ORIGINAL_ARTICLE
Intracranial hemorrhage after carotid artery stenting in two patients taking omega-3 fatty acids with dual antiplatelet therapy: two case reports
Patients undergoing Carotid Artery Stenting (CAS) may encounter serious complications including Intracranial hemorrhage (ICH). ICH after carotid re-vascularization has been usually attributed to cerebral hyperperfusion syndrome (CHS) and it is reported as a significant cause of mortality and morbidity. Factors mentioned as risk factors for ICH after carotid intervention are preoperative hypertension, renal failure, bilateral carotid disease or contralateral carotid occlusion, impaired cerebrovascular reserve, female gender, age, nonselective admission, increased Charlson comorbidities score. In this study, we report two cases of ICH after CAS in patients receiving dual antiplatelet regimen plus omega-3 fatty acids before and after carotid intervention. It seems that administration of omega 3 with other antiplatelets could augment inhibition of platelet aggregation and may increase the risk of ICH in patients undergoing CAS especially in those with several risk factors for ICH. These findings are important because of the wide availability of omega-3 supplements as an over-the-counter (OTC) drug and the propensity for usage of it in alternative medicine.
https://tips.sums.ac.ir/article_44932_070dbb1b48005cf9832b21c685a7457f.pdf
2019-03-01
1
6
10.30476/tips.2019.81725.1005
Intracranial Hemorrhage
Carotid artery stenting
Fatty acids
Omega-3
Dual antiplatelets
Farzaneh
Foroughinia
farzanehforoughinia@yahoo.com
1
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
LEAD_AUTHOR
Afshin
Borhani-Haghighi
neuro.ab@gmail.com
2
Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Elaheh
Jamshidi
jamshidiel@sums.ac.ir
3
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Haniyeh
Javanmardi
haniejavanmardi.sums@gmail.com
4
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
ORIGINAL_ARTICLE
Hydrogels as Drug Delivery Systems; Pros and Cons
Hydrogels are cross-linked polymers with hydrophilic groups which enable them to absorb large amounts of water. Hydrogel based delivery systems have been used for delivery of different types of active pharmaceuticals. Although hydrogels have numerous capability and advantages in drug delivery including biocompatibility, low toxicity and good swelling behavior but depending on chemical moieties of the gel forming polymers and route of administration some limitations would appear in delivery of active pharmaceutical using hydrogel as delivery vehicle. Development of successful hydrogel based delivery system is possible upon knowledge about the hydrogels forming polymers physiochemical properties and understanding the influencing factors which control the swelling behaviors, hydrophilicity, biodegradability, biocompatibility and targetability of the selected polymer. In this review at first classification of the hydrogel with different approaches including chemical moieties, crosslinking agent behaviors and release controller mechanism was performed and limitations arise from each category was described and finally different approaches to overcome each of this limitation was proposed.
https://tips.sums.ac.ir/article_44931_c496389d981845155e9289cc5a678987.pdf
2019-03-01
7
24
10.30476/tips.2019.81604.1002
Hydrogels
Polymers
Drug delivery
Pros and Cons
Parisa
Ghasemiyeh
pa_ghasemeyeh@sums.ac.ir
1
Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
Soliman
Mohammadi-Samani
smsamani@sums.ac.ir
2
Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
LEAD_AUTHOR
ORIGINAL_ARTICLE
Passive Enhancement of Transdermal Drug Delivery: Lipid-Based Colloidal Carriers as an Emerging Pharmaceutical Technology Platform
Transdermal drug delivery (TDD) is an attractive approach to minimize the limitations encountered by other drug administration routes such as oral and parenteral. Apart from specialized devices fabricated for modifying the barrier properties of the stratum corneum such as iontophoresis, sonophoresis and microneedles, there are several passive methods applied through physicochemical manipulations in drug formulation, including prodrugs, ion-pairs, supersaturated solutions, inclusion complexes, eutectic mixtures, ionic liquids and use of chemical penetration enhancers. More recently, colloidal carriers due to their small size, high specific surface area, unique structural and biochemical features, are suggested for the skin penetration enhancement through transcellular or shunt routes. This review considers challenges and achievements of colloidal TDD systems, either used alone or in combination with other techniques, with a special concern about lipid-based vesicular nanocarriers including liposomes, niosomes, transfersomes, pharmacosomes, ethosomes, catesomes, and invasomes. Undoubtedly, understanding interplay between physicochemical properties and the underlying mechanisms of skin penetration enhancement is a prerequisite for optimized TDD applications.
