Association between culture and the preference for, and perceptions of, 11 routes of medicine administration: A survey in 21 countries and regions

Medicines can be taken by various routes of administration. These can impact the effects and perceptions of medicines. The literature about individuals' preferences for and perceptions of the different routes of administration is sparse, but indicates a potential influence of culture. Our aim was to determine: (i) any association between one's culture and one's preferred route of medicine administration and (ii) individual perceptions of pain, efficacy, speed of action and acceptability when medicines are swallowed or placed in the mouth, under the tongue, in the nose, eye, ear, lungs, rectum, vagina, on the skin, or areinjected. A cross-sectional, questionnaire-based survey of adults was conducted in 21 countries and regions of the world, namely, Tunisia, Ghana, Nigeria, Turkey, Ethiopia, Lebanon, Malta, Brazil, Great Britain, United States, India, Serbia, Romania, Portugal, France, Netherlands, Japan, South Korea, Hong Kong, mainland China and Estonia, using the Inglehart–Welzel cultural map to ensure coverage across all cultures. Participants scored the pain/discomfort, efficacy, speed of onset and acceptability of the different routes of medicine administration and stated their preferred route. Demographic information was collected. A total of 4435 participants took part in the survey. Overall, the oral route was the most preferred route, followed by injection, while the rectal route was the least preferred. While the oral route was the most preferred in all cultures, the percentage of participants selecting this route varied, from 98% in Protestant Europe to 50% in the African-Islamic culture. A multinomial logistic regression model revealed a number of predictors for the preferred route. Injections were favoured in the Baltic, South Asia, Latin America and African-Islamic cultures while dermal administration was favoured in Catholic Europe, Baltic and Latin America cultures. A marked association was found between culture and the preference for, and perceptions of the different routes by which medicines are taken. This applied to even the least favoured routes (vaginal and rectal). Only women were asked about the vaginal route, and our data shows that the vaginal route was slightly more popular than the rectal one

Toxicity studies on Alchornea cordifolia leaf extract in mince

Alchornea cordifolia (Schum. and Thonn.) Müll. Arg (Euphorbiaceae), a widely used traditional medicinal agent was assessed for possible toxicity in mice. We investigated the effect of the ethanolic extract of Alchornea on blood cells and chemistry, histology, and relative weight of selected organs in mice. Administration of Alchornea cordifolia (250-2000 mg/kg, p.o daily) for two weeks did not affect significantly the relative organ weights, blood cells or renal function. Histology of liver and kidney at dose levels up to 1000 mg/kg was normal and similar to vehicle- treated controls. However, liver sections of mice treated with 2000 mg/kg Alchornea extract showed perivascular aggregates of lymphocytes, eosinophilia and pyknosis, evidence of hepatic damage. These results suggest that Alchornea cordifolia is relatively non-toxic but has the propensity to induce hepatic injury at high doses

Effects of Tetrapleura Tetraptera (Taub) Fruit Extract On Some Isolated Tissues: Possible Mechanism(S) of Antihypertensive Action

Hypotensive activities of the alcoholic extract of T. tetraptera fruits have been earlier demonstrated in cats, rats and rabbits. In the present study, we demonstrate myorelaxant actions of the extract in isolated smooth muscle preparations. Relaxations were dose-dependent: EC50s were 0.3 ± 0.01, 2.4 ± 0.1 and 4.3 ± 0.01 mg/ml for rat anococcygeus, rat uterus and guinea-pig taenia coli respectively. Also, spasmogenic actions of noradrenaline, carbachol, Ca2+ and K+ in the rat anococcygeus and uterus were all suppressed by the extract. The effect of the extract on Ca2+-induced contractions were investigated in guinea-pig isolated taenia coli and atria preparations and compared to nifedipine, a calcium- channel blocker . Pre-treatment with T. tetraptera (1-10 mg/ml) and nifedipine (0.01-0.1 μg/ml) for 15 minutes in Ca2+-free K+ (100 mM) medium caused a right ward shift of the concentrationresponse curves for CaCl2-induced contractions in atria and taenia coli with depressed maximal response, suggestive of a non-competitive interaction. In all tissues investigated, the extract nonspecifically reduced both the natural tone and agonist-induced contractions. Thus smooth muscle relaxant actions of the extract may partly account for the hypotensive actions of T. tetraptera fruits. Journal of Science and Technology Vol. 28 (1) 2008 pp. 23-3

Alchornea Cordifolia (Euphorbiaceae), the Major Constituent of Antiasthmatic Herbal Formulations in Ghana, Stimulates β- adrenoceptors.

