Current clinical pharmacology最新文献

{"title":"Metformin and Pregnancy Outcomes: Evidence Gaps and Unanswered Questions.","authors":"Claudio D Gonzalez,&nbsp;Jorge Alvariñas,&nbsp;Maria F G Bagnes,&nbsp;Guillermo Di Girolamo","doi":"10.2174/1574884714666181224151116","DOIUrl":"https://doi.org/10.2174/1574884714666181224151116","url":null,"abstract":"<p><strong>Background: </strong>Metformin is sometimes used as an alternative to insulin in gestational diabetes mellitus (GDM). It is also used to achieve ovulation in polycystic ovary syndrome (PCOS). Pre-natal exposure to metformin results from its continuation after a successful ovulation in women with PCOS, its maintenance in women with pre-gestational diabetes or the installation of metformin in GDM. Little is known about the potential consequences of metformin exposure on pregnancy outcomes and offspring development. The aim of this review is to summarize the metformin effects on pregnancy outcomes and offspring development. Gaps in the available evidence and unanswered questions are also discussed.</p><p><strong>Methods: </strong>A comprehensive literature search was carried out to identify eligible studies from MEDLINE/PubMed, EMBASE and SCIELO databases through 1995 first semester.</p><p><strong>Results: </strong>Several factors limit the effect of metformin on embryos. In contrast, placental transport of metformin is effective allowing for a higher fetal exposure; the impact of this finding remains unclear. It seems that the interruption of metformin after a pregnancy diagnosis in women with PCOS is not associated with a higher miscarriage risk and it continuation does not seem to impair the maternal metabolic prognosis or prevent emerging GDM.</p><p><strong>Conclusions: </strong>It seems to have no sense to prolong the use of metformin after a pregnancy diagnosis in women with PCOS. Patients with GDM may be treated with metformin under on judicious basis, and a careful attachment to clinical guidelines and regulations is recommended. The long-term effects of pre-natal exposure to metformin on the offspring remain uncertain.</p>","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":"14 1","pages":"54-60"},"PeriodicalIF":3.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1574884714666181224151116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36813773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin Modulates Regulation of NOX2 and NOX4 Following Irradiation in the Lung.","authors":"Masoud Najafi,&nbsp;Alireza Shirazi,&nbsp;Elahe Motevaseli,&nbsp;Ghazale Geraily,&nbsp;Peyman Amini,&nbsp;Leila Farhadi Tooli,&nbsp;Dheyauldeen Shabeeb","doi":"10.2174/1574884714666190502151733","DOIUrl":"https://doi.org/10.2174/1574884714666190502151733","url":null,"abstract":"<p><strong>Background: </strong>Exposure to ionizing radiation may lead to chronic upregulation of inflammatory mediators and pro-oxidant enzymes, which give rise to continuous production of reactive oxygen species (ROS). NADPH oxidases are among the most important ROS producing enzymes. Their upregulation is associated with DNA damage and genomic instability. In the present study, we sought to determine the expressions of NADPH oxidases; NOX2 and NOX4, in rat's lung following whole body or pelvis irradiation. In addition, we evaluated the protective effect of melatonin on the expressions of NOX2 and NOX4, as well as oxidative DNA injury.</p><p><strong>Methods: </strong>35 male rats were divided into 7 groups, G1: control; G2: melatonin (100 mg/kg) treatment; G3: whole body irradiation (2 Gy); G4: melatonin plus whole body irradiation; G5: local irradiation to pelvis area; G6: melatonin treatment plus 2 Gy gamma rays to pelvis area; G7: scatter group. All the rats were sacrificed after 24 h. afterwards, the expressions of TGFβR1, Smad2, NF- κB, NOX2 and NOX4 were detected using real-time PCR. Also, the level of 8-OHdG was detected by ELISA, and NOX2 and NOX4 protein levels were detected by western blot.</p><p><strong>Results: </strong>Whole body irradiation led to the upregulation of all genes, while local pelvis irradiation caused upregulation of TGFβR1, NF-κB, NOX2 and NOX4, as well as protein levels of NOX2 and NOX4. Treatment with melatonin reduced the expressions of these genes and also alleviated oxidative injury in both targeted and non-targeted lung tissues. Results also showed no significant reduction for NOX2 and NOX4 in bystander tissues following melatonin treatment.</p><p><strong>Conclusion: </strong>It is possible that upregulation of NOX2 and NOX4 is involved in radiation-induced targeted and non-targeted lung injury. Melatonin may reduce oxidative stress following upregulation of these enzymes in directly irradiated lung tissues but not for bystander.