Gene Expression in MC3T3-E1 Cells Treated with Diclofenac and Methylprednisolone

Nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids (GCs) are often used to treat articular-skeletal disorders. The extended use of NSAIDs and GCs have adverse effects on bone metabolism, reducing bone quality and impairing fracture healing. In the present study, we used mouse pre-osteoblast cells MC3T3-E1 to demonstrate the effects of diclofenac (DF) and methylprednisolone (MP) on cell proliferation and gene expression. Cells were incubated with three doses of DF or MP: 0.5 µM, 5 µM, and 50 µM. MP decreased cell viability even after 24 h, but DF inhibited cell viability after only seven days of treatment. The cells were lysed after one, two, three, and seven days of treatment, and gene expression was analyzed by reverse transcription and quantitative PCR (RT-qPCR) assays. DF did not significantly affect the expression of the osteogenic marker genes. MP modified the expression of Osx, Runx, and Col1a1. We concluded that MP is a more potent inhibitor of mouse pre-osteoblast differentiation and viability than is DF. Our results suggest that prolonged DF treatment could be less harmful to osteoblasts than MP treatment.

Molecular and Antioxidant Characterization of Opuntia robusta Fruit Extract and Its Protective Effect against Diclofenac-Induced Acute Liver Injury in an In Vivo Rat Model

A molecular characterization of the main phytochemicals and antioxidant activity of Opuntia robusta (OR) fruit extract was carried out, as well as an evaluation of its hepatoprotective effect against diclofenac (DF)-induced acute liver injury was evaluated. Phenols, flavonoids and betalains were quantified, and antioxidant characterization was performed by means of the ABTS^•+, DPPH and FRAP assays. UPLC-QTOF-MS/MS was used to identify the main biocompounds present in OR fruit extract was carried out via. In the in vivo model, groups of rats were treated prophylactically with the OR fruit extract, betanin and N-acteylcysteine followed by a single dose of DF. Biochemical markers of oxidative stress (MDA and GSH) and relative gene expression of the inducible antioxidant response (Nrf2, Sod2, Hmox1, Nqo1 and Gclc), cell death (Casp3) and DNA repair (Gadd45a) were analyzed. Western blot analysis was performed to measure protein levels of Nrf2 and immunohistochemical analysis was used to assess caspase-3 activity in the experimental groups. In our study, the OR fruit extract showed strong antioxidant and cytoprotective capacity due to the presence of bioactive compounds, such as betalain and phenols. We conclude that OR fruit extract or selected components can be used clinically to support patients with acute liver injury.

Molecular Docking and Study of the Anti-inflammatory Effect of Triterpene and Diarylheptanoid Isolated from Pellacalyx axillaris

OBJECTIVE

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of drugs widely used around the world for their analgesic, antipyretic and anti-inflammatory effect, but still have many limitations due to their side effects. So, these lead to the development of a new approach to search for a new product from natural plants that have similar therapeutic effects without common side effects like gastrointestinal ulcers.

METHODS

The anti-inflammatory effect of β-amyrin palmitate (1) as triterpene and 1,7-bis (4- hydroxyphenyl) hept-4-en-3-one (2) as diarylheptanoid, isolated from Pellacalyx axillaris was studied by molecular docking to find the probability of binding position and binding strength of new compounds with particular Prostaglandin G/H synthase 2 (PDB ID: 1CX2). In vivo acute anti-inflammatory activity of the isolated compounds (1 and 2) was evaluated in rats using the egg-white induced edema model of inflammation in a dose correspondent to 3 mg/Kg of Diclofenac Sodium.

RESULTS

The tested isolated compounds showed a high activity to inhibit the swelling in paw edema and their anti-inflammatory effect began shortly after the injection of the egg white and continued to the end of the experiment in comparison to the reference and control.

CONCLUSION

The isolated compounds show a rapid onset of action and a very potent effect, this may be related to their suitable acidity and may have perfect hydrophilic -lipophilic balance. This is the first study of anti-inflammatory effect using Paw edema model and molecular docking.

