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Background Prescription of medications for elderly individuals is complex, potentially involving polypharmacy, drug interactions, and inappropriate medication. Notable among the medications are benzodiazepines, whose long-term use is common and growing among the elderly population. Objective This study aimed to evaluate the occurrence of potential drug interactions (PDI) in elderly community-dwelling patients who use benzodiazepines. Method Cross-sectional study, conducted via household survey, with 73 elderly persons in Juiz de Fora, MG, Brazil. The search and classification of PDIs was carried out using the Micromedex® system. Results The prevalence of benzodiazepine use in this population was 18.3% (95% CI, 15.2-21.6). The use of benzodiazepines was associated with polypharmacy (p

Human immunodeficiency virus (HIV) affects over 36 million people worldwide. Antiretroviral therapy (ART) is expanding and improving HIV viral suppression, resulting in increasing exposure to drugs and drug interactions. Polypharmacy is a common complication as people are living longer on ART, increasing the risk of drug toxicities. Polypharmacy is related not only to ART exposure and medication for opportunistic infections, but also to treatment of chronic lifestyle diseases. Acute kidney injury (AKI) is frequent in HIV and is commonly the result of sepsis, dehydration and drug toxicities. Furthermore, HIV itself increases the risk of chronic kidney disease (CKD). Drug treatment is often complicated in people living with HIV because of a greater incidence of AKI and/or CKD compared to the HIV-negative population. Impaired renal function affects drug interactions, drug toxicities and importantly drug dosing, requiring dose adjustment. This review discusses ART and its nephrotoxic effects, including drug-drug interactions. It aims to guide the clinician on dose adjustment in the setting of renal impairment and dialysis, for the commonly used drugs in patients with HIV.

The first line treatment for uncomplicated falciparum malaria is artemisinin-based combination therapy (ACT), which consists of an artemisinin derivative coadministered with a longer-acting partner drug. However, the spread of Plasmodium falciparum resistant to both artemisinin and its partner drugs poses a major global threat to malaria control activities., The first line treatment for uncomplicated falciparum malaria is artemisinin-based combination therapy (ACT), which consists of an artemisinin derivative coadministered with a longer-acting partner drug. However, the spread of Plasmodium falciparum resistant to both artemisinin and its partner drugs poses a major global threat to malaria control activities. Novel strategies are needed to retard and reverse the spread of these resistant parasites. One such strategy is triple artemisinin-based combination therapy (TACT). We developed a mechanistic within-host mathematical model to investigate the efficacy of a TACT (dihydroartemisinin-piperaquine-mefloquine [DHA-PPQ-MQ]) for use in South-East Asia, where DHA and PPQ resistance are now increasingly prevalent. Comprehensive model simulations were used to explore the degree to which the underlying resistance influences the parasitological outcomes. The effect of MQ dosing on the efficacy of TACT was quantified at various degrees of DHA and PPQ resistance. To incorporate interactions between drugs, a novel model is presented for the combined effect of DHA-PPQ-MQ, which illustrates how the interactions can influence treatment efficacy. When combined with a standard regimen of DHA and PPQ, the administration of three 6.7-mg/kg doses of MQ was sufficient to achieve parasitological efficacy greater than that currently recommended by World Health Organization (WHO) guidelines. As a result, three 8.3-mg/kg doses of MQ, the current WHO-recommended dosing regimen for MQ, combined with DHA-PPQ, has the potential to produce high cure rates in regions where resistance to DHA-PPQ has emerged.

Современная терапия, направленная на эрадикацию H.pylori, включает комплекс антисекреторных и антибактериальных препаратов, иногда препаратов висмута. Особенностью современных эрадикационных схем является четырнадцатидневное применение антибактериальных средств, назначаемых в высоких суточных дозах и избираемых преимущественно с учётом резистентности микроорганизма к кларитромицину и метронидазолу в соответствующем регионе. Однако каждый компонент эрадикационной схемы может иметь достаточно серьёзные неблагоприятные побочные реакции, а также влиять на биодоступность, биотрансформацию, выведение и потенцирование эффектов лекарственных препаратов, которые больной может принимать одновременно с антихеликобактерной терапией. В статье перечислены наиболее серьёзные и распространённые варианты лекарственных взаимодействий компонентов эрадикационных схем, дано описание механизма их развития, если таковой выяснен. До появления практических рекомендаций относительно профилактики лекарственных взаимодействий препаратов, включаемых в эрадикационные схемы, следует использовать общедоступные базы данных, содержащие сведения о таких взаимодействиях., Modern therapy, aimed at eradication of H.pylori, includes a set of antisecretory and antibacterial drugs and sometimes bismuth preparations. A feature of modern eradication schemes is the 14-day use of antibiotics, prescribed in high daily doses and selected mainly based on microorganism resistance to clarithromycin and metronidazole in the respective region. However, each component of eradication scheme can have rather serious sode effects, as well as affect the bioavailability, biotransformation, excretion, and the potentiation of the effects of the drugs that the patient can take simultaneously with anti H.pylori therapy. The article lists the most serious and common variants of drug-drug interactions of the eradication schemes' components, it gives a description of the mechanism of their development, when applicable. Before the approval official of practical recommendations for the prevention of drug-drug interactions of drugs included in the eradication schemes, commonly available databases containing information about such interactions should be used.

