• Title/Summary/Keyword: Drug Interaction

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Pharmacokinetic Interaction Between Atorvastatin and Nifedipine (아톨바스타틴과 니페디핀의 약물동태학적 상호작용)

  • Moon, Hong-Seop;Choi, Jun-Shik
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.25-29
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    • 2010
  • The purpose of this study was to investigate the effect of atorvastatin on the pharmacokinetics of nifedipine (6 mg/kg) after oral administration of nifedipine with or without atorvastatin (0.5 and 2.0 mg/kg) in rats, and also was to evaluate to the effect of atorvastatin on the CYP3A4 activity. The 50% inhibiting concentration ($IC_{50}$) values of atorvastatin on CYP3A4 activity is 46.1 ${\mu}M$. Atorvastatin inhibited CYP3A4 enzyme activity in a concentration-dependent manner. Coadministration of atorvastatin increased significantly (p<0.05, 2.0 mg/kg) the plasma concentration-time curve (AUC) and the peak concentration ($C_{max}$) of nifedipine compared to the control group. The relative bioavailability (RB%) of nifedipine was increased from 1.15- to 1.37-fold. Coadministration of atorvastatin did not significantly change the terminal half-life ($T_{1/2}$) and the time to reach the peak concentration ($T_{max}$) of nifedipine. Based on these results, we can make a conclusion that the significant changes of these pharmacokinetic parameters might be due to atorvastatin, which possesses the potency to inhibit the metabolizing enzyme (CYP3A4) in the liver and intestinal mucosa, and also inhibit the P-glycoprotein (P-gp) efflux pump in the intestinal mucosa. It might be suggested that atorvastatin altered disposition of nifedipine by inhibition of both the first-pass metabolism and P-glycoprotein efflux pump in the small intestine of rats. In conclusion, the presence of atorvastatin significantly enhanced the oral bioavailability of nifedipine, suggesting that concurrent use of atorvastatin with nifedipine should require close monitoring for potential drug interation.

Multilevel Precision-Based Rational Design of Chemical Inhibitors Targeting the Hydrophobic Cleft of Toxoplasma gondii Apical Membrane Antigen 1 (AMA1)

  • Vetrivel, Umashankar;Muralikumar, Shalini;Mahalakshmi, B;K, Lily Therese;HN, Madhavan;Alameen, Mohamed;Thirumudi, Indhuja
    • Genomics & Informatics
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    • v.14 no.2
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    • pp.53-61
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    • 2016
  • Toxoplasma gondii is an intracellular Apicomplexan parasite and a causative agent of toxoplasmosis in human. It causes encephalitis, uveitis, chorioretinitis, and congenital infection. T. gondii invades the host cell by forming a moving junction (MJ) complex. This complex formation is initiated by intermolecular interactions between the two secretory parasitic proteins-namely, apical membrane antigen 1 (AMA1) and rhoptry neck protein 2 (RON2) and is critically essential for the host invasion process. By this study, we propose two potential leads, NSC95522 and NSC179676 that can efficiently target the AMA1 hydrophobic cleft, which is a hotspot for targeting MJ complex formation. The proposed leads are the result of an exhaustive conformational search-based virtual screen with multilevel precision scoring of the docking affinities. These two compounds surpassed all the precision levels of docking and also the stringent post docking and cumulative molecular dynamics evaluations. Moreover, the backbone flexibility of hotspot residues in the hydrophobic cleft, which has been previously reported to be essential for accommodative binding of RON2 to AMA1, was also highly perturbed by these compounds. Furthermore, binding free energy calculations of these two compounds also revealed a significant affinity to AMA1. Machine learning approaches also predicted these two compounds to possess more relevant activities. Hence, these two leads, NSC95522 and NSC179676, may prove to be potential inhibitors targeting AMA1-RON2 complex formation towards combating toxoplasmosis.