Synergistic interaction and activation of the opioid receptor-NO-cGMP-K+ channel pathway on peripheral antinociception induced by the α-Bisabolol-diclofenac combination

Introduction: The local peripheral combination of analgesic drugs with herbal derivatives may have beneficial effects. Information on the action mechanism of these interactions between drugs is scarce. Therefore, the main of the present study was to determine the pharmacological interaction and action mechanism of the combination α-Bisabolol and diclofenac. Methods: Rats were injected in the dorsal surface of the right hind paw with 1% formalin. Rats received subcutaneous injections in the dorsal surface of paw of vehicles or increasing doses of α-Bisabolol, diclofenac or their combination before formalin injection into the paw. Antinociception of the α-Bisabolol + diclofenac combination was evaluated with and without the local treatment of naloxone, metformin, NG-nitro-L-arginine methyl ester (L-NAME), 1H- (1,2,4)-oxadiazolo (4,2-a) quinoxalin-1-one (ODQ), glibenclamide, glipizide, 4-aminopyridine, tetraethylammonium, apamin, or charybdotoxin. Results: α-Bisabolol, diclofenac or α-Bisabolol-diclofenac combinations produced significant antinociception in the rat (p < 0.05). The experimental effective dose (ED) value of 109.2 µg/paw was different significantly of the theoretical effective dose (ED) of 245.7 µg/paw (synergism). Blockers significantly reverted the antinociception produced by the synergistic combination of α-Bisabolol and diclofenac. Discussion: Data showed a synergism of the α-Bisabolol-diclofenac combination and the activation of the opioid receptor-Nitric Oxide-cyclic GMP-K⁺ channels pathway and a biguanide-dependent mechanism in order to produce the potentiation of its peripheral antinociception in the formalin test.

[The use of a fixed combination of diclofenac and orphenadrine in the treatment of acute pain syndrome in patients with discogenic lumbosacral radiculopathy and lumboischialgia]

Acute pain syndromes caused by discogenic lumbosacral radiculopathy and lumboischialgia are not uncommon in clinical practice and characterized by a high risk of becoming chronic. The pathogenetic aspects, features of the clinical picture, existing approaches to conservative treatment of these conditions are analyzed in this paper. Data on the efficacy and safety of a fixed combination of diclofenac and orphenadrine (Neodolpasse) use in the treatment of vertebrogenic pain syndromes based on the NEODOLEX study results are presented, and the authors' own clinical observations are given. Possible reasons for the high efficacy of Neodolpasse in patients with discogenic radiculopathies and nonspecific back and neck pain are discussed.

Anaphylactic shock due to intra-articular injection of diclofenac etalhyaluronate sodium: A case report

Background

Anaphylactic shock of diclofenac etalhyaluronate agent can be prolonged and recurrent. However, its reports are rare, and consequently, its method of management remains to be established.

Case Presentation

A 65-year-old woman received an intra-articular injection of diclofenac and hyaluronate. After 20 min, systemic urticaria and severe hypotension developed after walking. After an intramuscular adrenaline injection, she was transferred to our hospital. Despite administration of continuous noradrenaline and adrenaline, hypotension persisted. Seven hours after the joint injection, 25 mL of knee joint fluid was aspirated under ultrasound guidance. Mobilization was performed 24 h after joint injection. However, urticaria rapidly spread after standing. At 45 and 46 h after joint injection, we confirmed that no symptoms, including urticaria, recurred after walking.

Conclusion

Anaphylactic shock due to intra-articular injection of diclofenac etalhyaluronate is prolonged and requires extended observation. Aspiration of joint fluid may be one of the treatment options.

[The use of a fixed combination of diclofenac and orphenadrine for postoperative pain relief in orthopedic patients]

OBJECTIVE

To evaluate the efficacy and safety of using a fixed combination of diclofenac and orphenadrine for early postoperative pain relief in orthopedic patients following hip prosthetics.

MATERIAL AND METHODS

A prospective comparative study enrolled 65 patients with primary total hip replacement in the setting of spinal bupivacaine anesthesia. Patients were divided into 2 groups - study (39 patients) and control (26 people). The study group underwent Neodolpasse infusion (orphenadrine 30 mg + diclofenac 75 mg) after the end of surgery and morphine infusion in a patient-controlled analgesia (PKA) regimen. The control group underwent morphine monotherapy in the PKA regimen. The intensity of pain syndrome was compared on a visual-analog scale (VAS) from 0 to 100, the total amount of morphine administered, the number of bolus requests, the change in kidney function and the side effect were assessed.

RESULTS

In the control group, the duration of the intervention was shorter and amounted to 70 [59; 82] minutes, in the study group - 83 [65; 94] minutes (p=0.05). No significant difference was found in the number of bolus requests (32 [22; 38] and 23 [15; 36], p=0.085 and pain intensity 2 and 12 hours after the start of therapy (5 [4; 6] and 3 [2; 4] and 5 [4; 6] and 2 [2; 3] points) in the control group and in the study group. When assessing the intensity of pain syndrome 24 hours after the start of therapy, differences were found in the groups - in the control group 30 [2; 3] mm, in the study group 20 [2; 3] mm (p=0.05). There was no nephrotoxic effect on Neodolpasse. Complications of analgesic therapy in the form of nausea, vomiting, pruritus were recorded in both groups in equal amounts, which is explained by the administration of morphine in both groups.

