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Chiappini S, Ceci F, Mosca A, Di Carlo F, Burkauskas J, Pettorruso M, Martinotti G, Guirguis A, Corkery JM, Scherbaum N, Schifano F, Di Giannantonio M. Knowledge and Use of Over-the-counter Drugs in Italy: An Exploratory Survey-based Study in the General Population. Curr Neuropharmacol 2023; 21:133-141. [PMID: 35838215 PMCID: PMC10193759 DOI: 10.2174/1570159x20666220714104231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/29/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND During the past decade, the misuse of over-the-counter (OTC) medicines has become a global public health concern, especially among young people. In this study, we aimed to explore the OTC consumption and related misuse in Italy and identify the demographic characteristics of people/individuals involved in this phenomenon, understanding eventual risk factors. METHODS The study consisted of an anonymous online survey distributed by direct contact and via the Internet between June-November 2021 to the general population living in Italy. Descriptive statistics were reported, and binary regression analyses were performed to identify risk factors for lifetime misuse of OTC. The University of Hertfordshire approved the study (aLMS/SF/UH/02951). RESULTS The final sample size was composed of 717 respondents. The sample was mainly represented by female (69.3%) students (39.9%) in the 20-25 years age group (30.0%). Based on the survey responses, study participants were divided into two groups according to the presence/absence of OTC abuse/misuse (127 versus 590), which were compared for possible predictors of OTC diversion. Multivariate regression showed that OTC abuse/misuse was associated with the knowledge of the effects of OTC [odds ratio/OR = 2.711, 95%Confidence Interval/CI 1.794-4.097, p <0.001]. On the contrary, the educational level appeared to be a protective factor [OR = 0.695, 95%CI 0.58-0.94, p = 0.016]. CONCLUSION Although, according to our data, the phenomenon of OTC abuse appeared to be limited, increasing attention is needed because of possible underestimation and high-risk outcomes. Preventive strategies, including simplified access to information, may play a key role in limiting OTC misuse.
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Affiliation(s)
- Stefania Chiappini
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK
| | - Franca Ceci
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
| | - Alessio Mosca
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
| | - Francesco Di Carlo
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
| | - Julius Burkauskas
- Laboratory of Behavioural Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, 00142 Palanga, Lithuania
| | - Mauro Pettorruso
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK
| | - Amira Guirguis
- Swansea University Medical School, The Grove, Swansea University, Swansea, SA2 8PP, UK
| | - John M Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK
| | - Norbert Scherbaum
- LVR-Hospital Essen, Department of Addictive Behaviour and Addiction Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK
| | - Massimo Di Giannantonio
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, 66100 Chieti- Pescara, Italy
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Pharmacokinetics of seven major active components of Mahuang decoction in rat blood and brain by LC–MS/MS coupled to microdialysis sampling. Naunyn Schmiedebergs Arch Pharmacol 2020; 393:1559-1571. [DOI: 10.1007/s00210-019-01786-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/28/2019] [Indexed: 02/08/2023]
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Xu P, Song Y, Feng B, Zeng Q, Shan B, Liu K, Su D. Multi-component profiles through the blood-brain barrier in rat after oral administration of over-the-counter drug Keke capsule by ultra-performance liquid chromatography/quadrupole- time-of-flight MS E method. Biomed Chromatogr 2018; 33:e4380. [PMID: 30178888 DOI: 10.1002/bmc.4380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/18/2018] [Accepted: 08/30/2018] [Indexed: 01/10/2023]
Abstract
Keke capsule as a traditional Chinese medicine formulation is used to relieve cough, for analgesia and to reduce bronchial asthma. The multi-components are absorbed into the blood and brain after oral administration of Keke capsule, with no systematic investigation so far. A reliable and rapid UPLC-QTOF-MSE combined with a data processing software platform was used to characterize the components of Keke capsule and simultaneously identify bioactive components in blood and brain tissues in rat after oral administration. Consequently, a total of 41 components of Keke capsule, including alkaloids, flavone, flavonols, triterpene, lignanoid, organic acids, glycosides and coumarin were identified. Twenty-one components were found in plasma, including 18 prototypes and three metabolites; 15 components were found in brain tissues, including 10 prototypes and five metabolites. Alkaloids and flavonoids in Keke capsule were the main components which were absorbed into blood. The main alkaloids of Keke capsule can pass through the blood-brain barrier and show different distribution tendencies in brain tissues. The main components of keke capsule was simultaneously analyzed by throughput analysis, and the corresponding bioactive components were examined by blood-brain barrier in the rat after oral administration of the capsule.
