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Gallelli G, Cione E, Serra R, Leo A, Citraro R, Matricardi P, Di Meo C, Bisceglia F, Caroleo MC, Basile S, Gallelli L. Nano-hydrogel embedded with quercetin and oleic acid as a new formulation in the treatment of diabetic foot ulcer: A pilot study. Int Wound J 2019; 17:485-490. [PMID: 31876118 DOI: 10.1111/iwj.13299] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022] Open
Abstract
Wound healing, especially diabetic ones, is a relevant clinical problem, so it is not surprising that surgical procedures are often needed. To overcome invasive procedures, several strategies with drugs or natural compound are used. Recently, in an experimental study, we described an increase in keratinocyte proliferation after their exposition to quercetin plus oleic acid. In the present clinical study, we evaluated both the clinical efficacy and the safety of nano-hydrogel embedded with quercetin and oleic acid in the treatment of lower limb skin wound in patients with diabetes mellitus (DM). Fifty-six DM patients (28 men and 28 women, mean age 61.7 ± 9.2 years) unsuccessfully treated with mechanical compression were enrolled and randomised to receive an add on treatment with hyaluronic acid (0.2%) or nano-hydrogel embedded with quercetin and oleic acid. The treatment with nano-hydrogel embedded with quercetin and oleic acid significantly (P < .01) reduced the wound healing time, in comparison to hyaluronic acid (0.2%) without developing of adverse drug reactions, suggesting that this formulation could be used in the management of wound healing even if other clinical trials must be performed in order to validate this observation.
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Affiliation(s)
- Giuseppe Gallelli
- Division of Vascular surgery, Department of Sugery, Pugliese Hospital, Catanzaro, Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Raffaele Serra
- Department of Medical and Surgical Sciences, University Magna Graecia, Catanzaro, Italy
| | - Antonio Leo
- Department of Health Sciences, University of Catanzaro, Catanzaro, Italy.,Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini Hospital, Catanzaro, Italy
| | - Rita Citraro
- Department of Health Sciences, University of Catanzaro, Catanzaro, Italy.,Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini Hospital, Catanzaro, Italy
| | - Pietro Matricardi
- Department of Drug Chemistry and Technologies, Sapienza University of Roma, Rome, Italy
| | - Chiara Di Meo
- Department of Drug Chemistry and Technologies, Sapienza University of Roma, Rome, Italy
| | - Francesco Bisceglia
- Department of Health Sciences, University of Catanzaro, Catanzaro, Italy.,Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini Hospital, Catanzaro, Italy
| | - Maria C Caroleo
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Sonia Basile
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Luca Gallelli
- Department of Health Sciences, University of Catanzaro, Catanzaro, Italy.,Clinical Pharmacology and Pharmacovigilance Unit, Mater Domini Hospital, Catanzaro, Italy
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Golomb BA, Koslik HJ, Redd AJ. Fluoroquinolone-induced serious, persistent, multisymptom adverse effects. BMJ Case Rep 2015; 2015:bcr-2015-209821. [PMID: 26438672 DOI: 10.1136/bcr-2015-209821] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present a case series of four previously healthy, employed adults without significant prior medical history in each of whom symptoms developed while on fluoroquinolones (FQs), with progression that continued following discontinuation evolving to a severe, disabling multisymptom profile variably involving tendinopathy, muscle weakness, peripheral neuropathy, autonomic dysfunction, sleep disorder, cognitive dysfunction and psychiatric disturbance. Physicians and patients should be alert to the potential for FQ-induced severe disabling multisymptom pathology that may persist and progress following FQ use. Known induction by FQs of delayed mitochondrial toxicity provides a compatible mechanism, with symptom profiles (and documented mechanisms of FQ toxicity) compatible with the hypothesis of an exposure-induced mitochondrial neurogastrointestinal encephalomyopathy.
