- Home
- A-Z Publications
- Current Drug Therapy
- Previous Issues
- Volume 19, Issue 3, 2024
Current Drug Therapy - Volume 19, Issue 3, 2024
Volume 19, Issue 3, 2024
-
-
Challenges in Immunomodulation for Psoriasis: Recent Advancements and Need of Therapies
More LessPsoriasis is a chronic immune-mediated skin disorder affecting millions worldwide. The pathogenesis of psoriasis involves dysregulated immune responses characterized by aberrant activation of T cells and proinflammatory cytokines. Immunomodulation has emerged as a promising therapeutic approach for managing psoriasis, aiming to restore immune homeostasis. However, despite significant advancements, challenges persist in developing effective immunomodulatory therapies. This abstract reviews recent developments in psoriasis immunomodulation, encompassing novel targets and therapeutic modalities. Advances in biologics targeting interleukins (IL) and their receptors, such as IL-17, IL-23, and IL-12/23, have demonstrated substantial clinical efficacy. Additionally, small molecules that inhibit Janus kinases (JAK) and phosphodiesterase 4 (PDE4) have shown promise in regulating immune responses. Despite these advancements, certain limitations hinder the success of immunomodulatory therapies. Treatment resistance, safety concerns, and high costs remain critical challenges. Furthermore, a deeper understanding of the complex immunopathogenesis of psoriasis is essential for developing targeted and personalized therapies. In conclusion, immunomodulation has revolutionized the management of psoriasis, offering remarkable improvements in patient outcomes. Continued research and innovative therapeutic strategies are needed to overcome current challenges and pave the way for more efficient, safe, and accessible treatments for psoriasis.
-
-
-
3D Printing – A Revolution in Modern Healthcare: Recent Achievements & Challenges
Authors: Anshul Chaudhary, Samiksha Sharma and Arti R. ThakkarThe pharmaceutical industry grows every year keeping public health as a priority, protection, and economic development. The industry is mostly concentrated on the novel drug development process as well as new methods that can help improve the recovery rate of a condition and improve the quality of patient treatment. Pharmaceutical companies have recently experimented with producing medications using 3D printing to increase their quality and improve user health. Later, in 2015, the companies found success by producing the 3D-printed medication Spritam, which had already received US FDA approval. Over the past few years, the medical device industry has adapted to 3D printing technology and creative companies have used it to produce goods with distinctive content, appearance, and customizability. However, these distinctive capabilities of 3D printing have brought forth new legal difficulties and troubling issues with the regulatory agencies' acceptance of these devices. Customizability and distinctive construction procedures of medical devices printed via 3D printing techniques have difficulties in attaining quality assurance and regulatory criteria for manufacturing. Advancement in 3D printing technology has helped in the production of various innovative medical products along with new structures and constituents. The present review discusses distinctive regulatory problems faced by the USFDA as well as by other regulatory authorities in the case of approval of 3D printing products and measures required to develop regulations for the safety, quality, and effectiveness of 3D printing Devices.
-
-
-
An Outlook of Substantial Progress in Nanotechnology Emerged in Treatment Approaches for Rheumatoid Arthritis
Authors: Amana Parveen, Pranay Wal, Awani Kumar Rai and Ankita WalBackground: Rheumatoid arthritis affects roughly 5 out of every 1000 persons, rheumatoid arthritis is a persistent anarchic ailment with complicated pathophysiology a well-known cause of arthritis- related stinging apropos nexus, degradation of synovium, the creation of pannus, damage to bones, and loss of the cartilage. Thus, it is imperative to diagnose and treat rheumatoid arthritis. Due to rheumatoid arthritis's complexity, early diagnosis is difficult, which makes the treatment difficult. Moreover, anti- rheumatoid arthritis drugs taken on a long-term basis can damage patients' organs as well. Due to this, these anti- rheumatoid arthritis medications may cause severe side effects in extraarticular tissues since they cannot selectively target the affected zone. There has been substantial progress in the discovery of this disease's pathophysiology and treatment strategy over the past few years, as well as in developing effective diagnostic methods, early detection, and efficient treatment strategies. In the rheumatoid arthritis, nanotechnology has come to the fore as a game-changer in effectively managing many diseases. Various nanotechnology approaches are promising for designing formulations that can deliver drugs to bone and cartilage in targeted and non-targeted ways like Targeting receptors on inflammation-related cells (CD44, Scavengers receptors, etc.). Conclusion: Nanotechnology is used to treat Rheumatoid arthritis, improve implants and prostheses, and develop new diagnostic and treatment methods in orthopedic medicine. Many chronic orthopedic diseases exist, but rheumatoid arthritis is the most common. Several research studies have found that nanotechnology could deliver targeted drugs, reduce adverse effects on non-target organs, increase drug concentration in synovial tissues, and slow the progression of immune-mediated rheumatoid diseases such as rheumatoid arthritis. This review examines how nanotechnology can be used to diagnose and treat rheumatoid arthritis.
