Catharanthus roseus Combination Therapy with Orthodox Oral Hypoglycemic Drugs...Ram Sahu
Most of the chronic diseases including diabetes mellitus are difficult to treat successfully with orthodox drugs. Investigation in complementary and alternative medicines is now being intensified to proffer lasting solution. Natural products and their derivatives may be considered as a potential source of novel compounds which can combine with orthodox drugs to enhance their hypoglycemic effect. To investigate the complementary and synergistic effect of Catharanthus roseus (C. roseus) leaves extract with oral hypoglycemic synthetic drugs sulphonylurea (glibenclamide) and biguanide (metformin). Experimental induction of diabetes in rats using alloxan model was employed. Five rats each of six groups were used. Group I received distilled water only. Groups II, III and IV received 250 mg/kg of methanol extract, 100 mg/kg of biguanide (metformin) and 1 mg/kg of sulphonylurea (glibenclamide), respectively. Groups V and VI received extract-metformin and extract-glibenclamide combination at doses as above, respectively. Administration of the six groups was carried out once daily for seven days. At 2, 12, 24, 72 and 168 h, fasting blood glucose was determined using a glucometer. When compared with control alone, all medicaments significantly (p<0.05) lowered blood glucose levels. The highest percentage reduction in blood glucose (64.9%) occurred with extract-biguanide (metformin) combination. The leaves extract of C. roseus – biguanide (metformin) combination offered a promising novel approach to diabetes mellitus treatment.
Generic Metformin Tablets for Treatment of Type 2 Diabetes (Non-Insulin Dep...The Swiss Pharmacy
Glycomet (Generic Metformin Tablets) and Exermet XR or Glycomet SR (Metformin Extended Release Tablets) are used to treat type 2 diabetes mellitus (non-insulin dependent diabetes) in adults, when diet and exercise alone does not result in adequate control of blood glucose levels. Generic Metformin is also used in the treatment of polycystic ovary syndrome (PCOS).
Catharanthus roseus Combination Therapy with Orthodox Oral Hypoglycemic Drugs...Ram Sahu
Most of the chronic diseases including diabetes mellitus are difficult to treat successfully with orthodox drugs. Investigation in complementary and alternative medicines is now being intensified to proffer lasting solution. Natural products and their derivatives may be considered as a potential source of novel compounds which can combine with orthodox drugs to enhance their hypoglycemic effect. To investigate the complementary and synergistic effect of Catharanthus roseus (C. roseus) leaves extract with oral hypoglycemic synthetic drugs sulphonylurea (glibenclamide) and biguanide (metformin). Experimental induction of diabetes in rats using alloxan model was employed. Five rats each of six groups were used. Group I received distilled water only. Groups II, III and IV received 250 mg/kg of methanol extract, 100 mg/kg of biguanide (metformin) and 1 mg/kg of sulphonylurea (glibenclamide), respectively. Groups V and VI received extract-metformin and extract-glibenclamide combination at doses as above, respectively. Administration of the six groups was carried out once daily for seven days. At 2, 12, 24, 72 and 168 h, fasting blood glucose was determined using a glucometer. When compared with control alone, all medicaments significantly (p<0.05) lowered blood glucose levels. The highest percentage reduction in blood glucose (64.9%) occurred with extract-biguanide (metformin) combination. The leaves extract of C. roseus – biguanide (metformin) combination offered a promising novel approach to diabetes mellitus treatment.
Generic Metformin Tablets for Treatment of Type 2 Diabetes (Non-Insulin Dep...The Swiss Pharmacy
Glycomet (Generic Metformin Tablets) and Exermet XR or Glycomet SR (Metformin Extended Release Tablets) are used to treat type 2 diabetes mellitus (non-insulin dependent diabetes) in adults, when diet and exercise alone does not result in adequate control of blood glucose levels. Generic Metformin is also used in the treatment of polycystic ovary syndrome (PCOS).
