The role of phytoestrogen therapy in relieving postmenopausal symptoms

Summary Side effects and contraindications connected with hormonal replacement therapy in climacterium resulted in search for new methods of softening menopausal symptoms. The aim of the following study was to evaluate, based on literature analysis, the effectiveness of phytohormonal therapy as an alternative method of relieving the symptoms of menopausal period and preventing the diseases connected with deficiency of estrogens after menopause. Phytoestrogens therapy reduces the number and strength of the vasomotor symptoms and improves serum lipid profile. Moreover, phytoestrogens show beneficial effects on bone tissue metabolism, skin and mucous membranes condition and are applicable in chemoprevention. This therapy is an effective method, allowing to avoid further changes in blood and urogenital systems, which result from estrogen stimulation deficiency. Phytoestrogens administration is an efficient method of relieving postmenopausal symptoms, facilitating the difficult menopausal period and keeping good health condition

Pharmacokinetics, Pharmacodynamics and Drug–Drug Interactions of New Anti-Migraine Drugs—Lasmiditan, Gepants, and Calcitonin-Gene-Related Peptide (CGRP) Receptor Monoclonal Antibodies

In the last few years, there have been significant advances in migraine management and prevention. Lasmiditan, ubrogepant, rimegepant and monoclonal antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) are new drugs that were launched on the US pharmaceutical market; some of them also in Europe. This publication reviews the available worldwide references on the safety of these anti-migraine drugs with a focus on the possible drug–drug (DDI) or drug–food interactions. As is known, bioavailability of a drug and, hence, its pharmacological efficacy depend on its pharmacokinetics and pharmacodynamics, which may be altered by drug interactions. This paper discusses the interactions of gepants and lasmiditan with, i.a., serotonergic drugs, CYP3A4 inhibitors, and inducers or breast cancer resistant protein (BCRP) and P-glycoprotein (P-gp) inhibitors. In the case of monoclonal antibodies, the issue of pharmacodynamic interactions related to the modulation of the immune system functions was addressed. It also focuses on the effect of monoclonal antibodies on expression of class Fc gamma receptors (FcγR)

Analgesic efficacy and safety of tapentadol in comparison with oxycodone in patients after open abdominal hysterectomy.

Tapentadol is the newest opioid with dual mechanism of action, that gives the potential to spare some opioid-induced adverse events. Studies involving this drug in acute pain are not numerous. The aim of this study was to compare the efficacy and tolerance of tapentadol and oxycodone in patients after abdominal hysterectomy. Patients were randomly allocated into two groups receiving: I. tapentadol (50 mg) and II. oxycodone (10 mg), every 12 hours postoperatively. The Numerical Rating Scores (NRS), vital signs, main adverse events (postoperative nausea and vomiting, sedation) and other side effects would be recorded until discharge. Total opioid consumption, the patients’ satisfaction, adjuvants consumption, and length of hospital stay were also assessed Mean NRS scores for tapentadol and oxycodone after 24, 48 and 72 hours were: 3.43 (±1.29) vs 3.59 (±1.37), 2.87 (±1.07) vs 3.24 (±1.21), 2.80 (±1.05) vs 3.19 (±1.24), respectively. In the tapentadol group, superior pain control (p0.05). Mucosal dryness affected over >90% patients in both groups. The incidence of postoperative nausea was 39.5% (tapentadol) and 27% (oxycodone) on the first day. The incidence of drowsiness was 42.1% (tapentadol) and 37.8% (oxycodone). Other adverse events’ level, satisfaction with treatment, length of stay after surgery, effect on vital signs were comparable

Pharmacokinetic Drug Interaction Study of Sorafenib and Morphine in Rats

A combination of the tyrosine kinase inhibitor—sorafenib—and the opioid analgesic— morphine—can be found in the treatment of cancer patients. Since both are substrates of Pglycoprotein (P-gp), and sorafenib is also an inhibitor of P-gp, their co-administration may affect their pharmacokinetics, and thus the safety and efficacy of cancer therapy. Therefore, the aim of this study was to evaluate the potential pharmacokinetic drug–drug interactions between sorafenib and morphine using an animal model. The rats were divided into three groups that Received: sorafenib and morphine (ISOR+MF), sorafenib (IISOR), and morphine (IIIMF). Morphine caused a significant increase in maximum plasma concentrations (Cmax) and the area under the plasma concentration–time curves (AUC0–t, and AUC0–¥) of sorafenib by 108.3 (p = 0.003), 55.9 (p = 0.0115), and 62.7% (p = 0.0115), respectively. Also, the Cmax and AUC0–t of its active metabolite—sorafenib N-oxide—was significantly increased in the presence of morphine (p = 0.0022 and p = 0.0268, respectively). Sorafenib, in turn, caused a significant increase in the Cmax of morphine (by 0.5-fold, p = 0.0018). Moreover, in the presence of sorafenib the Cmax, AUC0–t, and AUC0–¥ of the morphine metabolite M3G increased by 112.62 (p < 0.0001), 46.82 (p = 0.0124), and 46.78% (p = 0.0121), respectively. Observed changes in sorafenib and morphine may be of clinical significance. The increased exposure to both drugs may improve the response to therapy in cancer patients, but on the other hand, increase the risk of adverse effects