Dyslipidemia Induced by Drugs Used for the Prevention and Treatment of Vascular Diseases

Τζιόμαλος, Κωνσταντίνος; Athyros, Vasilios G.; Karagiannis, Asterios; Mikhailidis, Dimitri P.

doi:10.2174/1874192401105010085

Cited by 14 publications

(6 citation statements)

References 71 publications

(91 reference statements)

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“…Vascular morbidity and mortality are caused by elevated levels of low‐density lipoprotein and cholesterol along with reduced levels of high‐density lipoprotein. Similarly, elevated triglycerides levels can also lead to higher vascular risk [30]. In the present study of HAZ treatment all the values of serum lipid profile remained within physiological range and showed no abnormal findings.…”

Section: Discussionsupporting

confidence: 58%

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Preclinical toxicity evaluation of Habb‐e‐Azaraqi: A nux‐vomica‐based traditional Unani polyherbal formulation in rats

Ara

Viquar

Zakir

et al. 2020

Traditional & Kampo Medicine

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Aim Habb‐e‐Azaraqi (HAZ) is a compound Unani formulation used clinically since decades for the management of Laqwa (facial palsy), Fālij (paralysis), Niqris (gout) and Waja'al‐Mafāsil (arthritis). The explicit nature of HAZ i.e., Muqawwi‐i‐A'sāb (nervine tonic), Muharrik‐i‐A'sāb (nervine stimulant) rationalizes its use in nervine disorders. The main ingredient of HAZ is Azaraqi/Kuchla (Strychnos nux‐vomica L.), which is considered to be toxic in nature. Methods Acute and repeated‐dose 90‐day toxicity studies were performed as per OECD Guidelines 425 and 408, respectively. The acute toxicity study was performed at limit dose, i.e. 2000 mg/kg. The repeated‐dose toxicity study was performed at the dose levels of 100, 500 and 1000 mg/kg bw/day. Clinical signs of toxicity, body weight, and feed consumption were recorded periodically. Blood samples were subjected to hematology and clinical chemistry evaluation followed up with gross pathology and histological examinations. Results No significant differences were observed in HAZ‐treated animals with respect to body weight gain, feed consumption, hematology, or clinical biochemistry as compared to control animals. There were no significant gross pathological observations between control and drug‐treated rats. A few histopathological changes were observed in the kidney of control and HAZ‐treated animals. Conclusion No treatment‐related toxicologically significant changes were observed up to the highest tested dose except a few histopathological observations in the kidney in the high‐dose HAZ group as well as in the vehicle and satellite control groups. Data of the present study support that the traditional detoxification process effectively minimizes toxic effects of nux‐vomica used in HAZ.

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Section: Discussionsupporting

confidence: 58%

“…Vascular morbidity and mortality are caused by elevated levels of low-density lipoprotein and cholesterol along with reduced levels of high-density lipoprotein. Similarly, elevated triglycerides levels can also lead to higher vascular risk [30].…”

Section: Discussionmentioning

confidence: 99%

Preclinical toxicity evaluation of Habb‐e‐Azaraqi: A nux‐vomica‐based traditional Unani polyherbal formulation in rats

Ara

Viquar

Zakir

et al. 2020

Traditional & Kampo Medicine

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“…8,200,235,236 Secondary causes of dyslipidemia Some conditions or medications can produce adverse changes in lipid levels and should be considered when evaluating patients with dyslipidemia. 3,[237][238][239][240][241][242][243][244] Medications that may elevate levels of LDL-C and/or triglycerides are shown in Table 5. Conditions that may produce adverse changes in lipid levels are summarized in Table 6.…”

Section: B Moderatementioning

confidence: 99%

National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 1—Full Report

Jacobson

Ito

Maki

et al. 2015

Journal of Clinical Lipidology

678

496

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The leadership of the National Lipid Association convened an Expert Panel to develop a consensus set of recommendations for patient-centered management of dyslipidemia in clinical medicine. An Executive Summary of those recommendations was previously published. This document provides support for the recommendations outlined in the Executive Summary. The major conclusions include (1) an elevated level of cholesterol carried by circulating apolipoprotein B-containing lipopro-teins (non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol [LDL-C], termed atherogenic cholesterol) is a root cause of atherosclerosis, the key underlying process contributing to most clinical atherosclerotic cardiovascular disease (ASCVD) events; (2) reducing elevated levels of atherogenic cholesterol will lower ASCVD risk in proportion to the extent that atherogenic cholesterol is reduced. This benefit is presumed to result from atherogenic cholesterol lowering through multiple modalities, including lifestyle and drug therapies; (3) the intensity of risk-reduction therapy should generally be adjusted to the patient's absolute risk for an ASCVD event; (4) atherosclerosis is a process that often begins early in life and progresses for decades before resulting a clinical ASCVD event. Therefore, both intermediate-term and long-term or lifetime risk should be considered when assessing the potential benefits and hazards of risk-reduction therapies; (5) for patients in whom lipid-lowering drug therapy is indicated, statin treatment is the primary modality for reducing ASCVD T.A.J. and M.K.I. are the joint first authors. risk; (6) nonlipid ASCVD risk factors should also be managed appropriately, particularly high blood pressure, cigarette smoking, and diabetes mellitus; and (7) the measurement and monitoring of athero-genic cholesterol levels remain an important part of a comprehensive ASCVD prevention strategy.