Herbal drugs are usually considered safe but when taken along with other drugs of chemical origin (allopathic drugs), they do interact with them and cause Bio-drug interaction
Background and aim: Diabetes Mellitus [DM] is a metabolic disorder characterized by disturbances in carbohydrate, protein and lipid metabolism and by complications like micro vascular (retinopathy, neuropathy and nephropathy) and macro vascular (heart attack,stroke and peripheral vascular disease) complications. Coriandrum sativum Linn has been claimed to possess antidiabetic properties in Traditional System of Medicine. This study aimed to evaluate molecular interaction of linalool in C.sativum and targeted protein related to Type 2 DM.
discusses about the interaction of certain drugs with some food materials and explains in detail about the effect of food on absorption, distribution, metabolism and excretion. Also dicsussed about the pharmacodynamic and pharmacogenomic aspects
Presentation on co drug strategy for treating hypertension in type iiLatika Budhalakoti
This presentation is on co-drug design, two drugs are chemically linked together for their improved delivery properties so as to reach a site simultaneously achieving better absorption as compared to when co-administered in separate dosage forms.
Often ignored, exploring the aspect of drug and diet interaction is one of the vital aspects of approaching any healthcare case study. Hence, here are my slides to understand the complexities of the same.
Effect of parkia biglobosa extract on open skin wound with joseph simeon oyepataoyepata
Effect of Parkia biglobosa extract on open skin wound
healing in dexamethasone- induced hyperglycaemia
and histological assessment in rats
Modupe Iretiola Builders1*, Oyepata Simeon Joseph1 and Akpobome Raymond Vhriterhire2
A Study of Prescription Patterns of DPP-4 inhibitors..Samya Sayantan
Diabetes Mellitus (DM) is a metabolic disorder of which inappropriate hyperglycemia is the hallmark. For this reason, several classes of oral hypoglycemic drugs like Sulfonylurea, Biguanides, Meglitinides, Thiazolidinediones, α-glucosidase inhibitors are prescribed to treat Diabetes Mellitus. But at present Dipeptidyl Peptidase (DPP-4) Inhibitors have attracted attention as oral hypoglycemic agents that recently introduced to Bangladesh. This study aims to evaluate the current prescribing pattern of DPP-4 inhibitors at BIRDEM hospital, Bangldesh.during the survey, 150 prescriptions were collected and investigated where only 49% DPP-4 inhibitors – Sitagliptin, Linagliptin, Vildagliptin are prescribed even along with other conventional oral hypoglycemic drug. According to this survey, it is clear that Dipetidyl Peptidase (DPP-4) inhibitors is becoming more popular day by day in the management of hyperglycemia in Type-2 Diabetes without causing weight gain or hypoglycaemia in Bangladesh.
Herbal drugs are usually considered safe but when taken along with other drugs of chemical origin (allopathic drugs), they do interact with them and cause Bio-drug interaction
Background and aim: Diabetes Mellitus [DM] is a metabolic disorder characterized by disturbances in carbohydrate, protein and lipid metabolism and by complications like micro vascular (retinopathy, neuropathy and nephropathy) and macro vascular (heart attack,stroke and peripheral vascular disease) complications. Coriandrum sativum Linn has been claimed to possess antidiabetic properties in Traditional System of Medicine. This study aimed to evaluate molecular interaction of linalool in C.sativum and targeted protein related to Type 2 DM.
discusses about the interaction of certain drugs with some food materials and explains in detail about the effect of food on absorption, distribution, metabolism and excretion. Also dicsussed about the pharmacodynamic and pharmacogenomic aspects
Presentation on co drug strategy for treating hypertension in type iiLatika Budhalakoti
This presentation is on co-drug design, two drugs are chemically linked together for their improved delivery properties so as to reach a site simultaneously achieving better absorption as compared to when co-administered in separate dosage forms.
Often ignored, exploring the aspect of drug and diet interaction is one of the vital aspects of approaching any healthcare case study. Hence, here are my slides to understand the complexities of the same.
