Herbal medicine : drug interactions

In today’s Western world, herbal medicine is used alongside conventional medicine. Herbal medicines may interefere with conventional medicines by several mechanisms.peer-reviewe

Drug interaction study in hospitalized hepatic cirrhosis patient in Dr.Ramelan navy hospital

Cirrhotic liver lead to some changes in pathophysiology such as reduction in liver blood flow, decrease some metabolic and synthetic function of the liver. Also there is a change in endothelial lining from hepatic sinusoid. These changes result in some consequences that are increase in drugs sensitivity and adverse events due to pharmacokinetic and pharmacodynamic influences. Treatments for complications cirrhosis induce polypharmacy. Therefore, hepatic cirrhosis patient are at risk for serious drug interactions. The outcome can be harmful if the inteactions causes an increase in the toxicity of the drug. To study drug interaction events from drug therapy in hospitalized hepatic cirrhosis patient. Samples were collected using purposive sampling methods. Both drug therapy and disease progress were followed prospectively until patient discharged from the hospital. Drug interactions events were recorded and evaluated according to some literature. Patients involved in this study were 85. The total number of drug interactions occured in this study were 5 cases (5,88%). All events is potential drug interactions. Potential drug interaction involved spironolactone, furosemide, kalium supplement, aminophylline, ranitidine, and digoxin. This study demonstrates that potential drug interactions were common among hepatic cirrhosis patient, and pharmaceutical care capable in reducing drug interactions events

Neuronal stem cell-drug interactions : a systematic review and meta-analysis

Stem cell therapy is a promising treatment option for neurodegenerative diseases that mostly affect geriatric patients who often suffer from comorbidities requiring multiple medications. However, not much is known about the interactions between stem cells and drugs. Here, we focus on the potential interactions between drugs used to treat the comorbidities or sequelae of neurodegenerative diseases and neuronal stem cells to reveal potential effects on drug safety and efficacy. To determine the potential effects of drugs frequently used in geriatric patients (analgesic, antibiotic, antidepressant, antidiabetic, antihyperlipidemic, and antihypertensive drugs) on neuronal stem cell differentiation and proliferation, we systematically searched PubMed to identify nonreview articles published in English in peer‐reviewed journals between January 1, 1991, and June 7, 2018. We identified 5,954 publications, of which 214 were included. Only 62 publications provided the complete data sets required for meta‐analysis. We found that antidepressants stimulated neuronal stem cell proliferation but not differentiation under physiologic conditions and increased the proliferation of stem cells in the context of stress. Several other potential interactions were identified, but the limited number of available data sets precludes robust conclusions. Although available data were in most cases insufficient to perform robust meta‐analysis, a clear interaction between antidepressants and neuronal stem cells was identified. We reveal other potential interactions requiring further experimental investigation. We recommend that future research addresses such interactions and investigates the best combination of pharmacological interventions and neuronal stem cell treatments for more efficient and safer patient care. Stem Cells Translational Medicine 2019;8:1202–121

Provenance-Centered Dataset of Drug-Drug Interactions

Over the years several studies have demonstrated the ability to identify potential drug-drug interactions via data mining from the literature (MEDLINE), electronic health records, public databases (Drugbank), etc. While each one of these approaches is properly statistically validated, they do not take into consideration the overlap between them as one of their decision making variables. In this paper we present LInked Drug-Drug Interactions (LIDDI), a public nanopublication-based RDF dataset with trusty URIs that encompasses some of the most cited prediction methods and sources to provide researchers a resource for leveraging the work of others into their prediction methods. As one of the main issues to overcome the usage of external resources is their mappings between drug names and identifiers used, we also provide the set of mappings we curated to be able to compare the multiple sources we aggregate in our dataset.Comment: In Proceedings of the 14th International Semantic Web Conference (ISWC) 201

Choosing the safest acute combination therapy during prophylactic treatment. pharmacokinetic and pharmacodynamic considerations

Drugs used in the treatment of migraine have been recently reported to be highly associated with the occurrence of clinically significant drug-drug interactions (DDIs)

Pharmacokinetic Herb-Drug Interactions: Insight into Mechanisms and Consequences

Herbal medicines are currently in high demand, and their popularity is steadily increasing. Because of their perceived effectiveness, fewer side effects and relatively low cost, they are being used for the management of numerous medical conditions. However, they are capable of affecting the pharmacokinetics and pharmacodynamics of coadministered conventional drugs. These interactions are particularly of clinically relevance when metabolizing enzymes and xenobiotic transporters, which are responsible for the fate of many drugs, are induced or inhibited, sometimes resulting in unexpected outcomes. This article discusses the general use of herbal medicines in the management of several ailments, their concurrent use with conventional therapy, mechanisms underlying herb-drug interactions (HDIs) as well as the drawbacks of herbal remedy use. The authors also suggest means of surveillance and safety monitoring of herbal medicines. Contrary to popular belief that "herbal medicines are totally safe," we are of the view that they are capable of causing significant toxic effects and altered pharmaceutical outcomes when coadministered with conventional medicines. Due to the paucity of information as well as sometimes conflicting reports on HDIs, much more research in this field is needed. The authors further suggest the need to standardize and better regulate herbal medicines in order to ensure their safety and efficacy when used alone or in combination with conventional drugs