-
-
-
An Update on the Role of Circadian Rhythms in Sleep Disorders
Authors: Namra Aziz, Vipin K. Garg, Yadav Rupali Vinod, Arpit Gupta, Ankita Wal, Shruti Rathore and Pranay WalBackground: The comprehension of the molecular, cellular, and biological mechanisms that underlie the management of the sleep-wake cycle, as well as the effects of circadian disruption on health and illness, has made significant strides. Methods: An extensive literature review was done from the standard databases such as Scopus, Elsevier, and PubMed using standard keywords “Circadian rhythm”, and “sleep disorders”. In this section, we examined circadian biology and provided adetailed description of the pathogenesis, clinical characteristics, diagnosis, and management of the most typical Circadian rhythm sleep disorders (CRSDs) seen in clinical practice. Conclusion: It can be concluded that the central circadian rhythm mechanism may be altered, or the intrinsic circadian clock and the environment may not be in sync, to produce circadian rhythm sleep disorders. As a consequence, we must focus on modifying our way of life in a constructive and healthy way. Even while the lifestyle is based on personal preferences and identities, it is important to examine it in isolation from its sociocultural environment.
-
-
-
Drug Targets, Current and Future Therapeutics for the Treatment of Multi Drug Resistant Tuberculosis with their Clinical Applications: A Critical Review
Multi drug-resistant or extensive drug resistance Mycobacterium tuberculosis poses numerous challenges for health care workers and for public health authorities. Treating multidrug resistant or extensive drug resistance tuberculosis continues to be a difficult task, as a longer regimen is associated with a higher number of adverse drug events and economic burden and has a significant negative effect on health care resources. Many trials and observational studies were conducted. Few studies are underway to develop the universal regimen and improve the outcomes related to multi or extensive drug resistance tuberculosis with a shorter regimen duration. The current review will discuss which drug inhibits what target, their synthesis, genetic aspects, repurposed drugs, novel drugs, and extensive trials for the treatment of multi or extensive drug resistance tuberculosis.
-
-
-
Preparation of Ketoconazole-loaded Nanoemulsions for Ophthalmic Delivery: Characterization and In-vitro Antifungal Activity Evaluation
Authors: Mohammad M. Mahboobian, Negin Azadi and Shabnam PourmoslemiBackground: Nanoemulsions (N.E.s) capable of ocular bioavailability elevation can be used for poor water-soluble drugs such as ketoconazole (K.Z.). The current investigation was designed for the purpose of overcoming this issue by developing K.Z. containing N.E.s for ophthalmic drug delivery with appropriate therapeutic efficiency. Methods: The preparation of ketoconazole N.E.s was performed by the low-energy technique. According to the phase diagram, three stable formulations were selected for more physicochemical analyses, including particle size, polydispersity index, pH, refractive index and viscosity. Finally, drug release patterns and in-vitro antifungal activity were assessed for the final selected formulation. Results: The developed N.E. formulations with droplet sizes less than 20 nm showed appropriate physicochemical characteristics for ocular delivery. The selected formulation released 100% of the encapsulated drug during 24 h. Moreover, antifungal assessments showed that prepared N.E. had acceptable in-vitro antifungal activity. Conclusions: Based on our findings, it can be concluded that N.E.s could be applied as effective carriers for the ophthalmic delivery of ketoconazole.