Effect of parkia biglobosa extract on open skin wound with joseph simeon oyepataoyepata
Effect of Parkia biglobosa extract on open skin wound
healing in dexamethasone- induced hyperglycaemia
and histological assessment in rats
Modupe Iretiola Builders1*, Oyepata Simeon Joseph1 and Akpobome Raymond Vhriterhire2
A Study of Prescription Patterns of DPP-4 inhibitors..Samya Sayantan
Diabetes Mellitus (DM) is a metabolic disorder of which inappropriate hyperglycemia is the hallmark. For this reason, several classes of oral hypoglycemic drugs like Sulfonylurea, Biguanides, Meglitinides, Thiazolidinediones, α-glucosidase inhibitors are prescribed to treat Diabetes Mellitus. But at present Dipeptidyl Peptidase (DPP-4) Inhibitors have attracted attention as oral hypoglycemic agents that recently introduced to Bangladesh. This study aims to evaluate the current prescribing pattern of DPP-4 inhibitors at BIRDEM hospital, Bangldesh.during the survey, 150 prescriptions were collected and investigated where only 49% DPP-4 inhibitors – Sitagliptin, Linagliptin, Vildagliptin are prescribed even along with other conventional oral hypoglycemic drug. According to this survey, it is clear that Dipetidyl Peptidase (DPP-4) inhibitors is becoming more popular day by day in the management of hyperglycemia in Type-2 Diabetes without causing weight gain or hypoglycaemia in Bangladesh.
ABSTRACT
Over the last decade, diabetes mellitus has emerged as an important clinical and public health
problem throughout the world. The aim of the study is perceive the Potentiality of a newer oral
Antihyperglycemic combination therapy over conventional therapy in type 2 diabetes. The
prospective study was conducted over a period of six months in the department of Medicine,
Guntur City Hospital. The prevalence of type2 diabetes was high in male 65.79 % than female
34.21%. Majority of the patients (23.68 %) belonged to age group of 51–55 years. Majority of
patients (55.26%) having a family history of Diabetes. Majority of patients receiving Combination
of Glibenclamide + Metformin (60.53%), evaluated for effect on FPG for both combinations. The
mean changes in FPG were noted. In the same way effect on HbA1c also noted. Mean changes in
for every month HbA1c will be noted. Our study reveals that Combination therapy with Metformin
plus Glimepiride is more effective than Glibenclamide plus Metformin; in improving glycemic
control in type 2 diabetes, while also allowing a reduction of the dosage of each drug.
BETH MARTINSExplain the difference between the types of dia.docxtangyechloe
BETH MARTINS
Explain the difference between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes
Type I Diabetes is hyperglycemia due to insulin deficiency. This is caused by autoimmune destruction of B cells that are within the islets of Langerhans (Chetan, Thrower,& Narendran, 2019). Some signs surrounding Type I DM is polydipsia, polyuria, and weight loss. This is more common in children, but can be diagnosed at any age throughout life. Type I diabetes used to be called juvenile diabetes,but this is now known to not be the correct way to view this disease.
Type 2 Diabetes is impaired insulin secretion and abnormal suppression of postprandial (Hurtado & Vella, 2019). Type 2 DM the pancreas resists insulin, or does not produce enough insulin on its own. Often Type I and Type 2 DM are diagnosed incorrectly or mistaken for each other as signs and symptoms are similar. Being overweight or reduced amount of exercise is though to be a contributing factor as well as genetics, but this is till not fully understood.
Gestational diabetes is characterized by spontaneous hyperglycemia during pregnancy. Some risk factors include family history of diabetes, obesity during pregnancy, and advanced maternal age (Plows, Stanley, Baker, 2019). B cell dysfunction which lacks the ability to release insulin when the body needs it is what causes gestational diabetes.
Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
Patients who have Type 2 DM have both insulin resistance and impaired insulin secretion (Rosenthal & Burchum, 2021). The liver, muscle and adipose tissue are insulin resistant and increased blood sugar causes B cell function to fail. Insulin secretion decreases and B cells must increase how hard they must work to work against insulin resistance within the tissues (Rosenthal & Burchum, 2021).
The medication I chose os Metformin from the class of Biguanide medications for treatment of Type 2 DM. Metformin uses 3 mechanisms to help lower blood sugar.
