The Pharmacist`s Responsibility in Reversing Drug-Induced Nutrient Depletion

Introduction: At present, it is commonly known that inadequate dietary intake can result in deficiencies of minerals and vitamins. Despite that, it is still less appreciated that pharmaceutical agents also have a negative impact on nutrients through a variety of mechanisms. Nowadays, this problem is on the rise especially for susceptible patients and/or patients on long-term medication therapy.Materials and Methods: An analysis of scientific web databases on the problem was performed and different lessons designed for continuing education for pharmacists were reviewed. On the basis of the analyzed lessons a questionnaire was created and conducted in Varna with the objective of displaying the practicing pharmacists` awareness of drug-induced nutrient depletion.Results: The overview of literature resources shows that drug-induced nutrient depletion is a rising problem. Special attention when consulting at the pharmacy should be paid to geriatric, cancer patients and patients with diabetes, obese or patients on weight loss programs. Some of the most used medications that negatively impact one`s nutrient status are the following - antacids, anticonvulsants, diuretics, antidiabetic, anti-inflammatory, cardiovascular, cholesterol-lowering drugs (HMG-CoA reductase inhibitors), estrogen-based replacement products. Survey results show that pharmacists are very knowledgeable about the impact of antibiotics on our gastrointestinal microbiota and reversing it, but their acquaintance with the negative effects of other medications on one`s nutrient status is uncertain.Conclusion: Living in years of deteriorated nutritional value of healthy food as well in addition to unhealthy food and chronic diseases, drug-induced nutrient depletion is an additional complication that should not be ignored. This is why, it is advisable for the studied issue to be included in future lessons for continuing education for pharmacists in Bulgaria

Anti-diabetic effect of cinnamon extract on blood glucose

Introduction Diabetes mellitus (DM) is the most common of the endocrine disorders. Despite advances in drug management of diabetes, the adverse drug effects have made scientists look towards hypoglycemic agents of plant origin, especially in the developing countries. It is postulated that spices play a major role in the management of diabetes. Cinnamon is one such spice, which has the potential to attenuate the development of dia-betes and its complication. It also does not have many adverse side effects. The anti-diabetic effect of Cinnamomi cassiae extract (Cinnamon bark: Lauraceae) in a type II diabetic animal model (C57BIKsj db/db) was studied. Cinnamon extract was administered at different dosages (50, 100, 150 and 200 mg/kg) for 6 weeks. Aim The aim of the present paper is to review the outstanding ability of cinnamon to tackle diabetes by boosting insulin function.Materials and Methods We used the following sources: Bioscience, Biotechnology and Biochemistry Journal, Science DirectResults It was found that blood glucose concentration is significantly decreased in a dose-dependent manner compared with the control. In addition, serum insulin levels and HDL–cholesterol levels were significantly higher and the concentration of triglyceride, total cholesterol and intestinal α-glycosidase activity were significantly lower after 6 weeks of administration. Conclusion These results suggest that the cinnamon extract has a regulatory role in the blood glucose level and lipids and it may also exert a blood glucose-suppressing effect by improving insulin sensitivity or slowing absorption of carbohydrates in the small intestine

The safety of herbal medicine: myth or reality

IntroductionThe use of herbal medicines continues to expand rapidly. Many people now take herbal medicines or herbal products for their health in different cases due to their low price and better compatibility with the human body. They are also regarded as minimal risk in terms of side effects, although researches on herbal medicine safety are still not broad or deep enough. Unfortunately, there are limited available published data regarding the potential toxicity of a variety of plant substances commonly used in herbal drugs.Aim The aim of this paper is to review safety issues associated with the use of herbal products.Materials and Methods We used the following web databases - Pubmed, ScienceDirect and Google Scholar. Results More and more reports have been documenting the apparent increasing popularity of herbal medicines. Although many popular herbal products are thought to be safe, a lot of unexpected effects of some of them are already described in the literature. Both minor and major toxicities have been determined, including emesis, hypersensitivity reactions, cardiovascular events, neurological dysfunction, hepatic and renal failure, and also development of malignant disease.Conclusion Our research shows the importance of pharmacists being aware of what nonprescription herbal medications their patients are taking and being informed of the potential side and toxic effects of these agents

Phytotherapy in the Management of Menopause-Associated Vasomotor Symptoms

Introduction: Menopause is the permanent cessation of menstruation for at least 12 consecutive months which results from the loss of ovarian follicular activity. Although it is a normal and natural part of aging occurring on average at age of 51 years, most menopausal women develop symptoms, which may deteriorate their quality of life for around one third of their life span (given the mean female life expectancy in Bulgaria of 78 years). The most common complaints are the vasomotor symptoms (VMS: hot flashes and night sweats). Hormone therapy was the gold standard of care for menopausal symptoms before the release of the Women`s Health Initiative. Afterwards, women became reluctant or anxious to use hormone therapy and sought natural non-hormonal alternatives.Materials and Methods: An analysis of accessible articles in scientific web databases (PubMed, ScienceDirect and Google Scholar) on the problem was conducted. Collected data considering evidence in alleviating vasomotor symptoms by popular herbal remedies was further reviewed and summarized.Results: Botanical supplements are considered to act through a number of different mechanisms of action including estrogenic, progestogenic, and/or serotonergic pathways that might mimic the actions of endogenous substances. But clinical studies of the main herbal drugs used to alleviate vasomotor symptoms either did not suggest significant efficacy (as not being superior to placebo) or were limited, and inconsistent, or show different improvements: in well-being, depression, health scores. Thus, patients should be informed to be cautious of possible side effects notwithstanding the general perception of that something is safe if it is of natural origin. In case of adverse reactions, women should be referred to specialists for reconsideration of their therapy.Conclusion: To conclude, as the evidence for phytotherapeutic menopausal VMS relief is both scarce and unconvincing, there is definitely a continued need for further work on the effectiveness and long-term safety of herbal medicinal products