ABSTRACT
Food-drug interactions occur as a result of pharmacokinetic or pharmacodynamics mechanisms. Pharmacokinetic mechanisms include what the body does to a drug while Pharmacodynamics mechanisms involve what drugs do to the body. Many types of food have been shown to influence metabolism and the absorption of drugs. Large numbers of drugs are produced and introduced yearly. The interaction between Food and drug may cause negative effects in the nutritional status of the patient as well as safety and efficacy of drug therapy. Due to the possibility of unexpected or poor outcomes, generally, food-drug interactions, in this case, should be avoided. As the good clinical practice, drugs taken by mouth must be absorbed either through the lining of the stomach or the small intestine. Reduction in the absorbance of a drug might be influenced by the presence of food in the digestive tract. The avoidance of such interactions could be possible if the drug is taken 1 hour before or 2 h after eating the food. The effects of several types of food such as milk or milk products, grapefruit and grapefruit juice, bananas, oranges, legumes, fermented meats and pickled fish and some nutrient elements such as calcium, potassium, magnesium, iron, zinc, and vitamin K are highlighted in this paper including their clinical implications.
ABSTRACT
OBJECTIVE: To establish an LC-MS/MS method for the determination of levetiracetam to investigate the pharmacokinetics of levetiracetam extended-release tablets at fasted and fed states. METHODS: The separation was achieved on a Waters Symmetry C18 column (3.9 mm×150 mm, 5 μm) with mobile phase consisting of acetonitrile-5 mmol·L-1 ammonium acetate and 0.3% formic acid aqueous solution (10/90, V/V). Two subjects were randomly assigned to receive single oral dose of levetiracetam extended-release tablets 1 000 mg after being fasted and fed by a randomized crossover design. The plasma concentrations of levetiracetam were measured by LC-MS/MS. RESULTS: The calibration curve of levetiracetam in human plasma was linear over the concentration rang of 0.100 0-80.00 μg·mL-1. Under fasted and fed conditions, the main pharmacokinetic parameters of levetiracetam were as follows:ρmax were 20.50 and 19.09 μg·mL-1, AUC0-48 h were 345.4 and 336.3 μg·h·mL-1, tmax were 4.5 and 7.0 h, respectively. CONCLUSION: The method is proved to be convenient, accurate and sensitive, and suitable for the pharmacokinetic study of 1 000 mg levetiracetam extended-release tablets in healthy Chinese volunteers after being fasted and fed. The result suggests that high fat and calories diet has effect on the pharmacokinetics of levetiracetam extended-release tablets, with tmax being delayed.
ABSTRACT
Objective:To investigate the effect of extract of mung bean seed coat ( MBSC) on the activity of CYP3A4 in vitro. Methods:Midazolam was used as the probe drug, and an HPLC method for determining the metabolite of midazolam ( l-hydroxyl mid-azolam) in rat liver microsome incubation system was established. Three important parameters including the incubation time, concen-tration of rat microsome and probe concentration were optimized for rat liver microsome incubation system, and then the optimal incuba-tion system was applied to study the effect of MBSC extract on CYP3A4 activity and the potential mechanism. Results: The results showed MBSC crude extract could inhibit CYP3A4 activity to 38. 14% as that in the control group(P<0. 05) with IC50 value of 489. 7μg·ml-1 . The mechanism might be related to competition-noncompetition inhibition. Conclusion: MBSC extract exhibits inhibitive potency to CYP3A4 in in-vitro model. Further studies should be conducted to check the influence of MBSC on CYP3A4 in vivo.
ABSTRACT
Objective:To investigate the effect of extract of mung bean seed coat ( MBSC) on the activity of CYP3A4 in vitro. Methods:Midazolam was used as the probe drug, and an HPLC method for determining the metabolite of midazolam ( l-hydroxyl mid-azolam) in rat liver microsome incubation system was established. Three important parameters including the incubation time, concen-tration of rat microsome and probe concentration were optimized for rat liver microsome incubation system, and then the optimal incuba-tion system was applied to study the effect of MBSC extract on CYP3A4 activity and the potential mechanism. Results: The results showed MBSC crude extract could inhibit CYP3A4 activity to 38. 14% as that in the control group(P<0. 05) with IC50 value of 489. 7μg·ml-1 . The mechanism might be related to competition-noncompetition inhibition. Conclusion: MBSC extract exhibits inhibitive potency to CYP3A4 in in-vitro model. Further studies should be conducted to check the influence of MBSC on CYP3A4 in vivo.
ABSTRACT
RESUMO Objetivo: descrever o perfil de medicamentos orais padronizados em uma unidade hospitalar e verificar sua adequação quanto ao uso por cateteres enterais, de acordo com recomendações da literatura. Método: estudo descritivo, com dados sobre medicamentos coletados do Sistema de Dispensação do Serviço de Farmácia. As recomendações específicas para uso de tais medicamentos por cateteres enterais foram obtidas após busca em bases literárias, livros, manuais, guidelines e bulários. Resultados: dos 236 medicamentos orais dispensados, 86% estavam na forma sólida; destes, 32 eram "não trituráveis", havendo disponibilidade da forma líquida na instituição. Foram identificados 28 medicamentos com potenciais interações com a nutrição enteral. Sessenta porcento deles apresentavam recomendações específicas sobre sua administração por cateter enteral. Conclusão: a participação conjunta das equipes multidisciplinares de terapia nutricional e de assistência e a implementação de programas para treinamento contínuo constituem estratégias sugeridas para a prevenção de potenciais problemas na administração de medicamentos no espaço hospitalar.
RESUMEN Objetivo: describir el perfil de medicamentos orales estandarizados en una unidad hospitalaria y verificar su adecuación respecto del uso vía sondas gástricas, según recomendaciones de la literatura. Método: estudio descriptivo, con datos sobre medicamentos recolectados del Sistema de Dispensación del Servicio de Farmacia. Las recomendaciones específicas de uso por sondas gástricas fueron obtenidas por búsqueda en bases de literatura, libros, manuales, guidelines y vademécums. Resultados: De los 236 medicamentos orales dispensados, 86% se presentaban en forma sólida; de ellos, 32 eran "no triturables", existiendo disponibilidad de la forma líquida en la institución. Fueron identificados 28 medicamentos con potenciales interacciones con la nutrición enteral. El 60% incluía recomendaciones específicas sobre administración por sonda gástrica. Conclusión: la participación conjunta de equipos multidisciplinarios de terapia nutricional y de atención y la implementación de programas de capacitación permanente constituye estrategias sugeridas para prevenir potenciales problemas en administración de medicamentos en el ámbito hospitalario.
ABSTRACT Objective: to describe the profile of standardized oral drugs at a hospital unit and assess their adequacy for use via enteral feeding tubes, according to recommendations from the literature. Method: descriptive study, with data on drugs collected from the Pharmacy Service Dispensing System. Specific recommendations for the use of these drugs via enteral feeding tubes were found after searches in literary databases, books, manuals, guidelines and package insert collections. Results: among the 236 dispensed oral drugs, 86% were in solid form; of those, 32 were "non-crushable", with the liquid form available at the institution. Twenty-eight drugs with potential interactions with enteral nutrition were identified. Sixty percent of those presented specific recommendations on their administration via enteral feeding tube. Conclusion: the joint participation of multidisciplinary nutritional therapy and care teams and the implementation of programs for continuous training are suggested strategies for the prevention of potential problems in the administration of drugs in the hospital setting.