CONCLUSION

1. The use of a fixed combination of orphenadrine 30 mg + diclofenac 75 mg as part of postoperative pain relief after operations of primary hip prosthetics improves the quality of postoperative pain relief according to the subjective assessment of patients. 2. The use of a fixed combination of orphenadrine 30 mg + diclofenac 75 mg did not lead to the development of side effects and complications.

Analgesic effect of curcumin topical formulation in knee osteoarthritis patients: a clinical trial

OBJECTIVES

The aim of this study was to recognize the efficacy and safety of curcumin ointment on patients with knee osteoarthritis (OA) compare to diclofenac as standard medication.

METHODS

The topical effects of curcumin (10%) and diclofenac (1%) ointments were assessed through the visual analog scale (VAS) and Western Ontario and McMaster Universities Arthritis (WOMAC) index after three times a day administration for two weeks in 60 patients.

RESULTS

Desirable effects compared to the pre-treatment period were observed after two weeks of continuous treatment. Based on our results, VAS and WOMAC index were altered after treatment significantly (p<0.0001).

CONCLUSIONS

Two-week use of curcumin ointment could ameliorate the pain, stiffness and function disability in patients with OA.

Effective adsorption of diclofenac sodium from aqueous solution using cationic surfactant modified Cuminum cyminum agri-waste: kinetic, equilibrium, and thermodynamic studies

The occurrence of pharmaceutical pollutants in aqueous media has increased where significant research is being conducted to eliminate these toxic compounds. In the present study, Tetradecyltrimethylammonium bromide (TTAB) modified Cuminum cyminum agri-waste (CCW) was prepared to investigate the removal of diclofenac sodium (DCF) from aqueous solution in the batch process for the first time. Physical and chemical characterizations of as-prepared adsorbent were conducted using field emission scanning electron microscopy, Fourier-transform infrared spectroscopy, N₂ adsorption-desorption, and point of zero charge analysis. Besides, the effect of the main parameters that affect the adsorption process, i.e., adsorbent dosage (0.25-6 g/L), contact time (0-300 min), initial DCF concentration (10-500 mg/L), and pH of the solution, were investigated. Furthermore, the resulted data were analyzed using various kinetic and isotherm models. The Pseudo-second-order model with R² = 0.9981 showed the highest agreement with kinetic behavior. Also, the maximum adsorption capacity of DCF is 93.65 mg/g, according to the Langmuir isotherm. In acidic media, the adsorption capacity reached the highest value (44.69 mg/g). As a result, this study revealed that the agri-waste material could be modified and, as a low-cost adsorbent, have promising adsorption potential to remove pharmaceutical contaminants from the aqueous solution.

Microglia as a cellular target of diclofenac therapy in Alzheimer's disease

Alzheimer's disease (AD) is an untreatable cause of dementia, and new therapeutic approaches are urgently needed. AD pathology is defined by extracellular amyloid plaques and intracellular neurofibrillary tangles. Research of the past decades has suggested that neuroinflammation plays a critical role in the pathophysiology of AD. This has led to the idea that anti-inflammatory treatments might be beneficial. Early studies investigated non-steroidal anti-inflammatory drugs (NSAIDS) such as indomethacin, celecoxib, ibuprofen, and naproxen, which had no benefit. More recently, protective effects of diclofenac and NSAIDs in the fenamate group have been reported. Diclofenac decreased the frequency of AD significantly compared to other NSAIDs in a large retrospective cohort study. Diclofenac and fenamates share similar chemical structures, and evidence from cell and mouse models suggests that they inhibit the release of pro-inflammatory mediators from microglia with leads to the reduction of AD pathology. Here, we review the potential role of diclofenac and NSAIDs in the fenamate group for targeting AD pathology with a focus on its potential effects on microglia.

Antimicrobial potential of new diclofenac hydrogels for disinfection in regenerative endodontics: An in vitro and ex vivo study

AIM

There is a need to explore new alternatives for root canal disinfection in regenerative endodontics, since the current strategies are far from ideal. Currently, the potential use of diclofenac (DC) is being investigated for controlling root canal infections. The objective was to evaluate the antimicrobial efficacy of novel DC-based hydrogels (DCHs) against polymicrobial biofilms grown in radicular dentine and root canals and to compare results with triantibiotic (TAH) and diantibiotic (DAH) hydrogels, and calcium hydroxide (Ca[OH]₂ ).

