Special Issue "Relationship between Drug Management and Women's Health"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: 31 August 2021.

Special Issue Editor

Prof. Dr. Sanika S. Chirwa
E-Mail Website
Guest Editor
Neuroscience & Pharmacology, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
Interests: dopaminergic system; brain and behavior; electrophysiology; epilepsy; hippocampus; long-term potentiation; memory consolidation; pharmacogenetics of efavirenz; sleep and alzheimer’s disease; sleep and pregnancy

Special Issue Information

Dear Colleagues,

There are major differences in disease prevalence, as well as variations in drug efficacy and adverse effect profiles, between men and women. Pharmacological responses clearly depend on multiple factors, including reproductive status (e.g., male vs female; prepubertal/pubertal/post-reproductive). Currently much less is known about women’s responses to medicines. Consequently, a concerted research effort is needed to address this dearth of knowledge. The cyclic nature of fluctuations in hormonal and neuronal function, and the unique events of female reproductive life (i.e., menstruation, pregnancy, lactation, and menopause) have contributed to the virtual exclusion of women from clinical trials, and of female animals from preclinical studies. Research funding bodies are now calling for the systemic integration of biological sex analyses. Sex-based differences in pharmacokinetics, pharmacodynamics and pharmacogenetics are being continuously discovered. For example, sex-related differences have been reported for gastric acidity, intestinal motility, and liver enzymes (primarily cytochrome P450s), and renal excretion, all of which may alter plasma drug levels. Further, findings consistently demonstrate that women exhibit frequent and more severe adverse effects than do men. Some of these differences are likely hormone-related. It is time, in fact overdue, to consolidate these diverse findings. This Special Issue calls for manuscripts addressing the differential effects of medicines in women—in relation to health, disease prevention, diagnosis, evaluation and treatment. We welcome original research papers using different study designs, as well as systematic reviews and meta-analyses.

Prof. Sanika S. Chirwa
Guest Editor

Manuscript Submission Information

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Keywords

  • Drug Adverse Effects
  • Pharmacodynamics
  • Pharmacogenetics
  • Pharmacokinetics
  • Reproductive Life
  • Sex-Based Differences
  • Women’s Health

Published Papers (4 papers)

