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1.
Pharmaceuticals (Basel) ; 17(8)2024 Jul 24.
Article in English | MEDLINE | ID: mdl-39204085

ABSTRACT

The molecular mechanisms underlying the observed anticancer effects of flavonoids remain unclear. Increasing evidence shows that the aryl hydrocarbon receptor (AHR) plays a crucial role in neoplastic disease progression, establishing it as a potential drug target. This study evaluated the potential of hydroxy flavonoids, known for their anticancer properties, to interact with AHR, both in silico and in vitro, aiming to understand the mechanisms of action and identify selective AHR modulators. A PAS-B domain homology model was constructed to evaluate in silico interactions of chrysin, naringenin, quercetin apigenin and agathisflavone. The EROD activity assay measured the effects of flavonoids on AHR's activity in human breast cancer cells (MCF7). Simulations showed that chrysin, apigenin, naringenin, and quercetin have the highest AHR binding affinity scores (-13.14 to -15.31), while agathisflavone showed low scores (-0.57 and -5.14). All tested flavonoids had the potential to inhibit AHR activity in a dose-dependent manner in the presence of an agonist (TCDD) in vitro. This study elucidates the distinct modulatory effects of flavonoids on AHR, emphasizing naringenin's newly described antagonistic potential. It underscores the importance of understanding flavonoid's molecular mechanisms, which is crucial for developing novel cancer therapies based on these molecules.

2.
Curr Drug Targets ; 25(9): 635-648, 2024.
Article in English | MEDLINE | ID: mdl-38847165

ABSTRACT

INTRODUCTION: Chikungunya fever is a disease caused by infection with the Chikungunya virus, transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Despite its self-limited character, more than 60% of patients have chronic recurrent arthralgia with debilitating pain that lasts for years. AIM: The objective of this review was to gather and analyze evidence from the literature on potential therapeutic strategies with molecules from natural products for the treatment of Chikungunya fever. METHODS: A search was performed for clinical trials, observational studies, in vitro or in vivo, without restriction of the year of publication or language in electronic databases (Medline/PubMed, EMBASE, Google Scholar, The Cochrane Library, LILACS (BVS), clinical trial registries (Clinical Trials.gov), digital libraries from CAPES theses and dissertations (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brazil) and conference abstracts. A quality assessment of the selected studies was performed using the SYRCLE, RoB2 and SciRAP tools. RESULTS: 42 studies were included, which showed molecules with potential antiviral pharmacological activity or with activity in reducing the joint complications caused by CHIKV infection. CONCLUSIONS: Among the molecules found in the survey of references, regarding the class of secondary metabolites, flavonoids stood out and for this reason, the molecules may be promising candidates for future clinical trials. Overall, evidence from in vitro studies was of acceptable quality; in vivo and intervention studies showed a high risk of bias, which is a limitation of these studies.


Subject(s)
Antiviral Agents , Biological Products , Chikungunya Fever , Chikungunya virus , Chikungunya Fever/drug therapy , Humans , Biological Products/therapeutic use , Biological Products/pharmacology , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Animals , Chikungunya virus/drug effects , Clinical Trials as Topic
3.
Curr Drug Targets ; 24(2): 201-210, 2023.
Article in English | MEDLINE | ID: mdl-36503390

ABSTRACT

INTRODUCTION: Diseases caused by protozoa are one of the leading causes of death worldwide, especially in tropical regions such as Brazil. Chagas disease, leishmaniasis, and malaria are responsible for around 234 million cases and more than 400,000 deaths worldwide. Despite this scenario, drugs for these diseases have several limitations, which justifies the search for new treatments. Iron superoxide dismutase is a promising target for the drug design to treat patients with these diseases. It is a validated target and protects against oxidative stress. AIM: Thus, this systematic review aimed to synthesize evidence on the importance of superoxide dismutase in the drug design to treat patients with this protozoosis. METHODS: A search was performed for in vitro and in vivo studies, without publication and language restrictions, in MEDLINE (PubMed), LILACS (BVS), Science Direct, and EMBASE (Elsevier). Studies that pointed to the relationship between the reduction or increase in superoxide dismutase activity and the diseases were included. 23 studies were selected for the qualitative synthesis. RESULTS: The results showed that the inhibition or reduction of the enzyme activity decreases the degree of infection and reinfection and improves the results in treating these diseases. In contrast, the increase in activity caused a high degree of survival and resistance of the parasites. CONCLUSION: However, the overall quality of evidence is low and more studies with methodological rigor are provided.


