Effect of food and dosing regimen on safety and efficacy of proton pump inhibitors therapy : a literature review

Proton pump inhibitors (PPIs) are the first-choice drugs used to prevent and treat acid-related diseases. However, a lack of satisfactory response to the standard PPI dose (“PPI failure”) is often reported, especially in patients with gastroesophageal reflux disease. Poor compliance seems to be one of the main causes of PPI failure; hence, it is crucial to gain knowledge on how to properly administer PPIs. In this review, we aimed to evaluate the effect of food, beverages, and dosing regimen on pharmacokinetics and pharmacodynamics of PPIs and to frame recommendations for healthcare professionals to improve both patient’s counseling and compliance to treatment with PPIs. A total of 201 papers were identified following a literature search. After full-text evaluation, 64 studies were included in the review. Co-administration of PPIs with a meal may affect both their bioavailability and effectiveness; however, the influence of food depends on the type of drug and its formulation. Except for pantoprazole, PPIs can be administered in the morning or evening; however, morning intake generally provides better daytime control of gastric acidity. In most cases, the choice of the proper schedule of administration should be based on the patient’s symptoms and individual dosing preferences

The impact of training in the field of drug-food interactions on the awareness of this problem among Polish physicians - pilot study

Object of the study Drug-food interactions can reduce or potentiate the effect of pharmacotherapy, contribute to an increase or decrease in the frequency and severity of adverse drug reactions, impair nutrient absorption or improve their bioavailability. One of the main sources of information on drug-food interactions for patients are physicians. Aim of the study The aim of the study was to analyse Polish physicians' knowledge of drug-food interactions before and after training in this area. Material and methods The study involved 285 physicians of various specialties. Study participants received a validated questionnaire containing 3 initial questions (asked only before training) and 30 single- or multiple-choice questions (asked twice, before and after training). Trainings were performed in three Polish cities: Gdynia, Kraków and Warsaw. Results 66 physicians (23%) returned pre- and post-training questionnaires. The mean age of respondents was 44.5 ± 14 years, 65% were female. 80% of participants judged that drug-food interactions can have a high or very high impact on patient safety and the effectiveness of pharmacotherapy. 52% of the respondents declared that while prescribing a drug, they always or almost always inform the patient at what time and how in relation to meals the drug should be taken, 21% admitted that they only provide this information when in their opinion it is relevant. On a scale of 1 - 5, where 1 refers to very low and 5 refers to very high, respondents rated their knowledge of drug-food interactions at an average of 2.6 before training and 3.9 after training. The mean percentage of correct answers to questions testing knowledge of drug-food interactions before and after training was 55% and 73%, respectively (p < 0.05, Chi2 test). Conclusions Although survey participants were aware of the importance of drug-food interactions, their knowledge of the topic appeared to be moderate. The low return rate of the questionnaires suggests that the actual level of physicians’ knowledge may be much lower than observed in the survey. The training significantly improved the knowledge of drug-food interactions among the respondents. The survey indicates the need to educate Polish physicians on the proper use of drugs in relation to food

Influence of brassica sprouts on short chain fatty acids concentration in stools of rats with thyroid dysfunction

The aim of the study was to investigate the influence of kohlrabi and broccoli sprouts added to the diet on the concentrations of short-chain fatty acids in feces samples of rats with thyroid dysfunction. Two models of hypothyroidism were used. The first one was based on the diet with iodine deficiency and the second by sulfadimethoxine addition to the animal drinking water. In most cases, the concentrations of acetic acid, propanoic acid and butanoic acid in stool samples obtained from rats with thyroid dysfunction were insignificantly lower than found in the control group. Moreover, almost in all cases the diet enriched with brassica sprouts insignificantly increased the concentration of fatty acids in investigated material. A significant positive correlation between concentrations of butanoic and acetic acids was found in different groups of rats. In conclusion, the addition of broccoli or kohlrabi sprouts in ratís diet may slightly alleviate the decline of concentrations of some fatty acids in the stool of animals with thyroid dysfunction. Long term effects of this phenomenon should be evaluated in future studies