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Affiliation(s)
- Pengfei Xu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Yonggui Song
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Bingwei Feng
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Qiang Zeng
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Baixi Shan
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Kuangyi Liu
- SCIEX, Analytical Instrument Trading Co., Changning District, Shanghai, People's Republic of China
| | - Dan Su
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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Kizilay F, Gali HE, Serefoglu EC. Diabetes and Sexuality. Sex Med Rev 2017; 5:45-51. [DOI: 10.1016/j.sxmr.2016.07.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 07/14/2016] [Accepted: 07/22/2016] [Indexed: 12/22/2022]
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Yu L, Huang J, Ma Z, Zhang J, Zou Y, Gao L. Inferring drug-disease associations based on known protein complexes. BMC Med Genomics 2015; 8 Suppl 2:S2. [PMID: 26044949 PMCID: PMC4460611 DOI: 10.1186/1755-8794-8-s2-s2] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Inferring drug-disease associations is critical in unveiling disease mechanisms, as well as discovering novel functions of available drugs, or drug repositioning. Previous work is primarily based on drug-gene-disease relationship, which throws away many important information since genes execute their functions through interacting others. To overcome this issue, we propose a novel methodology that discover the drug-disease association based on protein complexes. Firstly, the integrated heterogeneous network consisting of drugs, protein complexes, and disease are constructed, where we assign weights to the drug-disease association by using probability. Then, from the tripartite network, we get the indirect weighted relationships between drugs and diseases. The larger the weight, the higher the reliability of the correlation. We apply our method to mental disorders and hypertension, and validate the result by using comparative toxicogenomics database. Our ranked results can be directly reinforced by existing biomedical literature, suggesting that our proposed method obtains higher specificity and sensitivity. The proposed method offers new insight into drug-disease discovery. Our method is publicly available at http://1.complexdrug.sinaapp.com/Drug_Complex_Disease/Data_Download.html.
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Affiliation(s)
- Savithiri Ratnapalan
- Departments of Paediatrics and Dalla Lana School of Public Health, University of Toronto Divisions of Emergency Medicine, Clinical Pharmacology and Toxicology, The Hospital for Sick Children, 555 University Avenue, Toronto
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Abstract
Nonprescription drug, also referred to as over-the-counter (OTC) abuse, is a serious and growing global health challenge. Drugs from many different therapeutic classes and numerous dosage forms and drug delivery systems are implicated in nonprescription drug abuse. Individuals who commonly abuse certain nonprescription medications are likewise diverse, varying in age, demographics, and overall health status. The clinician is in a unique position to assist in identifying those patients at risk for nonprescription drug abuse and those who are abusers, and may play an important role in intervention, patient care, and in the treatment of nonprescription drug abuse. A concise review of nonprescription drug abuse may be of use to the clinician in this regard.
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Ellis D, Miyashita Y. Primary hypertension and special aspects of hypertension in older children and adolescents. Adolesc Health Med Ther 2011; 2:45-62. [PMID: 24600275 PMCID: PMC3926767 DOI: 10.2147/ahmt.s11715] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The prevalence of hypertension has increased at an accelerated rate in older children and adolescents. This has raised great concern about premature development of cardiovascular disease, which has major long-term health and financial implications. While obesity and sedentary habits largely explain this phenomenon, there are other social and cultural influences that may unmask genetic susceptibility to hypertension in the pediatric population. While it is essential to exclude numerous causes of secondary hypertension in every child, these disorders are not discussed in this review. Rather, the aim of this review is to familiarize pediatricians with casual and ambulatory blood pressure measurement, epidemiology, pathophysiology, and management of several common conditions that play a role in the development of hypertension in children and adolescents. Besides primary hypertension and obesity-related hypertension, emphasis is given to epidemiology, measurement of blood pressure, including ambulatory blood pressure monitoring, hypertension associated with drug use, teenage pregnancy, and video and computer games. Lastly, because pediatricians are increasingly confronted with special issues concerning the management of the hypertensive athlete, this topic is also addressed.
