Neuraminidase inhibitors as a strategy for influenza treatment: pros,cons and future perspectives

ABSTRACT

Introduction: Influenza represents a major public health threat worldwide. Implementation of good personal health and hygiene habits, together with vaccination, is the most effective tools to reduce influenza burden both in community and in healthcare setting. However, achieving adequate vaccination rates is challenging, and vaccination does not always guarantee complete protection. Neuraminidase inhibitors represent an important measure to reduce the risk of influenza-related complications among high-risk patients developing influenza infection.

Areas covered: Neuraminidase inhibitors have been proven to be safe and effective in reducing influenza severity, duration of symptoms, hospitalizations, and influenza-related-mortality. Here the authors review the available data on neuraminidase inhibitors, including the mechanism of action, pharmacokinetics, efficacy, safety and current indications for their use in clinical practice.

Expert opinion: Although vaccination is the most effective tool to reduce influenza-associated morbidity and mortality, neuraminidase inhibitors represent an important option for the treatment of patients with influenza infection, particularly in high-risk categories. Moreover, antivirals play an important role in influenza prevention and prophylaxis in selected settings.     

Pregabalin in clinical psychiatry and addiction: pros and cons

Pregabalin acts as a presynaptic modulator of excitatory neurotransmitter release, binding to the α2-δ subunit protein of voltage-gated calcium channels. Pregabalin use is becoming widespread in the psychiatric scenario. Data are encouraging, with some good evidence for efficacy in anxious spectrum, benzodiazepine abuse/dependence, and alcoholism. The abuse potential, however, is an issue that should be taken into account, mostly in subjects at risk for developing substance/alcohol misuse.     

克林霉素磷酸酯的分析与首批暂行对照品的建立

对国产克林霉素磷酸酯与ＵＳＰ对照品进行了紫外光谱、红外光谱及高效液相色谱等的对比分析，认为两者化学结构相同，所含结晶水及纯度有所不同。国产品精制后各项指标与ＵＳＰ对照品均一致。并在此基础上，以ＵＳＰ对照品为基准，采用ＨＰＬＣ法标定了首批克林霉素磷酸酯国内暂行对照品的含量。     

Nano anti-cancer drugs: pros and cons and future perspectives

For last one decade, scientists are working for developing nano anti-cancer drugs with claim of ideal ones due to their targeted chemotherapic nature. These drugs have many beneficial properties such as targeted drug delivery and gene therapy modalities with minimum side effects. This article describes pros and cons and future perspectives of nano anti-cancer drugs. Efforts have been made to address importance, special features, toxicities (general, blood identities, immune system and environmental) and future perspectives of nano anti-cancer drugs. It was concluded that nano anti-cancer drugs may be magic bullet drugs for cancer treatment leading to bright future of the whole world.     

激素替代疗法的利与弊

激素替代疗法（hormone replacement therapy,HRT）是对围绝经期和绝经后妇女通过补充性激素,调整绝经过渡期紊乱的月经周期,缓解或根除绝经前后出现的症状（如心悸、发热、面颊潮红、生殖道萎缩干燥等症状）,提高生活质量的一种治疗方法。HRT治疗从开始使用至今,其利弊之争就没有停止过,     

Cannabinoids and cancer: pros and cons of an antitumour strategy

In the last two decades, research has dramatically increased the knowledge of cannabinoids biology and pharmacology. In mammals, compounds with properties similar to active components of Cannabis sativa, the so called 'endocannabinoids', have been shown to modulate key cell-signalling pathways involved in cancer cell growth, invasion and metastasis. To date, cannabinoids have been licensed for clinical use as palliative treatment of chemotherapy, but increased evidences showed direct antiproliferative actions of cannabinoid agonists on several tumour cells in vitro and in animal models. In this article, we will review the principal molecular pathways modulated by cannabinoids on cancer and summarize pros and cons evidence on the possible future use of endocannabinoid-based drugs in cancer therapy.     

Potential use of NOACs in developing countries: pros and cons

Purpose

Although vitamin K antagonists (VKAs) are effective for long-term thromboprophylaxis in atrial fibrillation (AF), their limitations have led to widespread underutilisation, especially in the developing world. Novel oral anticoagulants (NOACs) have emerged as promising alternatives to VKAs, although there are some particular considerations and challenges to their introduction in developing countries. This review summarises the current state of antithrombotic management of AF in the developing world, explores the early evidence for the NOACs and describes some of the special considerations that must be taken into account when considering the role of the NOACs within developing countries’ health care systems.

Methods

A literature search was conducted via PubMed and Google Scholar to find articles published in English between the years 2000 to 2014. Search terms used were “atrial fibrillation”, “oral anticoagulants”, “warfarin”, “NOACs”, “dabigatran”, “rivaroxaban”, “apixaban”, “edoxaban”, “time in therapeutic range”, “International Normalized Ratio” “cost-effectiveness”, “stroke”, “adverse-drug reactions” and “drug–drug interactions”, together with the individual names of developing countries as listed by the World Bank. We reviewed the results of randomized clinical trials, relevant retrospective and prospective studies, case-studies and review articles.

Results

Many developing countries lack or have sporadic data on the quality of AF management, making it difficult to anticipate the potential impact of NOACs in these settings. The utilisation of anticoagulants for AF appears highly variable in developing countries. Given the issues associated with VKA therapy in many developing countries, NOACs offer some potential advantages; however, there is insufficient evidence to advocate the widespread replacement of warfarin at present. VKAs may continue to have a role in selected patients or countries, especially if alternative monitoring strategies can be utilised.