</p>","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":"14 3","pages":"224-231"},"PeriodicalIF":3.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1574884714666190502151733","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37215475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Zofenopril Alone or in Combination with Hydrochlorothiazide in Patients with Kidney Dysfunction.","authors":"Stefano Omboni,&nbsp;Claudio Borghi","doi":"10.2174/1574884713666181025145404","DOIUrl":"https://doi.org/10.2174/1574884713666181025145404","url":null,"abstract":"<p><p>Hypertension and kidney disease often coexist, further increasing the risk of future cardiovascular events. Treatment of hypertensive adults with an angiotensin converting enzyme inhibitor in case of concomitant kidney disease may slow disease progression. The third-generation liphophilic angiotensin converting enzyme inhibitor zofenopril, administered alone or combined with a thiazide diuretic, has proved to be effective in lowering blood pressure in hypertensive patients and to reduce the risk of fatal and non-fatal events in post-acute myocardial infarction and heart failure. In almost three-hundred hypertensive patients with kidney impairment zofenopril administered for 12 weeks showed a similar blood pressure-lowering effect irrespective of the stage of the disease, with larger effects in combination with a thiazide diuretic, particularly in patients with slightly or moderately impaired kidney function. In animal models, zofenopril produced a significant and long-lasting inhibition of kidney angiotensin converting enzyme inhibitor and prevented kidney morphological and functional alterations following kidney ischemia-reperfusion injury. Treatment of hypertensive patients for 18 weeks with a combination of zofenopril 30 mg and hydrochlorothiazide 12.5 mg resulted in a reduction in albumin creatinine ratio of 8.4 mg/g (49.6% reduction from baseline values) and no changes in glomerular filtration rate, variations in line with those obtained in the control group treated with a combination of irbesartan 150 mg and hydrochlorothiazide 12.5 mg. Thus, some preliminary evidence exists to support that relatively long-term treatment with the angiotensin converting enzyme inhibitor zofenopril alone or combined with hydrochlorothiazide is effective in controlling blood pressure and may confer some kidney protection due to ACE inhibition properties.</p>","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":"14 1","pages":"5-15"},"PeriodicalIF":3.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1574884713666181025145404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36617998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Drug Intolerance Syndrome: An Underreported Distinct Clinical Entity.","authors":"Sapan K Behera,&nbsp;Saibal Das,&nbsp;Kavadichanda G Chengappa,&nbsp;Alphienes S Xavier,&nbsp;Sandhiya Selvarajan","doi":"10.2174/1574884713666181112125714","DOIUrl":"https://doi.org/10.2174/1574884713666181112125714","url":null,"abstract":"<p><strong>Aim: </strong>Multiple drug intolerance syndrome (MDIS) is a unique clinical entity distinct from other drug hypersensitivity syndromes. The aim of this review was to critically appraise the various aspects of MDIS.</p><p><strong>Methods: </strong>A review was conducted to search for the causes, mechanism, clinical features, and management of MDIS.</p><p><strong>Results: </strong>The most common cause of MDIS is antibiotics followed by non-steroidal antiinflammatory drugs (NSAIDs). Although some non-specific immunological mechanisms are involved, the immunological tests for MDIS are negative. Rashes, gastrointestinal reflux, headache, cough, muscle ache, fever, dermatitis, hypertension, and psychiatric symptoms are the usual manifestations. Treatment is mostly symptomatic with the withdrawal of the offending drug. Drug rechallenges and desensitization may be required for the management of this syndrome.</p><p><strong>Conclusion: </strong>MDIS occurs by a nonimmune mechanism which requires a prompt withdrawal of the offending drug(s), and in some cases may require drug re-challenge and desensitization.</p>","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":"14 2","pages":"84-90"},"PeriodicalIF":3.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1574884713666181112125714","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36666698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why are there Variations in the Responses of Glucagon-like Peptide-1 Agonists among the Type 2 Diabetic Patients?","authors":"Thekkuttuparambil A Ajith","doi":"10.2174/157488471403191231143537","DOIUrl":"https://doi.org/10.2174/157488471403191231143537","url":null,"abstract":"","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":"14 3","pages":"247-248"},"PeriodicalIF":3.