Search Results (233)

Background: Primary care overload, limited access to physicians, and rising antimicrobial resistance highlight the role of pharmacists in managing minor ailments such as sore throats. We evaluated pharmacy-based counseling in Poland supported by point-of-care testing and symptomatic therapy. Methods: Multicenter, prospective observational study across 23 community pharmacies. Adults (≥18 years) with sore throat underwent group A streptococcus (GAS) rapid antigen testing. Patients with a positive test result were referred to physicians, while others received pharmacist counseling and ketoprofen throat spray. Standardized questionnaires captured symptom severity, perceived effectiveness, onset/duration, convenience, adherence, and patient-reported outcomes. Results: 142 patients were included. Among ketoprofen users, 98.4% reported improvement, and 75% rated relief ≥8/10. Compared with prior remedies, 88.3% judged ketoprofen more effective, and 86.7% reported faster onset. The spray was convenient for 91.4% of participants; no overdosing occurred. Qualitative feedback emphasized rapid relief, easier swallowing/speaking, and return to daily activities without physician consultation. Conclusions: Polish community pharmacy practice, an integrated sore throat pathway combining point-of-care RADT with structured pharmacist counseling and symptomatic treatment, was feasible, acceptable, and without notable safety concerns. As a pilot, these practice-based findings warrant larger comparative and economic studies to confirm clinical effects and assess potential impact on antibiotic use. Full article

A major objective in recent years has been the use of membrane sensors for the purpose of monitoring and recognizing environmental pollutants in pharmaceuticals. Ketoprofen (KTP) is likely to be found in the environment, particularly in surface water bodies like rivers, because of its extensive use in medicine. The photodegradability of KTP and the prolonged exposure of river water to sunlight may facilitate its photodegradation. To measure KTP along with its main photo-degradation products, three membrane electrodes were fabricated using different plasticizers. Dioctyl phthalate (DOP), dibutyl sebacate (DBS), and o-nitrophenyloctyl ether (o-NPOE) membrane electrodes were constructed for the selective analysis of the investigated medication. The fabricated sensors were prepared using tetraoctyl ammonium chloride as an ion-pairing agent. A linear range of 1 × 10⁻⁵ M to 1 × 10⁻¹ M was shown by the electrodes. The slopes (in mV/decade) for the DOP, DBS, and o-NPOE membranes were −58.80 ± 0.90, −57.90 ± 0.80, and −56.80 ± 1.10, respectively. All test parameters were refined to enhance electrochemical performance. The synthesized membranes were successfully utilized to accurately measure KTP amidst its primary photodegradants. The fabricated sensors were effectively utilized to measure KTP in river water samples without requiring pre-treatment processes. Full article

Background/Objectives: Mental health awareness is rising; thus, neurological and psychiatric side effects also benefit from increased attention from the medical and scientific community. Ibuprofen is a well-known non-steroidal anti-inflammatory drug (NSAID) that is often available over-the counter (OTC) for both adults and children, expressing good efficacy in reducing pain and fever through non-selective cyclooxygenase inhibition. As ibuprofen has already been associated with different neuropsychiatric disorders, the aim of this study was to perform an up-to-date analysis of such signals detected in the cases reported in EudraVigilance (EV). Methods: The disproportionality analysis offered a contextual insight into the real-world situation depicted in the analyzed database. Results: From the total cases reported for ibuprofen (n = 58,911), 13.9% contained nervous system disorders (n = 8214) and 10.7% entailed psychiatric disorders (n = 6295). The cases were distributed between all age groups, with a sensible higher incidence in teenagers and in women in general. Severe cases, including deaths, have been reported. By comparison with ketoprofen, acetylsalicylic acid, and diclofenac, ibuprofen presented a higher probability of reporting psychiatric and behavioral symptoms. Regarding cognitive and attention disorders and disturbances, no disproportionate signal was observed between ibuprofen and all other NSAIDs. Sleep disturbances (hypersomnia, narcolepsy and sleep paralysis) are reported as more probable for ibuprofen than for acetylsalicylic acid, naproxen, and diclofenac. A higher risk of reporting suicidal and self-injurious behaviors was noted for ibuprofen versus all other selected NSAIDs. A limitation of the study can be noted as due to suspected causality, not an established one, and EV reports cannot accurately determine adverse drug reaction frequencies. Conclusions: Considering that ibuprofen is easily accessible as an OTC drug and the higher probability of reporting several neuropsychiatric adverse effects as shown by this study, patient counseling, when possible, and general education for the public are valuable tools in managing these adverse reactions. Full article