Conclusion

The evaluation of the introduction of NOACs should consider safety, budget concerns and the quality of oral anticoagulation care achieved by each country. Prospective registries will be important in developing countries to better elucidate the comparative safety, efficacy and cost-effectiveness of NOACs and VKAs as NOACs are introduced into practice.     

Controlled and continuous release ocular drug delivery systems: pros and cons

Topical ocular drug administration is the most preferred route for treating conditions affecting the surface of the eye as well as anterior segment diseases; this is mainly due to the rapid and localised drug action and patient acceptability. However, the ocular bioavailability is typically less than 5% from conventional ophthalmic dosage forms such as eye drops. This is mainly due to the unique anatomical and physiological features of the eye. One of the effective pharmaceutical approaches is to provide a controlled and continuous drug release to the surface of the eye to compensate drug loss by nasolacrimal drainage and non-productive absorption of the topically applied drug. This review provides a critical appraisal (advantages and drawbacks) of the different drug delivery strategies that provides controlled and continuous drug supply to the surface of the eye; it covers research conducted over the past three decades.     

全身麻醉药物对发育期大脑影响的争鸣

麻醉药物作用于N-甲基-D-天冬氨酸(NMDA)受体和(或)γ氨基丁酸(GABA)引起发育期动物大脑神经退行性变和成年后认知功能障碍,且神经元凋亡或功能受损具有年龄、接触时间和剂量的依赖性。然而麻醉药物诱导神经细胞凋亡的假说仍存在争议。麻醉药物引起的凋亡是病理性凋亡还是生理性凋亡及其与与神经认知功能障碍间的因果关系尚不清楚。动物实验中不同种属动物麻醉/镇痛所需要的药物剂量、发育易感期各不相同,因此动物实验结果不能直接应用于临床。临床上全麻药物对婴幼儿神经毒性的临床研究证据尚不充分,仍需进一步获取多中心、大样本人类研究数据,以证实麻醉药物与发育期大脑退行性变的因果关系,阐述其机制,指导临床医师的工作。本文综述了全身麻醉药物对发育期大脑影响的研究进展。     

Historical review of sample preparation for chromatographic bioanalysis: pros and cons

Sample preparation is a major task in a regulated bioanalytical laboratory. The sample preparation procedure significantly impacts assay throughput, data quality, analysis cost, and employee satisfaction. Therefore, selecting and optimizing an appropriate sample preparation method is essential for successful method development. Because of our recent expertise, this article is focused on sample preparation for high‐performance liquid chromatography with mass spectrometric detection. Liquid chromatography with mass spectrometric detection (LC‐MS) is the most common detection technique for small molecules used in regulated bioanalytical laboratories. The sample preparation technologies discussed are pre‐extraction and post‐extraction sample processing, protein precipitation (PPT), liquid–liquid extraction (LLE), offline solid‐phase extraction (SPE), and online solid‐phase extraction. Since all these techniques were in use for more than two decades, numerous applications and variations exist for each technique. We will not attempt to categorize each variation. Rather, the development history, a brief theoretical background, and selected references are presented. The strengths and the limitations of each method are discussed, including the throughput improvement potential. If available, illustrations from presentations at various meetings by our laboratory are used to clarify our opinion. Drug Dev Res 68:107–133, 2007. ©2007 Wiley‐Liss, Inc.     

The pros and cons of a single 'Euro-price' for drugs

Parallel trade in pharmaceuticals has become a major European Union policy issue with several 'solutions' being considered by the European Commission, Member State governments and the pharmaceutical industry in the 'Bangemann Process'. This paper discusses the issues from an economic and public policy perspective--considering the economic cases for differential pricing and for 'Euro-prices', concluding that the economic case for parallel trade--to achieve convergence of prices--is not applicable to pharmaceuticals. It argues that health economic evaluation is not an appropriate tool to set 'Euro-prices' because of differences in clinical practice and in resource use and cost across countries. Pricing rules should reflect local willingness to pay for innovation. It concludes, however, that in the absence of policy changes there is a strong likelihood of companies refusing to supply new innovative products at low prices to traditionally 'low price' countries in order to avoid parallel trade undermining prices obtained elsewhere in Europe, with significant implications for the welfare of patients in those countries.     

The pros and cons of polyelectrolyte capsules in drug delivery

Polyelectrolyte multilayer microcapsules and nanocapsules are under review as multifunctional delivery systems. Tailoring functions in the entity of a single capsule is done by incorporation of functional polyelectrolytes or nanoparticles in between the layers during electrostatic self-assembly. The resulting capsules possess different properties such as controlled and triggered release, responsiveness to temperature, pH and light and could be navigated with a magnetic field. A variety of substances can be encapsulated and delivered to cells and tissues. Potential applications as well as in vivo experiments have recently been explored. Capsules made of biodegradable polymers showed low toxicity in vivo. Perspectives on and obstacles to a way of broader application are discussed.     

Weighing up the pros and cons: help-seeking by drug misusers in Baltimore, USA.

Forty drug misusers receiving treatment in Baltimore completed questionnaires, originally administered to drug misusers in London, about their reasons for seeking help and their worries about the treatment. Seeking help was related to the experiences of addiction, loss of control over life and financial and family difficulties. The main fears were of failing treatment. These responses are similar to those obtained in the London group. There was little correlation between objective assessment and subjects' views of their problems. This study illustrates the complexities of coming for treatment and it emphasises the need for social and medical help.