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Choudhary N, Bawari S, Burcher JT, Sinha D, Tewari D, Bishayee A. Targeting Cell Signaling Pathways in Lung Cancer by Bioactive Phytocompounds. Cancers (Basel) 2023; 15:3980. [PMID: 37568796 PMCID: PMC10417502 DOI: 10.3390/cancers15153980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Lung cancer is a heterogeneous group of malignancies with high incidence worldwide. It is the most frequently occurring cancer in men and the second most common in women. Due to its frequent diagnosis and variable response to treatment, lung cancer was reported as the top cause of cancer-related deaths worldwide in 2020. Many aberrant signaling cascades are implicated in the pathogenesis of lung cancer, including those involved in apoptosis (B cell lymphoma protein, Bcl-2-associated X protein, first apoptosis signal ligand), growth inhibition (tumor suppressor protein or gene and serine/threonine kinase 11), and growth promotion (epidermal growth factor receptor/proto-oncogenes/phosphatidylinositol-3 kinase). Accordingly, these pathways and their signaling molecules have become promising targets for chemopreventive and chemotherapeutic agents. Recent research provides compelling evidence for the use of plant-based compounds, known collectively as phytochemicals, as anticancer agents. This review discusses major contributing signaling pathways involved in the pathophysiology of lung cancer, as well as currently available treatments and prospective drug candidates. The anticancer potential of naturally occurring bioactive compounds in the context of lung cancer is also discussed, with critical analysis of their mechanistic actions presented by preclinical and clinical studies.
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Affiliation(s)
- Neeraj Choudhary
- Department of Pharmacognosy, GNA School of Pharmacy, GNA University, Phagwara 144 401, India
| | - Sweta Bawari
- Amity Institute of Pharmacy, Amity University, Noida 201 301, India
| | - Jack T. Burcher
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA
| | - Dona Sinha
- Department of Receptor Biology and Tumor Metastasis, Chittaranjan National Cancer Institute, Kolkata 700 026, India
| | - Devesh Tewari
- Department of Pharmacognosy and Phytochemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi 110 017, India
| | - Anupam Bishayee
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, FL 34211, USA
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Ayub F, Khan TM, Baig MR, Amin MU, Tahir H. Quality of life and wellbeing among breast cancer patients in Lahore, Pakistan. Front Oncol 2023; 13:1105411. [PMID: 37456255 PMCID: PMC10341154 DOI: 10.3389/fonc.2023.1105411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
Background Breast cancer has a high incidence rate, emphasizing the necessity of enhanced information on health-related quality of life (HrQOL) in this population of patients. The aim of this study was to identify the factors influencing the QOL experienced by patients in Pakistan. Methods A cross-sectional study was conducted on women with breast cancer, and four instruments were used on a random sample of 130 Pakistani women: FACIT-B Version 4 questionnaire,WHO causality assessment scale, Naranjo's algorithm, and a demographic/clinical characteristics section. Data analysis included descriptive analysis, independent sample t-test, and analysis of variance (ANOVA) test. Results The patients' mean age was 49.10 (standard deviation (SD) 10.89); 98.5% were married. The mean score was 18.34 for physical wellbeing (SD 5.92; interquartile range (IQR) 11), 16.33 for social/family wellbeing (SD 6.3; IQR 11.25), 13.6 for emotional wellbeing (SD 3.55; IQR 6), 17.13 for functional wellbeing (SD 3.73; IQR 6), and 24.86 for breast cancer subscale (SD 3.64; IQR 4). The study found that the age, entitlement, recurrence, marital status, salary, number of doses, duration of cancer treatment, and chemotherapy sessions were significantly related to QOL terms in the assessment of the FACIT-B scale. The WHO causality evaluation scale determined that 78.1% of the responses were "probable" and 20.1% were "possible". According to Naranjo's algorithm assessment scale, 80% of adverse drug reactions (ADRs) were "probable", whereas 18.4% were declared "possible". Chemotherapy-induced anemia was the most often reported ADR in 64.6% of patients, followed by chemotherapy-induced nausea and vomiting (61.5%). Conclusion Healthcare practitioners must acknowledge and take into account the significance of QOL in addition to therapy for breast cancer patients in order to enhance their health. The findings of this study will aid in filling gaps in current unknown knowledge and identifying sites where patients require additional assistance. Because cancer and chemotherapy clearly have a negative impact on individuals' QOL, oncologists must concentrate on strategies that help cancer patients during their sickness and treatment while also enhancing self-care and QOL. Those with cancer will benefit from emotional wellbeing and adaptation to their disease.
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Affiliation(s)
- Fiza Ayub
- Institute of Pharmaceutical Science, University of Veterinary and Animal Science UVAS, Lahore, Pakistan
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Science, University of Veterinary and Animal Science UVAS, Lahore, Pakistan
| | - Mirza Rafi Baig
- Department of Clinical Pharmacy and Pharmacotherapeutics, Dubai Pharmacy College for Girls, Dubai, United Arab Emirates
| | | | - Humera Tahir
- Ruth Pfau College of Nutrition Sciences, Lahore Medical and Dental College, Lahore, Pakistan
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Tola WO, Melaku T, Fufa D, Sheleme T. Adverse drug events and contributing factors among pediatric cancer patients at Jimma University medical center, Southwest Ethiopia. BMC Pediatr 2023; 23:77. [PMID: 36782170 PMCID: PMC9923905 DOI: 10.1186/s12887-023-03891-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The characteristics and incidence of adverse drug events (ADEs) among pediatric cancer patients in developing countries have not been well characterized. ADEs & medication errors associated with cancer chemotherapy in children need to be analyzed on their incidence and severity. The purpose of this study was hence, to assess the incidence of adverse drug events and contributing factors among pediatric cancer patients at Jimma university medical center, Jimma, Ethiopia. METHOD A prospective observational method was used to study adverse drug events in pediatrics admitted to the pediatric oncology unit of Jimma University medical center between October and December 2020. The ADEs were identified using multifaceted approaches involving daily chart review, interviews of Parents/caregivers (and/or children themselves), attendance at ward rounds, and voluntary staff reports. Both univariate and multivariate logistic regression were used to assess the predictors of the identified ADEs. Those factors that showed association at p-value < 0.25 in the univariate analysis were added to the backward multivariate logistic regression model and the significant association was checked at p-value < 0.05. RESULT A total of 73 (46 male and 27 female) patients were included in the study. A total of 466 ADEs were identified with an incidence of 638.36 ADEs per 100 patients, 38.35 ADEs per 100 patient days, and 2.34 ADEs per chemotherapy cycle. The most common ADEs were hematologic toxicities (anemia 55(11.8%), neutropenia 52(11.16%) & thrombocytopenia 31(6.65%)), and gastrointestinal effects (nausea 46(9.87%), vomiting 46(9.87%), anorexia 41(8.8%). Out of 466 ADEs, 150 (32.19%) were classified as common terminology criteria for adverse events (CTCAE) as Grade 1, 199 (42.70%) as Grade 2, 64(13.73%) as Grade 3, 48(10.30%) as grade 4 and 5(1.07%) as Grade 5. Severe acute malnutrition (SAM) is the most common comorbidity present, 20(27.40%) followed by pneumonia, 4(5.50%). Presence of comorbidity (AOR 12.700, CI 1.978-81.549), cancer type (AOR 13.332, CI 3.288-54.059), use of 4 or more chemotherapy drugs (AOR 6.179, CI 1.894-20.165) and length of hospital stay more than 8 days (AOR 5.367, CI 1.167-24.684) were associated with the risk of developing grades 3 and 4 ADEs. CONCLUSION Adverse drug events were common in the pediatric oncology ward of JUMC. In particular, children with multiple chemotherapy drugs and those with the comorbid condition were at greater risk for adverse drug events.