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Affiliation(s)
| | - Hayley Jean Koslik
- Department of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Alan J Redd
- Department of Anthropology, University of Kansas, Lawrence, Kansas, USA
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Leporini C, Rende A, Sorrentino A, Rizzica E, Russo E, Gallelli L, De Sarro G. Efficacy and safety of off-label use of fondaparinux in the management of heparin-induced thrombocytopenia with thrombosis in an elderly woman. J Clin Pharmacol 2013; 53:999-1002. [PMID: 23832870 DOI: 10.1002/jcph.124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 05/25/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Christian Leporini
- Centro Regionale di Informazione sul Farmaco, AO Mater Domini, Catanzaro, Italy
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Interactions among Low Dose of Methotrexate and Drugs Used in the Treatment of Rheumatoid Arthritis. Adv Pharmacol Sci 2013; 2013:313858. [PMID: 23737767 PMCID: PMC3667469 DOI: 10.1155/2013/313858] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 04/09/2013] [Accepted: 04/16/2013] [Indexed: 12/26/2022] Open
Abstract
Methotrexate (MTX) is a nonbiological disease-modifying antirheumatic drug that has shown both a good control of clinical disease and a good safety. Usually drug-drug interactions (DDIs) represent the most limiting factor during the clinical management of any disease, in particular when several drugs are coadministered to treat the same disease. In this paper, we report the interactions among MTX and the other drugs commonly used in the management of rheumatoid arthritis. Using Medline, PubMed, Embase, Cochrane libraries, and Reference lists, we searched for the articles published until June 30, 2012, and we reported the most common DDIs between MTX and antirheumatic drugs. In particular, clinically relevant DDIs have been described during the treatment with MTX and NSAIDs, for example, diclofenac, indomethacin, or COX-2 inhibitors, and between MTX and prednisone or immunosuppressant drugs (e.g., leflunomide and cyclosporine). Finally, an increase in the risk of infections has been recorded during the combination treatment with MTX plus antitumor necrosis factor-α agents. In conclusion, during the treatment with MTX, DDIs play an important role in both the development of ADRs and therapeutic failure.
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Gallelli L, Staltari O, Palleria C, Di Mizio G, De Sarro G, Caroleo B. A case of adverse drug reaction induced by dispensing error. J Forensic Leg Med 2012; 19:497-8. [PMID: 23084317 DOI: 10.1016/j.jflm.2012.04.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 04/17/2012] [Accepted: 04/21/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To report about a case of acute renal failure due to absence of communication between physician and patient. CASE SUMMARY A 78 year old man with human immunodeficiency virus (HIV) accessed our hospital and was brought to our attention in August 2011 for severe renal failure. Clinical history revealed that he had been taking highly active antiretroviral therapy with lamivudine/abacavir and fosamprenavir since 2006. In April 2011 due to an augmentation in creatinine plasma levels, a reduction in lamivudine dosage to 100 mg/day and the prescription of abacavir 300 mg/day became necessary. Unfortunately, the patient took both lamivudine and abacavir therefore the association of the two medications (lamivudine/abacavir) lead to asthenia and acute renal failure within a few days. CONCLUSIONS This case emphasizes the importance about how physicians must pay very careful attention during drug prescription, most particularly, as far as elderly patients are concerned. In fact, communication improvement between physicians and patients can prevent increase of adverse drug reactions related to drug dispensing, with consequential reduction of costs in the healthcare system.
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Affiliation(s)
- L Gallelli
- Department of Health Science, School of Medicine, University of Catanzaro and Operative Unit of Pharmacology, Mater Domini University Hospital, Viale Europa, Germaneto, 88100 Catanzaro, Italy.
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Pugi A, Longo L, Bartoloni A, Rossolini GM, Mugelli A, Vannacci A, Lapi F. Cardiovascular and metabolic safety profiles of the fluoroquinolones. Expert Opin Drug Saf 2011; 11:53-69. [PMID: 21958023 DOI: 10.1517/14740338.2011.624512] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Certain fluoroquinolones share similar indications of use. A comparison among Cardiovascular and metabolic (i.e., dysglycemia) safety profiles of the fluoroquinolones might be particularly useful for the prescribers' decision-making process as well as to hypothesize future researcher purposes. AREAS COVERED A literature search was conducted using keywords apt to identify information on safety profile of the fluoroquinolones. Publications concerned with descriptive and etiological surveys were manually reviewed. EXPERT OPINION Cardiac alterations and blood glucose impairments might be associated with any fluoroquinolone. However, the benefit/risk profile of these agents could be stratified for the single compounds. Several predisposing factors, such as diabetes, heart illnesses and their related pharmacotherapies, might exacerbate the risk of potentially serious adverse events. In this context, the opportunity of the more appropriate choice among different fluoroquinolones could be applicable.
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Affiliation(s)
- Alessandra Pugi
- University of Florence, Department of Pharmacology, Viale Pieraccini 6, 50139, Florence, Italy.
