Effect of aceclofenac on pharmacokinetic of phenytoin

Aceclofenac is presently most commonly prescribed analgesic for chronic pain and inflammatory conditions. In clinical practice, phenytoin and aceclofenac are used in a chronic condition of generalized seizure with concomitant chronic pain. Hence there are chances of drug-drug interaction because modulations of isoenzymes involved in metabolism of phenytoin and aceclofenac are CYP2C9/10 and CYP2C19. It is important to maintain the therapeutic level of phenytoin in plasma for effective control of seizure. So, the aim of the study was to determine the effect of aceclofenac on the pharmacokinetics of phenytoin in rabbits. In a parallel design study, phenytoin 30 mg/kg/day per oral was given daily for seven days. On day 7, blood samples were taken at various time intervals between 0-24 hours. In aceclofenac group, phenytoin was administered for seven days as above. On day 8, aceclofenac 14 mg/kg alongwith phenytoin 30 mg/kg/day was administered and blood samples drawn as above. Plasma phenytoin levels were assayed by HPLC and pharmacokinetic parameters were calculated. In aceclofenac group, there was decrease in t[1/2]el than phenytoin group significant changes were observed in the pharmacokinetic parameters in aceclofenac treated group. These results suggest that aceclofenac alter the pharmacokinetics of phenytoin. Confirmation of these results in human studies will warrant changes in phenytoin dose or frequency when aceclofenac is co-administered with it

Lacosamide, a newer antiepileptic

Lacosamide [LCM] is a newer antiepileptic drug with a dual mode of action. It selectively enhances slow inactivation of voltage-gated sodium channels without affecting fast inactivation, and modulates collapsing response mediator protein 2 [CRMP-2]. It has a high oral bioavailability of approximately 100%. It has shown potent and broad neuroprotective effects in vitro and in vivo animal models making it a potential candidate for long term treatment of epilepsy. In addition to this, it has demonstrated analgesic activity in various animal models. Apart from this, LCM has demonstrated potent effects in animal models for a variety of CNS disorders like schizophrenia and stress induced anxiety. Various safety pharmacology and toxicology studies have shown that LCM is well tolerated. Clinical trials have also suggested that LCM is a safe, effective, and well tolerated adjunctive treatment for reduction of seizure frequency in patients with highly refractory, partial seizures. Other potential indications of LCM are being investigated

Emerging role of uterine natural killer cells in establishing pregnancy

Normal pregnancy has been considered as a controlled state of inflammation at an early stage of blastocyst implantation that subsequently develops systemically. Till recent past most popular hypotheses regarding status of immune system in pregnancy were dominated by the Th[1] and Th[2] hypothesis, in which the fetus avoids maternal rejection through a bias towards I-helper [Th[2]] cytokine production. Recent findings have shown that predominant immune interactions in the human deciduas are between the placental trophoblast and maternal uterine natural killer [uNK] cells rather than the I cells. Thus NK cells are emerging as important players in the uterine immune response to invasive forms of placenta, as in cases of hemochorial placenta. In humans there is a lack of evidence for I-cell responses to trophoblast cells; therefore it was thought that uterine NK cells are the key factors by which the maternal immune system recognizes trophoblast cells. In this review we are trying to summarize the role of uNK cells in the maintenance of normal pregnancy in humans

Natural product and drugs interactions, its clinical implication in drug therapy management

The interaction of natural products and drugs is a common hidden problem encountered in clinical practice. The interactions between natural products and drugs are based on the same pharmacokinetic and pharmacodynamic principles as drug-drug interactions. Clinically important interactions appear to involve effects on drug metabolism via cytochrome P-450 isoenzymes, impairment of hepatic or renal function, and other possible mechanisms. To effectively counsel patients on interactions involving natural products, physicians, and pharmacists should be familiar with the most commonly used products, and have access to information on more obscure products. In this review, we describe details of drugs interaction with natural products and its impact on drug therapy management

Bird Flu: a new emerging pandemic threat and its pharmacological intervention

Bird flu is an infection caused by avian influenza viruses, which are of different types A, B and C. Type A avian influenza viruses are the most frequently associated with avian influenza epidemics and pandemics. There are 16 hemagglutinin [H1 to H16] and 9 neuraminidase types [N1 to N9] identified till date. A peculiar characteristic of influenza A viruses is their propensity for genetic change by two main processes: antigenic drift [small, gradual changes] and antigenic shift [abrupt, major change producing a novel influenza A virus subtype]. There are various modes of transmission of human influenza including inhalation, direct or indirect [fomite] contact etc., can have manifestations ranging from mild to severe or fatal disease, depend on the viral subtype causing the disease. Avian influenza A [H5N1] results in high death rate amongst infants and young children. The first outbreak of human infection by avian influenza viruses [H5N1] was observed in 1997 in Hong Kong. Since then a large number of outbreaks have been reported in different parts of the world. In fact, the spread of avian influenza H5N1 in various species including humans has lead to a current pandemic threat. Human avian influenza infections in persons at high risk of exposure can be prevented by adopting a series of protective measures, anti-viral vaccination and health monitoring. Drugs currently available for the treatment or prophylaxis of influenza infections include the adamantanes [amantadine and rimantadine] and the newer class of neuraminidase inhibitors [zanamivir, oseltamivir and peramivir]. However, vaccines are considered the first line of defense for reducing the excess morbidity and mortality that invariably accompany pandemics and a number of clinical trials are under way to test them

bird flu: a new emerging pandemic threat and its pharmacological intervention

Bird flu is an infection caused by avian influenza viruses, which are of different types A, B and C. Type A avian influenza viruses are the most frequently associated with avian influenza epidemics and pandemics. There are 16 hemagglutinin [H1 to H16] and 9 neuraminidase types [N1 to N9] identified till date. A peculiar characteristic of influenza A viruses is their propensity for genetic change by two main processes: antigenic drift [small, gradual changes] and antigenic shift [abrupt, major change producing a novel influenza A virus subtype]. There are various modes of transmission of human influenza including inhalation, direct or indirect [fomite] contact etc., can have manifestations ranging from mild to severe or fatal disease, depend on the viral subtype causing the disease. Avian influenza A [H5N1] results in high death rate amongst infants and young children. The first outbreak of human infection by avian influenza viruses [H5N1] was observed in 1997 in Hong Kong. Since then a large number of outbreaks have been reported in different parts of the world. In fact, the spread of avian influenza H5N1 in various species including humans has lead to a current pandemic threat. Human avian influenza infections in persons at high risk of exposure can be prevented by adopting a series of protective measures, anti-viral vaccination and health monitoring. Drugs currently available for the treatment or prophylaxis of influenza infections include the adamantanes [amantadine and rimantadine] and the newer class of neuraminidase inhibitors [zanamivir, oseltamivir and peramivir]. However, vaccines are considered the first line of defense for reducing the excess morbidity and mortality that invariably accompany pandemics and a number of clinical trials are under way to test them