Medical Pharmacology Commons^™

Limitations Of Plasma Exchange In Yellow Phosphorus-Induced Acute Liver Failure: A Case Report, Vihitha Vunnam, Swathi B.S

Digital Journal of Clinical Medicine

Yellow phosphorus is a highly toxic compound commonly used in rodenticides and is associated with significant morbidity and mortality following ingestion. Toxicity typically evolves through an initial gastrointestinal phase, a deceptive latent period, and a final phase characterized by fulminant hepatic failure and multiorgan dysfunction. We report the case of an 18-year-old male who intentionally ingested two tubes of Ratol containing 3% yellow phosphorus. After initial vomiting and transient clinical stability, he developed rapidly progressive acute liver failure with severe coagulopathy, conjugated hyperbilirubinemia, hepatic encephalopathy, acute pancreatitis, pancytopenia, acute kidney injury, metabolic derangements, and recurrent hypoglycemia. Serial laboratory trends demonstrated …

Family Mental Health – A Case Report, Vikrant Arora, Medha Kosireddy, Mathumitha Ananth, Kishor M. Manohar Rao

Digital Journal of Clinical Medicine

Psychiatric illness in India is estimated to be 15% as per National Mental Health Survey 2015-16.  Mental health challenges within families, especially depression, anxiety disorders that are not common and when unaddressed exert cascading effects on all members, disrupting emotional cohesion, relational functioning, and socioeconomic stability. There are few case reports on entire family presenting to psychiatry department.

With informed consent a city-based middle-class family of non-consanguineous origin, where the 40-year-old female, presented with intractable limb pains and health anxiety, she had multiple consultation in last few months and her 48-year-old husband also had with episodic pains, irritability and her …

Cb1 Allosteric Modulation: Preclinical Insights Into Therapeutic Potential And Misuse Liability, Mohammed A. Mustafa

Theses and Dissertations

Cannabinoid type-1 (CB1) allosteric modulators represent a promising approach to modulate CB1 receptor signaling by binding to distinct receptor sites, without producing adverse cannabimimetic and dependence-related effects associated with Δ9-tetrahydrocannabinol (THC) and other CB1 agonists. This dissertation investigates the pharmacological, behavioral, and dependence-related profiles of CB1 allosteric modulators for their therapeutic potential and misuse liability. Presented here, the chiral CB1 positive allosteric modulator (PAM) ZCZ011 was resolved into its R- and S-enantiomers and characterized across in vitro and in vivo assays. Both enantiomers enhance CB1 agonist activity and produce intrinsic effects in vitro. Behaviorally, they produce antinociceptive effects in the …

Experience Of Using Anti-Cd 20 Therapies In Multiple Sclerosis Patients In Kenya, Eunice Nyambane, Tejal Patel, Jacqueline Mavuti, Juzar Hooker, Dilraj Sokhi

Internal Medicine, East Africa

Objective: The objective of the study was to evaluate the safety and efficacy of ocrelizumab (OCR) and rituximab (RTX) in multiple sclerosis.

Methods: This was a retrospective single-centre study. Ocrelizumab- and rituximab-treated patients were identified through the multiple sclerosis (MS) registry maintained at Aga Khan University Hospital Nairobi (AKUHN), Kenya. Adult patients aged 18–65 years old who fulfilled the McDonald 2017 diagnosis criteria and received treatment with either rituximab or ocrelizumab between January 2016 and June 2025 were retrospectively evaluated. Data collected at baseline included age, gender, first symptoms, disease duration since onset, MS phenotype, treatment duration, previous …

Phentermine And The Failing Heart: A Case Of Phentermine Associated Cardiomyopathy Complicated By Pulmonary Hypertension, Nisha Puri, Cecil Jnawali, Ethan Wincler, Ryan Scagliarini, Dmitri Zbarsky, Julie Worthington

South Atlantic Division GME Research Days 2026

No abstract provided.

