Recent Trends in Pharmacology

1. Usage of sonochemistry in medicine, industry, environment, and synthesis

   Much progress has been made regarding ultrasound in chemical science and the chemical industry in recent years. Ultrasonic waves can defined as “inaudible sound with high frequency for humans” the frequency of which approximately exceeds 20 kHz. This paper focuses on using ultrasonic technologies in some areas such as polymer degradation, polymerization reactions, removal of toxic organic contaminants in water, organic synthesis, ultra-strong transfer processes including the extraction process, adsorption process, membrane process, demulsification, crystallization process, emulsification, heterogeneous chemical reaction process, and the electrochemical process

2. Unveiling Ecopharmacology: Insights into knowledge, attitude, and practices among medical and nursing students in tertiary care teaching hospital of district Almora, Uttarakhand

   Background: Ecopharmacology, a field emerging at the intersection of pharmacology and environmental science, focuses on the impact of pharmaceuticals on ecosystems and public health. Given the increasing recognition of environmental issues associated with pharmaceutical waste, understanding the knowledge, attitudes, and practices (KAP) of health-care students toward ecopharmacology is crucial. Aims and Objectives: This study aims to assess KAP toward ecopharmacology among HCPs at a tertiary care center. Materials and Methods: This descriptive and cross-sectional study employed a pre-validated self-administered structured online questionnaire conducted between december 2024 and January 2025. The questionnaire consisted 22 questions to assess the knowledge, attitude, and practices of medical and nursing students regarding ecopharmacology. The data were subsequently analyzed and presented as percentages. Results: Out of 468 consenting participants 453 (291 M.B.B.S. students and 162 nursing students) satisfactorily completed the questionnaire. The mean age was found to be 21.31±1.76 years.It was depicted that in response to knowledge both MBBS and nursing students had good knowledge about few aspects of ecopharmacology while knew less about drug-take back system. Regarding attitude they were empathetic towards the issue and worried about safe disposal of the drugs. Majority (89.3% medical and 97.5% nursing students) of participants agreed regarding the need for guidelines for ecologically safe disposal of drugs by people, whereas 77.3 % of medical students throw away the excess medicines in the household trash.Conclusion: The present study highlights a significant level of awareness and concern regarding pharmaceutical waste management among HCPs.

3. Evaluation of information on pregnancy and lactation in patient information leaflets of antirheumatic drugs

   Objective: The use of antirheumatic drugs during pregnancy and lactation should be arranged so as not to harm the fetus and mother. There are various sources of information, such as pregnancy guidelines and patient information leaflet (PIL), which are used to determine the course of treatment during these periods.Methods: In this study, different antirheumatic drug PILs were evaluated in terms of the inconsistency of their information on the use of drugs during pregnancy and lactation with the current The European League Against Rheumatism (EULAR) guidelines. Inconsistent PILs were categorized into 2 different groups according to their information on the use of the drug during pregnancy and lactation: I. lack of information and II. Conflict or contrary of information.Results: It was found that 72.1% of the 179 PILs had inconsistent pregnancy information (lack of information n=22, conflict or contrary of information n=107) and 75.4% had inconsistent lactation information (lack of information n=22, conflict or contrary of information n=113) compared with EULAR. According to the EULAR, 79.3% (n=142) of the drugs in this study were suitable for use in pregnancy and 80.4% (n=144) were suitable for use during lactation.Conclusion: The findings of this study draw attention to the need for national and international regulation to harmonize the information in PILs with the current literature. This study will be useful for patients and healthcare professionals to ensure that PILs are compatible with the current literature.

4. Low-dose hydrogen sulfide ameliorates cisplatin-induced hepatotoxicity in rats

   Objective: Cisplatin (CIS) is non-specific to the cell cycle, has a cytotoxic effect, and is used in many cancers. The side effects of CIS, such as hepatotoxicity, seriously limit its clinical use. This experimental study aims to prevent hepatotoxicity, one of the clinical side effects that cisplatin may cause. At the same time, Hydrogen sulfide (H2S) will be applied prophylactically and therapeutically and its effect levels will be compared. This study aims to contribute to the literature by preventing dose restriction due to the hepatotoxicity side effect of cisplatin, which plays an important role in cancer treatment, by prophylactic application of H2S. Our study investigated the protective and therapeutic efficacy of sodium hydrosulfide (NaHS, a donor of H2S), which activates the antioxidant system on CIS-induced hepatotoxicity. Method: Control (Vehicle), CIS (7.5 mg/kg CIS), H2S+CIS (10 µmol/kg NaHS+7.5 mg/kg CIS), CIS+H2S (7.5 mg/kg CIS+10 µmol/kg NaHS) groups were formed by using 35 rats in the study. At the end of the study, blood and liver tissue was taken, and histopathological and biochemical analyzes were performed. Results: It was determined that sinusoidal dilatation and congestion increased significantly in the CIS group and decreased in the H2S+CIS and CIS+H2S groups. Likewise, glycogen loss occurred in the CIS group, and a significant improvement was observed in the H2S+CIS group. In addition, significant deterioration was detected in malondialdehyde, catalase, glutathione, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase values in the CIS group compared to the control group. In contrast, significant improvements were observed in both the H2S+CIS and CIS+H2S groups compared to the CIS group. Conclusion: Both protective and therapeutic beneficial effects of H2S in CIS-induced hepatotoxicity were demonstrated by histopathological and biochemical analyses.

5. A randomized controlled trial to evaluate genotyping and therapeutic drug monitoring vs. only therapeutic drug monitoring as a strategy for risk minimization in epileptic patients on carbamazepine therapy

   Objective: Carbamazepine (CBZ) is a widely prescribed antiepileptic drug for the treatment of focal seizures. CBZ gets metabolized by cytochrome enzymes mainly CYP3A5. It is difficult to predict clinically whether a patient is likely to suffer from CBZ toxicity. Hence, we planned to evaluate the use of genotyping and therapeutic drug monitoring (TDM) vs. only TDM in epileptic patients on CBZ as a strategy for risk minimization. Methods: This double-blind, randomized controlled trial included 60 epileptic patients taking carbamazepine, divided into two equal groups. One group’s carbamazepine dosing was guided by genotyping, while the other group’s doses were based solely on clinical judgment.Results: A total of 60 patients were enrolled in the study, in two arms, group A (genotyping and TDM both) and Group B (only TDM), each arm comprising 30 patients. Among the CYP3A5 metabolizer group, the frequency of expressors and non-expressors was (57%) and (43%), respectively. During follow-up visits, at one month, three cases of adverse drug reactions (ADRs) were reported. ADR count decreased to two cases during the three-month follow-up and further reduced to only one case of ADR at the 12-month assessment. It was found that there is no statistically significant association between CYP3A5 metabolizer and ADR occurrence.Conclusion: Adding genotyping to TDM did not significantly reduce the risk of carbamazepine toxicity. However, genotyping may still be useful for patients who exhibit symptoms of toxicity.