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Irrational drug use is one of the main health problems all over the world, especially in developing countries. Limited studies about irrational drug use examples showed that main defects. These are polypharmacy, use of drug drug incompatible with diagnosis, inappropriate use of antibiotics, unnecessary use of expensive drug and people's self-treatment with over the counter and prescribing drugs. There are many reasons for irrational drug use. The main reasons are lack of education, sociocultural, economic and resulting from regulatory mechanism factors. These reasons affect each other, so problems become more complicated. Reasons resulting from pharmacist and doctors occurs basic of irrational drug use. So attitude of doctors and pharmacist toward rational drug use should be evaluated for resolve defects, formal and non-formal education should be continually used and improved. Rational drug use policies should be developed involving drug companies, doctors, pharmacists and patients. Key words: Rational drug use, irrational drug use, education. ÖZETAkılcı olmayan ilaç kullanımı bütün dünyada, özellikle de gelişmekte olan ülkelerde en temel sağlık sorunudur. Sınırlı sayıda yapılan akılcı olmayan ilaç kullanımı örneklerini araştıran çalışmalarda belirlenen temel sorunlar arasında; gereğinden fazla ilaç reçetelenmesi (polifarmasi), tanıyla ilişkisi olmayan ilaç kullanımı, uygunsuz antibiyotik kullanımı, gereksiz pahalı ilaç kullanımı ve halkın reçetesiz satılan ya da reçeteli olduğu halde reçetesiz satılan ilaçlarla kendi kendini uygunsuz tedavi gibi durumlar gözlemlenmiştir. Akılcı olmayan ilaç kullanımının eğitim eksikliğinden başlayarak

Drug safety in paediatric patients is a serious public health concern around the world. The paediatric patients are more prone to adverse drug reactions (ADRs) than adults. Moreover, there is a scarcity of information about ADRs in paediatric patients. This study was conducted to determine the frequency, causality, severity, preventability of paediatric patients’ ADRs reported in a tertiary care hospital in Adana, Turkey. A retrospective study was conducted on all spontaneously reported ADRs between January 01, 2020, to July 30, 2021, in paediatric patients. The ADRs reports were evaluated in terms of gender, age, ADR characteristics, suspected drugs and reporting source. All included ADRs reports were characterized according to the Naranjo Algorithm/World Health Organization (WHO) causality scales, Hartwig/Siegel and Common Terminology Criteria for Adverse Events (CTCAE) severity scales, the modified Schoumock and Thornton preventability scale and hospital pharmacovigilance center criteria for seriousness. Therapeutic groups were also coded using the WHO-Anatomical Therapeutic and Chemical (ATC) classification. During the study period, 8,912 paediatric patients who were admitted had 16 ADRs with 1.7 ADRs/1,000 admissions. The majority of ADRs were found in infants (31.2%) and children (56.2%) as compared to adolescents (12.5%). ADRs were observed more in females (81.2%) than males. Skin (62.5%) was the most affected organ due to the ADRs, and maculopapular rash and erythema multiforme were the most commonly reported symptoms. Most ADRs were probable/likely (93.7%), severe (50%), preventable or probably preventable (43.7%) and serious (37.5%). Antibiotics (93.7%) were found to be the most common cause of ADRs in paediatric patients. The majority of ADRs were associated with vancomycin (68.7%). Most of the ADRs were reported by a medical doctor in this study. This small sample size study highlights significant problems of ADRs in paediatric patients, mainly caused by antibiotics and with a majority of ADRs manifest as skin reactions. Furthermore, a high proportion of the identified ADRs were found to be preventable. More focused efforts are needed at the national level to avoid preventable ADRs in hospitals. Monitoring and management of ADRs and future studies would be beneficial for better patient care and safety.

We investigated whether bacterial lipopolysaccharide treatment causes any neuronal and vascular hyporeactivity in mouse cavernous tissue and also whether melatonin has any restorative effect on this possible neuronal and vascular hyporesponsiveness. Lipopolysaccharide treatment attenuated contractions in response to phenylephrine. Treatment with the inducible nitric oxide synthase inhibitor aminoguanidine or melatonin restored the hypocontractility of the cavernous smooth muscle to phenylephrine. Relaxant responses of corpus cavernosum precontracted by phenylephrine to acetylcholine or electrical field stimulation were significantly impaired in mice treated with bacterial lipopolysaccharide. Treatment with aminoguanidine or melatonin could prevent the impairment of the neuronal and endothelial relaxations. There was no significant difference between control and lipopolysaccharide-treated groups in the contractile response to high-dose KCl and in the relaxant response to papaverine. In conclusion, bacterial lipopolysaccharide treatment caused a neuronal and endothelial dysfunction in the mouse corpus cavernosum. A possible increased oxidative activity in the cavernous tissue may be a major reason for the impairment of relaxant responses and hypocontracility of tissue. The restorative effects of melatonin on this hyporeactivity may depend on its antioxidant properties and partly on its inhibitory action on the inducible nitric oxide synthase production.

