Open Access Systematic Review Article

Antidotes and their Mechanism of Action: A Systematic Review

Deva Tulasi Komatineni, Udaya Ratna Kolli, Mohammed Bashir Abazar Elmamoon Ball Elsheep, Varshitha Reddy Balineni, Keerthi Sri Gundla, Yousif Osman Salih Saeed, Jithendra Chimakurthy, Ravindra Babu Pingili

Journal of Pharmaceutical Research International, Page 67-87
DOI: 10.9734/jpri/2022/v34i38B36228

An antidote is a therapeutic agent that counteracts the hazardous effects of a medicine or toxin, according to the International Programmed of Chemical Safety. Antidotes have been defined as agents that alter the poisonous substance's kinetics or interfere with its impact at receptor sites. This could be due to the poison being prevented from being absorbed, bound, and neutralized immediately, antagonizing its end-organ impact, or inhibiting conversion to more hazardous metabolites. The kind of toxin eaten, the anticipated amount taken by the individual, the route of exposure, clinical toxicity characteristics, half-life, and pharmacokinetics, as well as the risk versus benefit of administering the antidote, all influence the length of antidotal therapy. An infusion may be necessary if the antidote has a short half-life, especially if poisoning symptoms return. To treat the negative effects of toxins, it is required. Occasionally, that intervention is necessary. may entail the use of pharmacological antagonists, also referred to as an antidote The most common poisons, according to the American Association of Poison Control Centers, include Acetylcysteine, naloxone, atropine, and deferoxamine are some of the most widely used antidotes.

Open Access Original Research Article

The Acceptance of Rubber Dam Isolation by Patients undergoing Endodontic Treatment and Its Feedback: A Questionnaire Based Survey

Aashish Handa, Kanwalpreet Kaur Bhullar, Sumandeep Kaur, Diksha Batra, Jasneel Singh Grover, Shantun Malhotra, Rupam Kaur

Journal of Pharmaceutical Research International, Page 11-17
DOI: 10.9734/jpri/2022/v34i38B36222

Objective: The study was done to evaluate the average time taken by the operators to apply the rubber dam, procedure time and the acceptability or rejection of placement of rubber dam by the patients during endodontic treatment procedures.

Design: The study was carried out on 450 patients requiring endodontic treatment reported at department during the time interval of May, 2021 to August, 2021. Out of 450 patients, 180 patients were randomly selected for the study by lottery method. All the endodontic procedures were performed under rubber dam isolation and rubber dam application time and time for isolation was determined. Further, a questionnaire survey was performed to evaluate the patient’s acceptance or rejection of procedures rubber dam and various reasons for rejection.

Results: The highest number of respondents belonged to 21-30 years of age group i.e. 26.6% followed by 31-40 years i.e. 26.11%. Average rubber dam application time and procedure time were estimated as 4.04 and 44.07 minutes respectively. More than 90 % of the participants were willing to accept the procedure under rubber dam isolation in future. However, on contrary, only 9.44 % of the participants rejected the procedure under rubber dam isolation and the most common reasons for rejection were uneasiness felt by the patient and difficulty in breathing.

Conclusions: The acceptability of rubber dam isolation while performing endodontic procedures/ treatments was quite significant among the patients. Very few patients had allergy to the latex material of rubber dam sheets and respiratory disorders.

Open Access Original Research Article

Effects of Letrozole on Trabecular Diameter of Long Bone: Mouse Model

Muhammad Haroon Khan, Nabila Momin, Sarah Javed, Faiqa Mobeen, Amna Shah Mehmood, Sana Ullah Khan

Journal of Pharmaceutical Research International, Page 18-24
DOI: 10.9734/jpri/2022/v34i38B36223

Background: Letrozole, a commonly prescribed Neoadjuvant endocrine therapeutic drug in hormone receptor positive breast cancer females, causes osteoporosis along with several other debilitating effects. The objective of this study was to observe the changes in trabecular diameter of femur of mice after exposure to Letrozole.