-
-
-
Nanoemulsion based in-situ Gel for Ocular Delivery of Brimonidine Tartrate
Authors: Bhupendra Prajapati, Chetna Modi, Uma Patel and Prakash KendreBackground: Brimonidine tartrate is currently used to treat glaucoma; however, conventional ocular formulations have some disadvantages in terms of treating disorders like glaucoma, as less than 5% of the drug reaches a posterior segment of the eye; hence, there is a need for sustained treatment. Objective: The objective of this study was to develop a self-nanoemulsion (SNEDDS) in-situ gel of brimonidine tartrate to investigate the sustained-release effect to improve ocular bioavailability. Methods: Oil, surfactant, and co-surfactant were screened using the pseudo-ternary phase diagram (TPD) by aqueous-titration method based on the drug solubility. Nanoemulsions were evaluated for the pH, viscosity, % drug content, % transmittance, dispersibility, particle size, zeta-potential, TEM, and conductivity test. Nanoemulsion was incorporated into in-situ gel and evaluated for gelling capacity, pourability, gel strength, in vitro drug release study, and drug release kinetics. Results: Castor oil (10%) as oil phase, Acrysol K-140 (10%) as surfactant, and PEG 400 (20%) as cosurfactant were selected in preparation of SNEDDS from TPD. Evaluation parameters of SNEDDS were found in an acceptable range. % Drug release showed the controlled release up to 8 hrs. Optimum % drug content and % CDR were 100.25% and 92.46% after 12hrs, respectively. Optimized SNEDDS in-situ gel followed the Higuchi model via diffusion mechanism having 0.99 R² value and exhibiting sustained release up to 12 hr. Stability study proved no significant changes during storage. In vitro, the ocular irritancy test proved suitable for ocular delivery. Conclusion: A sustained-release formulation was obtained by developing brimonidine tartrate SNEDDS in-situ gel as a stable formulation without irritancy during ocular administration.
-
-
-
Silymarin Improves Thyroid Function in Lithium-treated Bipolar Patients: A Randomized, Double-blind, Placebo-controlled Pilot Study
Authors: Sara Ataei, Mohammad R. Mahdian, Ali Ghaleiha, Nasrin Matinnia and Amir Nili-AhmadabadiBackground: Thyroid dysfunction is one of the most important side effects of lithium carbonate. Silymarin is a flavonolignan extracted from the milk thistle Silybum marianum (L.), which has remarkable antioxidant and therapeutic properties. This clinical trial study aimed to evaluate the effect of silymarin on thyroid function and serum antioxidant status in patients with lithium-treated bipolar disorder. Methods: Bipolar patients with a depression episode and a history of at least six months of lithium use were randomly divided into placebo-control (n=18) and intervention (n=19) groups. In addition to standard medication, patients in the intervention and control groups received silymarin (140 mg) and placebo tablets daily for ten weeks, respectively. Finally, thyroid function and serum antioxidant status were evaluated along with clinical signs at the beginning and the tenth week. Results: Following the administration of silymarin, a significant increase was observed in total antioxidant capacity (p = 0.004) and total thiol molecules (p = 0.005) levels in serum compared to the placebo group. Although silymarin had no significant effect on serum triiodothyronine (T3) and lithium levels, it could significantly improve the secretory status of thyroid-stimulating hormone (TSH; p = 0.002) and Thyroxine (T4; p = 0.02) hormones in comparison to the placebo group. Conclusion: The current study showed that silymarin might be effective for thyroid function in lithium- treated bipolar patients by improving body’s antioxidant status.