In Silico Structural and Functional Annotation of Hypothetical Proteins of Vibrio cholerae O139

  • Islam, Md. Saiful;Shahik, Shah Md.;Sohel, Md.;Patwary, Noman I.A.;Hasan, Md. Anayet
    • Genomics & Informatics
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    • v.13 no.2
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    • pp.53-59
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    • 2015
  • In developing countries threat of cholera is a significant health concern whenever water purification and sewage disposal systems are inadequate. Vibrio cholerae is one of the responsible bacteria involved in cholera disease. The complete genome sequence of V. cholerae deciphers the presence of various genes and hypothetical proteins whose function are not yet understood. Hence analyzing and annotating the structure and function of hypothetical proteins is important for understanding the V. cholerae. V. cholerae O139 is the most common and pathogenic bacterial strain among various V. cholerae strains. In this study sequence of six hypothetical proteins of V. cholerae O139 has been annotated from NCBI. Various computational tools and databases have been used to determine domain family, protein-protein interaction, solubility of protein, ligand binding sites etc. The three dimensional structure of two proteins were modeled and their ligand binding sites were identified. We have found domains and families of only one protein. The analysis revealed that these proteins might have antibiotic resistance activity, DNA breaking-rejoining activity, integrase enzyme activity, restriction endonuclease, etc. Structural prediction of these proteins and detection of binding sites from this study would indicate a potential target aiding docking studies for therapeutic designing against cholera.

Open Channel Block of Kv3.1 Currents by Genistein, a Tyrosine Kinase Inhibitor

  • Choi, Bok-Hee;Park, Ji-Hyun;Hahn, Sang-June
    • The Korean Journal of Physiology and Pharmacology
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    • v.10 no.2
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    • pp.71-77
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    • 2006
  • The goal of this study was to analyze the effects of genistein, a widely used tyrosine kinase inhibitor, on cloned Shaw-type $K^+$ currents, Kv3.1 which were stably expressed in Chinese hamster ovary (CHO) cells, using the whole-cell configuration of patch-clamp techniques. In whole-cell recordings, genistein at external concentrations from 10 to $100{\mu}M$ accelerated the rate of inactivation of Kv3.1 currents, thereby concentration-dependently reducing the current at the end of depolarizing pulse with an $IC_{50}$ value of $15.71{\pm}0.67{\mu}M$ and a Hill coefficient of $3.28{\pm}0.35$ (n=5). The time constant of activation at a 300 ms depolarizing test pulses from -80 mV to +40 mV was $1.01{\pm}0.04$ ms and $0.90{\pm}0.05$ ms (n=9) under control conditions and in the presence of $20{\mu}M$ genistein, respectively, indicating that the activation kinetics was not significantly modified by genistein. Genistein $(20{\mu}M)$ slowed the deactivation of the tail current elicited upon repolarization to -40 mV, thus inducing a crossover phenomenon. These results suggest that drug unbinding is required before Kv3.1 channels can close. Genistein-induced block was voltage-dependent, increasing in the voltage range $(-20\'mV{\sim}0\'mV)$ for channel opening, suggesting an open channel interaction. Genistein $(20{\mu}M)$ produced use-dependent block of Kv3.1 at a stimulation frequency of 1 Hz. The voltage dependence of steady-state inactivation of Kv3.1 was not changed by $20{\mu}M$ genistein. Our results indicate that genistein blocks directly Kv3.1 currents in concentration-, voltage-, time-dependent manners and the action of genistein on Kv3.1 is independent of tyrosine kinase inhibition.

Safety Evaluation of LB20304, a New Quinolone Antibiotic

  • Kim, Seong-Il;Kim, Hee-Jin;Kwak, Jin-Hwan;Kim, In-Chull;Lee, Chang-Ho
    • Biomolecules & Therapeutics
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    • v.3 no.4
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    • pp.322-326
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    • 1995
  • General pharmacology of LB20304, a quinolone antibiotic, were examined in terms of general behaviour, cardiovascular, and central nervous system. LB20304 at oral dose of 2,000 mg/kg did not induce significant behavioural changes in mice. In contrast with ciprofloxacin, LB20304 at dose of 20 mg/kg, iv. did not show any observable effects on the blood pressure in rats. Displacement of [$^3$H]muscimol binding to the rat brain synaptic membranes was measured. LB20304 was shown to be about five times less potent than ciprofloxacin in specific GABA receptor binding. Drug interaction between LB20304 and 4-biphenyl acetic acid, an active metabolite of fenbufen, was assessed in mice by measuring convulsion and/or subsequent death. A single oral pretreatment with 4-BPA at 400 mg/kg increased the incidence of convulsion and death after oral administration of ciprofloxacin at the doses of 25, 50, and 100 from zero of five to three of five, two of five, and four of five, respectively, whereas LB20304 alone or combination with 4-BPA caused neither convulsions nor death at the doses of 12.5, 25, 50, and 100 mg/kg, respectively. Quinolones-induced epileptogenic activities were assessed by a direct intracerebral injection of test articles. The CD$_{50}$ values (nmole) are as follows; 169.47, 35.36, 105.29, and 88.67 for LB20304, ciprofloxacin, of loxacin, and lomefloxacin, respectively. From these data, LB 20304 at therapeutic doses seems to be much more safe than any other quinolones tested.d.

