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Jarab AS, Al-Qerem W, Alajlouni HY, Alzoubi KH, Abu Heshmeh S, Mukattash TL, Naser AY, Al Hamarneh YN. Public knowledge and attitude towards drug-food interactions: implications for improved public health safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:3025-3035. [PMID: 38007813 DOI: 10.1080/09603123.2023.2286007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/13/2023] [Indexed: 11/28/2023]
Abstract
Drug-Food Interaction (DFI) can potentially lead to treatment ineffectiveness and adverse health outcomes. This study investigated knowledge and attitude towards DFI and the associated factors. A validated questionnaire was distributed to 2040 participants across Jordan. The participants had moderate knowledge and attitudes regarding DFIs. Regression results revealed that male gender, lower education level, not working in the healthcare sector, and utilizing non-scientific sources of information about DFIs were associated with lower knowledge about DFI. Furthermore, male gender, being unmarried, having a low or moderate education level, not working in the healthcare sector, not having a family member with chronic disease, and having low knowledge of DFI were significantly associated with negative attitudes towards DFIs. Future health education programs should emphasize using reliable scientific sources to enhance awareness about DFIs'. Additionally, healthcare professionals should counsel patients on avoiding DFIs and provide guidance accordingly.
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Affiliation(s)
- Anan S Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
- College of Pharmacy, AL Ain University, Abu Dhabi, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Haya Y Alajlouni
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, UAE
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shrouq Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Tareq L Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Yazid N Al Hamarneh
- Department of Pharmacology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Khong JHC, Tuan Mahmood TM, Tan SL, Voo JYH, Wong SW. Knowledge, attitude and practice (KAP) on food-drug interaction (FDI) among pharmacists working in government health facilities in Sabah, Malaysia. PLoS One 2024; 19:e0304974. [PMID: 38991042 PMCID: PMC11239116 DOI: 10.1371/journal.pone.0304974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/22/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Food-drug interaction (FDI) is prevalent in our day-to-day life. Widely recognised as drug expert, pharmacists are responsible to provide patient education, including on FDI, to ensure optimum safety and efficacy of treatment. Most pharmacists have knowledge and experience regarding FDI to certain extent. However, the level of knowledge, attitude and practice (KAP) towards FDI among pharmacists were yet to elucidated for many countries, including for Malaysia. OBJECTIVE This study aims to assess pharmacists' KAP on FDI, their inter-association, as well as association with sociodemographic characteristics in Sabah, Malaysia. METHODS & MATERIALS A cross-sectional study was conducted from 1 to 31 May 2023, using online, self-administered Google Form questionnaire, involving 24 government hospitals and 113 government health clinics in Sabah. RESULTS A total of 273 (or 35.5%) out of 768 pharmacists responded. Over two-third were female and serving government hospitals (79.6%). Mean score of KAP were 72.5 ± 14.3%, 93.2 ± 8.3% and 56.0 ± 16.7%, respectively, reflected good attitude but moderate knowledge and practice. Knowledge gaps identified include common medications such as paracetamol and metformin.Additionally, 28.2% respondents reported lack of FDI coverage during undergraduate, while merely 17.2% have received formal training on FDI after started working. Although 89.0% respondents agree that informing patients about possible FDIs is their responsibility, only 35.9% of the respondents usually or always practiced this. Such discrepancy maybe attributed to insufficient pharmacists' knowledge on FDI, where pharmacists with good level of knowledge have almost 2 times higher odd for good level of practice, compared to those with poor/moderate knowledge (odds ratio, OR: 1.92; 95% CI 1.02-3.61; p = 0.040) in this study. CONCLUSION There are significant training gaps to be filled in. Pharmacist possessing good knowledge is a prerequisite for better pharmacy practice. Adequate education strategies covering FDI should be emphasised for all pharmacy undergraduates and practising pharmacists.
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Affiliation(s)
- Jackie Ho Chit Khong
- Faculty of Pharmacy, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Department of Pharmacy, Sabah Women and Children Hospital, Kota Kinabalu, Sabah, Malaysia
| | | | - Sze Ling Tan
- Department of Pharmacy, Queen Elizabeth II Hospital, Kota Kinabalu, Sabah, Malaysia
| | - James Yau Hon Voo
- Department of Pharmacy, Duchess of Kent Hospital, Sandakan, Sabah, Malaysia
| | - See Wan Wong
- Pharmaceutical Services Division, Sabah State Health Department, Kota Kinabalu, Sabah, Malaysia
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Corvigno S, Liu Y, Bayraktar E, Stur E, Bayram NN, Ahumada AL, Nagaraju S, Rodriguez-Aguayo C, Chen H, Vu TC, Wen Y, Liang H, Zhao L, Lee S, Lopez-Berestein G, Sood AK. Enhanced plant-derived vesicles for nucleotide delivery for cancer therapy. NPJ Precis Oncol 2024; 8:86. [PMID: 38582949 PMCID: PMC10998889 DOI: 10.1038/s41698-024-00556-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 02/20/2024] [Indexed: 04/08/2024] Open
Abstract
Small RNAs (microRNAs [miRNAs] or small interfering RNAs [siRNAs]) are effective tools for cancer therapy, but many of the existing carriers for their delivery are limited by low bioavailability, insufficient loading, impaired transport across biological barriers, and low delivery into the tumor microenvironment. Extracellular vesicle (EV)-based communication in mammalian and plant systems is important for many physiological and pathological processes, and EVs show promise as carriers for RNA interference molecules. However, some fundamental issues limit their use, such as insufficient cargo loading and low potential for scaling production. Plant-derived vesicles (PDVs) are membrane-coated vesicles released in the apoplastic fluid of plants that contain biomolecules that play a role in several biological mechanisms. Here, we developed an alternative approach to deliver miRNA for cancer therapy using PDVs. We isolated vesicles from watermelon and formulated a hybrid, exosomal, polymeric system in which PDVs were combined with a dendrimer bound to miRNA146 mimic. Third generation PAMAM was chosen due to its high branching structure and versatility for loading molecules of interest. We performed several in vivo experiments to demonstrate the therapeutic efficacy of our compound and explored in vitro biological mechanisms underlying the anti-tumor effects of miRNA146, which are mostly related to its anti-angiogenic activity.
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Affiliation(s)
- Sara Corvigno
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yuan Liu
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Emine Bayraktar
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
- The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, TX, 77030, USA
| | - Elaine Stur
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Nazende Nur Bayram
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Adrian Lankenau Ahumada
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Supriya Nagaraju
- The University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, TX, 77030, USA
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Cristian Rodriguez-Aguayo
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Hu Chen
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Thanh Chung Vu
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yunfei Wen
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Han Liang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Li Zhao
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Sanghoon Lee
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Gabriel Lopez-Berestein
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Anil K Sood
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
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Hong Y, Xu H, Liu Y, Zhu S, Tian C, Chen G, Zhu F, Tao L. DDID: a comprehensive resource for visualization and analysis of diet-drug interactions. Brief Bioinform 2024; 25:bbae212. [PMID: 38711369 DOI: 10.1093/bib/bbae212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/01/2024] [Accepted: 04/21/2024] [Indexed: 05/08/2024] Open
Abstract
Diet-drug interactions (DDIs) are pivotal in drug discovery and pharmacovigilance. DDIs can modify the systemic bioavailability/pharmacokinetics of drugs, posing a threat to public health and patient safety. Therefore, it is crucial to establish a platform to reveal the correlation between diets and drugs. Accordingly, we have established a publicly accessible online platform, known as Diet-Drug Interactions Database (DDID, https://bddg.hznu.edu.cn/ddid/), to systematically detail the correlation and corresponding mechanisms of DDIs. The platform comprises 1338 foods/herbs, encompassing flora and fauna, alongside 1516 widely used drugs and 23 950 interaction records. All interactions are meticulously scrutinized and segmented into five categories, thereby resulting in evaluations (positive, negative, no effect, harmful and possible). Besides, cross-linkages between foods/herbs, drugs and other databases are furnished. In conclusion, DDID is a useful resource for comprehending the correlation between foods, herbs and drugs and holds a promise to enhance drug utilization and research on drug combinations.
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Affiliation(s)
- Yanfeng Hong
- Key Laboratory of Elemene Class Anti-cancer Chinese Medicines, School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Hongquan Xu
- Key Laboratory of Elemene Class Anti-cancer Chinese Medicines, School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Yuhong Liu
- Key Laboratory of Elemene Class Anti-cancer Chinese Medicines, School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Sisi Zhu
- Key Laboratory of Elemene Class Anti-cancer Chinese Medicines, School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Chao Tian
- Key Laboratory of Elemene Class Anti-cancer Chinese Medicines, School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Gongxing Chen
- Key Laboratory of Elemene Class Anti-cancer Chinese Medicines, School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
| | - Feng Zhu
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou 310058, China
- Innovation Institute for Affiliated Intelligence in Medicine of Zhejiang University, Alibaba-Zhejiang University Joint Research Center of Future Digital Healthcare, Hangzhou 330110, China
| | - Lin Tao
- Key Laboratory of Elemene Class Anti-cancer Chinese Medicines, School of Pharmacy, Hangzhou Normal University, Hangzhou 311121, China
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Attia KA. Physiological, Anatomical and Physicochemical Characteristics of Children Affecting Food-Drug Interaction-Review. Pak J Biol Sci 2024; 27:1-7. [PMID: 38413392 DOI: 10.3923/pjbs.2024.1.7] [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] [Indexed: 02/29/2024]
Abstract
The drug-food interaction has a great interest in nutrition research to minimize unfavorable reactions to nutritional treatment. Failure to supply appropriate nutrition to the child can harm both body development and growth. This review aimed to examine available data on the impact of diet on medication absorption in pediatric populations. Mechanisms underlying food-drug interactions were investigated to explore possible distinctions between adult and pediatric populations and to gain insight into how this may impact the pharmacokinetic profile in a child. Several changes in physiology, anatomy and physicochemical properties among children are likely to result in food-drug interactions that cannot be anticipated based on adult studies. The influence of food on medications results in decreased bioavailability and altered drug elimination. Drugs, on the other hand, can affect dietary intake, digestion, absorption and excretion. Literature shows that differences in gastrointestinal physiology and anatomy between pediatric and adult populations can have a major impact on drug absorption and bioavailability. A higher splanchnic blood flow may result in decreased drug bioavailability due to increased loss in first-pass metabolism. To overcome the overall lack of knowledge on analyzing food-drug interactions among pediatric populations, comprehensive procedures and recommendations must be developed.
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Zhang T, Tao Y, Pu J, Zhu M, Wan L, Tang C. Safety, tolerability, and pharmacokinetics of oral (S)-oxiracetam in Chinese healthy volunteers: A randomized, double-blind, controlled phase I study. Eur J Pharm Sci 2024; 192:106621. [PMID: 37898393 DOI: 10.1016/j.ejps.2023.106621] [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: 06/12/2023] [Revised: 10/22/2023] [Accepted: 10/22/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND AND OBJECTIVE (S)-oxiracetam is the major active enantiomer of oxiracetam, which is being developed for dementia. This trial was designed to evaluate the safety, tolerability, and pharmacokinetics of oral (S)-oxiracetam in healthy Chinese volunteers. METHODS A randomized, controlled, double-blind and dose-escalation design was used in this Phase I trial, which consisted of a single-ascending-dose (SAD) study (400-2000 mg) and a multiple-ascending-dose (MAD) study (400-1600 mg). Blood, urine and feces samples were collected for pharmacokinetic analysis. Safety was evaluated by monitoring adverse events (AEs). RESULTS AEs in both studies were mild or moderate in severity and dose-independent. In the SAD study, no chiral transformation was observed. 55.03% and 36.16% of (S)-oxiracetam was excreted unchanged in urine and feces, respectively. Exposures exhibited dose-proportional increases over the range of 400 to 1600 mg but almost unchanged from 1600 to 2000 mg. (S)-oxiracetam was absorbed rapidly, reaching a peak at 0.75-1.00 h, and t1/2 was 6.12-6.60 h. Food had no effect on AUC, but prolonged Tmax to 3.00 h. In the MAD study, steady-state was observed on day 5. Mild accumulations were observed after 7 days of repeated dosing. CONCLUSION (S)-oxiracetam was safe and tolerated with favorable pharmacokinetic profiles at all study doses, providing dosing evidence for further efficacy evaluation.
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Affiliation(s)
- Ting Zhang
- Phase I Clinical Trial Center, Bishan Hospital of Chongqing, Bishan hospital of Chongqing medical university, Chongqing, 402760, China
| | - Yi Tao
- Department of Phase I Clinical Trial Ward, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Junliang Pu
- Phase I Clinical Trial Center, Bishan Hospital of Chongqing, Bishan hospital of Chongqing medical university, Chongqing, 402760, China
| | - Mingxue Zhu
- Phase I Clinical Trial Center, Bishan Hospital of Chongqing, Bishan hospital of Chongqing medical university, Chongqing, 402760, China
| | - Lei Wan
- Phase I Clinical Trial Center, Bishan Hospital of Chongqing, Bishan hospital of Chongqing medical university, Chongqing, 402760, China
| | - Chengyong Tang
- Phase I Clinical Trial Center, Bishan Hospital of Chongqing, Bishan hospital of Chongqing medical university, Chongqing, 402760, China.