Trabajo fin de grado en Enfermería, INTRODUCCIÓN: El Síndrome Neuroléptico Maligno (SNM) es la complicación más grave asociada al uso de agentes que alteran la neurotransmisión del sistema dopaminérgicos, como antipsicóticos y/o antagonistas de la dopamina. (1) (13) Aparece en un 0,5-3% de los pacientes tratados con neurolépticos, generalmente en la edad adulta, en la población geriátrica y con mayor porcentaje en hombres que en mujeres (2-1) (3) y llega a ser potencialmente mortal en un 11,6% de los casos. (4)(9) OBJETIVO: Conocer el porcentaje de pacientes que sufren SNM asociado al tratamiento con antipsicóticos neurolépticos y/o atípicos. MÉTODO: Se lleva a cabo la revisión de casos clínicos para la realización de un estudio de cohortes retrospectivo con un tamaño de muestra de 100 pacientes en tratamiento con antipsicóticos, procedentes del CSM Colmenar Viejo. Los criterios de inclusión fueron: (i) estar diagnosticado de esquizofrenia; (ii) seguir un tratamiento con neurolépticos y (iii) acudir de forma regular al CSM de Colmenar Viejo para seguimiento. Los pacientes que cumplieron los criterios de inclusión fueron, una cohorte de 25 pacientes sobre los que se hará la revisión de las historias clínicas. Se analizaron las siguientes variables: (i) patología, (ii) sexo, (iii) edad, (iv) tratamiento 3 psiquiátrico, (v) adherencia terapéutica, (vi) eficacia, (vii) años en tratamiento, (viii) ingresos hospitalarios y (ix) evolución sanitaria durante un periodo de un año. RESULTADOS: Los resultados obtenidos del estudio para las diferentes variables son; para la (ii) edad, encontramos que el rango de más frecuencia de edad es entre los 40-50 años. En cuanto al (iii) sexo, el 60% de los pacientes de nuestro estudio son hombres. El (iv) tratamiento psiquiátrico más utilizado por los pacientes incluidos es el aripiprazol o la paliperidona IM, lo cual se relaciona directamente con la (v)adherencia terapéutica, la cual es total en un 64% de los casos, lo cual garantiza en un 32% la (vi) eficacia total. Un 28% de los pacientes incluidos en el estudio llevaban entre 1-5 (vii) años en tratamiento y un 24% entre 5-10 años, (viii) el número de ingresos hospitalarios mayoritarios fue un ingreso, y tres ingresos con un 24% sobre el total. Finalmente, el resultado del estudio es que de una muestra de 25 pacientes diagnosticados de esquizofrenia y con tratamiento con fármacos antipsicóticos únicamente un 4% sufrió SNM diagnosticado. CONCLUSIONES: Tras finalizar el estudio hemos observado que la edad de mayor frecuencia en la que se da el SNM es entre los 25-50 años y que se da con una mayor probabilidad en hombres que en mujeres, al recibir mayor cantidad de fármacos. Los tratamientos más habituales son el aripiprazol y la paliperidona y la vía más frecuente de administración es la IM. La vía IM garantiza una mayor adherencia y eficacia. De 25 pacientes estudiados, uno sufrió SNM diagnosticado, por lo que concluimos que la prevalencia de dicho síndrome es baja., INTRODUCTION: The Syndrome Malignant Neuroleptic (SNM) is the most serious complication associated with the agents' use that they alter the neurotransmisión of the system dopaminérgicos, since antipsychotic and / or antagonists of the dopamine. (1 (13)) Appears in 0,5-3 % of the patients treated with neuroleptics, generally in the adult age, in the geriatric population and with major percentage in men that in women (2-1 (3)) and it manages to be potentially mortal in 11,6 % of the cases. (4 (9)) I TARGET: To know the percentage of patients who suffer SNM associated with the treatment with antipsychotic neuroleptics and / or atypical. METHOD: there carries out the review of clinical cases for the accomplishment of a retrospective study of cohorts with a size of sample of 100 patients in treatment with antipsychotic, proceeding from the CSM Old Apiary. The 4 criteria of incorporation were: (i) to be diagnosed of schizophrenia; the (ii)nd to follow a treatment with neuroleptics and the (iii)rd to come of regular form to the CSM of Old Apiary for follow-up. The patients who fulfilled the criteria of incorporation were, a cohort of 25 patients on whom there will be done the review of the clinical histories. The following variables were analyzed: (i) pathology, the (ii)nd sex, the (iii)rd age, the (iv)th psychiatric treatment, (v) therapeutic adherence, the (vi)th efficiency, the (vii)th years in treatment, the (viii)th hospitable income and the (ix)th sanitary evolution during a period of one year. RESULTS: The results obtained of the study, for the different variables are; for the age (ii), we think that the range of more frequency of age is between 40-50 years. As for the sex (iii), 60 % of the patients of our study is men. The treatment (iv) psychiatric most used by the included patients is the aripiprazol or the palipelidona IM, which relates directly with (v) therapeutic adherence, which is total in 64 % of the cases, which guarantees in 32 % the efficiency (vi) total. 28 % of the patients included in the study was going between 1-5 (vii) years in treatment and 24 % between 5-10 years, the (viii)th the number of hospitable majority income was a revenue, and three income with 24 % on the total. Finally, the result of the study is that of a sample of 25 patients diagnosed of schizophrenia and with treatment with antipsychotic medicaments only 4 % suffered diagnosed SNM. CONCLUSIONS: After finishing the study we have observed that the age of major frequency in the one that gives herself the SNM is between 25-50 years and that one meets on a major probability in men that in women, on having received major quantity of medicaments. The most habitual treatments are the aripiprazol and the paliperidona and the most frequent route of administration is the IM. The route IM guarantees a major adherence and efficiency to the treatment. Of 25 studied patients, one suffered SNM diagnósticado, for what we conclude that the prevalencia of the above mentioned syndrome is low.