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Affiliation(s)
- Wayessa Olika Tola
- Department of Pharmacy, College of Public Health and Medical Science, Mettu University, Mettu, Ethiopia.
| | - Tsegaye Melaku
- grid.411903.e0000 0001 2034 9160Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Diriba Fufa
- grid.411903.e0000 0001 2034 9160Department of Pediatrics and Child Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tadesse Sheleme
- grid.513714.50000 0004 8496 1254Department of Pharmacy, College of Public Health and Medical Science, Mettu University, Mettu, Ethiopia
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Alam Fatmi1j SM, Koul1 R, Suruchi P, Ayub S. Severity in schizophrenia patients receiving atypical antipsychotic medications. Bioinformation 2022; 18:1154-1158. [PMID: 37701510 PMCID: PMC10492911 DOI: 10.6026/973206300181154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/20/2022] [Accepted: 12/31/2022] [Indexed: 09/14/2023] Open
Abstract
Atypical antipsychotic drugs are nowadays the mainstay of treatment of schizophrenia due to their lesser extrapyramidal symptoms (EPS) as adverse effects. However, these drugs have different profiles of adverse drug reactions (ADRs). Here, the objective of this study was to analyze the probability, occurrences, and more significant involvement of various risk factors. A prospective observational study was carried out on a patient with schizophrenia who has prescribed atypical antipsychotic drugs for their treatment. The probability of the ADR was analyzed by using the Naranjo causality assessment scale. While Glasgow antipsychotic Side effect Scale (GASS) was used to estimate the severity of side effects. Statistical software for social science (SPSS) ver 25; was used for different descriptive statistics and chi-square analysis. A total of 140 patients were included in the study of which the majority (58.57 %) was male. However, atypical antipsychotic drugs were primarily prescribed to the patient as mono therapy (81.43 %). Interestingly, COVID-19 infections were reported as positive in 39.29 % of total patients. Probability assessment of ADRs revealed that most (55 %) were "Probable". Subsequently, the GASS score was evaluated for severity, the majority (55.71 %) were reported as "Mild". The statistically significant association between gender and severity of side effects & duration of illness and severity of side effects were found (P>0.5).The Present study aids in knowing the risk factors and improving the management practices of ADR, thereby improving the guidelines in terms of safe clinical approaches for psychiatric patients.
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Affiliation(s)
| | - Rakesh Koul1
- Department of Pharmacology, KD Medical College, Hospital & Research Center, Mathura, India
| | - Prakash Suruchi
- Department of Pharmacology, KD Medical College, Hospital & Research Center, Mathura, India
| | - Sheenam Ayub
- Department of Pediatric and Preventive Dentistry, KD Dental College & Hospital, Mathura
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Aputen AD, Elias MG, Gilbert J, Sakoff JA, Gordon CP, Scott KF, Aldrich-Wright JR. Potent Chlorambucil-Platinum(IV) Prodrugs. Int J Mol Sci 2022; 23:ijms231810471. [PMID: 36142383 PMCID: PMC9499463 DOI: 10.3390/ijms231810471] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
The DNA-alkylating derivative chlorambucil was coordinated in the axial position to atypical cytotoxic, heterocyclic, and non-DNA coordinating platinum(IV) complexes of type, [PtIV(HL)(AL)(OH)2](NO3)2 (where HL is 1,10-phenanthroline, 5-methyl-1,10-phenanthroline or 5,6-dimethyl-1,10-phenanthroline, AL is 1S,2S-diaminocyclohexane). The resultant platinum(IV)-chlorambucil prodrugs, PCLB, 5CLB, and 56CLB, were characterized using high-performance liquid chromatography, nuclear magnetic resonance, ultraviolet-visible, circular dichroism spectroscopy, and electrospray ionization mass spectrometry. The prodrugs displayed remarkable antitumor potential across multiple human cancer cell lines compared to chlorambucil, cisplatin, oxaliplatin, and carboplatin, as well as their platinum(II) precursors, PHENSS, 5MESS, and 56MESS. Notably, 56CLB was exceptionally potent in HT29 colon, Du145 prostate, MCF10A breast, MIA pancreas, H460 lung, A2780, and ADDP ovarian cell lines, with GI50 values ranging between 2.7 and 21 nM. Moreover, significant production of reactive oxygen species was detected in HT29 cells after treatment with PCLB, 5CLB, and 56CLB up to 72 h compared to chlorambucil and the platinum(II) and (IV) precursors.
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Affiliation(s)
- Angelico D. Aputen
- School of Science, Western Sydney University, Locked Bag 1797, Penrith South DC, Sydney, NSW 2751, Australia
| | - Maria George Elias
- School of Science, Western Sydney University, Locked Bag 1797, Penrith South DC, Sydney, NSW 2751, Australia
- Ingham Institute, Liverpool, NSW 2170, Australia
| | - Jayne Gilbert
- Calvary Mater Hospital, Waratah, NSW 2298, Australia
| | | | - Christopher P. Gordon
- School of Science, Western Sydney University, Locked Bag 1797, Penrith South DC, Sydney, NSW 2751, Australia
| | | | - Janice R. Aldrich-Wright
- School of Science, Western Sydney University, Locked Bag 1797, Penrith South DC, Sydney, NSW 2751, Australia
- Correspondence: ; Tel.: +61-246203218
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Navale G, Singh S, Agrawal S, Ghosh C, Roy Choudhury A, Roy P, Sarkar D, Ghosh K. DNA binding, antitubercular, antibacterial and anticancer studies of newly designed piano-stool ruthenium( ii) complexes. Dalton Trans 2022; 51:16371-16382. [DOI: 10.1039/d2dt02577a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The chemotherapeutic potential of ruthenium(ii) complexes as DNA binding, antitubercular, antibacterial, and anticancer agents.
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Affiliation(s)
- Govinda Navale
- Department of Chemistry, Indian Institute of Technology, Roorkee 247667, India
| | - Sain Singh
- Department of Chemistry, Indian Institute of Technology, Roorkee 247667, India
| | - Sonia Agrawal
- Department of Organic Chemistry, CSIR-National Chemical Laboratory, Pune 411 008, India
| | - Chandrachur Ghosh
- Department of Biosciences and Bioengineering, Indian Institute of Technology, Roorkee 247667, India
| | - Angshuman Roy Choudhury
- Department of Chemical Sciences, Indian Institute of Science Education and Research, Mohali, India
| | - Partha Roy
- Department of Biosciences and Bioengineering, Indian Institute of Technology, Roorkee 247667, India
| | - Dhiman Sarkar
- Department of Organic Chemistry, CSIR-National Chemical Laboratory, Pune 411 008, India
| | - Kaushik Ghosh
- Department of Chemistry, Indian Institute of Technology, Roorkee 247667, India
- Department of Biosciences and Bioengineering, Indian Institute of Technology, Roorkee 247667, India
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Campbell KC, Rehemtulla A, Sunkara P, Hamstra D, Buhnerkempe M, Ross B. Oral D-methionine protects against cisplatin-induced hearing loss in humans: phase 2 randomized clinical trial in India. Int J Audiol 2021; 61:621-631. [PMID: 34622731 DOI: 10.1080/14992027.2021.1983215] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: This exploratory Phase 2 clinical trial is the first determining safety and efficacy of oral D-methionine (D-met) in reducing cisplatin-induced ototoxicity.Design: Randomised parallel double-blind placebo-controlled exploratory Phase 2 study.Study samples: Fifty adult cancer patients received oral D-met or placebo before each cisplatin dose. Physical examination, blood collection and audiometry occurred at baseline and subsequent visits plus post-treatment audiometry. After attrition, final analysis included 27 patients.Results: Significant treatment group by ear and time (baseline vs. post-treatment) interactions occurred at 10 kHz and 11.2 kHz. Placebo and D-met groups differed in threshold shift for left ear at 11.2 kHz (mean difference = 22.97 dB [9.59, 36.35]). Averaging across ears, placebo group showed significant threshold shifts from baseline to post-treatment at 10 kHz (mean shift= -13.65 dB [-21.32,-5.98]), 11.2 kHz (-16.15 dB [-25.19,-7.12]), and 12.5 kHz (-11.46 dB [-19.18,-3.74]) but not 8 kHz (-8.65 dB [-17.86, 0.55]). The D-met group showed no significant threshold shifts (8 kHz: -1.25 dB [-7.75, 5.25]; 10 kHz:-3.93 dB [-8.89, 1.03]; 11.2 kHz:-4.82 dB [-11.21, 1.57]; 12.5 kHz:-3.68 dB [-11.57, 4.21]). Side effects did not significantly differ between groups.Conclusion: Oral D-met reduces cisplatin-induced ototoxicity in humans.
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Affiliation(s)
- Kathleen C Campbell
- Department of Medical Microbiology, Immunology, and Cell Biology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Alnawez Rehemtulla
- Molecular Therapeutics, Molecular Cancer Therapeutics, Ann Arbor, MI, USA
| | | | - Daniel Hamstra
- Department of Radiation Oncology, William Beaumont Oakland University Medical School, Dearborn, MI, USA
| | - Michael Buhnerkempe
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Brian Ross
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
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Banani MA, Rahmatullah M, Farhan N, Hancox Z, Yousaf S, Arabpour Z, Moghaddam ZS, Mozafari M, Sefat F. Adipose tissue-derived mesenchymal stem cells for breast tissue regeneration. Regen Med 2021; 16:47-70. [PMID: 33533667 DOI: 10.2217/rme-2020-0045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
With an escalating incidence of breast cancer cases all over the world and the deleterious psychological impact that mastectomy has on patients along with several limitations of the currently applied modalities, it's plausible to seek unconventional approaches to encounter such a burgeoning issue. Breast tissue engineering may allow that chance via providing more personalized solutions which are able to regenerate, mimicking natural tissues also facing the witnessed limitations. This review is dedicated to explore the utilization of adipose tissue-derived mesenchymal stem cells for breast tissue regeneration among postmastectomy cases focusing on biomaterials and cellular aspects in terms of harvesting, isolation, differentiation and new tissue formation as well as scaffolds types, properties, material-host interaction and an in vitro breast tissue modeling.
