FORMULATION AND EVALUATION OF BI-LAYER SUSTAINED RELEASE
TABLET OF AZITHROMYCIN AND DOXYCYCLINE
DRUG.
Bilayer tablets, sometimes called double-layer tablets, are a newer technology for the development of controlled release formulation. They have a combination of two or more active pharmaceutical ingredients in a single dosage form. Nowadays, the use of bi-layered tablets is growing.
This document reviews potential treatment options for COVID-19 that are supported by early evidence. It summarizes in vitro and clinical evidence for remdesivir, chloroquine/hydroxychloroquine, and lopinavir/ritonavir. Remdesivir shows potent activity against SARS-CoV-2 and other coronaviruses in vitro and clinical benefit in animal studies of MERS and Ebola. Early clinical data in COVID-19 patients treated with remdesivir showed improvement. Chloroquine also has in vitro activity against SARS-CoV-2 and is supported by some clinical case studies from China. However, the efficacy of these agents specifically for COVID-19 treatment requires further evaluation in controlled
- The document discusses three drugs - hydroxychloroquine, ivermectin, and azithromycin - that have shown potential therapeutic effects against COVID-19. Hydroxychloroquine and azithromycin are thought to act by increasing pH within cells, while ivermectin may inhibit import of viral proteins.
- However, more in vivo clinical studies are still needed to fully evaluate the efficacy and safety of these drugs individually and in combination for treating and preventing COVID-19. Precautions around dosage will also be important given past issues with hydroxychloroquine poisoning.
O ptimization of hyrozycloroquine in mangement of covid 19Ahmed Ali
This document summarizes the potential use of hydroxychloroquine (HCQ) in treating COVID-19. It discusses HCQ's pharmacological properties including its immunomodulatory and antiviral effects. Based on its ability to increase lysosomal pH and disrupt viral fusion and replication, HCQ has demonstrated efficacy against SARS-CoV-1 in vitro and in animal models. The document proposes guidelines for optimizing HCQ's efficacy and safety in COVID-19 treatment, including early administration, loading doses, and continued maintenance doses under medical supervision. More clinical trials are needed to evaluate HCQ specifically for early COVID-19 treatment.
Phytochemicals in the Inhibition of COVID 19 A Systematic Reviewijtsrd
Ayurvedic medicines has benefits as adjuvant or main stream therapy in the treatment of COVID 19. This study identifies and recommends the evidence based herbs to aid the development of successful herbal products against COVID 19 and their variants. Aims This review article aims to systematically review existing articles on drug research in Ayurveda from AYUSH Research portal Method A search in AYUSH Research portal was conducted to retrieve studies conducted from January 2020 to December 2021. Using Inclusion criteria, we selected both in silico and in vitro studies that described the role of phytocompounds in ameliorating COVID 19. Results and conclusion Majority of the articles have focused on phytochemicals from W.somnifera targeting main protease of SARS CoV 2. The study method in all the articles is molecular docking and molecular dynamics. The experimental evidence for the prediction is very rare. The mean molecular docking scores of phytochemicals is 5.9 Kcal mol which is like the control values. In conclusion, there is a need to explore phytochemicals from other plants with experimental evidence such that the studies can aid lead identification. Dr. Annapoorna S "Phytochemicals in the Inhibition of COVID-19: A Systematic Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd48021.pdf Paper URL: https://www.ijtsrd.com/medicine/ayurvedic/48021/phytochemicals-in-the-inhibition-of-covid19-a-systematic-review/dr-annapoorna-s
Treatment of COVID-19; old tricks for new challengesLuisaSarlat
Coronavirus disease (COVID-19), which appeared in December 2019, presents a global challenge, particularly in the rapid increase of critically ill patients with pneumonia and absence of definitive treatment. To date, over 81,000 cases have been confirmed, with over 2700 deaths. The mortality appears to be around 2%; early published data indicate 25.9% with SARS-CoV-2 pneumonia required ICU admission and 20.1% developed acute respiratory distress syndrome
A cohort study evaluated the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on older COVID-19 patients. 17 patients received DMB and 26 did not. Significantly fewer DMB patients required oxygen therapy (17.6% vs 61.5%). DMB exposure was associated with reduced odds of oxygen therapy need and intensive care support. The study supports larger trials to determine if DMB can ameliorate COVID-19 severity through immunomodulation.
Efficacy of Xuebijing injection for the treatment of coronavirus disease 2019...LucyPi1
Abstract Background: To evaluate the mechanism of Chinese patent drug Xuebijing (XBJ) injection in the treatment of a new coronavirus disease 2019 (COVID-19) based on network pharmacology and molecular docking technology. Methods: The TCMSP database was employed to collect and screen the active ingredients of the Chinese herb contained in the XBJ injection. The GeneCards database and STRING database were applied to collect and expand the targets of COVID-19 and compare and screen the related targets of COVID-19 by XBJ injection. Cytoscape was employed to build a network connecting Chinese medicine, compounds, targets, disease, and topology analysis was performed via the Network Analyzer to screen the key ingredients and targets. The software of Schrödinger molecular docking was used to verify the binding activity of the key ingredients of XBJ injection and the key targets of COVID-19. Metascape platform and DAVID database were utilized to conduct Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes analysis on the key targets of COVID-19 treated by XBJ injection. Results: Eight key compounds and 15 key targets were screened and verified by molecular docking; these key compounds included luteolin, quercetin, baicalein, and kaempferol. The key targets included DPP4, AR, ESR1, CALM1, and protein kinase 1. Gene Ontology analysis involved an apoptosis and hypoxia reaction and the changes in blood vessel morphology. Kyoto Encyclopedia of Genes and Genomes analysis involved signaling pathways of hypoxia inducible factor-1, VEGF, and PI3K/AKT/NF-κB. Conclusion: The mechanism of XBJ injection when used to treat COVID-19 should be further investigated as the key compounds in XBJ regulated the expression of key targets such as protein kinase 1, VEGF-A, B-cell lymphoma-2, and TNF, which affected the COVID-19 receptors such as angiotensin-converting enzyme 2 and signaling pathways like hypoxia inducible factor-1, PI3K-Akt, and NF-κB, which alleviated the inflammation, respiratory distress, and hypoxia caused by COVID-19 infection.