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Pharmacokinetic Interaction between Nisoldipine and Repaglinide in Rats

  • Choi, In;Choi, Dong-Hyun;Yeum, Cheul-Ho;Choi, Jun-Shik
    • Biomolecules & Therapeutics
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    • v.19 no.4
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    • pp.498-503
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    • 2011
  • The purpose of this study was to investigate the effects of nisoldipine on the pharmacokinetics of repaglinide in rats. The effect of nisoldipine on cytochrome P450 (CYP) 3A4 activity and P-glycoprotein (P-gp) were evaluated. The pharmacokinetic parameters of repaglinide were also determined in rats after oral (0.5 $mg{\cdot}kg^{-1}$) and intravenous (0.2 $mg{\cdot}kg^{-1}$) administration of repaglinide to rats without or with nisoldipine (0.3 and 1.0 $mg{\cdot}kg^{-1}$). Nisoldipine inhibited CYP3A4 enzyme activity with a 50% inhibition concentration of 5.5 ${\mu}M$. In addition, nisoldipine significantly enhanced the cellular accumulation of rhodamine-123 in MCF-7/ADR cells overexpressing P-gp. Compared to the oral control group, nisoldipine significantly increased the $AUC_{0-{\infty}}$ and the $C_{max}$ of repaglinide by 46.9% and 24.9%, respectively. Nisoldipine also increased the absolute bioavailability (A.B.) of repaglinide by 47.0% compared to the oral control group. Moreover, the relative bioavailability (R.B.) of repaglinide was 1.16- to 1.47-fold greater than that of the control group. Nisoldipine enhanced the oral bioavailability of repaglinide, which may be attributable to the inhibition of the CYP3A4-mediated metabolism in the small intestine and/or in the liver and to inhibition of P-gp in the small intestine rather than to reduction of renal elimination of repaglinide by nisoldipine. The increase in the oral bioavailability of repaglinide should be taken into consideration of potential drug interactions when co-administering repaglinide and nisoldipine.

Public Participation in Healthcare Decision Making : Experience of Citizen Council for Health Insurance (보건의료 정책 의사결정과 시민참여 : 『건강보험 보장성 시민위원회』의 사례)

  • Kwon, Soonman;You, Myoungsoon;Oh, Juhwan;Kim, Soojung;Jeon, Boyoung
    • Health Policy and Management
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    • v.22 no.4
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    • pp.467-496
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    • 2012
  • Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.

Real-World Clinical Efficacy and Tolerability of Direct-Acting Antivirals in Hepatitis C Monoinfection Compared to Hepatitis C/Human Immunodeficiency Virus Coinfection in a Community Care Setting

