POTENTIAL RISKS IN MODERN ANTIBIOTIC THERAPY

Knowledge of the safety profile of antibacterial drugs is important for rational pharmacotherapy with antibiotics. The purpose of this information is to help the doctor, pharmacist and patient to (quickly) "navigate" in the safety of antibiotics to implement one of the basic principles of pharmacotherapy "Do no harm!". The aim of the study. Analysis of possible potential risks in modern antibiotic therapy. Materials and methods. Analysis of data from the scientific literature on the side effects of antibiotics. Results. Most antibiotics have a wide spectrum of antimicrobial action, much less of them have a narrow spectrum of activity, but all of them have side effects (SE). In particular, the neurotoxicity of penicillins and fluoroquinolones is a consequence of their antagonism with GABA. The latter mechanism is also responsible for the neurotoxicity of carbapenens, monobactams and cephalosporins. Cardiotoxicity and hematotoxicity of benzylpenicillins are the result of inhibition of tissue respiration and the process of converting fibrinogen to fibrin, which causes bleeding. The hematotoxicity of carbopenicillins, monobactams and cephalosporins is associated with the inhibition of the conversion of vicasol (vit. K) into its active form, as well as the obstruction of its synthesis due to the suppression of normal intestinal microflora (the main producer of endogenous vit. K). The nephrotoxicity of aminoglycosides and vancomycin is associated with the accumulation of these drugs in the cells of the proximal renal tubules and impaired enzyme activity (Na+-, K+-, ATP; respiratory, etc.), which leads to interstitial nephritis. Ototoxicity of antibiotics is observed when they are used over the age of 60 – a factor that predisposes to ototoxicity. Conclusions. In order to conduct effective antibiotic therapy, it is very important to take into account the side effects that are characteristic of certain groups of antibiotics and each is representatively individual.

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Small Molecular Gemcitabine Prodrugs for Cancer Therapy

Current Medicinal Chemistry ◽

10.2174/0929867326666190816230650 ◽

2020 ◽

Vol 27 (33) ◽

pp. 5562-5582 ◽

Cited By ~ 1

Author(s):

He Miao ◽

Xuehong Chen ◽

Yepeng Luan

Keyword(s):

Drug Resistance ◽

Side Effects ◽

Anticancer Drug ◽

Drug Stability ◽

Effective Means ◽

Active Form ◽

Deoxycytidine Kinase ◽

High Efficacy ◽

Pyrimidine Nucleoside ◽

Design And Synthesis

Gemcitabine as a pyrimidine nucleoside analog anticancer drug has high efficacy for a broad spectrum of solid tumors. Gemcitabine is activated within tumor cells by sequential phosphorylation carried out by deoxycytidine kinase to mono-, di-, and triphosphate nucleotides with the last one as the active form. But the instability, drug resistance and toxicity severely limited its utilization in clinics. In the field of medicinal chemistry, prodrugs have proven to be a very effective means for elevating drug stability and decrease undesirable side effects including the nucleoside anticancer drug such as gemcitabine. Many works have been accomplished in design and synthesis of gemcitabine prodrugs, majority of which were summarized in this review.

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First Do No Harm: An Analysis of the Risk Aspects and Side Effects of Clinical Holistic Medicine Compared With Standard Psychiatric Biomedical Treatment

The Scientific World JOURNAL ◽

10.1100/tsw.2007.268 ◽

2007 ◽

Vol 7 ◽

pp. 1810-1820 ◽

Cited By ~ 5

Author(s):

Søren Ventegodt ◽

Isack Kandel ◽

Joav Merrick

Keyword(s):