Subject(s)
Chagas Disease , Leishmaniasis , Malaria , Humans , Chagas Disease/drug therapy , Leishmaniasis/drug therapy , Malaria/drug therapy , Drug Design , Superoxide Dismutase/therapeutic use
4.
Parasitology ; 149(8): 1019-1026, 2022 07.
Article in English | MEDLINE | ID: mdl-35514112

ABSTRACT

The cattle tick Rhipicephalus microplus is an ectoparasite with high economic importance to bovine culture, mainly in tropical and subtropical regions. The resistance of the tick from the commercial acaricides has hindered its control, thus motivating the search for new strategies. The purpose of this study was to perform a critical review about the main molecular targets of R. microplus that are useful for the discovery of new acaricides. Bibliographic search was conducted in the databases PubMed, ScienceDirect and CAB Direct, using the following descriptors: 'Rhipicephalus microplus', 'Boophilus microplus', 'molecular targets' and 'action', published between 2010 and 2021. Out of the 212 publications identified, 17 articles were selected for study inclusion. This review described 14 molecular targets and among these 4 are targets from commercial acaricides. Most of them are enzymes to catalyse important reactions to tick survival, related to energetic metabolism, mechanisms of biotransformation and neurotransmission. The data will be helpful in the development of new more effective and selective acaricides.


Subject(s)
Acaricides , Cattle Diseases , Rhipicephalus , Tick Infestations , Acaricides/pharmacology , Animals , Cattle , Cattle Diseases/parasitology , Cattle Diseases/prevention & control , Tick Infestations/parasitology , Tick Infestations/prevention & control , Tick Infestations/veterinary
5.
J Biomol Struct Dyn ; 40(15): 6787-6797, 2022 09.
Article in English | MEDLINE | ID: mdl-33645442

ABSTRACT

Rhipicephalus microplus is an important ectoparasite of cattle, causing considerable economical losses. Resistance to chemical acaricides has stimulated the search for new antiparasitic drugs, including natural products as an eco-friendly alternative of control. Flavonoids represent a class of natural compounds with many biological activities, such as enzyme inhibitors. Acetylcholinesterase is an essential enzyme for tick survival that stands out as an important target for the development of acaricides. This work aimed to predict this 3D structure by homology modeling and use the model to identify compound with inhibitory activity. The model of R. microplus AChE1 (RmAChE1) was constructed using MODELLER program. The optimization and molecular dynamic investigation were performed in GROMACS program. The model developed was used, by molecular docking, to evaluate the anticholinesterase activity of flavonoids (quercetin, rutin, diosmin, naringin and hesperidin) and an acaricide synthetic (eserine). Additionally, in vitro inhibition of AChE and larval immersion tests were performed. The model of RmAChE1 showed to be sterically and energetically acceptable. In molecular dynamics simulations, the 3D structure remains stable with Root Mean Square Deviation = 3.58 Å and Root Mean Square Fluctuation = 1.43 Å. In molecular docking analyses, only eserine and quercetin show affinity energy to the RmAChE (Gridscore: -52.17 and -39.44 kcal/mol, respectively). Among the flavonoids, quercetin exhibited the best in vitro inhibition of AChE activity (15.8%) and mortality of larvae tick (30.2%). The use of in silico and in vitro techniques has shown that quercetin showed promising anti-tick activity and structural requirements to interact with RmAChE1. Communicated by Ramaswamy H. Sarma.


Subject(s)
Acaricides , Rhipicephalus , Acaricides/pharmacology , Acetylcholinesterase , Animals , Cattle , Cholinesterase Inhibitors/pharmacology , Larva , Molecular Docking Simulation , Molecular Dynamics Simulation , Physostigmine , Quercetin
6.
Braz. J. Pharm. Sci. (Online) ; 57: e18310, 2021. tab, graf
Article in English | LILACS | ID: biblio-1350230

