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1.
Cell Struct Funct ; 44(2): 183-194, 2019 Dec 26.
Article in English | MEDLINE | ID: mdl-31735740

ABSTRACT

The discovery of fluorescent proteins (FPs) has revolutionized cell biology. The fusion of targeting sequences to FPs enables the investigation of cellular organelles and their dynamics; however, occasionally, such fluorescent fusion proteins (FFPs) exhibit behavior different from that of the native proteins. Here, we constructed a color pallet comprising different organelle markers and found that FFPs targeted to the mitochondria were mislocalized when fused to certain types of FPs. Such FPs included several variants of Aequorea victoria green FP (avGFP) and a monomeric variant of the red FP. Because the FFPs that are mislocalized include FPs with faster maturing or folding mutations, the increase in the maturation rate is likely to prevent their expected localization. Indeed, when we reintroduced amino acid substitutions so that the FP sequences were equivalent to that of wild-type avGFP, FFP localization to the mitochondria was significantly enhanced. Moreover, similar amino acid substitutions improved the localization of mitochondria-targeted pHluorin, which is a pH-sensitive variant of GFP, and its capability to monitor pH changes in the mitochondrial matrix. Our findings demonstrate the importance of selecting FPs that maximize FFP function.Key words: fluorescent protein, organelle, fusion protein, mitochondria.


Subject(s)
Green Fluorescent Proteins/chemistry , Green Fluorescent Proteins/metabolism , Mitochondria/metabolism , Protein Folding , Recombinant Fusion Proteins/chemistry , Recombinant Fusion Proteins/metabolism , Animals , HEK293 Cells , HeLa Cells , Humans , Hydrozoa
2.
Cell Struct Funct ; 44(1): 61-74, 2019 Apr 25.
Article in English | MEDLINE | ID: mdl-30905923

ABSTRACT

Endocytosis mediates the internalization and ingestion of a variety of endogenous or exogenous substances, including virus particles, under the control of intracellular signaling pathways. We have previously reported that the complex formed between the small GTPase Ras and phosphoinositide 3-kinase (PI3K) translocates from the plasma membrane to endosomes, signaling from which thereby regulates clathrin-independent endocytosis, endosome maturation, influenza virus internalization, and infection. However, the molecular mechanism by which the Ras-PI3K complex is recruited to endosomes remains unclear. Here, we have identified the amino acid sequence responsible for endosomal localization of the Ras-PI3K complex. PI3K lacking this sequence failed to translocate to endosomes, and expression of the peptide comprising this PI3K-derived sequence inhibited clathrin-independent endocytosis, influenza virus internalization, and infection. Moreover, treatment of cells with this peptide in an arginine-rich, cell-penetrating form successfully suppressed influenza virus infection in vitro and ex vivo, making this peptide a potential therapeutic agent against influenza virus infection.Key words: signal transduction, endocytosis, endosome, imaging, influenza virus.


Subject(s)
Endocytosis/drug effects , Orthomyxoviridae/drug effects , Orthomyxoviridae/physiology , Peptide Fragments/pharmacology , Phosphatidylinositol 3-Kinase/chemistry , Amino Acid Sequence , Animals , Cell Line , Endosomes/drug effects , Endosomes/metabolism , Humans , Peptide Fragments/chemistry , Protein Transport/drug effects , Virus Internalization/drug effects , ras Proteins/metabolism
3.
Cell Host Microbe ; 23(6): 809-818.e5, 2018 06 13.
Article in English | MEDLINE | ID: mdl-29779930

ABSTRACT

Influenza A virus (IAV) infection is initiated by the attachment of the viral glycoprotein hemagglutinin (HA) to sialic acid on the host cell surface. However, the sialic acid-containing receptor crucial for IAV infection has remained unidentified. Here, we show that HA binds to the voltage-dependent Ca2+ channel Cav1.2 to trigger intracellular Ca2+ oscillations and subsequent IAV entry and replication. IAV entry was inhibited by Ca2+ channel blockers (CCBs) or by knockdown of Cav1.2. The CCB diltiazem also inhibited virus replication in vivo. Reintroduction of wild-type but not the glycosylation-deficient mutants of Cav1.2 restored Ca2+ oscillations and virus infection in Cav1.2-depleted cells, demonstrating the significance of Cav1.2 sialylation. Taken together, we identify Cav1.2 as a sialylated host cell surface receptor that binds HA and is critical for IAV entry.