https://tips.sums.ac.ir/article_44987_1c7001fc86b0443bd4d604d161cc345f.pdf
2019-03-01
25
40
10.30476/tips.2019.81614.1004
Transdermal drug delivery
passive enhancement
colloidal systems
liposomes
Leila
Moradi
leilamoradiab@gmail.com
1
Department of Pharmaceutical Nanotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Sanaz
Javanmardi
snzjavan@gmail.com
2
Department of Biology, Faculty of Science, University of Guilan, Rasht, Iran
AUTHOR
Samirasadat
Abolmaali
abolmaali@sums.ac.ir
3
Department of Pharmaceutical Nanotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Soliman
Mohammadi Samani
smsamani2014@gmail.com
4
Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
ORIGINAL_ARTICLE
Concurrent analysis of Simvastatin and citicoline using a Reversed-phase High Performance Liquid Chromatography-Ultra Violet Method
To develop and evaluate a sensitive, accurate, rapid and reproducible high performance liquid chromatography analytical method for concurrent assay of simvastatin, a hyperlipidemia controlling agent, and citicoline, a psychostimulant agent, a C18 column (Eurosphar 100-5, 150 mm × 4.6 mm) used as a reversed stationary phase and mobile phase was water (previously adjusted with phosphoric acid to a pH of 5.5), methanol and acetonitrile (20:20:60) with the flow rate 1.0 ml/min. The ultraviolet detector was set at 247 nm. A linear correlation between each concentration and its own AUC within concentration ranges of 15 to 100 g/ml for citicoline and 7.5 to 50 g/ml for simvastatin with a correlation coefficient 0.9969 for citicoline and 0.994 for simvastatin were produced. The within and between-day precision and accuracy were both in acceptable ranges. The outcomes of these tests show an accurate, rapid and robust HPLC-UV method for successful analysis of both simvastatin and citicoline simultaneously.
https://tips.sums.ac.ir/article_44989_257b890afc83bc99e5352ee938216eb9.pdf
2019-03-01
41
46
10.30476/tips.2019.81749.1006
Citicoline
Simvastatin
HPLC
Negin
Mozafari
mozafari.negin@gmail.com
1
Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
Soha
Azadi
azadiso@sums.ac.ir
2
Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Soliman
Mohammadi Samani
smsamani@sums.ac.ir
3
Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
Fatemeh
Farjadian
fatemehfarjadian@gmail.com
4
Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
Amir
Azadi
amirazadipharm@gmail.com
5
Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
LEAD_AUTHOR
ORIGINAL_ARTICLE
Synthesis of PEGylated Human Serum Albumin by Maleimide-Thiol Chemistry and Histopathological Evaluation in a Mice Model of Carrageenan-Induced Inflammation
Occasional incompetence of human serum albumin (HSA) as a plasma expander is linked to severity of the underlying endothelial cell injury so that HSA can readily extravasate if structural integrity of the endothelial is compromised. Consequently, the leaking HSA may exacerbate the oncotic plasma gradient and results in capillary leak syndrome; therefore, we hypothesized that HSA modification by the covalently attaching multiple PEG (polyethylene glycol) groups would result in enhanced retention of HSA in blood circulation in animal model of acute inflammation. PEGylation of HSA was performed by maleimide-thiol chemistry. The products were characterized by polyacrylamide gel electrophoresis and size-exclusion chromatography. Extravasation of PEGylated HSA was compared to the native protein in BALB/C mice model of carrageenan-induced inflammation by histopathological evaluations. HSA was thiolated by either reaction of 2-iminothiolane (Traut’s reagent) with lysine side chains or DTT reduction of disulfide bridges for subsequent reaction with methoxyPEG-maleimide (mPEG-Mal). The PEGylation reaction was optimized in terms of pH and mPEG/HSA molar ratio, producing high conjugation yield. mPEG 5 KDa-HSA demonstrated higher osmotic pressure and more homogeneous weight distribution than mPEG 20 KDa-HSA. According to the histopathological findings, mPEG 5 KDa-HSA showed lower extravasation in comparison to native HSA in carrageenan-induced inflammation model. Conclusively, PEGylated form of HSA might lessen the need of frequent HSA administration via decreasing the capillary leakage and endow a product with improved intravascular retention.
