Clinical Pharmacology articles list

A comparative study of social and economic aspect of migration

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

A comparative study of social and economic aspect of migration

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

Study of temperature variation in human peripheral region during wound healing process due to plastic surgery

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Metapuf: a challenge response pair generator

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

Intersection of caste and gender based subjugation

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Intersection of caste and gender based subjugation

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

Nano-catalyzed green synthesis of pyrazole derivatives & its biological activity as eac receptor antagonists

Different derivatives of Cinnamaldehydes were prepared by Claisen-Schmidt condensation (by using Strong basic reagent). The prepared Cinnamaldehydes were treated with Hydrazine hydrate in presence of ZnO Nano-catalyst under microwave assisted solvent-free conditions to afford different substituted Pyrazoles. Green chemistry was employed. Comparisons of both microwave & conventional methods were studied & found that the first was more potent than the later. The synthesized compounds were characterized by FT-IR, 1HNMR & elemental analysis. All synthesized compounds were screened for in vitro test against EAC cell lines. Most compounds exhibited good inhibitor potency with IC50 values.

Dr Ganesh N Yallappa

1. critical study of guggulu kalpana with special reference of bhaishajya ratnavali

Bhaishajya kalpana is an art and science of preparing and dispencing medicine. Guggulu is a Niryasa (oily latex) achieved from small tree called Indian bedellium. Botanical name is commiphora mukul. Guggulu is an amorphous, translucent, solid adhesive, oleo-gum resin is produced by the process of gummosis from its plant. Many other Ayurvedic classics have mentioned various formulations of Guggulu for the treatment of various ailments. Bhashajya ratnawali followed various kalpana use for formuations. Guggulu kalpana is secondary formulations of bhaishajya kalpana. . Guggulu is one among the best binding agents and its used as single or compound drug in the form of pills, Formulations which contains Guggulu as main ingredient, they can be called as Guggulu kalpana. Here in Bhaishajya Ratnawali, Guggulu is used in yoga for both purposes, as a base and as well as medicament also.In bhaishajya Ratnavali Guggulu when modified into different formulations. It can also be used in many diseases along with different combinations of drugs with their anupana, Guggulu kalpana beneficial in treating many diseases. The Guggulu Kalpana is indicated in almost all the strotovikaras and also a number of research works have been proved the wide range of action of Guggulu .

Suri abhiram

1. critical study of guggulu kalpana with special reference of bhaishajya ratnavali

Bhaishajya kalpana is an art and science of preparing and dispencing medicine. Guggulu is a Niryasa (oily latex) achieved from small tree called Indian bedellium. Botanical name is commiphora mukul. Guggulu is an amorphous, translucent, solid adhesive, oleo-gum resin is produced by the process of gummosis from its plant. Many other Ayurvedic classics have mentioned various formulations of Guggulu for the treatment of various ailments. Bhashajya ratnawali followed various kalpana use for formuations. Guggulu kalpana is secondary formulations of bhaishajya kalpana. . Guggulu is one among the best binding agents and its used as single or compound drug in the form of pills, Formulations which contains Guggulu as main ingredient, they can be called as Guggulu kalpana. Here in Bhaishajya Ratnawali, Guggulu is used in yoga for both purposes, as a base and as well as medicament also.In bhaishajya Ratnavali Guggulu when modified into different formulations. It can also be used in many diseases along with different combinations of drugs with their anupana, Guggulu kalpana beneficial in treating many diseases. The Guggulu Kalpana is indicated in almost all the strotovikaras and also a number of research works have been proved the wide range of action of Guggulu .