ABSTRACT

This study aimed to evaluate the anticholinesterase activities of extracts and fractions of Ocotea daphnifolia in vitro and characterize its constituents. The effects of hexane, ethyl acetate, and ethanolic extracts on acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activity were determined with a spectrophotometry assay. All extracts inhibited cholinesterase activity, and the ethanolic extract (2 mg/mL) exhibited the highest inhibition of both enzymes (99.7% for BuChE and 82.4% for AChE). The ethanolic extract was fractionated by column chromatography resulting in 14 fractions that were also screened for their anticholinesterase effects. Fraction 9 (2 mg/mL) showed the highest activity, inhibiting AChE and BuChE by 71.8% and 90.2%, respectively. This fraction was analyzed by high-performance liquid chromatography high-resolution mass spectrometry which allowed the characterization of seven glycosylated flavonoids (containing kaempferol and quercetin nucleus) and one alkaloid (reticuline). In order to better understand the enzyme-inhibitor interaction of the reticuline toward cholinesterase, molecular modeling studies were performed. Reticuline targeted the catalytic activity site of the enzymes. Ocotea daphnifolia exhibits a dual cholinesterase inhibitory activity and displays the same pattern of intermolecular interactions as described in the literature. The alkaloid reticuline can be considered as an important bioactive constituent of this plant.


Subject(s)
In Vitro Techniques/instrumentation , Cholinesterase Inhibitors/analysis , Lauraceae/classification , Ocotea/adverse effects , Molecular Docking Simulation/instrumentation , Plants, Medicinal/anatomy & histology , Acetylcholinesterase/adverse effects , Spectrophotometry/instrumentation , Flavonoids , Butyrylcholinesterase/adverse effects , Alkaloids
7.
Pharmacol Res ; 159: 104997, 2020 09.
Article in English | MEDLINE | ID: mdl-32534098

ABSTRACT

Myelin loss is the hallmark of the demyelinating disease multiple sclerosis (MS) and plays a significant role in multiple neurodegenerative diseases. A common factor in all neuropathologies is the central role of microglia, the intrinsic immune cells of the central nervous system (CNS). Microglia are activated in pathology and can have both pro- and anti-inflammatory functions. Here, we examined the effects of the flavonoid agathisflavone on microglia and remyelination in the cerebellar slice model following lysolecithin induced demyelination. Notably, agathisflavone enhances remyelination and alters microglial activation state, as determined by their morphology and cytokine profile. Furthermore, these effects of agathisflavone on remyelination and microglial activation were inhibited by blockade of estrogen receptor α. Thus, our results identify agathisflavone as a novel compound that may act via ER to regulate microglial activation and enhance remyelination and repair.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Biflavonoids/pharmacology , Cerebellum/drug effects , Microglia/drug effects , Myelin Sheath/metabolism , Neuroimmunomodulation/drug effects , Oligodendroglia/drug effects , Remyelination/drug effects , Animals , Cell Differentiation/drug effects , Cell Proliferation/drug effects , Cerebellum/immunology , Cerebellum/metabolism , Cerebellum/pathology , Cytokines/metabolism , Estrogen Receptor alpha/drug effects , Estrogen Receptor alpha/metabolism , Female , Green Fluorescent Proteins/genetics , Green Fluorescent Proteins/metabolism , Lysophosphatidylcholines/toxicity , Male , Mice , Mice, Inbred C57BL , Mice, Transgenic , Microglia/immunology , Microglia/metabolism , Microglia/pathology , Oligodendroglia/immunology , Oligodendroglia/metabolism , Oligodendroglia/pathology , Phenotype , Tissue Culture Techniques
8.
Bioorg Chem ; 86: 665-673, 2019 05.
Article in English | MEDLINE | ID: mdl-30826627

ABSTRACT

The new alkene lactone, (3E)-5,6-dihydro-5-(hydroxymethyl)-3-docdecylidenefuran-3(4H)-one (1), named majoranolide B, and three alkene lactones known as majorenolide (2), majoranolide (3) and majorynolide (4) were obtained from the aerial parts of Persea fulva (Lauraceae). The structures were elucidated in light of extensive spectroscopic analysis, including 1D, 2D NMR (1H, 13C, 1H-1H-COSY, HMBC and HSQC) and HR-ESI-MS. These compounds were screened for their in vitro antiproliferative activity in rat C6 glioma and astrocyte cells using MTT assay and in silico by molecular docking against targets that play a central role in controlling glioma cell cycle progression. Majoranolide (3) is the most active compound with IC50 6.69 µM against C6 glioma cells, followed by the compounds 1 (IC50 9.06 µM), 2 (IC50 12.04 µM) and 4 (IC50 41.90 µM). The alkene lactones 1-3 exhibited lower toxicity in non-tumor cells when compared to glioma cells. Molecular docking results showed that majoranolide establishes hydrogen bonds with all targets through its α,ß-unsaturated-γ-lactone moiety, whereas the long-chain alkyl group binds by means of several hydrophobic bonds. In the present study, it can be concluded from the anti-proliferative activity of isolates against C6 glioma cells that lactone constituents from P. fulva could have a great potential for the control of C6 glioma cells.