This document reviews potential treatment options for COVID-19 that are supported by early evidence. It summarizes in vitro and clinical evidence for remdesivir, chloroquine/hydroxychloroquine, and lopinavir/ritonavir. Remdesivir shows potent activity against SARS-CoV-2 and other coronaviruses in vitro and clinical benefit in animal studies of MERS and Ebola. Early clinical data in COVID-19 patients treated with remdesivir showed improvement. Chloroquine also has in vitro activity against SARS-CoV-2 and is supported by some clinical case studies from China. However, the efficacy of these agents specifically for COVID-19 treatment requires further evaluation in controlled
- The document discusses three drugs - hydroxychloroquine, ivermectin, and azithromycin - that have shown potential therapeutic effects against COVID-19. Hydroxychloroquine and azithromycin are thought to act by increasing pH within cells, while ivermectin may inhibit import of viral proteins.
- However, more in vivo clinical studies are still needed to fully evaluate the efficacy and safety of these drugs individually and in combination for treating and preventing COVID-19. Precautions around dosage will also be important given past issues with hydroxychloroquine poisoning.
O ptimization of hyrozycloroquine in mangement of covid 19Ahmed Ali
This document summarizes the potential use of hydroxychloroquine (HCQ) in treating COVID-19. It discusses HCQ's pharmacological properties including its immunomodulatory and antiviral effects. Based on its ability to increase lysosomal pH and disrupt viral fusion and replication, HCQ has demonstrated efficacy against SARS-CoV-1 in vitro and in animal models. The document proposes guidelines for optimizing HCQ's efficacy and safety in COVID-19 treatment, including early administration, loading doses, and continued maintenance doses under medical supervision. More clinical trials are needed to evaluate HCQ specifically for early COVID-19 treatment.
Phytochemicals in the Inhibition of COVID 19 A Systematic Reviewijtsrd
Ayurvedic medicines has benefits as adjuvant or main stream therapy in the treatment of COVID 19. This study identifies and recommends the evidence based herbs to aid the development of successful herbal products against COVID 19 and their variants. Aims This review article aims to systematically review existing articles on drug research in Ayurveda from AYUSH Research portal Method A search in AYUSH Research portal was conducted to retrieve studies conducted from January 2020 to December 2021. Using Inclusion criteria, we selected both in silico and in vitro studies that described the role of phytocompounds in ameliorating COVID 19. Results and conclusion Majority of the articles have focused on phytochemicals from W.somnifera targeting main protease of SARS CoV 2. The study method in all the articles is molecular docking and molecular dynamics. The experimental evidence for the prediction is very rare. The mean molecular docking scores of phytochemicals is 5.9 Kcal mol which is like the control values. In conclusion, there is a need to explore phytochemicals from other plants with experimental evidence such that the studies can aid lead identification. Dr. Annapoorna S "Phytochemicals in the Inhibition of COVID-19: A Systematic Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd48021.pdf Paper URL: https://www.ijtsrd.com/medicine/ayurvedic/48021/phytochemicals-in-the-inhibition-of-covid19-a-systematic-review/dr-annapoorna-s
Treatment of COVID-19; old tricks for new challengesLuisaSarlat
Coronavirus disease (COVID-19), which appeared in December 2019, presents a global challenge, particularly in the rapid increase of critically ill patients with pneumonia and absence of definitive treatment. To date, over 81,000 cases have been confirmed, with over 2700 deaths. The mortality appears to be around 2%; early published data indicate 25.9% with SARS-CoV-2 pneumonia required ICU admission and 20.1% developed acute respiratory distress syndrome
A cohort study evaluated the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on older COVID-19 patients. 17 patients received DMB and 26 did not. Significantly fewer DMB patients required oxygen therapy (17.6% vs 61.5%). DMB exposure was associated with reduced odds of oxygen therapy need and intensive care support. The study supports larger trials to determine if DMB can ameliorate COVID-19 severity through immunomodulation.