METHODOLOGY

The in vitro antimicrobial activity of intracanal medicaments was evaluated against 3-week-old polymicrobial root canal biofilms grown on human radicular dentine. Dentine samples were obtained and randomly divided into the study groups (n = 4/group): (1) 1 mg/ml TAH; (2) 1 mg/ml DAH; (3) 5% diclofenac (DCH); (4) 2.5% DCH; (5) 1.25% DCH; (6) 1 mg/ml DAH + 5% DCH; (7) Ca(OH)₂ paste; (8) positive control. The microbial viability, in terms of percentage of intact cell membranes, was assessed after 7 days by confocal scanning laser microscopy (CSLM). The ex vivo efficacy of intracanal medications was evaluated in root canals infected with a polymicrobial suspension. Intracanal microbiological samples at baseline (S1) and 7 days post-treatment (S2) were taken; microbial quantification and cell viability were assessed by quantitative polymerase chain reaction (qPCR) and flow cytometry (FC). The mean Log₁₀ of bacterial DNA copies in root canal samples before (S1) and the Log₁₀ reduction of DNA copies S1-S2 in qPCR were recorded. The absolute value of total cells stained, and the percentage reduction of intact membrane cells after treatment (S1-S2), were analysed by FC. Global comparison was done using the Kruskal-Wallis test, whilst the Mann-Whitney U test was used for pair-by-pair comparison.

RESULTS

Confocal scanning laser microscopy analysis indicated that the greatest effectiveness was obtained with 5% DCH, showing significant differences with respect to the other groups (p < .001). In root canals, the highest Log₁₀ DNA reduction S1-S2 was obtained with 5% DCH and TAH, with no differences between them. The results of FC showed that only 5% DCH proved significantly superior to the other treatments.

CONCLUSIONS

Sodium DC hydrogels demonstrate antimicrobial efficacy against endodontic biofilms.

Diclofenac Loaded Biodegradable Nanoparticles as Antitumoral and Antiangiogenic Therapy

Cancer is identified as one of the main causes of death worldwide, and an effective treatment that can reduce/eliminate serious adverse effects is still an unmet medical need. Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), has demonstrated promising antitumoral properties. However, the prolonged use of this NSAID poses several adverse effects. These can be overcome by the use of suitable delivery systems that are able to provide a controlled delivery of the payload. In this study, Diclofenac was incorporated into biodegradable polymeric nanoparticles based on PLGA and the formulation was optimized using a factorial design approach. A monodisperse nanoparticle population was obtained with a mean size of ca. 150 nm and negative surface charge. The release profile of diclofenac from the optimal formulation followed a prolonged release kinetics. Diclofenac nanoparticles demonstrated antitumoral and antiangiogenic properties without causing cytotoxicity to non-tumoral cells, and can be pointed out as a safe, promising and innovative nanoparticle-based formulation with potential antitumoral effects.

Cannabidiol and Its Combinations with Nonsteroidal Anti-Inflammatory Drugs Induce Apoptosis and Inhibit Activation of NF-κB Signaling in Vulvar Squamous Cell Carcinoma

Vulvar squamous cell carcinoma (VSCC) is a rare malignancy with a relatively good prognosis. However, the prognosis remains poor for elderly patients and those with a significant depth of tumor invasion; thus, novel treatment modalities are needed. The aim of this study was to analyze the impact of cannabidiol (CBD) and its combination with NSAIDs, diclofenac (DIC) and ibuprofen (IBU) on VSCC cells. In this regard, the MTT test was applied for cytotoxicity analysis. Moreover, the influence of CBD, DIC and IBU, as well as their combinations, on apoptosis and cell cycle distribution were analyzed by flow cytometry. The mechanisms of action of the analyzed compounds, including their impact on NF-κB signaling, p53 and COX-2 expression were evaluated using Western blot. This study shows that CBD and its combinations with NSAIDs are cytotoxic to A431 cells, but they also reduce, in a dose-dependent manner, the viability of immortalized keratinocyte HaCaT cells, and human umbilical vein cell line, EA.hy926. Moreover, the compounds and their combinations induced apoptosis, diminished the NF-κB signaling activation and reduced COX-2 expression. We conclude that CBD and its combination with DIC or IBU are promising candidates for the adjuvant treatment of high-risk VSCC patients. However, their impact on non-cancerous cells requires careful evaluation.