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Research

Article
Self-Medication and Safety Profile of Medicines Used among Pregnant Women in a Tertiary Teaching Hospital in Jimma, Ethiopia: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2020, 17(11), 3993; https://doi.org/10.3390/ijerph17113993 - 04 Jun 2020
Cited by 4 | Viewed by 1084
Abstract
Background: Despite the potential foetal and maternal risks of self-medication, studies on self-medication and safety profile of medicines used during pregnancy are scarce. This study determined the prevalence, predictors and safety profile of medicines used for self-medication during pregnancy at Jimma University Medical [...] Read more.
Background: Despite the potential foetal and maternal risks of self-medication, studies on self-medication and safety profile of medicines used during pregnancy are scarce. This study determined the prevalence, predictors and safety profile of medicines used for self-medication during pregnancy at Jimma University Medical Centre (JUMC) in Ethiopia. Methods: A hospital-based cross sectional study was conducted on 1117 hospitalized pregnant women or postpartum women in the maternity and gynaecology wards at JUMC between February and June 2017. Data were collected using an interviewer-administered structured questionnaire and by reviewing patient medical records. Data were analysed using descriptive statistics and logistic regression. Result: Nearly 3 out of 10 women reported taking at least one type of conventional medicine for self-medication, mainly analgesics 92.3%. Almost 75.0% of the self-medicated women used medicines classified as probably safe and 13.6% as potentially risky to use during pregnancy. Medicinal plant use, religion and access to a health facility near their residency were significantly associated with self-medication during pregnancy. Conclusions: Self-medication is common among pregnant women at JUMC. Most women used medicines classified as safe to use during pregnancy. There is need for enlightenment of pregnant women on the potential dangers of self-medication during pregnancy to prevent foetal and maternal risks. Full article
(This article belongs to the Special Issue Relationship between Drug Management and Women's Health)
Article
Predictive Factors of Response to Selective Progesterone Receptor Modulator (Ulipristal Acetate) in the Pharmacological Treatment of Uterine Fibroids
Int. J. Environ. Res. Public Health 2020, 17(3), 798; https://doi.org/10.3390/ijerph17030798 - 28 Jan 2020
Cited by 1 | Viewed by 791
Abstract
Background: Selective progesterone receptor modulator ulipristal acetate (UPA) is a drug used in management of symptomatic myomas. It was observed that the response to UPA treatment in uterine myomas varied amongst patients. An attempt was thus made at establishing predictive factors conducive [...] Read more.
Background: Selective progesterone receptor modulator ulipristal acetate (UPA) is a drug used in management of symptomatic myomas. It was observed that the response to UPA treatment in uterine myomas varied amongst patients. An attempt was thus made at establishing predictive factors conducive to better reaction to treatment with UPA. The aim of this study was to assess the efficacy of UPA treatment in women with myomas, depending on pretreatment myomas’ volume, number of myomas, age of patients, estrogenic status of women, and pretreatment blood flow in uterine arteries. Materials and methods: The study included patients with one to four myomas. The UPA treatment was a preparation stage for surgical treatment in all patients. The study group was divided into the subgroups according to pretreatment myomas’ volume, number of myomas, age of patients, estrogenic status of women, and pretreatment blood flow in uterine arteries. Results: A better effect of reduction in size of myomas after UPA treatment was noted when pretreatment myomas’ volume was lower than 30 cm3. A significant reduction in fibroids’ size was observed after UPA therapy independently of the number of myomas and age of patients. A good response after the UPA therapy was observed when pretreatment estradiol concentration was below 50 pg/mL and when uterine artery resistance index (RI) was above 0.8. Conclusions: Our research demonstrates that treatment with ulipristal acetate is an efficient method in preoperative preparation of patients with uterine fibroids. The most important factor of positive response to UPA therapy is myoma volume. The number of myomas and patient’s age do not interfere with effects of UPA therapy. Pretreatment estradiol concentration is significant, yet secondary for the effects of therapy. The UPA therapy has no impact on blood flow in the uterine arteries and no adverse influence on estradiol concentrations. Full article
(This article belongs to the Special Issue Relationship between Drug Management and Women's Health)
Article
Long-Term Effectiveness of Liraglutide for Weight Management and Glycemic Control in Type 2 Diabetes
Int. J. Environ. Res. Public Health 2020, 17(1), 207; https://doi.org/10.3390/ijerph17010207 - 27 Dec 2019
Cited by 9 | Viewed by 1471
Abstract
Background: Liraglutide is the first glucagon-like peptide-1 receptor agonist (GLP-1 RA) based on the human GLP-1 sequence, with potential weight loss benefits, approved for the treatment of type 2 diabetes (T2D) mellitus. Herein, we aimed to assess the 5-year effectiveness of Liraglutide [...] Read more.
Background: Liraglutide is the first glucagon-like peptide-1 receptor agonist (GLP-1 RA) based on the human GLP-1 sequence, with potential weight loss benefits, approved for the treatment of type 2 diabetes (T2D) mellitus. Herein, we aimed to assess the 5-year effectiveness of Liraglutide in the management of weight and glycometabolic control in a Southern Italian cohort of overweight/obese T2D patients, who were naïve to GLP-1 RAs. Patients and Methods: Forty overweight or obese patients treated with Liraglutide at doses up to 1.8 mg/day, in combination with one or more oral antidiabetic agents, were retrospectively assessed at baseline, during, and after 60 months of continuous therapy. Results: After 5 years of Liraglutide treatment, body weight decreased from 92.1 ± 20.5 kg to 87.3 ± 20.0 Kg (p < 0.001), with a mean reduction of 5.0 ± 7.0 Kg and a body mass index (BMI) decrement of −2.0 ± 3.1 Kg/m2. On Spearman’s univariate analysis, change in body weight was correlated with female gender and baseline BMI. Hemoglobin A1c (HbA1c) decreased from 7.9 ± 0.9% at baseline to 7.0 ± 0.7% at the end of the study period (p < 0.001), followed by a significant reduction in fasting plasma glucose. No significant differences emerged in other biochemical parameters, despite a trend toward improvement in lipid profile. Notwithstanding encouraging effects on several markers of cardiovascular disease (CVD), increments in the 5- and 10-year risk for the first atherosclerotic cardiovascular event were documented, as four incident cases of myocardial infarction. Conclusions: Prolonging treatment with Liraglutide can lead to durable benefits in relation to weight and glycemic control, with a greater impact on women. These results extend and corroborate previous observations, suggesting that gender per se may modulate the response to Liraglutide. Despite favorable effects on some established CVD risks factors, the long-term role of Liraglutide in primary prevention of CVD in patients with T2D remains controversial. Full article
(This article belongs to the Special Issue Relationship between Drug Management and Women's Health)
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Article
The Changing Process of Women’s Smoking Status Triggered by Pregnancy
Int. J. Environ. Res. Public Health 2019, 16(22), 4424; https://doi.org/10.3390/ijerph16224424 - 12 Nov 2019
Viewed by 707
Abstract
Although pregnancy is the trigger for many women to stop smoking, often they are unable to maintain cessation, undoing any health benefits for themselves and their children. Smoking is a complex phenomenon both before and after pregnancy, influenced by social background, relationships, and [...] Read more.
Although pregnancy is the trigger for many women to stop smoking, often they are unable to maintain cessation, undoing any health benefits for themselves and their children. Smoking is a complex phenomenon both before and after pregnancy, influenced by social background, relationships, and the specific experience of pregnancy and delivery. Therefore, it is necessary to clarify the experience and process of changes in women’s smoking status from pregnancy to after delivery. To explore possibilities for better smoking cessation support, the objective of this study was to clarify the changing process of smoking status from pregnancy to after delivery in women for whom pregnancy triggered a smoking cessation. We analyzed data obtained through semi-structured interviews with 31 women, using the grounded theory approach. Women reconsidered their smoking status, either quitting or smoking fewer cigarettes, because of externally motivated changes due to concerns regarding the influence of smoking on pregnancy and children. To prevent smoking relapse, it is important for the women themselves, as well as those around them, to appreciate their cessation, facilitating internal motivation and assessment of the situation. Furthermore, it is important to provide support, by implementing the process revealed in this study, not only during pregnancy but for an entire lifetime. Full article
(This article belongs to the Special Issue Relationship between Drug Management and Women's Health)
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