Nicotine dependence and role of pharmacist in nicotine addiction control

There are about one billion smokers in the world and death toll due to smoking is almost six million people a year. The tobacco use is increasing specially in the third world countries. By 2020, death will increase to more than 70% of smokers in some developing countries. Continuous tobacco use can cause tolerance and dependence. Tobacco dependence is the main cause of morbidity and mortality among smokers. Nicotine dependence is assumed to be present if tolerance, withdrawal and compulsive desire to consume tobacco are existing. It is well documented that environmental and genetic factors influence the possibility of nicotine addiction. Thus, actions are needed at different levels to avoid the health hazards induced by tobacco smoking. Governments have to play a vital role in smoking control. People at large needs to be involved in the fight against smoking. Within the health-sector, health professionals as physicians and pharmacists have a leading role to play because of their knowledge about the dangerous of smoking and its treatment in general. Community pharmacist is one of the most accessible health care professional to the public and can fulfil fundamental role in public health as key providers of tobacco cessation and prevention services. In addition, pharmacists have a significant knowledge of nicotine withdrawal symptoms, drugs used in smoking cessation and with special training can be involved in the treatment programs. Moreover, media campaigns (pharmacy and non-pharmacy groups) are needed to encourage smoking cessation and discourage smoking initiation. However, with any tobacco-use prevention program, it should always be remembered that long time is needed before success becomes effective and apparent

Health education in the Libyan Arab Jamahiriya: assessment of future needs.

The aim of this study was to determine priority health issues, target groups and education media for future health education programmes in the Libyan Arab Jamahiriya. A questionnaire was addressed to 2 groups: health officials (n=60) and the general public (n=300). In their lists of health issues to focus on, 7 were the same although prioritization differed. Children and youth were considered the most important target groups and the school setting the most appropriate medium for them. Broadcast media were acknowledged as valuable for health education for the general public. We recommend systematic consultation across official and lay groups as a preliminary requisite for health education initiatives.

Health education in the Libyan Arab Jamahiriya: assessment of future needs

The aim of this study was to determine priority health issues, target groups and education media for future health education programmes in the Libyan Arab Jamahiriya. A questionnaire was addressed to 2 groups: health officials [n = 60] and the general public [n = 300]. In their lists of health issues to focus on, 7 were the same although prioritization differed. Children and youth were considered the most important target groups and the school setting the most appropriate medium for them. Broadcast media were acknowledged as valuable for health education for the general public. We recommend systematic consultation across official and lay groups as a preliminary requisite for health education initiatives

Basic aspects of GABA-transmission in alcoholism, with particular reference to GABA-transaminase.

Neuronal dysfunction is the neurobiological basis for alcoholic behaviour, and ethanol craving seems related to hypofunction of the GABA-ergic activity. Gamma-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the central nervous system (CNS). In several studies, GABA has been shown to be an important target of ethanol in the CNS, partly, as a consequence of damage to membrane-bound enzymes and receptors. GABA is involved in mediating pre- and post-synaptic inhibition of neuronal activity. It is speculated that the initial excitatory effects of ethanol may be due to inhibition of GABA-ergic activity whereas the sedative effects of the higher doses may be mediated by the activation of this inhibitory system. In the CNS, GABA is synthesised from glutamic acid by the enzyme glutamate decarboxylase (GAD) and catabolized into succinic semialdehyde by the enzyme GABA-transaminase (GABA-T), which are pyridoxal phosphate (PLP) dependent enzymes. Platelet GABA-T was characterized as being similar to central GABA-T. Inhibition of GABA-T with certain potent and selective compounds markedly increases the levels of brain GABA. Experimentally, acute ethanol treatment does not alter GABA-T activity whereas chronic treatment produces an increase in the activity, though, with some reservations since a bimodal effect has been found in chronically ethanol-treated rats. Thus, as it will be discussed below, it may be suggested that GABA-T inhibitors (e.g. vigabatrin) could have a potential role in the treatment of alcoholism and in some of the problems of ethanol withdrawal and of other drugs of abuse. Related studies on metabolism and concentrations of GABA are also promising and show a greater increase in our understanding of the aetiology and treatment of ethanol dependence and withdrawal. In general, this article also reviews both the animal and clinical observations in the field of alcoholism with regard to the GABA system.

Basic aspects of GABA-transaminase in neuropsychiatric disorders.

Over the last two decades, there have been several studies suggesting the major inhibitory amino acid neurotransmitter gamma-aminobutyric acid (GABA) is involved directly and/or indirectly in the pathogenesis of many neurologic diseases and psychiatric disorders. GABA is mainly degradated to succinic semialdehyde in a reaction catalyzed by the enzyme GABA-transaminase (GABA-T). Inhibition of this enzyme produces considerable elevation of GABA contents in the brain, and such elevation has been found to correlate with pharmacologic and behavioral effects. We focus attention, from the basic aspects, on brain and platelet GABA-T activities in various species, with a special reference to neuropsychiatric disorders. It seems that the activity of GABA-T in the brain and/or in the blood platelets is correlated to certain neuropsychiatric disorders such as alcoholism, epilepsy, and Alzheimer's disease. In animal and human studies, platelet GABA-T was identified with similar kinetic and inhibitor characteristics to those of the brain. Therefore, in this way, studies of the activity of the enzyme GABA-T in relation to neuropsychiatric disorders could be undertaken to understand, diagnose, and treat GABA-related disorders of the central nervous system.

GABA-transaminase in brain and blood platelets: basic and clinical aspects.

Several lines of evidence suggest that the major inhibitory neuro-transmitter, gamma-aminobutyric acid (GABA) is involved, both directly and indirectly, in the pathogenesis of certain neurological and psychiatric disorders. The main enzyme responsible for GABA catabolism is gamma-aminobutyrate aminotransferase (GABA-T). Inhibition of this enzyme produces a considerable elevation of brain GABA concentrations, and such elevation has been correlated with many pharmacological effects. There seems to be that, as is discussed below, GABA-T activity in the brain and/or blood platelets is related to some neuro-psychiatric disorders such as alcoholism, epilepsy and Alzheimer's disease. GABA-T has been identified in the blood platelets with similar characteristics to those of brain GABA-T. In this way, studies on GABA-T activity in neuro-psychiatric disorders could be performed to understand, diagnosis and treat GABA-related disorders of the central nervous system (CNS).

gamma-Aminobutyrate aminotransferase activity in blood platelets of six species.

1. The kinetic parameters of gamma-aminobutyrate aminotransferase (GABA-T) were studied in washed blood platelets from cat, dog, horse, man, mouse and rat. 2. Wide differences were found in the maximal reaction velocity (Vmax) of GABA-T in blood platelets of the six species. 3. A significant increase in the activity of GABA-T was found in the blood platelets of adult rats as compared to those of young rats. 4. However, there was no significant difference in the activity of platelet GABA-T between male and female rats. 5. The activity of human platelet GABA-T estimated in platelet-rich plasma from healthy male subjects was found to be decreased in the presence of plasma and albumin. 6. The decrease was due to the specific binding of the cofactor pyridoxal phosphate to plasma albumin.