Yaşlılarda çoklu ilaç kullanımının değerlendirilmesi

Amaç: Çoklu ilaç kullanımı, polifarmasi olarak ta adlandırılmaktadır. Hastanın aynı anda veya belli aralıklarla, çoğu zaman endikasyon olmadan birden fazla ilacı bir arada kullanmasıdır. Polifarmasi en sık, birden fazla kronik hastalığın bir arada görüldüğü yaşlı hastalarda gözlenmektedir. Yaşlı hastalarda polifarmasiye bağlı en önemli sorun ise ilaç uyuncunun sağlanamamasıdır. Çalışmamızda bir grup yaşlı hastada çoklu ilaç kullanımı sonrasında ilaç uyuncu değerlendirilmiştir.Gereç ve Yöntem: Çalışma 55 yaş üstü, 70 hasta ile yürütülmüştür. Hastalarla yüz yüze görüşülerek çoklu ilaç kullanımları değerlendirilmiştir. Bulgular: İlaç uyuncu ve eğitim düzeyi arasında bir ilişki bulunmamıştır. Kadınların ilaçları doğru kullanım oranı, erkeklerden daha fazla bulunmuştur. Yaşlıların %19'unun alternatif tedavileri tercih ettikleri, geleneksel ve alternatif tedaviyi birlikte uygulayanların ise %22.9 olduğu bulunmuştur. Katılımcıların % 1.4'ünün hekim önerisi dışında ilaç kullandığı bulunmuştur.Sonuç: Yaşlanma süreci, tüm organ sistemlerini etkileyen yapısal ve fonksiyonel değişikliklerle karakterize, homeostatik kapasitenin azalmasına neden olan bir süreçtir. Vücut kompozisyonundaki değişiklikler, hepatik ve böbrek fonksiyonlarını etkileyerek yağda çözünen ilaçların dağılım hacminde artış ve suda çözünen ilaçların klerensinde azalmayla sonuçlanmaktadır. İlaçların plazma yarılanma ömrü genel olarak artmaktadır. Yaşlanmaya bağlı farmakokinetik ve farmakodinamik değişikliklerin terapötik rejimler üzerindeki etkisini iyi anlamak, tedavi etkinliğini artıracaktı

EFFECT OF DIHIDROPYRIDINE CALCIUM ANTAGONİST NITRENDIPINE IN EXPERIMENTAL DIABETES

EFFECT OF &nbsp;DIHIDROPYRIDINE CALCIUM ANTAGONİST NITRENDIPINE&nbsp; &nbsp;IN EXPERIMENTAL DIABETES &nbsp;&nbsp;Şule G&Uuml;RSOY1, Alim H&uuml;seyin DOKUMACI1, Ahmet BERK1, Bahadır KAYMAZ1, Nevin İLHAN2, G&ouml;knur AKTAY1&nbsp;1 İn&ouml;n&uuml; University, Faculty of Pharmacy, Pharmacology, 44280 Malatya, T&uuml;rkiye, ([email protected])2&nbsp; Fırat University, Faculty of Medicine, Biochemistry, 23119, Elazığ, T&uuml;rkiye&nbsp;&nbsp;The production of reactive oxygen species (ROS) is central to the pathogenesis of diabetes and its complications1. Dihydropyridine calcium antagonists such as nitrendipine (NIT), have been demonstrated to possess antioxidant activity and to reduce the intracellular production of &nbsp;ROS besides their antihypertensive actions, independent of calcium channel modulation2. The aim of this study was to examine the &nbsp;STZ induced-diabetes and its modulation on treatment with nitrendipine. The rats were divided 3 groups; Control (0.5ml cold citrate buffer 0.1M, pH 4.5, i.p.), STZ (45mg/kg, in cold citrate buffer 0.1M, pH 4.5, i.p.) and NIT (10mg/kg/day in the standard feed). &nbsp;After the 7 weeks from NIT treatment, the rats were sacrificed and tissues were removed to evalute the lipid peroxidation (TBARS), GSH, TSH and NO levels.&nbsp;&nbsp;NIT treatment significantly decreased the&nbsp; STZ-induced TBARS levels in kidney and eye (p&lt;0.05), heart (p&lt;0.01) and brain (p&lt;0.001). Significant ameliorates were also observed in the GSH and TSH levels in liver, kidney and heart tissues according to STZ group. Amazingly, ALT and AST levels were decreased with NIT therapy together with the fasting blood glucose level.&nbsp;We concluded that low dose NIT treatment may protect some diabetic complications in the long term diabetes management.&nbsp;[1]-Pazdro, R, Burgess JR. The role of vitamin E and oxidative stress in diabetes complications. &nbsp;Mech.Ageing.Dev,131,276-286,2010.&nbsp;[2]-Pizarro-Urz&uacute;a NA,N&uacute;&ntilde;ez-Vergara LJ. Nifedipine and nitrendipine reactivity toward singlet oxygen &nbsp;Photochem. Photobiol. A: Chemistry, 175, 129-137, 2005</p