Stim1-Dependent Treg Dysfunction Promotes Cardiometabolic Hfpef: Insights From Patients And Animal Studies, Balaji Srinivas, Alluri Kiran, Hongmei Peng, Jiang Xu, Paula Fortuno, Jennifer May, Ismail El Moudden, Nour-Eddine Rhaleb, John M. Herre, Raymond L. Benza, Khalid Matrougui

Department of Biomedical and Translational Sciences Faculty Publications

Background

Heart failure with preserved ejection fraction (HFpEF) arises from chronic cardiometabolic and vascular stress and is increasingly recognized as an inflammatory syndrome with immune dysregulation. Regulatory T cells (Tregs) are critical modulators of cardiovascular inflammation, yet the mechanisms driving Treg dysfunction in HFpEF remain poorly defined. stromal interaction molecule 1 (STIM1)-dependent calcium signaling is a key stress-responsive pathway in immune cells; however, its role in Treg maladaptation during HFpEF remains unknown.

Methods

Circulating Tregs from patients with and without HFpEF were analyzed for abundance, STIM1 expression, and stress-associated signaling pathways. To establish causality, mice with Treg-specific deletion of STIM1 …

Pioglitazone Uncouples Macrophage Inflammatory Signaling From Epithelial Oxidative Stress During Map Infection Mimicking Crohn’S Disease Treatment, Sabera Akter Bushra

Graduate Studies Theses and Dissertations 2026

Crohn’s disease (CD) is a chronic inflammatory bowel disease characterized by intestinal inflammation, epithelial barrier dysfunction, and abnormal immune signaling. CD pathophysiology is increasingly linked to Mycobacterium avium subspecies paratuberculosis (MAP) infection, which increases chronic macrophage activation and the production of inflammatory mediators that lead to epithelial damage. Among these mediators, CXCL10, TNF-α, and IL-6 contribute in inflammation, while NOX-1 and SERPINE-1 indicate epithelial oxidative stress and damage. Despite the role of macrophage-epithelial interaction in CD, selective pharmaceutical regulation of this axis remains unclear. Pioglitazone, an FDA-approved PPARγ agonist used for type 2 diabetes, is an appealing repurposing candidate, given …

Inflammatory Co-Regulation Of Voltage-Gated Sodium Channels And Na,K-Atpase In Metastatic Breast Cancer, Steven D. Scahill, Kelly Jean Sherman, Dennis Paul

School of Graduate Studies Faculty Publications

Sodium regulation is a potentially major driver of cancer metastasis. Voltage-gated sodium channels (VGSCs) and Na,K-ATPase are sodium transporters that are upregulated in many advanced carcinomas and are implicated as metastatic drivers. However, little is known about what drives this overexpression, how these proteins influence metastatic behavior, or whether these complementary sodium transporters are co-regulated in cancer. Using sodium transporter regulation in healthy neurons as a model, the present study demonstrated that the inflammatory mediator tumor necrosis factor alpha (TNFα) affects the expression of VGSCs and Na,K-ATPase in an in vitro model of metastatic breast cancer. Acute TNFα challenge increased …

Investigation On The Effects Of Hypoxia-Mimicking Agents In Cancer Progression And Oxidative Stress In Hepatocellular Carcinoma, June Wong Xin Ni

Student Works (2020-2029)

Hypoxia, or oxygen deprivation, is a common pathological feature found in hepatocellular carcinoma (HCC). Hypoxia-inducible factor (HIF) is the master transcription factor of oxygen homeostasis, eliciting a wide range of cellular adaptive responses to either enhance oxygen delivery or reduce oxygen consumption. HIF is primarily regulated by two types of oxygen sensors, the prolyl hydroxylase domain-containing proteins (PHDs) and factor-inhibiting HIF (FIH). In tumours, HIF functions as a double-edged sword whereby it could either promote or hinder tumour progression. This is mainly contributed by the pleiotropic nature of hypoxia and tumour heterogeneity. Recently, there is a growing interest in the …

The Next Drug Epidemic Is Legal: The Nation's Kratom Problem Is More Complicated—And More Harmful—Than It Seems, Elizabeth Walsh

Capstones

This two-part health and science investigative piece reports how kratom and its offshoots have quietly fueled a lucrative and legal addiction epidemic for the last decade. While kratom’s derivative alkaloid 7-hyrdoxymitragynine made headlines this year and as the DEA is poised to ban the strong derivative, “natural” kratom and other kratom-derived products will remain. This piece tracks the history of the 'gas‑station opioid' crisis in the U.S. over ten years: what was thought to be an innocuous southeast Asian supplement has become multi-billion dollar industry built on gray‑area laws, marketed falsehoods, and regulatory loophooles.