Subject(s)
Calcium Channels, L-Type/metabolism , Hemagglutinin Glycoproteins, Influenza Virus/metabolism , Influenza A virus/physiology , Influenza, Human/virology , Orthomyxoviridae Infections/virology , A549 Cells , Animals , COS Cells , Calcium Channels, L-Type/genetics , Chlorocebus aethiops , Dogs , HEK293 Cells , HeLa Cells , Hemagglutinin Glycoproteins, Influenza Virus/genetics , Humans , Influenza, Human/pathology , Madin Darby Canine Kidney Cells , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Orthomyxoviridae Infections/pathology
4.
Cell Struct Funct ; 42(1): 15-26, 2017 Feb 02.
Article in English | MEDLINE | ID: mdl-27928132

ABSTRACT

Although the co-development of companion diagnostics with molecular targeted drugs is desirable, truly efficient diagnostics are limited to diseases in which chromosomal translocations or overt mutations are clearly correlated with drug efficacy. Moreover, even for such diseases, few methods are available to predict whether drug administration is effective for each individual patient whose disease is expected to respond to the drug(s). We have previously developed a biosensor based on the principle of Förster resonance energy transfer to measure the activity of the tyrosine kinase BCR-ABL and its response to drug treatment in patient-derived chronic myeloid leukemia cells. The biosensor harbors CrkL, one of the major substrates of BCR-ABL, and is therefore named Pickles after phosphorylation indicator of CrkL en substrate. The efficacy of this technique as a clinical test has been demonstrated, but the number of cells available for analysis is limited in a case-dependent manner, owing to the cleavage of the biosensor in patient-derived leukemia cells. Here, we describe an improved biosensor with an amino acid substitution and a nuclear export signal being introduced. Of the two predicted cleavage positions in CrkL, the mutations inhibited one cleavage completely and the other cleavage partially, thus collectively increasing the number of cells available for drug evaluation. This improved version of the biosensor holds promise in the future development of companion diagnostics to predict responses to tyrosine kinase inhibitors in patients with chronic myeloid leukemia.


Subject(s)
Adaptor Proteins, Signal Transducing/genetics , Antineoplastic Agents/pharmacology , Biosensing Techniques/methods , Fluorescence Resonance Energy Transfer/methods , Fusion Proteins, bcr-abl/antagonists & inhibitors , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Nuclear Proteins/genetics , Protein Kinase Inhibitors/pharmacology , Adaptor Proteins, Signal Transducing/metabolism , Amino Acid Sequence , Amino Acid Substitution , Biomarkers, Pharmacological/metabolism , Fusion Proteins, bcr-abl/genetics , Fusion Proteins, bcr-abl/metabolism , Gene Expression , Humans , K562 Cells , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/enzymology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Myeloid Cells/drug effects , Myeloid Cells/enzymology , Myeloid Cells/pathology , Nuclear Export Signals/genetics , Nuclear Proteins/metabolism , Phosphorylation/drug effects , Plasmids/chemistry , Plasmids/metabolism , Transfection , Transgenes
5.
Br J Pharmacol ; 173(6): 1018-32, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26660861

ABSTRACT

BACKGROUND AND PURPOSE: Endothelin-1 (ET-1) reduces insulin-stimulated glucose uptake in skeletal muscle, inducing insulin resistance. Here, we have determined the molecular mechanisms underlying negative regulation by ET-1 of insulin signalling. EXPERIMENTAL APPROACH: We used the rat L6 skeletal muscle cells fully differentiated into myotubes. Changes in the phosphorylation of Akt was assessed by Western blotting. Effects of ET-1 on insulin-stimulated glucose uptake was assessed with [(3) H]-2-deoxy-d-glucose ([(3) H]2-DG). The C-terminus region of GPCR kinase 2 (GRK2-ct), a dominant negative GRK2, was overexpressed in L6 cells using adenovirus-mediated gene transfer. GRK2 expression was suppressed by transfection of the corresponding short-interfering RNA (siRNA). KEY RESULTS: In L6 myotubes, insulin elicited sustained Akt phosphorylation at Thr(308) and Ser(473) , which was suppressed by ET-1. The inhibitory effects of ET-1 were prevented by treatment with a selective ETA receptor antagonist and a Gq protein inhibitor, overexpression of GRK2-ct and knockdown of GRK2. Insulin increased [(3) H]2-DG uptake rate in a concentration-dependent manner. ET-1 noncompetitively antagonized insulin-stimulated [(3) H]2-DG uptake. Blockade of ETA receptors, overexpression of GRK2-ct and knockdown of GRK2 prevented the ET-1-induced suppression of insulin-stimulated [(3) H]2-DG uptake. In L6 myotubes overexpressing FLAG-tagged GRK2, ET-1 facilitated the interaction of endogenous Akt with FLAG-GRK2. CONCLUSIONS AND IMPLICATIONS: Activation of ETA receptors with ET-1 suppressed insulin-induced Akt phosphorylation at Thr(308) and Ser(473) and [(3) H]2-DG uptake in a GRK2-dependent manner in skeletal muscle cells. These findings suggest that ETA receptors and GRK2 are potential targets for overcoming insulin resistance.


