ABSTRACT
Introduction: The risk of drug-drug interactions (DDIs) is high in patients with chronic kidney disease (CKD) necessitating dose adjustments or the avoidance of drug combinations. This study aimed to evaluate DDIs among patients with CKD in the University of Nigeria Teaching Hospital (UNTH), Enugu, South-East Nigeria.Methods: this study was a retrospective review of patients with CKD who received treatment at the nephrology unit of UNTH between January 2004 and December 2014. The drug-drug interactions (DDIs) of the prescribed drugs were classified using the RxList interaction checker. The IBM SPSS Version 21.0 was utilized for statistical analysis with P-value ⤠0.05, considered statistically significant.Results: a total of 749 DDIs were identified from the folders of the 169 patients with CKD that were eligible. Majority were above 50 years old and in stage 4 or 5 CKD. Furosemide,lisinopril and amlodipine were the most frequently prescribed drugs and had the greatest likelihood for nephrotoxicity. The number of medications and hypertension (as co-morbidity) were significant and independent predictors of DDIs among the patients. About 70% of the drug combinations required monitoring as they fell within the "significant category" of the RxList interaction checker. The most common interactions were between lisinopril and furosemide; furosemide and calcium carbonate; lisinopril and calcium carbonate.Conclusion: the prevalence of DDIs was high among the CKD patients. Prescribers and pharmacists in Nigerian hospitals may need to pay close attention to prescriptions of patients with CKD to identify, prevent and resolve undesirable DDIs
Subject(s)
Drug Combinations , Drug Interactions , Hypertension , Nigeria , Renal Insufficiency, Chronic , Retrospective Studies , Tertiary Care CentersABSTRACT
Background: Healthcare workers are often reluctant to start combination antiretroviral therapy (ART) in patients receiving tuberculosis (TB) treatment because of the fear of high pill burden; immune reconstitution inflammatory syndrome; and side-effects.Object: To quantify changes in adherence to tuberculosis treatment following ART initiation.Design: A prospective observational cohort study of ART-naive individuals with baseline CD4 count between 50 cells/mm3 and 350 cells/mm3 at start of TB treatment at a primary care clinic in Johannesburg; South Africa. Adherence to TB treatment was measured by pill count;self-report; and electronic Medication Event Monitoring System (eMEMS) before and after initiation of ART.Results: ART tended to negatively affect adherence to TB treatment; with an 8% - 10% decrease in the proportion of patients adherent according to pill count and an 18% - 22% decrease in the proportion of patients adherent according to eMEMS in the first month following ART initiation; independent of the cut-off used to define adherence (90%; 95% or 100%). Reasons for non-adherence were multi factorial; and employment was the only predictor for optimal adherence (adjusted odds ratio 4.11; 95% confidence interval 1.06-16.0).Conclusion: Adherence support in the period immediately following ART initiation could optimise treatment outcomes for people living with TB and HIV
Subject(s)
Drug Combinations , Patient Compliance , Tuberculosis/therapyABSTRACT
Amodiaquine and artesunate are two antimalarial drugs sold in combination as Larimalr'. This drug is a very effective artemisinin-base combination. This study was to access the effects of amodiaquine and artesunate combination on the histology of the cerebellum. Twenty adult Wistar rats weighing between 150-180g were divided into four groups (A; B; C and D) of five animals each. Group A served as the control and the animals received distilled water; while group B received 8.75+2.86mg/kg of amodiaquine and artesunate combination for three days; group C received 8.75+2.86mg/kg of amodiaquine and artesunate combination for six days and group D received 17.50+5.71mg/kg of amodiaquine and artesunate combination for three days. Histological sections showed destruction of the Purkinje cortical layers in group B; with increased destructions in groups C and D compared to the control. These results reveal that amodiaquine and artesunate combination causes histological alterations; which were dose and time dependent and these may result in cerebellar dysfunction
Subject(s)
Amodiaquine , Cerebellum/drug effects , Drug Combinations , Histology , RatsABSTRACT
N.A.
Subject(s)
Artemisinins/adverse effects , Artemisinins/therapeutic use , Drug Combinations , Malaria/drug therapyABSTRACT
N.A.
