• Title/Summary/Keyword: Drug combinations

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Pharmacological interactions between intrathecal pregabalin plus tianeptine or clopidogrel in a rat model of neuropathic pain

  • Lee, Hyung Gon;Kim, Yeo Ok;Choi, Jeong Il;Han, Xue Hao;Shin, Yang Un;Yoon, Myung Ha
    • The Korean Journal of Pain
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    • v.35 no.1
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    • pp.59-65
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    • 2022
  • Background: There is still unmet need in treating neuropathic pain and increasing awareness regarding the use of drug combinations to increase the effectiveness of treatment and reduce adverse effects in patients with neuropathic pain. Methods: This study was performed to determine the individual and combined effects of pregabalin, tianeptine, and clopidogrel in a rat model of neuropathic pain. The model was created by ligation of the L5-L6 spinal nerve in male Sprague-Dawley rats; mechanical allodynia was confirmed using von Frey filaments. Drugs were administered to the intrathecal space and mechanical allodynia was assessed; drug interactions were estimated by isobolographic or fixed-dose analyses. Results: Intrathecal pregabalin and tianeptine increased the mechanical withdrawal threshold in a dose-dependent manner, but intrathecal clopidogrel had little effect on the mechanical withdrawal threshold. An additive effect was noted between pregabalin and tianeptine, but not between pregabalin and clopidogrel. Conclusions: These findings suggest that intrathecal coadministration of pregabalin and tianeptine effectively attenuated mechanical allodynia in the rat model of neuropathic pain. Thus, pregabalin plus tianeptine may be a valid option to enhance the efficacy of neuropathic pain treatment.

Antiherpetic Activities of Natural Hesperetin Alone and in Combinations with Acyclovir and Vidarabine (천연 Hesperetin의 항허피스바이러스작용과 Acyclovir 및 Vidarabine과의 병용효과)

  • Lee, Ji-Hyun;Eo, Seong-Kug;Kim, Young-So;Lee, Chong-Kil;Han, Seong-Sun
    • Korean Journal of Pharmacognosy
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    • v.30 no.1
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    • pp.40-47
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    • 1999
  • To search for less toxic antiherpetic agents, the inhibitory effects of natural hesperetin on the plaque formation of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in Vero cells were examined by the plaque reduction assay in vitro. Hesperetin inhibited plaque formations of HSV-1 and HSV-2 in a dose dependent manner. It also exhibited more potent antiherpetic activity on HSV-2 with selectivity index (SI) of 9.8 than on HSV-1 with SI of 8.4. The combined antiherpetic effects of hesperetin with nucleoside antiherpetic agents, acyclovir and vidarabine, were examined on the multiplication of these two strains of herpesviruses in Vero cells by the combination assay. The results of combination assay were evaluated by the combination index (CI) that was calculated by the multiple drug effect analysis. The combinations of hesperetin with acyclovir on HSV-1 and HSV-2 showed synergistic effects with CI values of $0.29{\sim}0.73$ for 50%, 70%, 90% effective levels and those with vidarabine showed partially synergistic or additive effects with CI values of $0.83{\sim}1.33$.

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Feature selection and prediction modeling of drug responsiveness in Pharmacogenomics (약물유전체학에서 약물반응 예측모형과 변수선택 방법)

  • Kim, Kyuhwan;Kim, Wonkuk
    • The Korean Journal of Applied Statistics
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    • v.34 no.2
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    • pp.153-166
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    • 2021
  • A main goal of pharmacogenomics studies is to predict individual's drug responsiveness based on high dimensional genetic variables. Due to a large number of variables, feature selection is required in order to reduce the number of variables. The selected features are used to construct a predictive model using machine learning algorithms. In the present study, we applied several hybrid feature selection methods such as combinations of logistic regression, ReliefF, TurF, random forest, and LASSO to a next generation sequencing data set of 400 epilepsy patients. We then applied the selected features to machine learning methods including random forest, gradient boosting, and support vector machine as well as a stacking ensemble method. Our results showed that the stacking model with a hybrid feature selection of random forest and ReliefF performs better than with other combinations of approaches. Based on a 5-fold cross validation partition, the mean test accuracy value of the best model was 0.727 and the mean test AUC value of the best model was 0.761. It also appeared that the stacking models outperform than single machine learning predictive models when using the same selected features.