Materials and Methods: This Laboratory based experimental study was carried out at Pakistan Council of Scientific and Industrial Research Centre (PCSIR) Peshawar and Khyber Medical University (KMU) Peshawar from 1st of June 2018 till 30th of July 2018. Thirty-three female albino mice were divided into control and experimental groups. The experimental group was given Letrozole drug at a dose of 1mg/kg/day for 28 days. Weight of these thirty-three mice was measured before and after administration of the drug. The animals were then sacrificed. Femurs were dissected and processed to find out changes in its gross morphology, weight, and trabecular diameter.

Results: The overall weight of mice, weight of femur and its trabecular diameter was greater in control Group as compared to experimental Group.

Conclusion: Use of Letrozole can cause significant reduction in trabecular diameter of long bones.

Open Access Original Research Article

Regulations for Testing and Licensing of Vaccines in United Kingdom

M. Ranjitha, H. R. Arjun, M. P. Venkatesh

Journal of Pharmaceutical Research International, Page 25-32
DOI: 10.9734/jpri/2022/v34i38B36224

Vaccines are one of the most significant achievements of science and public health for prevention of infectious disease. Overall vaccination policies for HCP in should be periodically revaluated in order to provide optimal protection against vaccine preventable diseases and infection control with in healthcare. The guidelines address ethical issues that arise during a vaccine study. A network of Adverse Drug Reaction (ADR) monitoring centre alone with adverse event following immunisation (AEFI) provide the machinery for vaccine pharmacovigilance.

Open Access Original Research Article

Frequency of Meningitis in Patients Presenting with Neonatal Sepsis at a Tertiary Care Hospital: A Cross-Sectional Study

Suneet Kumar, Yousuf Yahya, Muhammad Saad Raza, Kashif Habib Qadri, Rumana Sangi, Amber Kamran, Muhammad Nadeem Chohan

Journal of Pharmaceutical Research International, Page 59-66
DOI: 10.9734/jpri/2022/v34i38B36227

Aim: To investigate the prevalence of meningitis in neonatal sepsis patients at a tertiary care hospital.

Study Design: A cross-sectional study.

Place and Duration: Department of pediatrics, Civil Hospital Karachi from 11 – 2019 to 04 – 2020.

Methodology: A total of 120 Neonates within first 28 days of life with positive blood culture were included in this study. Patient’s data was collected on a predesigned proforma including demographics. Diagnosis of meningitis was done by performing lumber puncture. CSF analysis, blood, and CSF cultures were all tested in the lab.

Results: The average age of the patients was 10.75±7.24 days. There were 66(55%) males and 54(45%) females. Meningitis was found in 23.33% of patients with neonatal sepsis (28/120). Rate of meningitis was significantly high in late onset of sepsis as compared to early onset of sepsis (32.8% vs. 11.3%; p=0.006).

Conclusion: In this study the frequency of meningitis with neonatal sepsis was high. Meningitis has a strong link to neonatal sepsis, and it must be ruled out in those babies to avoid neurological problems.

Open Access Review Article

Herbal Infusions and Teas Taken Orally: What is not Taken into Account in the Phytotherapy of Type 2 Diabetes Mellitus

A. Urakov, N. Urakova, A. Shchemeleva, L. Lovtsova, R. Fayzullina, A. Akhmetyanova, N. Kudashkina, D. Suleymanova, E. Galiakhmetova, S. Khasanova, I. Krylova

Journal of Pharmaceutical Research International, Page 1-10
DOI: 10.9734/jpri/2022/v34i38B36221