Antazoline renaissance in the treatment of cardiac arrhythmia : a review

Antazoline is an antihistaminic, immunosuppressive, antiarrhythmic agent. Antazoline can be administered orally, intravenously, intramuscularly or via the ophthalmic route. Antazoline has a limited application as an antiarrhythmic drug. This review was undertaken with the aim to combine the old and the new results of different types of studies (clinical, retrospective, or pharmacokinetic) and sum up the positive and negative effects of antazoline in cardiology and emergency medicine. A literature queries were performed in the following databases: PubMed, Embase, Google Scholar, and Web of Science (all from their inception date till June 2019). The queries covered antazoline in combinations with such terms as antiarrhythmic activity, arrhythmia, electrocardiography, emergency medicine, and cardiology. Additional publications were found by checking all the reference lists. The newest research shows that antazoline may have the highest success rate of pharmacological cardioversion among all drugs used in the contemporary treatment of cardiac arrhythmia (up to 85.3%). The rate of cardioversion with antazoline alone was higher than the combined amiodarone and/or propafenone. Most of the studies which were reviewed indicated that paroxysmal atrial fibrillation, compared to chronic atrial fibrillation, responded more satisfactorily to antazoline treatment. Most patients tolerated antazoline well and conversion was safe, effective, and smooth. Some research proves that antazoline use may also reduce the rate of hospitalization due to the adverse effects. Antazoline has a definite place in the therapeutic repertoire for several cardiac arrhythmias. It should not be neglected as an old drug, and ought to be reconsidered in emergency medicine treatment recommendations

Supplementation during pregnancy according to the most recent recommendations of the Polish Society of Gynecologists and Obstetricians

In July 2020, new recommendations of the Polish Society of Gynecologists and Obstetricians for supplementation during pregnancy have been published. The experts emphasized that that "for pregnant women the main source of vitamins, macro-, and microelements should..." should not be multivitamin supplements, but a balanced and varied diet. However, they highlighted an important role of five active substances that are considered as the elementary components of supplementation during pregnancy, namely: folic acid, iodine, vitamin D, docosahexaenoic acid (DHA), and iron. This work aims to present the most recent recommendations of the Polish Society of Gynecologists and Obstetricians, in particular: the role, indications, contraindications, recommended daily dosage, and benefits of supplementation with the main five mentioned constituents, as well as their food sources, daily requirements in Polish population and possible results of deficiency and excessive intake. Summary of the recommendations is as follows: folic acid should be administered by all women at the reproductive age, in dosage range 400-600 pg. Additionally, higher doses should be considered by women with the risk of folates deficiency and with positive history of neural tube defects. Iodine supplementation is recommended in all pregnant women, in dosage range 150-200 pg. In case of thyroid disease, monitoring of thyroid hormones concentrations, as well as thyroidstimulating hormone (TSH) and thyroid antibodies levels is required. Due to high prevalence of vitamin D deficiency in our population, the experts from Polish Society of Gynecologists and Obstetricians recommend administering vitamin D in dosage range 1500-2000 IU, for all pregnant and lactating women. Doses need to be enlarged to 4000 IU when higher risk of deficiency is suspected, e.g. in women with BMI >30. Docosahexaenoic acid (DHA) should be supplemented by pregnant women in a dose of 200 mg, or higher - if the risk of premature birth occurs or low consumption of marine fish is reported. Iron supplementation, in a dose up to 30 mg, is recommended only for pregnant women with the iron deficiency anemia (Hb <11 g/dL), and with low level of ferritin (<60 pg/L). We believe that supplying the most up-to-date information on the topic of supplementation during pregnancy, would help pharmacists to provide pregnant women with professional advice about safe and effective supplementation, and hence contribute to the improvement of the pharmaceutical care quality in Poland

Evaluation of antioxidant activity of amaranth ("Amaranthus cruentus") grain and by-products (flour, popping, cereal)

Przedstawiono ocenę aktywności przeciwutleniającej nasion dwóch odmian szarłatu Amaranthus cruentus v. Aztek i v. Rawa oraz produktów spożywczych z niego otrzymanych (mąka, popping, płatki) w oparciu o metodę FRAP i zmodyfikowane metody ABTS i DPPH. Oznaczone wartości parametrów były skorelowane liniowo. Stwierdzono, że nasiona v. Rawa posiadały wyższą aktywność niż v. Aztek, wśród produktów spożywczych najwyższą zdolność antyoksydacyjną posiadały płatki zaś najniższą popping. Namaczanie nasion powodowało obniżenie ich aktywności antyoksydacyjnej.The objective of our study was evaluation antioxidant activity of Amaranthus cruentus grain and by-products (flour, cereals and popping). The evaluation was performed by FRAP, DPPH and ABTS methods. FRAP and ABTS assays gave comparable results, DPPH method gave lower values. Among by-products cereal had the highest activity as the least processed product. Additionally, antioxidant capacities of two cultivars of amaranth (varieties Aztek and Rawa) were compared and the influence of grain soaking on antioxidant properties was taken into account. It was found, that soaking decreased antioxidant activity of amaranth seed