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Silva MI, Khadra I, Pyper K, Halbert GW. Structured solubility behaviour in fed simulated intestinal fluids. Eur J Pharm Biopharm 2023; 193:58-73. [PMID: 37890541 DOI: 10.1016/j.ejpb.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/03/2023] [Accepted: 10/23/2023] [Indexed: 10/29/2023]
Abstract
Intestinal drug solubility is a key parameter controlling absorption after the administration of a solid oral dosage form. The ability to measure fed state solubility in vitro is limited and multiple simulated intestinal fluid recipes have been developed but with no consensus which is optimal. This study has utilised nine bioequivalent simulated fed intestinal media recipes that cover over 90% of the compositional variability of sampled fed human intestinal fluid. The solubility of 24 drugs (Acidic; furosemide, ibuprofen, indomethacin, mefenamic acid, naproxen, phenytoin, piroxicam, valsartan, zafirlukast: Basic; aprepitant, atazanavir, bromocriptine, carvedilol, dipyridamole, posaconazole, tadalafil: Neutral; acyclovir, carbamazepine, felodipine, fenofibrate, griseofulvin, itraconazole, paracetamol, probucol) has been assessed to determine if structured solubility behaviour is present. The measured solubility behaviour can be split into four categories and is consistent with drug physicochemical properties and previous solubility studies. For acidic drugs (category 1) solubility is controlled by media pH and the lowest and highest pH media identify the lowest and highest solubility in 90% of cases. For weakly acidic, basic and neutral drugs (category 2) solubility is controlled by media pH and total amphiphile concentration (TAC), a consistent solubility pattern is evident with variation related to individual drug media component interactions. The lowest and highest pH × TAC media identify the lowest and highest solubility in 70% and 90% of cases respectively. Four drugs, which are non-ionised in the media systems (category 3), have been identified with a very narrow solubility range, indicating minimal impact of the simulated media on solubility. Three drugs exhibit solubility behaviour that is not consistent with the remainder (category 4). The results indicate that the use of two bioequivalent fed intestinal media from the original nine will identify in vitro the maximum and minimum solubility values for the majority of drugs and due to the media derivation this is probably applicable in vivo. When combined with a previous fasted study, this introduces interesting possibilities to measure a solubility range in vitro that can provide Quality by Design based decisions to rationalise drug and formulation development. Overall this indicates that the multi-dimensional media system is worthy of further investigation as in vitro tool to assess fed intestinal solubility.
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Affiliation(s)
- Maria Inês Silva
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, United Kingdom
| | - Ibrahim Khadra
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, United Kingdom
| | - Kate Pyper
- Department of Mathematics and Statistics, University of Strathclyde, Livingstone Tower, 26 Richmond Street, Glasgow G1 1XH, United Kingdom
| | - Gavin W Halbert
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, United Kingdom.
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Preeti, Sambhakar S, Saharan R, Narwal S, Malik R, Gahlot V, Khalid A, Najmi A, Zoghebi K, Halawi MA, Albratty M, Mohan S. Exploring LIPIDs for their potential to improves bioavailability of lipophilic drugs candidates: A review. Saudi Pharm J 2023; 31:101870. [PMID: 38053738 PMCID: PMC10694332 DOI: 10.1016/j.jsps.2023.101870] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/09/2023] [Indexed: 12/07/2023] Open
Abstract
This review aims to provide a thorough examination of the benefits, challenges, and advancements in utilizing lipids for more effective drug delivery, ultimately contributing to the development of innovative approaches in pharmaceutical science. Lipophilic drugs, characterized by low aqueous solubility, present a formidable challenge in achieving effective delivery and absorption within the human body. To address this issue, one promising approach involves harnessing the potential of lipids. Lipids, in their diverse forms, serve as carriers, leveraging their unique capacity to enhance solubility, stability, and absorption of these challenging drugs. By facilitating improved intestinal solubility and selective lymphatic absorption of porously permeable drugs, lipids offer an array of possibilities for drug delivery. This versatile characteristic not only bolsters the pharmacological efficacy of drugs with low bioavailability but also contributes to enhanced therapeutic performance, ultimately reducing the required dose size and associated costs. This comprehensive review delves into the strategic formulation approaches that employ lipids as carriers to ameliorate drug solubility and bioavailability. Emphasis is placed on the critical considerations of lipid type, composition, and processing techniques when designing lipid-based formulations. This review meticulously examines the multifaceted challenges that come hand in hand with lipid-based formulations for lipophilic drugs, offering an insightful perspective on future trends. Regulatory considerations and the broad spectrum of potential applications are also thoughtfully discussed. In summary, this review presents a valuable repository of insights into the effective utilization of lipids as carriers, all aimed at elevating the bioavailability of lipophilic drugs.
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Affiliation(s)
- Preeti
- Banasthali Vidyapith, Vanasthali Road, Aliyabad, Rajasthan 304022, India
- Gurugram Global College of Pharmacy, Haily Mandi Rd, Farukh Nagar, Haryana 122506, India
| | - Sharda Sambhakar
- Banasthali Vidyapith, Vanasthali Road, Aliyabad, Rajasthan 304022, India
| | - Renu Saharan
- Maharishi Markandeswar Deemed to be University, Mullana, Ambala, Haryana 133203, India
| | - Sonia Narwal
- Panipat Institute of Engineering & Technology, Department of Pharmacy, GT Road, Samalkha, Panipat 132102, Haryana, India
| | - Rohit Malik
- Gurugram Global College of Pharmacy, Haily Mandi Rd, Farukh Nagar, Haryana 122506, India
| | - Vinod Gahlot
- HIMT College of Pharmacy, Knowledge Park - 1, Greater Noida, District - Gautam Buddh Nagar, UP 201310, India
| | - Asaad Khalid
- Substance Abuse and Toxicology Research Centre, Jazan University, Jazan 45142, Saudi Arabia
- Medicinal and Aromatic Plants Research Institute, National Center for Research, P.O. Box: 2424, Khartoum 11111, Sudan
| | - Asim Najmi
- Department of Pharmaceutical Chemistry and Pharmacognosy, College of Pharmacy, Jazan University, P.O. Box 114, Jazan, Saudi Arabia
| | - Khalid Zoghebi
- Department of Pharmaceutical Chemistry and Pharmacognosy, College of Pharmacy, Jazan University, P.O. Box 114, Jazan, Saudi Arabia
| | - Maryam A. Halawi
- Department of Cinical Pharmacy, College of Pharmacy, Jazan University, P.O. Box 114, Jazan, Saudi Arabia
| | - Mohammed Albratty
- Department of Pharmaceutical Chemistry and Pharmacognosy, College of Pharmacy, Jazan University, P.O. Box 114, Jazan, Saudi Arabia
| | - Syam Mohan
- Substance Abuse and Toxicology Research Centre, Jazan University, Jazan 45142, Saudi Arabia
- School of Health Sciences, University of Petroleum and Energy Studies, Dehradun, Uttarakhand, India
- Center for Global health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, India
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Zhang Y, Aldamarany WAS, Song G, Liu J, Liu S, Chen Y, Jiang W, Zhong G. Influence of konjac glucomannan and its derivatives on the oral pharmacokinetics of antimicrobial agent in antibiotics cocktails: Keep vigilant on dietary fiber supplement. Int J Biol Macromol 2023; 251:126306. [PMID: 37573922 DOI: 10.1016/j.ijbiomac.2023.126306] [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: 04/11/2023] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 08/15/2023]
Abstract
In this study, konjac glucomannan (KGM) and its derivatives were gavaged as dietary fiber supplements, followed by a single dose of antibiotic cocktail (Abx) containing amoxicillin, neomycin, metronidazole and vancomycin in mice. The effects of dietary fiber on the pharmacokinetics and tissue distribution of each antibiotic were investigated. The results showed that the specific effects of KGM and its derivatives on the absorption, distribution, and elimination of certain antibiotics varied and depended on the nature of the fibers and the characteristics of the antibiotics. Explicitly, the ingestion of KGM and its derivatives enhanced the absorption of metronidazole by 1.7 times and hindered that of amoxicillin by nearly 36 % without affecting the absorption of neomycin sulfate and vancomycin. KGM and its derivatives had no effect on the distribution of amoxicillin and metronidazole, but DKGM and KGM hindered the distributions of neomycin sulfate (from 1.25 h to 1.62 h) and vancomycin (from 0.95 h to 1.14 h), respectively. KGM and its derivatives promoted the elimination of amoxicillin by nearly 38 % while prolonging that of metronidazole by >50 %. KOGM boosted the elimination of neomycin sulfate and vancomycin, but KGM differed from DKGM in acting on the elimination of both.
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Affiliation(s)
- Yuan Zhang
- College of Food Science, Southwest University, Chongqing 400715, China; Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Southwest University, Chongqing 400715, China
| | - Waleed A S Aldamarany
- College of Food Science, Southwest University, Chongqing 400715, China; Food Science and Technology Department, Faculty of Agriculture, Al-Azhar University (Assiut Branch), Assiut 71524, Egypt
| | - Guangming Song
- College of Food Science, Southwest University, Chongqing 400715, China; Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Southwest University, Chongqing 400715, China
| | - Jie Liu
- College of Food Science, Southwest University, Chongqing 400715, China; Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Southwest University, Chongqing 400715, China
| | - Sha Liu
- College of Food Science, Southwest University, Chongqing 400715, China; Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Southwest University, Chongqing 400715, China
| | - Yuanyuan Chen
- College of Food Science, Southwest University, Chongqing 400715, China; Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Southwest University, Chongqing 400715, China
| | - Wenjing Jiang
- College of Food Science, Southwest University, Chongqing 400715, China; Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Southwest University, Chongqing 400715, China
| | - Geng Zhong
- College of Food Science, Southwest University, Chongqing 400715, China; Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Southwest University, Chongqing 400715, China.
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Alhubail SA, Alharthi MM, Alsayyah FF, Younis NS. Healthcare Professionals and Undergraduate Students' Knowledge Toward Drug-Food Interactions in the Eastern Region of Saudi Arabia. J Multidiscip Healthc 2023; 16:2883-2892. [PMID: 37790990 PMCID: PMC10543414 DOI: 10.2147/jmdh.s419544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/14/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction Drug and Food Interactions (DFI) arise when particular nutrients in food interact with drugs when consumed concurrently, consequently resulting in alterations in the pharmacokinetics, pharmacodynamics, and therapeutic effectiveness of the drug. This study aimed to evaluate the information and understanding of healthcare providers (HCPs) about common DFI. Methods A cross-sectional study was achieved by a self-administered online-based questionnaire to gather data from HCPs in eastern region of Saudi Arabia between Sep. to Oct. 2022. The questionnaire integrated questions related to HCP demographic features and knowledge of DFI. The DFI section included questions that assessed the general knowledge of DFI and knowledge of specific food and drug interactions. Results A total of 401 participants completed the study questionnaire; 41.4% were undergraduate students, 37.2% were pharmacists, 10.5% were nurses, and 9.5% were doctors. Unfortunately, HCPs are unable to recognize several food types that may interact with medications, which may lead to undesirable consequences associated with an enormous financial burden. For instance, only 27.9% of the HCPs stated that patients on monoamine oxidase inhibitors should avoid cheese. In addition, only approximately 11% of HCPs knew that patients on levothyroxine should avoid cauliflower, those taking digoxin should avoid wheat bran, those taking lithium should avoid cola, and those on heparin should avoid calcium-rich food. Overall knowledge was significantly higher among pharmacists and others HCPs with more than 5 years of experience. Discussion and Conclusion This study demonstrated a low level of knowledge regarding specific food and drug interactions among healthcare providers in the eastern region of Saudi Arabia.
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Affiliation(s)
- Sarah Abdullah Alhubail
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
| | - Mayar Mohammed Alharthi
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
| | - Fadiyah Faisal Alsayyah
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
| | - Nancy S Younis
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, 31982, Saudi Arabia
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11
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Abualhasan M, Tahan S, Nassar R, Damere M, Salameh H, Zyoud H. Pharmacists' knowledge of drug food administration and their appropriate patient counseling a cross-sectional study from Palestine. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:99. [PMID: 37710335 PMCID: PMC10500721 DOI: 10.1186/s41043-023-00444-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
Pharmacists have a responsibility in the treatment of patients. Interactions between food and drugs may lead to a loss of therapeutic effectiveness or drug toxicity. Our study's objectives were to assess pharmacists' knowledge of patient counseling with regard to informing the patient about taking the drug in relation to food, as well as community pharmacists' knowledge of any pharmaceutical instructions that must be given to patients when delivering the drug. The pharmacists were assessed using an interview questionnaire. The results showed a variation in the pharmacist's knowledge about the administration of the drug with food. The chief pharmacists had better knowledge of the proper food administration counseling than that of assistant pharmacists; the percentage of those who did not give the proper food counseling was 24 vs. 58%, respectively (P < 0.05). Only (21%) of pharmacists with more work experience provided proper counseling, while only 18.2 and 18.7% of pharmacists with moderate and low work experience provided proper counseling, respectively. The study showed the pharmacists' limited knowledge of drug administration with food and outdated counseling information. It is highly recommended that a continuous education system be encouraged and enforced by the ministry of health to update pharmacist's knowledge of dispensed drugs.