Subject(s)
Antineoplastic Agents, Phytogenic/pharmacology , Lactones/pharmacology , Lauraceae/chemistry , Molecular Docking Simulation , Animals , Antineoplastic Agents, Phytogenic/chemistry , Antineoplastic Agents, Phytogenic/isolation & purification , Cell Proliferation/drug effects , Cell Survival/drug effects , Dose-Response Relationship, Drug , Drug Screening Assays, Antitumor , Lactones/chemistry , Lactones/isolation & purification , Molecular Structure , Plant Leaves/chemistry , Rats , Structure-Activity Relationship , Tumor Cells, Cultured
9.
J Mol Model ; 24(9): 260, 2018 Aug 29.
Article in English | MEDLINE | ID: mdl-30159742

ABSTRACT

Leishmaniasis is caused by several protozoa species belonging to genus Leishmania that are hosted by humans and other mammals. Millions of new cases are recorded every year and the drugs available on the market do not show satisfactory efficacy and safety. A hierarchical virtual screening approach based on the pharmacophore model, molecular docking, and molecular dynamics was conducted to identify possible Leishmania braziliensis N-misristoyltransferase (LbNMT) inhibitors. The adopted pharmacophore model had three main features: four hydrophobic centers, four hydrogen-bond acceptor atoms, and one positive nitrogen center. The molecules (n=15,000) were submitted to alignment with the pharmacophore model and only 27 molecules aligned to model. Six molecules were submitted to molecular docking, using receptor PDB ID 5A27. After docking, the ZINC35426134 was a top-ranked molecule (- 64.61 kcal/mol). The molecule ZINC35426134 shows hydrophobic interactions with Phe82, Tyr209, Val370, and Leu391 and hydrogen bonds with Asn159, Tyr318, and Val370. Molecular dynamics simulations were performed with the protein in its APO and HOLO forms for 37 ns in order to assess the stability of the protein-ligand complex. Results showed that the HOLO form was more stable than the APO one, and it suggests that the ZINC35426134 binding stabilizes the enzyme. Therefore, the selected molecule has the potential to meet the herein proposed target.


Subject(s)
Acyltransferases/antagonists & inhibitors , Antiprotozoal Agents/chemistry , Enzyme Inhibitors/chemistry , Leishmania braziliensis/enzymology , Molecular Docking Simulation , Molecular Dynamics Simulation , Protozoan Proteins/antagonists & inhibitors , Acyltransferases/chemistry , Drug Evaluation, Preclinical , Protozoan Proteins/chemistry
10.
J Mol Model ; 24(8): 220, 2018 Jul 28.
Article in English | MEDLINE | ID: mdl-30056475

ABSTRACT

Malaria is the world's most widespread protozoan infection, being responsible for more than 445,000 annual deaths. Among the malaria parasites, Plasmodium falciparum is the most prevalent and lethal. In this context, the search for new antimalarial drugs is urgently needed. P. falciparum superoxide dismutase (PfSOD) is an important enzyme involved in the defense mechanism against oxidative stress. The goal of this study was to identify through hierarchical screening on pharmacophore models and molecular dynamics (MD), promising allosteric PfSOD inhibitors that do not show structural requirements for human inhibition. MD simulations of 1000 ps were performed on PfSOD using GROMACS 5.1.2. For this, the AMBER99SB-ILDN force field was adapted to describe the metal-containing system. The simulations indicated stability in the developed system. Therefore, a covariance matrix was generated, in which it was possible to identify residues with correlated and anticorrelated movements with the active site. These results were associated with the results found in the predictor of allosteric sites, AlloSitePro, which affirmed the ability of these residues to delimit an allosteric site. Then, after successive filtering of the Sigma-Aldrich® compounds database for HsSOD1 and PfSOD pharmacophores, 152 compounds were selected, also obeying Lipinski's rule of 5. Further filtering of those compounds based on molecular docking results, toxicity essays, availability, and price filtering led to the selection of a best compound, which was then submitted to MD simulations of 20,000 ps on the allosteric site. The study concludes that the ZINC00626080 compound could be assayed against SODs. Graphical Abstract Plasmodium falciparum superoxide dismutase.