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Affiliation(s)
- Mohammed A Banani
- Division of Surgery & Interventional Science, University College London, London, NW3 2PS, UK
| | - Mohammed Rahmatullah
- Division of Surgery & Interventional Science, University College London, London, NW3 2PS, UK
| | - Nawras Farhan
- Division of Surgery & Interventional Science, University College London, London, NW3 2PS, UK
| | - Zoe Hancox
- Department of Biomedical & Electronics Engineering, School of Engineering, University of Bradford, Bradford, BD7 1DP, UK
| | - Safiyya Yousaf
- Department of Biomedical & Electronics Engineering, School of Engineering, University of Bradford, Bradford, BD7 1DP, UK
| | - Zohreh Arabpour
- Department of Biomedical & Electronics Engineering, School of Engineering, University of Bradford, Bradford, BD7 1DP, UK
| | - Zoha Salehi Moghaddam
- Department of Biomedical & Electronics Engineering, School of Engineering, University of Bradford, Bradford, BD7 1DP, UK.,Interdisciplinary Research Centre in Polymer Science & Technology (IRC Polymer), University of Bradford, Bradford, BD7 1DP, UK
| | - Masoud Mozafari
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, M5G 1X5, Canada
| | - Farshid Sefat
- Department of Biomedical & Electronics Engineering, School of Engineering, University of Bradford, Bradford, BD7 1DP, UK.,Interdisciplinary Research Centre in Polymer Science & Technology (IRC Polymer), University of Bradford, Bradford, BD7 1DP, UK
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Ramasubbu SK, Pasricha RK, Nath UK, Das B. Frequency, nature, severity and preventability of adverse drug reactions arising from cancer chemotherapy in a teaching hospital. J Family Med Prim Care 2020; 9:3349-3355. [PMID: 33102295 PMCID: PMC7567243 DOI: 10.4103/jfmpc.jfmpc_352_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/28/2020] [Accepted: 04/13/2020] [Indexed: 01/22/2023] Open
Abstract
Background: An adverse drug reaction (ADR) is defined by the World Health Organization (WHO) as “Any response to a drug which is noxious, unintended and occurs at doses used in man for prophylaxis, diagnosis or therapy”. Cancer chemotherapy is associated with the occurrence of ADRs, which is a worldwide problem. Monitoring and reporting of these ADRs are essential to safeguard the patient and to manage it accordingly. The outcome would create alertness and prevent their recurrence. Hence, we have undertaken a hospital-based study to study the frequency and nature of ADRs due to chemotherapeutic agents. Methods: A total of 500 patients developed ADRs due to cancer chemotherapy from 13th April 2018 to 18th September 2019. Demographics of the patient, drugs taken, and ADRs encountered were recorded in a predesigned form. Results: A total of 665 ADRs were recorded from 500 patients. Anemia was the most common ADR encountered followed by nausea/vomiting and leucopenia. Leukemia (s) were common cancer observed followed by lung and breast cancers. The most common drugs implicated were cisplatin, paclitaxel, carboplatin, and doxorubicin. Naranjo's scale showed 92% of ADRs as probable and 7% as possible. Severity scale showed 80.2% of ADRs were of moderate (level 3 and 4) severity, 11.6% of mild (level 1 and 2) severity, and 8.2% of level 5 severity. A total of 26.8% of ADRs were deemed preventable and 73.2% were not preventable. Conclusions: Our study provides safety data regarding the usage of anti-cancer drugs. Hence, it creates alertness among the treating doctors to prevent its recurrence.
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Affiliation(s)
- Saravana Kumar Ramasubbu
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Rajesh K Pasricha
- Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Uttam K Nath
- Department of Hemato-Oncology, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Biswadeep Das
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
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Pluronic-based graphene oxide-methylene blue nanocomposite for photodynamic/photothermal combined therapy of cancer cells. Photodiagnosis Photodyn Ther 2020; 29:101640. [DOI: 10.1016/j.pdpdt.2019.101640] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/08/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022]
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Hashem MA, Shoeeb SB, Abd-Elhakim YM, Mohamed WA. The antitumor activity of Arthrospira platensis and/or cisplatin in a murine model of Ehrlich ascites carcinoma with hematinic and hepato-renal protective action. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.103831] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Sharma S, Jayakumar D, Palappallil DS. Pharmacovigilance of Cutaneous Adverse Drug Reactions among Patients Attending Dermatology Department at a Tertiary Care Hospital. Indian Dermatol Online J 2019; 10:547-554. [PMID: 31544074 PMCID: PMC6743381 DOI: 10.4103/idoj.idoj_419_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Context: Cutaneous adverse drug reactions (CADRs) are the most frequent of all manifestations of drug sensitivity that present with varied and diverse morphology and therefore, awareness about them is essential for diagnosis and prevention. Aims: To evaluate the clinical spectrum, morphology, causality, severity and preventability of cutaneous adverse drug reactions in a tertiary care hospital. Setting and Design: Descriptive study for six months in the Dermatology Department of a tertiary care hospital in Kerala. Methods and Materials: All patients of any gender and age who presented with visible skin lesions and were diagnosed or suspected cases of cutaneous adverse drug reactions were included in the study. All the relevant information was recorded using pre-structured proforma and ADR reporting form. Statistical Analysis: Data were analyzed using descriptive statistics. The quantitative variables were expressed as mean ± standard deviation and qualitative variables as frequencies and percentages. Odds ratio (OR) was calculated to assess the risk factors for severe cutaneous adverse drug reactions using SPSS 16. Results: Total 124 cutaneous adverse drug reactions were reported with mean age 39.22 ± 20.47 years, male:female ratio being 1:1.4. Most common cutaneous adverse drug reaction was maculopapular rash. Antibiotics accounted for maximum cases, of which beta-lactams were the most common. About 55.6% cutaneous adverse drug reactions occurred within 24 hours of drug administration. Mean hospital stay duration was 4.89 ± 6.23 days. Most reactions were either mild or moderate. Risk analysis revealed that concomitant use of more than one drug, delayed onset, oral route, more generalized area of involvement and medications prescribed for CNS indications were risk factors for severe cutaneous adverse drug reactions. All reactions were preventable. Majority got fully recovered. No fatality was observed. Conclusion: Identification and reporting of cutaneous adverse drug reactions reduces their future occurrences and encourages rational prescribing. The study emphasizes on having a deeper understanding of risk factors for serious cutaneous adverse drug reactions that may contribute significantly in improving their outcomes.
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Affiliation(s)
- Shweta Sharma
- Department of Pharmacology, Grant Govt. Medical College, J J Hospital, Byculla, Mumbai, Maharashtra, India
| | - Dhanya Jayakumar
- Department of Pharmacology, Govt. T. D. Medical College Vandanam, Alappuzha, Kerala, India
| | - Dhanya S Palappallil
- Department of Pharmacology, Govt. Medical College, Gandhi Nagar, Kottayam, Kerala, India
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Sharma PK, Misra AK, Gupta A, Singh S, Dhamija P, Pareek P. A retrospective analysis of reporting of adverse drug reactions to oncology drugs: An experience from a national center of clinical excellence. Indian J Pharmacol 2019; 50:273-278. [PMID: 30636831 PMCID: PMC6302695 DOI: 10.4103/ijp.ijp_544_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION: Adverse drug reaction (ADR) is a public health problem which constitutes one of the leading causes of morbidity and mortality worldwide. In India, only a few studies reported cancer chemotherapy-induced ADRs. The objectives of the present study were to assess the organ system involved, frequency, severity, and preventability of the ADRs occurred. MATERIALS AND METHODS: Data on ADRs of retrospective cohorts were extracted from the filled ADR forms received from the department of radiation oncology. Descriptive statistic was used to summarize and analyze the available data, namely patient demography, causality, severity, and preventability of the event. RESULTS: A total of 191 chemotherapy-induced ADR reports were received from 164 patients during the period March 2015 to August 2017. Almost three-fourth of the ADRs occurred in patients who were receiving regimens involving multiple drugs. Taxanes, alkylating agents, and platinum compounds were the common drug groups involved. The skin (n = 90) was the most frequently involved organ with alopecia and hyperpigmentation as most common manifestations. The severity (Hartwig and Siegel) and preventability scales (Modified Schumock and Thornton) indicated that most reactions were mild (54.45%) in nature and the majority of them were preventable. More than two-third (69%) of the reactions were related “possible” to the suspected drug as determined by the World Health Organization causality assessment. CONCLUSION: Chemotherapy-related ADRs among cancer patients are worrisome. It has a negative impact on patient quality of life and in addition increases cost of therapy. It is found that timely reporting of chemotherapy-related ADRs and having an effective ADR monitoring system in place ensure preventability of the ADRs in many cases. Oncologists, Radiotherapists and Onco-surgeons should be actively involved in ADR reporting (Onco-Pharmacovigilance) and exchange constructive information, update and educate each other about appropriate use of anticancer drugs. Onco-pharmacovigilance is the need of the hour and could be of immense value in reducing morbidity and mortality if practiced with utmost importance.