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Affiliation(s)
- Murad Abualhasan
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, State of Palestine, Palestine.
| | - Shahd Tahan
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, State of Palestine, Palestine
| | - Roa'a Nassar
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, State of Palestine, Palestine
| | - Maysoon Damere
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, State of Palestine, Palestine
| | - Hadeel Salameh
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, State of Palestine, Palestine
| | - Hiba Zyoud
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, State of Palestine, Palestine
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12
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Lau H, Woost PG, Friedrich U, Ong Clausen WH, Jacobberger JW, Saunthararajah Y. Pharmacokinetics and pharmacodynamics of an oral formulation of decitabine and tetrahydrouridine. Eur J Haematol 2023; 111:345-355. [PMID: 37417197 PMCID: PMC10524919 DOI: 10.1111/ejh.14009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is caused by an inherited structural abnormality of adult hemoglobin causing polymerization. Fetal hemoglobin interferes with polymerization but is epigenetically silenced by DNA methyltransferase 1 (DNMT1) in adult erythropoiesis. Decitabine depletes DNMT1 and increases fetal and total hemoglobin in SCD patients, but is rapidly catabolized by cytidine deaminase (CDA) in vivo. Tetrahydrouridine (THU) inhibits CDA, safeguarding decitabine. METHODS The pharmacokinetics and pharmacodynamics of three oral combination formulations of THU and decitabine, with different coatings producing different delays in decitabine release, were investigated in healthy participants. RESULTS Tetrahydrouridine and decitabine were rapidly absorbed into the systemic circulation after a single combination oral dose, with relative bioavailability of decitabine ≥74% in fasted males compared with separate oral administration of THU followed by decitabine 1 h later. THU and decitabine Cmax and area under the plasma concentration versus time curve were higher in females versus males, and fasted versus fed states. Despite sex and food effect on pharmacokinetics, the pharmacodynamic effect of DNMT1 downregulation was comparable in males and females and fasted and fed states. Treatments were well tolerated. CONCLUSION Combination oral formulations of THU with decitabine produced pharmacokinetics and pharmacodynamics suitable for oral DNMT1-targeted therapy.
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Affiliation(s)
| | - Philip G. Woost
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
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13
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Malouh MA, Sefidani Forough A, Cichero JAY, Lau ETL, Nissen LM, Steadman KJ. The prevalence and perceived effectiveness of using a medication-swallowing lubricant in aged care facilities across Australia. Aging Med (Milton) 2023; 6:239-244. [PMID: 37711253 PMCID: PMC10498827 DOI: 10.1002/agm2.12261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 09/16/2023] Open
Abstract
Objective To explore the extent of use and perceived effectiveness of using a medication lubricant that is specifically designed to help people who struggle to swallow their solid medications whole. Method Health care workers of varying professional levels in aged care facilities (ACFs) across Australia who are involved in medication administration were invited to participate in a structured online survey. Results Of the 355 health care workers who completed the survey, 48% had used the medication lubricant to aid administration of whole and/or crushed solid oral dosage forms, and of these 89% agreed with the statement that "it is effective method to facilitate medication swallowing in residents." The main benefits of using the medication lubricant were considered to be easier medication administration to residents (49%), reduction in need for crushing of medications (34%), and better adherence with medications (33%). Conclusions This study showed that using a medication lubricant for aged care residents may facilitate the process of medication administration for health care workers, which they perceive to improve residents' adherence with medications. Serious complications associated with solid dosage form modification may also be decreased by using a medication lubricant, as the need for modifying medications is reduced. Therapeutic Goods Administration (TGA)-approved medication lubricants could therefore be a valuable tool to aid the medication administration for patients who have difficulties swallowing medications. Future research may consider the clinical efficacy and acceptability of medication lubricants specifically for people with swallowing difficulties.
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Affiliation(s)
- Marwa A. Malouh
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
| | - Aida Sefidani Forough
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Julie A. Y. Cichero
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Esther T. L. Lau
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Lisa M. Nissen
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Kathryn J. Steadman
- School of PharmacyThe University of QueenslandBrisbaneQueenslandAustralia
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
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14
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Luo D, Lin Y, Chen J, Huang X, Xie Y, Liu Y, Ni S, Su Z, Li Y, Zhang Z. Stereoisomers of octahydrocurcumin, the hydrogenated metabolites of curcumin, display stereoselective activity on the CYP2E1 enzyme in L-02 cells. Food Funct 2023; 14:2822-2835. [PMID: 36866793 DOI: 10.1039/d2fo03892g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
As the final hydrogenated metabolite of curcumin, octahydrocurcumin (OHC) exhibits increased powerful bioactivities. The chiral and symmetric chemical structure indicated that there were two OHC stereoisomers, (3R,5S)-octahydrocurcumin (Meso-OHC) and (3S,5S)-octahydrocurcumin ((3S,5S)-OHC), which may induce different effects on metabolic enzymes and bioactivities. Thus, we detected OHC stereoisomers from rat metabolites (blood, liver, urine and feces) after oral administration of curcumin. In addition, OHC stereoisomers were prepared and then their different influences on cytochrome P450 enzymes (CYPs) and UDP-glucuronyltransferases (UGTs) in L-02 cells were tested to explore the potential interaction and different bioactivities. Our results proved that curcumin could be metabolised into OHC stereoisomers first. In addition, Meso-OHC and (3S,5S)-OHC exhibited slight induction or inhibition effects on CYP1A2, CYP2A6, CYP2C8, CYP2C9, CYP3A4 and UGTs. Furthermore, Meso-OHC exhibited more intensive inhibition toward CYP2E1 expression than (3S,5S)-OHC, ascribed to the different mode of binding to the enzyme protein (P < 0.05), which finally induced more effective liver protection effects in acetaminophen-induced L-02 cell injury.
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Affiliation(s)
- Dandan Luo
- Department of clinical pharmacy, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, P.R. China
| | - Yinsi Lin
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, P.R. China
| | - Jiannan Chen
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, P.R. China
| | - Xiaoqi Huang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, P.R. China
| | - Youliang Xie
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, P.R. China
| | - Yuhong Liu
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, P.R. China
| | - Suiqin Ni
- Department of clinical pharmacy, Guangzhou First People's Hospital, South China University of Technology, Guangzhou 510180, P.R. China
| | - Ziren Su
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, P.R. China
| | - Yucui Li
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, Guangzhou 510006, P.R. China
| | - Zhenbiao Zhang
- Tea Research Institute, Guangdong Academy of Agricultural Sciences, Guangdong Key Laboratory of Tea Resources Innovation & Utilization, Guangzhou 510640, China
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15
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Inês Silva M, Khadra I, Pyper K, Halbert GW. Fed Intestinal Solubility Limits and Distributions Applied to the Developability Classification System. Eur J Pharm Biopharm 2023; 186:74-84. [PMID: 36934829 DOI: 10.1016/j.ejpb.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/06/2023] [Accepted: 03/11/2023] [Indexed: 03/19/2023]
Abstract
For solid oral dosage forms drug solubility in intestinal fluid is an important parameter influencing product performance and bioavailability. Solubility along with permeability are the two parameters applied in the Biopharmaceutics and Developability Classification Systems (DCS) to assess a drug's potential for oral administration. Intestinal solubility varies with the intestinal contents and the differences between the fasted and fed states are recognised to influence solubility and bioavailability. In this study a novel fed state simulated media system comprising of nine media has been utilised to measure the solubility of seven drugs (ibuprofen, mefenamic acid, furosemide, dipyridamole, griseofulvin, paracetamol and acyclovir) previously studied in the fasted state DCS. The results demonstrate that the fed nine media system provides a range of solubility values for each drug and solubility behaviour is consistent with published design of experiment studies conducted in either the fed or fasted state. Three drugs (griseofulvin, paracetamol and acyclovir) exhibit very narrow solubility distributions, a result that matches published behaviour in the fasted state, indicating that this property is not influenced by the concentration of simulated media components. The nine solubility values for each drug can be utilised to calculate a dose/solubility volume ratio to visualise the drug's position on the DCS grid. Due to the derivation of the nine media compositions the range and catergorisation could be considered as bioequivalent and can be combined with the data from the original fed intestinal fluid analysis to provide a population based solubility distribution. This provides further information on the drugs solubility behaviour and could be applied to quality by design formulation approaches. Comparison of the fed results in this study with similar published fasted results highlight that some differences detected match in vivo behaviour in food effect studies. This indicates that a combination of the fed and fasted systems may be a useful in vitro biopharmaceutical performance tool. However, it should be noted that the fed media recipes in this study are based on a liquid meal (Ensure Plus) and this may not be representative of alternative fed states achieved through ingestion of a solid meal. Nevertheless, this novel approach provides greater in vitro detail with respect to possible in vivo biopharmaceutical performance, an improved ability to apply risk-based approaches and the potential to investigate solubility based food effects. The system is therefore worthy of further investigation but studies will be required to expand the number of drugs measured and link the in vitro measurements to in vivo results.
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Affiliation(s)
- Maria Inês Silva
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161, Cathedral Street, Glasgow, G4 0RE, United Kingdom
| | - Ibrahim Khadra
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161, Cathedral Street, Glasgow, G4 0RE, United Kingdom
| | - Kate Pyper
- Department of Mathematics and Statistics, University of Strathclyde, Livingstone Tower, 26, Richmond Street, Glasgow, G1 1XH, United Kingdom
| | - Gavin W Halbert
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161, Cathedral Street, Glasgow, G4 0RE, United Kingdom.
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16
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Fujita K, Masnoon N, Mach J, O’Donnell LK, Hilmer SN. Polypharmacy and precision medicine. CAMBRIDGE PRISMS. PRECISION MEDICINE 2023; 1:e22. [PMID: 38550925 PMCID: PMC10953761 DOI: 10.1017/pcm.2023.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 07/05/2024]
Abstract
Precision medicine is an approach to maximise the effectiveness of disease treatment and prevention and minimise harm from medications by considering relevant demographic, clinical, genomic and environmental factors in making treatment decisions. Precision medicine is complex, even for decisions about single drugs for single diseases, as it requires expert consideration of multiple measurable factors that affect pharmacokinetics and pharmacodynamics, and many patient-specific variables. Given the increasing number of patients with multiple conditions and medications, there is a need to apply lessons learned from precision medicine in monotherapy and single disease management to optimise polypharmacy. However, precision medicine for optimisation of polypharmacy is particularly challenging because of the vast number of interacting factors that influence drug use and response. In this narrative review, we aim to provide and apply the latest research findings to achieve precision medicine in the context of polypharmacy. Specifically, this review aims to (1) summarise challenges in achieving precision medicine specific to polypharmacy; (2) synthesise the current approaches to precision medicine in polypharmacy; (3) provide a summary of the literature in the field of prediction of unknown drug-drug interactions (DDI) and (4) propose a novel approach to provide precision medicine for patients with polypharmacy. For our proposed model to be implemented in routine clinical practice, a comprehensive intervention bundle needs to be integrated into the electronic medical record using bioinformatic approaches on a wide range of data to predict the effects of polypharmacy regimens on an individual. In addition, clinicians need to be trained to interpret the results of data from sources including pharmacogenomic testing, DDI prediction and physiological-pharmacokinetic-pharmacodynamic modelling to inform their medication reviews. Future studies are needed to evaluate the efficacy of this model and to test generalisability so that it can be implemented at scale, aiming to improve outcomes in people with polypharmacy.
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Affiliation(s)
- Kenji Fujita
- Departments of Clinical Pharmacology and Aged Care, Kolling Institute, Faculty of Medicine and Health, The University of Sydney and the Northern Sydney Local Health District, Sydney, NSW, Australia
| | - Nashwa Masnoon
- Departments of Clinical Pharmacology and Aged Care, Kolling Institute, Faculty of Medicine and Health, The University of Sydney and the Northern Sydney Local Health District, Sydney, NSW, Australia
| | - John Mach
- Departments of Clinical Pharmacology and Aged Care, Kolling Institute, Faculty of Medicine and Health, The University of Sydney and the Northern Sydney Local Health District, Sydney, NSW, Australia
| | - Lisa Kouladjian O’Donnell
- Departments of Clinical Pharmacology and Aged Care, Kolling Institute, Faculty of Medicine and Health, The University of Sydney and the Northern Sydney Local Health District, Sydney, NSW, Australia
| | - Sarah N. Hilmer
- Departments of Clinical Pharmacology and Aged Care, Kolling Institute, Faculty of Medicine and Health, The University of Sydney and the Northern Sydney Local Health District, Sydney, NSW, Australia
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17
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Mady OY, Osman MA, sarhan NI, Shatla AA, Haggag YA. Bioavailability enhancement of acyclovir by honey: Analytical and histological evidence. J Drug Deliv Sci Technol 2023. [DOI: 10.1016/j.jddst.2023.104155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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18
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Luo S, Zhang H, Jiang X, Xia Y, Tang S, Duan X, Sun W, Gao M, Chen C, Zou Z, Zhou L, Qiu J. Antibiotics administration alleviates the high fat diet-induced obesity through altering the lipid metabolism in young mice. Lipids 2023; 58:19-32. [PMID: 36253942 DOI: 10.1002/lipd.12361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/24/2022] [Accepted: 09/19/2022] [Indexed: 02/04/2023]
Abstract
Currently, there is a global trend of rapid increase in obesity, especially among adolescents. The antibiotics cocktails (ABX) therapy is commonly used as an adjunctive treatment for gut microbiota related diseases, including obesity. However, the effects of broad-spectrum antibiotics alone on young obese hosts have rarely been reported. In the present study, the 3-week-old C57BL/6J male mice fed a high-fat diet (HFD) were intragastric administration with ampicillin, vancomycin, metronidazole or neomycin for 30 days. The lipid metabolites in plasma were assessed by biochemical assay kits, and genes related to lipid metabolite in the white adipose were assessed by qPCR. To further analyze the underlying mechanisms, the expression of genes related to lipid metabolism, inflammatory reactions and oxidative stress in the liver were determined by qPCR assay. In addition, the expression of oxidative damage-associated proteins in the liver were detected by western blot. The results showed that oral antibiotics exposure could reduce body weight and fat index in HFD-fed mice, concurrent with the increase of white adipose lipolysis genes and the decrease of hepatic lipogenic genes. Furthermore, antibiotics treatment could clearly reverse the HFD-induced elevation of oxidative damage-related proteins in the liver. Together, these findings will provide valuable clues into the effects of antibiotics on obesity.