Part 1: The ‘Gas Station Opioid’ …

Topical Lidocaine For Pain Control With Intrauterine Device Insertion: Does It Work?, Piper Gaudet, Jahnavi Ramakrishnan, Fariha Azam

Physician Assistant Capstones, 2020-current

Objective: To evaluate whether topical lidocaine improves the subjective perception of pain during the insertion of an intrauterine device (IUD) in women of childbearing age, compared to a placebo. Design: Mini-systematic literature review. Methods: An initial search of PubMed, CINAHL, and Scopus was conducted using the terms "pain control," "IUD," and "lidocaine," yielding 49 articles, of which 31 were screened and 26 excluded based on pre-designated inclusion criteria. After assessing five articles for eligibility, three met the criteria and were evaluated using Duke University's Clinical Appraisal Worksheet and the Oxford Centre for Evidence-Based Medicine table to determine their level of …

The Need To Incorporate Polysubstance Use In Neuropsychopharmacology Research: Biological Lessons And New Opportunities, Max E. Joffe, Susan M. Ferguson, Nick W. Gilpin, Melissa A. Herman, Lori A. Knackstedt, Patrick A. Randall, Abigail G. Schindler, Mary M. Torregrossa, Jennifer A. Rinker

School of Medicine Faculty Publications

Critical evaluation and refinement of animal models is essential for neuroscientists to understand complex physiological and pathological processes related to psychiatric diseases. In general, preclinical studies modeling drug dependence and problematic substance use have been limited to the administration of a single substance; however, there is a growing appreciation that this approach has failed to capture the complexities of humans and has stifled translational efforts. Polysubstance use represents the overwhelmingly common patterns of alcohol and drug use in humans. For example, epidemiological studies generally determine that between 70–95 % of individuals with alcohol use disorder use tobacco daily, and upwards …

Endothelial-Derived Extracellular Vesicles During Exercise In Copd Patients, Samuel C Okpechi, Dorota Wyczechowska, Bennett Deboisblanc, Jessica L Johnson, Mohamed A Ghonim, Natalie Bauer, Hamid A Boulares, Matthew R Lammi

School of Medicine Faculty Publications

Introduction: There are no treatments directly targeting the pulmonary vasculature in chronic obstructive pulmonary disease (COPD), and further characterization of the underlying endothelial cell (EC) abnormalities could be helpful in drug development. Methods: We investigated the influence of exercise and the prostacyclin analog iloprost on extracellular vesicles derived from ECs (eEVs) in 15 moderate–severe COPD patients who were enrolled in a randomized, placebo-controlled crossover trial of iloprost. Results: Active smokers had a profile consistent with inflammatory-derived EVs, while exacerbation-prone COPD subjects had a profile consistent with apoptosis-derived eEVs. There were no significant effects of iloprost on eEV levels. However, there …

Effect Of Various Lactobacillus Probiotic Strains On Oral Antihypertensive Drug Response: A Systematic Review, Khoirunnisa Ramadhani, Keri Lestari

Pharmacology and Clinical Pharmacy Research

Hypertension is a major risk factor for cardiovascular disease, and the effectiveness of antihypertensive therapy can be influenced by metabolic and systemic inflammatory factors associated with gut microbiota conditions. Probiotic strains from the genus Lactobacillus have been reported to modulate antihypertensive effects through complex biological mechanisms. This article evaluates experimental evidence from seven in vivo studies on the influence of Lactobacillus strains on the response to antihypertensive drugs, including pharmacodynamic mechanisms and drug–probiotic interactions. The combination of Lactiplantibacillus plantarum with amlodipine enhanced nitric oxide production, increased eNOS expression, reduced IL-6 levels, and improved drug bioavailability, leading to greater blood pressure …

Optimization Of Guava Leaf Extract Cream Formulation Through Variations Of Xanthan Gum And Stearic Acid For Wound Cure In Rats, Ayudia Cipta Khairani, Mia Ariasti

Pharmacology and Clinical Pharmacy Research

Cuts are among the most common skin injuries caused by sharp objects and can lead to infection if not properly treated. Natural ingredients such as guava leaves have been widely investigated for their wound-healing potential. Guava leaves contain bioactive compounds including flavonoids, saponins, alkaloids, and tannins, which contribute to anti-inflammatory, antibacterial, and tissue regeneration processes. This study aimed to formulate and evaluate the physical properties and wound-healing effectiveness of guava leaf ethanol extract cream with varying concentrations of xanthan gum and stearic acid as emulsifiers. The extract was obtained by maceration using 70% ethanol and formulated into four cream formulas …