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Affiliation(s)
- Pramod Kumar Sharma
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Arup Kumar Misra
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Ajay Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Surjit Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Puneet Dhamija
- Department of Pharmacology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Puneet Pareek
- Department of Radiotherapy, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Bright HR, Chandy SJ, Chacko RT, Backianathan S. Intercycle Unplanned Hospital Admissions Due to Cisplatin-based Chemotherapy Regimen-induced Adverse Reactions: A Retrospective Analysis. Curr Drug Saf 2019; 14:182-191. [PMID: 31250766 PMCID: PMC6865053 DOI: 10.2174/1574886314666190619123047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/16/2019] [Accepted: 05/27/2019] [Indexed: 12/04/2022]
Abstract
BACKGROUND Cisplatin is a commonly used chemotherapy agent known to induce serious adverse reactions that may require hospital readmission. We aimed to analyze the extent and factors associated with unplanned hospital admissions due to cisplatin-based chemotherapy regimen-induced adverse reactions. METHODS Retrospective review of medical records of those patients who received at least one cycle of chemotherapy with cisplatin-based regimen during a six-month period from March to August 2017. RESULTS Of the 458 patients who received cisplatin during the study period, 142 patients did not meet inclusion criteria. The remaining 316 patients had a total of 770 episodes of primary admissions for chemotherapy administration. Overall, 187 episodes (24%) of intercycle unplanned hospital admission were recorded of which a major proportion (n=178; 23%) was due to chemotherapy-induced adverse reactions. Underweight patients had higher odds of unplanned admission (OR 1.77, 95% confidence interval [CI] 1.11 to 1.77). Significantly, more number of patients with cancers of head and neck and cancers of musculoskeletal were readmitted (p<0.001). Compared to high-dose cisplatin, low- and intermediate-dose cisplatin had lesser odds of unplanned admission (OR 0.52 and 0.77; 95% CI, 0.31 to 0.88 and 0.41 to 1.45, respectively). Patients without concomitant radiotherapy, drug-drug interaction and initial chemotherapy cycles had lesser odds of unplanned admission (OR 0.38, 0.50 and 0.52; 95% CI, 0.26 to 0.55, 0.25 to 0.99 and 0.32 to 0.84 respectively). Unplanned admissions were mainly due to blood-related (31%) and gastrointestinal (19%) adverse reactions. Among chemotherapy regimens, cisplatin monotherapy (34%) and cisplatin with doxorubicin (20%) regimens resulted in a major proportion of unplanned admissions. CONCLUSION These findings highlight risk factors that help identify high-risk patients and suggest that therapy modifications may reduce hospital readmissions due to cisplatin-based chemotherapy-induced adverse reactions.
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Affiliation(s)
- Heber Rew Bright
- Address correspondence to this author at the Pharmacy Services, Christian Medical College & Hospital, Vellore 632 004, Tamil Nadu, India; Tel: 91-416-228 2690; E-mail:
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Tewari D, Rawat P, Singh PK. Adverse drug reactions of anticancer drugs derived from natural sources. Food Chem Toxicol 2018; 123:522-535. [PMID: 30471312 DOI: 10.1016/j.fct.2018.11.041] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/11/2018] [Accepted: 11/17/2018] [Indexed: 12/20/2022]
Abstract
Cancer, a life threatening disease adversely affects huge population worldwide. Naturally derived drug discovery has emerged as a potential pathway in search of anticancers. Natural products-based drugs are generally considered safe, compared to their synthetic counterparts. A systematic review on adverse drugs reactions (ADRs) of the anticancer natural products has not been performed till date. We reviewed anticancer drugs, derived from plants, microbes and marine sources with their mechanistic action and reported ADRs. PubMed, ScienceDirect and Scopus were searched through Boolean information retrieval method using keywords "natural products", "cancer", "herbal", "marine drugs" and "adverse drug reaction". We documented ADRs of natural products based anticancer agents, mechanisms of action and chemical structures. It was observed that majority of the natural products based anticancer drugs possess ample adverse effects, dominantly hematological toxicities, alopecia, neurotoxicity and cardiotoxicity. These findings deviate from the preconceived notion about safer nature of herbal drugs. We also came across some anti-cancer natural products with less/no reported adverse events like Cabazitaxel and Arglabin. Comprehensive pharmacovigilance studies are needed to report ADRs and thereby predicting safety of anti-cancer drugs, either originated from natural sources or chemically synthesized.
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Affiliation(s)
- Devesh Tewari
- Value Addition Research and Development-Human Health, National Innovation Foundation-India, Autonomous Body of Department of Science and Technology, Govt. of India, Grambharti, Mahudi Road, Gandhinagar, 382650, Gujarat, India
| | - Pooja Rawat
- Value Addition Research and Development-Human Health, National Innovation Foundation-India, Autonomous Body of Department of Science and Technology, Govt. of India, Grambharti, Mahudi Road, Gandhinagar, 382650, Gujarat, India
| | - Pawan Kumar Singh
- Value Addition Research and Development-Human Health, National Innovation Foundation-India, Autonomous Body of Department of Science and Technology, Govt. of India, Grambharti, Mahudi Road, Gandhinagar, 382650, Gujarat, India.
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Singh S, Singh PK. Pattern and impact of drugs targeted toward toxicity amelioration in patients receiving cancer chemotherapy. Perspect Clin Res 2018; 9:23-30. [PMID: 29430414 PMCID: PMC5799948 DOI: 10.4103/picr.picr_156_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Drug therapy today is remarkably safe and efficacious. Still, some drugs - particularly anticancer drugs - are fraught with numerous adverse drug reactions (ADRs), severely jeopardizing quality of life of cancer patients. Fortunately, most of these ADRs are preventable provided adequate prophylactic drugs are administered along with chemotherapy. Aims: The aim of this study is to assess the pattern and impact of cytoprotective prophylactic drugs on anticancer ADRs in patients receiving cancer chemotherapy. Subjects and Methods: We included 200 patients receiving anticancer therapy for the first time. Patient details and for each cycle: details of baseline investigations, anticancer treatment given, ADRs observed and interventions done to prevent and manage the ADRs were recorded. Preventability and predictability scales were applied to assess the impact of drugs and strategies toward toxicity amelioration. Data were analyzed using descriptive statistics. Results: Adjuvant drugs were administered prophylactically along with anticancer drugs for the prevention of nausea and vomiting, gastritis, immediate allergic reactions, nephrotoxicity, ototoxicity, hemorrhagic cystitis, and other anticipated ADRs. About 94.80% reactions were found to be predictable and 5.20% unpredictable. Maximum reactions (56.47%) were probably preventable. Paracetamol, filgrastim, mucaine, etc., were used to manage a variety of ADRs. Conclusions: Although the predictability of ADRs was almost 95%, we could prevent only about 56% of them. Surprisingly, we have no ADRs that appear definitely preventable. This could be due to less attention being paid to the ADRs that could have been prevented by the appropriate use of prophylactic measures.
