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Abdel-Gawad DRI, Ibrahim MA, Moawad UK, Kamel S, El-Banna HA, El-Banna AH, Hassan WH, El-Ela FIA. Effectiveness of natural biomaterials in the protection and healing of experimentally induced gastric mucosa Ulcer in rats. Mol Biol Rep 2023; 50:9085-9098. [PMID: 37741810 PMCID: PMC10635934 DOI: 10.1007/s11033-023-08776-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/22/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND A gastric ulcer is a painful lesion of the gastric mucosa that can be debilitating or even fatal. The effectiveness of several plant extracts in the therapy of this illness has been demonstrated in traditional pharmacopoeias. AIM this study was aimed to see if propolis, ginseng in normal or nano form, and amygdalin might help in preventing the ulcerative effects of absolute ethanol. METHODS Gastroprotective properties of pretreatments before ethanol gavage in rats were compared to omeprazole. The ulcer and stomach parameters (ulcerated regions) were measured (mm2), ulcer inhibition percentage, the stomachs were assessed macroscopically with gastric biopsy histological examinations. RESULTS Amygdalin, normal and nano ginseng, nano propolis followed by propolis all showed great efficacy in protecting the cyto-architecture and function of the gastric mucosa. The number of ulcerated sites was greatly reduced, and the percentage of stomach protection was increased. Histopathological examination had confirmed great protective effects of the nanoformulations followed by amygdalin. The protection and healing rate was completed to about 100% in all tested materials while ulcer areas were still partially unhealed in normal propolis and omeprazole. Quantitative assay of the m-RNA levels Enothelin 1(ET-1), leukotriene4 (LT-4), and caspase 3(Cas-3) genes and Histamine were done and revealed significant up-regulations in ethanol group and the maximum protective effect was reported with ginseng nano, moreover the histamine content was significantly decreased with nano- formulated extracts. CONCLUSION Amygdalin and the nanoformulated ginseng and propolis had exhibited a marked protective effect against the ulcerative toxic effects of ethanol.
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Affiliation(s)
- Doaa R I Abdel-Gawad
- Lecturer of Toxicology and Forensic Medicine, Faculty of Veterinary Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Marwa A Ibrahim
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.
| | - Usama K Moawad
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Shaimaa Kamel
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | | | - Ahmed H El-Banna
- Michael Sayegh Faculty of Pharmacy, Aqaba University of Technology, Aqaba, Jordan
| | - Walid Hamdy Hassan
- Mycology and Immunology Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, 62511, Egypt
| | - Fatma I Abo El-Ela
- Department of Pharmacology, Faculty of Veterinary Medicine, Beni-Suef University, 62511, Beni-Suef, Egypt
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Yailian AL, Huet E, Charpiat B, Conort O, Juste M, Roubille R, Bourdelin M, Gravoulet J, Mongaret C, Vermorel C, Bedouch P, Janoly-Duménil A. Characteristics of Pharmacists' Interventions Related to Proton-Pump Inhibitors in French Hospitals: An Observational Study. Int J Clin Pract 2022; 2022:9619699. [PMID: 35846437 PMCID: PMC9256420 DOI: 10.1155/2022/9619699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 06/03/2022] [Indexed: 12/31/2022] Open
Abstract
METHODS The study was based on a retrospective analysis of pharmacist interventions for DRPs detected during the medication order review and documented into the French Act-IP© database over a 12-year period. DRPs and PIs were analyzed, and independent factors of physician acceptance were assessed via multiple logistic regression. RESULTS Out of the 620,620 PIs registered, 29,694 targeted a PPI (4.8%). PPI's DRPs were mostly related to the prescription of a "drug not available at the hospital" (26.1%) and a "drug use without indication" (18.3%); PIs were mostly "drug switch" (35.9%) and "drug discontinuation" (26.1%). In all, 18,919 PIs were accepted by physicians (63.7%). Acceptance was significantly associated with patient age: less accepted for the 18-75 years group (OR = 0.59, 95 CI [0.46-0.76]), and the >75 years group (OR = 0.57, 95 CI [0.44-0.73]) vs. <18 years group; for the type of DRP, "drug use without indication" was the less accepted (OR = 0.73, 95 CI [0.63-0.85]); for the type of PI, "dose adjustment" was the less accepted (OR = 0.32, 95 CI [0.23-0.45]). CONCLUSION Pharmacists contribute to preventing DRPs associated with PPI prescriptions during the medication order review process. Moreover, they often detect PPIs used without indication and they propose drug discontinuation, which contributes to the PPI deprescribing process. PIs should be further developed in the future to reduce PPI overprescription.
