Open Access Data Article

Polypharmacy in the Elderly: The Need for Concern and Strategies for Its Control

Abdulraheem Ibraheem Shola, Adeoye Adegboye

Journal of Pharmaceutical Research International, Page 1-12
DOI: 10.9734/BJPR/2015/19551

In the last three decades, problems related to aging, multi-morbidity, and polypharmacy have become a prominent issue in global healthcare. In this study, Polypharmacy is defined as a concomitant use of five or more drugs simultaneously and/or the administration of more medications than are clinically indicated, representing unnecessary drug use. The purpose of this study was to describe and quantify the magnitude of polypharmacy, analyze the factors associated with this practice among elderly and suggest control measures for its reduction. Other objectives include creating awareness about the risks of multiple drug use in ageing population and propose practical recommendations/interventions regarding rational drug use for elderly age groups. Materials for this study were obtained from a search of the MEDLINE database and International Pharmaceutical Abstracts to identify articles in people aged 60 years and above. A combination of the search terms like polypharmacy, multiple medications, polymedicine, elderly, geriatric, and aged were used. This study found out that polypharmacy is a common problem and a known risk factor for important morbidity and mortality in the elderly. Many medications are associated with negative health outcomes, but more research is needed to delineate the consequences associated with unnecessary drug use in elderly patients. Health care professionals should be aware of the risks associated with polypharmacy and fully evaluate all medications at each patient visit in order to prevent polypharmacy from occurring.

Open Access Commentary

Barriers of Medication Adherence and Health Outcomes

Sean Hyungwoo Kim, Haechung Chung, Dima Huneidi, Jongwha Chang

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/BJPR/2015/20490

Medication adherence is a worldwide health care problem. Medication adherence refers to whether patients take medication as prescribed by the healthcare provider. Increasing medication adherence may have a great impact on the health of the population. Poor adherence is associated with adverse health effects, increased financial burden, and loss of productivity. We examined both direct and indirect measurements of medication adherence that have been previously used in order to analyze the reasons for this problem. Reasons for non-adherence include patient-related factors, condition-related factors, therapy-related factors, social and economic factors, and the health care system structure. Overall, poor adherence compromises the effectiveness of treatment and may result in adverse events along with a significant cost to healthcare. A multidisciplinary approach needs to be taken in order to provide interventions for poor medication adherence. In conclusion, the quality of the relationship between the provider and the patient is the most important in regards to improving adherence.

Open Access Original Research Article

Preparation and Evaluation of Matrix Tablet of Metronidazole Using Carnauba Wax

Matthew I. Arhewoh, Sylvester O. Eraga, John A. Avbunudiogba, Queen Fregene, Paul Okah

Journal of Pharmaceutical Research International, Page 1-8
DOI: 10.9734/BJPR/2015/20576

Aim: To formulate a sustained release tablet dosage form of metronidazole using carnauba wax as matrix former and binder.

Methods: Batches of metronidazole tablets were formulated by using a combination of melt and wet granulation techniques. The formulated granules were evaluated for their flow properties, while the tablets for their friability, hardness, disintegration time and metronidazole release rate. The effect of varying concentrations of carnauba wax on the formulation was ascertained and compared with a conventional commercial product.

Results: The tablets had friability and hardness values ranging from 0.87-2.98% and 6.66 to 8.08 kp, respectively. Tablet weights did not vary significantly but the disintegration time varied from 2.61 to 4.86 min and the optimal batch of tablets released about 60% of its drug within 2 h as against that of the conventional tablet with a 100% release.

Conclusion: Carnauba wax can serve as a suitable binder to formulate a sustained release metronidazole tablets to achieve a reduction in the frequency of administration and consequently enhance compliance.

Open Access Original Research Article

Bioactive Phenylethanoids from the Seeds of Manilkara zapota

Marie Fomani, Achille Bissoue Nouga, Flavien Aristide Alfred Toze, Jean Claude Ndom, Alain François Kamdem Waffo, Jean Duplex Wansi

Journal of Pharmaceutical Research International, Page 1-5
DOI: 10.9734/BJPR/2015/20796

Aims: Discovering new lead compounds against cancer and bacterial infections is a crucial step to ensuring a sustainable global pipeline for new effective drugs. These study focuses on the isolation of secondary metabolites of methanol extract from the seeds of Manilkara zapota (Sapotaceae) a Cameroonian medicinal plant.

Study Design: According to the literature, plants of the genus Manilkara are potential sources of antibacterial and anticancer secondary metabolites.

Methodology: The air-dried and powdered seeds (1.8 kg) of M. zapota was extracted at room temperature for 72 h with a mixture of CH2Cl2/methanol (1/1). The extract was concentrated to dryness under vacuum and the residue was subjected to repeated column chromatographic separation. The structures of the isolates were established by means of spectroscopic methods. These compounds were screened in vitro for their free radical scavenging activity using DPPH.

Results: New phenylethanoid, 2-(4-hydroxyphenethyl) tetratriacontanoate (1), together with twelve known compounds were isolated from the CH2Cl2/methanol (1/1) extract from the seeds of Manilkara zapota. The structures of all compounds were determined by comprehensive analysis of their 1D and 2D NMR, mass spectral (EI and ESI) data, chemical reactions and comparison with previously known analogs. The radical scavenging activity using DPPH assay gave significantly high antioxidant values for the crude extract with IC508.50 μg/mL, and moderate activity for the phenylethanoid compounds 1-6 with IC50 62.52- 70.20 mM compared to the phenolic synthetic antioxidant standard BHA with IC50 44.20 mM.