Suri abhiram

A comprehensive study of gorvara puta in preparation of rasa bhasma

Ayurvedic formulations are of three types, Herbal, Mineral and Herbo-Mineral. Of which, Herbomineral is prepared either by Khalweeya or by Bhasmeekarana procedures. The quality of Bhasma depends on the number of putas given. Rasa Bhasma is one such kind of a Herbo-mineral preparation which can be obtained by Puta procedure as described in texts of Rasa Shastra. Though there are different procedures mentioned for preparation of Rasa Bhasma, maarana done with Gorvara puta seems to be an apt way to obtain the final product. Puta is the generalised way of heat application used during the pharmaceutical procedures of Rasa dravyas, where the purified organic Metal/Mineral is converted completely into powder form which can be absorbed easily into the body without causing any ill effects. Different types of Puta have been explained for bhasmeekarana of different metals and minerals. Among them, certain putas have been mentioned where Mandaagni plays a crucial role in Maarana (Incineration). These Mandaagniputas are in use of preparing certain Bhasmas like ShilajitBhasma, HaratalaBhasma, GouripashanaBhasma, and PaaradaBhasma. As these drugs are having relatively low boiling and melting points when compared to other dravyas, and are easy to evaporate when exposed to high temperatures, they need a standardized quantum of heat by which they can be transformed into Bhasma. Gorvara puta is one such kind where agni plays a major role in the preparation of Bhasma. So, the present study A Comprehensive Study of Gorvara Puta in Preparation of Rasa Bhasmahas has been under taken.

Suri abhiram

A critical review on mode of action of ayurvedic formulations on jwara

Rasa aushadhis are known for their uniqueness in curing the diseases with a very low dosage. These formulations are divided into two types based on their mode of preparation i.e., Single drug and Compound drug formulations. Based on their origin, the drugs are divided into three types, Herbal, Mineral and Animal. Any of these two or three together is combined to make a compound formulation. Apart from these, the other major factor which is needed for a formulation is the Rasa Panchaka of a Drug. Many of the formulations are being prepared based on their availability, keeping their Rasa Panchaka and Samprapti vighatana in mind. These formulations are designed in such a way that two or more drugs will be having one common quality, or Opposite Qualities or an Antidote of a particular Vishadravya, which can help in curing the disease. So an attempt is made to Review Tribhuvanakeerti Rasa with its Probable mode of action.

Suri abhiram

Assessment of drug prescribing pattern and prescription errors in elderly patients

The rate of aging is rapidly increasing and the term of geriatric refers to offer a medical care to elderly people. Drug consumption study on geriatric population is a vital issue since this group is totally neglected in Libya. The aim of this study was to assess drug utilization pattern among elderly patients in terms of world health organization core prescribing indicators and to evaluate the treatment cost. A total of 106 prescriptions were randomly collected from different community pharmacies located in Tripoli during the summer 2019, and were evaluated (total number of prescribed drugs is 359) for their clinical efficacy and safety. The findings revealed that 60 drugs acting on GIT (16.7%), 50 antimicrobial drugs (13.9%), 31 antihypertensive drugs (8.6%) and 30 drugs for respiratory diseases (8.4%) were prescribed to patients who are 65 years old or more. With regard to disease pattern in the elderly Libyan patients, 27 drugs were prescribed for diabetes mellitus (7.5%), 24 drugs for cardiovascular drugs (6.7%) and 14 drugs for anti-hyperlipidemia (3.9%). According to the WHO core drug use indicator pattern, the average number of drugs prescribed per encounter was 3.3. Prescription by generic name was low (41.5%). Antibiotics were 36.8% while injections were 26.6%. Thus, this study suggest that geriatric medicine and rational drug use should strongly be implanted in medical schools and teaching hospitals. Besides, a drug pattern use of the Libyan community is urgently required to avoid drug prescribing errors.

Fathi M. Sherif

Effectiveness of psilocybin on depression: a qualitative study

Introduction: Psilocybin mushroom use is well documented in spiritual and religious ceremonies globally. This drug is now the most popular in Europe and the USA. Objective: The objective of this study is to explore the experiences and effects of psilocybin on patients with depression and anxiety. Method: A qualitative study was conducted interviewing ten participants currently taking psilocybin while experiencing depression and/or anxiety. Ethical approval was obtained from the University ethics committee. Participants were recruited via social media and groups are known to have used psilocybin for the treatment of anxiety and/or depression. Participants were informed of study aims and consent was obtained before interviews commenced. Confidentiality was maintained throughout this study. Interviews began with informing participants that psilocybin may be effective in the management of depression. Initially, information around the way treatment with psilocybin was obtained was sought. This was followed by queries around the effects of the drug in terms of experiences both during and after treatment. Finally, participants were asked to outline the positive effects of psilocybin on their lives. Results: The data were thematically coded using Grounded Theory as an underpinning philosophical paradigm. Emerging themes included enhancement of smell, vision, hearing, and taste sensations. Another theme emerging was the experience of being ‘connected with the universe’ while on the drug. Additionally, participants reported a stabilization of mood, an increase in optimism and emotional control, and a healthier emotional connection with others. Most also felt an increase in comfort, peace and calmness. Another theme that emerged centered on the mechanism of action of psilocybin. Participants stated that this substance seemed to ‘make new connections in their brain,’ resulting in new perspectives. Some participants felt this resulted in a calming influence on the mind and body. This aligns with research showing that psilocybin works by changing the thinking and improving information processing. Conclusion: Psilocybin has promising effects on the patients with depression/anxiety even after a single dose. Psilocybin is safe but the administration should be guided by a health professional to yield safe and positive outcomes.