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Affiliation(s)
- Shruti Singh
- Department of Pharmacology, AIIMS, Patna, Bihar, India
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Le TN, Harvey RE, Kim CK, Brown J, Coleman RL, Smith JA. A retrospective evaluation of activity of gemcitabine/platinum regimens in the treatment of recurrent ovarian cancer. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2017; 4:16. [PMID: 29158911 PMCID: PMC5684736 DOI: 10.1186/s40661-017-0053-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 10/12/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND While many of these agents have been compared in prospective clinical trials, the gemcitabine/platinumbased regimens have not been compared in a prospective, randomized clinical trial. While bothgemcitabine/carboplatin and gemcitabine/cisplatin have a similar ORR in separate clinical trials, the tworegimens have never been directly been compared. With overlapping dose-limiting toxicity of thrombocytopenia, the gemcitabine/carboplatin regimen has been challenging to employ in the clinical setting in previously treated ovarian cancer patients and is often associated with treatment delays and/or dose reductions. Gemcitabine/cisplatin can also be a challenge due to its dose limiting neuropathy and renal toxicity, especially in previously treated patients. In the absence of any prospective, head to head comparison this retrospective study was embarked upon to compare the response rate and toxicity profiles of gemcitabine/cisplatin verses gemcitabine/carboplatin for the treatment of platinum-sensitive verses platinum-resistant recurrent ovarian cancer. METHODS This was a retrospective chart review study that identified patients that had received either gemcitabine/cisplatin or gemcitabine/carboplatin for treatment of recurrent ovarian cancer and compared documented hematological and non-hematological toxicity and response based on RECIST (v1.1). Data was evaluated based upon platinum sensitivity/resistance as well. RESULTS A total of 93 patients were identified that had received a gemcitabine/platinum regimen with 48 with recurrent ovarian cancer that were included in the study. There were 21 patients in the gemcitabine/cisplatin arm and 27 patients identified in the gemcitabine/carboplatin arm. Objective response rate (ORR) was greater in platinum-sensitive patients that received gemcitabine/carboplatin compared to gemcitabine/cisplatin (8 (67%) vs 2 (25%), p < 0.05). Conversely, ORR was greater in platinum-resistant patients treated with gemcitabine/cisplatin (4 (57%) vs 1 (25%), NS). Mean time to progression was greater in gemcitabine/cisplatin patients (7.2 vs 5.1 months, p < 0.03). Patients treated with gemcitabine/carboplatin discontinued due to toxicity at a greater rate (8 (33%) vs 5 (24%)). Specifically gemcitabine/carboplatin had a greater incidence (85%) of grade 2 or greater leukopenia, thrombocytopenia, and neutropenia compared to gemcitabine/cisplatin (19%) However, there was no significant difference in dose reductions, treatment delays, or granulocyte-colony stimulating factor (G-CSF) administration between regimens. CONCLUSIONS Gemcitabine/cisplatin appears to have greater efficacy in platinum-resistant patients, while gemcitabine/carboplatin seems to have greater efficacy in platinum-sensitive patients. Overall, gemcitabine/carboplatin was associated with a greater incidence of myelosuppression and discontinuation due to toxicity. Similar to findings in endometrial cancer, gemcitabine/cisplatin may have benefit specifically in platinum-resistant ovarian cancer.
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Affiliation(s)
- Tran N. Le
- Department of Obstetrics, Gynecology, and Reproductive Sciences, UTHealth McGovern Medical School, 6431 Fannin Street, Rm. 3.152, Houston, TX 77030 USA
| | | | - Christine K. Kim
- University of Texas M.D. Anderson Cancer Center, Houston, TX USA
| | - Jubilee Brown
- Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC USA
| | | | - Judith A. Smith
- Department of Obstetrics, Gynecology, and Reproductive Sciences, UTHealth McGovern Medical School, 6431 Fannin Street, Rm. 3.152, Houston, TX 77030 USA
- UTHealth-Memorial Hermann Cancer Center-TMC, Houston, TX USA
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Degu A, Njogu P, Weru I, Karimi P. Assessment of drug therapy problems among patients with cervical cancer at Kenyatta National Hospital, Kenya. GYNECOLOGIC ONCOLOGY RESEARCH AND PRACTICE 2017; 4:15. [PMID: 29075505 PMCID: PMC5648473 DOI: 10.1186/s40661-017-0054-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/13/2017] [Indexed: 02/07/2023]
Abstract
Background Although cervical cancer is preventable, it is still the second leading cause of cancer deaths among women in the world. Further, it is estimated that around 5–10% of hospital admissions are due to drug related problems (DRPs), of which 50% are avoidable. In cancer therapy, there is an immense potential for DRPs due to the high toxicity of most chemotherapeutic regimens. Hence, this study sought to assess DRPs among patients with cervical cancer at Kenyatta National Hospital (KNH). Methods A cross-sectional study was conducted at the oncology units of KNH. A total of 81 study participants were recruited through simple random sampling. Data were collected from medical records and interviewing patients. The appropriateness of medical therapy was evaluated by comparing with National Compressive Cancer Network and European Society for Medical Oncology practice guideline of cervical cancer treatment protocol. The degree of adherence was determined using eight-item Morisky medication adherence scale. The likelihood of drug interaction was assessed using Medscape, Micromedex and Epocrates drug interaction checkers. The data were entered in Microsoft Excel and analysed using statistical software STATA version 13.0. Descriptive statistics such as mean, percent and frequency were used to summarise patients’ characteristics. Univariable and multivariable binary logistic regression were used to investigate the potential predictors of DRPs. Result A total of 215 DRPs were identified from 76 patients, translating to a prevalence of 93.8% and a mean of 2.65 ± 1.22 DRPs. The predominant proportion of DRPs (48.2%) was identified in patients who had been treated with chemoradiation regimens. Adverse drug reactions 56(69.1%) and drug interactions 38(46.9%) were the most prevalent DRPs. Majority (67.9%) of the study population were adherent to their treatment regimens. Forgetfulness 18(69.2%), expensive medications 4(15.4%) and side effects of medications 4(15.4%) were the main reasons for medication non-adherence. Patients with advanced stage cervical cancer were 15.4 times (AOR = 15.4, 95% CI = 1.3–185.87, p = 0.031) more likely to have DRPs as compared to patients with early stage disease. Conclusion Adverse drug reactions, drug interactions, and need of additional drug therapy were the most common DRPs identified among cervical cancer patients. Advanced stage cervical cancer was the only predictor of DRPs.
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Affiliation(s)
- Amsalu Degu
- Department of Pharmaceutics and Pharmacy Practice, University of Nairobi, College of Health Sciences, School of Pharmacy, P.O. Box 19676-00202, Nairobi, Kenya
| | - Peter Njogu
- Department of Pharmaceutical Chemistry, University of Nairobi, College of Health Sciences, School of Pharmacy, Nairobi, 19676-00202 Kenya
| | - Irene Weru
- Kenyatta National Hospital, Division of Pharmacy, Nairobi, 20723-00202 Kenya
| | - Peter Karimi
- Department of Pharmaceutics and Pharmacy Practice, University of Nairobi, College of Health Sciences, School of Pharmacy, P.O. Box 19676-00202, Nairobi, Kenya
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Visacri MB, Pincinato EDC, Ferrari GB, Quintanilha JCF, Mazzola PG, Lima CSP, Moriel P. Adverse drug reactions and kinetics of cisplatin excretion in urine of patients undergoing cisplatin chemotherapy and radiotherapy for head and neck cancer: a prospective study. ACTA ACUST UNITED AC 2017; 25:12. [PMID: 28438219 PMCID: PMC5404337 DOI: 10.1186/s40199-017-0178-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/11/2017] [Indexed: 01/09/2023]
Abstract
Background Cisplatin is a high-potency anticancer agent; however, it causes significant adverse drug reactions (ADRs). Potential pharmacokinetic markers must be studied to predict or prevent cisplatin-induced ADRs and achieve better prognosis. This study was designed to investigate the relationship between ADRs and kinetics of cisplatin excretion in the urine of patients undergoing high-dose cisplatin chemotherapy and radiotherapy for head and neck cancer. Methods Outpatients with head and neck cancer received a first cycle of high-dose cisplatin chemotherapy (80–100 mg/m2) concurrent to radiotherapy. ADRs (haematological, renal, and gastrointestinal reactions) were classified based on severity by National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE, version 4, grade 0–4). The kinetics of cisplatin excretion in urine was evaluated by high-performance liquid chromatography over three time periods: 0–12, 12–24, and 24–48 h after the administration of cisplatin. Spearman Correlation test and regression analysis were performed to assess the relationship between ADRs and cisplatin excretion in the urine. Results In total, 59 patients with a mean age of 55.6 ± 9.4 years were analysed; most patients were male (86.4%), white (79.7%), and with pharyngeal tumours in advanced stages (66.1%). The most frequently observed ADRs were anaemia (81.4%), lymphopenia (78%), and nausea (64.4%); mostly grades 1 and 2 of toxicity. The mean cisplatin excretion was 70.3 ± 64.4, 7.3 ± 6.3, and 5 ± 4 μg/mg creatinine at 0–12, 12–24, and 24–48 h, respectively. Statistical analysis showed that the amount of cisplatin excreted did not influence the severity of ADRs. Conclusions The most frequent ADRs were anaemia, lymphopenia, and nausea. Grades 1 and 2 were the severities for most ADRs. The period over which the highest cisplatin excretion observed was 0–12 h after chemotherapy, and cisplatin excretion could not predict toxicity. Graphical abstract ![]()
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Affiliation(s)
- Marília Berlofa Visacri
- School of Medical Sciences (FCM), University of Campinas (UNICAMP), Tessália Vieira de Camargo, 126, Cidade Universitária "Zeferino Vaz", Zip Code 13083-887, Campinas, SP, Brazil
| | - Eder de Carvalho Pincinato
- Department of Biological and Health Science Center, Mackenzie Presbyterian University, Rua da Consolação 896, Consolação, Zip Code 01302-907, São Paulo, SP, Brazil
| | - Graziele Baldan Ferrari
- School of Medical Sciences (FCM), University of Campinas (UNICAMP), Tessália Vieira de Camargo, 126, Cidade Universitária "Zeferino Vaz", Zip Code 13083-887, Campinas, SP, Brazil
| | - Júlia Coelho França Quintanilha
- School of Medical Sciences (FCM), University of Campinas (UNICAMP), Tessália Vieira de Camargo, 126, Cidade Universitária "Zeferino Vaz", Zip Code 13083-887, Campinas, SP, Brazil
| | - Priscila Gava Mazzola
- Faculty of Pharmaceutical Sciences (FCF), University of Campinas (UNICAMP), Cândido Portinari, 200, Cidade Universitária "Zeferino Vaz" - Barão Geraldo, Zip Code 13083-871, Campinas, SP, Brazil
| | - Carmen Silvia Passos Lima
- School of Medical Sciences (FCM), University of Campinas (UNICAMP), Tessália Vieira de Camargo, 126, Cidade Universitária "Zeferino Vaz", Zip Code 13083-887, Campinas, SP, Brazil
| | - Patricia Moriel
- Faculty of Pharmaceutical Sciences (FCF), University of Campinas (UNICAMP), Cândido Portinari, 200, Cidade Universitária "Zeferino Vaz" - Barão Geraldo, Zip Code 13083-871, Campinas, SP, Brazil.
