Original Research article


Green Synthesis of Nalidixic Acid by Ionic Liquid

Hamid Reza Ahfad-Hosseini, Hasan Bagheri, Salimeh Amidi

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e1:1-5
https://doi.org/10.22037/ipa.v5i1.36873

In this study, a green process was applied for the preparation of nalidixic acid by the assistance of an ionic liquid. Nalidixic acid was prepared by reaction of 6-methylpyridin-2-amine, ethyl formate and diethyl malonate in tris-(2-hydroxyethyl) ammonium acetate solution as ionic liquid (IL) which was provided by reaction of triethanolamine and acetic acid. The 1HNMR, 13CNMR, FTIR, mass spectroscopy and melting point were used to characterize the structure of the synthesized compounds. The ionic liquid was recovered and reused for four runs. This method introduces a novel idea for synthesis of nalidixic acid with high yield (86%) and the least damage to the environment. This IL can be used as a green solvent in synthesis of compounds instead of using harmful solvents.

Tyrosinase Inhibitory Activity of Selected Plants Based on Iranian Traditional Medicine

Saeedeh Ghafari, Shamim Sahranavard, Parisa Sarkhail, Behnaz keramatian

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e4: 1-5
https://doi.org/10.22037/ipa.v5i1.38023

Discovery of safe and stable skin whitening agents for medical and cosmetic purposes has drawn attention in recent years. For the same reason, this study was undertaken to evaluate tyrosinase inhibitory activity of some medicinal plants introduced in Iranian Traditional Medicine as hypopigmenting agents. In recent research, tyrosinase inhibitory effect and antioxidant activity of selected plants were evaluated using mushroom tyrosinase inhibitory assay and DPPH radical scavenging test and, in addition, total phenol content of extracts was measured. Out of nine aqueous extracts of selected plants, the effect of Ricinus communis L. and Nepeta glomerulosa Boiss. on tyrosinase inhibition was significant with 71.99 and 89.98 percent inhibition, respectively. Moreover, Pistacia atlantica L. showed the highest total phenol content with the most potent DPPH radical scavenging effect and high anti-tyrosinase activity with 59.07 percent of inhibition. The obtained results suggest that Ricinus communis, Nepeta glomerulosa and Pistacia atlantica could be good candidates for further investigation to find novel agents for skin hyperpigmentation.

One-pot Synthesis, Cytotoxic Evaluation and Molecular Docking of 3,4,7,8-tetrahydroquinazoline-2,5-(1H,6H)-dione Derivatives

Mahdi Rafian-boroujeni, Rezvan Rezaeinasab, Nasim Bahrami

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e5: 1-9
https://doi.org/10.22037/ipa.v5i1.38025

In this study, a proper multicomponent process was developed for synthesis of tetrahydroquinazolinone derivatives. Dimedone, urea, and various aryl aldehydes were applied to the evaluation of a one-pot reaction under solvent-free and solvent conditions in the presence of CaCl2.2H2O and aniline as catalysts. It was optimized by employing at 110 °C and 10% mol for CaCl2.2H2O and 60% mol in the presence of EtOH at room temperature for aniline.  All chemical structures of tetrahydroquinazolinones were determined by FT-IR, 1HNMR, 13CNMR, mass spectroscopy, elemental analysis, and melting point. The synthesized compounds were evaluated for their cytotoxicity activity against MCF-7 cell line by MTT assay. All of the synthesized compounds showed moderate cytotoxicity activity against MCF-7 cell line. Especially, Compound 4h was the most potent compound. Also, the potential EGFR inhibitory activity of these compounds was investigated in silico using molecular docking simulation method. Especially compound 4h which showed the lowest ΔGbind results (-7.37 Kcal/mol).