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Affiliation(s)
- Shiyue Luo
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Hongyang Zhang
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xuejun Jiang
- Center of Experimental Teaching for Public Health, Experimental Teaching and Management Center, Chongqing Medical University, Chongqing, People's Republic of China.,Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yinyin Xia
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China.,Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shixin Tang
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Xinhao Duan
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Wei Sun
- Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Min Gao
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Chengzhi Chen
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China.,Department of Occupational and Environmental Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhen Zou
- Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China.,Institute of Life Sciences, Chongqing Medical University, Chongqing, People's Republic of China
| | - Lixiao Zhou
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China.,Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
| | - Jingfu Qiu
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China.,Research Center for Environment and Human Health, School of Public Health, Chongqing Medical University, Chongqing, People's Republic of China
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19
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Wang T, Yang J, Xiao Y, Wang J, Wang Y, Zeng X, Wang Y, Peng J. DFinder: a novel end-to-end graph embedding-based method to identify drug-food interactions. Bioinformatics 2022; 39:6965015. [PMID: 36579885 PMCID: PMC9828147 DOI: 10.1093/bioinformatics/btac837] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/07/2022] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
MOTIVATION Drug-food interactions (DFIs) occur when some constituents of food affect the bioaccessibility or efficacy of the drug by involving in drug pharmacodynamic and/or pharmacokinetic processes. Many computational methods have achieved remarkable results in link prediction tasks between biological entities, which show the potential of computational methods in discovering novel DFIs. However, there are few computational approaches that pay attention to DFI identification. This is mainly due to the lack of DFI data. In addition, food is generally made up of a variety of chemical substances. The complexity of food makes it difficult to generate accurate feature representations for food. Therefore, it is urgent to develop effective computational approaches for learning the food feature representation and predicting DFIs. RESULTS In this article, we first collect DFI data from DrugBank and PubMed, respectively, to construct two datasets, named DrugBank-DFI and PubMed-DFI. Based on these two datasets, two DFI networks are constructed. Then, we propose a novel end-to-end graph embedding-based method named DFinder to identify DFIs. DFinder combines node attribute features and topological structure features to learn the representations of drugs and food constituents. In topology space, we adopt a simplified graph convolution network-based method to learn the topological structure features. In feature space, we use a deep neural network to extract attribute features from the original node attributes. The evaluation results indicate that DFinder performs better than other baseline methods. AVAILABILITY AND IMPLEMENTATION The source code is available at https://github.com/23AIBox/23AIBox-DFinder. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Tao Wang
- School of Computer Science, Northwestern Polytechnical University, Xi’an 710072, China,Key Laboratory of Big Data Storage and Management, Northwestern Polytechnical University, Ministry of Industry and Information Technology, Xi’an 710072, China
| | - Jinjin Yang
- School of Computer Science, Northwestern Polytechnical University, Xi’an 710072, China,Key Laboratory of Big Data Storage and Management, Northwestern Polytechnical University, Ministry of Industry and Information Technology, Xi’an 710072, China
| | - Yifu Xiao
- School of Computer Science, Northwestern Polytechnical University, Xi’an 710072, China,Key Laboratory of Big Data Storage and Management, Northwestern Polytechnical University, Ministry of Industry and Information Technology, Xi’an 710072, China
| | - Jingru Wang
- School of Computer Science, Northwestern Polytechnical University, Xi’an 710072, China,Key Laboratory of Big Data Storage and Management, Northwestern Polytechnical University, Ministry of Industry and Information Technology, Xi’an 710072, China
| | - Yuxian Wang
- School of Computer Science, Northwestern Polytechnical University, Xi’an 710072, China,Key Laboratory of Big Data Storage and Management, Northwestern Polytechnical University, Ministry of Industry and Information Technology, Xi’an 710072, China
| | - Xi Zeng
- School of Computer Science, Northwestern Polytechnical University, Xi’an 710072, China,Key Laboratory of Big Data Storage and Management, Northwestern Polytechnical University, Ministry of Industry and Information Technology, Xi’an 710072, China
| | - Yongtian Wang
- School of Computer Science, Northwestern Polytechnical University, Xi’an 710072, China,Key Laboratory of Big Data Storage and Management, Northwestern Polytechnical University, Ministry of Industry and Information Technology, Xi’an 710072, China
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20
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Zuo X, Zhao X, Zhang T. Pharmacokinetics and bioequivalence evaluation of 2 oral formulations of methotrexate tablets in healthy Chinese volunteers under fasting and fed conditions. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2022; 396:803-809. [PMID: 36484803 DOI: 10.1007/s00210-022-02337-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2022]
Abstract
Methotrexate is an anti-metabolite drug that is frequently used for rheumatoid arthritis treatment. This study is aimed at evaluating the bioequivalence of 2 methotrexate tablets (2.5 mg) under fasting and fed conditions in healthy Chinese volunteers. A single-center, randomized, open-label, two-drug, two-period, crossover, single-dose trial protocol was designed. Fifty-two healthy Chinese participants were enrolled and randomly classified into fasting (n = 26) and fed (n = 26) group. Fifty of them participated in the whole trial course. Blood samples for pharmacokinetic (PK) analysis were collected 1 h before and up to 24 h after drug administration. To evaluate the bioequivalence of test and reference tablets, PK parameters including maximum plasma drug concentration (Cmax), time to reach maximum concentration (Tmax), area under the plasma concentration-time curve from time 0 to the last measurable concentration (AUC0-t), and area under the plasma concentration-time curve from time 0 to infinity (AUC0-∞) were calculated. Our data revealed that 90% CIs of geometric mean ratio of the test or reference drugs for Cmax, AUC0-t, and AUC0-∞ fell within the acceptance range for bioequivalence (80-125%). Besides, it is worthwhile to mention that Cmax and Tmax in the fed group were lower than those in the fasting group. Interestingly, the absorption, measured by AUC, did not have significant difference in both groups. There were no suspected serious adverse reactions or serious adverse events over the entire trial. Our results demonstrated that the test and reference tablets were bioequivalent under fasting and fed conditions.
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Affiliation(s)
- Xu Zuo
- Phase I Clinical Trial Research Laboratory, Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University, Xinxiang, China
| | - Xin Zhao
- Phase I Clinical Trial Research Laboratory, Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University, Xinxiang, China
| | - Tiandong Zhang
- Phase I Clinical Trial Research Laboratory, Xinxiang Central Hospital, The Fourth Clinical College of Xinxiang Medical University, Xinxiang, China.
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21
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Huang K, Shi Y, Chu N, Que L, Ding Y, Qian Z, Qin W, Gu X, Wang J, Zhang Z, Xu J, He Q. The effect of food on the pharmacokinetics of WXFL10203614, a potential selective JAK1 inhibitor, in healthy Chinese subjects. Front Pharmacol 2022; 13:1066895. [PMID: 36506530 PMCID: PMC9729727 DOI: 10.3389/fphar.2022.1066895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022] Open
Abstract
Objective: This study was performed to investigate the effect of food on the pharmacokinetics (PK) of WXFL10203614 in healthy Chinese subjects. Methods: This was a randomized, open-label, single-dose, two-treatment (fed vs fasted), two-period, two-sequence, crossover study. 14 eligible subjects were averagely randomized into 2 sequences and then received 10 mg WXFL10203614 under fasted or fed condition. In each period, the blood samples were collected from 0 h (pre-dose) and serially up to 72 h post-dose, and plasma concentrations were detected using the high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method. The effect of food on the PK profile and safety of WXFL10203614 were assessed. Results: 70 subjects were screened, and 14 subjects (10 male and 4 female) were enrolled and completed the study. Under the fasted condition, WXFL10203614 was absorbed rapidly with a Tmax of 0.98 h. The absorption rate was slower, Tmax delayed by 2.98 h, and the Cmax decreased by 16.3% when WXFL10203614 administered after the high-fat and high-calorie diet, other PK parameters were not affected. The 90% confidence intervals (CIs) for the ratio (fed/fasted) of geometric means of the Cmax, AUC0-t and AUC0-∞ were 0.73-1.01, 0.90-1.03 and 0.90-1.03, indicating that the high-fat and high-calorie diet might impact the absorption process of WXFL10203614. Although the Cmax was slightly decreased, there was no significant difference in the Cmax under fasted and fed conditions. Thus, it was not considered clinically significant owing to the small magnitude of changes in Cmax. All Treatment-emergent adverse events (TEAEs) were mild and resolved spontaneously without treatment. Conclusion: Food had no clinically relevant effects on drug system exposure of WXFL10203614. It was well tolerated under fasted and fed conditions in healthy Chinese subjects, so WXFL10203614 could be administered orally with or without food. Clinical Trial Registration: http://www.chinadrugtrials.org.cn/index.html, identifier CTR20191636.
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Affiliation(s)
- Kai Huang
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Yunfei Shi
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Nannan Chu
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Linling Que
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Ying Ding
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Zhenzhong Qian
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Wei Qin
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Xianghong Gu
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Jiakun Wang
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Zhiwei Zhang
- Wuxi Fuxin Pharmaceutical Research and Development Co., Ltd., Wuxi, China
| | - Jianguo Xu
- Wuxi Fuxin Pharmaceutical Research and Development Co., Ltd., Wuxi, China
| | - Qing He
- Drug Clinical Trial Institution, Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, China,*Correspondence: Qing He,
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22
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Total Parenteral Nutrition and Neuroleptic Malignant-Like Syndrome in Parkinson Disease. Am J Ther 2022; 29:e709-e710. [PMID: 33021549 DOI: 10.1097/mjt.0000000000001259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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23
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Factors associated with variation in single-dose albendazole pharmacokinetics: A systematic review and modelling analysis. PLoS Negl Trop Dis 2022; 16:e0010497. [DOI: 10.1371/journal.pntd.0010497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/14/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022] Open
Abstract
Background
Albendazole is an orally administered anti-parasitic medication with widespread usage in a variety of both programmatic and clinical contexts. Previous work has shown that the drug’s pharmacologically active metabolite, albendazole sulfoxide, is characterised by substantial inter-individual pharmacokinetic variation. This variation might have implications for the efficacy of albendazole treatment, but current understanding of the factors associated with this variation remains incomplete.
Methodology/Principal findings
We carried out a systematic review to identify references containing temporally disaggregated data on the plasma concentration of albendazole and/or (its pharmacologically-active metabolite) albendazole sulfoxide following a single oral dose. These data were then integrated into a mathematical modelling framework to infer albendazole sulfoxide pharmacokinetic parameters and relate them to characteristics of the groups being treated. These characteristics included age, weight, sex, dosage, infection status, and whether patients had received a fatty meal prior to treatment or other drugs alongside albendazole. Our results highlight a number of factors systematically associated with albendazole sulfoxide pharmacokinetic variation including age, existing parasitic infection and receipt of a fatty meal. Age was significantly associated with variation in albendazole sulfoxide systemic availability and peak plasma concentration achieved; as well as the clearance rate (related to the half-life) after adjusting for variation in dosage due to differences in body weight between children and adults. Receipt of a fatty meal prior to treatment was associated with increased albendazole sulfoxide systemic availability (and by extension, peak plasma concentration and total albendazole sulfoxide exposure following the dose). Parasitic infection (particularly echinococcosis) was associated with altered pharmacokinetic parameters, with infected populations displaying distinct characteristics to uninfected ones.
Conclusions/Significance
These results highlight the extensive inter-individual variation that characterises albendazole sulfoxide pharmacokinetics and provide insight into some of the factors associated with this variation.