Carrasco-Correa E, Varanasupakul P, Kubáň P, Miró M. Programmable Millifluidic Platform Integrating Automatic Electromembrane Extraction Cleanup and In-Line Electrochemical Detection: A Proof of Concept

A fully automatic millifluidic sensing platform coupling in-line nonsupported microelectromembrane extraction (μ-EME) with electrochemical detection (ECD) is herein proposed for the first time. Exploiting the features of the second generation of flow analysis, termed sequential injection (SI), the smart integration of SI and μ-EME-ECD enables (i) the repeatable formation of microvolumes of phases for the extraction step in a membrane-less (nonsupported) arrangement, (ii) diverting the acceptor plug to the ECD sensing device, (iii) in-line pH adjustment before the detection step, and (iv) washing of the platform for efficient removal of remnants of wetting film solvent, all entirely unsupervised. The real-life applicability of the miniaturized sensing system is studied for in-line sample cleanup and ECD of diclofenac as a model analyte after μ-EME of urine as a complex biological sample. A comprehensive study of the merits and the limitations of μ-EME solvents on ECD is presented. Under the optimal experimental conditions using 14 μL of unprocessed urine as the donor, 14 μL of 1-nonanol as the organic phase, and 14 μL of 25 mM NaOH as the acceptor in a 2.4 mm ID PTFE tubing, an extraction voltage of 250 V, and an extraction time of 10 min, an absolute (mass) extraction recovery of 48% of diclofenac in urine is obtained. The proposed flow-through system is proven to efficiently remove the interfering effect of predominantly occurring organic species in human urine on ECD with RSD% less than 8.6%.

A Peptide-Based Hydrogel for Adsorption of Dyes and Pharmaceuticals in Water Remediation

The removal of dyes and pharmaceuticals from water has become a major issue in recent years due to the shortage of freshwater resources. The adsorption of these pollutants through nontoxic, easy-to-make, and environmentally friendly adsorbents has become a popular topic. In this work, a tetrapeptide-pyrene conjugate was rationally designed to form hydrogels under controlled acidic conditions. The hydrogels were thoroughly characterized, and their performance in the adsorption of various dyes and pharmaceuticals from water was investigated. The supramolecular hydrogel efficiently adsorbed methylene blue (MB) and diclofenac (DCF) from water. The effect of concentration in the adsorption efficiency was studied, and results indicated that while the adsorption of MB is governed by the availability of adsorption sites, in the case of DCF, concentration is the driving force of the process. In the case of MB, the nature of the dye-hydrogel interactions and the mechanism of the adsorption process were investigated through UV-Vis absorption spectroscopy. The studies proved how this dye is first adsorbed as a monomer, probably through electrostatic interactions; successively, at increasing concentrations as the electrostatic adsorption sites are depleted, dimerization on the hydrogel surface occurs.

Screen-Printed Graphite Electrode Modified with Graphene-Co3O4 Nanocomposite: Voltammetric Assay of Morphine in the Presence of Diclofenac in Pharmaceutical and Biological Samples

This work focuses on the development of a novel electrochemical sensor for the determination of morphine in the presence of diclofenac. The facile synthesis of graphene-Co₃O₄ nanocomposite was performed. The prepared material (graphene-Co₃O₄ nanocomposite) was analyzed by diverse microscopic and spectroscopic approaches for its crystallinity, composition, and morphology. Concerning the electrochemical determinations, after drop-casting the as-fabricated graphene-Co₃O₄ nanocomposite on the surface of a screen-printed graphite electrode (SPGE), their electrochemical performance was scrutinized towards the morphine detection. It was also found that an SPGE modified by a graphene-Co₃O₄ nanocomposite exhibited better electrocatalytic activity for morphine oxidation than unmodified electrode. Under optimal conditions, the differential pulse voltammetry (DPV) was employed to explore the present sensor (graphene-Co₃O₄/SPGE), the findings of which revealed a linear dynamic range as broad as 0.02-575.0 µM and a limit of detection (LOD) as narrow as 0.007 μM. The sensitivity was estimated to be 0.4 µM/(µA cm²). Furthermore, the graphene-Co₃O₄/SPGE sensor demonstrated good analytical efficiency for sensing morphine in the presence of diclofenac in well-spaced anodic peaks. According to the DPV results, this sensor displayed two distinct peaks for the oxidation of morphine and diclofenac with 350 mV potential difference. In addition, the graphene-Co₃O₄/SPGE was explored for voltammetric determination of diclofenac and morphine in pharmaceutical and biological specimens of morphine ampoule, diclofenac tablet, and urine, where recovery rates close to 100% were recorded for all of the samples.

