Calidad de prescripción de montelukast en pacientes adultos: Estudio en tres farmacias comunitarias de la Comunidad Valenciana

Introducción: El objetivo de este trabajo es analizar la utilización de montelukast en adultos desde tres farmacias comunitarias.Material y métodos: Estudio descriptivo, observacional en tres farmacias comunitarias (enero 2009 - febrero 2013) en pacientes mayores de 15 años que acuden a la farmacia con receta de montelukast. Los datos se recogen a través de encuesta (edad, patología, régimen terapéutico, duración del tratamiento, medicación asociada) y se valora la idoneidad de la prescripción según las indicaciones autorizadas y su adecuación a las guías de práctica clínica. Se remitió al médico, cuando se detectó un tratamiento inadecuado para la revisión del mismo.Resultados: Se incluyen un total de 106 pacientes, de los cuales, el 26 % no padece asma y están tomando montelukast fuera de indicación. De los asmáticos, el 29 % de los tratamientos pautados no se ajusta a las recomendaciones de las guías. Destaca tanto la elevada instauración de montelukast como tratamiento de inicio (59 % asmáticos, 63 % no asmáticos), como el empleo de montelukast en monoterapia (16 % asmáticos, 41 % no asmáticos).Conclusiones: Se está haciendo un uso fuera de indicación de montelukast en pacientes no asmáticos con rinitis alérgica o bronquitis que podría derivar de la falta de claridad en las indicaciones de algunas guías. Además, en pacientes asmáticos, no siempre se está utilizando montelukast según las recomendaciones de las guías clínicas, lo que evidencia la necesidad de información clara a los profesionales sanitarios sobre el papel de montelukast en la terapéutica actual

Red de innovación docente interuniversitaria en Farmacología

Se ha formado una red interuniversitaria con objeto de crear un espacio común para compartir e intercambiar las experiencias, los resultados de investigación y el material elaborado en diferentes aspectos de innovación docente (nuevas tecnologías, metodologías, sistemas de evaluación, …) en el proceso de enseñanza-aprendizaje en Farmacología en diferentes grados/posgrados de Ciencias de la Salud (Enfermería, Farmacia, Medicina, Veterinaria, Ciencias Biomédicas, Óptica, Nutrición y Dietética, ...). Además del grupo de innovación docente de la Universitat de València, participan en la red un total de 45 profesores pertenecientes a 13 Universidades: U. de Alicante, U. Autónoma de Barcelona, U. de Barcelona, U. Pompeu Fabra (Barcelona), U. CEU Cardenal Herrera, U. Complutense de Madrid, U. Francisco de Vitoria (Madrid), U. de Granada, U. de Málaga, U. País Vasco, U. de Salamanca y U. de Sevilla. Todos los profesores que integran la red han participado y tienen experiencia en diferentes proyectos de innovación docente convocados por las Universidades a las que pertenecen. Se ha iniciado el proyecto con la creación de una plataforma Moodle común para intercambiar experiencias docentes

A History of the Pharmacological Treatment of Bipolar Disorder

In this paper, the authors review the history of the pharmacological treatment of bipolar disorder, from the first nonspecific sedative agents introduced in the 19th and early 20th century, such as solanaceae alkaloids, bromides and barbiturates, to John Cade’s experiments with lithium and the beginning of the so-called “Psychopharmacological Revolution” in the 1950s. We also describe the clinical studies and development processes, enabling the therapeutic introduction of pharmacological agents currently available for the treatment of bipolar disorder in its different phases and manifestations. Those drugs include lithium salts, valproic acid, carbamazepine, new antiepileptic drugs, basically lamotrigine and atypical antipsychotic agents (olanzapine, risperidone, quetiapine, ziprasidone, aripiprazole, asenapine, cariprazine and lurasidone). Finally, the socio-sanitary implications derived from the clinical introduction of these drugs are also discussed

Differences in the signaling pathways of α1A- and α1B-adrenoceptors are related to different endosomal targeting