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Affiliation(s)
- Demetrius Ellis
- Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, PA, USA
| | - Yosuke Miyashita
- Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, PA, USA
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Virmani A, Ali SF, Binienda ZK. Neuroprotective strategies in drug abuse-evoked encephalopathy. Ann N Y Acad Sci 2010; 1199:52-68. [PMID: 20633109 DOI: 10.1111/j.1749-6632.2009.05171.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Encephalopathy is evidenced as an altered mental state with various neurological symptoms, such as memory and cognitive problems. The type of a substance-evoked encephalopathy will depend on the drug, substance, or combination being abused. The categories into which we could place the various abused substances could be tentatively divided into stimulants, amphetamines, hallucinogens, narcotics, inhalants, anesthetics, anabolic steroids, and antipsychotics/antidepressants. Other factors that may underlie encephalopathy, such as infectious agents, environmental, and other factors have also to be taken into account. Drugs of abuse can be highly toxic to the CNS following acute, but more so in chronic exposure, and can produce significant damage to other organs, such as the heart, lungs, liver, and kidneys. The damage to these organs may be at least partially reversible when drug abuse is stopped but CNS damage from repeated or prolonged abuse is often irreversible. The major pathways for the organ and CNS toxicity could be related to ischemic events as well as increased cell damage due to metabolic or mitochondrial dysfunction resulting in increased excitotoxicity, reduced energy production, and lowered antioxidant potential. These susceptibilities could be strengthened by the use of antioxidants to combat free radicals (e.g., vitamin E, lipoic acid); trying to improve energy generation by using mitochondriotropic/metabolic compounds (e.g., thiamine, coenzyme Q10, carnitine, riboflavin); by reducing excitotoxicity (e.g., glutamate antagonists) and other possible strategies, such as robust gene response, need to be investigated further. The drug-abuse-evoked encephalopathy still needs to be studied further to enable better preventative and protective strategies.
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Affiliation(s)
- Ashraf Virmani
- Scientific & Medical Affairs, Sigma tau, Pomezia 00040, Roma, Italy.
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Abstract
Ergogenic dietary supplement use is highly prevalent among adolescent and collegiate athletes, and use is increasing. To make appropriate recommendations for or against use by individual athletes, physicians who work with adolescent athletes should be knowledgeable about the most commonly used supplements and be able to access high-quality information about others. This article first discusses the legal and regulatory environment of dietary supplements. Several of the most commonly used supplements are then discussed in detail, including creatine, beta-hydroxy-beta-methylbutyrate, protein, amino acids, stimulants, alkalotic agents, glycerol, vitamins, and minerals. Finally, the "Gateway Theory" as it may relate to adolescent supplement and other drug use is discussed.
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Affiliation(s)
- Anthony Lattavo
- Department of Medical Education, Grant Medical Center, 285 East State Street, Suite 670, Columbus, OH 43215-4354, USA.
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Iyadurai SJP, Chung SS. New-onset seizures in adults: possible association with consumption of popular energy drinks. Epilepsy Behav 2007; 10:504-8. [PMID: 17349826 DOI: 10.1016/j.yebeh.2007.01.009] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Revised: 01/25/2007] [Accepted: 01/26/2007] [Indexed: 11/27/2022]
Abstract
Energy drinks contain a mixture of compounds, of which caffeine, guarana, and herbal supplements such as ginkgo and ginseng are major components. Survey of popular literature reveals anecdotal observations of adverse events associated with consumption of energy drinks. However, there are no reported cases in the published literature. We report a series of four patients who had discrete seizures on multiple occasions, following heavy consumption of energy drinks. Once the patients were abstinent from the energy drinks, no recurrent seizures were reported. We propose that the large consumption of energy drinks rich in caffeine, taurine, and guarana seed extract could have provoked these seizures.
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Affiliation(s)
- Stanley Jones P Iyadurai
- Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 58013, USA.
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