Toxicological assessment of the hydroethanolic leaf extract of clerodendrum capitatum in Wistar rats

Introduction: Clerodendrum capitatum (Willd) Schumach. & Thonn (Lamiaceae) is used in African traditional medicine for the treatment of malaria, hypertension, obesity, jaundice and diabetes however there is lack of experimental data on its possible toxicity. This study investigated the acute and 28 days sub-chronic toxicity of C. capitatum in Wistar rats. Methods: In acute toxicity tests, a single administration of the hydroethanolic C. capitatum leaf extract (5 g/kg) was given orally to 5 female rats. The general behavior, adverse effects and mortality were recorded for up to 14 days post treatment. On the 15th day, the rats were weighed and euthanized for necropsy. In sub-chronic toxicity tests, the extract (4, 8 and 16 g/kg/day) was given orally to both male and female rats for 28 days. The animal body weight was recorded throughout the experiment, while hematological and biochemical parameters of blood and relative organs weights were evaluated on the 29th day. Results: Clerodendrum Capitatum did not cause any death or any hazardous symptoms of acute toxicity, showing an LD50 higher than 5 g/kg. Sub-chronic administration of C. capitatum resulted in no noticeable changes in weight gain and water or food consumption. White blood cells and hemoglobin increased while urea concentration, liver enzymes, total cholesterol and glucose concentrations significantly decreased in treated animals. No changes in macroscopical aspect of organs were observed in the animals. Conclusion: These results showed that acute or subchronic oral administration of the hydroethanolic leaf extract of Clerodendrum capitatum may be considered as relatively free of toxicity.Pan African Medical Journal 2016; 2

Fetal Toxicity and Cytotoxicity of Lannea kerstingii Engl and Krause Stem Bark (Anacardiaceae)

Purpose: To evaluate the fetal toxicity and cytotoxicity of L. kerstingii in pregnant rats exposed in the organogenic period.Methods: Mated female rats were randomly assigned to three experimental groups of 8 animals each. Pregnant rats received orally 500 or 1000 mg/kg of 50 % hydroalcohol extract of L. kerstingii, daily from the 17th to the 20th day of gestation. On day 21 of pregnancy, the females were sacrificed. Laparotomy was performed and uterine horns were removed. The number of implants, resorptions, dead and live fetuses were then recorded. The ovaries were also observed and corpora lutea were counted. The cytotoxic effect of L. kerstingii hydroalcohol extract was evaluated on Caco-2 cell lines using MTT (3-(4, 5-dimetylthiazol-2-yl)-2, 5- diphenyltetrazolium bromide) and neutral red uptake assay.Results: No visible signs of toxicity were observed in the female rats and their pups through-out the study period. However, L. kerstingii (500 and 1000 mg/kg) caused a significant decrease (p < 0.01) in fetal weight compared with control. With regard to implantation, resorption and mortality, there was no significant difference between groups. L. kerstingii hydroal-cohol extract (IC50, 29 μg/mL) was more cytotoxic than the aqueous extract (IC50, 141 μg/mL).Conclusion: The administration of hydroalcohol extract of L. kerstingii to female rats in late pregnancy is toxic to the fetus.Keywords: Lannea kerstingii, Fetal toxicity, Cytotoxicity, Mortality, Oxidative stress, Anorexi

The use of plants in the traditional management of diabetes in Nigeria: Pharmacological and toxicological considerations