Effect of Salt Form on Gelation and Drug Delivery Properties of Diclofenac-Loaded Poloxamer Gels for Delivery to Impaired Skin

PURPOSE

Treating chronic wounds is a significant clinical challenge, and a topical product would be ideal for pain management. Poloxamer 407, a thermosensitive polymer, would allow an analgesic drug to be topically applied to a wound as a liquid that transitions to a gel at physiologic temperature. Using diclofenac as a model analgesic drug, our goal was to determine effects of salt form on poloxamer gelation and drug delivery from poloxamer gels applied to excised skin with impaired barrier function.

METHODS

Gelation properties of 17% and 20% poloxamer gels loaded with 0.4 to 1.7% diclofenac sodium, potassium, epolamine, or diethylamine were evaluated rheologically. Drug release and delivery were quantified using cellulose membranes, porcine skin, and tape-stripped porcine skin.

RESULTS

Poloxamer gelation temperature increased with higher diclofenac concentration, regardless of salt form; the magnitude of increase varied in the following order: sodium>potassium>diethylamine>epolamine. Gelation temperature differences resulting from the various counterions generally matched previously observed trends of ion-specific effects on macromolecule solubility (the Hofmeister series). Despite changes in gelation behavior, we observed minimal corresponding effects on drug release or delivery. There were no significant differences in diclofenac released or delivered through intact porcine skin over 48 h. However, in studies with impaired (tape-stripped) skin, diclofenac delivery was slowest overall with the epolamine salt.

CONCLUSION

Varying the salt form of a model analgesic drug can impact gelation and drug delivery characteristics of poloxamer systems. Further study of the mechanisms of these changes will be important for continued development of topical poloxamer products for clinical wound care.

Dermal Delivery of Diclofenac Sodium-In Vitro and In Vivo Studies

Previously, we reported the use of confocal Raman spectroscopy (CRS) as a novel non-invasive approach to determine drug disposition in the skin in vivo. Results obtained by CRS were found to correlate with data from the well-established in vitro permeation test (IVPT) model using human epidermis. However, these studies used simple vehicles comprising single solvents and binary or ternary solvent mixtures; to date, the utility of CRS for monitoring dermal absorption following application of complex marketed formulations has not been examined. In the present work, skin delivery of diclofenac sodium (DFNa) from two topical dermatological drug products, namely Diclac® Lipogel 10 mg/g and Primofenac® Emulsion gel 1%, was determined by IVPT and in vivo by both CRS and tape stripping (TS) methodologies under similar experimental conditions. The in vivo data were evaluated against the in vitro findings, and a direct comparison between CRS and TS was performed. Results from all methodologies showed that Diclac promoted significantly greater DFNa delivery to the skin (p < 0.05). The cumulative amounts of DFNa which permeated at 24 h in vitro for Diclac (86.5 ± 9.4 µg/cm2) were 3.6-fold greater than the corresponding amounts found for Primofenac (24.4 ± 2.7 µg/cm2). Additionally, total skin uptake of DFNa in vivo, estimated by the area under the depth profiles curves (AUC), or the signal intensity of the drug detected in the upper stratum corneum (SC) (4 µm) ranged from 3.5 to 3.6-fold greater for Diclac than for Primofenac. The shape of the distribution profiles and the depth of DFNa penetration to the SC estimated by CRS and TS were similar for the two methods. However, TS data indicated a 4.7-fold greater efficacy of Diclac relative to Primofenac, with corresponding total amounts of drug penetrated, 94.1 ± 22.6 µg and 20.2 ± 7.0 µg. The findings demonstrate that CRS is a methodology that is capable of distinguishing skin delivery of DFNa from different formulations. The results support the use of this approach for non-invasive evaluation of topical products in vivo. Future studies will examine additional formulations with more complex compositions and will use a wider range of drugs with different physicochemical properties. The non-invasive nature of CRS coupled with the ability to monitor drug permeation in real time offer significant advantages for testing and development of topical dermatological products.

Efficacy of Diclofenac Transdermal Patch in Therapeutic Extractions: A Literature Review

Diclofenac sodium is a nonsteroidal anti-inflammatory drug that effectively manages pain following therapeutic extractions. Post-extraction pain is commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs). In addition to their high bioavailability and long duration of action, transdermal NSAIDS have several other advantages. The review tries to understand and elucidate the use of transdermal patches, here Diclofenac, as a postoperative pain management modality. Drug delivery is one of the essential aspects of drug administration where transdermal patches are to be found equally effective when compared to oral administration of drugs. Various analgesics can be administered as patches, for example, ketoprofen, diclofenac, etc. There are also comparative studies between diclofenac and ketoprofen to see and understand the efficacy of transdermal patches compared with oral administration. Compared to oral administration, transdermal patches offer numerous benefits. These include avoidance of first-pass metabolism, sustained and non-rapid absorption, steady plasma levels that remain for prolonged periods, lack of patient dependence on drugs, prevention of gastric distress, and flexibility of stopping delivery of medications by simply removing the patch. This review aims to examine the diclofenac transdermal patch's effectiveness in reducing postoperative pain after orthodontic extraction.

