New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What has been Investigated and What is in the Pipeline?

A wide range of support is available to help smokers to quit and aid attempts at harm reduction, including three first-line smoking cessation medications: nicotine replacement therapy, varenicline and bupropion. Despite the efficacy of these, there is a continual need to diversify the range of medications so that the needs of tobacco users are met. This paper compares the first-line smoking cessation medications to: 1) two variants of these existing products: new galenic formulations of varenicline and novel nicotine delivery devices; and 2) twenty-four alternative products: cytisine (novel outside of central and eastern Europe), nortriptyline, other tricyclic antidepressants, electronic cigarettes, clonidine (an anxiolytic), other anxiolytics (e.g. buspirone), selective 5-hydroxytryptamine (5-HT) reuptake inhibitors, supplements (e.g. St John’s wort), silver acetate, nicobrevin, modafinil, venlafaxine, monoamine oxidase inhibitors (MAOI), opioid antagonist, nicotinic acetylcholine receptors (nAChR) antagonists, glucose tablets, selective cannabinoid type 1 receptor antagonists, nicotine vaccines, drugs that affect gamma-aminobutyric acid (GABA) transmission, drugs that affect N-methyl-D-aspartate receptors (NMDA), dopamine agonists (e.g. levodopa), pioglitazone (Actos; OMS405), noradrenaline reuptake inhibitors, and the weight management drug lorcaserin. Six criteria are used: relative efficacy, relative safety, relative cost, relative use (overall impact of effective medication use), relative scope (ability to serve new groups of patients), and relative ease of use (ESCUSE). Many of these products are in the early stages of clinical trials, however, cytisine looks most promising in having established efficacy and safety and being of low cost. Electronic cigarettes have become very popular, appear to be efficacious and are safer than smoking, but issues of continued dependence and possible harms need to be considered

Removal of gaseous formaldehyde by portable photocatalytic air purifier equipped with bimetallic Pt@Cu-TiO2 filter

In this research, a mini-scale air purifier (AP) system was built with a series of honeycomb (HC) ceramic filters coated with 1 wt% Pt@Cu/TiO2 (AP (PCT-x), where x = 1, 2, and 3 for Pt:Cu weight ratios). The designed AP (PCT-x) photocatalytic systems were investigated for the removal of formaldehyde (FA) vapor under varying operational conditions (e.g., FA concentration (0.5-5 ppm), AP-flow rate (100-160 L/min), and UV light intensity (0.004-0.982 W)). The enhanced photocatalytic activities of AP (PCT-x) system (e.g., compared to the monometallic analogues) are suspected to reflect the synergistic role of Pt metal sites (in terms of high work function (5.93 eV) for the 111 crystal plane) in the Pt@Cu bimetallic structures and the high electronic transitions between Pt and Cu sites on the TiO2 surface. Nonetheless, their photocatalytic activities tend to decrease at higher Pt content (e.g., PCT-3 relative to PCT-2) due possibly to the formation of Pt clusters and associated shielding effect. Overall, AP (PCT-2) exhibited the highest efficacy (over five reuse cycles) to attain 100% removal of FA (0.5 ppm) within 5 min at an AP-flow rate of 160 L/min and UV light intensity of 0.982 W (quantum yield (QY) of 1.94E-04 molecules/photon and figure of merit (FOM) of 1.21E-06 L & BULL;mol/ (mg & BULL; J & BULL;h)). According to the in-situ DRIFTS analysis, Pt2@Cu metal sites were favorable to promote the transfer of photoinduced charge carriers by TiO2 so as to accelerate the oxidation reaction of FA vapor (e.g., through the generation of OH & BULL; and O2 & BULL;- radicals). This study offers practical insights into the potential of controlled tuning of redox dynamics (i.e., between Pt and Cu metal sites on TiO2) in the enhancement of the photocatalytic performance for air purification system

Efficacy of single-dose rasburicase in the management of tumor lysis syndrome: a case series from a regional cancer center in western India

Background: Tumor lysis syndrome (TLS) is an oncological emergency. Rasburicase (recombinant urate oxidase) has been proven to be an effective therapy for prevention of TLS and its serious consequences in patients with hematological malignancies such as acute leukemias with high white blood cells count, Burkitt lymphoma, and lymphoblastic lymphoma with high tumor burden. The US Food and Drug Administration recommended daily dosing regimen for 5 days is unaffordable by each and every patient in developing countries such as India. Recently, the conducted studies have clearly shown a similar efficacy for a single dose of rasburicase. Herein, we report a case series of 15 patients, including children and adults with hematologic malignancies, in whom TLS was managed by a single dose of rasburicase. Materials and Methods: We retrospectively analyzed the efficacy of single-dose rasburicase (SDR) (0.15 mg/kg intravenous infusion over 30 min) in patients with hematologic malignancies at risk for TLS. The drug was administered in five adult and 10 pediatric patients admitted to the Gujarat Cancer and Research Institute between January 2013 and December 2014. Results: The study included 15 patients, out of which 10 were pediatric (8 male:2 female) and five were adults (5 male:0 female). Patients with hematologic malignancies having Eastern Cooperative Oncology Group performance status 0–2 and at high risk or potential risk for TLS were selected. The median ages in pediatric and adult groups were 7.7 years and 32 years, respectively. The presence of hyperuricemia (plasma uric acid (UA) levels ≥7.5 mg/dl) or a diagnosis of very aggressive lymphoma or leukemia based on the World Health Organization classification of hematopoietic and lymphoid neoplasms in patients was classified as high-risk. Rasburicase was administered in a single dose of 0.15 mg/kg intravenously over 30 min. Patients were evaluated by clinical examination and blood biochemical tests at frequent intervals. Plasma samples for UA were collected at baseline before rasburicase, 6–24 h post-rasburicase, 48 h post-rasburicase, and daily during treatment. The blood samples for UA during the course of treatment were collected in prechilled tubes containing heparin and immediately immersed and transported on ice. The blood samples were analyzed within 4 h of collection. Serum electrolytes, blood urea nitrogen, creatinine, calcium, and phosphorous were monitored daily during this period. A single dose of rasburicase produced a rapid and sustained therapeutic effect of lowering the plasma UA levels in all the 15 patients. Renal parameters normalized within 72 h. UA levels remained below 4 mg/dl throughout the administration of chemotherapy until discharge, and none of the patients required a repeat dosing of rasburicase. Conclusion: SDR is a highly economical and clinically effective way of managing patients with TLS and could serve as an alternative to the 5-day treatment in a resource-limited country such as India