Subject(s)
Endothelin-1/pharmacology , G-Protein-Coupled Receptor Kinase 2/metabolism , Glucose/metabolism , Insulin/pharmacology , Muscle Fibers, Skeletal/drug effects , Proto-Oncogene Proteins c-akt/metabolism , Animals , Cell Differentiation , Cell Line , G-Protein-Coupled Receptor Kinase 2/genetics , Muscle Fibers, Skeletal/metabolism , Muscle, Skeletal/cytology , MyoD Protein/genetics , Myoblasts/cytology , Myogenin/genetics , Phosphorylation , RNA, Messenger/metabolism , RNA, Ribosomal, 18S/genetics , Rats
7.
J Biol Chem ; 289(51): 35283-95, 2014 Dec 19.
Article in English | MEDLINE | ID: mdl-25381251

ABSTRACT

Two types of G protein-coupled receptors for endothelin-1 (ET-1), ET type A receptor (ETAR) and ETBR, closely resemble each other, but upon ET-1 stimulation, they follow totally different intracellular trafficking pathways; ETAR is recycled back to plasma membrane, whereas ETBR is targeted to lysosome for degradation. However, the mechanisms for such different fates are unknown. Here we demonstrated that ETBR but not ETAR was ubiquitinated on the cell surface following ET-1 stimulation and that ETBR was internalized and degraded in lysosome more rapidly than ETAR. The mutant ETBR (designated "5KR mutant") in which 5 lysine residues in the C-tail were substituted to arginine was not ubiquitinated, and its rates of internalization and degradation after ET-1 stimulation became slower, being comparable with those of ETAR. Confocal microscopic study showed that following ET-1 stimulation, ETAR and 5KR mutant of ETBR were co-localized mainly with Rab11, a marker of recycling endosome, whereas ETBR was co-localized with Rab7, a marker of late endosome/lysosome. In the 5KR mutant, ET-1-induced ERK phosphorylation and an increase in the intracellular Ca(2+) concentration upon repetitive ET-1 stimulation were larger. A series of ETBR mutants (designated "4KR mutant"), in which either one of 5 arginine residues of the 5KR mutant was reverted to lysine, were normally ubiquitinated, internalized, and degraded, with ERK phosphorylation being normalized. These results demonstrate that agonist-induced ubiquitination at either lysine residue in the C-tail of ETBR but not ETAR switches intracellular trafficking from recycling to plasma membrane to targeting to lysosome, causing decreases in the cell surface level of ETBR and intracellular signaling.


Subject(s)
Cell Membrane/metabolism , Lysosomes/metabolism , Receptor, Endothelin A/metabolism , Receptor, Endothelin B/metabolism , Blotting, Western , Endothelin-1/pharmacology , Extracellular Signal-Regulated MAP Kinases/metabolism , HEK293 Cells , Humans , Microscopy, Confocal , Mutation , Phosphorylation , Protein Transport/drug effects , Receptor, Endothelin A/agonists , Receptor, Endothelin A/genetics , Receptor, Endothelin B/agonists , Receptor, Endothelin B/genetics , Ubiquitination/drug effects , rab GTP-Binding Proteins/metabolism , rab7 GTP-Binding Proteins
8.
PLoS One ; 9(9): e107856, 2014.
Article in English | MEDLINE | ID: mdl-25229830