Effect of Diclofenac and Simvastatin on Bone Defect Healing-An In Vivo Animal Study

Non-steroidal, anti-inflammatory drugs and statins are two widely prescribed drug classes that affect bone formation. The aim of this study was to elucidate the effect of diclofenac and simvastatin in artificial bone defect healing. One hundred and forty-four male Wistar rats were used, and the specimens were divided into groups, with respect to the route of drug administration and the type of defect healing (with or without collagen membrane), and subgroups, with respect to the study duration (2, 4 or 8 weeks). Diclofenac was intramuscularly administered while simvastatin was administered both systemically and locally. Animals were euthanized and specimens were histomorphometrically analyzed to evaluate the percentage of new bone formation (%). Bone healing that occurred without any intervention developed more steadily than that of all other groups. Diclofenac exerted a clear, direct inhibitory effect on bone healing and its systemic administration should be avoided. The systemic administration of simvastatin was related to severe myopathy, while the solvent for the local administration of simvastatin seemed to play significant role in bone growth, as simvastatin, when it is administered intraperitoneally in a DMSO solution, appeared to promote bone healing. Local administration may have a significant impact on bone healing and it should be further investigated with the type of solvent or carrier that is used, which both may play a significant role in bone repair induction.

Formulation and Evaluation of the In Vitro Performance of Topical Dermatological Products Containing Diclofenac Sodium

The selection of an appropriate vehicle in a semi-solid topical product is of utmost importance since the vehicle composition and microstructure can potentially cause changes in drug-vehicle or vehicle-skin interactions and affect drug release and subsequent permeation into and across skin. Hence, the aim of this study was to evaluate different semi-solid formulations containing diclofenac sodium for the physicochemical and structural performance of excipients used and various physiological factors governing permeation of drugs applied to skin. The formulations (emulsion, emulgel, gel, and ointment) were prepared using conventional excipients and were found to be homogenous and stable. Rheological analysis demonstrated characteristic shear-thinning and viscoelastic behavior of formulations. The mean release rate of the gel formulation (380.42 ± 3.05 µg/cm²/h^0.5) was statistically higher compared to all other formulations. In vitro permeation using human skin showed a significantly greater extent of drug permeation and retention for the emulgel formulation (23.61 ± 1.03 µg/cm² and 47.95 ± 2.47 µg/cm², respectively). The results demonstrated that the different formulations influenced product performance due to their inherent properties. The findings of this study demonstrated that a comprehensive physicochemical and structural evaluation is required to optimize the in vitro performance for dermatological formulations depending on the intended therapeutic effect.

Determination and Removal of Selected Pharmaceuticals and Total Organic Carbon from Surface Water by Aluminum Chlorohydrate Coagulant

In the present research, the removal of Total Organic Carbon (TOC) and erythromycin (ERY), fluoxetine (FLX), amoxicillin (AMO), colistin (COL), ethynylestradiol (EE), and diclofenac (DIC) from surface water by coagulation is studied. The concentration of selected pharmaceuticals in 24 surface water samples originating from some rivers located in Lesser Poland Voivodeship and Silesia Voivodeship, Poland, was determined. The removal of TOC and pharmaceuticals was carried out using the application of Design of Experiments (DOE), Response Surface Methodology (RSM), and by addition of aluminum chlorohydrate (ACH) as a coagulant. The study found that the concentration ranges of ERY, FLX, AMO, COL, EE, and DIC in analyzed water samples were 7.58−412.32, 1.21−72.52, 1.22−68.55, 1.28−32.01, 5.36−45.56, 2.20−182.22 ng/L, respectively. In some cases, concentrations lower than 1 ng/L were determined. In optimal conditions of coagulation process of spiked surface water (pH = 6.5 ± 0.1, ACH dose = 0.35 mL/L, Time = 30 min; R2 = 0.8799, R2adj = 0.7998), the concentration of TOC, ERY, FLX, AMO, COL, EE, and DIC was decreased by 88.7, 36.4, 24.7, 29.0, 25.5, 35.4, 30.4%, respectively. Simultaneously, turbidity, color, Total Suspended Solids (TSS), Chemical Oxygen Demand (COD), Total Nitrogen (Total N), and Ammonium-Nitrogen (N-NH4) were decreased by 96.2%, >98.0%, 97.8%, 70.0%, 88.7%, 37.5%, respectively. These findings suggest that ACH may be an optional reagent to remove studied pharmaceuticals from contaminated water.