Conclusion: Six phenylethanoids with moderate antioxidant activity were isolated from the seeds of Manilkara zapota.

Open Access Original Research Article

In vitro Antioxidant, Antimicrobial and in vivo Peripheral Analgesic Activities of Methanol and Petroleum Ether Extracts of Whole Plant of Uraria lagopoides DC

Md. Monir Hossain, Md. Nur Alam, Nizam Uddin, Mohammad Burhan Uddin, A. Y. Sk. Ferozuddin A. Chowdhury

Journal of Pharmaceutical Research International, Page 1-14
DOI: 10.9734/BJPR/2015/8884

Aims: To study and evaluate in vitro antioxidant, antimicrobial and in vivo peripheral analgesic activities of both methanol and petroleum ether extracts of whole plant of Uraria lagopoides DC (Family-Fabaceae).

Study Design: Preliminary phytochemical screening, evaluation of antioxidant, antimicrobial and peripheral analgesic activities.

Place and Duration of Study: Department of Pharmacy, Jahangirnagar University, Savar, Dhaka-1342 and Department of Pharmacy, Primeasia University, Dhaka-1213. The studies were carried out during February- September 2013.

Methodology: Phytochemical constituents were identified by qualitative analysis. In vitro antioxidant activity of the extracts were studied using DPPH radical scavenging assay, total phenol, total flavonoid content and total antioxidant capacity determination assays. Antimicrobial activity was investigated by disc diffusion technique and acetic acid induced writhing test was used for the evaluation of in vivo peripheral analgesic activity of the whole plant extracts.

Results: Phytochemical screening for both extracts showed positive results for carbohydrates, flavonoids and glycosides while only methanol extract showed positive results for alkaloids, saponins, steroids and tannins. Methanol extract of the plant showed higher total phenolic content and as well as higher DPPH free radical scavenging activity than petroleum ether extract. On the other hand, petroleum ether extract showed higher total flavonoid content and total antioxidant capacity than methanol extract. In disc diffusion technique among six bacterial species, methanol extract showed concentration dependent activity against one Gram positive (Staphylococcus aureus) and three Gram negative bacteria (Escherichia coli, Salmonella typhi and Klebsiella pneumoniae) while petroleum ether extract showed concentration dependent activity against only one Gram negative bacteria (Salmonella typhi). In acetic acid induced writhing test both methanol and petroleum ether extracts of 250 mg/kg and 500 mg/kg (per oral) both doses showed significant (P < 0.001) analgesic activity.

Conclusion: The results demonstrate that methanol and petroleum ether extracts of whole plant of U. lagopoides can be used as a potential source of antioxidant, antimicrobial and analgesic agent.

Open Access Original Research Article

Haematinic Potential of Jussiaea repens L – A Search for Antianaemic Herb

Arnab Das, Subhasish Ghosal, Indrani Chakraborty, Nirmal Pradhan

Journal of Pharmaceutical Research International, Page 1-11
DOI: 10.9734/BJPR/2015/20409

Background: Anaemia is a common nutritional disorder. Different harmful synthetic drugs are used to combat it. So herbal remediation is in demand.

Aims: In this study a common medicinal herb Jussiaea repens (JR) was used. It is traditionally used to prevent diabetes, diuretics, fever, cough etc. But no report yet is available on anaemia prevention.

Methodology: 30 adult male albino rats were grouped as control (n=6), 2,4-DNPH induced anaemia (2 mg/100 gm body weight/day i.p.,n=18) and JR treatment (20 mg/100 gm body weight/day orally, n=6). After 7 days, 6 anaemic animals were killed, 6 kept as DNPH withdrawal and other 6 as JR supplement followed by 2,4-DNPH withdrawal. All animals were maintained till 21st day of treatment.

Results: Body growth rate was significantly (P<0.001) decreased in 2,4-DNPH induced anaemic group which was partially recovered in withdrawal and JR supplement. Liver weight was significantly decreased (P<0.01) in anaemic group than control but was significantly increased (P<0.01) in JR treatment. Spleen weight was significantly increased (P<0.05) in anaemic group but significantly decreased (P<0.05) in JR supplement and treatment. Significant decrease (P<0.05) in adrenal weight was found after 2,4-DNPH withdrawal, where other organs remain unchanged. The anaemic group showed insignificant reduction in total erythrocyte count and significant reduction (P<0.05) in haemoglobin concentration than control and were significantly recovered (P<0.05) after JR supplementation and treatment. PCV was significantly higher in withdrawal (P<0.05) and JR treatment (P<0.01) than anaemic group, where MCHC was significantly higher (P<0.01) only in JR treatment. But no remarkable change observed in MCH and total leukocyte count. Free haemoglobin in plasma showed significant rise (P<0.005) in anaemic group, but was significantly reduced alike MCV after 2,4-DNPH withdrawal, JR supplementation and treatment, which supported higher osmotic fragility of RBC in anaemic group. SEM observation of erythrocyte morphology also supported it.

Conclusion: So, crude ethanolic extract of JR can prevent anaemia and can be used further as potent antianaemic drug.