Medication compliance behavior in psychiatric out-patients with psychoactive substance use comorbidity in a Nigerian tertiary hospital.

BACKGROUND: Psychotropic medication adherence is a major challenge in psychiatric patients with comorbidity. OBJECTIVE: The objective was to determine medication adherence behavior among psychiatric out-patients with psychoactive substance use comorbidity in a Nigerian Tertiary Hospital. SETTINGS AND DESIGN: A cross-sectional study of a tertiary hospital in Northern Nigeria. METHODS: Adult patients who have been attending the out-patient clinic for at least 1 year were included. From the routine clinic, each consecutive fourth patient completed a socio-demographic and drug use questionnaire, a self-administered medication adherence scale, and a semi-structured proforma which sought reasons for poor adherence, information on supervision and who keeps patient medications at home; until a calculated sample of 208 was attained. STATISTICAL ANALYSIS: Done by means of descriptive statistics using the Statistical Package for Social Sciences version 16. The level of significance was set at P < 0.05. RESULTS: Totally, 208 patients participated in the study. 61 (29.3%) of them were substance users, out of which 59% never reported missing their medications. No statistically significant relationship was found between substance use and medication adherence. A significant proportion of substance users were compliant with medication use when the drugs were in their possession. For substance users and nonusers, the major reason for poor drug adherence was the unavailability of the medications, while nonsubstance users were more likely to complain about being tired of the medications. No report of side effects in supervised patients. CONCLUSION: The use of psychoactive substances in patients with other mental disorders influences their medication adherence behavior.

Bioassay-guided fractionation and in vivo antiplasmodial effect of fractions of chloroform extract of Artemisia maciverae Linn.

In the search for new plant-derived anti-malarial compounds, chromatographic fractions of chloroform extract of whole plants of Artemisia maciverae were tested in vivo using chloroquine resistant and chloroquine sensitive Plasmodium berghei NK 65 infected Swiss albino mice. One fraction and a sub-fraction of this were most active at 10/mg and cleared parasitemia in mice within 3 days. The different fractions and sub-fractions were tested with different reagents to determine the broad classes of compounds present. The active fraction tested positive for triterpenes and alkaloids, and the sub-fraction for only triterpenes. These tests suggest that the anti-malarial activities observed with these fractions may be due to these classes of compounds in the chloroform extract of the A. maciverae. Further chemical work is however required to characterize the active constituents.

Pharmacological studies on siculine syrup. II: effects on smooth, skeletal and cardiovascular muscle preparations.

Earlier pharmacological screening showed that siculine syrup (a traditional herbal remedy purported to be useful in the prevention and treatment of sickle cell pain - crises, due to sickle cell anaemia - SCA) had antisickling and analgesic activities as well as antimicrobial and diuretic effects. SCA is an important haemoglobinopathy in Africa and many other communities/countries worldwide, with relatively high morbidity and mortality. The present study was to determine the effects of the extract on various isolated muscle preparations - smooth, skeletal and cardiovascular. Siculine (4-20 microg/mL), like acetylcholine (40-400 microg/mL), contracted the isolated rat uterus concentration dependently. Similar effects were observed with the guinea-pig ileum and rabbit jejunum (2-20 microg/mL). In contrast to these effects, the direct (muscle) and indirect (nerve) stimulations of rat phrenic nerve-diaphragm were relaxed by siculine (4 and 8 microg/mL) and d-tubocurarine (0.8 microg/mL). Siculine also concentration-dependently decreased both the rate and force of contraction of guinea-pig atria and rabbit heart and also resulted in a fall in cat blood pressure in a manner similar to those of acetylcholine. The possible therapeutic and/or toxicological consequences of these effects including the hypotensive activity is noteworthy since siculine syrup is used by the local population for the prevention and treatment of sickle cell pain crises.

Antinociceptive profile of the methanolic extract of Neorautanenia mitis root in rats and mice.

The antinociceptive activity of the methanolic extract of Neorautenania mitis was studied in mice and rats. Five experimental models of nociception employed were: acetic acid-induced abdominal constriction and hot-plate test in mice, formalin-induced pain, analgesy-meter and Randall-Selitto tests in rats. The antinociceptive action of the extract was tested against naloxone in the hot-plate test in a bid to further elucidate probable mechanisms of antinociception. Results showed that the extract at doses of 5, 10 and 20 mg/kg body weight caused significant (P<0.05) dose-dependent antinociceptive activity in all the nociceptive models. Naloxone (2 mg/kg), significantly (P<0.05) antagonised the antinociceptive activity at the highest dose of the extract (20 mg). The study showed that the methanolic extract of Neorautanenia mitis possesses both peripherally and centrally mediated antinociceptive activity. The peripherally mediated action may be linked partly to lipoxygenases and/or cyclo-oxygenases, while the central anti-nociception is likely to be mediated via opioid receptors in the CNS.

Antinociceptive and smooth muscle contracting activities of the methanolic extract of Cassia tora leaf.