Ethnopharmacological relevance: The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health in the 21st century. In Nigeria, the use of herbal medicine alone or alongside prescription drugs for its management is quite common. We hereby carry out a review of medicinal plants traditionally used for diabetes management in Nigeria. Based on the available evidence on the species׳ pharmacology and safety, we highlight ways in which their therapeutic potential can be properly harnessed for possible integration into the country׳s healthcare system. Materials and methods: Ethnobotanical information was obtained from a literature search of electronic databases such as Google Scholar, Pubmed and Scopus up to 2013 for publications on medicinal plants used in diabetes management, in which the place of use and/or sample collection was identified as Nigeria. ‘Diabetes’ and ‘Nigeria’ were used as keywords for the primary searches; and then ‘Plant name – accepted or synonyms’, ‘Constituents’, ‘Drug interaction’ and/or ‘Toxicity’ for the secondary searches. Results: The hypoglycemic effect of over a hundred out of the 115 plants reviewed in this paper is backed by preclinical experimental evidence, either in vivo or in vitro. One-third of the plants have been studied for their mechanism of action, while isolation of the bioactive constituent(s) has been accomplished for twenty three plants. Some plants showed specific organ toxicity, mostly nephrotoxic or hepatotoxic, with direct effects on the levels of some liver function enzymes. Twenty eight plants have been identified as in vitro modulators of P-glycoprotein and/or one or more of the cytochrome P450 enzymes, while eleven plants altered the levels of phase 2 metabolic enzymes, chiefly glutathione, with the potential to alter the pharmacokinetics of co-administered drugs. Conclusion: This review, therefore, provides a useful resource to enable a thorough assessment of the profile of plants used in diabetes management so as to ensure a more rational use. By anticipating potential toxicities or possible herb–drug interactions, significant risks which would otherwise represent a burden on the country׳s healthcare system can be avoided

Etude de la qualité de la prescription des médicaments au Togo résultats d'une enquête en milieu urbain à Lomé

No Abstract Available J. Rech. Sci. Univ. Lomé (Togo) 2002, 6(2) : 205-21

Etude de la qualité de la prescription des médicaments au Togo: résultats d'une enquête en milieu urbain à Lomé

Dans une étude prospective les auteurs ont mené une enquête dans 17 pharmacies privées et publiques de la ville de Lomé. Le but de l’étude était d’évaluer la qualité de la prescription de médicaments dans la ville de Lomé. Au total, 1020 ordonnances ont été recueillies chez des clients tout-venant. L'analyse de ces ordonnances a fait apparaître plusieurs catégories de prescripteurs : médecins (31,37%), assistants médicaux (12,55%), sages-femmes (8,33%), infirmiers (14,71%) et anonymes (33,04%). Cette étude a montré une très grande variabilité dans l'observation des critères de qualité d'une ordonnance médicale: les prescripteurs n'ont pas mentionné leur nom, ni leur qualification dans 47,75% et 33,04% des cas respectivement; les ordonnances n'ont pas porté le nom du malade dans 41,18% des prescriptions; l'usage des caractères d'imprimerie pour le nom des médicaments prescrits n'a pas été respecté dans 70% des cas ; la posologie n'a pas été précisée dans 54,51% des cas; de même que la durée du traitement dans 78,04% des prescriptions. Les conditions de prescription de la présente étude ne peuvent pas garantir la sécurité d'emploi des médicaments.Mots clés : Ordonnance médicale, qualité de la prescription, pharmacographie, médicaments.In a prospective survey the authors conducted an investigation in 17 private and public pharmacies of the city of Lomé. The goal of the survey was to assess the quality of the medicines prescription in the Lomé city. To the total, 1020 prescriptions have been collected among customers all coming. The analysis of these prescriptions revealed several categories of prescribers: physicians (31.37%), medical assistants (12.55%), midwives (8.33%), nurses (14.71%) and anonymous (33.04%). This survey showed a wide variability in the observation of the criteria of the prescription quality : the prescribers didn't mention their name, nor their qualification in 47.75% and 33.04% of the cases respectively; the prescriptions didn't mention the patient's name in 41.18% of the prescriptions; the use of the printing characters for the name of the prescribed medicines has not been respected in 70% of the cases; the posology has not been specified in 54.51% of the cases; as well as the duration of the treatment in 78.04% of the prescriptions. The conditions of prescription of the present survey cannot guarantee the security of the medicines use.Key words : Medical prescription, prescription quality , pharmacography, medicine

Problématique de l'information sur les médicaments au Togo : à propos d'une enquête auprès de 150 médecins et pharmaciens de la ville de Lomé