Subject(s)
Antimalarials/chemistry , Enzyme Inhibitors/chemistry , Molecular Dynamics Simulation , Plasmodium falciparum/chemistry , Protozoan Proteins/chemistry , Superoxide Dismutase/chemistry , Allosteric Regulation , Amino Acid Sequence , Antimalarials/metabolism , Databases, Chemical , Drug Discovery , Enzyme Inhibitors/metabolism , Humans , Molecular Docking Simulation , Plasmodium falciparum/enzymology , Protein Binding , Protein Interaction Domains and Motifs , Protein Structure, Secondary , Protozoan Proteins/antagonists & inhibitors , Protozoan Proteins/metabolism , Sequence Homology, Amino Acid , Species Specificity , Structure-Activity Relationship , Superoxide Dismutase/antagonists & inhibitors , Superoxide Dismutase/metabolism , Thermodynamics , User-Computer Interface
11.
Comput Biol Chem ; 75: 65-73, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29747077

ABSTRACT

BACKGROUND: In Brazil, the Asemeia genus has 19 species (12 endemic) and 2 varieties (both endemic) and some of them are found in semi-arid Bahia. OBJECTIVE: The objective of this study was to quantitatively determine identified substances by HPLC-DAD in Asemeia ovata extracts and to predict their biological activities in silico. METHOD: The quantification method by HPLC-DAD has been validated according to the guidelines of the International Conference of Harmonization. The prediction in silico activities was made by Target Fishing methods (TF), followed by docking by the program DOCK 6.7 and assessment of interaction profiles for Protein-Ligand Interaction Profiler server. RESULTS: It was possible to identify and quantify using HPLC-DAD substances: rutin, luteolin-7-O-glucoside, caffeic acid, p-coumaric acid and trans-ferulic acid. The ChemProt 2.0 server was selected for TF method, which has shown potential activity of compounds on molecular targets such as Carbonic anhydrase 12, epidermal growth factor receptor and sodium-glucose cotransporter 2. CONCLUSION: This work provides new results for the species both from a biological and chemical point of view, and has interesting potential to be discovered with the prospect of further studies.


Subject(s)
Flavones/analysis , Glucosides/analysis , Plant Extracts/analysis , Polygalaceae/chemistry , Rutin/analysis , Chromatography, High Pressure Liquid , Flavones/metabolism , Glucosides/metabolism , Molecular Docking Simulation , Molecular Structure , Plant Extracts/metabolism , Rutin/metabolism , Species Specificity
12.
Front Cell Neurosci ; 8: 308, 2014.
Article in English | MEDLINE | ID: mdl-25324722

ABSTRACT

The blood-brain barrier (BBB) is known to protect healthy brain cells from potentially dangerous chemical agents, but there are many evidences supporting the idea that this protective action is extended to tumor cells. Since the process of angiogenesis in brain tumors leads to BBB breakdown, biochemical characteristics of the BBB seem to be more relevant than physical barriers to protect tumor cells from chemotherapy. In fact, a number of resistance related factors were already demonstrated to be component of both BBB and tumor cells. The enzyme glutathione S-transferases (GST) detoxify electrophilic xenobiotics and endogenous secondary metabolites formed during oxidative stress. A role has been attributed to GST in the resistance of cancer cells to chemotherapeutic agents. This study characterized 8-methoxypsoralen (8-MOP) as a human GST P1-1 (hGST P1-1) inhibitor. To identify and characterize the potential inhibitory activity of 8-MOP, we studied the enzyme kinetics of the conjugation of 1-chloro-2,4-dinitrobenzene (CDNB) with GSH catalyzed by hGST P1-1. We report here that 8-MOP competitively inhibited hGST P1-1 relative to CDNB, but there was an uncompetitive inhibition relative to GSH. Chromatographic analyses suggest that 8-MOP is not a substrate. Molecular docking simulations suggest that 8-MOP binds to the active site, but its position prevents the GSH conjugation. Thus, we conclude that 8-MOP is a promising prototype for new GST inhibitors pharmacologically useful in the treatment of neurodegenerative disorders and the resistance of cancer to chemotherapy.