The potential role of clinical pharmacist in the practice of heart transplantation

Zargham Hossein Ahmadi, Hadi Hamidia, Raha Eskandari, Mohammed Bhia, Roodabeh Haghgoo, Jamshid Salamzadeh, Farzaneh Dastan

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e6: 1-7
https://doi.org/10.22037/ipa.v5i1.37635

Due to the complexity of heart transplant procedure and risk of organ rejection, most heart transplant patients receive multiple medications such as antibiotics, antifungals, and immunosuppressants. Since some medications have narrow therapeutic indexes, more attention is needed by the clinical pharmacists to solve and reduce medication-related problems. Pharmacists can play an essential role in assisting patients and physicians in receiving better treatment with the lowest risk of medication errors.

The purpose of this study was to investigate the types and quality of clinical pharmacist recommendations, the recommendations acceptance rate, and the outcomes related to clinical pharmacist interventions in heart transplant patients. The study was conducted at National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Dr.Masih Daneshvari Hospital, a university affiliated hospital, Tehran, Iran. Main outcome measures included determination of the quality of clinical pharmacist recommendations, physician acceptance rate and the effects of recommendations on patients’ clinical outcomes. Clinical pharmacist recommendations were divided into ten categories, and physicians’ acceptance rate for each recommendation was recorded. The quality of pharmacist recommendations was also classified into six categories.

The total number of recommendations that were recorded for 46 patients was 344, about 7.47 recommendations per patient. Dose adjustment recommendations were the most recommendations that were made (n=100, 29.06 %). However, this type of recommendation had the lowest physician acceptance rate (62%). Antibiotics had the least acceptance rate in dose adjustment recommendations (40%). Clinical pharmacist recommendations in the drug interaction category prevented 265 moderate and 28 severe interactions, respectively. Clinical pharmacist made 27 (7.84%) extreme significant recommendations and 88 (25.58%) significant recommendations.

Clinical pharmacists could have a critical role in optimizing medication regimens and minimizing drug interactions as well as adverse reactions in transplant patient care and their treatment programs.

Hepatoprotective Properties of Starflowers from an Annual Herb, Borago officinalis L. (Boraginaceae)

Sanjay Samanth Manthena, Haritha Polimati, Satya Sowbhagya Priya Annam, Ho Viet Hieu

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e7: 1-7
https://doi.org/10.22037/ipa.v5i1.38060

Traditionally, the decoction of leaves, flowers and stems of Borago officinalis was widely used in the treatment of liver diseases. The present work is aimed to assess the hepatoprotective properties of selected ethanolic fractions of Borago officinalis flowers in D-galactosamine (GalN)-induced oxidative stress in rats. In vitro antioxidant activities were assessed through superoxide radical and ferric ion assays, while hepatoprotective effects were evaluated by GalN-induced oxidative stress in rats. Initially, ethanolic extract of B. officinalis flowers was fractionated using column chromatography. The preliminary antioxidant screening of these fractions identified two main bioactive fractions (BoF2 and BoF5), which were found to have significant radical scavenging properties compared to ascorbic acid. Based on the antioxidant profile, BoF2 and BoF5 were evaluated for hepatoprotective activity in GalN-induced rats. The Wistar rats were grouped (n = 6) and treated with BoF2 and BoF5 (100 and 200 mg/kg), silymarin (25 mg/kg) orally for 7 days, and GalN (200 mg/kg, i.p) was dosed on day 5. this study found that chronic administration of GalN significantly (P < 0.0001) altered the liver parameters and oxidative stress markers (MDA, SOD, and CAT). The administration of BoF5 prominently ameliorated the oxidative stress induced by GalN compared to BoF2. Histopathological studies further supported the significant hepatoprotective action of BoF5. The present study demonstrates that the B. officinalis possess significant antioxidant properties by augmenting the magnitude of the antioxidant enzymes (SOD and CAT), and further reducing MDA levels.