POSSIBLE PROTECTİVE EFFECT OF ATORVASTATIN AGAINST VARIOUS DIABETIC COMPLICATIONS

POSSIBLE PROTECTİVE EFFECT OF ATORVASTATIN AGAINST VARIOUS DIABETIC COMPLICATIONS &nbsp;&nbsp;Alim H&uuml;seyin DOKUMACI1, Umut UYUMLU1, , Şule G&Uuml;RSOY1, Ahmet BERK1Bahadır KAYMAZ1, &nbsp;Nevin İLHAN2, G&ouml;knur AKTAY1&nbsp;1 İn&ouml;n&uuml; University, Faculty of Pharmacy, Pharmacology, 44280 Malatya, T&uuml;rkiye, ([email protected])2&nbsp; Fırat University, Faculty of Medicine, Biochemistry, 23119, Elazığ, T&uuml;rkiye&nbsp;Recent studies have shown that the positive clinical efficacy of HMG-CoA reductase inhibitors (statins) seems to be dependent not only on lipid-lowering efficacy but also on their ability to inhibit oxidative stress. &nbsp;Oxidative stress is increased in diabetes and plays a major role in the development of macrovascular and microvascular complications of diabetes1. Therefore, the &nbsp;favourable effect of statins in preventing or reducing atherosclerosis may be partially due to a reduction of lipid peroxidation. &nbsp;The purpose of this study, to investigate whether atorvastatin, given in a low dose has any effect on oxidative stress and lipid profiles in the streptozotocin-induced diabetic conditions in rats.The rats were divided three groups; Control (0.5ml cold citrate buffer 0.1M, pH 4.5, i.p.), STZ (45mg/kg, in cold citrate buffer 0.1M, pH 4.5, i.p.) and ATOR (12mg/kg/day in the standard feed).&nbsp; After the 7 weeks from ATOR treatment, the rats were sacrificed and blood/tissues were removed to evalute the lipid peroxidation (TBARS), GSH, TSH and NO levels beside ALT, AST, TG, total cholesterol, HDL-cholesterol and fasting blood glucose levels.STZ treatment&nbsp; significantly increased the TBARS levels in liver, brain and eye (p&lt;0.001) while it reduced the GSH and TSH levels in heart, kidney, brain or eye. ATOR treatment significantly decreased the STZ-induced TBARS levels in kidney, heart and especially in the eye (p&lt;0.001). Furthermore, significant ameliorates were observed in the GSH levels in the heart (p&lt;0.05) and brain (p&lt;0.001) tissues according to STZ group. The biochemical parameters were given below;&nbsp;TGALTASTTotal-Chol.HDL-Chol. FBGControl101.5&plusmn;13.281.2&plusmn;22.6197.5&plusmn;44.256.5&plusmn;15.645.1&plusmn;10.795.6&plusmn;7.1&nbsp;STZ144.0&plusmn;24.0*&nbsp;423.7&plusmn;80.7&pi;&nbsp;577.0&plusmn;102.6 &pi;&nbsp;59.8&plusmn;4.336.3&plusmn;4.4411.2&plusmn;35.4&pi;&nbsp;ATOR113.2&plusmn;39.6191.7&plusmn;55.3&para;&nbsp;194.0&plusmn;47.7&para;58.4&plusmn;7.040.5&plusmn;8.9336.5&plusmn;31.2&para;&nbsp;&nbsp;FBG:fasting blood glucose *p&lt;0.05, &pi;p&lt;0.001 according to control; &para;p&lt;0.001 according to STZ.ALT and AST levels also significantly reduced with ATOR treatment. An important another result in this study is reducing the FBG level was found extremely significant according to STZ group. However, there is not a significant difference neither total cholesterol nor HDL-cholesterol levels when compared to STZ group.&nbsp;&nbsp;Our data support the emerging role of statin treatment in diabetes mellitus despite of their lipid-lowering power. The role of statins independently of their lipid-lowering properties on oxidative stress can be benefit on the treatment of some diabetic complications such as retinopathy, nephropathy etc.&nbsp;[1]-Evans JL, Goldfine ID, Maddux BA, Grodsky GM. Oxidative stress and stress-activated signaling pathways: a unifying hypothesis of type 2 diabetes. Endocr.Rev., 23, 599&ndash;622,2002.&nbsp;[2]- Human, J, Ubbink&nbsp; J, Jerling R, Delport&nbsp; WSH, Vermaak HH. &nbsp;The effect of simvastatin on the plasma antioxidant concentrations in patients with hypercholesterolemia. Clin.Chim.Acta, 263, 67&ndash;77, 1997.&nbsp;</p

Synthesis and Characterization of Celecoxib Derivatives as Possible Anti-Inflammatory, Analgesic, Antioxidant, Anticancer and Anti-HCV Agents

A series of novel N-(3-substituted aryl/alkyl-4-oxo-1,3-thiazolidin-2-ylidene)-4-[5-(4-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl]benzenesulfonamides 2a–e were synthesized by the addition of ethyl a-bromoacetate and anhydrous sodium acetate in dry ethanol to N-(substituted aryl/alkylcarbamothioyl)-4-[5-(4-methylphenyl)-3-(trifluoro-methyl)-1H-pyrazol-1-yl]benzene sulfonamides 1a–e, which were synthesized by the reaction of alkyl/aryl isothiocyanates with celecoxib. The structures of the isolated products were determined by spectral methods and their anti-inflammatory, analgesic, antioxidant, anticancer and anti-HCV NS5B RNA-dependent RNA polymerase (RdRp) activities evaluated. The compounds were also tested for gastric toxicity and selected compound 1a was screened for its anticancer activity against 60 human tumor cell lines. These investigations revealed that compound 1a exhibited anti-inflammatory and analgesic activities and further did not cause tissue damage in liver, kidney, colon and brain compared to untreated controls or celecoxib. Compounds 1c and 1d displayed modest inhibition of HCV NS5B RdRp activity. In conclusion, N-(ethylcarbamothioyl)-4-[5-(4-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl]benzenesulfonamide (1a) may have the potential to be developed into a therapeutic agent