Antiherpetic Activities of Natural Quercetin Alone and in Combinations with Nucleoside Antiherpetic Agents (천연 Quercetin의 항허피스바이러스작용과 Nucleoside계 항허피스바이러스제와의 병용효과)

  • Kim, Young-So;Han, Seong-Sun
    • Korean Journal of Pharmacognosy
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    • v.30 no.2
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    • pp.151-157
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    • 1999
  • In order to find less toxic antiherpetic agents, the effect of natural quercetin on the plaque formation of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) was studied in vitro in cell culture monolayers employing the technique of viral plaque reduction assay. Quercetin caused a concentration-dependent reduction in the plaque formation of herpesviruses. It also exhibited more potent antiherpetic activity on HSV-1 with effective concentration $(EC_{50})$ of $18.7\;{\mu}g/ml$ than on HSV-2 with $EC_{50}$ of $24.5\;{\mu}g/ml$. The combined antiherpetic effects of quercetin with nucleoside antiherpetic agents, acyclovir and vidarabine, were examined on the multiplication of these two strains of herpesviruses in Vero cells by the combination assay. The results of combination assay were evaluated by the combination index (CI) that was calculated by the multiple drug effect analysis. The combinations of quercetin with acyclovir on HSV-1 and HSV-2 showed more potent synergism with CI values of $0.19{\sim}0.89$ for 50%, 70%, 90% effective levels than those with vidarabine with CI values of $0.43{\sim}1.46$.

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Therapeutic Duplication as a Medication Error Risk in Fixed-Dose Combination Drugs for Dyslipidemia: A Nationwide Study

  • Wonbin Choi;Hyunji Koo;Kyeong Hye Jeong;Eunyoung Kim;Seung-Hun You;Min-Taek Lee;Sun-Young Jung
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.3
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    • pp.168-177
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    • 2023
  • Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6. 44 (95% CI 5. 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.

Enhancement of Cytotoxicity by the Combination of Anticancer Drugs in Human Lung Adenocarcinoma Cell Line (PC-14) (폐암세포주 (PC-14)에서 복합항암제 처치시 암세포살해능의 증강에 관한 연구)

  • Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.525-533
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    • 1997
  • Background : No ideal combination chemotherapy for lung cancer has been established even though lots of combination anticancer chemotherapies have been tried. For the combination of anticancer drugs, the interaction of anticancer drugs is very important but unpredictable factor. In this experiment, we designed and tested new experiment to measure the interaction of two anticancer drugs using MIT assay in an attempt to predict clinical response of the combination regimen. Methods : With human lung adenocarcinoma cell line (PC-14), the cytotoxic effect of cisplatin, adriamycin, mitomycin C and etoposide were measured by in vitro chemosensitivity test (MIT assay). The combined cytotoxic effects of combination of two drugs were also measured in every combination of the drug concentrations and analyzed the interaction by Anava analysis of two way factorial design. Results : Four individual drugs showed cytotoxic effects on PC-14 by dose dependent fashion. Comparison of two drug combinations revealed that mitomycin C + cisplatin and adriamycin + cisplatin combinations showed stronger synergistic cytotoxic effects. Conclusion : From this experiment, we suggest two combinations of mitomycin C + cisplatin and adriamycin + cisplatin as chemotherapeutic regimens for unresectable non-small cell lung cancer. Furthermore, this experimental design could be applied to other types of cancer requiring combination anticancer chemotherapy.

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Simultaneous Inhibition of CXCR4 and VLA-4 Exhibits Combinatorial Effect in Overcoming Stroma-Mediated Chemotherapy Resistance in Mantle Cell Lymphoma Cells

  • Kim, Yu-Ri;Eom, Ki-Seong
    • IMMUNE NETWORK
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    • v.14 no.6
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    • pp.296-306
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    • 2014
  • There is growing evidence that crosstalk between mantle cell lymphoma (MCL) cells and stromal microenvironments, such as bone marrow and secondary lymphoid tissues, promotes tumor progression by enhancing survival and growth as well as drug resistance of MCL cells. Recent advances in the understanding of lymphoma microenvironment have led to the identification of crucial factors involved in the crosstalk and subsequent generation of their targeted agents. In the present study, we evaluated the combinatory effect of blocking antibodies (Ab) targeting CXCR4 and VLA-4, both of which were known to play significant roles in the induction of environment-mediated drug resistance (EMDR) in MCL cell line, Jeko-1. Simultaneous treatment with anti-CXCR4 and anti-VLA-4 Ab not only reduced the migration of Jeko-1 cells into the protective stromal cells, but also enhanced sensitivity of Jeko-1 to a chemotherapeutic agent to a greater degree than with either Ab alone. These combinatorial effects were associated with decreased phosphorylation of ERK1/2, AKT and NF-${\kappa}B$. Importantly, drug resistance could not be overcome once the adhesion of Jeko-1 to the stromal occurred despite the combined use of Abs, suggesting that the efforts to mitigate migration of MCLs should be attempted as much as possible. Our results provide a basis for a future development of therapeutic strategies targeting both CXCR4 and VLA-4, such as Ab combinations or bispecific antibodies, to improve treatment outcomes of MCL with grave prognosis.