ABSTRACT

Cigarette smoke consists of tar and gas phase: the latter is toxicologically important because it can pass through lung alveolar epithelium to enter the circulation. Here we attempt to establish a standard method for preparation of gas phase extract of cigarette smoke (CSE). CSE was prepared by continuously sucking cigarette smoke through a Cambridge filter to remove tar, followed by bubbling it into phosphate-buffered saline (PBS). An increase in dry weight of the filter was defined as tar weight. Characteristically, concentrations of CSEs were represented as virtual tar concentrations, assuming that tar on the filter was dissolved in PBS. CSEs prepared from smaller numbers of cigarettes (original tar concentrations ≤ 15 mg/ml) showed similar concentration-response curves for cytotoxicity versus virtual tar concentrations, but with CSEs from larger numbers (tar ≥ 20 mg/ml), the curves were shifted rightward. Accordingly, the cytotoxic activity was detected in PBS of the second reservoir downstream of the first one with larger numbers of cigarettes. CSEs prepared from various cigarette brands showed comparable concentration-response curves for cytotoxicity. Two types of CSEs prepared by continuous and puff smoking protocols were similar regarding concentration-response curves for cytotoxicity, pharmacology of their cytotoxicity, and concentrations of cytotoxic compounds. These data show that concentrations of CSEs expressed by virtual tar concentrations can be a reference value to normalize their cytotoxicity, irrespective of numbers of combusted cigarettes, cigarette brands and smoking protocols, if original tar concentrations are ≤15 mg/ml.


Subject(s)
Cytotoxins/isolation & purification , Filtration/standards , Gases/chemistry , Smoke/analysis , Tobacco Products/analysis , Animals , Buffers , Cell Line, Tumor , Cytotoxins/toxicity , Glass/chemistry , Humans , Hydrocarbons/isolation & purification , Phosphates/chemistry , Rats , Reference Standards , Reproducibility of Results , Smoke/adverse effects , Temperature , Time Factors
9.
Life Sci ; 104(1-2): 24-31, 2014 May 28.
Article in English | MEDLINE | ID: mdl-24735959

ABSTRACT

AIMS: Endothelin (ET) system plays a critical role in the development of insulin resistance and type 2 diabetes. In skeletal muscle, differentiation of myoblasts to myotubes is accompanied by the development of insulin sensitivity. Activation of extracellular signal-regulated kinase (ERK) 1/2 inhibits the differentiation of myoblasts, leading to insulin resistance. Although ET receptor (ETR) stimulation generally activates ERK1/2, the mechanism for ETR-mediated ERK1/2 activation in skeletal muscle is unknown. The purpose of this study was to determine the signal transduction pathway involved in ET-1-stimulated ERK1/2 phosphorylation in L6 myoblasts derived from rat skeletal muscle. MAIN METHODS: Changes in phosphorylation levels of ERK1/2 following stimulation with ET-1 were analyzed by Western blot in L6 myoblasts. To inhibit receptor internalization, dominant-negative dynamin (K44A) was overexpressed in L6 myoblasts using adenovirus-mediated gene transfer. KEY FINDINGS: ET-1 induced phosphorylation of ERK1/2 in L6 myoblasts. The ERK1/2 phosphorylation was abolished by BQ123 (a selective ET type A receptor (ETAR) antagonist), YM-254890 (a Gαq/11 protein inhibitor), and AG370 (a platelet-derived growth factor receptor (PDGFR) kinase inhibitor), while U-73122 (a phospholipase C (PLC) inhibitor) was less potent. The ERK1/2 phosphorylation was inhibited by overexpression of dominant-negative dynamin (K44A). These results suggest that ETAR stimulation induces ERK1/2 phosphorylation in L6 myoblasts through Gq/11 protein-dependent, PLC-independent PDGFR transactivation which requires dynamin-dependent ETAR internalization. SIGNIFICANCE: Because activation of ERK1/2 is considered to inhibit differentiation of myoblasts with the development of insulin sensitivity, the ETAR-mediated PDGFR transactivation and subsequent ERK1/2 activation play an important role in ET-1-induced insulin resistance.


Subject(s)
Endothelin-1/metabolism , Extracellular Signal-Regulated MAP Kinases/metabolism , Myoblasts/metabolism , Receptors, Platelet-Derived Growth Factor/metabolism , Transcriptional Activation , Animals , Calcium/metabolism , Cell Line , Dynamins/genetics , Gene Expression Regulation, Enzymologic , Gene Transfer Techniques , Genes, Dominant , Insulin/metabolism , Insulin Resistance , Muscle, Skeletal/metabolism , Phosphorylation , Rats , Receptor, Endothelin A/metabolism , Signal Transduction
10.
Toxicology ; 314(1): 1-10, 2013 Dec 06.
Article in English | MEDLINE | ID: mdl-23981515