Efficacy of Xuebijing injection for the treatment of coronavirus disease 2019...LucyPi1
Abstract Background: To evaluate the mechanism of Chinese patent drug Xuebijing (XBJ) injection in the treatment of a new coronavirus disease 2019 (COVID-19) based on network pharmacology and molecular docking technology. Methods: The TCMSP database was employed to collect and screen the active ingredients of the Chinese herb contained in the XBJ injection. The GeneCards database and STRING database were applied to collect and expand the targets of COVID-19 and compare and screen the related targets of COVID-19 by XBJ injection. Cytoscape was employed to build a network connecting Chinese medicine, compounds, targets, disease, and topology analysis was performed via the Network Analyzer to screen the key ingredients and targets. The software of Schrödinger molecular docking was used to verify the binding activity of the key ingredients of XBJ injection and the key targets of COVID-19. Metascape platform and DAVID database were utilized to conduct Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes analysis on the key targets of COVID-19 treated by XBJ injection. Results: Eight key compounds and 15 key targets were screened and verified by molecular docking; these key compounds included luteolin, quercetin, baicalein, and kaempferol. The key targets included DPP4, AR, ESR1, CALM1, and protein kinase 1. Gene Ontology analysis involved an apoptosis and hypoxia reaction and the changes in blood vessel morphology. Kyoto Encyclopedia of Genes and Genomes analysis involved signaling pathways of hypoxia inducible factor-1, VEGF, and PI3K/AKT/NF-κB. Conclusion: The mechanism of XBJ injection when used to treat COVID-19 should be further investigated as the key compounds in XBJ regulated the expression of key targets such as protein kinase 1, VEGF-A, B-cell lymphoma-2, and TNF, which affected the COVID-19 receptors such as angiotensin-converting enzyme 2 and signaling pathways like hypoxia inducible factor-1, PI3K-Akt, and NF-κB, which alleviated the inflammation, respiratory distress, and hypoxia caused by COVID-19 infection.
Chloroquine has been shown to be effective against SARS-CoV-2 in vitro and has a well-established safety profile due to decades of use for malaria prevention and treatment. It is a cheap and widely available drug. Chinese researchers plan to promptly evaluate chloroquine's potential use for both preventing and treating the disease caused by the novel coronavirus, based on these promising in vitro results. If clinical trials confirm the biological effects, chloroquine could become one of the simplest and most affordable treatments available for this respiratory infection.
A systemic review on antibiotic use evaluation in paediatricsJing Zang
Drug utilization is the marketing, distribution, prescription, and use of drug in a society, with special emphasis on the resulting medical, social and economic consequences. Antibiotics are valuable discoveries of modern medicine and their definitive and or appropriate use has led to a decline in the morbidity and mortality associated with various infectious diseaseswhile inappropriate use of antibiotics can increase morbidity, mortality, patient cost and bacterial antibiotic resistance.Antimicrobial agents are among the most commonly prescribed drug in Paediatrics. Because of an overall rise in health care costs, lack of uniformity in drug prescribing and the emergence of antibiotic resistance, monitoring and control of antibiotic use are of growing concern and strict antibiotic policies should be warranted. The caution use for antimicrobial agents is very important as their unavailability or resistance can be life threatening. Irrational drug use is a common practice in developing countries. In India, clinician often prescribe three or four drugs to treat the most trivial conditions for the sake of satisfying the patients need to receive drugs or the drug sellers need for profit. Thus drug use evaluation studies are required for all drugs in general and particularly for antibiotics.
Review on Pharmacivigilance and mucomycocis disease VaishnaviMore55
This document outlines the course structure and contents for a Practice School pharmacovigilance course. It includes an introduction to pharmacovigilance, definitions, clinical research principles, good clinical practices, adverse drug reaction identification and assessment. It also discusses ICH E2E guidelines, selection of the antifungal drug Amphotericin B for analysis, identification of its adverse effects through patient interviews and hospital visits.
A broad perspective on COVID-19: a global pandemic and a focus on preventive ...LucyPi1
Abstract Coronavirus 2019 has become a highly infectious disease caused by severe acute respiratory syndrome coronavirus-2, a strain of novel coronavirus, which challenges millions of global healthcare facilities. Coronavirus are sub-microscopic, single stranded positive sense RNA viruses that leads to multi organ dysfunction syndrome, severe acute and chronic respiratory distress syndrome and pneumonia. The spike glycoprotein structure of the virus causes the viral protein to bind with the receptors on the lung and gut through angiotensin-converting enzyme 2. In some cases, the infected patients become hyper to the immune system because of the uncontrolled production of cytokines resulting in “cytokine storm”, a devastating consequence of coronavirus disease 2019. Due to the rapid mutant strain and infective nature of severe acute respiratory syndrome coronavirus-2, discovering a drug or developing a vaccine remains a global challenge. However, some anti-viral agents, certain protease inhibitor drugs, non-steroidal inflammatory drugs and convalescent plasma treatment were suggested. The containment and social distancing measures only aim at reducing the rate of new infections. In this view, we suggest certain traditional herbs and complementary and alternative medicine as a supporting public healthcare measure to boost the immune system and also may provide some lead to treat and prevent this infection.
The document summarizes a systematic review of treatments for COVID-19. It analyzed 19 studies on antiviral drugs, antimalarial drugs like hydroxychloroquine, and immunotherapy approaches. The top three treatments were antiviral drugs (9 studies), hydroxychloroquine or chloroquine (8 studies), and passive antibody transfer therapy (2 studies). Hydroxychloroquine showed the best success rate of reducing symptoms but larger randomized controlled trials are still needed to verify effectiveness and safety. The review proposes hydroxychloroquine combined with azithromycin as a first-line treatment based on current evidence.
Outcome Reporting Bias in COVID-19 mRNA Vaccine Clinical TrialsGuy Boulianne
The document presents a critical appraisal of the reported efficacy measures for the Pfizer/BioNTech and Moderna COVID-19 mRNA vaccines. Using epidemiological tools and data from the vaccine clinical trials, the author calculates that the absolute risk reduction for the Pfizer vaccine is 0.7% and for the Moderna vaccine is 1.1%. These measures of absolute risk reduction are much lower than the reported relative risk reduction measures of 95.1% and 94.1%, respectively. The author argues that reporting absolute risk reduction is essential to prevent outcome reporting bias and allow for informed decision making about vaccine efficacy.