Aims: To compare the constitutive and agonist-dependent endosomal trafficking of α1A- and α1B-adrenoceptors (ARs) and to establish if the internalization pattern determines the signaling pathways of each subtype. Methods: Using CypHer5 technology and VSV-G epitope tagged α1A- and α1B-ARs stably and transiently expressed in HEK 293 cells, we analyzed by confocal microscopy the constitutive and agonist-induced internalization of each subtype, and the temporal relationship between agonist induced internalization and the increase in intracellular calcium (determined by FLUO-3 flouorescence), or the phosphorylation of ERK1/2 and p38 MAP kinases (determined by Western blot). Results and Conclusions: Constitutive as well as agonist-induced trafficking of α1A and α1B ARs maintain two different endosomal pools of receptors: one located close to the plasma membrane and the other deeper into the cytosol. Each subtype exhibited specific characteristics of internalization and distribution between these pools that determines their signaling pathways: α1A-ARs, when located in the plasma membrane, signal through calcium and ERK1/2 pathways but, when translocated to deeper endosomes, through a mechanism sensitive to β-arrestin and concanavalin A, continue signaling through ERK1/2 and also activate the p38 pathway. α1B-ARs signal through calcium and ERK1/2 only when located in the membrane and the signals disappear after endocytosis and by disruption of the membrane lipid rafts by methyl-β-cyclodextrin

A History of the Pharmacological Treatment of Bipolar Disorder

In this paper, the authors review the history of the pharmacological treatment of bipolar disorder, from the first nonspecific sedative agents introduced in the 19th and early 20th century, such as solanaceae alkaloids, bromides and barbiturates, to John Cade’s experiments with lithium and the beginning of the so-called “Psychopharmacological Revolution” in the 1950s. We also describe the clinical studies and development processes, enabling the therapeutic introduction of pharmacological agents currently available for the treatment of bipolar disorder in its different phases and manifestations. Those drugs include lithium salts, valproic acid, carbamazepine, new antiepileptic drugs, basically lamotrigine and atypical antipsychotic agents (olanzapine, risperidone, quetiapine, ziprasidone, aripiprazole, asenapine, cariprazine and lurasidone). Finally, the socio-sanitary implications derived from the clinical introduction of these drugs are also discussed

Red de innovación docente interuniversitaria en Farmacología

Se ha formado una red interuniversitaria con objeto de crear un espacio común para compartir e intercambiar las experiencias, los resultados de investigación y el material elaborado en diferentes aspectos de innovación docente (nuevas tecnologías, metodologías, sistemas de evaluación, …) en el proceso de enseñanza-aprendizaje en Farmacología en diferentes grados/posgrados de Ciencias de la Salud (Enfermería, Farmacia, Medicina, Veterinaria, Ciencias Biomédicas, Óptica, Nutrición y Dietética, ...). Además del grupo de innovación docente de la Universitat de València, participan en la red un total de 45 profesores pertenecientes a 13 Universidades: U. de Alicante, U. Autónoma de Barcelona, U. de Barcelona, U. Pompeu Fabra (Barcelona), U. CEU Cardenal Herrera, U. Complutense de Madrid, U. Francisco de Vitoria (Madrid), U. de Granada, U. de Málaga, U. País Vasco, U. de Salamanca y U. de Sevilla. Todos los profesores que integran la red han participado y tienen experiencia en diferentes proyectos de innovación docente convocados por las Universidades a las que pertenecen. Se ha iniciado el proyecto con la creación de una plataforma Moodle común para intercambiar experiencias docentes

Hypoxia Increases Nitric Oxide-Dependent Inhibition of Angiogenic Growth

Nitric oxide (NO) is a proangiogenic factor acting through the soluble guanylate cyclase (sGC) pathway. However, angiogenic growth increases energy demand, which may be hampered by NO inhibition of cytochrome c oxidase (CcO). Then, NO activity would be the balanced result of sGC activation (pro-angiogenic) and CcO inhibition (anti-angiogenic). NO activity in a rat and eNOS−/− mice aortic ring angiogenic model and in a tube formation assay (human aortic endothelial cells) were analyzed in parallel with mitochondrial O2 consumption. Studies were performed with NO donor (DETA-NO), sGC inhibitor (ODQ), and NOS or nNOS inhibitors (L-NAME or SMTC, respectively). Experiments were performed under different O2 concentrations (0–21%). Key findings were: (i) eNOS-derived NO inhibits angiogenic growth by a mechanism independent on sGC pathway and related to inhibition of mitochondrial O2 consumption; (ii) NO inhibition of the angiogenic growth is more evident in hypoxic vessels; (iii) in the absence of eNOS-derived NO, the modulation of angiogenic growth, related to hypoxia, disappears. Therefore, NO, but not lower O2 levels, decreases the angiogenic response in hypoxia through competitive inhibition of CcO. This anti-angiogenic activity could be a promising target to impair pathological angiogenesis in hypoxic conditions, as it occurs in tumors or ischemic diseases