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Miedziaszczyk M, Bajon A, Jakielska E, Primke M, Sikora J, Skowrońska D, Idasiak-Piechocka I. Controversial Interactions of Tacrolimus with Dietary Supplements, Herbs and Food. Pharmaceutics 2022; 14:pharmaceutics14102154. [PMID: 36297591 PMCID: PMC9611668 DOI: 10.3390/pharmaceutics14102154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 12/05/2022] Open
Abstract
Tacrolimus is an immunosuppressive calcineurin inhibitor used to prevent rejection in allogeneic organ transplant recipients, such as kidney, liver, heart or lung. It is metabolized in the liver, involving the cytochrome P450 (CYP3A4) isoform CYP3A4, and is characterized by a narrow therapeutic window, dose-dependent toxicity and high inter-individual and intra-individual variability. In view of the abovementioned facts, the aim of the study is to present selected interactions between tacrolimus and the commonly used dietary supplements, herbs and food. The review was based on the available scientific literature found in the PubMed, Scopus and Cochrane databases. An increase in the serum concentration of tacrolimus can be caused by CYP3A4 inhibitors, such as grapefruit, pomelo, clementine, pomegranate, ginger and turmeric, revealing the side effects of this drug, particularly nephrotoxicity. In contrast, CYP3A4 inducers, such as St. John’s Wort, may result in a lack of therapeutic effect by reducing the drug concentration. Additionally, the use of Panax ginseng, green tea, Schisandra sphenanthera and melatonin in patients receiving tacrolimus is highly controversial. Therefore, since alternative medicine constitutes an attractive treatment option for patients, modern healthcare should emphasize the potential interactions between herbal medicines and synthetic drugs. In fact, each drug or herbal supplement should be reported by the patient to the physician (concordance) if it is taken in the course of immunosuppressive therapy, since it may affect the pharmacokinetic and pharmacodynamic parameters of other preparations.
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Affiliation(s)
- Miłosz Miedziaszczyk
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
- Correspondence:
| | - Aleksander Bajon
- Student’s Scientific Section of Nephrology and Clinical Transplantology, 61-701 Poznan, Poland
| | - Ewelina Jakielska
- Student’s Scientific Section of Nephrology and Clinical Transplantology, 61-701 Poznan, Poland
| | - Marta Primke
- Student’s Scientific Section of Nephrology and Clinical Transplantology, 61-701 Poznan, Poland
| | - Jędrzej Sikora
- Student’s Scientific Section of Nephrology and Clinical Transplantology, 61-701 Poznan, Poland
| | - Dagmara Skowrońska
- Student’s Scientific Section of Nephrology and Clinical Transplantology, 61-701 Poznan, Poland
| | - Ilona Idasiak-Piechocka
- Department of Nephrology, Transplantology and Internal Medicine, Poznan University of Medical Sciences, 60-355 Poznan, Poland
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Pawłowska I, Kuźbicka K, Krzyżaniak N, Kocić I. Interactions between selected over-the-counter drugs and food: clinical relevance and prevention. Int J Food Sci Nutr 2022; 73:1005-1018. [PMID: 36068659 DOI: 10.1080/09637486.2022.2119214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The use of medicines is associated with both therapeutic and adverse effects and interactions. In particular, interactions between drugs and food are common, and can either enhance the action of drugs or diminish their effect. Health professionals have a responsibility to screen for and educate patients about food-drug interactions, as well as to assist in decreasing their occurrence. The aim of this study was to identify any interactions present between food and selected over-the-counter (OTC) drugs. Sixty-five publications out of a potential 1112 found in the search were included in the study and among them 28 concerned painkillers, 6 - antihistamines, 4 - nasal decongestants, 10 were for proton pump inhibitors and for iron and 8 for sildenafil. Interactions between food and OTC drugs do exist. These drugs should not be taken regardless of the meal. Providing relevant information to the patient will increase drug safety and efficacy.
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Affiliation(s)
- Iga Pawłowska
- Department of Pharmacology, Medical University of Gdańsk, Gdańsk, Poland
| | - Karolina Kuźbicka
- Department of Pharmacology, Medical University of Gdańsk, Gdańsk, Poland
| | - Natalia Krzyżaniak
- School of Pharmacy, The University of Queensland, Brisbane, Woolloongabba, Australia
| | - Ivan Kocić
- Department of Pharmacology, Medical University of Gdańsk, Gdańsk, Poland
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Karagiannis D, Mitsis K, Nikita KS. Development of a Low-Power IoMT Portable Pillbox for Medication Adherence Improvement and Remote Treatment Adjustment. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22155818. [PMID: 35957374 PMCID: PMC9370836 DOI: 10.3390/s22155818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 05/14/2023]
Abstract
Patients usually deviate from prescribed medication schedules and show reduced adherence. Even when the adherence is sufficient, there are conditions where the medication schedule should be modified. Crucial drug-drug, food-drug, and supplement-drug interactions can lead to treatment failure. We present the development of an internet of medical things (IoMT) platform to improve medication adherence and enable remote treatment modifications. Based on photos of food and supplements provided by the patient, using a camera integrated to a portable 3D-printed low-power pillbox, dangerous interactions with treatment medicines can be detected and prevented. We compare the medication adherence of 14 participants following a complex medication schedule using a functional prototype that automatically receives remote adjustments, to a dummy pillbox where the adjustments are sent with text messages. The system usability scale (SUS) score was 86.79, which denotes excellent user acceptance. Total errors (wrong/no pill) between the functional prototype and the dummy pillbox did not demonstrate any statistically significant difference (p = 0.57), but the total delay of the intake time was higher (p = 0.03) during dummy pillbox use. Thus, the proposed low-cost IoMT pillbox improves medication adherence even with a complex regimen while supporting remote dose adjustment.
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An open label, randomized phase 2 trial assessing the impact of food on the tolerability of abemaciclib in patients with advanced breast cancer. Breast Cancer Res Treat 2022; 195:275-287. [PMID: 35915198 PMCID: PMC9464758 DOI: 10.1007/s10549-022-06690-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/12/2022] [Indexed: 11/11/2022]
Abstract
Purpose Abemaciclib, a CDK4 & 6 inhibitor, is indicated for advanced breast cancer treatment. Diarrhea is a frequently associated adverse event of abemaciclib. The study objective was to investigate if food intake impacts local gastrointestinal toxicity. Methods This Phase 2 study (I3Y-MC-JPCP, NCT03703466) randomized 72 patients 1:1:1 to receive abemaciclib 200 mg monotherapy twice daily (1) with a meal, (2) in a modified fasting state or (3) without regard to food. Primary endpoints included: incidence of investigator assessed severe (≥ Grade 3), prolonged (> 7 days) Grade 2 diarrhea, treatment discontinuation, dose modifications, and loperamide utilization during the first 3 cycles of treatment. Patient outcomes were captured via a daily electronic diary. Pharmacokinetics (PK) are reported. Results Incidence of investigator assessed severe diarrhea (Grade ≥ 3) was 1.4% (1 patient in Arm 1). Median duration of Grade 3 diarrhea was 1 day by both investigator assessment (1 patient in Arm 1) and patient-reported assessment (1 patient each in Arms 1 and 3). Median duration of investigator-assessed Grade 2 diarrhea was 2 days overall. No patient discontinued treatment due to diarrhea. Nine patients (12.7%) had a dose reduction, and 7 patients (9.9%) had a dose omission due to diarrhea. Ninety-four percent of patients used loperamide at least once. Abemaciclib PK was comparable across the 3 arms. Conclusion The results suggest that diarrhea incidence associated with abemaciclib was unrelated to timing of food intake, was predominantly low grade, of short duration and well managed with loperamide and dose modifications. Supplementary Information The online version contains supplementary material available at 10.1007/s10549-022-06690-5.
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28
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Scherf-Clavel O. Drug-Drug Interactions With Over-The-Counter Medicines: Mind the Unprescribed. Ther Drug Monit 2022; 44:253-274. [PMID: 34469416 DOI: 10.1097/ftd.0000000000000924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/21/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND This review provides a summary of the currently available clinical data on drug-drug interactions (DDIs) involving over-the-counter (OTC) medicines. It aims to educate and increase awareness among health care providers and to support decisions in daily practice. METHODS An extensive literature search was performed using bibliographic databases available through PubMed.gov. An initial structured search was performed using the keywords "drug-drug-interaction AND (over-the-counter OR OTC)," without further restrictions except for the language. The initial results were screened for all described DDIs involving OTC drugs, and further information was gathered specifically on these drugs using dedicated database searches and references found in the bibliography from the initial hits. RESULTS From more than 1200 initial hits (1972-June 2021), 408 relevant publications were screened for DDIs involving OTC drugs, leading to 2 major findings: first, certain types of drug regimens are more prone to DDIs or have more serious DDI-related consequences, such as antiretroviral, anti-infective, and oral anticancer therapies. Second, although most DDIs involve OTC drugs as the perpetrators, some prescription drugs (statins or phosphodiesterase-5 inhibitors) that currently have OTC status can be identified as the victims in DDIs. The following groups were identified to be frequently involved in DDIs: nonsteroidal anti-inflammatory drugs, food supplements, antacids, proton-pump inhibitors, H2 antihistamines, laxatives, antidiarrheal drugs, and herbal drugs. CONCLUSIONS The most significant finding was the lack of high-quality evidence for commonly acknowledged interactions. High-quality interaction studies involving different phenotypes in drug metabolism (cytochrome P450) and distribution (transporters) are urgently needed. This should include modern and critical drugs, such as oral anticancer medications and direct oral anticoagulants.
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Affiliation(s)
- Oliver Scherf-Clavel
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Würzburg, Germany
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29
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Bio-enabling strategies to mitigate the pharmaceutical food effect: a mini review. Int J Pharm 2022; 619:121695. [PMID: 35339633 DOI: 10.1016/j.ijpharm.2022.121695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/02/2022] [Accepted: 03/19/2022] [Indexed: 12/27/2022]
Abstract
The concomitant administration of oral drugs with food can result in significant changes in bioavailability, leading to variable pharmacokinetics and considerable clinical implications, such as over- or under-dosing. Consequently, there is increasing demand for bio-enabling formulation strategies to reduce variability in exposure between the fasted and fed state and/or mitigate the pharmaceutical food effect. The current review critically evaluates technologies that have been implemented to overcome the positive food effects of pharmaceutical drugs, including, lipid-based formulations, nanosized drug preparations, cyclodextrins, amorphisation and solid dispersions, prodrugs and salts. Additionally, improved insight into preclinical models for predicting the food effect is provided. Despite the wealth of research, this review demonstrates that application of optimal formulation strategies to mitigate the positive food effects and the evaluation in preclinical models is not a universal approach, and improved standardisation of models to predict the food effects would be desirable. Ultimately, the successful reformulation of specific drugs to eliminate the food effect provides a panoply of advantages for patients with regard to clinical efficacy and compliance.
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30
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Stouras I, Papaioannou TG, Tsioufis K, Eliopoulos AG, Sanoudou D. The Challenge and Importance of Integrating Drug-Nutrient-Genome Interactions in Personalized Cardiovascular Healthcare. J Pers Med 2022; 12:jpm12040513. [PMID: 35455629 PMCID: PMC9033008 DOI: 10.3390/jpm12040513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/12/2022] [Accepted: 03/18/2022] [Indexed: 12/30/2022] Open
Abstract
Despite the rich armamentarium of available drugs against different forms of cardiovascular disease (CVD), major challenges persist in their safe and effective use. These include high rates of adverse drug reactions, increased heterogeneity in patient responses, suboptimal drug efficacy, and in some cases limited compliance. Dietary elements (including food, beverages, and supplements) can modulate drug absorption, distribution, metabolism, excretion, and action, with significant implications for drug efficacy and safety. Genetic variation can further modulate the response to diet, to a drug, and to the interaction of the two. These interactions represent a largely unexplored territory that holds considerable promise in the field of personalized medicine in CVD. Herein, we highlight examples of clinically relevant drug–nutrient–genome interactions, map the challenges faced to date, and discuss their future perspectives in personalized cardiovascular healthcare in light of the rapid technological advances.
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Affiliation(s)
- Ioannis Stouras
- Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, Attikon Hospital Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Theodore G. Papaioannou
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (T.G.P.); (K.T.)
| | - Konstantinos Tsioufis
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (T.G.P.); (K.T.)
| | - Aristides G. Eliopoulos
- Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- Department of Biology, Medical School, National and Kapodistrian University of Athens, 15771 Athens, Greece
- Molecular Biology Division, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Despina Sanoudou
- Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, Attikon Hospital Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- Molecular Biology Division, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
- Correspondence:
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Li X, Mo E, Chen L. Pharmacokinetics and Bioequivalence Evaluation of 2 Olmesartan Medoxomil and Amlodipine Besylate Fixed-Dose Combination Tablets in Healthy Chinese Volunteers Under Fasting and Fed Conditions. Clin Pharmacol Drug Dev 2022; 11:761-769. [PMID: 35289500 DOI: 10.1002/cpdd.1086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/24/2022] [Indexed: 01/19/2023]
Abstract
Combined antihypertensive drugs have become the basic method of treating hypertension. Olmesartan and amlodipine, as representative drugs of angiotensin receptor blockers and calcium channel blockers, were developed as a compound formulation for antihypertensive treatment. The purpose of this study was to evaluate the bioequivalence of olmesartan medoxomil/amlodipine besylate tablet (20 mg/5 mg) under fasting and fed conditions in healthy Chinese volunteers. A phase 1 randomized, open-label, 2-period, single-dose crossover study (n = 56) was designed, with subjects under fasting (n = 28) or fed (n = 28) conditions. Of the 56 enrolled participants, 55 healthy volunteers completed the study. Blood samples for pharmacokinetic analysis were collected from 1.5 hours before dosing to 168 hours after dosing. The 90%CIs for the geometric mean ratios of maximum plasma drug concentration, area under the plasma concentration-time curve (AUC) from time 0 to the last measurable concentration and AUC from time 0 to infinity of the test/reference were all within the acceptance range for bioequivalence (80%-125%). The data showed that the absorption of amlodipine is not affected by food, but the exposure of olmesartan (both AUC from time 0 to the last measurable concentration and AUC from time 0 to infinity were P < .05) reduced significantly after consuming a high-fat meal, which indicates that the effects of food on olmesartan exposure in healthy Chinese were clinically relevant. During the study, there were no suspected serious adverse reactions or serious adverse events. All adverse events were determined to be mild after Common Terminology Criteria for Adverse Events 5.0 evaluation. These results indicated that both the test and reference formulations were bioequivalent with similar safety profiles.