Inhibits glucose production in the liver
Reduces glucose absorption in the gut
Sensitizes insulin receptors in fat and skeletal muscle
Metformin is taken by mouth and is absorbed by the small intestines and excreted by the kidneys. Metformin is known to be a great choice for those who skip meals as it will not make blood sugar levels become dangerously low. Those with DM Type 2 should eat healthy carbs such as fruits and vegetables and not indulge in sugary drinks. Protein and polyunsaturated fats should be a staple in the everyday diet. Alcohol should be avoided, and the patient should try to eat several small “meals” per day tp keep blood sugar steady. If blood sugar becomes low having a sugary snack with a complex carbohydrate such as peanut butter and crackers should be on hand.
Short-term and long-t.
Effect of emulin on blood glucose in type 2 diabetics - https://emulincanada.comAj Martirano
Effect of Emulin on Blood Glucose in Type 2 Diabetics https://emulincanada.com
,effect of emulin on blood glucose in type 2 diabet ,emulin diabetes ,igalen emulin diabetes ,emulin type 2 diabetes
Synthetic Drugs/Hormones - Boon or Bane- Concept of Dooshivisha and Gara VishaIJARIIT
21st century is the world full of synthetics and everyone are living in the influence of synthetic substances. Altered life
styles, food habits and irregular sleep pattern had resulted not only Non communicable disease but also resulting in reduced
immunity and is risking the person more for infections. Pharma Industry has grown as big as hierarchy in recent centauries
and introduces new chemical molecules quoting as capable for treating diabetes, hypertension etc. But bitter truth is prolonged
usage these medications itself has adverse effect on liver and kidneys causes hepatotoxicity and nephrotoxicity or organs
specific toxicity.
Obesity is a multifactorial disorder of energy balance, in which long-term calorie intake exceeds energy output. The generally accepted benchmark is the body mass index (BMI).
2014 Report: Medicines in Development for DiabetesPhRMA
Nearly 26 million Americans are affected by diabetes—including 7 million people who are unaware they have the disease. One of the top 10 causes of death in the United States, diabetes has far-reaching implications for patients and their families and our health care system.
Biopharmaceutical Research Companies Are Developing 180 Medicines to Treat Diabetes and Related Conditions.
DIABETES IS A PROGRESSIV DISEASE AND WE NEED TO STAY ONE STEP AHEAD OF THE DISEASE.WE HAVE TO TITRATE THE MEDICATIONS EVERY THREE MONTHS AND THE TIME IS NOT OUR FRIEND AS FAR AS THE MANAGEMENT OF DIABETES IS CONCERNED
Similar to The potency of some brands of anti diabetic medicine- metformin hydrochloride b.p 500 mg tablet on the ghanaian market (20)
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
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Protonitazene (hydrochloride) CAS: 119276-01-6
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The potency of some brands of anti diabetic medicine- metformin hydrochloride b.p 500 mg tablet on the ghanaian market
1. Chemistry and Materials Research
ISSN 2224- 3224 (Print) ISSN 2225- 0956 (Online)
Vol.3 No.12, 2013
www.iiste.org
The Potency of Some Brands of Anti-Diabetic MedicineMetformin Hydrochloride B.P 500 mg Tablet on the Ghanaian
Market
George Louis Williams1 , Dennis Agbotse1**
Science Laboratory Technology Department, Accra Polytechnic, P.O box GP561, Accra. Ghana
*E-mail: glowils@hotmail.com ; **denagbo210@gmail.com
Abstract
Metformin hydrochloride tablet is a drug of choice in the treatment of diabetes mellitus type-2 especially in
obese patients. It is normally given in initial doses of 500mg tablet two or three times daily or 850mg once
or twice daily with or after meals. Recently there were numerous concerns on the increase in substandard
pharmaceutical products on the market. A study was therefore carried out to determine the potency of some
brands of metformin hydrochloride tablet BP 500mg using the test method for assay as prescribed in the
British Pharmacopoeia (BP) monograph. In the study, seven different brands of sample were purchased
from various pharmacies in Accra and analyzed. The results indicated that all the samples analyzed passed
the test for assay, dissolution rate and uniformity of weight. It is recommended that a study work be carried
out on other brands.