Assessing Pharmacies’ Preparedness for Disasters and Emergencies: The Case of Tehran, Iran

Sajjad Esmaeili, Mohammad Peikanpour, Farzad Peiravian

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e8: 1-7
https://doi.org/10.22037/ipa.v5i1.36770

Large-scale disasters and emergencies can pose serious challenges to various aspects of social life. Pharmacies’ preparedness further comes to the fore in these times. This study design and implement a model for assessing the disaster and emergency preparedness of pharmacies in Iran.

The study utilized qualitative and quantitative methods. An exploratory interview was conducted with experts to identify and select relevant indicators. A survey was then conducted to collect data from a sample of pharmacies from five geographical districts of Tehran, Iran’s capital and largest and most populated city.

The developed preparedness assessment tool includes five dimensions and 67 indicators. Employing the tool on the study samples, it was found that only 27.5% of pharmacies were ready in terms of medicine supplies, 41.7% in terms of medical consumables, 55.8% in terms of physical facilities, 52% in terms of software, and 32.7% in terms of human resource training and management.

The level of preparedness for pharmaceutical services and medicine providing centers revealed serious deficiencies in all dimensions. Since these centers are not adequately prepared for disasters and emergencies, improving the level of preparedness for this important element of the health sector should be the government’s immediate pressing concern.

Country Pharmaceutical Situation Based on World Health Organization Indicators: Evidence from an Upper-Middle Income Country

Mohammad Peikanpour, Farzad Peiravian, Hossein Minaei, Javad Shamsaee, Sahar Farrokhi, Nazila Yousefi

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e9:1-10
https://doi.org/10.22037/ipa.v5i1.36671

Evaluating the performance of national authorities has a pivotal role in the development of evidence-based policymaking. Regarding the complexity of the pharmaceutical sector and its severe impacts on public health, Food and Drug Administrations' (FDA) performance should be evaluated at regular intervals. This study aims to depict a comprehensive picture of the Iranian pharmaceutical situation and its structural gaps. In this cross-sectional descriptive study, inspired by indicators proposed by the world health organization (WHO), a checklist was developed with six component topics and 239 indicators. These topics considered the existence and performance of six critical structures, including national drug policy (NDP), regulatory system, medicine supply system, medicine financing, production and trade, and rational use of drugs (RUD). Afterward, the translation validity and then face and content validity of the research tool was confirmed by relevant experts. The data were collected by referring to official documents, reports, and critical informants in the Iranian Food and Drug Administration (IRFDA). According to the WHO indicators, the scores for structures of IRFDA are 80% in NDP, 61.5% in the regulatory system, 64.7% in the medicines supply system, 84.8% in medicines financing, and 60% in production, and trade, and 71.7% in RUD. Considering the status of structures and processes, IRFDA should attempt to provide an action plan commensurate with the NDP. Besides, it should modify the regulations regarding its responsibilities and authorities, develop transparency and accountability in its offices, publish a national essential medicines list, and revise motivational and punitive policies to create RUD.

Comparison of some physical parameters of different brands of acyclovir tablets marketed in Iran

Ali Amini, Maria Tavakoli-Ardakani, Naeime Zarepishe, Mohammad Mahboubi-Rabbani, Salimeh Amidi

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e11: 1-5
https://doi.org/10.22037/ipa.v5i1.38921

Acyclovir is the nucleoside analogue of guanosine, which is used as an antiviral drug. Since the quality requirements set for a higher quality product are necessary, the purpose of this study was to investigate the quality control characteristics of selected Iranian brands of acyclovir 400 mg tablets. Different brands and batches of acyclovir tablets were collected and subjected to various quality control tests such as weight variation, friability, hardness, disintegration and dissolution. The results obtained for all the selected brands of acyclovir were in acceptable range and, it can be stated that all brands of acyclovir tablets met the specification in quality tests.

