Evaluation of Proper Usage of Glucocorticosteroid Inhalers and Their Adverse Effects in Asthmatic Patients.

BACKGROUND: The frequent use of corticosteroid inhalers (CSIs), especially at higher doses, has been accompanied by concern about both systemic and local adverse reactions. The local adverse reactions of inhaled corticosteroids (ICSs) are considered to constitute infrequent and minor problems. However, while not usually serious, these local adverse reactions are of clinical importance. This study assessed the prevalence of local adverse reactions, their clinical features, role of inhaler devices and current measures that have been suggested to prevent the problem. MATERIALS AND METHODS: This study was performed in YAS clinic in Tabriz on 500 asthmatic patients. A questionnaire about the patients' demographic information, methods of using CSIs, local care after using CSIs, using spacer devices, doses of ICSs, and adverse reactions were filled then the patients were clinically examined for local adverse reactions. RESULTS: Only 56% patients were using CSIs properly. In general, the incidence of complications was: oropharyngeal candidiasis 25.6%, laryngeal weakness 8.8%, choking 17.6%, tooth decay 15.2%, speechlessness 36.2%, taste decrease 20.8%, tongue burning 29.8% and tongue abrasion 27.8%. CONCLUSION: Persistent asthma can be effectively controlled with currently available CSIs. Although not life-threatening, local adverse reactions of ICSs are clinically significant and warrant attention. Use of spacer devices and changes in CSI usage, dosage amount and frequency and rinsing and gargling are the methods that have been used to reduce the incidence of local adverse reactions.

Socio-demographic characteristics of the addicted inmates of Qom and Tabriz prisons in Iran.

PURPOSE: The aim of this investigation was to study the factors responsible for drug addiction amongst the inmates of Tabriz and Qom prisons, to further understand the reasons for drug abuse particularly in the young and find improved methods for combating these widespread problems. METHODS: A multi-choice questionnaire was provided to inmates to potentially assess the reasons for their drug addiction psychiatric, personal, social, economical, and political factors were thought to be implicated. Two hundred drug addicted prisoners were individually interviewed randomly in both Tabriz and Qom prisons. A questionnaire including questions about the inmates' demographic characteristics and 49 multiple answers questions, was provided to identify the effects of different reasons for drug addiction for instance: psychiatric, personal, social, economical, and political factors. The collected data were analyzed by Student t-test and chi-squared test using SPSS software. RESULTS: The results showed that the following factors could lead to drug addiction e.g. company with addicted friends and offenders, curiosity, imitation, illiteracy, family problems, crowded family, poverty, unemployment, and lack of self confidence. There were significant differences between Tabriz and Qom prisoners in relation to age, starting age of addiction, job, income, education, class of addiction, marital status, and hobbies. Mean age, mean starting age of addiction, poverty, alcohol drinking before addiction, marital status, heroin addiction, codeine and benzodiazepines abuse were significantly greater for Tabriz prisoners than those of Qom. CONCLUSION: It is clear that the governmental programs for reducing unemployment, creation of safe hobbies, proper control on drug dispensing in the pharmacies, proper birth control programs, and encouragement to higher education could alleviate addiction problem in Iran.

Determination of glyceryl trinitrate and its two main metabolites in human plasma using a new sensitive gas chromatography method.

The aim of the present study was to determine the concentrations of nitroglycerin (glyceryl trinitrate, GTN, CAS 55-63-0) and its two main stable metabolites; 1,2-dinitroglycerin (1,2-glyceryl dinitrate, GDN, CAS 621-65-8) and 1,3-dinitroglycerin (1,3-GDN, CAS 623-87-0) in human plasma using a capillary gas chromatography method with an electron capture detection. Using the GC conditions, linear calibrations were obtained for 1,3-GDN from 0.14 to 3 ng/mL, for 1,2-GDN from 0.06 to 6 ng/mL, and for GTN from 0.01 to 0.3 ng/mL in plasma samples by the following calibration curve equations: [y = 0.1924x - 0.0088 (r = 0.999)], [y = 0.2273x + 0.0164 (r = 0.995)], [y = 17.434x - 0.0751] for 1,3-GDN, 1,2-GDN, and GTN respectively. The calculated limits of quantification values for GTN, 1,2-GDN, and 1,3-GDN were 0.03 ng/mL, 0.2 ng/mL, and 0.15 ng/mL respectively. This method was verified with a bioequivalence study of an Iranian brand of oral sustained release nitroglycerin with an innovator formulation.

Pharmacokinetics of oral taurine in healthy volunteers.

Taurine, a sulfur-containing amino acid, is a normal constituent of the human diet. Little is known of the pharmacokinetics of taurine in man after oral administration. We studied the pharmacokinetics of 4 g taurine in eight healthy male volunteers (median age 27.5, range 22-45) following orally administration in the fasting state in the morning. Blood samples were taken at regular intervals and plasma taurine concentration was measured by a modified HPLC method. Data were subjected to noncompartmental analysis. Maximum plasma taurine concentration (C(max)) was measured at 1.5 ± 0.6 hr after administration as 86.1 ± 19.0 mg/L (0.69 ± 0.15 mmol). Plasma elimination half-life (T(1/2)) and the ratio of clearance/bioavailability (Cl/F) were 1.0 ± 0.3 hr and 21.1 ± 7.8 L/hr, respectively. Since taurine is occasionally used in therapeutics as a medicine, the pharmacokinetics and effects of oral taurine in healthy volunteers would be useful in the future studies of taurine in pharmacology and nutrition.

Evaluation of taurine as a biomarker of liver damage in paracetamol poisoning.

Taurine is one of the most abundant amino acids in the body. Plasma taurine levels of 217 paracetamol positive and 100 paracetamol negative poisoned patients (related to non-hepatotoxic agents) referred to the Toxicology lab in Cardiff Poisons unit and 90 healthy humans (age between 18 and 45) were measured by a high performance liquid chromatography method. The data were analysed using linear regression and two-tailed unpaired student t-test using Prism software package. We showed that the mean plasma taurine concentration in the paracetamol-poisoned patients (mean 26.4+/-1.6 mg/l) was significantly different from the control groups (mean 5.6+/-0.2 mg/l) (P<0.0001) and the non-paracetamol group (mean 18.1+/-1.1 mg/l) (P<0.01). Taurine is produced by the liver in response to a toxic insult and subsequent leakage from damaged cells leads to increased concentrations in plasma and urine. Therefore a plasma or urinary taurine concentration could be a useful marker for paracetamol-induced hepatic damage.