ABSTRACT

Smoking is a major risk factor for atherosclerotic vascular diseases, but the mechanism for its genesis is unknown. We have recently shown that the gas phase of cigarette smoke (nicotine- and tar-free cigarette smoke extract; CSE) likely to reach the systemic circulation contains stable substances which cause cytotoxicity like plasma membrane damage and cell death in cultured cells, and also that the plasma membrane damage is caused through sequential activation of protein kinase C (PKC) and NADPH oxidase (NOX) and the resulting generation of reactive oxygen species (PKC/NOX-dependent mechanism), whereas cell death is caused through PKC/NOX-dependent and -independent mechanisms. To identify these stable substances, the CSE was prepared by passing the main-stream smoke of 10 cigarettes through a Cambridge glass fiber filter, trapping of the smoke in a vessel cooled at -80°C, and subsequent dissolution in 10ml of water. The CSE was fractionated into nine fractions using reversed-phase HPLC, and each fraction was screened for cytotoxicity in cultured cells, using propidium iodide uptake assay for cell membrane damage and MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] reduction assay for cell viability. The cytotoxicity was positive in two of the nine fractions (Fr2 and Fr5). After extraction of the active fractions into dichloromethane, GC/MS analysis identified 2-cyclopenten-1-one (CPO) in Fr5 but none in Fr2. After derivatization of the active fractions with O-(2,3,4,5,6-pentafluorobenzyl) hydroxylamine hydrochloride, GC/MS analysis identified acrolein, acetone and propionaldehyde in Fr2, and methyl vinyl ketone (MVK) in Fr5. After 4-h incubation, authentic acrolein and MVK induced concentration-dependent cytotoxicity with EC50 values of 75.9±8.2 and 47.0±8.0µM (mean±SEM; n=3), respectively, whereas acetone, propionaldehyde and CPO were without effect. However, after 24-h incubation, CPO induced concentration-dependent cytotoxicity with an EC50 value of 264.0±16.9µM (n=3). The concentrations of acrolein, MVK and CPO in the CSE were 3368±334, 2429±123 and 392.9±31.8µM (n=4), respectively, which were higher than the cytotoxic concentrations. The cytotoxicity of acrolein and MVK consisted of plasma membrane damage and decreased cell viability: the plasma membrane damage was totally prevented by treatment with an inhibitor of PKC or NOX, whereas the decreased cell viability was only partially prevented by these inhibitors. The cytotoxicity of CPO consisted only of decreased cell viability, which was totally resistant to these inhibitors. These results show that acrolein and MVK are responsible for the acute cytotoxicity of the CSE through PKC/NOX-dependent and -independent mechanisms, whereas CPO is responsible for the delayed cytotoxicity of the CSE through a PKC/NOX-independent mechanism.


Subject(s)
Cell Survival/drug effects , Tobacco Smoke Pollution/adverse effects , Tobacco Smoke Pollution/analysis , Butanones/chemistry , Butanones/toxicity , Cell Line, Tumor , Cell-Free System , Chromatography, High Pressure Liquid , Cyclopentanes/chemistry , Cyclopentanes/toxicity , Data Interpretation, Statistical , Gas Chromatography-Mass Spectrometry , Humans , Hydroxylamines , Indicators and Reagents , Mass Spectrometry , NADPH Oxidases/antagonists & inhibitors , Nicotine/chemistry , Protein Kinase C/antagonists & inhibitors , Tars/pharmacology
11.
J Pharmacol Sci ; 120(4): 310-4, 2012.
Article in English | MEDLINE | ID: mdl-23149578

ABSTRACT

Nicotine- and tar-free cigarette smoke extract (CSE) is reported to induce cell damage via activation of protein kinase C (PKC) and NADPH oxidase (NOX) in rat C6 glioma cells. Here we determined PKC isozyme(s) activated by CSE and their activation mechanism. In C6 glioma cells, mRNAs for PKCα, PKCδ, PKCε, and PKCι were expressed. CSE triggered translocation of PKCα and PKCε to plasma membrane. CSE-induced cell damage and PKC translocation were inhibited by chelating intracellular Ca(2+) but not extracellular Ca(2+). These results suggest that CSE induces cell damage through intracellular Ca(2+)-dependent activation of PKCα and PKCε and subsequent NOX activation.