Use Pattern of Personal Care Products: A Cross-Sectional National Survey

Zahra Karimi Majd, Mohammad Peikanpour, Seyed Mostafa Ghasemi, Sajjad Esmaeili, Hamidreza Rasekh, Rasoul Sadeghi, Mehdi Moeini, Alireza Salmanzadeh Aghdam

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e12: 1-14
https://doi.org/10.22037/ipa.v5i1.36310

Personal care products are amongst the most consistently used goods in every population. To evaluate the market trends of these products in Iran, this study considers their use frequency, use prevalence, cross-sectional perceptions of retail brand loyalty, purchase location preferences, and sources, be them domestic or foreign.

Usage patterns of 125 types of personal care products  were collected in over 2021 households in 8 cities of Iran by means of a checklist fill out. The strength of the study were the separation of data by socio-demographic factors such as gender, education level, economic status, occupational status, and level of religiosity.

Daily shampoo, bath soap, toothpaste, and face and hand moisturizer were the most frequent products used while the use of face and eye care products was less prevalent. The most repeatedly use-pattern was once-daily for sunscreens, moisturizers, lightnings, deodorants, toothpastes, mouth-washes, eye-care, anti-acne, and anti-chap products. Men and women with a higher economic status were more likely to use eye moisturizer, intense anti-acne-peeling, nourishing antiaging, cream soap, and body lotion/oil. Moreover, in all products studied, respondents prefer domestic over foreign ones except in deodorants and anti-perspirants. In addition, 42% and 29.8% of respondents prefer to purchase their personal care products from pharmacies and beauty shops, respectively.

Given the immense popularity of such products, their impact on community health an  consumers’ preferences, results of this study can have far-reaching implications for manufacturing companies and health authorities in terms of developing strategies and regulations to optimize the use pattern of these products.

Evaluation and improvement of venous thromboembolism prophylaxis pattern in patients admitted to orthopedic ward in a tertiary teaching hospital

Maria Tavakoli-Ardakani, Farinaz Jafarinejad, Amin Rakhshan, Bardia Rahmati-Kamel, Reza Zandi

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e13: 1-6
https://doi.org/10.22037/ipa.v5i1.38782

Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE incidence in major orthopedic surgery ranges from 40% to 60%. Several risk factors are responsible for VTE incidences, such as age, obesity and immobility. This study was designed and performed to evaluate the process of thromboprophylaxis in patients undergoing orthopedic surgery with and without pharmacist intervention to improve prescribing. A total of 306 patients were randomly enrolled in the two phases of this study. To investigate the cause of VTE, 201 patients receiving no pharmacist interference as study phase one and 105 patients receiving pharmacist interference as study phase two were evaluated. Rate of occurrence of risk was calculated using the Caprine scoring system. The trend of prescription and the reasons for not prescribing the drugs under consideration for the patients, were investigated. As a subsidiary aim to the study and to increase economical productivity, the prescription of heparin instead of other anticoagulating drugs was suggested in pharmacotherapy consultation. In the first phase of the research, it was proven that 161 (80.1%) of the patients under consideration needed the prophylaxis but 40 (19.9%) of them did not. After the investigation, 171 (85.1%) of the patients according to the guideline and 30 (14.9%) without considering the guideline underwent prophylaxis. In the second phase of the research, 40 (38.1%) of the patients did not require prophylaxis treatment but 65 (61.9%) did. After investigation and drug interaction results, 96 (91.43%) according to the guideline and 9 without considering the guideline were treated with the prophylaxis drug. Despite the active presence and cooperation of pharmacists, 4.76% who did not need prophylaxis received it, and 6.15% who needed prophylaxis did not receive it despite the pharmacist's intervention. Moreover, 2.86% of patients who were prohibited from taking enoxaparin were allowed to take heparin after pharmacist intervention. This research showed that active cooperation between orthopedist and pharmacist in prescribing the required drug(s) is very low. For this reason, the continuous presence of a pharmaceutical group as well as changes in protocols can serve as an effective, logical step in the prescription of drugs.