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“…22,23 Unlike nebivolol and carvedilol, the third generation ß-blockers, other ß-blockers, in particular atenolol, cause adverse effects on the components of the cardio-metabolic syndrome such as lipid profile, insulin sensitivity and increase the incidence of new-onset diabetes. [24][25][26][27][28] Thiazide and thiazide-like diuretics (at doses >25mg/day) are associated with hyperglycemia, hyperuricemia, hyperlipidemia, hypokalemia (which may contribute to cardiac arrhythmias) and other electrolyte changes. 22,29 Long-term use of diuretics can also increase the cost of treatment owing to the therapeutic interventions needed to treat diuretic-induced metabolic and electrolyte abnormalities.…”

Section: The Therapeutic Reasoning Skill Assessmentmentioning

confidence: 99%

Acquisition of prescribing skill by medical students in a problem-based learning curriculum: preclerkship to clerkship phase transition

Khaja

James

Sequeira

2017

Int J Basic Clin Pharmacol

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INTRODUCTIONA prescription is "a written order, which includes detailed instructions of what medicine should be given to whom, in what formulation and dose, by what route, when, how frequently, and for how long.1 Ordering a valid and complete prescription requires a thorough knowledge and understanding of patho-physiology of disease, the pharmacological properties of the relevant drugs, and the ways in which the two dovetail. 2The drug-related components of a prescription include both inscription (i.e. appropriateness of drug(s) selected, strength, dosage form, quantity to be dispensed) and signtura (i.e. direction for use). The inscription and signtura are deemed to be the most challenging part of the prescription writing skill to be achieved by preclerkship medical students in both problem-based learning curriculum and traditional curriculum. [3][4][5][6] Acquisition of therapeutic reasoning and prescribing competency, as a clinical skill, has been reported to be sub-optimal among students in preclerkship phase and junior doctors, regardless of the curriculum strategy used in medical schools. [3][4][5][6][7][8][9][10] At the College of Medicine and Medical Sciences (CMMS), Arabian Gulf University (AGU), we have introduced a pharmacotherapeutic context learning program in order to develop the prescription writing competency of medical students at the preclerkship phase through a total of 16-hour educational interactive sessions. The program is interrupted thereafter during clerkship phase, assuming that the students" prescription writing competency would be further enhanced at realworld prescribing setting. ABSTRACTBackground: Medical school training for students in pharmacotherapy is suboptimal and junior doctors are not confident to prescribe drugs. This study was conducted to assess the prescribing competency of students in preclerkship and clerkship phases at a medical school that implements problem-based learning curriculum. Methods: Objective structured practical examination was used to assess prescribing competency of students in both phases. The prescribing performance was empirically categorized into poor, moderate and good competency. Results:The prescription writing skills achieved by the clerkship students did not significantly differ from that attained by students in preclerkship phase. Good prescribing competency was attained by approximately 20% of the students at the end of both phases. Preclerkship students performed better on therapeutic reasoning than those in clerkship phase. Cognitive skill that involves choosing the superior drug(s) among several alternatives as achieved less satisfactorily by majority of students from both phases of the program. Conclusions: Acquisition and further development of the prescribing competency during the clerkship phase was sub-optimal. The continuation of pharmacotherapeutic context-learning program during clerkship phase is recommended.

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Dyslipidemia Induced by Drugs Used for the Prevention and Treatment of Vascular Diseases

Cited by 14 publications

References 71 publications

Preclinical toxicity evaluation of Habb‐e‐Azaraqi: A nux‐vomica‐based traditional Unani polyherbal formulation in rats

Preclinical toxicity evaluation of Habb‐e‐Azaraqi: A nux‐vomica‐based traditional Unani polyherbal formulation in rats

National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 1—Full Report

Acquisition of prescribing skill by medical students in a problem-based learning curriculum: preclerkship to clerkship phase transition

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