Paracetamol and nonsteroidal anti-inflammatory drugs are the most popular first-line analgesics, being freely available without any medical prescription. For this reason, it is difficult to estimate their actual consumption among the population. One tool for surveillance of pharmaceutical use is wastewater-based epidemiology, a useful approach for monitoring public health by analyzing specific biomarkers in wastewater. Background/Objectives: In this study, the consumption of paracetamol and four nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen, ketoprofen, and diclofenac) was evaluated by analyzing their residues as specific biomarkers in wastewater and the fraction excreted as drug metabolites in urine. Methods: For this purpose, composite wastewater samples were collected from the influent of the wastewater treatment plant in Cluj-Napoca, Romania, in four sampling campaigns (September 2021, February 2022, February 2024, and October 2024), and the target biomarkers were analyzed by liquid chromatography–tandem mass spectrometry. Results: The results of consumption expressed in g/day/1000 inhabitants showed variations for the five studied pharmaceuticals in the following ranges: 6.65–185.57 for paracetamol, 0.32–2.44 for ibuprofen, 0.29–0.82 for naproxen, 0.21–2.65 for ketoprofen, and 0.23–1.11 for diclofenac, depending on the sampling period. This variation can be explained either by the different behaviors regarding the consumption of the pharmaceutical products studied by the population during the sampling periods or by an inappropriate estimate of the number of inhabitants connected to the sewage system. Conclusions: Future studies need to establish a more comprehensive model that considers many other variables that may influence the results obtained through WBE. Full article

Background: Pharmaceutical compounds frequently co-occur in environmental waters, but studies on their combined effects on animals and humans remain limited. The present study investigated the individual and combined short-term effects of ketoprofen (Kp, a nonsteroidal anti-inflammatory drug inhibiting cyclooxygenase-2), valproic acid (VPA, an anticonvulsant acting as a voltage-gated sodium channel modulator), and meropenem (Mp, a β-lactam antibiotic) at environmentally relevant concentrations on zebrafish behavior, acetylcholinesterase (AChE) activity, and oxidative status. Methods: Adult zebrafish were exposed for 4 days to Kp, VPA, Mp, and their binary and ternary mixtures. Behavioral effects were assessed using 3D novel tank and social behavior tests, while the oxidative stress response was assessed through malondialdehyde (MDA) content, superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities. Results: Zebrafish exposed to Mp showed a notable increase in immobility, whereas those exposed to VPA and Mp + Kp exhibited a significant augmentation of average velocity and counter-clockwise rotations. All treated groups exhibited a notable increase in the time spent near the walls (thigmotaxis), and except for the control and Mp-exposed zebrafish, the other groups mostly stayed in the bottom tank zone (geotaxis). Kp, VPA + Kp, and VPA + Mp + Kp treatments impaired social behavior, with zebrafish displaying less interest in conspecifics. Biochemical analysis demonstrated that both the individual drugs and their combination caused oxidative stress, characterized by decreased GPx activity and increased SOD activity and MDA levels. Moreover, AChE activity was more strongly inhibited in zebrafish exposed to the binary and ternary mixtures than to individual drugs. Conclusions: The results indicate that acute exposure to individual and/or combined pharmaceuticals induces behavioral changes, oxidative damage, and AChE inhibition in zebrafish, highlighting the need to assess the effects of pharmaceutical mixtures for comprehensive ecosystem risks evaluation. Full article

Background: Ibuprofen is one of the most accessible non-steroidal anti-inflammatory drugs (NSADs), exhibiting non-selective reversible inhibition on COX-1 and COX-2. A series of common adverse reactions have been mentioned through the years: gastrointestinal (gastritis, ulceration, hemorrhage, or perforation), renal, hematologic, and cardiovascular. Objective: The aim of this study was to assess the real-world impact of ibuprofen regarding cardiovascular safety, utilizing an established pharmacovigilance database. Methods: Descriptive and disproportionality-based methods were used. Forty specific descriptors of cardiovascular effects were selected. Eight other NSADs and the combination of ibuprofen and pseudoephedrine were used as comparators. Results: A total of 58,760 cases were identified as being associated with ibuprofen in EudraVigilance. Stroke was reported for ibuprofen with a lower probability compared with etoricoxib (ROR: 0.34; 95% CI: 0.21–0.55), celecoxib (ROR: 0.07; 95% CI: 0.06–0.10), meloxicam (ROR: 0.25; 95% CI: 0.14–0.43), acetylsalicylic acid (ROR: 0.07; 95% CI: 0.05–0.09), and ibuprofen/pseudoephedrine (ROR: 0.11; 95% CI: 0.05–0.25). Thrombosis was reported for ibuprofen with a higher probability only relative to ketoprofen (ROR: 2.95; 95% CI: 1.71–5.09). Hypertension was reported for ibuprofen as being more probable than for acetylsalicylic acid (ROR: 1.58; 95% CI: 1.43–1.76). Myocardial infarction was reported as being more probable for ibuprofen than ketoprofen (ROR: 2.31; 95% CI: 1.57–3.40) or nimesulide (ROR: 2.43; 95% CI: 1.25–4.73). Conclusions: Overall, according to our study, the probability of reported cardiovascular adverse reactions is lower than those determined for the rest of the NSAIDs; however, taking into consideration the inherent limitations of the study, further clinical investigations would contribute to a better understanding of the cardiovascular safety of ibuprofen. Full article