These results suggest that relaxation to nitrergic stimulation is thiol-dependent, and nitrosothiols, possibly S-nitrosoglutathione may play a role, as an intermediate compound in nitrergic neurotransmission in mouse duodenum.

Dipyrone ameliorates behavioural changes induced by unpredictable chronic mild stress: gender differences Abstract Purpose: Antidepressant effects of analgesics have been investigate in both clinical and experimental studies. The purpose of this study was to investigate if the analgesic-antipyretic drug, dipyrone, also had antidepressant-like effects.Methods: Depression-like effects were investigated in an unpredictable chronic mild stress (UCMS) model in both male and female mice. Cage changes, light-dark cycle reversal, cage tilting, wet floor, empty cage, foreign material on the floor and predator sounds were used to induce light stress at different times for six weeks. Dipyrone was administered intraperitoneally beginning from the third week. Splash, rota-rod (RR) and forced swimming (FST) tests were performed at the seventh week as behavioural tests to evaluate the antidepressant-like effects of dipyrone. Coat state score (CSS) and weights of animals were recorded at seventh weeks. Results were analyzed using one or two-way ANOVA followed by the Bonferonni post hoc test.Results: Weight of UCMS-exposed mice did not change compared with controls; however, significant changes were observed in CSS in both sexes of stressed mice (p<0.05). RR latency decreased and immobility time enhanced in FST test in both sexes of stressed mice (p<0.05). Grooming behaviour was not different between the groups in female mice, but different in male mice in the splash test. Dipyrone did not produce a significant change in CSS in the UCMS-exposed group but reversed the latency time and immobility time to normal values in both sexes of mice and augmented the number of grooming behaviour only in stressed male mice. Conclusion:These results indicate that dipyrone produce antidepressant-like effects to some symptoms of UCMS according to gender.SUPPLEMENT

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Aim: The aim of this study was to investigate whether superoxide dismutase (SOD) enzymes and ascorbate play a role in the protection of the nitrergic relaxation against superoxide anion inhibition in the mouse duodenum. Methods: The effects of exogenous SOD, N,N'-bis(salicylidene) ethylenediamine chloride (EUK-8; a synthetic cell-permeable mimetic of the manganese SOD [Mn SOD] and ascorbate on relaxant responses induced by nitrergic nerve stimulation), exogenous nitric oxide (NO), and nitroglycerin were investigated in isolated mouse duodenum tissues. Results: Diethyldithiocarbamate (DETCA) inhibited the relaxation to exogenous NO and nitroglycerin, but not relaxation to electrical field stimulation (EFS). SOD and ascorbate partially prevented the inhibitory effect of DETCA on relaxation to NO, abut not to nitroglycerin. The DETCAinduced inhibition on nitroglycerin was prevented by EUK-8. Hemoglobin, 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazolinel-oxyl-3-oxide, and hydroxocobalamin inhibited the relaxation to NO, but not to EFS and nitroglycerin in the presence of DETCA. Pyrogallol and hydroquinone inhibited the relaxation to NO, but not to EFS and nitroglycerin. This inhibition was prevented by exogenous SOD and ascorbate, but was not prevented by EUK-8. Pyrogallol and hydroquinone did not inhibit the EFS-induced relaxation in the presence of DETCA. Duroquinone and 6-anilino-5.8-quinolinedione inhibited the relaxation to EFS, NO, and nitroglycerin, and this inhibition was prevented by EUK-8. Conclusion: These results suggest that the nitrergic neurotransmission in the mouse duodenum is protected by endogenous tissue antioxidants against superoxide anions, and Mn SOD, in addition to copper/zinc SOD, can protect NO from attack from superoxide anion generators intracellularly. Also, the possibility that the endogenous neurotransmitter may not be the free NO but a NO-containing or NOgenerating molecule in the mouse duodenum remains open.