Keywords: Metformin hydrochloride, Diabetes , Potency claim , British Pharmacopeia (BP)
1. Introduction
Metformin Hydrochloride Tablet is a biguanide anti-diabetic. It is given by mouth in the treatment of Type-2
Diabetes Mellitus and it is a drug of first choice in obese patients. The initial dosage is 500mg two or three times
daily or 850mg once or twice daily with or after meals, gradually increased if necessary to 2 to 3g daily dose
(MDR, 2005).
Metformin hydrochloride is slowly and incompletely absorbed from the gastrointestinal tract, the absolute
bioavailability of a single 500mg dose is reported to be about 50 to 60% although this is reduced somewhat if
taken with food. Once absorbed, plasma binding is negligible, and it is excreted unchanged in the urine. The
plasma elimination half-life is reported to range from about 2 to 6 hours after oral doses.
Diabetes mellitus type-2 is a metabolic disorder that is characterized by a high blood glucose in the context of
insulin resistance and relative insulin deficiency (Jayasagar et al, 2002). This is in contrast to diabetes mellitus
type-1, in which there is an absolute insulin deficiency due to the destruction of islet cells in the pancreas. The
classic symptoms are excess thirst, frequent urination and constant hunger. Type-2 diabetes makes up about 90%
of cases of diabetes with the other 10% due primarily due to diabetes mellitus type-1 and gestational diabetes.
On the 13th of February 2013, the Food and Drugs Authority (FDA) of Ghana released alert on several media
platforms including the 14th February edition of the Daily Graphic, captioned; “Osons Chemist and Roxin Ghana
Imports Fake medicines from India”. In the alert which was signed by the Chief Executive Officer, the FDA
claimed Osons Chemist imported and placed on the Ghanaian market fake and substandard MIMET
(Ergometrine) and Rox-Clav 625 tablets respectively. Consequently the FDA banned the manufacturers of these
medicines and also revoked the registration of all medicines (which includes Metformin hydrochloride tablets)
registered with it by the manufacturers of the two substandard counterfeit medicines.
From the above concern, it is therefore necessary to carry out an assessment of the potency (label claim) of
Metfromin hydrochloride 500mg tablets sold in pharmacy shops in order to ascertain their potency.
1.1Problem statement
Counterfeit and substandard medicines have been a serious problem facing health delivery system as a country
especially a developing one. Could metformin hypochloride bp 500 mg be one of the fake or substandard
drugs on the market?
By some estimation, about 40-60% of medicines on the market are fake or substandard. Several efforts have
been both proposed and undertaking to combat the problem. Perhaps the most recent of these is the drug
enforcement operation by the Food and Drugs Authority of Ghana. More action is needed to drastically reduce to
33
2. Chemistry and Materials Research
ISSN 2224- 3224 (Print) ISSN 2225- 0956 (Online)
Vol.3 No.12, 2013
www.iiste.org
acceptable levels or totally eliminate this canker from the health delivery system and systematically assaying
the various drugs on the market will expose the fake and substandard ones.
1.2 Objectives
The objective is to carry out Assay, Dissolution Rate and Weight Uniformity of metformin hydrochloride tablet
BP 500mg, and comparing it to the British Pharmacopoeia (BP) standards to determine their potency or
otherwise.
2. Metformin
Metformin is an oral anti-diabetic drug in the biguanide class. It is the first- line drug of choice for the treatment
of type-2 diabetes, in particularly, in overweight and obese people and those with normal kidney function (RCP,
2008). Metformin is the only antidiabetic drug that has been conclusively shown to prevent the cardiovascular
complications of diabetes. It helps to reduce LDL cholesterol and triglyceride levels, and is not associated with
weight gain. As of 2010, metformin is one of the only two antidiabetic drugs in the World Health Organization
model list of essential medicines. (WHO, 2010).
When prescribed correctly, metformin causes few adverse effects (the most common is gastrointestinal upset)
and is associated with a low risk of hypoglycaemia. First synthesized and and found to reduce blood sugar in the
1920’s, metformin was forgotten for the next two decades as research shifted to insulin and other antidiabetics.
Interest in metformin was rekindled in the late 1940’s after several reports that it could reduce blood sugar levels
in people, and in 1957, French physician Jean Sterne published the first chemical trial of metformin as a
treatment for diabetes. Metformin is now believed to the the most widely prescribed antidiabetic drug in the
world. (Bailey, 2004).