Evaluation of cutaneous adverse drug reactions due to antimicrobial agents: A...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Medicines and vaccines have helped deliver improvements in patient health. History shows us the great advances we have made - today we continue to see the potential to eradicate disease and improve health outcomes when we invest in science and adopt and use new medicines.
Dissecting the underlying pharmaceutical mechanism of Danggui Buxue decoction...LucyPi1
Abstract Backgroud: Danggui Buxue decoction (DBD), a classical prescription in traditional Chinese medicine, has been found to have protective effect on bleomycin-induced pulmonary fibrosis in rats by reducing alveolar inflammation and fibrosis. However, the biological activity of individual chemical components and mechanism of action of whole formula are not clear. Methods: Potential targets of active ingredients of DBD were collected through Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and SymMap database. Target genes related to idiopathic pulmonary fibrosis were obtained from the Online Mendelian Inheritance in Man database, Therapeutic Targets Database and Gkb database. Then, the common targets were obtained by overlapping the potential targets of active ingredients in DBD and diseases related targets. The selected targets were subjected to Kyoto Encyclopedia of Genes and Genomes signaling pathway and Gene Ontology analysis, and the network map of active component-target-pathway was established using Cytoscape 3.7.1 software. The active components of DBD with most targets were selected for fibrosis-related marker verification. The mRNA and protein expression of fibrosis markers, α-smooth muscle actin, collagen 1 and fibronectin, were detected in TGF-β1-induced fibroblast cell line after treatment with the active components. Results: The 14 active ingredients, such as quercetin and kaempferol, were screened from DBD. It acts on 26 targets like estrogen receptor 2 and prostaglandin-endoperoxide synthase 2, and mainly involves 38 signaling pathways such as cell inflammation and autophagy. Kaempferol and quercetin are the two compounds with the highest network regulation, which can inhibit the transformation of fibroblasts into myofibroblasts and reduce the expression of fibrosis markers α-smooth muscle actin, collagen 1 and fibronectin. Conclusion: The integration mode of multi-component, multi-target, multi-channel and mechanism of DBD in the treatment of idiopathic pulmonary fibrosis are predicted by means of network pharmacology. Our study could indicate the direction of further anti-fibrotic mechanism research.
This document provides guidelines from the Infectious Diseases Society of America (IDSA) for the management of cryptococcal disease. A group of medical mycology experts reviewed and updated the previous 2000 IDSA guidelines. The guidelines discuss management of cryptococcal meningitis in three at-risk groups and make recommendations for other sites of infection. Key principles include induction therapy with fungicidal regimens followed by suppressive therapy, early recognition and treatment of increased intracranial pressure and immune reconstitution inflammatory syndrome, and use of lipid formulations of amphotericin B for patients with renal impairment. While cryptococcosis remains challenging, adherence to these guidelines can lead to successful management for most patients.
This document provides guidelines from the Infectious Diseases Society of America (IDSA) for the management of cryptococcal disease. It discusses recommendations for treating cryptococcal meningoencephalitis in 3 patient groups: HIV-infected individuals, organ transplant recipients, and non-HIV/nontransplant patients. Key recommendations include using induction therapy with a polyene and flucytosine, followed by fluconazole suppressive therapy. It emphasizes the importance of treating increased intracranial pressure and immune reconstitution inflammatory syndrome. Lipid formulations of amphotericin B are recommended for patients with renal impairment. Overall management of cryptococcosis requires a multifaceted approach considering the underlying disease, ant
Understanding The Benefits of COVID Flu Combo TestYesNo Covidtest
In the face of evolving respiratory threats, the COVID Flu Combo Test emerges as a valuable tool in diagnostic capabilities. By providing efficiency, convenience, and comprehensive results, this test contributes significantly to individual healthcare and broader public health initiatives. For further details or to schedule a COVID-19 Flu Combo Test, please visit our website now.
Role of Budesonide in Corona Virus Disease: Systematic Review DrHeena tiwari
Inhaled budesonide has been shown to significantly reduce the likelihood of Covid-19 patients requiring urgent or emergency care or hospitalization when given early to patients with mild symptoms. A systematic review of studies found inhaled budesonide reduced the risk of these adverse outcomes by 91% in one study. It also reduced the median time to recovery by 3 days in another study of patients with risk factors who were not hospitalized. The studies support the potential for inhaled budesonide to control the excessive inflammatory response to Covid-19 and prevent disease progression when administered early in mild cases.
Impact of potential inappropriate nsai ds use in chronic painAbout Silvia Ussai
This study analyzed data from a pharmacovigilance surveillance system to assess patterns of NSAID and opioid use in patients with chronic pain. It found that 97% of patients used NSAIDs for over 21 consecutive days, which is considered potentially inappropriate. About one-fourth of long-term NSAID users also took medications for gastrointestinal issues. The study estimated that the annual cost per individual for long-term NSAID use combined with gastrointestinal medications was 61.23 euros. Only 11% of patients received opioids, and only 2% used them long-term over 90 days. The study found no evidence of escalating opioid dosages, a proxy for dependence risk.
A Revisit To The Research Updates Of Drugs, Vaccines, And Bioinformatics Appr...Lisa Garcia
This review summarizes recent research on drugs, vaccines, and bioinformatics approaches for combating the COVID-19 pandemic. It discusses candidate drugs like remdesivir, hydroxychloroquine, and dexamethasone currently in human clinical trials. Vaccine candidates in trials include mRNA-1273 and those based on measles, mumps and rubella. The review also discusses in silico studies using molecular docking and dynamics simulations to identify potential drug targets for COVID-19. It aims to provide researchers an update on efforts to develop effective treatments and preventive strategies against SARS-CoV-2.