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Affiliation(s)
- Xinjing Li
- College of Pharmacy of Jinan University, Guangzhou, China
| | - Enpan Mo
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lin Chen
- The First Affiliated Hospital of Jinan University, Guangzhou, China
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Diez R, Diez MJ, Garcia JJ, Rodríguez JM, Lopez C, Fernandez N, Sierra M, Sahagun AM. Improvement of Albendazole Bioavailability with Menbutone Administration in Sheep. Animals (Basel) 2022; 12:ani12040463. [PMID: 35203171 PMCID: PMC8868263 DOI: 10.3390/ani12040463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
The pharmacokinetic interaction between a benzimidazole (albendazole, ABZ) and a choleretic drug (menbutone, MEN) was evaluated in sheep. The plasma disposition of albendazole sulfoxide (ABZSO, active metabolite) and albendazole sulfone (ABZSO2, inactive metabolite) was investigated following an oral administration of albendazole (ABZ) (5 mg/kg) alone or with menbutone (MEN) (intramuscular, 10 mg/kg). Blood samples were collected over 3 days post-treatment, and drug plasma concentrations were measured by high performance liquid chromatography (HPLC). ABZSO was measured from 0.5 to 48 h, and ABZSO2 from 2 to 60 h. No parent drug was detected at any sampling time. Mean maximum plasma concentration (Cmax) and the area under the plasma concentration-time curve (AUC) were 12.8% and 21.5% higher for ABZSO when ABZ and MEN were administered together, which indicates a significant increase in the amount absorbed. The rate of absorption was not modified, with similar values for the time to reach Cmax (tmax) (11.5 h with ABZ + MEN and 10.7 h with ABZ treatment), although no significant differences were observed for these latter pharmacokinetic parameters. Regarding ABZSO2, Cmax, AUC and tmax values were similar after both treatments (ABZ or ABZ + MEN). The results obtained indicate that co-administration of ABZ and MEN may be an interesting and practical option to increase the efficacy of this anthelmintic.
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Affiliation(s)
| | | | | | | | - Cristina Lopez
- Correspondence: (C.L.); (A.M.S.); Tel.: +34-987-291846 (C.L. & A.M.S.)
| | | | | | - Ana M. Sahagun
- Correspondence: (C.L.); (A.M.S.); Tel.: +34-987-291846 (C.L. & A.M.S.)
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Siritientong T, Thet D, Methaneethorn J, Leelakanok N. Pharmacokinetic Outcomes of the Interactions of Antiretroviral Agents with Food and Supplements: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:520. [PMID: 35276881 PMCID: PMC8840371 DOI: 10.3390/nu14030520] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/19/2022] [Accepted: 01/23/2022] [Indexed: 12/04/2022] Open
Abstract
Because pharmacokinetic changes in antiretroviral drugs (ARV), due to their concurrent administration with food or nutritional products, have become a clinical challenge, it is necessary to monitor the therapeutic efficacy of ARV in people living with the human immunodeficiency virus (PLWH). A systematic review and meta-analysis were conducted to clarify the pharmacokinetic outcomes of the interaction between supplements such as food, dietary supplements, and nutrients, and ARV. Twenty-four articles in both healthy subjects and PLWH were included in the qualitative analysis, of which five studies were included in the meta-analysis. Food−drug coadministration significantly increased the time to reach maximum concentration (tmax) (p < 0.00001) of ARV including abacavir, amprenavir, darunavir, emtricitabine, lamivudine, zidovudine, ritonavir, and tenofovir alafenamide. In addition, the increased maximum plasma concentration (Cmax) of ARV, such as darunavir, under fed conditions was observed. Area under the curve and terminal half-life were not significantly affected. Evaluating the pharmacokinetic aspects, it is vital to clinically investigate ARV and particular supplement interaction in PLWH. Educating patients about any potential interactions would be one of the effective recommendations during this HIV epidemic.
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Affiliation(s)
- Tippawan Siritientong
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
- Center of Excellence in Burn and Wound Care, Chulalongkorn University, Bangkok 10330, Thailand
| | - Daylia Thet
- Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Janthima Methaneethorn
- Pharmacokinetic Research Unit, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand;
- Center of Excellence for Environmental Health and Toxicology, Naresuan University, Phitsanulok 65000, Thailand
| | - Nattawut Leelakanok
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand;
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A novel graph mining approach to predict and evaluate food-drug interactions. Sci Rep 2022; 12:1061. [PMID: 35058561 PMCID: PMC8776972 DOI: 10.1038/s41598-022-05132-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/05/2022] [Indexed: 12/26/2022] Open
Abstract
Food-drug interactions (FDIs) arise when nutritional dietary consumption regulates biochemical mechanisms involved in drug metabolism. This study proposes FDMine, a novel systematic framework that models the FDI problem as a homogenous graph. Our dataset consists of 788 unique approved small molecule drugs with metabolism-related drug-drug interactions and 320 unique food items, composed of 563 unique compounds. The potential number of interactions is 87,192 and 92,143 for disjoint and joint versions of the graph. We defined several similarity subnetworks comprising food-drug similarity, drug-drug similarity, and food-food similarity networks. A unique part of the graph involves encoding the food composition as a set of nodes and calculating a content contribution score. To predict new FDIs, we considered several link prediction algorithms and various performance metrics, including the precision@top (top 1%, 2%, and 5%) of the newly predicted links. The shortest path-based method has achieved a precision of 84%, 60% and 40% for the top 1%, 2% and 5% of FDIs identified, respectively. We validated the top FDIs predicted using FDMine to demonstrate its applicability, and we relate therapeutic anti-inflammatory effects of food items informed by FDIs. FDMine is publicly available to support clinicians and researchers.
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Assessment of knowledge of drug-food interactions among healthcare professionals in public sector hospitals in eThekwini, KwaZulu-Natal. PLoS One 2021; 16:e0259402. [PMID: 34731227 PMCID: PMC8565720 DOI: 10.1371/journal.pone.0259402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 10/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background Foods and the nutrients they contain can interact with drugs and thereby interfere with their therapeutic safety and efficacy. Adequate knowledge of healthcare professionals (HCPs) about drug-food interactions can help in preventing potential drug-food interactions among patients. This study aimed to assess the knowledge of HCPs about common drug-food interactions. Methods A cross-sectional study was carried out among 459 HCPs from three public hospitals in eThekwini district, KwaZulu-Natal between November 2018, and January 2019. Informed consent was obtained from the HCPs, and a structured questionnaire was thereafter administered. Data were analysed using SPSS® version 25. Factors associated with knowledge of the HCPs were determined using logistic regression analysis. Results Of the 459 participants, 22.2% (n = 102) were doctors, 11.3% (n = 52) pharmacists, 63.8% (n = 293) nurses and 2.6% (n = 12) dietitians. Most of the HCPs were females 79.7% (n = 366), the mean age of the HCPs was 38.61±0.48. The knowledge score of the HCPs was 22.66±0.25 out of an overall score of 46. The HCPs poorly identified food types that interact with drugs and correct administration time of drugs relative to meals. Being a pharmacist (OR: 14.212, CI: 4.941–40.879, p<0.001), doctor (OR: 5.223, CI: 2.146–12.711, p<0.001), or a dietitian (OR: 5.476, CI: 1.103–27.191, p = 0.038) was associated with higher knowledge of drug-food interactions. Conclusion The HCPs in this survey had low drug-food interaction knowledge. These findings suggest the need for additional training and educational courses for the HCPs on drug-food interactions.
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Preparation and Pharmacokinetic Characterization of an Anti-Virulence Compound Nanosuspensions. Pharmaceutics 2021; 13:pharmaceutics13101586. [PMID: 34683879 PMCID: PMC8540953 DOI: 10.3390/pharmaceutics13101586] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/23/2021] [Accepted: 09/25/2021] [Indexed: 12/05/2022] Open
Abstract
Antibiotic resistance has become a worldwide public health threat due to the rapid evolution and spread of antibiotic-resistant bacteria. CCG-211790 is a novel anti-virulence compound that does not kill bacteria but could ameliorate human diseases by inhibiting expression of virulence factors, thereby applying less selection pressure for antibiotic resistance. However, its potential clinical use is restricted because of its poor aqueous solubility, resulting in formulation challenges. Nanosuspension technology is an effective way to circumvent this problem. Nanosuspensions of CCG-211790 with two different particle sizes, NanoA (315 ± 6 nm) and NanoB (915 ± 24 nm), were prepared using an antisolvent precipitation-ultrasonication method with Tween 80 as the stabilizer. Particle and pharmacokinetics (PK) of CCG-211790 nanosuspensions were characterized. Both NanoA and NanoB demonstrated remarkable increases in dissolution rate compared with the bulk compound. The PK parameters of NanoA were comparable to those of CCG-211790 solution formulation in intravenous or oral administration, suggesting that CCG-211790 nanosuspensions with smaller particle size improved oral bioavailability and drug exposure compared to traditional formulations of drug candidates.
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Zietek T, Boomgaarden WAD, Rath E. Drug Screening, Oral Bioavailability and Regulatory Aspects: A Need for Human Organoids. Pharmaceutics 2021; 13:1280. [PMID: 34452240 PMCID: PMC8399541 DOI: 10.3390/pharmaceutics13081280] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 12/31/2022] Open
Abstract
The intestinal epithelium critically contributes to oral bioavailability of drugs by constituting an important site for drug absorption and metabolism. In particular, intestinal epithelial cells (IEC) actively serve as gatekeepers of drug and nutrient availability. IECs' transport processes and metabolism are interrelated to the whole-body metabolic state and represent potential points of origin as well as therapeutic targets for a variety of diseases. Human intestinal organoids represent a superior model of the intestinal epithelium, overcoming limitations of currently used in vitro models. Caco-2 cells or rodent explant models face drawbacks such as their cancer and non-human origin, respectively, but are commonly used to study intestinal nutrient absorption, enterocyte metabolism and oral drug bioavailability, despite poorly correlative data. In contrast, intestinal organoids allow investigating distinct aspects of bioavailability including spatial resolution of transport, inter-individual differences and high-throughput screenings. As several countries have already developed strategic roadmaps to phase out animal experiments for regulatory purposes, intestinal organoid culture and organ-on-a-chip technology in combination with in silico approaches are roads to go in the preclinical and regulatory setup and will aid implementing the 3Rs (reduction, refinement and replacement) principle in basic science.
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Affiliation(s)
- Tamara Zietek
- Doctors against Animal Experiments, 51143 Köln, Germany
| | | | - Eva Rath
- Chair of Nutrition and Immunology, Technische Universität München, 85354 Freising, Germany
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Osuala EC, Ojewole EB. Knowledge, attitudes and practices of healthcare professionals regarding drug-food interactions: a scoping review. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:406-415. [PMID: 34355752 DOI: 10.1093/ijpp/riab049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/12/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Drug-food interactions (DFIs) are a problem in clinical practice as they can alter the bioavailability of drugs and nutrients and may lead to various adverse effects. Healthcare professionals (HCPs) play a significant role in counselling patients and preventing these interactions. Knowledge, attitudes and practices (KAPs) regarding DFIs are, therefore, vital to ensure that they carry out their role efficiently. This review maps evidence on KAPs of HCPs regarding DFIs and highlights gaps for further research. METHODS A systematic literature search for the period from 1990 to 2018 was done using Google Scholar, PubMed and ScienceDirect. Keywords such as 'knowledge, attitudes, practices, healthcare professionals, drug-food interactions' in combination with the Boolean operator (AND) were used. Articles published only in English that described KAPs of HCPs relating to DFIs were included. KEY FINDINGS Twelve studies were included in this review. Inadequate knowledge was observed among the HCPs as they were unable to identify important DFIs. The HCPs had a positive attitude towards acquiring knowledge, reporting and counselling patients on DFIs. Most of the medical residents felt that they were inadequately trained on DFIs and over half believed that DFIs were only slightly important in clinical practice. CONCLUSION Deficits exist in the KAPs of HCPs regarding DFIs. An educational intervention targeting HCPs is recommended. Further research assessing the KAPs of the HCPs is required as the small number of studies conducted was a limitation.