The study of harmful and beneficial drug interactions in intensive care, Kerman, Iran

Since multidrug therapy is common in the intensive care unit (ICU), the risk of drug interactions is high. This study aimed to examine the prevalence of drug interactions and risk factors in patients who were admitted to ICUs. In a crosssectional study, the medication flow sheet of 101 patients was investigated in terms of the number and the type of drug interactions. The Drug Interaction Facts reference text book (2010 edition) was used to determine the type and the number of drug interactions. In total, 609 potential drug interactions were found. The mean number of drug interactions per patient was 6.1 (SD=5.6). Of all observed drug interactions, 66.9 were classified as harmful and 33.1 beneficial. In terms of the nature of interactions, delayed, moderate, and possible were the most common types. The most frequent harmful interaction was between phenytoin and omeprazole (63 occasions). Critically ill patients are at a higher risk of drug interactions. Although 33.1 of the drug interactions were considered beneficial, medical teams should be awarethat even beneficial interactions can have undesirable side-effects in the critically ill. © The Intensive Care Society 2013

Smoking and drug interactions

When patients enter hospital they may have to stop smoking abruptly if the hospital has a 'no smoking' policy. Abrupt smoking cessation can affect the metabolism of drugs. Cigarette smoking induces the activity of human cytochromes P450 (CYP) 1A2 and 2B6. These enzymes metabolise several clinically important drugs, including clozapine, olanzapine and methadone. Decreased CYP1A2 activity after smoking cessation increases the risk of adverse drug reactions, with reports of increased toxicity from clozapine and olanzapine. Predicting the required dose reduction of drugs metabolised by CYP1A2 after smoking cessation is challenging. Therapeutic drug monitoring should be used when possible. Nicotine replacement therapy does not influence CYP1A2 activity

Potential drug–drug interactions in alzheimer patients with behavioral symptoms

The use of multi drug regimens among the elderly population has increased tremendously over the last decade although the benefits of medications are always accompanied by potential harm, even when prescribed at recommended doses. The elderly populations are particularly at an increased risk of adverse drug reactions considering comorbidity, poly-therapy, physiological changes affecting the pharmacokinetics and pharmacodynamics of many drugs and, in some cases, poor compliance due to cognitive impairment and/or depression. In this setting, drug-drug interaction may represent a serious and even life-threatening clinical condition. Moreover, the inability to distinguish drug-induced symptoms from a definitive medical diagnosis often results in addition of yet another drug to treat the symptoms, which in turn increases drug-drug interactions. Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, are the most widely prescribed agents for Alzheimer's disease (AD) patients. Behavioral and psychological symptoms of dementia, including psychotic symptoms and behavioral disorders, represent noncognitive disturbances frequently observed in AD patients. Antipsychotic drugs are at high risk of adverse events, even at modest doses, and may interfere with the progression of cognitive impairment and interact with several drugs including anti-arrhythmics and acetylcholinesterase inhibitors. Other medications often used in AD patients are represented by anxiolytic, like benzodiazepine, or antidepressant agents. These agents also might interfere with other concomitant drugs through both pharmacokinetic and pharmacodynamic mechanisms. In this review we focus on the most frequent drug-drug interactions, potentially harmful, in AD patients with behavioral symptoms considering both physiological and pathological changes in AD patients, and potential pharmacodynamic/pharmacokinetic drug interaction mechanisms

Prevalence and patterns of higher-order drug interactions in Escherichia coli.

Interactions and emergent processes are essential for research on complex systems involving many components. Most studies focus solely on pairwise interactions and ignore higher-order interactions among three or more components. To gain deeper insights into higher-order interactions and complex environments, we study antibiotic combinations applied to pathogenic Escherichia coli and obtain unprecedented amounts of detailed data (251 two-drug combinations, 1512 three-drug combinations, 5670 four-drug combinations, and 13608 five-drug combinations). Directly opposite to previous assumptions and reports, we find higher-order interactions increase in frequency with the number of drugs in the bacteria's environment. Specifically, as more drugs are added, we observe an elevated frequency of net synergy (effect greater than expected based on independent individual effects) and also increased instances of emergent antagonism (effect less than expected based on lower-order interaction effects). These findings have implications for the potential efficacy of drug combinations and are crucial for better navigating problems associated with the combinatorial complexity of multi-component systems