2.1 Medical Uses Of Metformin
Metfromin is primarily used for type-2 diabetes, but it is increasingly beein used in Polysytic Ovary Syndrome
(PCOS), non-alcoholic Fatty Liver Disease (NAFLD) (Marchesini et al, 2001). The benefit of metformin in
NAFLD has not been extensively studied and may only be temporary. (Nair et al, 2004).
2.1.1 Type-2 Diabetes
The main use of Metformin is in the treatment of diabetes mellitus type-2, especially in overweight people. In
this group, over 10 years of treatment, metformin reduced diabetes complications and overall mortality by 30%
when compared with insulin and sulfonylureas (glibenclamide and chlorpropamide) and by about 40% when
compared with the group only given dietary advice. (Lancet, 1998). The difference held in people who were
followed up for five to ten years after the study. (Holman et al, 2008).
Since intensive glucose control with metformin appears to decrease the risk of diabetes-related end points in
overweight people with diabetes, and is associated with less weight gain and fewer hypoglycaemic attacks than
are insulin and sulfonylureas. Metformin affords a similar level of blood sugar control to insulin and
sulfonylureas, it appears to decrease mortality primarily through decreasing heart attacks, strokes and other
cardiovascular complications. (Selvin et al, 2007)
2.1.2 Pre-diabetes
Metformin treatment for people at risk for type-2 diabetes may decrease their chances of developing the disease,
although intensive physical exercise and dieting work significantly better for this purpose. In a large United
States study known Diabetes Preventive Program, participants were divided into groups and given either place
on, metformin or lifestyle intervention, and followed for an average of three years. The intensive program of
lifestyle modification included a 16-lesson training on dieting and exercise followed by monthly individualized
sessions with the goals to decrease the body weight by 7% and engage in a physical activity for at least 150
minutes per week. The incidence of diabetes was 58% lower in the lifestyle group and 31% lower in those given
metformin. Among younger people with a higher body mass index lifestyle modification was no more effective
than metformin, and for older individuals with a lower body mass index, metfromin was no better than placebo
in preventing diabetes. After 10 years, the incidence of diabetes was 34% lower in the group of participants
given diet and exercise and 18% lower in those given metformin (Knowler et al, 2009).
It is unclear whether metformin slowed down the progression of pre-diabetes to diabetes (true preventive effect)
, or the decrease of diabetes in treated population was simply due to its glucose-lowering action (treatment
effect) (Lilly, 2009).
3. Materials And Methods
3.1 Sampling
Seven different brands of Metformin hydrochloride 500mg BP Tablet were purchased from different pharmacy
shops in Accra.
3.2 Procedures
Reference Procedure: British Pharmacopoeia, 2010
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3. Chemistry and Materials Research
ISSN 2224- 3224 (Print) ISSN 2225- 0956 (Online)
Vol.3 No.12, 2013
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3.2.1 Assay
Twenty tablets was weighed and grounded into powder. 0.1 g of the powdered metformin hydrochloride was
added to 70 ml of water and shaked for 15 minutes. The suspension was further diluted to
100 ml with
water and filtered. 20ml of the resulting solution was discarded after settling and 10 ml of the resulting
solution again diluted to 100 ml. the absorbance of the final solution was measured at a wavelength of 232nm
using the ultraviolet- visible spectrophotometer .
The content of metformin hydrochloride was then computed taking 798 as the value of A (1%, 1cm) at a
peak of 232nm.
The expression A (1%, 1cm) representing the specific absorbance of a dissolved substance refers to the
absorbance of 1% w/v solution in a 1 cm cell and measured t a defined wavelength so that;
A (1%, 1cm) = 10ε/M
Where M is the molecular weight of the substance being examined.
The specific absorbance is therefore the national absorbance of a 1cm layer of a 1% w/v solution of the
absorbing solute.
3.2.2 Tablet Dissolution Rate
Six tablets were selected randomly from a brand, weighed and placed in the dissolution basket and lowered into
a medium (900ml of 0.68% w/v solution of potassium di-hydrogen orthophosphate, pH 6.8). The chamber was
then operated at 100rpm for 45 minutes, after which a sample of the resulting solution was drawn separately
from each chamber and filtered, 10ml of the filtrate was then diluted to 100ml. The absorbance of the filtered
solutions was then determined at the peak wavelength of 233nm using the ultraviolet-visible spectrophotometer.