In this paper, co-grinding mixtures of omeprazole-amoxicillin trihydrate (CGM samples) and omeprazole-anhydrous amoxicillin (CGMa samples) at 3:7, 1:1 and 7:3 molar ratios, respectively, were studied with the aim of obtaining a co-amorphous system and determining the potential intermolecular interactions. These systems were fully characterized by differential scanning calorimetry (DSC), FT-infrared spectroscopy (FTIR), X-ray powder diffraction (PXRD), scanning electron microscopy (SEM) and solid state Nuclear Magnetic Resonance (ssNMR). The co-grinding process was not useful to get a co-amorphous system but it led to obtaining the 1:1 CGMa disordered phase. Moreover, in this system both FTIR and ssNMR analysis strongly suggest intermolecular interactions between the sulfoxide group of omeprazole and the primary amine of amoxicillin anhydrous. The solubility measurements were performed in simulated gastric fluid (SGF) to prove the effect of the co-grinding process. Complementarily, we carried out density functional theory calculations (DFT) followed by quantum theory of atoms in molecules (QTAIM) and natural bond orbital (NBO) analyses in order to shed some light on the principles that guide the possible formation of heterodimers at the molecular level, which are supported by spectroscopic experimental findings. Fil: Russo, Marcos Guillermo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Investigaciones en Tecnología Química. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Investigaciones en Tecnología Química; Argentina Fil: Sancho, Matias Israel. Universidad Nacional de San Luis; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Silva, Lorena M. A.. Universidade Federal do São Carlos; Brasil Fil: Baldoni, Hector Armando. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Matemática Aplicada de San Luis "Prof. Ezio Marchi". Universidad Nacional de San Luis. Facultad de Ciencias Físico, Matemáticas y Naturales. Instituto de Matemática Aplicada de San Luis "Prof. Ezio Marchi"; Argentina Fil: Venancio, Tiago. Universidade Federal do São Carlos; Brasil Fil: Ellena, Javier. Universidade de Sao Paulo; Brasil Fil: Narda, Griselda Edith. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Investigaciones en Tecnología Química. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Investigaciones en Tecnología Química; Argentina