Review article


The gut-brain axis affecting TLR4 in Parkinson’s diseases

Fatemeh Hemmati, Abolhassan Ahmadiani, Farshad Hosseini Shirazi

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e2:1-8
https://doi.org/10.22037/ipa.v5i1.38226

Parkinson’s disease (PD) is a chronic neurodegenerative illness, which is increasing in developing countries and creating a burden on these economies. Multiple motor and non-motor symptoms have been connected to PD, and patients are diagnosed using clinical observations. Unfortunately, clinical symptoms are found in the late stages of the disease, when preventing is no longer an option. The gastrointestinal system, and more specifically the gut microbiota have an important role in the bidirectional communication taking place between the gut and brain. As a result, the gut microbiota dysbiosis and its effect on the brain-gut axis are among important factors to be considered in PD pathology. In addition, the role of Toll-like receptors (TLRs) in recognizing pathogenic molecules and creating immune responses can affect PD pathogenesis. In this review, we have tried to better understand the effect of TLR4 on the gut microbiota and their dysbiosis, creating a bidirectional feedback loop. Even though the effect of blocking TLR4 signaling on PD is still not well known, it affects PD, and brings hope of using microbial based medications to control this chronic neurodegenerative disease.

Piper nigrum is one of the most familiar spices due to its’ pharmacological and physiological properties. Piperine is a main active alkaloid of Piper nigrum with a broad spectrum of biological activities including anti-aging, anti-inflammatory, anti-cancer, anti-depressant, and cognition enhancer, thus it is effective in correlated diseases. Principally, the useful effects of piperine in neurological conditions have been confirmed in in-vitro and in-vivo studies. Beta-caryophyllene a major constituent of its essential oils well known for neuroprotective and specially nootropic effects. Some clinical trials have reported that Piper nigrum possesses preventive and therapeutic effects in memory loss related disorders.

The current systematic review aimed to consider the effects of Piper nigrum on cognition and memory performance as well as Alzheimer’s disease. Electronic databases including Scopus, PubMed, Web of Science, ProQuest, and Embase were searched with the keywords “piper nigrum” OR piperine OR “black pepper” OR β-caryophyllene OR beta-caryophyllene AND “Alzheimer’s disease” OR dementia OR amnesia OR memory OR cognitive OR cognition OR nootropic until 18 January 2020. Only in-vivo and clinical studies with sufficient data were included in this review.

The results of this systematic review showed that Piper nigrum may have significant effects on memory and cognitive performance assessed by related tests though more randomized clinical trials are needed to validate its’ indication in cognitive impairments.

Brief Communication and Method report


Use of Zeolive (Composition with Zeolites Base) as an Adjunct in the Treatment of Acetaminophen Overdose

Shahin shadnia, Afshin Zarghi, Dariush Taghiloo, Mitra Rahimi, Peyman Erfan Talab Evini, Maral Ramezani, Babak mostafazadeh, Sayed Masoud Hosseini

International Pharmacy Acta, Vol. 5 No. 1 (2022), 19 June 2022, Page e10:1-3
https://doi.org/10.22037/ipa.v5i1.39008

One of the most important of zeolite's applications is the detoxification of toxic substances. This study was planned to evaluate the effect of Zeolive on acetaminophen toxicity. This was a single-blind clinical trial study. The participating population was patients with acetaminophen poisoning in Loghman Hakim Hospital from December 2021 to March 2022. Patients were randomly divided into two groups of 30 patients. The control group was given routine treatments and the intervention group was given 1000 mg of Zeolive per day for 2 weeks in addition to routine treatments. Levels of AST, ALT, ALP and PT were measured before and after the intervention. Data were analyzed by SPSS software.

The mean age was 28.3 ±7.6 in the intervention group and 25.9 ±6.8 years in the control group. The observed decrease in PT and activities of AST, ALT, and ALP after the intervention was not statistically significant with the control group. Statistical analysis of the difference values before and after the intervention for liver enzymes and PT showed no significant difference between the two groups

Zeolive, as an absorbent powder, may not affect the amount of enzymes and blood factors. Further studies and consideration of other factors are recommended.