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Singh S, Dhasmana DC, Bisht M, Singh PK. Pattern of Adverse Drug Reactions to Anticancer Drugs: A Quantitative and Qualitative Analysis. Indian J Med Paediatr Oncol 2017; 38:140-145. [PMID: 28900321 PMCID: PMC5582550 DOI: 10.4103/ijmpo.ijmpo_18_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Anticancer drugs contribute significantly to the global burden of adverse drug reactions (ADRs). Any attempt to quantify their magnitude and provide upgraded knowledge would help oncologists in writing safer prescriptions. AIM This observational follow-up study was conducted on newly diagnosed cancer patients receiving anticancer therapy with an aim to determine the frequency, severity, causality, predictability, and preventability of ADRs. SUBJECTS AND METHODS The patients were followed up for 6 months for the appearance of adverse events. Data were analyzed using IBM SPSS Statistics for Windows, Version 22.0. (Armonk, NY) and presented in the form of descriptive statistics. RESULTS Each patient was prescribed approximately 6.85 ± 1.51 (mean ± standard error) drugs on average. All the patients (100%) receiving anticancer chemotherapy had ADRs. Alopecia, nausea and vomiting, burning tingling, and numbness were the most frequently encountered ADRs. The incidence of alopecia (P < 0.0004), nausea (P < 0.03), and oral ulceration (P < 0.02) was higher in females. Maximum reactions were of Grade 2 (69.53%). Most of the reactions (75.80%) appeared within 10 days of receiving the first cycle. 99.58% reactions were not serious. According to the WHO - The Uppsala Monitoring Centre criteria, 99.47% ADRs fell in possible category. According to the Naranjo's algorithm, 100% ADRs fell in probable category. About 94.80% reactions were found to be predictable. About 56.47% reactions were probably preventable, and 43.53% reactions were not preventable. CONCLUSION Multiple ADRs were seen in newly diagnosed cancer patients. Most of them were predictable, of mild-to-moderate severity, nonserious, and preventable. A majority of the ADRs recovered over time.
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Affiliation(s)
- Shruti Singh
- Department of Pharmacology, AIIMS, Patna, Bihar, India
| | - DC Dhasmana
- Department of Pharmacology, HIMS, Dehradun, India
| | - Manisha Bisht
- Department of Pharmacology, AIIMS, Rishikesh, Uttarakhand, India
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Rezaee R, Momtazi AA, Monemi A, Sahebkar A. Curcumin: A potentially powerful tool to reverse cisplatin-induced toxicity. Pharmacol Res 2017; 117:218-227. [DOI: 10.1016/j.phrs.2016.12.037] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/25/2016] [Accepted: 12/27/2016] [Indexed: 01/06/2023]
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Wahlang JB, Laishram PD, Brahma DK, Sarkar C, Lahon J, Nongkynrih BS. Adverse drug reactions due to cancer chemotherapy in a tertiary care teaching hospital. Ther Adv Drug Saf 2016; 8:61-66. [PMID: 28255433 DOI: 10.1177/2042098616672572] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND An adverse drug reaction (ADR) is defined by World Health Organization (WHO) as 'Any response to a drug which is noxious, unintended and occurs at doses used in man for prophylaxis, diagnosis or therapy'. ADRs associated with cancer chemotherapy warrant analysis on their severity and preventability. The outcome would create awareness among health care providers and prevent their recurrence. We have performed a hospital-based prospective observational study designed to analyze the pattern of ADRs to chemotherapeutic agents in cancer patients of a tertiary care hospital. METHODS A total of 119 cancer patients were monitored for suspected ADRs during the course of chemotherapy from November 2014 to December 2015. Clinical events were recorded and analyzed with regard to the demographics and drug details of the patients. RESULTS A total of 106 ADRs were recorded from 119 cases. The ADRs commonly encountered included constipation, nausea, vomiting, alopecia and hematological changes. Cisplatin, cyclophosphamide, paclitaxel and 5-FU were used for the treatment of commonly found cancers in this region affecting the lungs, esophagus and lymphomas. Naranjo's causality assessment showed 86.7% possible (score 4) and 13.2% probable (score 5-6). Severity of adverse reactions showed 77.4% mild, 18.9% moderate and 3.8% severe. A total of 45.3% of ADRs were preventable reactions such as nausea, vomiting and constipation. CONCLUSIONS This study highlights the role of active monitoring as an important tool for early detection, assessment and timely management of ADRs in patients undergoing cancer chemotherapy. The observed ADRs were preventable although ADRs such as hiccough, anemia, neutropenia and alopecia were not preventable.
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Affiliation(s)
- Julie Birdie Wahlang
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Mawdiangdiang, Shillong, Meghalaya, 793001, India
| | - Purnima Devi Laishram
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, India
| | - Dhriti Kumar Brahma
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, India
| | - Chayna Sarkar
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, India
| | - Joonmoni Lahon
- North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, India
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Manohar HD, Adiga S, Thomas J, Sharma A. Adverse drug reaction profile of microtubule-damaging antineoplastic drugs: A focused pharmacovigilance study in India. Indian J Pharmacol 2016; 48:509-514. [PMID: 27721535 PMCID: PMC5051243 DOI: 10.4103/0253-7613.190725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 08/21/2016] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The aim of the study was to analyze the adverse drug reaction (ADR) profile of microtubule-damaging antineoplastic drugs (taxanes and vinca alkaloids) and to look for unexpected ADRs among the local population. Focused study on these drugs, rampantly used in oncology department for a wide variety of tumors including early and advanced malignancies, would enable better treatment care by physicians. MATERIALS AND METHODS Data on ADRs were collected from the cancer patients belonging to both gender and of all ages, on taxanes- or vinca-based cancer chemotherapy and reported in the Indian Pharmacopoeia Commission form. Causality was assessed using the WHO criteria and Naranjo's Algorithm. Preventability and severity of ADRs were also assessed. RESULTS A total of 97 ADRs were reported among 488 patients on microtubule-damaging anticancer drugs admitted over a period of 1 year. The incidence rate was 19.87%. Gastrointestinal system (40.2%) was the most affected followed by bone marrow (33%) and skin (8.2%). The highest incidence of ADRs was reported among paclitaxel (54.6%), and vincristine (39.2%). Most of the reported ADRs were of milder nature and preventable. The WHO causality assessment scale indicated 71.1% possible reactions. CONCLUSIONS This study showed that most ADRs are preventable with effective ADR monitoring. There is a great need to create awareness among healthcare professionals regarding the importance of the pharmacovigilance system. Judicious use of the preventive measures will lead to a reduction in the incidence of ADRs due to the drug armamentarium, thereby enabling additional economic benefit to the patient and society.
