Potential interactions of central nervous system drugs used in the elderly population

OBJECTIVE: To describe the use of CNS drugs and to identify the most frequently observed potential drug interactions in the elderly living in Southern Brazil. METHODS: A population-based, transversal and observational study was carried out during 2006-2007. Four hundred and eighty elderly individuals of both genders were randomly recruited and interviewed. A validated pharmacotherapeutic questionnaire and the Micromedex® Healthcare Series were utilized to analyze potential drug interactions. A severity rating scale employing the categories of "mild", "moderate" and "severe" was used to describe the interactions. RESULTS: A population of elderly living in Southern Brazil was interviewed and 98 reported using CNS drugs, 74.5% female and 25.5% male. Out of these patients, 32.0% reported severe or moderate pharmacological interactions related to the use of other drugs. Alprazolam and imipramine were reported to potentially interact with tobacco. Twenty potential moderate drug/ethanol interactions were found. The potential drug/caffeine interactions were classified as mild on the severity scale. CONCLUSION: Elderly being prescribed drugs that act on the CNS should be closely monitored, and furthermore, should be warned against potential drug-drug, drug-ethanol, and drug-tobacco interactions.OBJETIVO: Descrever o uso de medicamentos que atuam no sistema nervoso central (SNC) e identificar as possíveis interações mais frequentes com esses medicamentos em idosos do sul do Brasil. MÉTODOS: Estudo de base populacional, transversal e observacional, realizado durante 2006-2007. Quatrocentos e oitenta idosos de ambos os sexos foram randomizados e entrevistados. Foram utilizados um questionário farmacoterapêutico validado e o programa Micromedex® Healthcare Series para analisar as potenciais interações com os medicamentos. Foi utilizada uma escala para descrever a gravidade das interações nas categorias de "leve", "moderada" e "grave". RESULTADOS: A população idosa, moradora do sul do Brasil, que utilizava medicamentos para o SNC, era formada por 98 pacientes, 75,5% mulheres e 25,5% homens. Destes pacientes, 32,0% apresentaram interações farmacológicas graves ou moderadas relacionadas com a utilização de outros medicamentos. Alprazolam e Imipramina, usados pela população, apresentaram riscos de potenciais interações com tabaco. Foram encontradas vinte potenciais interações moderadas medicamento/etanol. As potenciais interações medicamento/cafeína foram classificadas como leves. CONCLUSÃO: Os pacientes idosos deveriam ser rigorosamente monitorizados, e ainda, é necessário advertir quanto às potenciais interações de medicamentos que atuam no SNC com outros medicamentos, etanol e tabaco

Iron from haemoglobin and haemin modulates nucleotide hydrolysis inTrichomonas vaginalis

Extracellular ATP may act as a danger signalling molecule, inducing inflammation and immune responses in infection sites. The ectonucleotidases NTPDase and ecto-5’-nucleotidase are enzymes that modulate extracellular nucleotide levels; these enzymes have been previously characterised in Trichomonas vaginalis. Iron plays an important role in the complex trichomonal pathogenesis. Herein, the effects of iron on growth, nucleotide hydrolysis and NTPDase gene expression in T. vaginalis isolates from female and male patients were evaluated. Iron from different sources sustained T. vaginalis growth. Importantly, iron from haemoglobin (HB) and haemin (HM) enhanced NTPDase activity in isolates from female patients and conversely reduced the enzyme activity in isolates from male patients. Iron treatments could not alter the NTPDase transcript levels in T. vaginalis. Furthermore, our results reveal a distinct ATP, ADP and AMP hydrolysis profile between isolates from female and male patients influenced by iron from HB and HM. Our data indicate the participation of NTPDase and ecto-5’-nucleotidase in the establishment of trichomonas infection through ATP degradation and adenosine production influenced by iron