Subject(s)
Glioma/enzymology , Glioma/pathology , Nicotine/adverse effects , Protein Kinase C-alpha/metabolism , Protein Kinase C-epsilon/metabolism , Smoke/adverse effects , Tobacco Products/adverse effects , Animals , Calcium/metabolism , Calcium/physiology , Cell Membrane/enzymology , Enzyme Activation , NADPH Oxidases/metabolism , Rats , Reactive Oxygen Species , Tars , Tumor Cells, Cultured
12.
Biochem Biophys Res Commun ; 428(2): 252-8, 2012 Nov 16.
Article in English | MEDLINE | ID: mdl-23068106

ABSTRACT

Stromal interaction molecule 1 (STIM1) is the endoplasmic reticulum (ER) Ca(2+) sensor to control ER Ca(2+) levels. A recent study has shown that STIM1L, a new splice variant of STIM1, is expressed in various tissues of rodent and in human skeletal muscle, and that the interaction of STIM1L with actin filament allows rapid activation of store-operated Ca(2+) entry (SOCE) mediated through Orai1 channels. Here, we characterize mRNA expression and function of human STIM1 and STIM1L, and compare their binding property to Orai1 functioning as store-operated Ca(2+) channels (SOCCs), and TRPC3 (transient receptor potential canonical 3) and TRPC6 channels functioning as endothelin type A receptor (ET(A)R)-operated Ca(2+) channels (ROCCs). Although mRNA for STIM1 was ubiquitously expressed in human tissues, STIM1L was detected only in skeletal muscle. STIM1L augmented thapsigargin- and endothelin-1-induced SOCE more strongly than STIM1 in human embryonic kidney 293 cells stably expressing ET(A)R, whereas, it tends to suppress ET(A)R-operated Ca(2+) entry (ROCE) via TRPC3 and TRPC6 more strongly than STIM1. Coimmunoprecipitation experiments have revealed that when compared with STIM1, STIM1L binds more abundantly to Orai1 and also to TRPC3 and TRPC6. These results suggest that the higher binding capacity of STIM1L to SOCCs and ROCCs plays an important role in the regulation of Ca(2+) signaling such as the augmentation of SOCE via Orai1 and the inhibition of ROCE via TRPC3 and TRPC6.


Subject(s)
Calcium Channels/metabolism , Membrane Proteins/metabolism , Neoplasm Proteins/metabolism , TRPC Cation Channels/metabolism , Calcium/metabolism , Cerebral Ventricles/metabolism , Female , HEK293 Cells , HeLa Cells , Human Umbilical Vein Endothelial Cells/metabolism , Humans , Membrane Proteins/genetics , Muscle, Skeletal/metabolism , Neoplasm Proteins/genetics , ORAI1 Protein , Placenta/metabolism , Pregnancy , Protein Binding , Protein Isoforms/genetics , Protein Isoforms/metabolism , RNA, Messenger/biosynthesis , RNA, Messenger/genetics , Stromal Interaction Molecule 1 , TRPC6 Cation Channel
13.
J Pak Med Assoc ; 59(10): 726-31, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19813695

ABSTRACT

OBJECTIVE: To evaluate the drug dispensing practices and patients' knowledge on drug use among the outpatients and to identify and analyze the problems in drug prescribing and dispensing. METHODS: A prospective cross-sectional descriptive study was conducted using World Health Organization (WHO) core drug use indicators from July 13, 2008 to August 15, 2008 in Manipal Teaching Hospital, Pokhara, Nepal. RESULTS: A total of 4231 prescriptions were encountered with the total of 10591 drugs prescribed. The average number of drug per prescription was 2.5. Only 13% (n=10591) of drugs were prescribed by generic name. Percentage of drug prescribed from WHO model list of Essential drugs, Essential drug list of Nepal and Nepalese National Formulary was 21.7%, 32.8% and 42.3% respectively. Antibiotics and injections encountered were 28.3% and 3.1% respectively. Average cost per prescription was found to be Nepalese Rupees (NRs) 285.99 (US $ 3.73). Patient knowledge on correct use of drugs and appropriate labeling was found to be 81% and 1.4% respectively. Average dispensing time per prescription was 52 seconds. CONCLUSION: The finding from current study shows a trend towards irrational prescribing and dispensing. Hence, there is a need for effective intervention programme to encourage the physicians and dispensing pharmacists in promoting more rational drug use.


Subject(s)
Drug Prescriptions/statistics & numerical data , Hospitals, Teaching , Practice Patterns, Physicians'/statistics & numerical data , Adult , Cross-Sectional Studies , Female , Humans , Male , Nepal , Prospective Studies
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