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Affiliation(s)
- Hasitha Diana Manohar
- Department of Pharmacology, Karpaga Vinayaga Institute of Medical Sciences and Research, Dr. M. G. R. Medical University, Chennai, Tamil Nadu, India
| | - Shalini Adiga
- Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Joseph Thomas
- Department of Medical Oncology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Ajitha Sharma
- Department of Pharmacology, Pondicherry Institute of Medical Sciences, Puducherry, India
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Lim KM, An S, Lee OK, Lee MJ, Lee JP, Lee KS, Lee GT, Lee KK, Bae S. Analysis of changes in microRNA expression profiles in response to the troxerutin-mediated antioxidant effect in human dermal papilla cells. Mol Med Rep 2015; 12:2650-60. [PMID: 25955790 PMCID: PMC4464413 DOI: 10.3892/mmr.2015.3717] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 03/26/2015] [Indexed: 01/08/2023] Open
Abstract
Dermal papilla (DP) cells function as important regulators of the hair growth cycle. The loss of these cells is a primary cause of diseases characterized by hair loss, including alopecia, and evidence has revealed significantly increased levels of reactive oxygen species (ROS) in hair tissue and DP cells in the balding population. In the present study, troxerutin, a flavonoid derivative of rutin, was demonstrated to have a protective effect against H2O2-mediated cellular damage in human DP (HDP) cells. Biochemical assays revealed that pretreatment with troxerutin exerted a protective effect against H2O2-induced loss of cell viability and H2O2 induced cell death. Further experiments confirmed that troxerutin inhibited the H2O2-induced production of ROS and upregulation of senescence-associated β-galactosidase activity. Using microRNA (miRNA) microarrays, the present study identified 24 miRNAs, which were differentially expressed in the troxerutin pretreated, H2O2-treated HDP cells. Subsequent prediction using bioinformatics analysis revealed that the altered miRNAs were functionally involved in several cell signaling pathways, including the mitogen-activated protein kinase and WNT pathways. Overall, these results indicated that ROS-mediated cellular damage was inhibited by troxerutin and suggested that the use of troxerutin may be an effective approach in the treatment of alopecia.
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Affiliation(s)
- Kyung Mi Lim
- Molecular‑Targeted Drug Research Center and Korea Institute for Skin and Clinical Sciences, Konkuk University, Seoul 143‑701, Republic of Korea
| | - Sungkwan An
- Molecular‑Targeted Drug Research Center and Korea Institute for Skin and Clinical Sciences, Konkuk University, Seoul 143‑701, Republic of Korea
| | - Ok-Kyu Lee
- Molecular‑Targeted Drug Research Center and Korea Institute for Skin and Clinical Sciences, Konkuk University, Seoul 143‑701, Republic of Korea
| | - Myung Joo Lee
- Molecular‑Targeted Drug Research Center and Korea Institute for Skin and Clinical Sciences, Konkuk University, Seoul 143‑701, Republic of Korea
| | - Jeong Pyo Lee
- Coreana Cosmetics Co., Ltd., Cheonan, Chungcheong 330‑882, Republic of Korea
| | - Kwang Sik Lee
- Coreana Cosmetics Co., Ltd., Cheonan, Chungcheong 330‑882, Republic of Korea
| | - Ghang Tai Lee
- Coreana Cosmetics Co., Ltd., Cheonan, Chungcheong 330‑882, Republic of Korea
| | - Kun Kook Lee
- Coreana Cosmetics Co., Ltd., Cheonan, Chungcheong 330‑882, Republic of Korea
| | - Seunghee Bae
- Molecular‑Targeted Drug Research Center and Korea Institute for Skin and Clinical Sciences, Konkuk University, Seoul 143‑701, Republic of Korea
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Sharma A, Kumari KM, Manohar HD, Bairy KL, Thomas J. Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care hospital in South India. Perspect Clin Res 2015; 6:109-15. [PMID: 25878957 PMCID: PMC4394577 DOI: 10.4103/2229-3485.154014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Studies regarding pattern of adverse drug reactions (ADRs) in cancer chemotherapy patients are scarce in India. This study was conducted to evaluate the pattern of occurrence of ADRs due to cancer chemotherapy in hospitalized patients and to assess the causality, severity, predictability, and preventability of these reactions. MATERIALS AND METHODS This was a retrospective, descriptive study and the occurrence and nature of ADR, suspected drug, duration of hospital stay and outcome were noted from case records. These ADRs were assessed for causality using both World Health Organization (WHO) causality assessment scale and Naranjo's algorithm. The severity and preventability of the reported reactions were assessed using modified Hartwig and Siegel scale and modified Schumock and Thornton scale respectively. RESULTS Five hundred ADRs were recorded from 195 patients. Most common ADRs were infections (22.4%), nausea/vomiting (21.6%) and febrile neutropenia (13%). Platinum compounds, nitrogen mustards, taxanes, antibiotics and 5-fluorouracil were the most common drugs causing ADRs. WHO causality assessment scale showed 65% of the reactions to be "probable" and 35% to be "possible", while Naranjo's algorithm indicated that 65.6% of ADRs were "probable" and 34.4% were "possible". Modified Hartwig and Siegel scale showed most reactions (41.4%) to be of "moderate level 4(a)" severity, while 30.6% of reactions were of "mild level 1" severity. About 30.8% of the ADRs were "definitely preventable" according to the modified Schumock and Thornton scale. CONCLUSION ADRs are most important causes of morbidity and mortality and increase the economic burden on patient and society. By careful ADR monitoring, their incidence can be decreased.
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Affiliation(s)
- Ajitha Sharma
- Department of Pharmacology, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - K. Meena Kumari
- Department of Pharmacology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India
| | - Hasitha Diana Manohar
- Department of Pharmacology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India
| | - K. L. Bairy
- Department of Pharmacology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India
| | - Joseph Thomas
- Department of Medical Oncology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India
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26
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Wang HF, Lv JQ. The Clinical Evaluation of Tegafur Gimeracil Oteracil Combined with THP and DDP for Second-Line Treatment of Advanced Cardiac Carcinoma. Cell Biochem Biophys 2015; 72:695-9. [PMID: 25618173 DOI: 10.1007/s12013-015-0520-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study is to explore the clinical effect of tegafur gimeracil oteracil combined with pirarubicin hydrochloride (THP) and diamminedichloroplatinum (DDP) for second-line treatment of advanced cardiac carcinoma, and find the most effective method to improve its survival rate and decrease the adverse reactions. 70 patients with advanced cardiac carcinoma admitted during February 2010-March 2014 were selected and divided into two groups with 35 cases in each group. All patients were treated with THP and DDP, and tegafur gimeracil oteracil was added to the observation group. The differences of effective rate, life quality, and adverse reactions after treatment in observational group were observed. The result of total curative effect indicated that the occurrence rate of complete remission + partial remission (CR + PR) in the control group was 28.57 %, the total effective rate was 51.43 %, the occurrence rate of CR + PR in the observational group was 34.29 %, and the total effective rate was 57.15 %; there was no statistical difference between the two groups (P > 0.05). The result of KPS scoring indicated that the improvement rate in the control group was 28.57 %, the total effective rate was 62.86 %, the improvement rate in the observational group was 42.86 %, and the total effective rate was 80 %; there was statistical difference between two groups (P < 0.05); the occurrence rates of adverse reactions including leukocyte decrease, thrombocytopenia, anemia, nausea and vomiting, constipation, peripheral neurovirulence, hepatotoxicity, and renal toxicity were statistically different (P < 0.05). Tegafur gimeracil oteracil combined with THP and DDP in treating advanced cardiac carcinoma can improve the life quality and decrease the adverse reactions.
