Analysis of potential drug interactions in medical clinic sector in a Hospital of João Pessoa - PB

Abstract The objective of this study was to evaluate drug interactions based on medical records of patients hospitalized in University Hospital Lauro Wanderley (UHLW) in João Pessoa-PB, Brazil. This was a quantitative, descriptive study with a cross-sectional design. This research was conducted in the medical clinic of the above hospital by analyzing pharmaceutical intervention in medical records. The investigated samples consisted of all medical profiles with drug interaction information of patients hospitalized from June 2016 to June 2017. Most of these drug interactions were determined and classified by Micromedex® Solutions database. This research was approved by the Ethics Committee in Institutional Human Research, protocol number 2.460.206. In total, 331 drug interactions were found in 131 medical profiles. Dipyrone, enoxaparin, sertraline, ondansetron, quetiapine, tramadol, bromopride, amitriptyline, and simvastatin were medications that showed highest interactions. According to Anatomical Therapy Classification (ATC), drugs that act on the central nervous system result in more interactions. The most prevalent interaction was between dipyrone and enoxaparin. Some limitations of this study are the lack of notifications and data on drug interactions.

Inhibitory effect of Pyr6 (an Orai channel blocker) on agonist-induced contractions in rat uterus.

AIM: Both human and rat myometrium express stromal interaction molecule (STIM) and Orai/transient receptor potential canonical (TRPC) proteins, which are components of plasma membrane Ca2+ store-operated channels. There are reports that these proteins mediate agonist-induced Ca2+ influx in cultured myometrial cells. In this study, we aimed to determine the effects of Pyr6, an Orai channel blocker, on different agonist-induced contractions in isolated segments of rat uterus. MAIN FINDINGS: In Ca2+ -free Tyrode's solution, Pyr6 (3 µM) promoted a reduction in both the magnitude and frequency of Ca2+ (1 mM)-induced uterine contractions after the addition of carbachol (CCh, 100 µM), but not after the addition of oxytocin (OT, 150 nM). In Ca2+ (0.18 mM)-Tyrode's solution, Pyr6 completely relaxed uterine contractions induced by both CCh and cloprostenol (300 nM), but not those induced by either KCI (40-80 mM) or OT. The addition of Pyr6 abolished the oscillatory uterine contractions induced by Ca2+ after the addition of cyclopiazonic acid (CPA, 10 µM). When pre-incubated (5 min), Pyr6 reduced the magnitude of both CCh-induced phasic and tonic contractions. The addition of Pyr2 (3 µM), an Orai and TRPC channel blocker, abolished uterine contractions induced by CCh or OT. CONCLUSION: Considering Pyr6 as an Orai channel blocker and its inhibitory effect on uterine contractions induced by CCh, CPA, and cloprostenol, we suggest that Orai channels are required for the maintenance of contractions induced by these agonists in rat uterus.

Technological Evaluation of Emulsions Containing The Volatile Oil from Leaves of Plectranthus Amboinicus Lour.

BACKGROUND: Plectranthus amboinicus Lour is a species which is widespread throughout tropical countries where it is widely used against respiratory tract disorders such as bronchodilator, antitussive, and expectorant conditions. OBJECTIVE: This study aims to characterize the essential oil of P. amboinicus (PaEO) and produce and evaluate emulsions containing PaEO. MATERIALS AND METHODS: The essential oil was characterized by physical-chemical analyses for density, refractive index, 90% ethanol solubility, color, appearance, and identification by gas chromatography coupled to mass spectrometry detection. The emulsions were prepared following a hydrophile-lipophile balance [HLB] spreadsheet design from two nonionic surfactants (Span 80® and Tween 20®) producing HLB values ranging from 4.3 to 16.7. The products were stored at room temperature at 5°C. The emulsion stabilities were tested both in the long and short-term. RESULTS: The PaEO was obtained by steam distillation and the total extraction was reached after 3 hours yielding of 0.2% (w/w). This essential oil was characterized by physicochemical analyses for density [1.5 g.ml-1], refraction index [0.9167], ethanol 90% solubility [1:2], color, and appearance (yellow/clear). Nineteen components were identified in the oil, among them the sesquiterpenes: carvacrol [33.50%], p-cymene [28.20%] and γ-terpinene [14.77%]. The emulsions obtained successfully showed, for the first time, HLB values for essential oils from Plectranthus amboinicus [15.7]. CONCLUSION: The experimental data shows a relationship between HLB values of the surfactant mixtures contributing to the emulsified systems production containing phytopharmaceuticals. Such an approach is of great importance to the development of lipid carriers for therapeutic drugs. SUMMARY: The essential oil from leaves of Plectranthus amboinicus was extracted by steam distillation and characterized.The emulsions containing essential oil were produced and the stability was performed in the short and long term.The critical hydrophilic-lipophilic balance (HLB) of the essential oil was 15.7 and was achieved by the combination of surfactants (Tween 80® and Span 20®). Abbreviations used: PaEO: essential oil of P. amboinicus, HLB: hydrophilic-lipophilic balance, CI: Creaming Index, MET: micro-emultocrit technique.

