Hypertensive crises are elevations of blood pressure higher than 180/120 mmHg. These can be urgent or emergent, depending on the presence of end organ damage. The clinical presentation of hypertensive crises is quite ...Hypertensive crises are elevations of blood pressure higher than 180/120 mmHg. These can be urgent or emergent, depending on the presence of end organ damage. The clinical presentation of hypertensive crises is quite variable in elderly patients, and clinicians must be suspicious of non-specific symptoms. Managing hypertensive crises in elderly patients needs meticulous knowledge of the pathophysiological changes in them, pharmacological options, pharmacokinetics of the medications used, their side effects, and their interactions with other medications. Clevidipine, nicardipine, labetalol, esmolol, and fenoldopam are among the preferred choices in the elderly due to their efficacy and tolerability. Nitroprusside, hydralazine, and nifedipine should be avoided, unless there are no other options available, due to the high risk of complications and unpredictable responses.展开更多
Data from both basic research and clinical experience continue to suggest that mesalamines and thioputines are effective and efficient for the maintenance of remission of inflammatory bowel diseases. Several decades f...Data from both basic research and clinical experience continue to suggest that mesalamines and thioputines are effective and efficient for the maintenance of remission of inflammatory bowel diseases. Several decades following the formalization of their indications, attention on these two drugs has been fostered by recent achievements. Demonstration of the ability of mesalamine to activate a colonocyte differentiation factor has shed light on its chemopreventive effects on colorectal cancer; in addition to their anti-proliferative efficacy, thiopurines have been shown to be specific regulators of apoptosis. The two drugs are often coadministered in clinical practice. Recent advancements have shown that mesalamines exert a positive synergism in this context, insofar as they can inhibit sidemethylation of thiopurines and hasten the function of the main immunosuppressive pathways. Considering that up to 40% of patients cannot tolerate thiopurines, such renovated targets have stimulated efforts to improve compliance by research on the toxicity mechanisms. The definition of genetic polymorphisms in the enzymes of thiopurine metabolism, and the uncovering of synergistic drug interactions, such as that with allopurinol, are just two of the results of such efforts. Interaction between basic research and clinical practice has continued to inform indications and refine the prescriptions of mesalamines and thiopurines; these have not been restrained （they have been implemented in some cases） by the advent of the novel biological molecules with anti-cytokine activity.展开更多
The assay of acyclovir in plasma seems to be a challenge because of its high hydrophily.In our present study,a reversed-phase high-performance liquid chromatography(RP-HPLC)method for the determination of acyclovir in...The assay of acyclovir in plasma seems to be a challenge because of its high hydrophily.In our present study,a reversed-phase high-performance liquid chromatography(RP-HPLC)method for the determination of acyclovir in rat plasma was described and validated in drug-drug interaction(DDI)between gefitinib and acyclovir in rats.The analytes were separated with gradient elution on C18 column(4.6 mm×250 mm,5μm),and the peaks were recorded using ultraviolet detector at a wavelength of 254 nm.Protein precipitation followed by methyl tertiary butyl ether extraction was used for sample preparation.The calibration curve was established between 0.2 and 40μg/mL(r^(2)=0.9999).The intra-and inter-day precisions were all less than 8%,and all the biases were not more than 10%.This new method was successfully applied to a DDI study between gefitinib and acyclovir in rats.Gefitinib up-regulated the absorption of acyclovir by about three times,and our findings guided the clinical co-administration of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)with acyclovir.展开更多
文摘Hypertensive crises are elevations of blood pressure higher than 180/120 mmHg. These can be urgent or emergent, depending on the presence of end organ damage. The clinical presentation of hypertensive crises is quite variable in elderly patients, and clinicians must be suspicious of non-specific symptoms. Managing hypertensive crises in elderly patients needs meticulous knowledge of the pathophysiological changes in them, pharmacological options, pharmacokinetics of the medications used, their side effects, and their interactions with other medications. Clevidipine, nicardipine, labetalol, esmolol, and fenoldopam are among the preferred choices in the elderly due to their efficacy and tolerability. Nitroprusside, hydralazine, and nifedipine should be avoided, unless there are no other options available, due to the high risk of complications and unpredictable responses.
文摘Data from both basic research and clinical experience continue to suggest that mesalamines and thioputines are effective and efficient for the maintenance of remission of inflammatory bowel diseases. Several decades following the formalization of their indications, attention on these two drugs has been fostered by recent achievements. Demonstration of the ability of mesalamine to activate a colonocyte differentiation factor has shed light on its chemopreventive effects on colorectal cancer; in addition to their anti-proliferative efficacy, thiopurines have been shown to be specific regulators of apoptosis. The two drugs are often coadministered in clinical practice. Recent advancements have shown that mesalamines exert a positive synergism in this context, insofar as they can inhibit sidemethylation of thiopurines and hasten the function of the main immunosuppressive pathways. Considering that up to 40% of patients cannot tolerate thiopurines, such renovated targets have stimulated efforts to improve compliance by research on the toxicity mechanisms. The definition of genetic polymorphisms in the enzymes of thiopurine metabolism, and the uncovering of synergistic drug interactions, such as that with allopurinol, are just two of the results of such efforts. Interaction between basic research and clinical practice has continued to inform indications and refine the prescriptions of mesalamines and thiopurines; these have not been restrained （they have been implemented in some cases） by the advent of the novel biological molecules with anti-cytokine activity.
基金Discipline and Master's Site Construction Project of Guiyang University by Guiyang City Financial Support Guiyang University (Grant No. SY-2020)Guizhou Biopharmaceutical Engineering Research Center (Grant No. QJH KYZ[2019]051)。
文摘The assay of acyclovir in plasma seems to be a challenge because of its high hydrophily.In our present study,a reversed-phase high-performance liquid chromatography(RP-HPLC)method for the determination of acyclovir in rat plasma was described and validated in drug-drug interaction(DDI)between gefitinib and acyclovir in rats.The analytes were separated with gradient elution on C18 column(4.6 mm×250 mm,5μm),and the peaks were recorded using ultraviolet detector at a wavelength of 254 nm.Protein precipitation followed by methyl tertiary butyl ether extraction was used for sample preparation.The calibration curve was established between 0.2 and 40μg/mL(r^(2)=0.9999).The intra-and inter-day precisions were all less than 8%,and all the biases were not more than 10%.This new method was successfully applied to a DDI study between gefitinib and acyclovir in rats.Gefitinib up-regulated the absorption of acyclovir by about three times,and our findings guided the clinical co-administration of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)with acyclovir.