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Affiliation(s)
- Emmanuella Chinonso Osuala
- Discipline of Pharmaceutical Sciences, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Elizabeth Bolanle Ojewole
- Discipline of Pharmaceutical Sciences, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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The Impact of Diet and Exercise on Drug Responses. Int J Mol Sci 2021; 22:ijms22147692. [PMID: 34299312 PMCID: PMC8304791 DOI: 10.3390/ijms22147692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/15/2021] [Indexed: 12/14/2022] Open
Abstract
It is well known that lifestyle changes can alter several physiological functions in the human body. For exercise and diet, these effects are used sensibly in basic therapies, as in cardiovascular diseases. However, the physiological changes induced by exercise and a modified diet also have the capacity to influence the efficacy and toxicity of several drugs, mainly by affecting different pharmacokinetic mechanisms. This pharmacological plasticity is not clinically relevant in all cases but might play an important role in altering the effects of very common drugs, particularly drugs with a narrow therapeutic window. Therefore, with this review, we provide insights into possible food–drug and exercise–drug interactions to sharpen awareness of the potential occurrence of such effects.
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Fournier E, Roussel C, Dominicis A, Ley D, Peyron MA, Collado V, Mercier-Bonin M, Lacroix C, Alric M, Van de Wiele T, Chassard C, Etienne-Mesmin L, Blanquet-Diot S. In vitro models of gut digestion across childhood: current developments, challenges and future trends. Biotechnol Adv 2021; 54:107796. [PMID: 34252564 DOI: 10.1016/j.biotechadv.2021.107796] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 02/08/2023]
Abstract
The human digestion is a multi-step and multi-compartment process essential for human health, at the heart of many issues raised by academics, the medical world and industrials from the food, nutrition and pharma fields. In the first years of life, major dietary changes occur and are concomitant with an evolution of the whole child digestive tract anatomy and physiology, including colonization of gut microbiota. All these phenomena are influenced by child exposure to environmental compounds, such as drugs (especially antibiotics) and food pollutants, but also childhood infections. Due to obvious ethical, regulatory and technical limitations, in vivo approaches in animal and human are more and more restricted to favor complementary in vitro approaches. This review summarizes current knowledge on the evolution of child gut physiology from birth to 3 years old regarding physicochemical, mechanical and microbial parameters. Then, all the available in vitro models of the child digestive tract are described, ranging from the simplest static mono-compartmental systems to the most sophisticated dynamic and multi-compartmental models, and mimicking from the oral phase to the colon compartment. Lastly, we detail the main applications of child gut models in nutritional, pharmaceutical and microbiological studies and discuss the limitations and challenges facing this field of research.
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Affiliation(s)
- Elora Fournier
- Université Clermont Auvergne, INRAE, UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, CRNH Auvergne, 63000 Clermont-Ferrand, France; Toxalim, Research Centre in Food Toxicology, INRAE, ENVT, INP-Purpan, UPS, Université de Toulouse, 31000 Toulouse, France
| | - Charlène Roussel
- Laval University, INAF Institute of Nutrition and Functional Foods, G1V 0A6 Quebec, Canada
| | - Alessandra Dominicis
- European Reference Laboratory for E. coli, Istituto Superiore di Sanità, Rome, Italy
| | - Delphine Ley
- Université Lille 2, Faculté de Médecine, Inserm U995 Nutritional Modulation of Infection and Inflammation, 59045 Lille, France
| | - Marie-Agnès Peyron
- Université Clermont Auvergne, INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Valérie Collado
- Université Clermont Auvergne, EA 4847, CROC, Centre de Recherche en Odontologie Clinique, 63000 Clermont-Ferrand, France
| | - Muriel Mercier-Bonin
- Toxalim, Research Centre in Food Toxicology, INRAE, ENVT, INP-Purpan, UPS, Université de Toulouse, 31000 Toulouse, France
| | - Christophe Lacroix
- Laboratory of Food Biotechnology, Institute of Food, Nutrition and Health, ETH Zurich, 8092 Zürich, Switzerland
| | - Monique Alric
- Université Clermont Auvergne, INRAE, UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Tom Van de Wiele
- Ghent University, Center for Microbial Ecology and Technology (CMET), Coupure Links 653, 9000 Ghent, Belgium
| | - Christophe Chassard
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMRF, 15000 Aurillac, France
| | - Lucie Etienne-Mesmin
- Université Clermont Auvergne, INRAE, UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, CRNH Auvergne, 63000 Clermont-Ferrand, France
| | - Stéphanie Blanquet-Diot
- Université Clermont Auvergne, INRAE, UMR 454 MEDIS, Microbiologie Environnement Digestif et Santé, CRNH Auvergne, 63000 Clermont-Ferrand, France.
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Bækdal TA, Breitschaft A, Donsmark M, Maarbjerg SJ, Søndergaard FL, Borregaard J. Effect of Various Dosing Conditions on the Pharmacokinetics of Oral Semaglutide, a Human Glucagon-Like Peptide-1 Analogue in a Tablet Formulation. Diabetes Ther 2021; 12:1915-1927. [PMID: 34080123 PMCID: PMC8266944 DOI: 10.1007/s13300-021-01078-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/10/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Oral semaglutide is a novel tablet formulation of the human glucagon-like peptide-1 analogue semaglutide. In two trials, the effects of prior food ingestion (food effect), post-dose fasting period and water volume with dosing (dosing conditions) on oral semaglutide pharmacokinetics were investigated. METHODS Subjects received once-daily oral semaglutide for 10 days. In the food-effect trial, 78 healthy subjects were randomised 1:1:1 to fed (meal 30 min pre-dose; 240 mL water with dosing), fasting (overnight until 4 h post-dose; 240 mL) or reference (fasting overnight until 30 min post-dose; 120 mL) arms. In the dosing conditions trial, 161 healthy men were randomised into eight dosing groups (overnight fasted with 50/120 mL water and 15/30/60/120 min post-dose fasting). Semaglutide plasma concentrations were measured frequently until 504 h after the 10th dose. RESULTS In the food-effect trial, limited or no measurable semaglutide exposure was observed in the fed arm, while all subjects in the fasting arm had measurable semaglutide exposure. Area under the semaglutide concentration-time curve (AUC0-24h,semaglutide,day10) and maximum semaglutide concentration (Cmax,semaglutide,day10) were numerically greater by approximately 40% for the fasting versus reference arm (p = 0.082 and p = 0.080, respectively). In the dosing conditions trial, AUC0-24h,semaglutide,day10 and Cmax,semaglutide,day10 were not different between water volumes (p = 0.541 and p = 0.676), but increased with longer post-dose fasting (p < 0.001). CONCLUSION Administration of oral semaglutide in the fasting state with up to 120 mL water and at least 30 min post-dose fasting results in clinically relevant semaglutide exposure. These dosing conditions have been used in the oral semaglutide phase 3 trials and are part of the approved label. TRIAL REGISTRATION ClinicalTrials.gov identifiers NCT02172313, NCT01572753.
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Affiliation(s)
- Tine A Bækdal
- Novo Nordisk A/S, Vandtårnsvej 114, 2860, Søborg, Denmark.
| | - Astrid Breitschaft
- Early Phase Clinical Unit - Berlin, Parexel International GmbH, Klinikum Westend - Haus 18, Spandauer Damm 130, 14050, Berlin, Germany
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The Effect of Single-Dose Ougan Juice Application on the Pharmacokinetics of Erlotinib. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6679082. [PMID: 34195278 PMCID: PMC8214503 DOI: 10.1155/2021/6679082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 05/11/2021] [Accepted: 05/29/2021] [Indexed: 12/02/2022]
Abstract
The aim of our study was to investigate the effects of single-dose Ougan (Citrus reticulata cv. Suavissima) juice application on the pharmacokinetics of erlotinib in vivo. Twelve Sprague-Dawley rats were randomly divided into the Ougan juice and control groups (n = 6 each). The rats were given a single dose of 1 mL/100 g Ougan juice or 1 mL/100 g normal saline (NS) by intragastric administration, followed by a single oral administration of 20 mg/kg erlotinib. The plasma concentration of erlotinib in rats was determined using ultra performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS). Erlotinib-d6 was used as the internal standard for chromatographic analysis on the UPLC BEH C18 analysis column (2.1 mm × 50 mm, 1.7 μm). The mobile phase was composed of acetonitrile and 0.1% formic acid eluting by gradient. Different pharmacokinetic (PK) parameters of erlotinib were calculated. The Ougan juice promoted the absorption of erlotinib and reduced the clearance of the drug. The area under the curve of erlotinib in the single-dose Ougan juice pretreatment group was approximately 1.87 times higher, and the maximum blood concentration (Cmax) was approximately 1.34 times higher than that in the control group. The mean residence time of erlotinib in the Ougan juice group was larger, and the clearance rate was smaller than those in the control group; the difference was statistically significant (P < 0.05). Ougan juice affected the PK spectrum of erlotinib in rats by improving the bioavailability of the drug and significantly increasing its plasma concentration.
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Ochoa D, Saiz-Rodríguez M, González-Rojano E, Román M, Sánchez-Rojas S, Wojnicz A, Ruiz-Nuño A, García-Arieta A, Abad-Santos F. High-Fat Breakfast Increases Bioavailability of Albendazole Compared to Low-Fat Breakfast: Single-Dose Study in Healthy Subjects. Front Pharmacol 2021; 12:664465. [PMID: 33935787 PMCID: PMC8082448 DOI: 10.3389/fphar.2021.664465] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/22/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose: Albendazole is a benzimidazole carbamate drug with anthelmintic and antiprotozoal activity against intestinal and tissue parasites. It has been described that the administration with meals increases albendazole absorption. Our aim was to compare the systemic exposure in healthy volunteers of two albendazole formulations after a single oral dose under fed conditions and to evaluate the effect of breakfast composition on albendazole and albendazole sulfoxide bioavailability. Methods: 12 healthy volunteers were included in a 4-period, 4-sequence, crossover, open, randomized, bioequivalence clinical trial, including two stages to compare two formulations of albendazole. Single oral doses of 400 mg albendazole were administered under fed conditions (a low-fat breakfast in first stage and a high-fat breakfast in the second) separated by 7-day washout periods. Plasma albendazole and albendazole sulfoxide concentrations were measured by HPLC-MS/MS. Findings: Albendazole absorption was clearly influenced by the meal composition. A high-fat breakfast increased albendazole and albendazole sulfoxide area under the concentration-time curve (AUC) and maximum concentration (Cmax) by double, compared to a low-fat breakfast. The bioavailability of the two formulations was very similar, although the sample size was not sufficient to demonstrate bioequivalence because the intraindividual variability of albendazole was approximately 60%. Implications: The higher albendazole and albendazole sulfoxide levels when administered with a high-fat meal could be of importance in clinical practice. Since albendazole labeling recommends its administration with meals, it is necessary to insist on taking it with a fatty meal so that the effectiveness of albendazole is not compromised.
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Affiliation(s)
- Dolores Ochoa
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
- UICEC Hospital Universitario de La Princesa, Plataforma SCReN (Spanish Clinical Reseach Network), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
| | - Miriam Saiz-Rodríguez
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
- Research Unit, Fundación Burgos por La Investigación de La Salud, Hospital Universitario de Burgos, Burgos, Spain
| | - Esperanza González-Rojano
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
| | - Manuel Román
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
- UICEC Hospital Universitario de La Princesa, Plataforma SCReN (Spanish Clinical Reseach Network), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
| | - Sergio Sánchez-Rojas
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
| | - Aneta Wojnicz
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
| | - Ana Ruiz-Nuño
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
| | - Alfredo García-Arieta
- Service on Pharmacokinetics and Generics, Division of Pharmacology and Clinical Evaluation, Department of Human Use Medicines, Spanish Agency for Medicines and Health Care Products, Madrid, Spain
| | - Francisco Abad-Santos
- Clinical Pharmacology Department, Hospital Universitario de La Princesa, Instituto Teófilo Hernando, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
- UICEC Hospital Universitario de La Princesa, Plataforma SCReN (Spanish Clinical Reseach Network), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain
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Zaidi SF, Mgarry R, Alsanea A, Almutairi SK, Alsinnari Y, Alsobaei S, Ahmed K. A Questionnaire-Based Survey to Assess the Level of Knowledge and Awareness about Drug-Food Interactions among General Public in Western Saudi Arabia. PHARMACY 2021; 9:pharmacy9020076. [PMID: 33917944 PMCID: PMC8167613 DOI: 10.3390/pharmacy9020076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: Various drug-food interactions exist that may hinder treatment and can sometimes be lethal. Our aim was to assess the level of public knowledge and awareness in Jeddah city, Western Saudi Arabia, about drug-food interactions, along with the effects of demographics on their knowledge. Methods: A survey questionnaire was administered in this cross-sectional study to participants spread across multiple locations in Jeddah, including in malls and public gatherings. Participants included both males and females. Sample size was calculated through Raosoft® software. Data analysis was executed using IBM Statistic SPSS and the level of statistical significance was set at p < 0.05. Results: A total of 410 people participated in the study and only 92.68% (380) of responses were enrolled in the study; 7.32% (30) were not enrolled due to the exclusion criteria. Surprisingly, only six out of eighteen questions regarding drug-food interactions in the administered questionnaire were correctly answered by 380 participants. Data indicated that the participants had a poor to intermediate level of both knowledge and awareness with respect to drug-food interactions. Furthermore, participants showed moderate to strong awareness of the effects of alcohol and tea generally, and their interaction with medication. Conclusion: Participants in our study showed inadequate knowledge of basic and fundamental information about drug-food interactions, which highlights the dire need to increase awareness.
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Affiliation(s)
- Syed Faisal Zaidi
- College of Medicine, King Saud bin Abdulaziz University for Health Science, Jeddah 21423, Saudi Arabia; (R.M.); (A.A.); (S.K.A.); (Y.A.); (S.A.); (K.A.)