The leaves of Cassia tora Linn. (Family: Caesalpiniaceae) were soxhlet extracted with methanol. The spasmogenic effects of the extract were evaluated on guinea pig ileum, rabbit jejunum and mice intestinal transit. Antinociceptive activity of the extract was also evaluated in the mice. The LD(50) values of the extract in mice were >2000 mg/kg i.p. and p.o. The extract contracted smooth muscles of guinea pig ileum and rabbit jejunum in a concentration-dependent manner. Atropine reversibly blocked this activity. Mepyramine also reduced the contractile amplitude due to the extract in a concentration-dependent manner. The extract increased intestinal transit in mice dose dependently. C. tora extract significantly (P<0.05) reduced the number of acetic acid induced abdominal constrictions in mice and the effect was comparable to that of aspirin (150 mg/kg i.p.). The extract also significantly (P<0.05) reduced the nociceptive response of mice to increased force (g). The effects were dose-dependent. The studies suggest that the use of C. tora, traditionally, as a purgative and in the treatment of other ailments is justifiable.

Effects of acute bovine trypanosomosis (Trypanosoma vivax) on plasma kinetics of intravenously administered lactose.

Four calves infected with Trypanosoma vivax and four uninfected control calves were each injected intravenously with repeated doses of 0.5 g lactose kg-1 body weight, thrice daily at intervals of 4 h. Plasma samples were collected at specified time intervals and analysed for lactose. Pharmacokinetic parameters were calculated from the data. T. vivax infection delayed excretion of lactose from the body, thus leading to significantly (P < 0.001) increased biological half life (t1/2) and a significantly (P < 0.001) reduced elimination rate constant for lactose in the body. The apparent volume of distribution and total clearance of lactose were not affected by the infection. T. vivax infection also appeared to cause accumulation of lactose in the plasma after repeated intravenous administration.

Screening of "Kargasok tea". IV: Studies of pathological effects in BALB/C mice and Wistar rats.

Forty-eight BALB/C mice (30 males, 18 females) and 18 male Wistar rats were given Kargasok tea in their drinking water. Zero, 15, 25, 50, 75 or 100% concentrations were administered to mice for 2 or 8 w while the rats were given 0, 15 or 50% concentrations of the beverage for 12 w. Neither the mice nor rat's organ/body weight ratios were significantly affected by treatment. Rats receiving 15 or 50% concentrations of the tea had nephropathy and non-suppurative necrosis of the duodenum, pancreas and intestine. No significant microscopic lesions were found in any treated mice even when given 100% concentration of the tea. These findings suggest species variation in susceptibility to toxicity from the tea. The tea may be a cause of renal failure, diabetes mellitus and malabsorption syndrome and may not be safe for human or animal consumption.

Effects of cimetidine on drug metabolism in rat pups.

The effects of cimetidine on drug metabolism were studied in male and female rat pups and compared to similar effects in adult rats. As in adult rats, cimetidine 50 mg/kg/day i.p. for 7 days in the 2nd, 3rd, 4th or 5th weeks of life resulted in prolonged pentobarbitone sleeping times (diminished pentobarbitone hydroxylase activities), particularly when administered during the 3rd week. These effects of cimetidine were reversible since they continued only up to 2 weeks in males and 4 weeks in females, but by the 6th week were no longer observed. Pretreatment with cimetidine 15, 25 and 50 mg/kg/day i.p. for 7 days, resulted in a dose-dependent inhibition of aminopyrine N-demethylase and aniline hydroxylase as well as a prolongation of pentobarbitone sleeping time in both pups and adults, aniline hydroxylase being the least affected. In general, female pups were more adversely affected than male pups and adults. The therapeutic and toxicological relevance of these results in man are discussed.

Dose-related and other effects of maternal cimetidine pretreatment during lactation on drug metabolism in mouse dams and pups.

The effects of maternal cimetidine pretreatment at different dose levels during lactation, on drug metabolism, were investigated in mouse dams and recently weaned pups. Aminopyrine N-demethylase, aniline hydroxylase and pentobarbitone metabolism were inhibited in both dams and pups in a dose-dependent manner (15, 25 and 50 mg/kg/day, i.p.). Pretreatment at a dose level of 50 mg/kg/day resulted in comparable levels of inhibition of drug metabolism in dams and female pups while male pups were less affected. Of the three indices studied, aniline hydroxylase was the least influenced by cimetidine pretreatment. Thus, the effects of maternal cimetidine pretreatment on drug metabolism in the nursing pair varied with the dose, sex and substrate. The possible implications of these results for man are discussed.

Effect of dietary vitamin E (alpha-tocopherol) on aflatoxin B metabolism.

Intraperitoneal injection of rats with 2 mg/kg ring labelled 14C AFB1 (spec. act. 110 mCi/mM/nmole) showed a higher level of radioactivity in the urine of test animals on diets containing 600 mg/kg vit. E 24 h after pretreatment. Analysis of the urine by chloroform extraction, thin layer chromatography and liquid scintillation counting of the various fractions showed less aflatoxin M1 (AFM1) and less unmetabolized AFB1 in test samples than in controls. Incubation of ring labelled 14C AFB1 with hepatic 10,000 g supernatant fractions, however, showed increased metabolism of AFB1 by fractions from test animals as compared with the controls. Rate of disappearance of 14C AFB1 and the consequent formation of AFM1 was greater in the test fractions than in the controls. At 30 days all test animals showed higher levels of serum vitamin E than the controls. Hepatic aniline hydroxylase and ethyl morphine N-demethylase activities of the liver fractions and blood glutathione reductase activity were greater in the tests. P-nitroanisole-O-demethylase activity was reduced while hepatic and serum reduced glutathione levels remained basically unaltered.