Indian Medicinal Herbs’ Pharmacological Interventions in the Management of CO...BRNSSPublicationHubI
The document discusses the potential use of Indian medicinal herbs in managing COVID-19. It notes that while no current treatments exist for SARS-CoV-2, medicinal plants may offer antiviral compounds that could target the viral life cycle. The review highlights several phytochemicals isolated from medicinal plants that have demonstrated antiviral effects against coronaviruses. It argues that numerous aromatic herbs and phytochemicals found in plants await further assessment for their therapeutic potential against COVID-19 and other viral illnesses.
Candidiasis is a fungal infection caused by yeasts from the genus Candida. It is commonly called oral candidiasis or thrush when it affects the mouth. It is one of the common side effects associated with the long term use of steroid inhalers. Nebulizing therapy with corticosteroids is widely accepted treatment approach for patients with acute exacerbations of Chronic Obstructive Pulmonary Disease. The other side effects of steroid inhalers include hoarseness of voice and dysphonia, which are usually ignorable. We report this case of 74 year old male patient who was on metered dosage inhaler and nebulizer therapy with corticosteroid and presented with oral candidiasis. If oral thrush develops, treatment with oral fluconazole or nystatin mouth wash is beneficial. Proper patient education by the clinical pharmacist to the patient regarding safe and effective usage of inhalers and nebulizers especially corticosteroids can minimize these drug related problems.
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
Emphysema is an abnormal permanent enlargement of the air spaces distal to terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema of lung is defined as hyper inflation of the lung ais spaces due to obstruction of non respiratory bronchioles as due to loss of elasticity of alveoli.
It is a type of chronic obstructive
pulmonary disease.
It is a progressive disease of lungs.
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Chloroquine has been shown to be effective against SARS-CoV-2 in vitro and has a well-established safety profile due to decades of use for malaria prevention and treatment. It is a cheap and widely available drug. Chinese researchers plan to promptly evaluate chloroquine's potential use for both preventing and treating the disease caused by the novel coronavirus, based on these promising in vitro results. If clinical trials confirm the biological effects, chloroquine could become one of the simplest and most affordable treatments available for this respiratory infection.
A systemic review on antibiotic use evaluation in paediatricsJing Zang
Drug utilization is the marketing, distribution, prescription, and use of drug in a society, with special emphasis on the resulting medical, social and economic consequences. Antibiotics are valuable discoveries of modern medicine and their definitive and or appropriate use has led to a decline in the morbidity and mortality associated with various infectious diseaseswhile inappropriate use of antibiotics can increase morbidity, mortality, patient cost and bacterial antibiotic resistance.Antimicrobial agents are among the most commonly prescribed drug in Paediatrics. Because of an overall rise in health care costs, lack of uniformity in drug prescribing and the emergence of antibiotic resistance, monitoring and control of antibiotic use are of growing concern and strict antibiotic policies should be warranted. The caution use for antimicrobial agents is very important as their unavailability or resistance can be life threatening. Irrational drug use is a common practice in developing countries. In India, clinician often prescribe three or four drugs to treat the most trivial conditions for the sake of satisfying the patients need to receive drugs or the drug sellers need for profit. Thus drug use evaluation studies are required for all drugs in general and particularly for antibiotics.
Review on Pharmacivigilance and mucomycocis disease VaishnaviMore55
This document outlines the course structure and contents for a Practice School pharmacovigilance course. It includes an introduction to pharmacovigilance, definitions, clinical research principles, good clinical practices, adverse drug reaction identification and assessment. It also discusses ICH E2E guidelines, selection of the antifungal drug Amphotericin B for analysis, identification of its adverse effects through patient interviews and hospital visits.
A broad perspective on COVID-19: a global pandemic and a focus on preventive ...LucyPi1
Abstract Coronavirus 2019 has become a highly infectious disease caused by severe acute respiratory syndrome coronavirus-2, a strain of novel coronavirus, which challenges millions of global healthcare facilities. Coronavirus are sub-microscopic, single stranded positive sense RNA viruses that leads to multi organ dysfunction syndrome, severe acute and chronic respiratory distress syndrome and pneumonia. The spike glycoprotein structure of the virus causes the viral protein to bind with the receptors on the lung and gut through angiotensin-converting enzyme 2. In some cases, the infected patients become hyper to the immune system because of the uncontrolled production of cytokines resulting in “cytokine storm”, a devastating consequence of coronavirus disease 2019. Due to the rapid mutant strain and infective nature of severe acute respiratory syndrome coronavirus-2, discovering a drug or developing a vaccine remains a global challenge. However, some anti-viral agents, certain protease inhibitor drugs, non-steroidal inflammatory drugs and convalescent plasma treatment were suggested. The containment and social distancing measures only aim at reducing the rate of new infections. In this view, we suggest certain traditional herbs and complementary and alternative medicine as a supporting public healthcare measure to boost the immune system and also may provide some lead to treat and prevent this infection.
The document summarizes a systematic review of treatments for COVID-19. It analyzed 19 studies on antiviral drugs, antimalarial drugs like hydroxychloroquine, and immunotherapy approaches. The top three treatments were antiviral drugs (9 studies), hydroxychloroquine or chloroquine (8 studies), and passive antibody transfer therapy (2 studies). Hydroxychloroquine showed the best success rate of reducing symptoms but larger randomized controlled trials are still needed to verify effectiveness and safety. The review proposes hydroxychloroquine combined with azithromycin as a first-line treatment based on current evidence.
