MESNA (2-Mercaptoethanesulfonate) Attenuates Brain, Heart, and Lung Injury Induced by Carotid Ischemia-Reperfusion in Rats.

Background: Ischemia-reperfusion (I/R) causes organ dysfunction as a result of the increased formation of various reactive oxygen metabolites, infiltration of inflammatory cells, interstitial edema, cellular dysfunction, and tissue death. Aim: The study aimed to investigate the cytoprotective effect of 2-mercaptoethanesulfonate (MESNA) against tissue damage in rats exposed to carotid ischemia-reperfusion. Materials and Methods: Twenty-four male Wistar albino rats were divided into four groups (n = 6): sham, carotid I/R, I/R + MESNA (75 mg/kg), and I/R + MESNA (150 mg/kg) groups. To induce ischemia in rats, the carotid arteries were ligated with silk sutures for 10 min; the silk suture was then opened, and 1 h reperfusion was done. MESNA (75 and 150 mg/kg) was administered intraperitoneally 30 min before ischemia-reperfusion. Tissue samples from the animals were taken for histological examination, while the serum levels of some biochemical parameters were utilized to evaluate the systemic alterations. ANOVA and Tukey's post hoc tests were applied with a significance level of 5%. Results: The ischemia-reperfusion-induced tissue damage as evidenced by increase in serum levels of alanine transaminase, aspartate aminotransferase, alkaline phosphatase, malondialdehyde, lactate dehydrogenase, and matrix metalloproteinases (MMP-1, -2, -8) was significantly (P < 0.05-0.0001) reversed after treatment with MESNA in a dose-dependent manner. Treatment with MESNA (75 and 150 mg/kg), significantly (P < 0.05-0.0001) decreased the I/R-induced increase in serum tumor necrosis factor-alpha (TNF-α) and Interleukin-1-beta (IL-1 ß). Conclusion: The results of this study suggest that MESNA has a protective effect on tissues by suppressing cellular responses to oxidants and inflammatory mediators associated with carotid ischemia-reperfusion.

Evaluation of drug-drug interactions in cancer patients treated at a university hospital in North Cyprus using two interaction databases.

BACKGROUND: Drug interactions in oncology are of clinical importance owing to the inherent use of multiple medications in cancer treatment which predisposes patients to drug-related problems. AIM: This study aimed to compare two electronic databases based on the frequency, mechanism and severity of drug-drug interactions (DDIs) in cancer treatment at Near East University Hospital. METHOD: A retrospective observational study of hospitalized cancer patients who had received more than one chemotherapy and/or supportive-care drugs from April 2017 to April 2019. Lexi-interact tool by Lexicomp and Drugs.com databases were used to check (DDIs and all detected interactions were categorized based on the severity-level and mechanism of interaction. RESULTS: A total of 681 prescriptions were evaluated and the median medication per patient was 4 (IQR 3-6). Drugs.com identified potential DDIs in 129 (84.9%) patients while Lexicomp identified potential DDIs in 113 (74.3%) patients. Drugs.com reported DDIs of 394 pairs while Lexicomp reported DDIs of 313 pairs. More than 50% of the potential DDIs were classified as pharmacodynamic interactions in both databases. There were varied reports of severity of potential DDIs, but the test of agreement using kappa index was 0.592 (95% CI: 0.502-0.682, P = 0.0001) and this was interpreted as a moderate agreement between the two databases. CONCLUSION: Lexicomp documented more detailed information relevant to clinical practice. However, Drugs.com with more sensitivity, detected more potential DDIs. Therefore, we suggest the use of at least two drug databases for quality screening, especially for patients predisposed to polypharmacy.