The total content of metformin hydrochloride in the medium was determined using 806 as the value of A (1%,
1cm) at the peak at 233nm.
3.2.3 Weight Uniformity
Twenty tablets of each brand was selected randomly and weighed. The average weight was then evaluated,
acceptable deviations are not to be more than 5 %.
4.Results And Discussions
4.1Assay
Table 1gives the distribution of the Metformin Hydrochloride content of samples of the various brands used in
the study work. Generally, all samples analyzed fall within the acceptable limit of 95% ~105% assay. Assay is a
single test carried out for the purpose of estimating the potency of a material/preparation or the pooled results of
two or more such tests.(BP, 2010)
4.2 Dissolution
Generally, all the samples passed the test for dissolution rate which should not be less than 85%.These
recorded (table 2 ) values within the recommended values according to the British Pharmacopeia BP 2010.
In the Pharmaceutical industry, drug dissolution testing is routinely used to provide critical in vitro drug release
information for both quality control purposes, [ to assess the batch-to-batch consistency of solid oral dosage
forms such as tablets, and drug development, ] to predict in vivo drug release profiles. (Bai, et al 2011). In vitro
drug dissolution data generated from dissolution testing experiments can be related to in vivo pharmaco-kinetic
data by means of in vitro-in vivo correlations (IVIVC).
A well established predictive IVIVC model can be very helpful for drug formulation design and port-approval
manufacturing changes. (Kortejarvi, et al, 2006). The main objective of developing and evaluating an IVIVC is
to establish the dissolution test as a surrogate for human bioequivalence studies; as stated by the Food and Drugs
Administration (FDA). Analytical data from drug dissolution testing are sufficient in many cases to establish
safety and efficacy of a design product without in vivo tests, following minor formulation and manufacturing
changes. (Qureshi, 2001)
4.3 Weight Uniformity
When 20 individuals units are taken at random and weighed, not more than two of the individual masses should
deviate from the average mass by more than 5% for 250 mg and above tablets (BP 2010);
Generally, all samples passed the test for Uniformity of Weights (table 3).
5.Conclusion
Inferential analysis of the analytical results proves that many brands (as sampled in the study) of Metformin
hydrochloride 500mg tablet sold in various pharmacies in Accra are potent in terms of label claim, dissolution
rate and uniformity in weight. The possible reasons could be the;
-the effective surveillance activities of the Food and Drugs Authority of Ghana
-the proper storage of these medicines by wholesalers, retailers and pharmacies who stock these medicines.
- and the relatively stable nature of Metfromin hydrochloride compound
35
4. Chemistry and Materials Research
ISSN 2224- 3224 (Print) ISSN 2225- 0956 (Online)
Vol.3 No.12, 2013
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These results are based on the laboratory analysis carried out on seven (7) brands of metformin hydrochloride
500mg tablet B.P obtained from various pharmacies in Accra, namely; GLUCOPHAGE Tablet, METFORMINDENK Tablet, KINAMET 500mg Tablet, METFORMIN 500mg Tablet, DIABETMIN Tablet, GRMETFRORMIN, and BGMET Tablet.
References
American Diabetes Association. Standards of medical care in diabetes—2009. Diabetes Care. 2009;32 Suppl
1:S13–61
Bai, G., Wang, Y., Armenante, P. M., 2011, “Velocity profiles and shear strain rate variability in the USP
Dissolution Testing Apparatus 2 at Different Impeller Agitation Speeds, ” International Journal of Pharmaceutics,
403 (1-2), Pages 1-14
Bailey CJ, Day C, 2004, Metformin: its botanical background. Practical Diabetes International.;21(3):115–7
Holman RR, 2008, 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J
Med.;359(15):1577–89.