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Affiliation(s)
- AL Yailian
- Pharmacy Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Université de Lyon, UR 4129 Parcours Santé Systémique, Lyon, France
| | - E. Huet
- Pharmacy Department, Dieppe Hospital, Dieppe, France
| | - B. Charpiat
- Pharmacy Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon 69004, France
- Université Grenoble Alpes, CNRS/TIMC UMR5525, F-38041, Grenoble, France
- Working Group ‘Valorization of Pharmaceutical Interventions/Valorisation des Interventions Pharmaceutiques – Act-IP©' of the French Society for Clinical Pharmacy, Marseille, France
| | - O. Conort
- Working Group ‘Valorization of Pharmaceutical Interventions/Valorisation des Interventions Pharmaceutiques – Act-IP©' of the French Society for Clinical Pharmacy, Marseille, France
- Clinical Pharmacy Department, Cochin Hospital, APHP Centre, Cochin, Université de Paris, Paris, France
| | - M. Juste
- Working Group ‘Valorization of Pharmaceutical Interventions/Valorisation des Interventions Pharmaceutiques – Act-IP©' of the French Society for Clinical Pharmacy, Marseille, France
- Pharmacy Department, Auban Mouet Hospital, Epernay, France
| | - R. Roubille
- Pharmacy Department, Lucien Hussel Hospital, Vienne, France
| | - M. Bourdelin
- Working Group ‘Valorization of Pharmaceutical Interventions/Valorisation des Interventions Pharmaceutiques – Act-IP©' of the French Society for Clinical Pharmacy, Marseille, France
- Pharmacy Department, Nord-Ouest Villefrance Hospital, Villefranche sur Saône, France
| | - J. Gravoulet
- Working Group ‘Valorization of Pharmaceutical Interventions/Valorisation des Interventions Pharmaceutiques – Act-IP©' of the French Society for Clinical Pharmacy, Marseille, France
- Regional Union of Healthcare Professionals Pharmacists of the Grand Est (URPS), Nancy 54000, France
- Lorraine University, Faculty of Pharmacy, Nancy 54000, France
| | - C. Mongaret
- Working Group ‘Valorization of Pharmaceutical Interventions/Valorisation des Interventions Pharmaceutiques – Act-IP©' of the French Society for Clinical Pharmacy, Marseille, France
- Pharmacy Department, Reims University Hospital, Reims, France
- Reims Champagne Ardennes, Faculty of Pharmacy, Reims, France
| | - C. Vermorel
- Université Grenoble Alpes, CNRS/TIMC UMR5525, F-38041, Grenoble, France
| | - P. Bedouch
- Université Grenoble Alpes, CNRS/TIMC UMR5525, F-38041, Grenoble, France
- Working Group ‘Valorization of Pharmaceutical Interventions/Valorisation des Interventions Pharmaceutiques – Act-IP©' of the French Society for Clinical Pharmacy, Marseille, France
- Pharmacy Department, Grenoble Alpes University Hospital, Grenoble 38043, France
| | - A. Janoly-Duménil
- Pharmacy Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Université de Lyon, UR 4129 Parcours Santé Systémique, Lyon, France
- Working Group ‘Valorization of Pharmaceutical Interventions/Valorisation des Interventions Pharmaceutiques – Act-IP©' of the French Society for Clinical Pharmacy, Marseille, France
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Veremme L, Janoly-Dumenil A, Charpiat B. Curbing proton pump inhibitor overprescribing: Multifaceted strategies in an academic hospital. J Clin Pharm Ther 2021; 46:1041-1045. [PMID: 33629438 DOI: 10.1111/jcpt.13395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Proton pump inhibitors (PPI) have become essential in the management of upper gastrointestinal disorders, yet they are prescribed without an indication in up to 89% of cases and the number of prescribed PPIs is on the rise. A working group developed several multifaceted strategies in our multihospital trust to curb inappropriate PPI use. We describe herein these strategies and assess their impact on PPI consumption in a hospital belonging to this trust. METHODS From 2012 to 2019, our actions included the publication and presentation of a review of emergent PPI side effects, the development of an appropriate use leaflet, medication audits, journal club meetings, and prescription analysis. We considered that a decrease in PPI consumption could be a relevant surrogate criterion for the appropriation and acceptance of these interventions; this was assessed from 2012 to 2019 and expressed as defined daily dose (DDD)/1000 patient-days. RESULTS AND DISCUSSION There was a clear downward trend in the consumption of PPIs, both in medical and surgical wards. The overall PPI use decreased by 17.1% (from 566 to 468 DDD/1000 patient-days). IV PPI consumption dropped by 37.7% (from 146 to 91 DDD/1000 patient-days), while oral PPIs consumption decreased by 10% (from 420 to 378 DDD/1000 patient-days). WHAT IS NEW AND CONCLUSION Sustained strategies aimed at curbing PPI overprescribing led to a sustained decrease in PPI consumption in our hospital. This decrease encourages us to pursue this strategy and to diversify our actions.