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/157488471403191231143537","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37570294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meet Our Editorial Board Member","authors":"E. V. van Hoogdalem","doi":"10.2174/157488471303181123162824","DOIUrl":"https://doi.org/10.2174/157488471303181123162824","url":null,"abstract":"","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/157488471303181123162824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47942856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meet Our Editorial Board Member","authors":"R. Mehvar","doi":"10.2174/157488471302181009101032","DOIUrl":"https://doi.org/10.2174/157488471302181009101032","url":null,"abstract":"","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":"1 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2018-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/157488471302181009101032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43661947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meet Our Editorial Board Member","authors":"U. Çakatay","doi":"10.2174/157488471301180820113007","DOIUrl":"https://doi.org/10.2174/157488471301180820113007","url":null,"abstract":"","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2018-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/157488471301180820113007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46468819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meet Our Section Editor","authors":"C. Supuran","doi":"10.2174/157488471202180209141818","DOIUrl":"https://doi.org/10.2174/157488471202180209141818","url":null,"abstract":"","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":"12 1","pages":"61-61"},"PeriodicalIF":3.2,"publicationDate":"2018-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/157488471202180209141818","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43822012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the Methods to Obtain Paediatric Drug Safety Information: Spontaneous Reporting and Healthcare Databases, Active Surveillance Programmes, Systematic Reviews and Meta-analyses.","authors":"Marta Gentili,&nbsp;Marco Pozzi,&nbsp;Gabriella Peeters,&nbsp;Sonia Radice,&nbsp;Carla Carnovale","doi":"10.2174/1574884713666180206164634","DOIUrl":"https://doi.org/10.2174/1574884713666180206164634","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of drugs safety collected during the pre-marketing phase is inevitably limited because the randomized clinical trials (RCTs) are rarely designed to evaluate safety. The small and selective groups of enrolled individuals and the limited duration of trials may hamper the ability to characterize fully the safety profiles of drugs. Additionally, information about rare adverse drug reactions (ADRs) in special groups is often incomplete or not available for most of the drugs commonly used in the daily clinical practice. In the paediatric setting several highimpact safety issues have emerged. Hence, in recent years, there has been a call for improved post-marketing pharmacoepidemiological studies, in which cohorts of patients are monitored for sufficient time in order to determine the precise risk-benefit ratio.</p><p><strong>Objective: </strong>In this review, we discuss the current available strategies enhancing the post-marketing monitoring activities of the drugs in the paediatric setting and define criteria whereby they can provide valuable information to improve the management of therapy in daily clinical practice including both safety and efficacy aspects. The strategies we cover include the signal detection using international pharmacovigilance and/or healthcare databases, the promotion of active surveillance initiatives which can generate complete, informative data sets for the signal detection and systematic review/meta-analysis.</p><p><strong>Conclusion: </strong>Together, these methods provide a comprehensive picture of causality and risk improving the management of therapy in a paediatric setting and they should be considered as a unique tool to be integrated with post-marketing activities.</p>","PeriodicalId":10746,"journal":{"name":"Current clinical pharmacology","volume":"13 1","pages":"28-39"},"PeriodicalIF":3.2,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35803011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}