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Affiliation(s)
- Hai-Feng Wang
- Gastrointestinal Tumor Surgery Department, Shaoxing People's Hospital, Zhejiang University, Shaoxing, 312000, Zhejiang, People's Republic of China.
| | - Jie-Qing Lv
- Gastrointestinal Tumor Surgery Department, Shaoxing People's Hospital, Zhejiang University, Shaoxing, 312000, Zhejiang, People's Republic of China
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27
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Ugur S, Ulu R, Dogukan A, Gurel A, Yigit IP, Gozel N, Aygen B, Ilhan N. The renoprotective effect of curcumin in cisplatin-induced nephrotoxicity. Ren Fail 2015; 37:332-6. [PMID: 25594614 DOI: 10.3109/0886022x.2014.986005] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The polyphenol curcumin has several pharmacological effects, including antioxidant, anti-inflammatory and anti-cancer features. In this study, we evaluated the effects of curcumin in cisplatin-induced nephrotoxicity in rats. Male Wistar rats were divided into four groups: (1) control; (2) cisplatin (7 mg/kg body weight, intraperitoneal as a single dose); (3) curcumin (100 mg/kg via gavage, for 10 days); and (4) cisplatin and curcumin. The cisplatin-treated rats exhibited kidney injury manifested by increased serum urea and creatinine (p<0.05). The kidney tissue from the cisplatin treated rats also exhibited a significant increase in the malondialdehyde (MDA) levels (p<0.05). The treatment with curcumin prevented a rise in the serum urea, creatinine and MDA levels when compared to the control group kidneys (p<0.05). The analysis the nicotinamide phosphoribosyltransferase (NAMPT) and sirtuin (SIRT) proteins (SIRT1, SIRT3 and SIRT4), which play important roles in the resistance to stress and the modulation of the threshold of cell death, showed similar trends (p<0.05). In the cisplatin-only treated rats, the induced renal injury decreased the levels of the NAMPT and SIRT proteins. Conversely, the curcumin increased the levels of the NAMPT and SIRT proteins in the cisplatin-treated rats (p<0.05). These data suggest that curcumin can potentially be used to reduce chemotherapy-induced nephrotoxicity, thereby enhancing the therapeutic window of cisplatin.
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Affiliation(s)
- Sıddık Ugur
- Department of Nephrology, Medical Faculty, Firat University , Elazig , Turkey and
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28
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Shamna M, Dilip C, Ajmal M, Linu Mohan P, Shinu C, Jafer CP, Mohammed Y. A prospective study on Adverse Drug Reactions of antibiotics in a tertiary care hospital. Saudi Pharm J 2014; 22:303-8. [PMID: 25161373 DOI: 10.1016/j.jsps.2013.06.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Adverse reactions are the recognized hazards of drug therapy and they can occur with any class of drugs and many studies revealed that the incidence is more in case of antibiotics. The main aim of this study was to detect and analyze Adverse Drug Reactions of antibiotics in inpatients of a tertiary care hospital. A prospective spontaneous reporting study by active and passive methods was carried out for a period of six months. A total of 49 ADRs were reported during the study period with male predominance (53.06%) and geriatric age group. More number of ADRs was from General Medicine and Pediatric departments in which the most affected organ systems were the GIT (38.77%) and the skin (30.61%). The antibiotic classes mostly accounted were cephalosporins (34.69%) followed by fluoroquinolones and others in which type A reactions were more compared to type B and 59.18% of them were predictable. The severity assessment revealed that most of them were moderate (63.26%) followed by mild and severe reactions. Of the reported reactions, 55.10% were definitely preventable and causality assessment was done which showed that 71.42% of the reactions were probable, possible (18.36%), definite (10.20%) and no reactions were unlikely. The study concluded that Adverse Drug Reactions to antibiotics are common and some of them resulted in increased healthcare cost due to the need of some interventions and increased length of hospital stay. The health system should promote the spontaneous reporting of Adverse Drug Reactions to antibiotics, proper documentation and periodic reporting to regional pharmacovigilance centers to ensure drug safety.
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Affiliation(s)
- M Shamna
- Al Shifa College of Pharmacy, Kizhattur, Kerala, India
| | - C Dilip
- Al Shifa College of Pharmacy, Kizhattur, Kerala, India
| | - M Ajmal
- Al Shifa College of Pharmacy, Kizhattur, Kerala, India
| | - P Linu Mohan
- Al Shifa College of Pharmacy, Kizhattur, Kerala, India
| | - C Shinu
- Al Shifa College of Pharmacy, Kizhattur, Kerala, India
| | - C P Jafer
- Al Shifa College of Pharmacy, Kizhattur, Kerala, India
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Sahin K, Orhan C, Tuzcu M, Muqbil I, Sahin N, Gencoglu H, Guler O, Padhye SB, Sarkar FH, Mohammad RM. Comparative in vivo evaluations of curcumin and its analog difluorinated curcumin against cisplatin-induced nephrotoxicity. Biol Trace Elem Res 2014; 157:156-63. [PMID: 24415068 DOI: 10.1007/s12011-014-9886-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 01/01/2014] [Indexed: 12/12/2022]
Abstract
Curcumin, a polyphenol, has pharmacological effects including antioxidant, anti-inflammatory and anti-cancer features. In this study, we have performed comparative in vivo evaluations of CDF (curcumin difluorinated) and curcumin in cisplatin-induced nephrotoxicity in rats. Male Wistar rats were divided into four groups: (1) Control; (2) Cisplatin (7 mg/kg body wt, intraperitoneal as a single dose); (3) Cisplatin and CDF (50 mg/rat/day; for 12 days); (4) Cisplatin and curcumin (50 mg/rat/day), for 12 days). Cisplatin treated rats exhibited kidney injury manifested by increased serum N-urea and creatinine (P < 0.001). Kidney from cisplatin treated rats also exhibited significant increase in malondialdehyde (MDA) and 8-isoprostane levels (P < 0.001). Treatment with CDF and curcumin prevented the rise in serum N-urea, creatinine, MDA and 8-isoprostane as compared to experimental control group in kidney (P < 0.05). Compared to curcumin, CDF had greater potential in suppressing cisplatin-induced pro-inflammatory factors NF-κB and COX-2 as well as downstream markers Nrf2 and HO-1 (P < 0.05) in kidney. The analysis on anion transport markers (OAT1 and OAT3) showed a similar trend (CDF > curcumin). CDF could reduce the expression of multi-drug resistance markers OCT1, OCT2, MRP2 and MRP4 to a much greater extent than curcumin (P < 0.05). We also demonstrate that CDF influenced the expression of p-mTOR, p-p70S6K1, p-4E-BP1 and p-Akt. These data suggest that CDF can potentially be used to reduce the chemotherapy induced nephrotoxicity thereby enhancing the therapeutic window of cisplatin. The results also proved that compared to curcumin, CDF has superior protective effect in nephrotoxicity.
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Affiliation(s)
- Kazim Sahin
- Department of Animal Nutrition, Faculty of Veterinary Science, Firat University, Elazig, 23100, Turkey,
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Arunkumar PA, Viswanatha GL, Radheshyam N, Mukund H, Belliyappa MS. Science behind cisplatin-induced nephrotoxicity in humans: a clinical study. Asian Pac J Trop Biomed 2012; 2:640-4. [PMID: 23569986 PMCID: PMC3609353 DOI: 10.1016/s2221-1691(12)60112-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Revised: 10/27/2011] [Accepted: 12/12/2011] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To investigate the relationship between serum electrolyte changes and cisplatin induced nephrotoxicity. METHODS We collected data from 18 patients undergoing cisplatin chemotherapy including serum electrolytes, creatinine, blood urea nitrogen (BUN) and urine potassium, sodium and pH levels before and after the cisplatin chemotherapy. All the patients had cancer and were treated with 40-50 mg/day cisplatin. Renal injury was assessed by measuring serum electrolytes, creatinine, BUN levels and urine potassium, sodium and pH levels. RESULTS The five cycles of cisplatin based chemotherapy resulted in hypomagnesia (P=0.029), hypocalcaemia (P=0.001*), hypophosphatemia (P=0.003*), hypokalemia (P=0.001*) and increased serum creatinine (P=0.001*) and BUN (P=0.292*) levels. In urine analysis, decrease in potassium (P=0.024*) was found, except potassium there was no significant changes in sodium and urine pH. CONCLUSIONS The present study demonstrates that, acute nephrotoxicity was observed in patients with different types of cancers undergoing cisplatin based chemotherapy due to electrolyte disturbances, when no corrective measures were initiated.
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Affiliation(s)
- PA Arunkumar
- Department of Pharmacology, PES College of Pharmacy, Bangalore-560 050, India
| | - GL Viswanatha
- Department of Pharmacology, PES College of Pharmacy, Bangalore-560 050, India
| | - N Radheshyam
- Medical Oncology, Curie Centre for Oncology, St.John's Medical College, Bangalore-560 035, India
| | - H Mukund
- Department of Pharmacology, PES College of Pharmacy, Bangalore-560 050, India
| | - MS Belliyappa
- Radiation Oncology, Curie Centre for Oncology, St.John's Medical College, Bangalore-560 035, India
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