Side Effects ◽

Psychiatric Treatment ◽

Treatment Method ◽

Mental Illnesses ◽

Holistic Medicine ◽

Treatment As Usual ◽

Philosophy Of Life ◽

Do No Harm ◽

Comparative Review ◽

Patients At Risk

Clinical holistic medicine (CHM) is short-term psychodynamic psychotherapy (STPP) complemented with bodywork and philosophical exercises, to be more efficient in treating patients with severe mental and physical illness. STPP has already been found superior to psychiatric treatment as usual (TAU) and thus able to compete with psychiatric standard treatment as the treatment of choice for all non-organic mental illnesses; we have found the addition of bodywork and philosophy of life to STPP to accelerate the process of existential healing and recovery (salutogenesis). In this paper we compare the side effects, suicidal risk, problems from implanted memory and implanted philosophy of CHM with psychopharmacological treatment. Method: Qualitative and quantitative comparative review. Results: In all aspects of risks, harmfulness, and side effects, we have been considering, CHM was superior to the standard psychiatric treatment. The old principle of “first do no harm“ is well respected by CHM, but not always by standard psychiatry. CHM seems to be able to heal the patient, while psychopharmacological drugs can turn the patient into a chronic, mentally ill patient for life. Based on the available data CHM seems another alternative to patients with mental illness. There seem to be no documentation at all for CHM being dangerous, harmful, having side effects of putting patients at risk for suicide. As CHM uses spontaneous regression there is no danger for the patient developing psychosis as, according to some experts, has been seen with earlier intensive psychodynamic methods. CHM is an efficient, safe and affordable cure for a broad range of mental illnesses.

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Essential Oil-Based Bioherbicides: Human Health Risks Analysis

International Journal of Molecular Sciences ◽

10.3390/ijms22179396 ◽

2021 ◽

Vol 22 (17) ◽

pp. 9396

Author(s):

Chloë Maes ◽

Jeroen Meersmans ◽

Laurence Lins ◽

Sandrine Bouquillon ◽

Marie-Laure Fauconnier

Keyword(s):

Side Effects ◽

Essential Oil ◽

Essential Oils ◽

Health Risks ◽

Good Alternative ◽

Aquatic Systems ◽

Air Transport ◽

Human Health Risks ◽

Potential Risks ◽

Negative Side Effects

In recent years, the development of new bio-based products for biocontrol has been gaining importance as it contributes to reducing the use of synthetic herbicides in agriculture. Conventional herbicides (i.e., the ones with synthetic molecules) can lead to adverse effects such as human diseases (cancers, neurodegenerative diseases, reproductive perturbations, etc.) but also to disturbing the environment because of their drift in the air, transport throughout aquatic systems and persistence across different environments. The use of natural molecules seems to be a very good alternative for maintaining productive agriculture but without the negative side effects of synthetic herbicides. In this context, essential oils and their components are increasingly studied in order to produce several categories of biopesticides thanks to their well-known biocidal activities. However, these molecules can also be potentially hazardous to humans and the environment. This article reviews the state of the literature and regulations with regard to the potential risks related to the use of essential oils as bioherbicides in agricultural and horticultural applications.

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Inhaled antibiotics to improve efficacy and safety in the treatment of upper airway and lung inflammatory diseases

Medical Council ◽

10.21518/2079-701x-2021-1-84-92 ◽

2021 ◽

pp. 84-92

Author(s):

Vladimir N. Drozdov ◽

Konstantin I. Arefev ◽

Svetlana Y. Serebrova ◽

Irina A. Komissarenko ◽

Evgenia V. Shikh ◽

...

Keyword(s):

Antibiotic Therapy ◽

Targeted Delivery ◽

Whooping Cough ◽

Inflammatory Diseases ◽

Wide Spectrum ◽

Chronic Obstructive ◽

Combination Drug ◽

Antibacterial Drugs ◽

Systemic Antibiotic Therapy ◽

Inhaled Antibiotics

Inhaled antibacterial drugs have been used since the 1940s with greater or lesser effectiveness, due to the possibility of targeted delivery of drugs directly to the infection site at concentrations higher than MICs. High local concentrations of antibacterial agents expand the possibilities of treating infections caused by multiresistant strains and reduces antibiotic resistance in the population. The inhaled delivery method is characterized by a high level of safety due to the absence of systemic toxic effects, which reduces the risk of pseudomembranous colitis and other complications of antibiotic therapy. Thiamphenicol glycinate acetylcysteinate is a combined drug that includes thiamphenicol and N-acetylcysteine, which causes its antibacterial and mucolytic activity. The results of clinical studies have demonstrated the effectiveness of TGA in the treatment of acute and chronic bronchitis, chronic obstructive pulmonary disease, community-acquired pneumonia, laryngotracheitis, rhinosinusitis and other infections of the upper and lower respiratory tract. In pediatrics, the drug is used to treat bronchitis and pneumonia, especially those that cannot be treated with other antibacterial drugs, bronchiolitis, whooping cough, and cystic fibrosis. The article presents data on the effectiveness and safety of containing TGA. A wide spectrum of antibacterial actions, the ability to form high local concentrations of antibacterial and mucolytic components in the focus of infection, a low risk of serious side effects in both adults and children are noted. The topical use of the combination drug has proven to be effective not only in bringing about a pronounced clinical improvement, but also in reducing the frequency of use of systemic antibiotic therapy. The efficacy of thiamphenicol glycinate acetylcysteinate is not inferior to macrolide antibiotics.