Gwen Erlam

Thrombolytic therapy versus primary percutaneous coronary intervention: role of clinical pharmacist

Cardiovascular drugs constitute one of the largest and most widely used among other diseases and cardiovascular drug market has largely been exploded . Although these drugs have the potential to significantly improve the treatment of various cardiac diseases. They are potent agents with potential for serious adverse effects, toxicity and drug interactions. Newer agents are considerably costly than older drugs and, therefore, cost-effective strategies must be developed. Thrombolytics are pharmacological agents come from bacterial origin as streptokinase and staphylokinase or from human origin as urokinase or t-PA. Thrombolytics are used to restore blood flow to infracted artery quickly. Only streptokinase, alteplase, reteplase and tenecteplase are approved by US-FDA for treatment of ST-elevation myocardial infraction (ST-EMI) [3]. This reopens blood vessels after their occlusion and prevents tissue necrosis. Although, the safe and effective use of each of these drugs requires a thorough understanding of appropriate patient selection, drug timing, dosing regimens and monitoring parameters. The greatest benefit to risk ratio for specific drugs is seen in certain subsets of patients the complexities of cardiovascular drug therapy illustrate the need for an in depth current knowledge of clinical trial evidence.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Descriptive analysis to use the community pharmacy by patients and customers

Community pharmacies not only act as sites of drug purchase but also as healthcare setting. The aim of this study is to examine the extent of public’s use of community pharmacy and their reasons of visiting to Sabha, South part of Libya. Thus, a descriptive, cross-sectional survey with self-administered questionnaire was developed and validated. Data was collected during 2019 by registered pharmacists using the self-designed prepared questionnaire for community pharmacies in Sebha. Of all 600 questionnaires were handed during 2020, 462 forms were returned (77%, response rate). The majority of the respondents reported they had visited the community pharmacies at least once in a month (n = 343, 74%). The highest reason of visiting reported by the respondents was dispensing their prescription medications (n = 304, 65%) while purchasing medication without prescriptions was accounted with n = 162, (35%). The highest rate of the respondents was given advice about antibiotic use (n = 224, 48%) followed by physical exercises (n = 178, 39%) and healthy eating (n = 173, 37%). The majority of the respondents preferred to visit community pharmacy over other healthcare centers because of minor health problems (n = 358, 77%). The major factors influence the consumers choose any particular pharmacy were the professionalism of pharmacy staff (n = 254, 55%) and the availability of the medical products (n = 221, 48%). The respondents incline to choose community pharmacy as a primary health center when they faced drug related problem (n = 248, 54%). In conclusion, the current study revealed that the majority of Libyan people are regular users of community pharmacies and various services and topics of advice have been given by their staff. However, shortage of professional pharmacists in community pharmacies can undermine the opportunity of given reliable pharmaceutical care from these communications.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Therapy and characteristics of hypoglycemia in admitted diabetic patients