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Affiliation(s)
- Léo Veremme
- Pharmacy, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Audrey Janoly-Dumenil
- Pharmacy, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,EA 41 29 Parcours Santé Systémique, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Bruno Charpiat
- Pharmacy, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
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Gramont B, Bertoletti L, Roy M, Roblin X, Tardy B, Cathébras P. [Use and management of proton pump inhibitors: An observational study]. Therapie 2020; 75:649-662. [PMID: 32591130 DOI: 10.1016/j.therap.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/09/2020] [Accepted: 03/17/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Proton pump inhibitors (PPIs) have improved the management and prevention of digestive diseases, leading to a heavy prescription of this therapy. In 2015, nearly one quarter of the French population had consumed a PPI and half of them were long-term users. The main objective of this study was to analyze, in patients hospitalized in several medical departments, the adequacy of long-term PPI prescriptions to recommendations. METHOD The Use and management of proton pump inhibitors: an observational study project (UTOPPIA) is a longitudinal observational study conducted at the University Hospital of Saint-Étienne in the departments of hepato-gastroenterology, infectious and tropical diseases, internal medicine, vascular medicine and nephrology. All patients with PPI treatment on their usual outpatient prescription were interviewed. RESULTS Over a 3-month period, 334 of hospitalized patients (30.7%) had received a long-term PPI prescription and 181 patients (54.2%) could be included in the study for a total of 274 indications. Ninety-nine patients (54.7%) had a long-term PPI prescription in accordance with the recommendations. The most frequent indication (70 prescriptions) was the prescription of an antiplatelet drug or anticoagulant for subjects at high risk of bleeding in 70 prescriptions. Fifty-three PPI treatments were amended during the hospital stay, including 9 discontinuations. The justification for the change was documented in the patients' chart in only 17% of cases. Individual interviews of patients revealed that 75.1% of them were in favour of discontinuing their PPI treatment. CONCLUSIONS About one-third of hospitalized patients in medical wards in France have long-term PPI treatment and half of these prescriptions do not comply with good practice recommendations. A majority of patients report being willing to try to stop PPI therapy.
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Affiliation(s)
- Baptiste Gramont
- Service de médecine interne, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
| | - Laurent Bertoletti
- Service de médecine vasculaire et thérapeutique, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - Michel Roy
- Centre régional de pharmacovigilance, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - Xavier Roblin
- Service d'hépato-gastro-entérologie, CHU de Saint-Étienne, 42055 Saint-Étienne, France
| | - Bernard Tardy
- Centre d'investigation clinique, Inserm CIC 1408, 42055 Saint-Étienne, France
| | - Pascal Cathébras
- Service de médecine interne, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France
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Effectiveness of Opuntia ficus indica L. inermis Seed Oil in the Protection and the Healing of Experimentally Induced Gastric Mucosa Ulcer. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:1568720. [PMID: 31827668 PMCID: PMC6881774 DOI: 10.1155/2019/1568720] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/09/2019] [Indexed: 12/11/2022]
Abstract
Gastric ulcer is a painful lesion of the gastric mucosa which can be disabling, or even more very serious in the case of a perforation of the stomach and internal hemorrhage. Traditional pharmacopeias have shown the efficacy of various plant extracts in the treatment of this pathology. Some extracts from Opuntia ficus indica (OFI) have been proven to have medicinal therapeutic benefits. The aim of this study was to investigate the preventive and curative effects of OFI seed oil extracted by cold pressing on an ethanol-induced gastric ulcer model in rats. Gastroprotective activities of the oil were assessed as pretreatments prior to ethanol gavage of Wistar rats compared to reference drugs. Two oil dose effects were tested. Ulcer and gastric parameters were measured (ulcerated areas (mm2), % of ulcer inhibition, gastric juice volume and pH, and mucus weight). Macroscopical and microscopical assessments of the stomachs as well as gastric biopsy histological studies were carried out. OFI oil exhibited a high efficiency in the protection of the cytoarchitecture and function of the gastric mucosa against the severe damages provoked by ethanol intake. Ulcerated areas were very significantly reduced and the % of ulcer inhibition was the highest under OFI oil pretreatment. Mucus production was stimulated, gastric juice volume was reduced, and its pH was increased. Histopathological examination of H&E-stained biopsies collected from gastric mucosae from the different experimental groups confirmed the gastroprotective efficacy of OFI oil against ethanol-induced symptoms such as inflammation and damages like bleeding, erosions, lesions, necrosis, and ulcers. Furthermore, OFI oil treatment speeded-up the reduction of the surface of ethanol-induced ulcerated areas in a dose-dependent manner, leading to a time gain in the healing process. The healing rate reached 91% on day 2 and 99% on day 3, and a complete heal was attained at the fourth day under OFI oil treatment, while ulcer areas were still partially unhealed in all the other groups. The therapeutic effects of OFI oil against gastric ulcer could be mediated by its varied bioactive compounds that we have demonstrated in the analytical study. They could act synergistically or in a delayed manner to optimize the healing process through protective antioxidant properties, as well as an antagonism against histamine H2-receptors, a stimulation of the signaling pathways necessary for mucus and bicarbonate production, and reduction of inflammatory processes in the gastric mucosa. Additionally, OFI oil fatty acids (especially unsaturated) and triacylglycerols contribute to the reconstruction and the repair of the cell membrane lipid bilayer during the gastric ulcer healing process.
