Cardiovascular disease has a high rate of mortality in both Western and developing countries. Atherosclerosis and generation of reactive oxygen species through oxidative stress is the major risk factor for cardiovascular disease. Atherothrombosis with low levels of high-density lipoprotein (HDL) and high levels of low-density lipoprotein is a major risk factor for atherosclerosis-induced cardiovascular disease. Lipid-lowering drugs like statins, niacin, fibrates, and some newer agents, ie, the apolipoprotein A-I mimetics and the cholesteryl ester transfer protein inhibitors, not only increase HDL levels but are also effective in reducing key atherogenic lipid components, including triglyceride-rich lipoproteins. The aim of this review is to discuss the accumulating evidence suggesting that HDL possesses a diverse range of biological actions, and that increasing HDL levels by drug treatment may be beneficial in the prevention of cardiovascular disease.
Morbidity and mortality from cardiovascular diseases are still high, even with the use of the best available therapies. There is mounting evidence that excessive renin-angiotensin system activation triggers much of the damaging and progressive nature of cardiovascular and kidney diseases through expression of angiotensin II. Moreover, angiotensin II play a major role in the development of end organ damage through a variety of inflammatory mechanisms. Today, angiotensins-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists have clearly demonstrated their efficacy in preventing target organ damage and in reducing cardiovascular morbidity and mortality in ischemic heart disease (IHD). Moreover, the development of angiotensin II receptor antagonists has enabled a large gain in tolerability and safety. Several clinical trials have firmly established that these drugs act on the renin-angiotensin system, reducing the incidence of coronary events with monotherapy and combination therapy. In this review we summarize the role mono-and combined therapy of ACE inhibitors and angiotensin II receptor antagonists play in ischemic heart disease. In this respect the review will improve ideas for developing new formulations with combinations of these drugs in the future.
Herbal drugs are frequently considered to be less toxic and also free from side effects, than synthetic ones. Hence, the present study was designed to investigate one such combination of herbal drugs, Asystasia gangetica and Morus indica for their antidiabetic and antioxidant potential against alloxan-induced diabetes in albino rats. The effect of both individual and a combination of Asystasia gangetica and Morus indica on blood glucose and liver glycogen were studied in the diabetic rats. The study also assessed for the effect of selected plant extracts for their effect on Superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and Lipid peroxidation (LPO) in the homogenates of the pancreas. The results of the present study attests significant antidiabetic and antioxidant potential for the selected plants individually and also in combination as a prominent decrease in blood glucose and liver glycogen was observed in the rats treated with the extracts of the selected plants. Similarly, the levels of the protective antioxidant enzymes like SOD, CAT and GSH were increased along with decrease in the LPO levels. The present study provides a scientific evidence for antidiabetic and antioxidant potential of Asystasia gangetica and Morus indica. Further studies to isolate bioactive compounds will pave the way to identify potential lead compounds for developing safe and efficacious antidiabetic agents.
Atrial fibrillation is the most common type of tachyarrhythmia caused by multiple re-entrant wave forms within the atria and bombarding the atrioventricular node several times making it beat in a rapid, disorganized fashion termed "fibrillation". In atrial fibrillation, atria beat more than 300 times per minute. The arrhythmatous condition needs to be controlled, as humans cannot withstand this rapid and chaotic beating of the heart. New investigational drugs like Dronedarone ® are being used. Dronedarone is the most recent antiarrhythmic drugs. It was approved by US-FDA on July 2nd 2009 and is available in the USA as Multaq tablets (400 mg). Dronedarone falls under the category of multiple ion channel blocker. It mainly targets the repolarization currents, making them less active and hence prolonging the action potential duration (APD). Dronedarone also exhibits antiadrenergic activity, thus reducing the pace of the pacemaker. Dronedarone has been proven to be a safer and efficacious AAD, evidenced by both animal and human studies. These studies showed that there was prolongation of the APD and absence of QT interval prolongation with long term administration of the drug. Also there was reduced thyroid hormone receptor expression. Dronedarone is significantly safer and effective in maintaining the sinus rhythm and reducing the ventricular proarrhythmias, justifying it for the long term treatment of atrial fibrillation compared to other antiarrhythmic drugs.
Objectives: In the recent years, effectiveness data obtained from real-world evidence settings are required to support healthcare decision making in the pre-, peri-and post launch activities for medicines worldwide. The study aims to review, examine prescribing practice and estimate costs of medicine treatment for uterine fibroids in Ukraine and propose the use of real-world evidence in HTA process in Ukraine, while its currently developing. MethOds: We analyzed e-database registry of patients in Lviv Regional Reproductive Health Centre in 2015. We examined total 130 e-medical records of women, 37 of them were diagnosed with uterine fibroids. Average direct costs of medicine treatment were estimated per patient with the use of weighted average prices from Morion company database (Ukraine) on 01.12.2015 (1 USD = 23,3 UAH). Results: The direct costs for out-patient care were evaluated from the patients' perspective while all expenditures were out-of-pocket. The prescribing practice included 43 medicines by trade name of 7 pharmacological subgroups by ATC-classification. In 32% of cases pharmacotherapy was carried out along with hysteroscopy. Among the prescribed medicines were hormonal (22% cases) and symptomatic treatment schemes (in 18% of cases analyzing diagnosis was associated with inflammatory gynecological disorders). ABC-analysis showed that the most expensive drugs (81,1% of expenditures) in the prescribing structure were 12 medicines: herbal, hormones (triptorelin, levonorgestrel, dydrogesterone, norethisterone), antibacterial (dequalinium), fibrinolytics and probiotics.
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