5-Fluorouracil Potentiates the Anti-Cancer Effect of Oxaliplatin on Colo320 Colorectal Adenocarcinoma Cells.

5-Fluorouracil potentiates the anti-cancer effect of oxaliplatin on Colo320 colorectal adenocarcinoma cells.

J Gastrointestin Liver Dis. 2013 Mar; 22(1): 37-43
Berindan-Neagoe I, Braicu C, Pileczki V, Cojocneanu Petric R, Miron N, Balacescu O, Iancu D, Ciuleanu T

BACKGROUND & AIMS. The present study was designed to examine the combined effects of Oxaliplatin (OXA) and 5-Fluorouracil (5-FU) in the Colo320 cell line. METHODS. The antiproliferative effects were evaluated using the MTT assay, apoptosis by flow cytometry, and RT-PCR-array technology was used to determine the major effects of the two chemotherapeutic drugs upon the most important genes involved in apoptosis. RESULTS. The antiproliferative effects of the therapeutic agents, as individual therapy or combined, proved to be dose and time-dependent, with increased efficiency for the combined treatment. Flow cytometry data revealed increased apoptotic processes in the case of the combined treatment at 24 hours after administration. The RT-PCR-array data indicated that at 24 hours after OXA treatment, 49 genes were differentially expressed, of which 45 were up-regulated and 4 down-regulated. In the case of the 5-FU treatment, 35 genes were down regulated and 2 up regulated. In the combined treatment of 5-FU and OXA, 19 genes were up-regulated and 15 down-regulated. CONCLUSIONS. This study proved that drug resistance could be counteracted by combining OXA with 5-FU to form a tandem that is capable of reducing cell proliferation and to stimulate extrinsic apoptosis pathway by targeting death receptors on the cell surface. HubMed – drug

Endoscopic procedures in patients under clopidogrel/dual antiplatelet therapy: to do or not to do?

J Gastrointestin Liver Dis. 2013 Mar; 22(1): 33-6
Abdel Samie A, Theilmann L

Dual antiplatelet therapy has to be used for at least one month after placement of bare metal coronary stents and for a minimum of one year after placement of drug eluting stents. Because of the higher risk of bleeding, guidelines recommend cessation of clopidogrel seven days prior to high-risk endoscopic procedures and to delay elective surgery/endoscopy until dual antiplatelet therapy is ended. Premature cessation of clopidogrel however, may lead to catastrophic cardiovascular sequelae.We searched the MEDLINE database, EMBASE, and the Cochrane Library for English-language literature up to October 2012 to identify clinical trials on the bleeding risk of gastrointestinal endoscopic procedures in patients on uninterrupted clopidogrel/dual antiplatelet therapy.Six studies (high-risk endoscopic procedures: 5, low-risk endoscopic procedures: 1) on this issue were identified through the literature search. A total of 1,245 endoscopic procedures were performed under clopidogrel. Thirteen bleeding complications occurred (1%). None of the patients required angiographic or surgical intervention and there were no long-term sequelae.To date, data published on this issue are scarce and of poor quality. Nevertheless, there is no evidence to support the recommendations of the current guidelines to stop clopidogrel for at least one week prior to high-risk endoscopic procedures. In this setting, the clinical decision making should take place on an individual basis. HubMed – drug

Problem based review: The patient taking methadone.

Acute Med. 2013; 12(1): 51-4
Arora A, Williams K

Methadone Maintenance Treatment (MMT) is an effective therapy for opioid-dependence; its use is based on a harm reduction philosophy and represents one of a range of treatment approaches for opioid-dependent individuals. The medical literature supports MMT as a well established and cost-effective treatment for opioid-dependence that allows a return-to-normal physiological, psychological and societal functioning. The effectiveness of MMT is enhanced by psycho-social interventions such as contingency management and addressing other co-existing health and social needs. MMT saves lives and reduces violent and non-violent crime, drug use and the transmission of HIV, hepatitis C and other communicable diseases. For some people, MMT may continue for life, while others may eventually be able to discontinue and remain abstinent. Methadone interacts with numerous drugs and prolongs the corrected QT interval (QTc) with risk of sudden cardiac death. It has a prolonged half-life and premature discharge of patients after methadone overdose may be fatal. Each patient must be assessed, treated and monitored on an individual basis. Successful outcomes through MMT require knowledge, experience, vigilance, and diligence on the part of the physician, the patient and all of those involved in treatment. HubMed – drug