Jayasagar G, Krishna Kumar M, Chandrasekhar K, Madhusudan Rao C, Madhusudan Rao Y, 2002,
Effect of cephalexin on the pharmacokinetics of metformin in healthy human volunteers. Drug Metabol Drug
Interact. 2002;19(1):41–8
Knowler WC, Barrett-Connor E, Fowler SE, 2009, 10-year follow-up of diabetes incidence and weight loss in
the Diabetes Prevention Program Outcomes Study. Lancet.;374(9702):1677–86
Kortejärvi H, Malkki J, Marvola M, Urtti A, Yliperttula M, Pajunen P. 2006, "Level A In Vitro-In Vivo
Correlation (IVIVC) Model with Bayesian Approach to Formulation Series". J Pharm Sci. 95 (7), Pages 15951605,
Lilly M, Godwin M, 2009, Treating prediabetes with metformin: systematic review and meta-analysis. Can Fam
Physician.;55(4):363–9
Nair S, Diehl AM, Wiseman M, Farr GH Jr, Perrillo RP,2004, Metformin in the treatment of non-alcoholic
steatohepatitis: a pilot open label trial. Aliment Pharmacol Ther.;20(1):23–28
Qureshi SA., Shabnam J., 2001, Cause of high variability in drug dissolution testing and its impact on setting
tolerances. Euro J Pharm Sci. 12 (3),271–276.
Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J, Coresh J, Brancati FL, 2008,
Cardiovascular outcomes in trials of oral diabetes medications: a systematic review. Arch Intern
Med.;168(19):2070–80.
WHO Model List of Essential Medicines, 2010 16th edition, World Health Organization, p. 24
Table 1:Potency (Label claim) of metformin hydrochloride tablet 500mg
Name of Sample
Manufacturer
Batch Number
Expiry Date
Potency (Label
claim) (%)
GLUCOPHAGE
METFORMIN-DENK
Merck Sante s.a.s
Denk Pharma GmbH &
Co.
102841
February 2016
100.63
8MI
January 2016
99.96
KINAMET
Kinapharma Ltd
810
June 2016
99.96
METFORMIN-500
Bristol Labs Ltd
BUH032088
May 2016
99.01
DIABEMET
Hovid Pharma
BC12657
December 2015
99.01
GR-METFORMIN
GR Industries Ltd
MF121204
November 2015
97.34
BGMET
Bliss GVS Pharma Ltd
BG-112
November 2013
97.25
36
5. Chemistry and Materials Research
ISSN 2224- 3224 (Print) ISSN 2225- 0956 (Online)
Vol.3 No.12, 2013
www.iiste.org
Table 2: Dissolution Rate of metformin hydrochloride tablet 500mg
Name of Sample
Manufacturer
Batch Number
Expiry Date
METFORMINDENK
Denk Pharma GmbH
8MI
January 2016
Dissolution
Rate (%)
98.2
DIABEMET
Hovid Pharma
BC12657
December 2015
98.0
GLUCOPHAGE
Merck Sante s.a.s
102841
February 2016
96.5
BGMET
Bliss GVS Pharma Ltd
BG-112
November 2013
96.4
GR-METFORMIN
METFORMIN-500
GR Industries Ltd
MF121204
November 2015
96.2
Bristol Labs Ltd
BUH032088
May 2016
96.0
Kinapharma Ltd
810
June 2016
92.4
KINAMET
Table 3: Weight Uniformity of metformin hydrochloride tablet 500mg
Name of Sample
Manufacturer
Batch
Expiry Date
Number
METFORMIN-
Weight
Uniformity
Denk Pharma GmbH
8MI
January 2016
-2.2 % ~ +1.4%
DIABEMET
Hovid Pharma
BC12657
December 2015
-1.6% ~ +1.2 %
GLUCOPHAGE
Merck Sante s.a.s
102841
February 2016
-0.9% ~ +1.1%
BGMET
Bliss GVS Pharma Ltd
BG-112
November 2013
-1.6% ~ +1.4%
GR-METFORMIN
GR Industries Ltd
MF121204
November 2015
-2.2% ~ +2.6%
Bristol Labs Ltd
BUH032088
May 2016
-2.0% ~ +2.6%
Kinapharma Ltd
810
June 2016
-2.9% ~ +2.8%
DENK
METFORMIN-500
KINAMET
37
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