Subject(s)
Antimalarials , Artemisinins/adverse effects , Drug Combinations , Treatment RefusalABSTRACT
The formulation of sulphamethoxazole (S) and trimethopin (T) (C)-TRIMOXAZOLE) in a combination mixture is very good pharmacologically since it enhances the efficacy of the individual drugs. However in this combination; difficulties in analysis on ordinary UV spectrophotometry are introduced because the two components gove overlapping spectral bands on zero-order. The United States Pharmacopoea (USP) recommended HPLC analytical method is quite expensive. Objective: The objective of the present work was to assess whether derivative spectrophotometry could be used to circumvent the overlapping spectral bands of the components and hence use it for routine analysis of the drug. Study design: Experimental. Methods: The aqueous solution of the individual drugs and their binary mixtures were scanned on zero order and on first derivative at the wave length between 200-300nm and at the pH of 4.5. Results: The zero-order spectra of the compound were completely overlapping. However the first-derivative scan offered better separation and hence T was determined from the absorbance at 237.6nm with negligible contribution from S (since at this point it was reading zero). Likewise S was determined at a wavelength of 259nm when T was reading zero. The linear calibration graphs were obtained for 4-25ugml of S and for 4-20ugml of T. Conclusion: The method is rapid; simple and can be applied successfully to assay a mixture of the two drugs in pharmaceutical preparations
Subject(s)
Drug Combinations , Sulfamethoxazole , TrimethoprimABSTRACT
La pharmacore Ì sistance constitue l'une des plus graves menaces pour la lutte antipaludique. En Afrique, l'efficacite Ìdesantipaludiques e Ì conomiquement abordables s'amenuise tre` s vite alors que les me Ì dicaments hautement efficaces onttendance a` couË ter trop cher. Or des strate Ì gies d'un bon rapport cout-efficacite Ì s'imposent pour prolonger la dure Ìedevie utile des antipaludiques. Des observations faites en Asie du Sud-Est sur un traitement associant des dérivés del'arte Ì misinine a`delame Ì floquine indiquent un ralentissement du phe Ì nome` ne de pharmacore Ì sistance a` l'e Ì gard de cesdeux substances. D'ou` la possibilite Ì de trouver une solution au proble` me de la pharmacore Ì sistance en Afrique ou`denombreux obstacles s'opposent toutefois a` la mise en place efficace d'un traitement associe Ì . En effet, les taux detransmission sont relativement e Ì leve Ì s, une forte proportion d'infections asymptomatiques se produit chez des sujetssemi-immuns, les me Ì dicaments sont souvent utilise Ì s de fac ̧ on inopportune et sans informations suffisantes, les diagnostics de laboratoire font souvent de Ì faut et les services de sante Ì publique sont, en general, insuffisants en Afrique subsaharienne. En outre, le traitement associé coute relativement cher. Les auteurs examinent ici le traitement associe Ìtel qu'il est applique Ì en Asie du Sud-Est, en relevant au passage les problèmes à résoudre si l'on veut l'adopter avecsucce` s en Afrique subsaharienne
Subject(s)
Africa , Antimalarials/pharmacology , Cross-Cultural Comparison , Drug Combinations , Drug Resistance , Forecasting , Malaria/drug therapy , Malaria/transmission , Sesquiterpenes/pharmacologyABSTRACT
De janvier 1994 a decembre 1998; 27 malades ages de 19 a 65 ans; et atteints de sarcome de kaposi associe au sida ont ete traites dans le Service de Medecine et Carcinologie du CHU de Brazzaville. Le traitement ainsi administre; etait constitue de l'association vincristine-bleomycine. En dehors de la confirmation microscopique du diagnostic et d'un bilan prealable d'extension; les malades devaient avoir un indice superieur ou egal a 50 pour cent. Nous avons enregistre un taux de reponse objective de 59;5 pour cent avec une duree de 9 mois
Subject(s)
Acquired Immunodeficiency Syndrome , Bleomycin , Drug Combinations , Sarcoma, Kaposi , VincristineABSTRACT
Une association composee de trois plantes : Ammi visnaga; Erythrea centaurium et Thymus ciliatus est utilisee en medecine traditionnelle marocaine dans le traitement du diabete. Des etudes preliminaires ont demontre les proprietes hypoglycemiantes de l'extrait aqueux de l'association sur des rats normoglycemiques; et ont conclu a la non toxicite aigue et chronique de l'association. Cet article est une contribution a l'etude de l'activite antidiabetique de l'extrait aqueux sur des rats atteints de diabete alloxanique