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CURCUMIN, A NATURAL GOLDEN DRUG AND ITS ANTICANCER ASPECTS FROM SYNTHESIS TO DELIVERY: A REVIEW

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2020v12i5.38586 ◽

2020 ◽

pp. 70-84

Author(s):

GEETA KRISHNAMURTHY ◽

DEEPTI ROY ◽

JYOTSNA KUMAR

Keyword(s):

Side Effects ◽

Anticancer Activity ◽

Review Paper ◽

Chemotherapeutic Agent ◽

Wide Spectrum ◽

Curcuma Longa ◽

Structure Modification ◽

Synthetic Drugs ◽

Effective Drugs ◽

Novel Delivery Systems

Cancer is a dreadful disease and, in most cases, leads to death even when it is being treated. Even though synthetic drugs are still in use for the treatment of cancer, the seriousness of the side effects of these drugs has boggled researcher’s mind to find more effective drugs which will help to overcome the side effects and have greater potency in trying to make the patient completely free of the disease. Recently, researchers turned their attention towards bio-components present in natural products. Curcumin, a polyphenol and the main constituent of a rhizome Curcuma longa, has geared significant interest due to its wide spectrum of therapeutics values, especially anticancer activity. Paper summarizes the chemistry and bio-metabolism of curcumin in the human body. Aim of this review article is to gather the dispersed efforts of researchers predominantly in improving the bioavailability of curcumin. In the present review, comprehensive literature on anticancer activity of Curcumin via combination therapy, structure modification, synthesis of analogues, novel delivery systems have been highlighted. Besides, the review paper explicated several challenges associated with Curcumin as an adjuvant chemotherapeutic agent and emphasizes more on clinical studies.

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Problems in differential diagnosis of secondary hyperparathyroidism

Perm Medical Journal ◽

10.17816/pmj381161-167 ◽

2021 ◽

Vol 38 (1) ◽

pp. 161-167

Author(s):

S. G. Shulkina ◽

D. O. Sirin ◽

E. N. Smirnova ◽

V. G. Zhelobov ◽

N. Yu. Kolomeets ◽

...

Keyword(s):

Vitamin D ◽

Differential Diagnosis ◽

Kidney Disease ◽

Secondary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

Clinical Case ◽

Kidney Diseases ◽

Active Form ◽

Renal Tubules ◽

Vitamin D Metabolism

Hyperparathyroidism is an endocrine disease characterized by excessive production of parathyroid hormone in the main cells of the parathyroid glands. Depending on the cause of this disease, there are primary, secondary (SHPT) and tertiary hyperparathyroidism. The most common causes of SHPT are vitamin D deficiency and chronic kidney disease (CKD). Vitamin D is converted to its active form by hydroxylation in the renal tubules. Developmental abnormalities and chronic kidney diseases lead to atrophy of the tubular epithelial cells that causes a violation of vitamin D metabolism and the development of SHPT, which in turn are accompanied by a violation of calcium-phosphorus metabolism and a syndrome of musculoskeletal disorders. This article presents an analysis of a clinical case of a patient diagnosed secondary hyperparathyroidism against the background of vitamin D deficiency combined with polycystic kidney disease. This clinical case reflects the complexity of the differential diagnosis of the disease and the tactics of patient's management.