Outcome Reporting Bias in COVID-19 mRNA Vaccine Clinical TrialsGuy Boulianne
The document presents a critical appraisal of the reported efficacy measures for the Pfizer/BioNTech and Moderna COVID-19 mRNA vaccines. Using epidemiological tools and data from the vaccine clinical trials, the author calculates that the absolute risk reduction for the Pfizer vaccine is 0.7% and for the Moderna vaccine is 1.1%. These measures of absolute risk reduction are much lower than the reported relative risk reduction measures of 95.1% and 94.1%, respectively. The author argues that reporting absolute risk reduction is essential to prevent outcome reporting bias and allow for informed decision making about vaccine efficacy.
Evaluation of cutaneous adverse drug reactions due to antimicrobial agents: A...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Medicines and vaccines have helped deliver improvements in patient health. History shows us the great advances we have made - today we continue to see the potential to eradicate disease and improve health outcomes when we invest in science and adopt and use new medicines.
Dissecting the underlying pharmaceutical mechanism of Danggui Buxue decoction...LucyPi1
Abstract Backgroud: Danggui Buxue decoction (DBD), a classical prescription in traditional Chinese medicine, has been found to have protective effect on bleomycin-induced pulmonary fibrosis in rats by reducing alveolar inflammation and fibrosis. However, the biological activity of individual chemical components and mechanism of action of whole formula are not clear. Methods: Potential targets of active ingredients of DBD were collected through Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and SymMap database. Target genes related to idiopathic pulmonary fibrosis were obtained from the Online Mendelian Inheritance in Man database, Therapeutic Targets Database and Gkb database. Then, the common targets were obtained by overlapping the potential targets of active ingredients in DBD and diseases related targets. The selected targets were subjected to Kyoto Encyclopedia of Genes and Genomes signaling pathway and Gene Ontology analysis, and the network map of active component-target-pathway was established using Cytoscape 3.7.1 software. The active components of DBD with most targets were selected for fibrosis-related marker verification. The mRNA and protein expression of fibrosis markers, α-smooth muscle actin, collagen 1 and fibronectin, were detected in TGF-β1-induced fibroblast cell line after treatment with the active components. Results: The 14 active ingredients, such as quercetin and kaempferol, were screened from DBD. It acts on 26 targets like estrogen receptor 2 and prostaglandin-endoperoxide synthase 2, and mainly involves 38 signaling pathways such as cell inflammation and autophagy. Kaempferol and quercetin are the two compounds with the highest network regulation, which can inhibit the transformation of fibroblasts into myofibroblasts and reduce the expression of fibrosis markers α-smooth muscle actin, collagen 1 and fibronectin. Conclusion: The integration mode of multi-component, multi-target, multi-channel and mechanism of DBD in the treatment of idiopathic pulmonary fibrosis are predicted by means of network pharmacology. Our study could indicate the direction of further anti-fibrotic mechanism research.
This document provides guidelines from the Infectious Diseases Society of America (IDSA) for the management of cryptococcal disease. A group of medical mycology experts reviewed and updated the previous 2000 IDSA guidelines. The guidelines discuss management of cryptococcal meningitis in three at-risk groups and make recommendations for other sites of infection. Key principles include induction therapy with fungicidal regimens followed by suppressive therapy, early recognition and treatment of increased intracranial pressure and immune reconstitution inflammatory syndrome, and use of lipid formulations of amphotericin B for patients with renal impairment. While cryptococcosis remains challenging, adherence to these guidelines can lead to successful management for most patients.
This document provides guidelines from the Infectious Diseases Society of America (IDSA) for the management of cryptococcal disease. It discusses recommendations for treating cryptococcal meningoencephalitis in 3 patient groups: HIV-infected individuals, organ transplant recipients, and non-HIV/nontransplant patients. Key recommendations include using induction therapy with a polyene and flucytosine, followed by fluconazole suppressive therapy. It emphasizes the importance of treating increased intracranial pressure and immune reconstitution inflammatory syndrome. Lipid formulations of amphotericin B are recommended for patients with renal impairment. Overall management of cryptococcosis requires a multifaceted approach considering the underlying disease, ant
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Role of Budesonide in Corona Virus Disease: Systematic Review DrHeena tiwari
Inhaled budesonide has been shown to significantly reduce the likelihood of Covid-19 patients requiring urgent or emergency care or hospitalization when given early to patients with mild symptoms. A systematic review of studies found inhaled budesonide reduced the risk of these adverse outcomes by 91% in one study. It also reduced the median time to recovery by 3 days in another study of patients with risk factors who were not hospitalized. The studies support the potential for inhaled budesonide to control the excessive inflammatory response to Covid-19 and prevent disease progression when administered early in mild cases.
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FORMULATION AND EVALUATION OF BI-LAYER SUSTAINED RELEASE TABLET OF AZITHROMYCIN AND DOXYCYCLINE DRUG..pptx
1. FORMULATION AND EVALUATION OF BI-LAYER SUSTAINED
RELEASE TABLET OF AZITHROMYCINAND DOXYCYCLINE
DRUG.
GUIDED BY –
PROF. P.V. VEERKAR
M.PHARM
PREPARED BY-
MR.ADINATH
SANGALE
M.PHARM SEM-1
PHARMACEUTICAL
QUALITYASSURANCE
DEPARTMENT
ROLLNO. 10
MULAEDUCATION SOCEITY COLLEGE OF PHARMACY, SONAI
AHMEDNAGAR (2021-2022)
2. CONTENTS :
Introduction.
Literature Review
Need of Work.
Aim and objective.
Plan of Work.
Material and method
Evaluation Parameters.
Result and Disscusion.
Conclusion.