Hypoglycemia is a common complication of intensive diabetes mellitus therapy. This study was aimed to review the profile of admitted Libyan cases of non-pregnant adults and adolescents. A retrospective study for patients admitted to Tripoli Diabetes Hospital, Tripoli, Libya. Data were collected from medical files of diabetic patients with hypoglycemia from January 2017 to July 2018. Thus, during this period, a total of 29 cases with hypoglycemia were admitted to the hospital. Their age was ranged from 18 to 86 years in which 76.0% were female, 25.0% were non-smokers, 59.0% were married and 55.0% were non-employers. Patients with diabetes mellitus (86%) showed hypoglycemia attack per month of 3.90 ± 2.25. From the 25 cases with diabetes mellitus, 7.0% were newly diagnosed (> one year), 45.0% their duration of diabetes mellitus were more than 9 years and 35.0% were less than nine years. Their Hemoglobin A1C was on target (6.5–7.0%) in 21.0% of the cases, in which 17.0% were on below target range (< 6> 7.0%). 14.0% were on glibenclamide, 3.0% on glimepiride and 69.0% on insulin. Patients on insulin therapy twice daily in 28.0%, triple in 17.0% and basal bolus regime in 24.0%. Hypoglycemia unawareness was presented in 17.0%, hypoglycemia was major in 45.0% of the cases, and in 38.0% were in daytime. Insulin induced hypoglycemia were in 66.0%, and suicidal attempt were in 10.0%. Exercise induced hypoglycemia 10.0% and 3.0% of cases with malignancy induced hypoglycemia. Co-exist systemic illness was mainly absent in 69.0% but cardiovascular diseases in 14.0% and renal diseases in 7.0%. Majority of cases were discharged in good condition (86.0%) and 14.0% discharged against medical advice. Hypoglycemia mostly occurs in patients with diabetes mellitus treated with insulin and in most the cases were reversible and saved with good management. Thus, patient education is a fundamental issue in prevention and reducing complications of hypoglycemia in patients with diabetes mellitus.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Hematological consequences of antiepileptic drug therapy among children with epilepsy

Epilepsy is a chronic neurologic disease that comes third after cerebrovascular and Alzheimer’s disease. Anti-epileptic drugs may affect certain hematological parameters of epileptic patients. Few researches investigated hematological adverse effects of antiepileptic drugs in Libya. Thus, the aim was to evaluate hematological parameters in epileptic children who are on antiepileptic drugs. This retrospective study included 83 pediatric patients with epilepsy recruited from Benghazi Children Hospital, Department of Neurology, from December 2017 to April 2018. Data collected included demographic characteristics, types of epilepsy, anti-epileptic drugs and serum hematological parameters. Hematological parameters recorded included: hemoglobin, hematocrit, platelet, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration and white blood cell count. In all treated patients, regardless of the number of antiepileptic drugs therapy used, the average levels of hematological parameters were significantly lower in treated group compared to control group (11.64 gm per dl, 34.53%, 27.74 pg and 33.13 gm per dl, respectively). A significant increase (12.12109 per l) in white blood cell counts in treated group was found. Average hemoglobin, hematocrit and mean cell hemoglobin concentration levels were significantly lower in patients on poly-therapy compared to mono-therapy and control groups. Average white blood cell counts were significantly increased in patients on anti-epileptic drugs. In sodium valproate users, levels of hematological parameters were significantly decreased but significantly increased in white blood cell counts. In diazepam users, significant increases in white blood cells and platelet but no difference in other parameters observed. There were no differences in all hematological parameters among patients using carbamazepine except for platelet counts (significantly decreased). In conclusion, there is substantial effect of the anti-epileptic drugs, especially sodium valproate, on hematological parameters of children despite the effects were not critical as the changes were still in the normal range.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Pharmaceutical situation of the pharmacological treatment of hospitalized patients with covid-19 in libya

By January 2020, severe acute respiratory syndrome coronavirus-2 has spread internationally to a pandemic that mainly targets the respiratory system. The relevant infectious disease has been identified as coronavirus disease-2019 (COVID-19) by World Health Organization and declared as a global pandemic. In Libya, National Center for Disease Control reported the first case of coronavirus disease-2019 on 24th March, 2020. The authorities decided to close borders and activate designated treatment centers to deal with COVID-19 cases and contain the outbreak of SARS-COV-2. This study aimed to assess and evaluate the pharmaceutical situation of medications used in pharmacological management of hospitalized COVID-19 patients in Tripoli, Libya. Three WHO availability indicators were selected to be studied and reported. A comprehensive list of medicines used in the management of hospitalized COVID-19 patients was constructed after reviewing and comparing seven national and international pharmacological management protocols and guidelines for hospitalized COVID-19 patients. This comparison revealed that nearly 50 medications are intended for use in COVID-19 inpatient pharmacological management. They all agreed about the use of three medications, representing one from each main class. This list was used to cross check their availability at the chosen designated COVID-19 treatment center. This study proved that local treatment center’s protocol is more in line with international guidelines than the national treatment guideline. The later was issued on March 2020. The Libyan National Essential Medicines’ List contained 25 out of 50 medications of the comprehensive list based on the last update in April 2019. This study recommends that national treatment guidelines and National Essential Medicines’ list require updating. Not all medications used in COVID-19 inpatient management were available in local treatment centers, although, the Emergency Management Department of Ministry of Health in Libya is responsible for the supply of the required medical supplies and medications to the COVID-19 treatment centers.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Role of human liver microsomes in in vitro metabolism of metamizole