Combined action of Aminoglycoside and Cephalosporin Against Pseudomonas aeruginosa (녹농균에 대한 Aminoglycoside계와 Cephalosporin계의 병합작용)

  • Oh, Jong-Suk;Ahn, Tai-Hew
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.3
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    • pp.375-380
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    • 1986
  • Thirty-one strains of Pseudomonas aeruginosa were submitted to the synergistic activity test of amikacin(AK) and gentamicin(GM) combined with moxalactam(MX), ceftizoxime(CTZ) or cefoperazone(CFZ). The minimal inhibitory concentrations(MICs) of each drug and drugs combined in various ratios were measured by checkerboard dilution method. The synergism was determined through analysing the MIC distribution curve on isobologram and calculating the fractional inhibitory concentration index(FICI). MICs of GM, AK, MX, CFZ and CTZ against the 31 tested strains were distributed from $12.5{\mu}g/ml$ to $800{\mu}g/ml$, from $0.8{\mu}g/ml$ to $25{\mu}g/ml$, from $3.1{\mu}g/ml$ to $50{\mu}g/ml$, from $3.1{\mu}g/ml$ to $400{\mu}g/ml$, and from $12.5{\mu}g/ml$ to $100{\mu}g/ml$, respectively. The rate synergism of each drug combination by means of FICl was 45.5% in GM-MX, 36.4% in GM-CFZ, 63.6% in GM-CTZ, 48.6% in AK-MX, 35.3% in AK-CFZ, and 35.7% in AK-CTZ combination. Thus, it is suggested that Pseudomonas aeruginosa may effectively be inhibited by various aminoglycoside and cephalosporin combinations.

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Effects of Temperature, pH, and Potassium Lactate on Growth of Listeria monocytogenes in Broth

  • Jin, Sung-Sik;Khen, Bimal Kumar;Yoon, Ki-Sun;Woo, Gun-Jo;Hwan, In-Gyun;Oh, Deog-Hwan
    • Food Science and Biotechnology
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    • v.14 no.6
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    • pp.847-853
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    • 2005
  • A total of 60 growth curves were generated with combinations of temperature, pH, and potassium lactate (PL) (60% (v/v) commercial solution) to determine the lag time (LT) and specific growth rate (SGR) of L. monocytogenes in broth. LT and SGR were significantly (P<0.05) affected by temperature, pH, concentration of PL, or the combined interaction of these factors. LT was extended and SGR was reduced significantly (P<0.05) by increased concentration of PL at lower temperature and pH. Listericidal effect was observed in the broth containing 2, 3, and 4% PL at pH 5.0 and $4^{\circ}C$. The antimicrobial activity of PL against L. monocytogenes increased when the pH of the medium was decreased at all temperatures tested. The results suggest that PL has antimicrobial properties to suppress the growth of L. monocytogenes. Potassium lactate has many potential applications as an antimicrobial additive in variety of refrigerated ready-to-eat foods.

Combined Treatment with Stattic and Docetaxel Alters the Bax/Bcl-2 Gene Expression Ratio in Human Prostate Cancer Cells

  • Mohammadian, Jamal;Sabzichi, Mehdi;Molavi, Ommoleila;Shanehbandi, Dariush;Samadi, Nasser
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.5031-5035
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    • 2016
  • Docetaxel, recognized as a stabilizing microtubule agent, is frequently administrated as a first line treatment for prostate cancers. Due to high side effects of monotherapy, however, combinations with novel adjuvants have emerged as an alternative strategy in cancer therapy protocols. Here, we investigated the combined effects of stattic and docetaxel on the DU145 prostate cancer cell line. Cytotoxicity was evaluated by MTT assay. To understand molecular mechanisms of stattic action, apoptotic related genes including Bcl-2, Mcl-1, Survivin and Bax were evaluated by real-time RT-PCR. Alteration in the expression of pro-apoptotic Bax and anti-apoptotic Bcl-2 genes and Bax/Bcl-2 ratio were investigated via the $2^{{\Delta}{\Delta}CT}$ method. The $IC_{50}$ values for docetaxel and stattic were $3.7{\pm}0.9nM$ and $4.6{\pm}0.8{\mu}M$, respectively. Evaluation of key gene expression levels revealed a noticeable decrease in antiapoptotic Bcl-2 and Mcl-1 along with an increase in pro-apoptotic Bax mRNA levels (p<0.05). Our results suggest that combination of a STAT3 inhibitor with doctaxel can be considered as a potent strategy for induction of apoptosis via increasing Bax mRNA expression.