Diclofenac Concentrations in Post-Mortem Specimens-Distribution, Case Reports, and Validated Method (UHPLC-QqQ-MS/MS) for Its Determination

The aim of the research was to establish a sensitive method for the quantification of diclofenac in postmortem samples. The developed method was applied in six cases: three fetuses in which the use of abortion pills by their mothers was suspected, one case of duodenal ulcer perforation, one case of traffic accident with fatal outcome, and one acute renal failure in which the distribution of diclofenac was examined. The analyses were performed using liquid-liquid extraction of postmortem samples and the quantification of diclofenac via ultra-high performance liquid chromatography, coupled with triple quadrupole tandem mass spectrometry. Gradient elution using a C18 column was applied. Electrospray ionization measurement in positive multiple reaction monitoring mode was used. Diclofenac-d4 was used as an internal standard. The validation parameters were as follows: lower limit of quantification: 0.5 ng/mL, linearity of calibration curve: 0.5-500 ng/mL, intra- and interday accuracies and precisions: not greater than 15%; recovery values: 72.0-102.2%, and matrix effect: 2.2-28.0%. The developed method enabled the determination of diclofenac in human postmortem biological fluids (blood, urine, vitreous humor, bile, and stomach content), tissues (placenta, kidney, liver, and heart), and in exhumated fetus bones, with high recovery, sensitivity, precision, and accuracy.

Tirbanibulin for the Treatment of Actinic Keratosis: A Review

Actinic keratosis (AK) is a common precancerous condition found on chronically sun-damaged skin, particularly on the face, scalp, arms, and legs. Early and effective treatment of AKs is important to prevent progression to squamous cell carcinoma. Many topical treatments for AKs are often limited because of poor tolerability, prolonged treatment duration, and reduced adherence. Tirbanibulin 1% ointment, a new topical field therapy for AKs, reduces these issues. It requires a consecutive 5-day application period and is effective, demonstrating complete (100%) clearance of AK lesions in 49% of patients, partial (>75%) clearance in 72%, and a median reduction in lesion count of 87.5% while exhibiting a favorable safety profile, mild adverse events, improved tolerability, and long-term results.

Resveratrol mitigates diclofenac-induced hepatorenal toxicity in rats via modulation of miR-144/Nrf2/GSH axis

Despite the extensive therapeutic uses of diclofenac, it may cause several adverse effects, including hepatorenal injury. The antioxidant and anti-inflammatory properties of resveratrol, a polyphenolic compound, make the agent effective in ameliorating a variety of drug-induced injuries. This study investigated the potential beneficial effects of resveratrol on diclofenac-induced hepatorenal toxicity and explored the role of miR-144 and its relationship to oxidative stress and inflammation triggered by diclofenac. Rats were divided into four groups: control; diclofenac group received diclofenac (10 mg/kg/day, intraperitoneal [ip]) for 7 days; prevention group received resveratrol concomitantly with diclofenac for 7 days; and the treatment group received diclofenac for 7 days followed by resveratrol (20 mg/kg/day, per oral) for another 7 days. Diclofenac administration induced a significant increase in serum hepatorenal biomarkers and histopathological aberrations. In addition, diclofenac upregulated miR-144 while reducing nuclear factor erythroid 2-related factor 2 (Nrf2) protein levels and glutathione (GSH) content. Moreover, diclofenac induced tissue inflammation and apoptosis as evidenced by increased protein expression of nuclear factor kappa B (NF-κB), tumor necrosis factor α (TNF-α), and caspase-3. Intriguingly, resveratrol prevention or treatment significantly mitigated the toxic effects of diclofenac as manifested by normalization of the hepatorenal functions and amelioration of the histopathological changes. Resveratrol also triggered miR-144 downregulation with Nrf2 upregulation. Consequently, resveratrol showed hepatorenal antioxidant, anti-inflammatory, and antiapoptotic activities as manifested by improvement in the antioxidant markers along with a decline in NF-κB, TNF-α, and caspase-3 expressions. In conclusion, this study demonstrates a potential therapeutic role of resveratrol in mitigating diclofenac-induced hepatorenal insult, possibly via modulating miR-144/Nrf2/GSH axis.