- Department of Pharmacology, School of Medicine, Batterjee Medical College for Sciences and Technology, Jeddah 21442, Saudi Arabia
- Correspondence: ; Tel.: +966-553543869
| | - Rayan Mgarry
- College of Medicine, King Saud bin Abdulaziz University for Health Science, Jeddah 21423, Saudi Arabia; (R.M.); (A.A.); (S.K.A.); (Y.A.); (S.A.); (K.A.)
| | - Abdullah Alsanea
- College of Medicine, King Saud bin Abdulaziz University for Health Science, Jeddah 21423, Saudi Arabia; (R.M.); (A.A.); (S.K.A.); (Y.A.); (S.A.); (K.A.)
| | - Sakar Khalid Almutairi
- College of Medicine, King Saud bin Abdulaziz University for Health Science, Jeddah 21423, Saudi Arabia; (R.M.); (A.A.); (S.K.A.); (Y.A.); (S.A.); (K.A.)
| | - Yaser Alsinnari
- College of Medicine, King Saud bin Abdulaziz University for Health Science, Jeddah 21423, Saudi Arabia; (R.M.); (A.A.); (S.K.A.); (Y.A.); (S.A.); (K.A.)
| | - Saad Alsobaei
- College of Medicine, King Saud bin Abdulaziz University for Health Science, Jeddah 21423, Saudi Arabia; (R.M.); (A.A.); (S.K.A.); (Y.A.); (S.A.); (K.A.)
| | - Kanwal Ahmed
- College of Medicine, King Saud bin Abdulaziz University for Health Science, Jeddah 21423, Saudi Arabia; (R.M.); (A.A.); (S.K.A.); (Y.A.); (S.A.); (K.A.)
- Fakeeh College for Medical Sciences, Jeddah 21461, Saudi Arabia
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Thiab S, Barakat M, Al-Qudah R, Abutaima R, Jamal R, Riby P. The perception of Jordanian population towards concomitant administration of food, beverages and herbs with drugs and their possible interactions: A cross-sectional study. Int J Clin Pract 2021; 75:e13780. [PMID: 33098614 DOI: 10.1111/ijcp.13780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Many people are used to administering their drugs with food, beverages or herbs. These substances may contain chemicals that interfere with the prescribed drugs and could potentially lead to changes in their efficacy or safety, and could result in alterations in their pharmacokinetic properties. OBJECTIVE To assess the extent of the perception and consumption of food, beverages and herbs alongside conventional drugs, along with their potential interactions, specifically in Jordanian society. METHODS A descriptive cross-sectional survey was conducted in Jordan (20 April - 5 May 2020). The survey was developed using Google Forms, then validated and distributed via social media platforms. Data were analysed using Statistical Package for Social Sciences-24. MAIN OUTCOME MEASURE Use and perception of food, beverages, herbs and how they interact with drugs among Jordanians. RESULTS Of all the participants (n = 789), 77.8% were females, 46.2% were 50-year-olds, 69.7% were married, 70.8% were medically insured, and 51.1% had bachelor's degrees. 70% of the study participants reported use of medicinal plants. About 66% of participants agreed that medicinal plants or herbs could treat diseases and 58.6% thought that medications could interact with drugs. In general, the participants' knowledge about food/beverage/herb-drug interactions was considered poor. However, a linear regression analysis showed that the level of knowledge was significantly affected (P < .05) by gender, marital status, social status, educational level and employment sector. CONCLUSION Jordanians have a positive perception towards herbs and their ability to treat diseases. However, their knowledge about food/beverage-drug interactions was poor. There is therefore a need to enhance the community awareness of food/beverage/herb-drug interactions.
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Affiliation(s)
- Samar Thiab
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Muna Barakat
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Raja'a Al-Qudah
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Rana Abutaima
- Faculty of Pharmacy, Zarqa Private University, Zarqa, Jordan
| | - Rahma Jamal
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Philip Riby
- The University of Manchester, Manchester, United Kingdom
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In vitro antagonistic inhibitory effects of palm seed crude oils and their main constituent, lauric acid, with oxacillin in Staphylococcus aureus. Sci Rep 2021; 11:177. [PMID: 33420288 PMCID: PMC7794437 DOI: 10.1038/s41598-020-80481-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022] Open
Abstract
Infections caused by Staphylococcus aureus are a serious global threat, and with the emergence of antibiotic resistance, even more difficult to treat. One of the possible complications in antistaphylococcal therapy represents negative interactions of antibiotics with food. In this study, the in vitro interaction between oxacillin and crude palm seed oil from Astrocaryum vulgare, Cocos nucifera, and Elaeis guineensis against nine strains of S. aureus was determined using the checkerboard method. Lauric acid was identified as a major constituent of all tested oils by gas chromatography. The results showed strong concentration dependent antagonistic interactions between palm oils and oxacillin with values of fractional inhibitory concentrations indices ranging from 4.02 to 8.56 at concentrations equal or higher than 1024 µg/mL of the tested oils. Similarly, lauric acid in combination with oxacillin produced antagonistic action with fractional inhibitory concentration indices ranging from 4.01 to 4.28 at 1024 µg/mL. These findings suggest that interference between oxacillin and palm oils and their constituents can negatively affect the treatment of staphylococcal infections in humans and other animals.
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The Effect of Food Intake on the Pharmacokinetics of Oral Basal Insulin: A Randomised Crossover Trial in Healthy Male Subjects. Clin Pharmacokinet 2020; 58:1497-1504. [PMID: 31093929 PMCID: PMC6856260 DOI: 10.1007/s40262-019-00772-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Oral insulin 338 is a novel tablet formulation of a long-acting basal insulin. This randomised, open-label, four-period crossover trial investigated the effect of timing of food intake on the single-dose pharmacokinetic properties of oral insulin 338. Methods After an overnight fast, 44 healthy males received single fixed doses of oral insulin 338 administered 0, 30, 60 or 360 min before consuming a standardised meal (500 kcal, 57 energy percent [E%] carbohydrate, 13 E% fat, 30 E% protein). Blood samples for pharmacokinetic assessment were taken up to 288 h post-dose. Results Total exposure (area under the concentration-time curve from time zero to infinity [AUCIns338,0–∞]) and maximum concentration (Cmax,Ins338) of insulin 338 were both significantly lower for 0 versus 360 min post-dose fasting (ratio [95% confidence interval (CI)]: 0.36 [0.26–0.49], p < 0.001, and 0.35 [0.25–0.49], p < 0.001, respectively). There were no significant differences in AUCIns338,0–∞ and Cmax,Ins338 for 30 or 60 versus 360 min post-dose fasting (ratio [95% CI] 30 versus 360 min: 0.85 [0.61–1.21], p = 0.36, and 0.86 [0.59–1.26], p = 0.42; ratio [95% CI] 60 versus 360 min: 0.96 [0.72–1.28], p = 0.77, and 0.99 [0.75–1.31], p = 0.95). The mean half-life was ~ 55 h independent of the post-dose fasting period. Oral insulin 338 was well-tolerated with no safety issues identified during the trial. Conclusions Oral insulin 338 pharmacokinetics are not affected by food intake from 30 min after dosing, implying that patients with diabetes mellitus do not need to wait more than 30 min after a morning dose of oral insulin 338 before having their breakfast. This is considered important for convenience and treatment compliance. ClinicalTrials.gov identifier NCT02304627. Electronic supplementary material The online version of this article (10.1007/s40262-019-00772-2) contains supplementary material, which is available to authorized users.
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Zawiah M, Yousef AM, Khan AH, AL-Ashwal FY, Matar A, ALKhawaldeh B, Nassar R, Abduljabbar R, Abdo Ahmed AA. Food-drug interactions: Knowledge among pharmacists in Jordan. PLoS One 2020; 15:e0234779. [PMID: 32555684 PMCID: PMC7299397 DOI: 10.1371/journal.pone.0234779] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/02/2020] [Indexed: 01/27/2023] Open
Abstract
Background Pharmacists have crucial role in providing drug information and medication counseling to patients. This survey aimed to benchmark the current knowledge of the pharmacists concerning food-drug interactions (FDIs) in Jordan. Methods A cross-sectional study was conducted in Amman, the capital and largest city of Jordan, using a validated questionnaire. It was distributed to pharmacists working in community and hospital pharmacies using a convenience sampling technique. Descriptive and inferential statistics were performed in this study. Results A total of 340 questionnaires distributed, 300 (88%) pharmacists responded. Over 50% of pharmacists claimed that they have sufficient knowledge regarding FDI. Virtually, the overall median (interquartile range) knowledge score was 18 (15–21), approximately 60%. The highest knowledge scores were for alcohol-drug interactions section (66.6%) followed by both common food-drug interactions and the timing of drug intake to food consumption sections with a score of (58.3%) for each, reflecting a suboptimal knowledge of FDIs among the pharmacists. Conclusion Pharmacists had unsatisfactory knowledge about common FDIs, with no significant difference between hospital and community pharmacists. Therefore, more attention and efforts should be played to improve awareness about potential food-drug interactions.
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Affiliation(s)
- Mohammed Zawiah
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | - Al-Motassem Yousef
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
- * E-mail: ,
| | - Amer Hayat Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | - Fahmi Y. AL-Ashwal
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | - Amal Matar
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Batool ALKhawaldeh
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Rand Nassar
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Rami Abduljabbar
- College of Pharmacy, Yemeni University of Sciences and Technology, Taizz, Yemen
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Requena-Méndez A, Davies G, Waterhouse D, Ardrey A, Jave O, López-Romero SL, Ward SA, Moore DAJ. Intra-individual effects of food upon the pharmacokinetics of rifampicin and isoniazid. J Antimicrob Chemother 2020; 74:416-424. [PMID: 30412245 DOI: 10.1093/jac/dky444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 10/01/2018] [Indexed: 01/21/2023] Open
Abstract
Background Poor response to TB therapy might be attributable to subtherapeutic levels in drug-compliant patients. Pharmacokinetic parameters can be affected by comorbidities or the interaction of drugs with food. Objectives This study aimed to determine the effect of food intake upon pharmacokinetics of rifampicin and isoniazid in a Peruvian population with TB. Methods Rifampicin and isoniazid levels were analysed at 2, 4 and 6 h after drug intake in both fasting and non-fasting states using LC-MS methods. Results Sixty patients participated in the study. The median rifampicin Cmax and AUC0-6 were higher during fasting than non-fasting: 7.02 versus 6.59 mg/L (P = 0.054) and 28.64 versus 24.31 mg·h/L (P = 0.002). There was a statistically significant delay overall of non-fasting Tmax compared with the fasting state Tmax (P = 0.005). In the multivariate analysis, besides the effect of fasting, Cmax for females was 20% higher than for males (P = 0.03). Concerning isoniazid, there were significant differences in the Cmax during non-fasting (median = 3.51 mg/L) compared with fasting (4.54 mg/L). The isoniazid dose received had an effect upon the isoniazid levels (1.26, P = 0.038). In the multivariate analysis, isoniazid exposure during fasting was found to be 14% higher than during non-fasting (CI = 1.02-1.28, P < 0.001). Neither radiological extent of the disease nor consumption of food with drug intake nor pharmacokinetics of rifampicin or isoniazid was associated with a poorer treatment outcome. Conclusions Rifampicin in particular and isoniazid pharmacokinetics were significantly affected by the intake of the drug with food between and within individuals.
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Affiliation(s)
- Ana Requena-Méndez
- Barcelona Institute for Global Health (ISGlobal-CRESIB), Hospital Clinic-Universitat de Barcelona, Barcelona, Spain
| | - Geraint Davies
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - David Waterhouse
- Department of Molecular Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Alison Ardrey
- Department of Molecular Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Oswaldo Jave
- Servicio de Pneumología, Hospital Dos de Mayo, Lima, Peru
| | - Sonia Llanet López-Romero
- Laboratorio de Investigación de Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Stephen A Ward
- Department of Molecular Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David A J Moore
- TB Centre and Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Schultze AE, Bennet B, Rae JC, Chiang AY, Frazier K, Katavolos P, McKinney L, Patrick DJ, Tripathi N. Scientific Regulatory Policy Committee Points to Consider*: Nuisance Factors, Block Effects, and Batch Effects in Nonclinical Safety Assessment Studies. Toxicol Pathol 2020; 48:537-548. [PMID: 32122253 DOI: 10.1177/0192623320906385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Detection of test article-related effects and the determination of the adversity of those changes are the primary goals of nonclinical safety assessment studies for drugs and chemicals in development. During these studies, variables that are not of primary interest to investigators may change and influence data interpretation. These variables, often referred to as "nuisance factors," may influence other groups of data and result in "block or batch effects" that complicate data interpretation. Definitions of the terms "nuisance factors," "block effects," and "batch effects," as they apply to nonclinical safety assessment studies, are reviewed. Multiple case examples of block and batch effects in safety assessment studies are provided, and the challenges these bring to pathology data interpretation are discussed. Methods to mitigate the occurrence of block and batch effects in safety assessment studies, including statistical blocking and utilization of study designs that minimize potential confounding variables, incorporation of adequate randomization, and use of an appropriate number of animals or repeated measurement of specific parameters for increased precision, are reviewed. [Box: see text].
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