Drug-Related Problems In Hemodialysis Patients With Chronic Kidney Disease: A Study At X Hospital (January–May 2022), Muhammad Refki Abrari, Jatmiko Susilo

Pharmacology and Clinical Pharmacy Research

The prevalence of chronic kidney disease (CKD) in Indonesia has increased from 2.0 ‰in 2013 to 3.8 ‰in 2018. The presence of complex comorbidities associated with CKD causes varied therapy regimens (poly-pharmacy), leading to an increased risk of drug-related problems (DRPs). To overcome these complications, dialysis is often used to remove metabolic waste and rebalance electrolytes to maintain life in patients experiencing rapid loss of kidney function. This study aims to evaluate drugs consumed as well as DRPs experienced by patients diagnosed with CKD undergoing hemodialysis at X Hospital from January to May 2022. The study procedures were carried out …

What Is The Hospital Pharmaceutical Care? Perceptions And Expectations Of Doctors In Interprofessional Collaboration In 2 Types Of Indonesia Hospitals, Anisyah Achmad, Savvy Augustin Tirta, Titi Annisa Bella, Ratna Kurnia Illahi, Bambang Sidharta, Valentina Yurina, Wara Rejeki

Pharmacology and Clinical Pharmacy Research

Hospital Pharmaceutical Care (HPC) is the pharmacist’s direct responsibility to aim for patient safety and quality of life. HPC is a means of avoiding medication and human errors. Carrying out a HPC requires a good collaboration between doctors and pharmacists in treatment management. The aim of the research was to determine the relationship between doctors’ perceptions and expectations of clinical pharmacists at HPC. This research is descriptive quantitative observational with a cross-sectional approach. The data were collected using purposive sampling (type A hospital) and total sampling (type C hospital) through interviews using perception and expectations questionnaires on doctors’ to pharmacists …

Β-Glucan As A Potential Modulator Of Tgf-Β Signaling And Emt-Driven Resistance In Triple-Negative Breast Cancer, Hanifa Dinda Hayati, Riezki Amalia, Gemilang Lara Utama, Dika Pramita Destiani

Pharmacology and Clinical Pharmacy Research

Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer that lacks expression of estrogen, progesterone, and HER2 receptors, limiting the effectiveness of targeted therapies and making chemotherapy the primary treatment option. However, resistance to chemotherapy remains a major clinical challenge, often driven by dysregulation of the transforming growth factor-β (TGF-β) signaling pathway. TGF-β plays a dual role in cancer, initially acting as a tumor suppressor but later promoting tumor progression through mechanisms such as epithelial–mesenchymal transition (EMT), immune evasion, and the establishment of cancer stemness. This review aims to explore the role of TGF-β signaling and EMT …

Perceived Effects Of Verbal Orders On In-Patient Medication Reconciliation And Safety: A Multi-Center Cross-Sectional Study, Yahaya Jafaru, Abubakar K. Sahabi, Mohammed M. Sani

Pharmacology and Clinical Pharmacy Research

Medication reconciliation presents significant challenges for healthcare professionals, particularly due to communication gaps that contribute to patient safety incidents. The aim of the study was to investigate the perceived effect of verbal orders on in-patient medication reconciliation and safety. The study was a cross-sectional survey with nurse employees of the three tertiary hospitals in Kebbi State, Nigeria as population of the study. The instrument for the data collection was a 21-items researcher-constructed self-administered questionnaire. Chi-square and binomial regression analysis were used in data analysis. Over two-thirds (70.7%) of the respondents reported a negative perceived effect on the patient’s compliance. The …

Crosstalk Between Gut Microbiota And Antihypertensive Drugs: A Systematic Review, Dhiya'ul Haq, Keri Lestari

Pharmacology and Clinical Pharmacy Research

Hypertension is a multifactorial condition characterized by persistently elevated blood pressure. In addition to genetic and environmental factors, recent studies suggest that the gut microbiota contributes to the development of hypertension and modulates the response to antihypertensive therapy. This review aims to summarize the latest knowledge on the bidirectional interaction between gut microbiota and antihypertensive drugs. Original studies published up to May 2025 on this topic were collected from two online databases: PubMed and Scopus. A total of 220 articles were identified, and 9 articles met the inclusion criteria for further discussion. Three of these included articles discussed how gut …