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Therapeutics and Medical Emergencies

Oxford Assess and Progress: Clinical Dentistry ◽

10.1093/oso/9780198825173.003.0021 ◽

2019 ◽

Author(s):

Nicholas Longridge ◽

Pete Clarke ◽

Raheel Aftab ◽

Tariq Ali

Keyword(s):

Side Effects ◽

Life Support ◽

The Body ◽

Practice Setting ◽

Oral Side ◽

Do No Harm ◽

Medical Emergencies ◽

The Will ◽

Key Topics ◽

Basic Level

Firstly, do no harm. This is held as the first law of clinical practice when considering any intervention to improve the health of our patients. This may at times be a difficult proposition, especially when the approach to treating a condition is fraught with risks and can carry the danger of adverse and unwanted side effects. Prescribing therapeutics is the time perhaps when this maxim should be most at the forefront of a clinician’s mind, as therapeutic interventions may not cause any immediately discernible danger or harm in the same way as operative interventions. It is therefore important for the prescriber to understand the relevant pharmacodynamics (the effects of the agent on the body) and pharmacokinetics (the effects of the body on the agent). To add a further layer of complexity, the reader should understand that pharmacological sciences are possibly the fastest evolving part of medicine. It would be a fair bet to say that, within the course of the reader’s undergraduate education, entire new classes of therapeutics will have emerged and established perceptions of other agents would have significantly changed. Practically speaking, this does not mean that it is necessary to memorize the nuances of all therapeutic agents (although you should have a good grasp of those you prescribe regularly); rather it is more important that a clinician understands how to recognize potential dangers and then be resourceful enough to mitigate against them, given the best knowledge available at the time. Access to an up- to-date formulary and the will to use it are the surest way to navigate any prescribing pitfalls. ‘We don’t rise to the occasion, we fall to the most basic level of our training’. Thankfully, medical emergencies occur infrequently in the general practice setting. It is the rarity of such events that often leads to anxieties when dealing with them. This reaction is amplified by the caregiver’s natural instinct to do something immediately, but often not knowing exactly what to do because the diagnosis is not immediately clear. The ABCDE approach, as advocated by the Resuscitation Council, is a safe and methodical way to approach any emergency. ABCDE is not only a hierarchy of importance for systems critical to life, but it also acts as an aide- memoire to undertake examinations and interventions when necessary. Most importantly, it buys time whilst the diagnosis is found or declares itself, without adversely affecting the outcome by inaction. Key topics include: ● Common drugs for common medical conditions ● Drug interactions ● Oral side effects of medications ● Basic life support ● Medical emergencies in dentistry (including the Resuscitation Council UK guidelines) ● ABCDE approach.

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β 1 -Adrenoreceptor Autoantibodies in Heart Failure

Circulation Heart Failure ◽

10.1161/circheartfailure.119.006155 ◽

2020 ◽

Vol 13 (1) ◽

Cited By ~ 4

Author(s):

Hans-Dirk Düngen ◽

Aleksandar Dordevic ◽

Stephan B. Felix ◽

Burkert Pieske ◽

Adriaan A. Voors ◽

...

Keyword(s):

Heart Failure ◽

Wide Spectrum ◽

Therapeutic Option ◽

Receptor Activation ◽

Novel Approach ◽

Treat Heart Failure ◽

Patients With Heart Failure ◽

Β Blocker ◽

Potential Risks ◽

Cellular Dysfunction

Antibodies that activate the β 1 -AR (β 1 -adrenoreceptor) can induce heart failure in animal models. These antibodies are often found in patients with heart failure secondary to varying etiologies. Their binding to the β 1 receptor leads to prolonged receptor activation with subsequent induction of cellular dysfunction, apoptosis, and arrhythmias. β-blocker therapy while highly effective for heart failure, may not be sufficient treatment for patients who have β 1 receptor autoantibodies. Removal of these autoantibodies by immunoadsorption has been shown to improve heart failure in small studies. However, immunoadsorption is costly, time consuming, and carries potential risks. An alternative to immunoadsorption is neutralization of autoantibodies through the intravenous application of small soluble molecules, such as peptides or aptamers, which specifically target and neutralize β 1 -AR autoantibodies. Peptides may induce immunogenicity. Animal as well as early phase human studies with aptamers have not shown safety concerns to date and have demonstrated effectiveness in reducing autoantibody levels. Novel aptamers have the potential advantage of having a wide spectrum of action, neutralizing a variety of known circulating G-protein coupled receptor autoantibodies. These aptamers, therefore, have the potential to be novel therapeutic option for patients with heart failure who have positive for β 1 -AR autoantibodies. However, clinical outcomes trials are needed to assess the clinical utility of this novel approach to treat heart failure.

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