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Mosnier-Thoumas S, Videau MN, Lafargue A, Martin-Latry K, Salles N. [Benefit of the geriatric mobile unit's intercession on the quality of medical prescriptions for the elderly: Past year assessment]. ANNALES PHARMACEUTIQUES FRANÇAISES 2018; 77:136-145. [PMID: 30392589 DOI: 10.1016/j.pharma.2018.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 10/27/2022]
Abstract
Our multidisciplinary geriatric mobile unit works in behalf of the frail elderly people, aged at least 75, who are in loss of self-reliance. One of its main aims is so optimize medical prescriptions. The purpose of this study was to show the benefit of geriatrician and pharmacist interventions over the quality of medical prescriptions for the elderly. Medication reconciliation of treatment and reassessment of the appropriateness of the prescriptions was systematically carried out. The problems related to drug therapy have been listed and classified according to the criteria of pharmaceutical interventions defined by the French Society of Clinical Pharmacy (SFPC). Out of 181 patients, 86,2% had potentially an inappropriate or sub-optimal prescription. Finally, 462 optimizations were proposed (2.9±1.9 by patients): 204 withdrawals, 166 additions, 58 dosage adaptations, 21 therapeutic follow-ups and 13 modalities of administration. This reassessment of the prescriptions allowed to develop between our geriatric mobile unit and the liberal professionals a communication focused on the therapeutic optimization and to spread recommendations on the proper use of drugs in the elderly population.
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Affiliation(s)
- S Mosnier-Thoumas
- Unité mobile de gériatrie, pôle de gérontologie clinique, CHU de Bordeaux, hôpital Xavier Arnozan, avenue du Haut-Lévêque, 33604 Pessac, France.
| | - M-N Videau
- Unité mobile de gériatrie, pôle de gérontologie clinique, CHU de Bordeaux, hôpital Xavier Arnozan, avenue du Haut-Lévêque, 33604 Pessac, France
| | - A Lafargue
- Unité mobile de gériatrie, pôle de gérontologie clinique, CHU de Bordeaux, hôpital Xavier Arnozan, avenue du Haut-Lévêque, 33604 Pessac, France
| | - K Martin-Latry
- Pôle cardio-thoracique, centre d'exploration, de prévention et de traitement de l'athérosclérose, échographie vasculaire (CEPTA), CHU de Bordeaux, avenue du Haut-Lévêque, 33604 Pessac, France
| | - N Salles
- Médecine gériatrique, pôle de gérontologie clinique, CHU de Bordeaux, avenue du Haut-Lévêque, 33604 Pessac, France
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Duwicquet F, Gras-Champel V, Masmoudi K. Hyperprolactinémie avec galactorrhée induites par le lansoprazole : à propos d’un cas. Therapie 2017; 72:691-693. [DOI: 10.1016/j.therap.2017.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 05/30/2017] [Accepted: 06/01/2017] [Indexed: 12/12/2022]
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[DGRh recommendations for the implementation of current security aspects in the NSAID treatment of musculoskeletal pain]. Z Rheumatol 2016; 75:103-16. [PMID: 26768271 DOI: 10.1007/s00393-015-0018-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
NSAIDs exert their anti-inflammatory and analgesic effects by inhibition of COX‑2, a key enzyme for proinflammatory prostanoid synthesis. Therapy with NSAIDs is limited by their typical gastrointestinal, cardiovascular and renal side effects, which are caused by inhibition of COX‑1 (gastrointestinal toxicity), COX‑2 (cardiovascular side effects) or both COX-isoenzymes (renal side effects). Appropriate prevention strategies should be employed in patients at risk. If gastrointestinal risk factors are present, co-administration of a proton pump inhibitor or misoprostol is recommended; in patients with cardiovascular risk, coxibs, diclofenac and high-dose ibuprofen should be avoided. Furthermore, drug interactions and contraindications should be considered. In patients with renal impairment (GFR < 30 ml/min) all NSAIDs must be avoided. Ulcer anamnesis is a contraindication for traditional NSAIDs. Preexisting cardio- or cerebrovascular diseases are contraindications for coxibs. Treatment decisions should be individually based with a continuous monitoring of the risk - benefit ratio and exploitation of non-pharmacological treatment options.
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