Adverse Effects and Drug Interactions of the Non‐Steroidal Anti‐Inflammatory Drugs

The aim of this chapter is to increase the awareness of health‐care professionals concerning potential adverse effects and drug interactions of non‐steroidal anti‐inflammatory drugs (NSAIDs), which are among the most widely prescribed medicines, globally. They have a variety of clinical applications due to their anti‐inflammatory, analgesic, antipyretic, or antithrombotic effect, but these drugs are not entirely innocuous, since they could increase the risk of gastrointestinal and cardiovascular complications. Furthermore, the drugs from this class have the potential of altering the pharmacokinetics of associated drugs, and also pharmacodynamic interactions have been reported. The clinical significance, mechanisms, and epidemiology of the adverse effects and drug interactions of NSAIDs are presented in this chapter. Prevention strategies for particularly high‐risk groups of patients are also exposed. Detailed and up‐to‐date information regarding the adverse effects and drug interactions of NSAIDs are needed for all healthcare professionals in order to maximize efficacy in treating various illnesses while minimizing the risks for the patients

Safety Profile of Essential Oils

Essential oils are complex mixtures of terpenes and phenylpropanoid compounds, present in multiple species of aromatic plants. They are extensively used in food and cosmetic industries in order to give flavor to food and drinks or as natural fragrances. Moreover, several compounds present in essential oils are important for the pharmaceutical industry due to their antioxidant, antimicrobial, anxiolytic or spasmolytic effects. Although many essential oils are generally recognized as safe, a series of adverse reactions have been reported after their use either by internal or external routes. The aim of this chapter is to increase the awareness of healthcare professionals concerning possible safety issues of essential oils. Common adverse effects of essential oils like sensitization and dermatitis but also more severe phenomena like neurotoxicity will be presented in detail, concerning their epidemiology, mechanism and clinical significance. A thorough understanding of the safety profile of essential oils is necessary for healthcare and food industry professionals in order to maximize their beneficial effects while minimizing the risk for the users

Utilization of psychotropic medicines in Romania during 1998–2018

Background: Mental disorders can have a significant impact on patients’ life, including economic, social and individual consequences, and psychotropic medication is essential to treat these conditions. Psychotropic drug utilization studies contribute to a clearer picture of the management of these conditions. Data published from Romania on this topic is limited. The present study aims to characterize the utilization patterns of anxiolytics, antidepressants (ADs), and antipsychotics (APs) in Romania during 1998–2018.Methods: Drug utilization data were provided by Management Center for Documentation, Information and Marketing (CEGEDIM) Romania and quantitative data for each psychotropic medicine were converted to total defined daily doses (DDDs) and to DDD/1000inhabitants/day (DDD/TID). The total use of medicines in DDD/TID was computed in order to obtain the drug utilization 90% (DU90%) segment.Results: An increasing trend in total utilization of psychotropic medicines in Romania started in 2004. Anxiolytics use was predominant until 2013 and the yearly anxiolytic use over the entire study period remained between 10 and 15 DDD/TID. Diazepam lost popularity over time in detriment of the utilization of other anxiolytic benzodiazepines, such as alprazolam and lorazepam. ADs utilization markedly increased during the study period (the average annual growth rate was 13.66% starting 1999). Selective serotonin reuptake inhibitors (SSRIs) became present on the 2008 DU90% and was the dominant class of ADs, with sertraline being the most prescribed, followed by escitalopram and paroxetine. APs utilization showed an increasing trend from 2003 until 2018. Atypical APs became present on the 2008 DU90%, while typical APs were no longer included in the 2018 DU90%. Among atypical APs, olanzapine was the main agent prescribed, and starting 2010 was followed by quetiapine and risperidone. The uptake of APs long-acting formulations became more evident during the last analyzed years (2015–2018).Conclusion: We observed an increasing utilization of APs and a more prominent increase in ADs utilization in Romania during 1998–2018. The anxiolytic prescribing remained nearly stable during this time. Further research can bring more information on the various factors influencing psychotropic utilization in Romania

Ophthalmic Nanosystems with Antioxidants for the Prevention and Treatment of Eye Diseases