Metamizole or Novalgin® is a widely used well tolerated analgesic drug which is however compromised by agranulocytosis as adverse effect. Subsequent to nonenzymatic hydrolysis, the primary metabolic step is N-demethylation of 4-methylaminoantipyrine (4-MAA) to 4-aminoantipyrine (4-AA). The aim of the present study was to identify the human cytochrome P-450 enzyme (CYP) mediating this reaction. This study identified the relevant CYP using virus expressed isolated human CYP, human liver microsomes and rat liver microsomes with chemical inhibition studies. The substrate of 4-methylaminantipyrine was employed at six different concentrations (25, 50, 100, 400, 800 and 1200 µmol per l) with varying concentrations of selective inhibitors of CYP1A2 (furafylline, fluvoxamine), CYP3A4 (ketoconazole), CYP2A6 (coumarin), CYP2D6 (quinidine), CYP2C19 (omeprazole, fluvoxamine, tranylcypromine), CYP2C9 (sulphaphenazole) and CYP1A1 (alpha-naphthoflavone). 4-MAA and 4-AA were analyzed by HPLC and enzyme kinetic parameters (Km and Vmax) were determined by regression (Sigma plot 9.0). The N-demethylation of 4-MAA by microsomes prepared from baculovirus expressing human CYP was pronounced with CYP2C19. Intrinsic clearance of the most active enzymes were 0.092, 0.027 and 0.026 for the CYP enzymes 2C19, 2D6 and 1A2, respectively. Metabolism by human liver microsomes was strongly inhibited by fluvoxamin, omeprazole and tranylcypromine (IC50 of 0.07, 0.07 and 0.18, respectively) but with coumarin, sulphaphenazole, ketoconazole, moclobemid, quinidine alpha-naphthoflavone and furafylline were 0.79, 1.20, 1.36, 1.44, 3.46, 4.68 and 8.41, respectively. The enzyme CYP2C19 apparently has an important role in N-demethylation of 4-methylaminoantipyrine which should be further analyzed in clinical studies and which may also be interesting concerning the agranulocytosis.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

Unveiling of cannabidiol in the treatment of rare childhood epilepsies: dravet and lennox gastaut syndromes

In childhood, epilepsy is the most common globally widespread neurological problem, usually with serious consequences for this most critical period of development. Dravet and Lennox Gastaut syndromes are two forms of rare and severe treatment resistant epilepsies that occur early in the life. These resistant epilepsies recognised by continuous unrelenting seizures of many types including the occurrence of status epilepticus. In addition, it is associated with the development of behavioural, neurological, cognitive deficits and the sequelae of increased risk of mortality rate. Historically, cannabis was found to possess several medical benefits including its use for epilepsy. In this review, information and data were extracted from 99 references using PubMed and Google Scholar (November, 2021). Data with clinical evidence on cannabidiol regarding its efficacy on Dravet syndrome and Lennox Gastaut syndrome, mechanism of action, safety, pharmacokinetic properties and interactions with anti-epileptic medications were all reviewed and discussed. Highly purified cannabidiol is a cannabis derived compound that is suggested in recent research as an add-on therapy to the existing treatment of both resistant epileptic types; since it is able to reduce the duration, frequency and severity of seizure disorders. It is also characterised with multiple signalling transduction mechanisms, primarily via inhibition of excitatory and potentiation of inhibitory pathways.

Mediterranean Journal of Pharmacy and Pharmaceutical Sciences

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