Potential drug-drug interactions among prescriptionsfor elderly patients in primary health care.

BACKGROUND/AIM: Elderly patients are at high risk from drug-drug interactions (DDIs). This study evaluates the potential DDIs in Turkish elderly patients at a primary health care outpatient clinic. MATERIALS AND METHODS: Online database systems were used to examine DDIs on the prescriptions of patients (n = 1206). The clinical severity of DDIs was classified by the Lexi-Interact Online database. RESULTS: Of the 5059 prescriptions, 33% were found to have DDIs. We detected 29 (0.9%) A, 380 (11.8%) B, 2494 (77.7%) C, 289 (9%) D, and 18 (0.6%) X risk rating category DDIs among the prescriptions. Prescriptions of female patients and patients aged between 65 and 72 years showed significantly higher number of DDIs. The frequency of DDIs increased both with the number of drugs and combined preparations per prescription. Acetylsalicylic acid and salbutamol were the most frequently prescribed drugs contributing to clinically important DDIs. Additionally, acetylsalicylic acid and escitalopram, which interact with each other, were found on the list of Beers criteria. The most predicted clinical outcomes of DDIs were increase in therapeutic efficacy and adverse/toxic reactions. Conclusions: Prediction of DDIs in elderly patients will provide better prescribing and drug safety. Use of nonsteroidal anti-inflammatory agents, selective serotonin reuptake inhibitors, and beta-2 adrenergic receptor agonists should be closely monitored.

Effects of combined estrogen and progesterone replacement treatment on detrusor contractility and histology in oophorectomized rats.

AIM: The aim of this study was to investigate the effects of estrogen plus progesterone treatment administered after surgical menopause on morphological and muscarinic receptor sensitivity in detrusor muscle bands of rats. MATERIALS AND METHODS: A total of 40 female Albino-Wistar rats were assigned into two groups to undergo surgical menopause with sham operation (n = 10) and bilateral oophorectomy (n = 30). Thirty oophorectomized rats were assigned into three groups for different treatments administered for 8 weeks beginning from the 7th postoperative day. At the end of the 8th postoperative week, laparotomy was performed in all of them and the urinary bladders were excised and investigated with light microscope. All statistical analysis and graphs were performed using GraphPad Prism version 4. P < 0.05 was considered to be statistically significant. RESULTS: It was determined that average bodyweights were increased to some extent in oophorectomized and sham groups after treatment and while it was more marked in the group receiving estrogen therapy, bodyweights were decreased in the group receiving estrogen plus progesterone therapy. However, this was not statistically significant. No statistically significant difference was determined between the sham, placebo and 17-ß estradiol treatment groups regarding contractile response of urinary bladder tapes to carbachol (P > 0.05). Contractile responses of urinary bladder tapes of the estrogen plus progesterone treatment group were found to be statistically lower than the placebo group (P < 0.05). CONCLUSION: Our in vitro findings demonstrate that treatment with estrogen plus progesterone decreases muscarinic activity in oophorectomized rats, whereas estrogen-only treatment does not. Our study establishes the basis for further studies to answer whether combination of estrogen and progesterone treatment can restore detrusor overactivity associated with sex hormone defects seen at menopause.

Assessment of therapeutic effect of Inula heterolepsis Boiss in alcoholic rats.

An aqueous extract from the root of Inula heterolepsis Boiss was prepared and then tested for its ability to treat experimentally induced alcoholic hepatic injury in rats. Alcoholic rats were divided into two groups. The first group of rats were given 200 mg/kg/day plant extract. Repeated doses of extract preparations were given at 12 h intervals for 10 days. Differences between the recovery of tissue injury, with and without Inula plant extract, were evaluated. The second group of rats were given vehicle. Liver, testis and kidney injuries due to the chronic alcohol consumption were proven biochemically and histopathologically. Rats were killed, serum SGOT, SGPT, alkaline phosphatase, and albumin levels were measured. SGOT, SGPT and alkaline phosphatase levels were significantly higher in alcoholic rats due to the tissue damage compared with intact, vehicle and Inula treated groups of rats (p < 0.05). Liver, testis, kidneys, stomach, intestine, heart, lungs and bladder were examined histopathologically. According to our study, the root extract of Inula heterolepsis Boiss has a slight therapeutic effect on alcoholic liver, kidney and testis damage in rats. Comparing the therapeutic effects in these organs, the liver seemed to be affected meaningfully after treatment with the plant extract.

Evaluation of the analgesic and anti-inflammatory activities of some thiazolo[4,5-d]pyrimidines.

Some thiazolo[4,5-d]pyrimidine-7(6H)-one derivatives were evaluated in vivo for their analgesic and anti-inflammatory activities. The results were compared with that of acetyl salicylic acid and phenylbutazone. Compounds 3b and 3h were the most active in the anti-inflammatory paw edema inhibition test. In terms of the analgesic activity (acetic acid writhing test), the most active compound was 2a followed by 31. The most active members of the series were investigated for their ED50 values and ulcerogenic potential.