13.
Rev. Soc. Bras. Clín. Méd ; 12(2)abr.-jun. 2014. tab
Article in Portuguese | LILACS | ID: lil-712259

ABSTRACT

OBJETIVOS E JUSTIFICATIVA: Identificar e caracterizar as interações medicamentosas presentes em prescrições médicas da Unidade de Terapia Intensiva (UTI) de um hospital público da cidade de Feira de Santana, Bahia. Uma vez que Interações medicamentosas (IM) representam fontes potencialmente remediáveis de erros na assistência e um risco para os pacientes. MÉTODOS: O estudo realizado foi do tipo descritivo. Após aprovação do Comitê de Ética em Pesquisa foram coletadas aleatoriamente 28 prescrições médicas da Unidade de Terapia Intensiva do hospital no ano de 2013, sendo necessário o preenchimento de uma ficha de coleta previamente estabelecida. Os dados coletados foram analisados pelo programa Micromedex® Drug Interactions, este caracterizou as interações medicamentosas segundo a gravidade e documentação comprobatória. RESULTADOS: Das 28 prescrições analisadas, 2 apresentaram nenhuma interação medicamentosa, enquanto 26 apresentaram alguma interações medicamentosas, resultando 99 potenciais interações medicamentosas, sendo os fármacos mais envolvidos: Midazolam, Ácido Acetilsalicílico, Fentanil e Dipirona. Interações medicamentoas mais frequentes foram: Fentanil + Mi­ dazolam; Dipirona + Enoxaparina; Midazolam + Omeprazol; Ácido Acetilsalicílico + Insulina Humana Regular. Segundo a gravidade foram encontradas: 5 contra Indicado, 31 maior, 58 moderado e 5 menor. 29 interações medicamentosas possuíam documentação excelente, 39 boa, 31 razoável e nenhuma com documentação desconhecida O uso, simultâneo de Fentanil + Midazolam pode resultar em depressão respiratória aditiva. Já o uso de Metoclopramida + Haloperidol pode aumentar o risco de reações extrapiramidais ou síndrome maligna dos neurolépticos. CONCLUSÃO: Confirmou­se que as interações medicamentosas são um problema frequente e cada vez mais relevante, pois identificá­las tornou­se um desafio para os profissionais de saúde...


BACKGROUND AND OBJECTIVE: To identify and characterize the Drug Interaction present in prescriptions of Intensive Care Unit (ICU) of a public hospital in the city of Feira de Santana, Bahia. Since, Drug Interaction (DI) represent potentially remediable sources of errors in care and a risk to patients. METHODS: The study was observational in nature. After approval by the Research Ethics Committee were randomly collected from 28 medical prescriptions in the Intensive Care Unit of the hospital in 2013, completing a previously established data collection form is required. The collected data were analyzed by ® Drug Interactions, Micromedex this program characterized the drug interaction according to the severity and supporting documentation. RESULTS: Of the 28 prescriptions analyzed, 2 showed no drug interaction, while 26 showed some drug interaction, resulting in 99 potential drug interactions being the drugs most involved: Midazolam, Acetylsalicylic Acid, Fentanyl and Dipyrone. Frequently drugs interactions were: Midazolam + Fentanyl; Dipyrone + Enoxaparin, Midazolam + Omeprazole, Acetylsalicylic Acid + Regular Human Insulin. According to severity were found: 5 against Indicated, 31 largest, 58 moderate and 5 smaller. 29 drug interaction had excellent documentation, 39 good, 31 fair, and none with unknown Using documentation, simultaneous Midazolam + Fentanyl may result in additive respiratory depression. Already using Metoclopramide + Haloperidol may increase the risk of extrapyramidal reactions or neuroleptic malignant syndrome. CONCLUSION: It was confirmed that the drug interaction is a frequent problem and increasingly relevant because identifying it became a challenge for health professionals...


Subject(s)
Humans , Drug Interactions , Drug Prescriptions , Intensive Care Units , Neuroleptic Malignant Syndrome , Hospitals, Public
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