-
-
-
Knowledge, Attitude, and Dispensing Practice of Emergency Contraceptive Pills among Community Pharmacists: A Cross-sectional Survey
Authors: Anjo Sunny, Treesa P. Varghese and Nila Mary VargheseBackground: The improper or incorrect usage of birth control results in unintended pregnancy. In India, 78% of pregnancies are accidental, with unwanted pregnancies accounting for about 25% of all pregnancies. The family, society, and country may all be financially impacted by such pregnancies. Community pharmacists must have a good attitude and sufficient knowledge of emergency contraception pills (ECPs) in order for women to receive them in a timely manner and as a result, have fewer unintended pregnancies. The purpose of this study is to investigate the knowledge, attitude, and, practices of community pharmacy practitioners towards ECPs. Methods: A cross-sectional study was carried out on retail pharmacies located in Madhya Pradesh, Mumbai. A standardized questionnaire was used in 164 community pharmacies to interview about CPPs using a convenience sampling technique. The survey evaluated the CPP's dispensing procedures, knowledge, attitude, and demographic profile. Data analysis was carried out by using the statistical package for the social sciences (SPSS) version 18 (SPSS Inc., Chicago, IL, USA). Results: A total of 164 registered pharmacists participated in the study, which included 76.1 % (n=124) males and 23.9% (n=39) females. Among all the participants, 73.0% of them had a diploma in pharmacy (D Pharm) education, and half of the study participants had a working experience between 1-5 years. In this study, 56.64 %, 27.6%, and 16% of participants had average knowledge, sound knowledge, and poor knowledge, respectively. Results showed that 90.2% (147) of pharmacists came under the positive attitude category, 5.5% of pharmacists had a negative attitude, and 4.3% had a neutral attitude. A moderate positive linear relationship (0.401) existed between the knowledge and attitude of the pharmacist in this study. Attitude and dispensing of emergency OC as OTC to people older than 18 years old and less than 18 years old showed a moderate negative linear relationship. After adjusting the possible confounder variables, age and years of experience significantly affected the knowledge, attitude, and practice of EC. Conclusion: In conclusion, the present study has shown that there is generally a lack of knowledge and poor attitude toward emergency contraceptive medicines among community pharmacists. Therefore, it is recommended that improving pharmacist's knowledge, attitude, and practice (KAP) through proper training and counseling about EC can enhance the appropriate use of drugs.
-
-
-
Steroid as a Saviour and Culprit in Pemphigus Vulgaris Therapy: A Rare Case Series
Authors: Deepthi Avvaru, Raushan K. Chaudhary, Bhavana Doshi and Ramesh BhandariIntroduction: Pemphigus is a group of autoimmune dermatological life-threatening diseases of which Pemphigus Vulgaris (PV) is the most common (1-5 cases/million/year) with a mortality rate of 60-90%. PV is generally characterized by painful oral erosions, along with or without cutaneous lesions, as blisters are often misdiagnosed. The management strategy of PV includes steroids along with adjuvant therapy. Case Presentation: We report the case of three female patients with a mean age of 30.67 years who were diagnosed with pemphigus vulgaris and was on steroid therapy for a long duration. The longterm steroid therapy in all these three patients resulted in adverse drug reactions such as Cushing syndrome, oral and vaginal candidiasis. Although the steroid was found to cause ADR among these patients, the treatment with steroids and rituximab was continued. The withdrawal of steroids results in flare-up conditions, whereas the addition of rituximab serves as a steroid sparring partner in the management of PV. However, premedication was administered before the infusion of rituximab to prevent potential toxicity associated with rituximab. Further, administration of pulse therapy over oral dosing of steroids lowers the risks of ADR and long-term complications associated with steroids. Conclusion: As PV requires the management with high doses of steroids along with the immunosuppressant, patients are more prone to developing drug-related problems. Hence, the rigorous monitoring of the therapy is vital to prevent adverse effects of long-term therapy. Clinical pharmacists and pharmacologists are the most suitable pillar of the healthcare system for drug therapy management.
-
Volumes & issues
-
Volume 19 (2024)
-
Volume 18 (2023)
-
Volume 17 (2022)
-
Volume 16 (2021)
-
Volume 15 (2020)
-
Volume 14 (2019)
-
Volume 13 (2018)
-
Volume 12 (2017)
-
Volume 11 (2016)
-
Volume 10 (2015)
-
Volume 9 (2014)
-
Volume 8 (2013)
-
Volume 7 (2012)
-
Volume 6 (2011)
-
Volume 5 (2010)
-
Volume 4 (2009)
-
Volume 3 (2008)
-
Volume 2 (2007)
-
Volume 1 (2006)