Beta-adrenoceptors and GRK3 in hypertension

31 p., figuras, abreviaturas y bibliografíaOBJECTIVE: The objective of our work was to analyze if changes in the expression of betaadrenoceptors (b-ARs) and G-protein-coupled receptor kinases (GRKs) in human lymphocytes - a practical surrogate for myocardial or vascular cells - are related to the hypertensive state and its clinical consequences. METHODS: real time quantitative RT-PCR was employed to evaluate the expression of the three b-ARs (b1, b2, b3) and three GRKs (GRK2, GRK3, GRK5) in human lymphocytes obtained from both normotensive and hypertensive subjects, some of whom had been treated with blockers of the renin-angiotensin system. Office blood pressure, 24-hour ambulatory blood pressure, urinary albumin excretion and serum biochemical profile were also recorded. RESULTS AND CONCLUSIONS: b1-AR expression levels were higher in circulating lymphocytes from hypertensive patients (2-ΔΔCt =2.135 ± 0.4252*, vs control group), but this difference was not observed when these subjects were treated with blockers of the renin-angiotensin system. b1- AR levels directly correlated (r2=0.5711, P=0.0185) with urinary albumin excretion in microalbuminuric patients, which relates alterations of this receptor to cardiovascular risk. An inverse correlation was observed between the expression levels of b2-AR and diastolic blood pressure (r2=0.2078, P=0.0031), suggesting that b2-ARlevels in lymphocytes mirror their expression in vascular cells, in which b2-AR-mediated relaxation regulates vascular resistance. mrRNA levels for GRK3 were inversely correlated with systolic and diastolic blood presure (day, night and 24h), which suggests a protective role for GRK3 in the regulation of human blood pressure, as supported by previous findings in transgenic mice.This study was supported by research grants from the Comisión Interministerial de Ciencia y Tecnología of the Spanish goverment (SAF2004-01541), Generalitat Valenciana (GV2004-B-085, GRUPOS05-038) and Instituto de Salud Carlos III, Fondo de Investigaciones Sanitarias (FIS PI070509).Eduardo Oliver Pérez is the recipient of a fellowship of the FPU programme of the Spanish Ministry of Education and SciencePeer reviewe

MicroRNAs and Oxidative Stress: An Intriguing Crosstalk to Be Exploited in the Management of Type 2 Diabetes

Type 2 diabetes is a chronic disease widespread throughout the world, with significant human, social, and economic costs. Its multifactorial etiology leads to persistent hyperglycemia, impaired carbohydrate and fat metabolism, chronic inflammation, and defects in insulin secretion or insulin action, or both. Emerging evidence reveals that oxidative stress has a critical role in the development of type 2 diabetes. Overproduction of reactive oxygen species can promote an imbalance between the production and neutralization of antioxidant defence systems, thus favoring lipid accumulation, cellular stress, and the activation of cytosolic signaling pathways, and inducing β-cell dysfunction, insulin resistance, and tissue inflammation. Over the last few years, microRNAs (miRNAs) have attracted growing attention as important mediators of diverse aspects of oxidative stress. These small endogenous non-coding RNAs of 19–24 nucleotides act as negative regulators of gene expression, including the modulation of redox signaling pathways. The present review aims to provide an overview of the current knowledge concerning the molecular crosstalk that takes place between oxidative stress and microRNAs in the physiopathology of type 2 diabetes, with a special emphasis on its potential as a therapeutic target

RyR2R420Q catecholaminergic polymorphic ventricular tachycardia mutation induces bradycardia by disturbing the coupled clock pacemaker mechanism

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