Reference.
1
3. INTRODUCTION :
Bilayer tablets, sometimes called double-layer tablets, are a
newer technology for the development of controlled release
formulation. They have a combination of two or more active
pharmaceutical ingredients in a single dosage form.
Nowadays, the use of bi-layered tablets is growing.
the medicines which consist of two same or different drugs
combined in a single dose for effective treatment of the
disease.
Bi-layer tablets are developed to achieve controlled delivery
of different drugs with pre-defined release profiles.
Bi-layer tablets are presently being developed by several
pharmaceutical companies.
2
4. Patent expansion, therapeutic, marketing to name a
few, for a multitude of purposes.
Bilayer tablets have certain problems such as layer
separation, compression, colour shading. There are
also various methods to minimize or solve these
problems.
3
5. Sustained Release Tablets:
4
Sustained-release tablets are manufactured to be more potent
but dissolve slowly so they release small amounts of a
medication into a patient's system over an extended period of
time. Controlled release technologies allow patients and
physicians to be in better control of patient health.
Sustained-release (SR) drugs maintain drug release over a
sustained period but not at a constant rate.
Reduces the number of doses which lowers expenses and
improves patient compliance, especially for chronic diseases.
Decreases side effects.
6. COVID-19 :
5
Covid-19 is a pandemic disease with high mortality which is
caused by the rapid spread of the Severe Acute Respiratory
Syndrome SARS-COV-2. It appeared for the first time in
Wuhan, China, in December 2019, WHO later announced that
the disease had become a global pandemic When this research
was prepared in early July 2020, about half a million deaths
were reported; out of approximately 11 million confirmed
cases of COVID-19 worldwide .
7. Secondary infection :
6
Viral pneumonia increases the risk of bacterial co-infection which raises the
severity and mortality of the disease.
2020 reported that about 50% of patients who are died after hospitalization
due to COVID-19 had secondary bacterial infections. Studies indicated that
10-30% of hospitalized patients with severe COVID-19 commonly suffer
secondary infections.
8. Role of antibiotics in COVID-19 :
European Respiratory Society China, Germany (Indian MOH (MOHFW-Guidlines -India,
2020). Turkish (and Egyptian (MOHP.EG, 2020) (guidelines described the importance of
antibiotics in the management of secondary infection associated with COVID-19. Some other
guidelines didn't mention the role of antibiotics, examples include web published guidelines
Australia and the SaudiArabia Ministry of Health.
This review aims to recall experience regarding the role of antibiotics in previous viral
pneumonia pandemics and to provide a pharmacological basis of the potential role of
specified antibiotics Doxycycline (DOX) and Azithromycin (AZ) to improve clinical
outcomes of management of COVID -19. SARS-CoV-2, Viral pneumonia, Antibiotics,
antiviral drugs, immunomodulation, secondary infection, Antibiotics- Macrolide
Azithromycin, Tetracycline- Doxycycline Use. 7
9. The current review provided the detailed antiviral, immunomodulatory effect,
unique pharmacokinetic profile of two antibiotics namely azithromycin and
doxycycline. It summarizes current clinical trials and concerns regarding
safety issues of these drugs.
Azithromycin has excellent lung tissue penetration, broad antibacterial
effectiveness, and potential antiviral activity against COVID-19.
In limited clinical trials, it also showed efficacy when paired with other
antiviral medications, however many clinicians are concerned about
cardiovascular risk in susceptible patients.
Doxycycline plays an important role in the treatment of pneumonia. It has a
number of advantages, including cardiac safety, easy access to lung tissue,
antiviral potential, and immunomodulation effects through a variety of routes.
The pharmacological characteristics of these medicines raise the possibility of
additional research into their use in the treatment of COVID-19.
8
10. Literature Review :
Ahmed S. Ali, Mai A. ASattar. (2021) - A novel corona virus SARS-CoV-7 has
led to an outbreak of the highly infectious pan demic COVID-19 complicated viral
pneumonia. Patients with risk factors frequently develop sec on dary infections
where the role of appropriate antibiotics is mandatory. However, the efforts of
drug repurposing lead to recognizing the role of certain antibiotics beyond the
management of infection. The current review provided the detailed antiviral,
immunomodulatory effect, unique pharmacokinetic profile of two antibiotics
namely azithromycin (AZ) and doxycycline (DOX).
Usha Yendrapalli. (202112 patients (9.5%) required oxygen of 1-2 Lat discharge. 80.9% of
patients have been discharged home or inpatient rehabilitation. 2021 Published by Elsevier
Ltd on behalf of King Saud BinAbdulaziz University for Health Sciences.
Nobuaki Mori (2020)- specific therapy is available for COVID-19. We report the
effectiveness and adverse effects of triple therapy with hydroxychloroquine,
azithromycin.
9
11. Muneeba Akhtar (2020)- Bilayer tablets are the medicines which consist of two
same or different drugs combined in a single dose for effective treatment of the
disease. The aim of this review is to reveal the challenges that appear during the
preparation of bilayer tablets, and also propose solutions for these challenges.
Nobuaki Mori (2020)- specific therapy is available for COVID-19. We report the
effectiveness and adverse effects of triple therapy with hydroxychloroquine,
azithromycin.
10
12. NEED OF WORK :
Bi-Layer sustained release tablet and a mixture of drugs that are two
different drugs are effective combination in one dose.
To overcome following the problems of drugs and diseases:-
Future Prospects Benefits of CombiningAZI and DOXY is more
advantageous.
avoiding multiple doses in a day.
To avoid the risk of corona and pneumonia.