Infusions, decoctions and teas made from hot drinking water and various medicinal plants are widely used in folk medicine and pharmacy in the Russian Federation and in the countries of Southwest Asia. In this study, the methods of ethnopharmacology and pharmacy were combined to clarify the mechanism of action of traditional herbal mixtures in the phytotherapy of type 2 diabetes mellitus.  The technology of preparation of infusions, decoctions and teas from medicinal plants and the quality of water are analyzed. It is shown that the traditional assessment of the pharmacological activity of herbal mixtures was previously considered only from the point of view of the biological activity of the main chemical components, without taking into account the influence of water, its volume, as well as without taking into account acidic, osmotic (hypotonic) activity and temperature of water extracts. However, it has been shown that drinking water is also the main active ingredient of water extracts, and the quality of water and its physical-chemical properties can be important in the effect on the body of patients. In particular, attention is drawn to the fact that ingestion of 250 ml of such aqueous extracts can dilute blood plasma, reduce the concentration of all substances in it, including glucose concentration, reduce osmotic activity of the plasma and promote the removal of glucose from the body due to its "washing". Therefore, traditional herbal medicine based on ingestion of 250 ml of aqueous extracts 2-4 times a day may be accompanied by hypoglycemia and a decrease in the concentration of all other ingredients in the blood plasma not so much due to the action of biologically active substances, but also due to the action of water. The process of reducing the concentration of glucose in the blood is more intense and significant, the faster the water is absorbed into the blood and the more water is drunk. It is also obvious that some of the glucose is excreted with water from the body during urination and sweating. Nevertheless, in order to give a definitive answer to the role of herbal teas and infusions in the phytotherapy of diabetes mellitus, new and more comprehensive pharmacological studies are required in the future, taking into account the volume of water and the physico-chemical properties of water extracts.


Open Access Review Article

Inflammation and Oxidative Stress from E-cigarette Exposure: Implications for COPD and Asthma

Amy Hutchinson, Marwan ElBagoury

Journal of Pharmaceutical Research International, Page 33-50
DOI: 10.9734/jpri/2022/v34i38B36225

Currently, little is known about the effects of e-cigarette use on chronic respiratory diseases, due to their relative novelty. This review compiles data on the cellular effects of e-cigarette use with population data on disease incidence to determine potential risk for COPD and asthma development, two of the most prevalent respiratory diseases. We searched the Google Scholar database for studies on e-cigarette exposure and levels of inflammation and oxidative stress in human cells and e-cigarette users, as well a population studies analyzing e-cigarette use and respiratory disease incidence. All reviewed studies found significant increases in inflammatory biomarkers, as well as pro-inflammatory cytokines, demonstrating a correlation between e-cigarette use and a pro-inflammatory affect. Our findings suggest e-cigarette vapor contains reactive oxygen species, and that exposure increases cellular oxidation and lowers antioxidant power. Every population study we reviewed found significant correlations between COPD and e-cigarette use, and asthma and e-cigarette use. These population studies cannot provide causational data, though the basic cellular data provides support for causative effects. Further research should investigate the link between the cellular and population data to identify causation and understand the impact of e-cigarette use on disease rates.

Open Access Review Article

Fedratinib: A Review of Its Pharmacology and Clinical Use

P. Ashisha, M. Archana, Mariya Palathingal, K. Athulya Damodharan, . Nuaman, Akash Marathakam

Journal of Pharmaceutical Research International, Page 51-58
DOI: 10.9734/jpri/2022/v34i38B36226

Fedratinib (INREBIC®) is a JAK2-selective inhibitor that has been developed as an oral treatment for myelofibrosis. It was approved for the first time in the United States in August 2019 to treat adult patients with intermediate-2 or high-risk primary or secondary (post-polycythaemia vera or post-essential thrombocythemia) myelofibrosis. Fedratinib is an anilinopyrimidine derivative and is metabolized by CYP3A4, CYP2C19 and flavin-containing monooxygenase-3. Fedratinib is mainly excreted in faeces, and the effective half-life is 41 hours. The recommended dosage is 400 mg once daily (with or without food. The dosage should be reduced to 200 mg once daily in patients receiving CYP3A4 inhibitors and in patients with severe renal impairment. Fedratinib's recent approval adds to the few therapeutic option choices available to individuals with MF. The most common adverse events were mild gastrointestinal toxicities. Fedratinib comes with a boxed warning about the risk of serious and potentially deadly encephalopathies, such as Wernicke's.