation to which she responded favorably. Medication history revealed that she had ingested 2 capsules of Stacker 2 (NVE Pharmaceuticals, Newton, NJ), a dietary supplement promoted for weight loss, prior to experiencing her initial symptoms. Among other active ingredients, this product contains willow bark. Of significance is that this patient also reported a history of allergy to acetylsalicylic acid. No other causes for anaphylaxis were identified. She continued to receive routine supportive care and the remaining hospital course was uncomplicated. DISCUSSION: Dietary supplements, including herbal products, are used by many individuals who consider them to be inherently safe despite limited regulatory oversight by the Food and Drug Administration. While there may be value to specific botanical ingredients, a potential for adverse effects also exists. The popular product consumed by our patient is used for weight loss and contains willow bark, a source of salicylates. Based on the Naranjo probability scale, it is probable that this case of anaphylaxis was due to this dietary supplement. CONCLUSIONS: The use of any willow bark–containing dietary supplement may present a risk of anaphylactic reaction to patients with a history of allergy to salicylates. Clinicians need to recognize the potential for adverse effects from dietary supplements.

scholarly journals A Systematic Review and Critical Analysis of the Role of Graphene-Based Nanomaterialsin Cancer Theranostics

Pharmaceutics ◽  
2018 ◽  
Vol 10 (4) ◽  
pp. 282 ◽  
Author(s):  
Teresa Viseu ◽  
Carla M. Lopes ◽  
Eduarda Fernandes ◽  
Maria Elisabete C.D. Real Oliveira ◽  
Marlene Lúcio
Keyword(s):  
Systematic Review ◽  
Critical Analysis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cancer Diagnostics ◽  
Inclusion Criteria ◽  
Therapeutic Outcomes ◽  
Cancer Theranostics ◽  
Potential Use

Many graphene-based materials (GBNs) applied to therapy and diagnostics (theranostics) in cancer have been developed. Most of them are hybrid combinations of graphene with other components (e.g, drugs or other bioactives, polymers, and nanoparticles) aiming toward a synergic theranostic effect. However, the role of graphene in each of these hybrids is sometimes not clear enough and the synergic graphene effect is not proven. The objective of this review is to elaborate on the role of GBNs in the studies evaluated and to compare the nanoformulations in terms of some of their characteristics, such as therapeutic outcomes and toxicity, which are essential features for their potential use as bionanosystems. A systematic review was carried out using the following databases: PubMed, Scopus, and ISI Web of Science (2013–2018). Additional studies were identified manually by consulting the references list of relevant reviews. Only English papers presenting at least one strategy for cancer therapy and one strategy for cancer diagnostics, and that clearly show the role of graphene in theranostics, were included. Data extraction and quality assessment was made by reviewer pairings. Fifty-five studies met the inclusion criteria, but they were too heterogeneous to combine in statistical meta-analysis. Critical analysis and discussion of the selected papers are presented.

scholarly journals Systematic Review and Network Meta-Analysis of Bevacizumab Plus First-Line Topotecan-Paclitaxel or Cisplatin-Paclitaxel Versus Non–Bevacizumab-Containing Therapies in Persistent, Recurrent, or Metastatic Cervical Cancer

2017 ◽  
Vol 27 (6) ◽  
pp. 1237-1246 ◽  
Author(s):  
Virginia M. Rosen ◽  
Ines Guerra ◽  
Mary McCormack ◽  
Angélica Nogueira-Rodrigues ◽  
Andre Sasse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Meta Analysis ◽  
Cervical Cancer Prevention ◽  
Standards Of Care ◽  
Inclusion Criteria ◽  
First Line ◽  
Recurrent Cervical Cancer ◽  
Random Effects Models ◽  
Fixed And Random Effects

ObjectiveDespite advances in cervical cancer prevention and diagnosis, outcomes for patients given a diagnosis of advanced and recurrent disease are poor. In the GOG240 trial, the addition of bevacizumab to paclitaxel-topotecan or paclitaxel-cisplatin has been shown to prolong survival compared with paclitaxel-topotecan or paclitaxel-cisplatin in patients with persistent, recurrent, or metastatic disease. However, standards of care vary between regions and countries. The purpose of this systematic review and network meta-analysis was to enable a comparison between bevacizumab + chemotherapy with multiple monotherapy or combination chemotherapy regimens in the treatment for women with advanced, recurrent, or persistent cervical cancer.Methods/MaterialsA systematic literature review was conducted to identify randomized or nonrandomized controlled trials of patients with recurrent, persistent, or metastatic cervical cancer published in English from 1999 to 2015. A feasibility study was performed to assess the heterogeneity of the trials, and a network meta-analysis was conducted. Fixed- and random-effects models were fitted to calculate the hazard ratio for overall survival (OS) for all pairwise comparisons and ranking of all interventions.ResultsTwenty-three studies (19 trials) met inclusion criteria and were included in the review. Sample sizes ranged from 69 to 452, and median patient age ranged from 45 to 53 years. There was a trend toward prolonged OS with cisplatin-paclitaxel-bevacizumab and topotecan-paclitaxel-bevacizumab compared with all non–bevacizumab-containing therapies. Cisplatin-paclitaxel-bevacizumab had the highest probability of being the most efficacious compared with all regimens (68.1%), and cisplatin monotherapy had the lowest (0%).ConclusionsThe results of this network meta-analysis show that bevacizumab in combination with paclitaxel-topotecan or paclitaxel-cisplatin is likely to prolong OS over other non–bevacizumab-containing chemotherapies (eg, paclitaxel-carboplatin), which were not included in the GOG240 trial. In patients with advanced, persistent, and recurrent cervical cancer, cisplatin-paclitaxel-bevacizumab and topotecan-paclitaxel-bevacizumab showed the highest efficacy in all regimens investigated in this analysis.

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