The mixture of one tablet works on many diseases. Such as Covid-19,
pneumonia, nongonococcal uthirites.
Future Prospects Benefits ofAzi + Doxy - Combining doxy and azi is
more advantageous.
This is because when the two medications are taken together, they
work better.At the same time
11
13. From literature survey, it was found that not a single work has been done on
the combination of these two drugs. Majority of the work has been done on
each drug individually or with these drugs in combinations with the drugs of
their own categories only. However literature survey did not indicate the
availability of any research article related to combination of these two drugs in
combination and in the form of bilayer tablets.
12
14. AIM AND OBJECTIVE OF WORK :
13
Formulation, Evaluation and Development of Sustained
Release Bi-layer tablet of combination Azithromycin and
Doxycycline drugs.
Azithromycin has excellent lung tissue penetration, broad antibacterial
effectiveness, and potential antiviral activity against COVID-19.
Doxycycline plays an important role in the treatment of pneumonia. It has a
number of advantages, including cardiac safety, easy access to lung tissue,
antiviral potential, and immunomodulation effects through a variety of routes.
The pharmacological characteristics of these medicines raise the possibility of
additional research into their use in the treatment of COVID-19.
15. The Main Objectives of Present Work Are:
14
Formulation of a bilayer tablet for convenience and ease of
administration.Accuracy in Dosing Size.
Avoiding multiple tablets in a day for the patients for two diseases.
Avoiding dose dumping and thus reducing toxicity levels in
patients.
Longer Duration of action and efficacy.
Decrease in cost i.e Cost effective.
Attractive colour in one layer to differentiate between two layers
and also to increase patient acceptability.
16. Plan of Work
PLAN OF WORK
Literature survey
Selection of drug
Selection of excipients
Preformulation study
API
Preformulation study
of Excipients
15
17. Solubility, melting point, UV,
pH, maximum wavelength
Physical evaluation of
excipients
Formulation SR release tablet by suitable
method
Bulk and tapped
density
Angle of repose
Hausner’s ratio
and car’s index
Drug content
In-Vitro drug release
study
16
18. 2) Doxycycline
API- 1)Azithromycin
Excipients-
Croscarmellose.
Sodium starch glycolate.
Talcum.
PVP K 30.
Aerosil.
Microcrystalline cellulose.
Magnesium stearate.
I. Disintegrating-
II. Superdisintegrant-
III. Absorb moisture-
IV. Good adhesive properties-
V. Increased hardness –
VI. Binder/Diluent -
VII.Flow agent-
VIII.
IX.
Excellent compressibility properties- Lactose.
Binder or matrix former- CMC/Carboxymethel cellulose.
MATERIALS AND METHOD :
17
19. Appearance and color-
18
1) Azithromycin – White crystalline powder, odourless powder.
2) Doxycycline – light-yellow crystalline powder, odorless powder.
Melting point detection-
The melting point ofAzithromycin and Doxycycline is matched with standard melting point.
Sr.
No. Melting Point Range
AZITHROMYCIN
(API)
DOXYCYCLINE
(API)
1. As per Literature 1130-1150 C 212-219 0 C
2. Practical 1150 C 2140 C
28. IR peak value of Azithromycin and Doxycycline Mixture
with Polymers :
Types of Bonds Wave Number /cm -1
Found
N-H Stretching 3456.78
C-H Stretching (Methyl) 2970.8
C-H Stretching Vibration of (aromaticring) 3114.47
C=O Stretching Vibration of Amide Moiety 1650.77
Aliphatic C-H Stretch 2962.13
CH2 (Bending) 1461.78
C=C Stretching/bending 1599.66
COOH bending 1381.75
Disubstituted benzene 1696.09
27
29. Differential Scanning Calorimetry (DSC):
28
As per literature the thermogram of Azithromycin was observed at 115°C.
The above DSC thermogram is observed at 115°C which is similar to the
literature. . The Azitromycin and Doxycycline bilayer Tablet Formulation
exhibited double, sharp endothermic peaks at 214.43°C, 155.73°C and
170.91°C.
30. Azithromycin and Doxycycline DSC thermogram was evaluated and it is concluded
that, there no such
interference occurs in between drug and excipient. The thermogram of Azithromycin
and Doxycycline ,
29
Azithromycin and Doxycycline with polymer given in Figure.
42. CONCLUSION :
40
Sustained release Tablet (SR) of (AZI-DOX) were formulated successfully with desired
characteristics; disintegrated rapidly.
Prepared SR will provide Rapid onset of action.
Prepared SR will enhanced the patients convenience and Patients compliance.
The sustained-release tablet works at the right time.
Prepared SR is shown better andAdvanced formulation than Marketed tablet.
43. REFERENCES :
41
• 1) formulation development and in-vitro evaluation of double layer tablet of sustained release (s.r.)
flurbiprofen and immediate release doxycycline.
international journal of pharmaceutical sciences and research
IJPSR (2017), Volume 8, Issue 9
http://dx.doi.org/10.13040/UPSR.0975-8232.8 (9).3978-85
• 2) Preparation and evaluation of sustained-release azithromycin tablets in vitro and in vivo
Sustained-release tabletAzithromycinPharmacokineticsUPLC-MS-MS
journal homepage: http://ees.elsevier.com/ajps/default.asp
• 3) Design and Development of Bi-layered Sustained ReleaseAzithromycin Tablets
(Received: December 2, 2016;Accepted: December 18, 2016; Published (web): December 27,
2016)
• 4) Development and evaluation of bilayer tablets of combination of antibiotics for the treatment of
sexually transmitted disease