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Lapi F, Tuccori M, Motola D, Pugi A, Vietri M, Montanaro N, Vaccheri A, Leoni O, Cocci A, Leone R, Conforti A, Moretti U, Sessa E, Mazzaglia G, Mugelli A, Mazzei T, Vannacci A. Safety profile of the fluoroquinolones: analysis of adverse drug reactions in relation to prescription data using four regional pharmacovigilance databases in Italy. Drug Saf 2010; 33:789-99. [PMID: 20701411 DOI: 10.2165/11536810-000000000-00000] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Fluoroquinolones are widely used both in primary care and in hospital settings. Since the last comparison performed in Italy on the safety profiles of different fluoroquinolones, a new molecule, prulifloxacin, has been introduced into the market and several warnings concerning this class of drugs have been released. The aim of this study was to reassess the safety profiles of fluoroquinolones using the database of the Italian Interregional Group of Pharmacovigilance (IGP) and the administrative data of fluoroquinolone prescriptions. METHODS All adverse drug reactions (ADRs) reported in four Italian regions (Lombardy, Veneto, Emilia Romagna and Tuscany) were retrieved from the IGP database. Consumption data (defined daily dose [DDD]/1000 inhabitants/day) were used as denominators. Both single reports and all ADRs (classified by System Organ Classes and MedDRA Preferred Term [PT]) due to fluoroquinolones were considered as numerators of each analysis, comparing two periods (2005 vs 2006). All fluoroquinolones with at least ten reports per year were included in the analysis. RESULTS On the basis of 272 reports (532 single ADRs or PTs), patients did not show any statistically significant differences between 2005 and 2006 in terms of sex, age and number of concurrent medications. After adjustment for drug consumption, moxifloxacin showed the highest reporting rate (84.6 reports/DDD/1000 inhabitants/day; 15.4 serious reports/DDD/1000 inhabitants/day) followed by prulifloxacin (72.2; 22.2 serious) and levofloxacin (55.3; 30.6 serious) in 2005. An increment of ADR/report rates was observed over the 2 years for all fluoroquinolones except prulifloxacin, which had the lowest ADR reporting rate in 2006 (25.0; 12.5 serious). In 2006, the rate of serious ADRs associated with prulifloxacin was lower than with ciprofloxacin, while in 2005 serious events were almost equal for both compounds (55.6 vs 47.6 serious ADRs/DDD/1000 inhabitants/day). Ciprofloxacin showed the highest proportion of cutaneous PTs (e.g. rash, exanthema). Tendinopathies were mainly due to levofloxacin. CONCLUSIONS These data suggest that different fluoroquinolones are characterized by different rates and types of ADRs. Among them, prulifloxacin was associated with more ADRs than other fluoroquinolones in 2005 but with fewer ADRs in 2006, when its consumption increased. Although these findings may represent an encouraging perspective towards a more appropriate use of fluoroquinolones because of their individual safety profiles, further pharmacoepidemiological studies must be performed to substantiate these results.
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Affiliation(s)
- Francesco Lapi
- Department of Pharmacology, University of Florence, Tuscan Regional Centre of Pharmacovigilance, Florence, Italy.
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Giannarini G, Tascini C, Selli C. Prulifloxacin: clinical studies of a broad-spectrum quinolone agent. Future Microbiol 2009; 4:13-24. [PMID: 19207096 DOI: 10.2217/17460913.4.1.13] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Prulifloxacin, the lipophilic prodrug of ulifloxacin, is a new oral fluoroquinolone with a broad spectrum of in vitro activity against various Gram-positive and Gram-negative microorganisms. Currently, it is the most potent in vitro fluoroquinolone against Escherichia coli and Pseudomonas aeruginosa, and also has the lowest potential of inducing the emergence of resistant strains for these bacteria. It exhibits good penetration in target tissues and fluids, and possesses a long half-life, thus allowing for once-daily administration. Prulifloxacin has been successfully tested in Phase III randomized, controlled trials including patients with acute exacerbations of chronic bronchitis, uncomplicated and complicated urinary tract infections, and chronic bacterial prostatitis. Results are awaited from recently completed and ongoing Phase III randomized, placebo-controlled studies testing prulifloxacin for the treatment of traveler's diarrhea. Prulifloxacin has an acceptable toxicity profile, comparable to that of other fluoroquinolones, with gastric disturbances, diarrhea, nausea and skin rash of mild-to-moderate severity being the most frequent adverse events. Additional research is needed to further elucidate the promising role of prulifloxacin in the treatment of infections sustained by multidrug-resistant pathogens and to consolidate the wide spectrum of activity from a clinical standpoint.
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