https://tips.sums.ac.ir/article_44991_b8b26597533bd0d770c0e90bab8d64ed.pdf
2019-03-01
47
56
10.30476/tips.2019.81610.1003
PEGylation
Maleimide-Thiol Chemistry
Human Serum Albumin
Acute Inflammation
Mice Model
Mehdi
Hoorang
hoorang@gmail.com
1
Student Research Center, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Alimohammad
Tamaddon
amtamadon@gmail.com
2
Center for Nanotechnology in Drug Delivery, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz 71345, Iran
LEAD_AUTHOR
Gholamhosein
Yousefi
ghyousefi@sums.ac.ir
3
Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
ORIGINAL_ARTICLE
Attenuation of hyperlipidemia in diabetic and Triton x-100 induced hyperlipidemic rats by Thymus daenensis Celak extract
Hyperlipidemia is one of vital complications in diabetes. The leaves of thymus daenensis Celak are being widely used to reduce hyperlipidemia in Persian folk medicine. Objective: Present study is based upon the investigation of total phenol content and antioxidant activity of thymus daenensis Celak extract (Td) as well as the effect of Td on some biochemical parameters (glucose, total cholesterol, HDL, LDL and Triglyceride level) in normal and streptozotocin-induced (STZ-induced) and Triton x-100 induced hyperlipidemic male Sprague Dawley rats. Also, synergic effect of this extract with atorvastatin was evaluated in mentioned groups. Animals were divided into five groups: healthy control group (sham), diabetic and hyperlipidemic control group (STZ+ Tri), diabetic and hyperlipidemic groups treated with Td fraction (Ex 1000); diabetic and hyperlipidemic groups treated with atorvastatin (Ator 10), diabetic and hyperlipidemic groups treated with Td fraction + atorvastatin (Ex 1000 + Ator 10). Treatment of diabetic rats with Td (1000 mg/kg) significantly decreased glucose, total cholesterol, triglyceride and LDL level as compared with the diabetic hyperlipidemic control group. Nevertheless, there were no synergistic effects between Td and atorvastatin on reducing lipid indications. The total phenol content of Td was 76 mg/g and the result of nitric oxide radical scavenging assay showed IC50 of 451.14± 44.4 and 486.94± 8.91μg/ml for Td and ascorbic acid respectively. The results of this study indicate that Td is potent antioxidant and hypoallergenic, which may be proper to prevent coronary heart disease in diabetes in future clinical studies.
https://tips.sums.ac.ir/article_45007_df00b70f698f6ee8beee5266342ad452.pdf
2019-03-01
57
64
10.30476/tips.2019.81594.1001
Thymus daenensis Celak
Diabetes
Hyperlipidemia
Hyperglycemia
STZ
Mohammad Javad
Khoshnoud
khoshnoudm@sums.ac.ir
1
Department of Pharmacology and Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Zahra
Sabahi
sabahiz@sums.ac.ir
2
Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
LEAD_AUTHOR
Mahmoudreza
Moein
mrmoein@sums.ac.ir
3
1Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran. 2Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
Marzieh
Rashedinia
rashedinia@sums.ac.ir
4
Department of Toxicology and Pharmacology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
Sareh
Pourshahsavari
pourshahsavari@yahoo.com
5
Department of Toxicology and Pharmacology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
ORIGINAL_ARTICLE
Medication reconciliation at admission by pharmacists in a teaching referral hospital in Iran
Background: Medication errors may prolong hospitalization period, enhance its costs and make harmful impacts on health. Inappropriate drug history taking is a type of medication errors which may occur on admission, resulting in medication discrepancies. Objective: This work presents a report of discrepancies between the drug history acquired by pharmacists and the drugs administered by the physicians at a teaching hospital in Shiraz, Iran. Method: This prospective study was conducted from October 2016 to March 2017 in 7 wards of Namazi hospital affiliated to Shiraz University of Medical Sciences. Both the physicians/nurses and pharmacists obtained medication history from patients recruited in this study during the first 24 hours of their admission. The medications were classified according to the ATC classification.Results: Totally, 103 patients were recruited and 557 medications were recorded in this study. The mean±standard deviation age of patients was 58.52±18.75 years. Comparing pharmacist drug history with medication lists obtained by nurses or physicians revealed 353 discrepancies. On average, 3.42 discrepancies were identified per patient (ranged from 0 to 12). Most (85.8%) of medication discrepancies were related to omission errors. Metformin and aspirin were the most common medications involved in omission errors.Conclusion: The rate of medication discrepancies at admission in our hospital was high. Active contribution of pharmacists and providing accurate medication histories at the time of hospital admission can be considered as possible solutions for this problem.
https://tips.sums.ac.ir/article_45014_e7f2279bf1dcc3842d3cf95574fa34dd.pdf
2019-03-01
65
72
10.30476/tips.2019.82104.1009
Medication reconciliation
Hospital admission
Pharmacists
Medication errors
Iman
Karimzadeh
karimzadehiman@gmail.com
1
Assistant Professor of Clinical Pharmacy, Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Mahtabalsadat
Mirjalili
mahtab.mirjalili@gmail.com
2
PharmD, PhD student of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Ehsan
Mirzaei
ehsan.mirzaei.1369@gmail.com
3
PhD student of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Shaghayegh
Mottaghi
shaghayeghm_70@yahoo.com
4
PharmD, PhD student of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Afsaneh
Vazin
vazeena@sums.ac.ir
5
PharmD, PhD, Associated Professor of Clinical Pharmacy, Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR