The potential for drug-drug interactions (pDDIs) is higher with cardiac medications, and reports of pDDIs in cardiovascular patients are more common. Multimorbidity, a greater number of drugs prescribed, longer hospital stays, complexity of disease, physiological changes with advancing age or conditions like renal failure, shock, hepatic disease like cirrhosis or acute viral hepatitis, stages of disease, and the influence of heart disease on drug metabolism make patients with CVD especially susceptible to DDIs. Our research found that pDDIs occurred at a much higher rate than expected in the Cardiology Division. Incidence of pDDIs was observed to rise with age, polypharmacy, and duration of hospital stay; pDDIs were also more common in males than females. Most of the interactions were of a pharmacodynamic character and were considered to be quite serious. Most pDDIs involved aspirin and clopidogrel, then aspirin and enalapril, and finally enalapril and enalapril. The surveillance of pDDIs in cardiac inpatients may benefit from the creation of such a database in hospitals.
Diabetes mellitus is among the most common disorder in developed and developing countries, and the disease is increasing rapidly in most parts of the world. It has been estimated that up to one-third of patients with diabetes mellitus use some form of complementary and alternative medicine. One plant that has received the most attention for its anti-diabetic properties is bitter melon, Momordica charantia (M. charantia), commonly referred to as bitter gourd, karela and balsam pear. Its fruit is also used for the treatment of diabetes and related conditions amongst the indigenous populations of Asia, South America, India and East Africa. Abundant pre-clinical studies have documented in the anti-diabetic and hypoglycaemic effects of M. charantia through various postulated mechanisms. However, clinical trial data with human subjects are limited and flawed by poor study design and low statistical power. The present review is an attempt to highlight the antidiabetic activity as well as phytochemical and pharmacological reports on M. charantia and calls for better-designed clinical trials to further elucidate its possible therapeutic effects on diabetes.
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