We have investigated the scientific basis for the traditional use of Alchornea cordifolia (Euphorbiaceae), by using isolated tissue models of smooth muscles in the laboratory. The aqueous extract of the leaves of Alchornea cordifolia produced a dose-related relaxation of the isolated rabbit duodenum in a manner similar to noradrenaline, adrenaline and isoprenaline, which were antagonised by propranolol (10μg/ml) by 63% but not phentolamine, suggesting a non-specific β- receptor-mediated activity. Additionally, the extract (12mg) evoked increased rate and force of contraction similar to isoprenaline on the Langendorff's isolated perfused rabbit heart preparation by 87% by an action on β1- receptors. These effects were blocked by propranolol (0.1mg), a nonspecific β-blocker. Carbachol-induced contractions on the guinea-pig tracheal smooth muscle were reversed by the extract in a cumulative dose manner, akin to the bronchodilator actions of isoprenaline. Similarly, 4μg/ml carbachol-elicited contractions on both pregnant and non-pregnant rat uterus were antagonised by the extract (50mg/ml) by 72% and 64% respectively. All together, our data suggest that the extract stimulates smooth muscles through activation of β-adrenoceptors in a manner similar to isoprenaline, which supports its traditional use as a constituent of anti-asthmatic and cough formulations, and in the control of spontaneous abortion. Journal of the Ghana Science Association Vol. 10 (2) 2008: pp. 1-1

Toxicological assessment of Parquetina nigrescens extracts in rats

The toxicological potential of Parquetina nigrescens was investigated using Sprague-Dawley rats. Liver enzymes like Aspartate and Alanine aminotranferases (AST/ALT), Alkaline phoshatase(ALP), &#947;-glutamyl transferase (GGT), as well as some haematological indices (red and white blood cells), and urea levels were assayed as evidence of toxicity. The extract, administered (400-1600 mg kg-1, p.o.) for six weeks did not cause any significant (p < 0.05) changes in RBC counts in comparison with the mean vehicle-treated control. The total WBC count was not affected after 4 weeks of extract administration (400–1600 mg kg-1 p.o), but in the sixth week the mean total WBC count in rats treated with 1600 mg kg-1 p.o of the extract reduced by 49.0 %.The dose range 400–1600 mg kg-1, p.o did not cause any significant (p < 0.05) changes in both the blood AST and ALT levels. The extract, at all dose levels caused an increase of GGT levls within the first two weeks of treatment, implicating the extract in enzyme induction. Mean serum urea levels in all treatment groups remained statistically unchanged over the six-week period. At the dosage range used, the extract did not cause major changes in the biochemical parameters assessed, indicating the liver and kidney had not undergone any toxic assault. However, the authors suggest the WBC count should be monitored when high doses are administered for long period as the highest dose caused a decrease in WBC count. Journal of Science and Technology Vol. 26 (3) 2003: pp. 24-3

Effect of Aqueous Extract of Euphorbia hirta on Haematological and Biochemical Parameters of Sprague Dawley Rats

An oral toxicity assessment of the aqueous extract of the whole plant of Euphorbia hirta selected for use in animal healthcare in Ghana was carried out in Sprague Dawley (SD) rats. The extract was administered at a dose rate of 500 - 2000mg/kg per os for 14 days. At the end of the period, blood samples were collected by jugular veno-puncture for haematological and biochemical analysis to assess liver and kidney function. Significant (P &lt; 0.01) decreases occurred in the values of red blood cell (RBC) counts of the groups receiving 1000mg/kg and 2000mg/kg of the extract. Consequently haemoglobin concentrations also decreased significantly (P &lt; 0.001) compared with the control. The haematocrit (HCT) value of these groups also decreased significantly (P &lt; 0.05) below that of the control. Biochemical studies did not suggest any malfunction or abnormality of the renal or hepato-biliary systems. The present results indicate that aqueous extract of the whole plant of E. hirta up to a dose of 500mg/kg orally is generally safe. This finding perhaps justifies the widespread use of the plant in the treatment of several diseases all over the world and may also be used for the treatment of diseases in animals. However, caution should be taken with doses &gt; 500mg/kg as these may induce anaemia.Keywords: Aqueous extract, toxicity, rats, Euphorbia hirta

Academic Journals Toxicological assessment of Cryptolepis sanguinolenta for possible use in veterinary medicine

Acute and sub-acute oral toxicity assessment of the aqueous root extract of Cryptolepis sanguinolenta was studied in Sprague Dawley rats for possible use as animal medication. The extract (250 -3000 mg/kg, p.o) was administered daily for a period of 72 h and (500 -2000 mg/kg, p.o) for 14 days for acute and sub-acute studies respectively. Acute administration of the extract did not produce any physiological and behavioural changes. In the subacute toxicity studies however, a dose-dependent increase in the number of platelets (from a vehicle-treated control value of 353.00 ± 49.40 -958.00 ± 42.50 in animals treated with 2000 mg/kg) was observed. Granulocyte number also increased dosedependently (0.77±0.15 -3.70±0.20) from the vehicle-treated control to the group that received 2000 mg/kg, indicating possible inflammation. Central nervous system toxicity and marginal enlargement of liver and kidney were evident in the 2000 mg/kg treated group. These findings however did not correlate with the biochemical and histopathological studies as no pathological changes occurred in the renal or hepato-biliary systems. The present results suggest that the aqueous root extract of C. sanguinolenta &lt; 500 mg/kg orally is generally safe. However, caution should be taken with doses &gt; 500 mg/kg as these may induce thrombocytosis, inflammation and central nervous system toxicity