  • Gayam, Vijay;Hossain, Muhammad Rajib;Khalid, Mazin;Chakaraborty, Sandipan;Mukhtar, Osama;Dahal, Sumit;Mandal, Amrendra Kumar;Gill, Arshpal;Garlapati, Pavani;Ramakrishnaiah, Sreedevi;Mowyad, Khalid;Sherigar, Jagannath;Mansour, Mohammed;Mohanty, Smruti
    • Gut and Liver
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    • v.12 no.6
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    • pp.694-703
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    • 2018
  • Background/Aims: Limited data exist comparing the safety and efficacy of direct-acting antivirals (DAAs) in hepatitis C virus (HCV) monoinfected and HCV/human immunodeficiency virus (HIV) coinfected patients in the real-world clinic practice setting. Methods: All HCV monoinfected and HCV/HIV coinfected patients treated with DAAs between January 2014 and October 2017 in community clinic settings were retrospectively analyzed. Pretreatment baseline patient characteristics, treatment efficacy, factors affecting sustained virologic response at 12 weeks (SVR12) after treatment, and adverse reactions were compared between the groups. Results: A total of 327 patients were included in the study, of which 253 were HCV monoinfected, and 74 were HCV/HIV coinfected. There was a statistically significant difference observed in SVR12 when comparing HCV monoinfection and HCV/HIV coinfection (94% and 84%, respectively, p=0.005). However, there were no significant factors identified as a predictor of a reduced response. The most common adverse effect was fatigue (27%). No significant drug interaction was observed between DAA and antiretroviral therapy. None of the patients discontinued the treatment due to adverse events. Conclusions: In a real-world setting, DAA regimens have lower SVR12 in HCV/HIV coinfection than in HCV monoinfection. Further studies involving a higher number of HCV/HIV coinfected patients are needed to identify real predictors of a reduced response.

Loading Behavior of pH-Responsive P(MAA-co-EGMA) Hydrogel Microparticles for Intelligent Drug Delivery Applications (지능형 약물전달시스템을 위한 pH 감응형 P(MAA-co-EGMA) 수화젤 미세입자의 탑재거동)

  • Shin, Young-Chan;Kim, Kyu-Sik;Kim, Bum-Sang
    • Polymer(Korea)
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    • v.32 no.5
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    • pp.421-426
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    • 2008
  • pH-responsive P(MAA-co-EGMA) hydrogel microparticles were synthesized via dispersion photo polymerization and the feasibility of the particles as the cosmetic formulation was investigated. Rh-B and the functional materials for the cosmetic application such as ascorbic acid, adenosine, EGCG, and arbutin were loaded in the P (MAA-co-EGMA) hydrogel microparticles in order to examine the interaction between the hydrogel and the loaded materials. In the loading experiments, Rh-B showed the highest loading efficiency to the P(MAA-co-EGMA) hydrogels due to the electrostatic attraction between the negative charge of the hydrogels and the positive charge of Rh-B at the ionized states. However, the functional materials showed relatively low loading efficiencies because of the electrostatic repulsions between the negative charges of both the hydrogels and the materials at the ionized states. In addition, P(MAA-co-EGMA) hydrogel microparticles showed pH-responsive release behavior of Rh-B according to the external pH changes.

Effects of Omeprazole and Caffeine Alone and in Combination with Gentamicin and Ciprofloxacin Against Antibiotic Resistant Staphylococcus Aureus and Escherichia Coli Strains

  • Bazzaz, Bibi Sedigheh Fazly;Fakori, Mahmoud;Khameneh, Bahman;Hosseinzadeh, Hossein
    • Journal of Pharmacopuncture
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    • v.22 no.1
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    • pp.49-54
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    • 2019
  • Objective: Antibiotic resistance is a global health problem and threatens health of societies. These problems have led to a search for alternative approaches such as combination therapy. The aim of the present study was to investigate the effect of caffeine and omeprazole in combination with gentamicin or ciprofloxacin against standard and clinically resistant isolates of Staphylococcus aureus and Escherichia coli. Methods: The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of different agents against bacterial strains were determined. The interaction of non- antibiotic drugs with gentamicin and ciprofloxacin was studied in vitro using a checkerboard method and calculating fraction inhibitory concentration index (FICI). Verapamil as efflux pump inhibitor was used to evaluate the possible mechanism of bacterial resistance to antibiotics. Results: The MIC and MBC values of gentamicin against bacterial strains were in the range of $20-80{\mu}g/ml$ and $40-200{\mu}g/ml$, respectively. Caffeine and omeprazole had no intrinsic inhibitory activity against tested microorganisms. However, upon combination of caffeine with antibiotics, the synergistic effects were observed. Verapamil was able to reduce the MIC values of gentamicin (4 folds) only in some bacterial strains. Conclusion: These findings indicated that caffeine was effective in removing bacterial infection caused by S. aureus and E. coli. The relevant mechanisms of antibiotic resistance were not related to the drug efflux.