Oxidative stress may induce a series of pathophysiological modifications that are directly involved in the development of ophthalmic diseases like age-related cataract, macular degeneration or diabetic retinopathy, considered to be responsible for the majority of vision loss cases. Although various treatment options for eye diseases are available, multiple factors could limit their efficacy. Recently, the accelerated development of ophthalmic nanosystems has provided new possibilities for overcoming the limitations of existing ocular drug delivery methods. This review evaluates the current status of ophthalmic nanosystems loaded with antioxidants for the prevention and treatment of several eye diseases

Perspectives of Molecularly Imprinted Polymer-Based Drug Delivery Systems in Ocular Therapy

Although the human eye is an easily accessible sensory organ, it remains a challenge for drug administration due to the presence of several anatomical and physiological barriers which limit the access of drugs to its internal structures. Molecular imprinting technology may be considered the avant-garde approach in advanced drug delivery applications and, in particular, in ocular therapy. In fact, molecularly imprinted polymers hold the promise to compensate for the current shortcomings of the available arsenal of drug delivery systems intended for ocular therapy. The present manuscript aims to review the recent advances, the current challenges and most importantly to raise awareness on the underexplored potential and future perspectives of molecularly imprinted polymer-based drug delivery systems intended for the treatment of eye diseases

Antispasmodic Effect of Essential Oils and Their Constituents: A Review

The antispasmodic effect of drugs is used for the symptomatic treatment of cramping and discomfort affecting smooth muscles from the gastrointestinal, billiary or genitourinary tract in a variety of clinical situations.The existing synthetic antispasmodic drugs may cause a series of unpleasant side effects, and therefore the discovery of new molecules of natural origin is an important goal for the pharmaceutical industry. This review describes a series of recent studies investigating the antispasmodic effect of essential oils from 39 plant species belonging to 12 families. The pharmacological models used in the studies together with the mechanistic discussions and the chemical composition of the essential oils are also detailed. The data clearly demonstrate the antispasmodic effect of the essential oils from the aromatic plant species studied. Further research is needed in order to ascertain the therapeutic importance of these findings

Potential Role of Propolis in the Prevention and Treatment of Metabolic Diseases

Propolis is a resinous mixture with a complex chemical composition, produced by honeybees and stingless bees from a variety of vegetal sources. In the last decades, propolis was extensively researched, multiple studies confirming its anti-inflammatory, antioxidant, antimicrobial, and wound-healing properties. More recently, due to an exponential increase in the number of patients with metabolic diseases, there is also a growing interest in the study of antidiabetic, antihyperlipidemic, and anti-obesity effects of propolis. The aim of this review was to evaluate the potential role of propolis in the prevention and treatment of metabolic diseases like diabetes mellitus, dyslipidemia, and obesity. The preclinical in vivo and in vitro pharmacological models investigating antidiabetic, antihyperlipidemic, and anti-obesity effects of propolis were reviewed with a focus on the putative mechanisms of actions of several chemical constituents. Additionally, the available clinical studies and an evaluation of the safety profile of propolis were also presented

A Comparative Analysis of the Chemical Composition, Anti-Inflammatory, and Antinociceptive Effects of the Essential Oils from Three Species of Mentha Cultivated in Romania

This work was aimed at correlating the chemotype of three Mentha species cultivated in Romania with an in vivo study of the anti-inflammatory and antinociceptive effects of essential oils. The selected species were Mentha piperita L. var. pallescens (white peppermint), Mentha spicata L. subsp. crispata (spearmint), and Mentha suaveolens Ehrh. (pineapple mint). Qualitative and quantitative analysis of the essential oils isolated from the selected Mentha species was performed by gas chromatography coupled with mass spectrometry (GC-MS). The anti-inflammatory activity of the essential oils was determined by the rat paw edema test induced by λ-carrageenan. The antinociceptive effect of the essential oils was evaluated by the writhing test in mice, using 1% (v/v) acetic acid solution administered intraperitonealy and by the hot plate test in mice. The results showed a menthol chemotype for M. piperita pallescens, a carvone chemotype for M. spicata, and a piperitenone oxide chemotype for M. suaveolens. The essential oil from M. spicata L. (EOMSP) produced statistically significant and dose-dependent anti-inflammatory and antinociceptive effects