In vitro effects of nano-hydroxyapatite paste on initial enamel carious lesions.

PURPOSE: The purpose of this study was to analyze the protective effect of remineralizing agents on enamel caries lesions using surface Knoop microhardness testing (KHN) and atomic force microscopy (AFM). METHODS: Forty-eight human enamel blocks were assigned to four groups (N=12): (1) control (without agent); (2) fluoride varnish (Duraphat); (3) nano-HAP paste (Desensibilize Nano P); and (4) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (MI Paste Plus). Incipient caries-like lesions were artificially developed. Cariogenic challenge (pH-cycling) was performed for seven days. The pastes were applied before each immersion in demineralization solution, and the varnish was applied only once. KHN values were obtained at baseline, after incipient enamel lesion, and after challenge. The percentage of surface hardness recovery (%SMHR) was performed, and the surface morphology was evaluated by atomic force microscopy (AFM). ANOVA, Tukey's, and student paired t tests were applied at P<.05. RESULTS: After the cariogenic challenge, the nano-HAP group showed significantly higher KHN and %SMHR values than varnish. The CPP-ACP group showed no increase in KHN. The nano-HAP group showed, via AFM, a protective layer formation with globular deposits on the surface. CONCLUSION: SMHR and AFM morphology revealed that nano-hydroxyapatite paste showed a protective effect against in vitro enamel caries development.

In Vitro Effects of Nano-hydroxyapatite Paste on Initial Enamel Carious Lesions.

PURPOSE: The purpose of this study was to analyze the protective effect of remineralizing agents on enamel caries lesions using surface Knoop microhardness testing (KHN) and atomic force microscopy (AFM). METHODS: Forty-eight human enamel blocks were assigned to four groups (N=12): (1) control (without agent); (2) fluoride varnish (Duraphat); (3) nano-HAP paste (Desensibilize Nano P); and (4) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (MI Paste Plus). Incipient caries-like lesions were artificially developed. Cariogenic challenge (pH-cycling) was performed for seven days. The pastes were applied before each immersion in demineralization solution, and the varnish was applied only once. KHN values were obtained at baseline, after incipient enamel lesion, and after challenge. The percentage of surface hardness recovery (%SMHR) was performed, and the surface morphology was evaluated by atomic force microscopy (AFM). ANOVA, Tukey's, and student paired t tests were applied at P<.05. RESULTS: After the cariogenic challenge, the nano-HAP group showed significantly higher KHN and %SMHR values than varnish. The CPP-ACP group showed no increase in KHN. The nano-HAP group showed, via AFM, a protective layer formation with globular deposits on the surface. CONCLUSION: SMHR and AFM morphology revealed that nano-hydroxyapatite paste showed a protective effect against in vitro enamel caries development.

A preformulation study of a new medicine for Chagas disease treatment: physicochemical characterization, thermal stability, and compatibility of benznidazole.

This work aimed the studies of physicochemical characterization, thermal stability, and compatibility of benznidazole (BNZ) drug by spectroscopy (NMR, IR), thermoanalytical (differential thermal analysis, differential scanning calorimetry, and thermogravimetry), and chromatographic (HPLC) techniques, beyond the analytical tools of Van't Hoff equation and Ozawa model. The compatibility study was conducted by binary mixtures (1:1, w/w) of the drug with microcrystalline cellulose 102 and 250, anhydrous lactose, and sodium starch glycolate. The physicochemical characterization confirmed data reported in scientific literature, guaranteeing authenticity of the analyzed raw material. The drug melts at 191.68°C (∆H, 119.71 J g(-1)), characteristic of a non-polymorphic raw material, and a main stage decomposition at 233.76-319.35°C (∆m, 43.32%) occurred, ending the study with almost all mass volatilized. The quantification of drug purity demonstrated a correlation of 99.63% between the data obtained by chromatographic (99.20%) and thermoanalytical technique (99.56%). The Arrhenius equation and Ozawa model showed a zero-order kinetic behavior for the drug decomposition, and a calculated provisional validity time was 2.37 years at 25°C. The compatibility study evidenced two possible chemical incompatibilities between BNZ and the tested excipients, both associated by the authors to the reaction of the BNZ's amine and a polymer carbohydrate's carbonile, being maillard reactions. The BNZ reaction with anhydrous lactose is more pronounced than with the sodium starch glycolate because the lactose has more free hydroxyl groups to undergo reduction by the drug. In this sense, this work guides the development of a new solid pharmaceutical product for Chagas disease treatment, with defined quality control parameters and physicochemical stability.