Afin d’améliorer la qualité de l’information sur les médicaments en vue de leur usage rationnel, une étude prospective a été menée d’avril à août1998 auprès des médecins et des pharmaciens de Lomé. Au total 150 praticiens dont 93 médecins (62%) et 57 pharmaciens (38%) ont été interrogés. Parmi les sources d’information utilisées, le dictionnaire Vidal a été le plus consulté (96,7% des praticiens) suivi par la visite médicale (86%). Les éléments d'information sur le médicament fournis par les visiteurs médicaux ont porté surtout sur le nom de spécialité (100% des praticiens), les indications (91,3%), la posologie (84,7%) ; il a souvent manqué l’information sur les contre-indications auprès de 48,7% des praticiens, de même que les effets secondaires (61,3% des praticiens). L'information d'origine promotionnelle a été la plus utilisée dans nos milieux. Il est impérieux de la réglementer eu égard à sa forte influence sur la pratique de la pharmacothérapie par les professionnels de la santé. Mots clés : Médicaments, information, médecins, pharmaciens, usage rationnel.In order to improve the quality of information on the medicines in view of their rational use, a prospective survey has been conducted from April to August 1998 by the physicians and the pharmacists of Lomé. To the total 150 practitioners of whom 93 physicians (62%) and 57 pharmacists (38%) have been submitted to the questionnaire. Among the sources of information used by the practitioners, the Vidal dictionary was the most consulted (96.7%) followed by the medical visit (86%). The elements of information on the medicines provided by the medical visitors were especially about the label name of medicines (100% of the practitioners), the indications (91.3%), the posology (84.7%); they often missed information on the contra-indications by 48.7% of the practitioners, as well as the adverse effects (61.3% of the practitioners). The promotional information was widely diffused. It is imperious to regulate the medical visit because of its strong influence on the practice of the pharmacotherapy by health professionals.Key words: Drugs, information, physicians, pharmacists, rational use

Utilisations des médicaments antalgiques en milieu hospitalier au CHU-Campus de Lomé

Il s’agit d’une étude prospective menée au CHU-Campus de Lomé chez des malades hospitalisés. L’étude avait pour but d’évaluer la prescription des médicaments contre la douleur dans les services de médecine. 58 dossiers d’adultes dont 32 hommes (24,24%), 26 femmes (19,70%) et 74 d’enfants dont 36 garçons (27,27%) et 38 filles (28,79%) ont été retenus. Le profil des antalgiques utilisés chez ces patients se répartit en 7 groupes pharmacothérapeutiques parmi lesquels: les antalgiques antipyrétiques (84,08%) dont les salicylés (46,52%) et les pyrazolés (37,55%) ; les antalgiques morphiniques faibles (5,55%) et les coanalgésiques anti-inflammatoires non stéroïdiens (4,15%). Les antalgiques prescrits appartiennent à 2 des 3 paliers de l’échelle pharmacoclinique de l’O.M.S. dont le palier 1 qui s’adresse aux douleurs légères a représenté 90,30% des prescriptions. Le service de Pédiatrie a été en tête des prescriptions des antalgiques antipyrétiques avec 53,47%. La voie d’administration la plus utilisée a été la voie intraveineuse (79,00%). Elle a été prescrite chez 95,94% de cas pédiatriques. Les indications des médicaments antalgiques, ont été dominées en Pédiatrie par les affections hyperpyrétiques (82,43%) et chez les adultes par les affections hyperpyrétiques (32,75%), les céphalées (24,13%) et les affections viscérales douloureuses (22,41%) avec une nette prédominance des indications dans les affections à composante fébrile.Mots clés : Médicaments antalgiques, médicaments antalgiques antipyrétiques, prescription, indications thérapeutiques, milieu hospitalier.The authors conducted a prospective survey among the hospitalized patients in CHU-Campus of Lomé. The aim of the study was to assess the analgesic drugs prescription in medicine services. In total, 58 adult’s medical files of which 32 for men (24.24%), 26 for women (19.70%) and 74 children’s medical files of which 36 for boys (27.27%) and 38 for girls (28.79%) were examined. The profile of the analgesic drugs used for these patients distributes in 7 pharmacotherapeutic groups among which: the analgesic antipyretic drugs (84.08%) of which the salicylic drugs (46.52%) and the pyrazolic drugs (37.55%); the weak morphinic analgesic drugs (5.55%) and the coanalgesic non steroidal anti-inflammatory drugs (4.15%). The analgesic drugs prescribed belong to 2 of the 3 levels of the WHO pharmacoclinic scale of which the level 1 that addresses to the light pains represented 90.30% of the prescriptions. The service of Pediatrics was the 1st prescriber of the analgesic antipyretic drugs with 53.47% of prescriptions. The main route of administration used was the intravenous route (79.00%); it has been prescribed at 95.94% of pediatric patients. The indications of the analgesic medecines, have been dominated in Pediatrics by the hyperthermia disease (82.43%) and in the medicine services by the hyperthermia disease (32.75%), the headache (24.13%) and the visceral painful disease (22.41%) with a clean predominance of the indications in the febrile affections.Key words: Analgesics medicines, analgesic antipyretic medicines, prescription, therapeutic indications, hospital conditions

