Background Human biodistribution, bioprocessing and possible toxicity of nanoscale silver receives increasing health assessment. Methods We prospectively studied commercial 10- and 32-ppm nanoscale silver particle solutions in a single-blind, controlled, cross-over, intent-to-treat, design. Healthy subjects (n=60) underwent metabolic, blood counts, urinalysis, sputum induction, and chest and abdomen magnetic resonance imaging. Silver serum and urine content was determined. Results No clinically important changes in metabolic, hematologic, or urinalysis measures were identified. No morphological changes were detected in the lungs, heart or abdominal organs. No significant changes were noted in pulmonary reactive oxygen species or pro-inflammatory cytokine generation. Conclusion In vivo oral exposure to these commercial nanoscale silver particle solutions does not prompt clinically important changes in human metabolic, hematologic, urine, physical findings or imaging morphology. Further study of increasing time exposure and dosing of silver nanoparticulate silver, and observation of additional organ systems is warranted to assert human toxicity thresholds.

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Consumer respondents were generally resistant to the notion of pharmacist prescribing, with most viewing pharmacists as dispensers and not prescribers. Community pharmacists were more open to the idea, while reimbursement decision-makers were the most receptive to the notion of pharmacist prescribing.

This United States national study provides empirical support for a model of providing primary care services through community pharmacy settings that would increase access, with the potential to improve the public health.

An 8-week, multicenter, double-blind, randomized, parallel-group, forced-titration A ngiotensin II receptor blockers (ARBs) inhibit the renin-angiotensin system by selectively blocking the AT 1 subtype of angiotensin II receptor. Various studies have demonstrated their effectiveness in lowering blood pressure with an excellent tolerability and safety profile. 1 Further large-scale studies are being conducted to determine whether the use of this class of drugs will result in end-organ protection, as well as beneficial effects on morbidity and mortality. 2 Different ARBs vary in their binding characteristics to the AT 1 subtype of angiotensin II receptor. Preclinical studies have demonstrated that candesartan is a highly selective, insurmountable ARB. 3 It has an in vitro affinity for the AT 1 receptor 80 times greater than that of losartan and 10 times greater than that of EXP-3174, the active metabolite of losartan. 4 However, it remains uncertain whether these differences in pharmacologic properties result in greater blood pressure (BP) lowering efficacy for candesartan, compared to that of other ARBs.

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ABSTRACT:Nanosilver particles are present in consumer and health care products. Their effects on human microsomal cytochrome P450 (P450) activities and induction in luciferase reporter-engineered Caco-2 (MDR1.C) and HepG2 (DPX2 and 1A2DRE) cells have been investigated. The LD 50 values were ϳ4 g silver/ml for HepG2 and 5 g/ml for Caco-2 cells. At silver concentrations that showed no decreased cell viability (<1 g silver/ml), the pregnane X receptor (PXR)-driven 4.5-fold induction response of MDR1.C cells to 50 M omeprazole was unaffected. In DPX2 cells, the PXR-driven 5.5-and 6.5-fold induction responses to omeprazole and 10 M rifampicin were attenuated to 4-and 3.5-fold, respectively. Nanosilver particles alone showed no induction. In 1A2DRE cells, the aryl hydrocarbon receptor-driven 5.5-fold induction response to omeprazole was attenuated to 4-fold. In 1A2DRE cells, nanosilver alone elicited slight induction at 1 g/ml. The inhibition of human P450-selective activities by nanosilver particles in vitro was proportional to the silver/microsomal protein ratio. At a fixed (0.5 mg/ml) protein concentration, P450-selective activities differed in sensitivity (IC 50 value).

This study confirms the considerable scope of the asthma therapy non-adherence problem. Therefore, it is imperative to conduct survey-based research linked directly to pharmacy-based dispensing data to derive patient behavioural, attitudinal and environmental factors that may contribute to the issue, and then pilot and evaluate interventions for change.