Background: Increasing dietary supplement (DS) consumption was observed during the COVID-19 pandemic, including during the post-Delta wave period. This study aimed to measure the practice of DS consumption and respondents’ knowledge of DS. Methods: An internet-based survey was distributed from October-December 2021 and obtained 541 valid and completed responses. Descriptive analysis was performed to present the practice of DS consumption, including frequency, duration, aim, preferable dosage form etc. Level of knowledge on DS principles, side effects and regulation were also measured. Inferential analyses were conducted to determine the predictors of the respondents’ DS practice and level of knowledge. Results: Data from 541 valid responses showed that 77.63% of respondents consumed DS in the last 3 months, with only 59.52% reporting also consuming DS before the COVID-19 pandemic. One half of the respondents had good knowledge about DS; however, some knowledge regarding side effects and possible drug-supplement interaction needed improvement. Their DS consumption practice was affected by their economic status and history of contracting COVID-19. Nevertheless, the level of knowledge was not affected by the sociodemographic factors and DS supplement experience. Conclusions: Taken together, the practice of self-consumption of DS in Indonesia is increasing; hence, knowledge of DS is necessary to avoid detrimental effects that might occur in the future. Increasing access to information on better labelling and educating consumers about DS are important actions to consider.
In the era of “Bad Bugs, No Drugs,” optimizing antibiotic therapy against multi-drug resistant (MDR) pathogens is crucial. Mathematical modelling has been employed to further optimize dosing regimens. These models include mechanism-based PK/PD models, systems-based models, quantitative systems pharmacology (QSP) and population PK models. Quantitative systems pharmacology has significant potential in precision antimicrobial chemotherapy in the clinic. Population PK models have been employed in model-informed precision dosing (MIPD). Several antibiotics require close monitoring and dose adjustments in order to ensure optimal outcomes in patients with infectious diseases. Success or failure of antibiotic therapy is dependent on the patient, antibiotic and bacterium. For some drugs, treatment responses vary greatly between individuals due to genotype and disease characteristics. Thus, for these drugs, tailored dosing is required for successful therapy. With antibiotics, inappropriate dosing such as insufficient dosing may put patients at risk of therapeutic failure which could lead to mortality. Conversely, doses that are too high could lead to toxicities. Hence, precision dosing which customizes doses to individual patients is crucial for antibiotics especially those with a narrow therapeutic index. In this review, we discuss the various strategies in optimizing antimicrobial therapy to address the challenges in the management of infectious diseases and delivering personalized therapy.
The general notion of activation of Gq-protein coupled receptors (GPCR) involves the mobilisation of stored and extracellular calcium and leads to smooth muscle tissue contraction. The aim of this study was to investigate the involvement of calcium mediated contractions in vascular and airway smooth muscles. Using standard organ bath procedures, aortic and tracheal rings were obtained from 6 to 8 week-old male Sprague Dawley rats. To activate the Gq protein receptors, phenylephrine (PE), an α1-adrenoceptor agonist, and carbachol, a M3 cholinoceptor agonist was added to baths containing the aortic and tracheal rings, respectively. The maximum response (Emax) to PE was reduced from 158.8 ± 11.8% (n=6) to 62.5 ± 12.4 % (n=8) upon removal of extracellular calcium in Krebs-Ringer solution. Maximal response to PE was also suppressed in the presence of nifedipine, a L-type Ca 2+ channel inhibitor, (70.3 ± 11 %, n=8) and SKF96365, a canonical transient receptor potential cation channel inhibitor, (26.7 ± 13.2 %, n=5) when the influx of extracellular calcium was blocked. Removal of stored calcium also attenuated the PE contraction (p<0.05). Contractile responses to carbachol in the airway were totally abolished in the absence of calcium in the Krebs-Ringer solution (208.6 ± 23 % [n=8] vs 10.7 ± 4.2 % [n=3]). This was different from the aorta where a measurable response was detected despite the absence of external calcium. Blockage of extracellular calcium influx in the presence of nifedipine and SKF96365 also showed similar lack of responses in the trachea. Interestingly, removal of stored calcium did not affect the carbachol responses (p>0.05). From these observations, we conclude that the role of stored and extracellular calcium in Gq protein activation is not the same across different types of smooth muscle tissues.
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