Connaissances, attitudes, pratiques et appréciations du personnel médical du CHU-Tokoin sur le rôle de la pharmacie hospitalière dans sa mission d’appui au fonctionnement des unités de soins et de diagnostic

A partir de deux constats : une diminution et une irrégularité dans l’approvisionnement (dotation) des services hospitaliers ; la distribution gratuite de médicaments et consommables médicaux aux unités de soins a fait place à la vente de ces produits désormais prescrits aux usagers de l’hôpital, nous nous proposons d’étudier le rôle actuel du service de la pharmacie ou pharmacie centrale de l’hôpital (PCH) au sein d’un CHU. Notre étude est une enquête prospective réalisée auprès du personnel médical du CHU -Tokoin, le dernier échelon de référence dans le système de soins. En dehors de la création de points de vente (50,6% de satisfaits), de la fourniture de kits (56,5% de satisfaits), d’anesthésiques (71,4% de chefs de service satisfaits), toutes les autres prestations de la PCH n’ont pas satisfait au moins 60% du personnel médical. Les dysfonctionnements de la PCH ont de sérieuses répercussions sur les prestations (58,4% pour le retard dans les soins d’urgence) de l’hôpital. La principale suggestion pour optimiser les prestations de la PCH a été une bonne collaboration entre le pharmacien hospitalier et les prestataires de soins (43%). Notre étude a montré que la PCH tient toujours des rôles multiples et stratégiques au sein du CHU.Mots clés : Pharmacie centrale de l’hôpital, médicaments, dispositifs médicaux, personnel médical, CHU -Tokoin, Lomé (Togo)Starting from two established facts: a reduction and an irregularity in the supplying (endowment) of the hospital departments; the sale of medicines and medical devices henceforth prescribed to the users of the hospital took the place of their free distribution to the unities of care, we intend to study the present role of the pharmacy unit or central pharmacy of the hospital (CPH) within a CHU. Our survey is a prospective investigation achieved close by the medical staff of CHU-Tokoin, the last level of reference in the system of care. Apart from the creation of points of sale (50,6% of satisfied), of the supply of kits (56,5% of satisfied) and anaesthetics (71,4% of chiefs of service satisfied), all of the other services of the PCH didn't satisfy at least 60% of medical staff. The dysfunctions of the CPH have serious after-effects on the activities of the hospital (58,4% for the delay in the attentiveness of emergency). The main suggestion in order to optimize the services of the CPH was a good collaboration between the hospital pharmacist and the medical staff (43%). Our survey showed that the CPH always holds some multiple and strategic roles within CHU.Key words: Central pharmacy of the hospital, medicines, medical devices, medical staff, CHU-Tokoin, Lome (Togo