Background: Osteoarthritis (OA) of the hip and knee is a common age-related degenerative disease characterized by joint pain, stiffness, and gait disturbances. This study investigated the influence of genetic polymorphisms in the OPRM1 (rs1799971) and COMT (rs4633, rs4680, rs4818, and rs6269) genes on the postoperative analgesic requirements in 195 diabetic and non-diabetic patients undergoing total hip or knee arthroplasty. Methods: The prospective study included all patients who were admitted between January and September 2020 and agreed to participate. Postoperative pain management was assessed based on acetaminophen, ketoprofen, and morphine consumption on the first and second postoperative day. Results: Multilevel regression analyses revealed a significant three-way interaction between diabetes, type of analgesic, and OPRM1rs1799971 polymorphism, indicating different analgesic dosing patterns in diabetic and non-diabetic patients. Two-way interactions between diabetes and COMT polymorphisms rs4633, rs4680, and rs6269 further influenced the analgesic requirements. No significant associations were found for COMT rs4818. The results show that diabetes and genetic factors significantly influence opioid requirements and pain perception. Conclusions: Given the complexity of pain management in diabetic patients, personalized analgesic strategies tailored to genetic and metabolic profiles could be useful in postoperative pain management and reducing opioid consumption. Full article

The study investigated the antinociceptive effects of four compounds (F1–F4) based on a 1H-isoindole-1,3(2H)-dione core, using various in vivo pain models—tonic (formalin test), neurogenic (capsaicin and glutamate tests), neuropathic (oxaliplatin-induced model of peripheral neuropathy as well as the streptozotocin-induced model of painful diabetic neuropathy), and inflammatory (carrageenan-induced). Pharmacokinetic parameters were also assessed. In the capsaicin test, F1, F2, and F4 (5–20 mg/kg) significantly reduced pain, while compound F3 was only active at 20 mg/kg. In the glutamate test, F1, F2, and F3 (5–20 mg/kg) demonstrated the most pronounced effect. In phase I of the formalin test, compounds F1 and F2 were active at doses of 5 and 10 mg/kg, respectively, while F3 and F4 exhibited activity only at the 20 mg/kg dose. In phase II, a dose-dependent reduction in pain was observed, with the weakest effect noted at F4. At a dose of 20 mg/kg, the compounds significantly reduced edema and carrageenan-induced pain, but to a lesser extent than ketoprofen. The compounds tested (10 mg/kg) showed significant anti-allodynic activity in the oxaliplatin- and streptozotocin-induced neuropathy pain models. All compounds demonstrated favorable pharmacokinetic results. The results of this study indicate that the compounds have a broad analgesic spectrum of activity. Full article

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause hypersensitivity reactions and lead to anaphylactic shock. These drugs also act as cofactors in allergic reactions. Lipid transfer proteins (LTPs), found in plants, represent a unique group of allergens in which cofactors play a crucial role. This case report describes a 26-year-old female who developed anaphylactic symptoms after ingesting grapes and taking ketoprofen. The patient experienced swelling of the lips, tongue, and throat, as well as shortness of breath, dizziness, and loss of consciousness, after consuming grapes and taking ketoprofen. She had previously used ketoprofen and acetylsalicylic acid without issues but had developed urticaria on several occasions after consuming multi-ingredient dishes. Skin prick tests showed positive results for peanut and orange allergens. Further testing using the ALEX multiparametric test detected antibodies to several LTP allergens. Intradermal tests with ketoprofen yielded a positive result, although irritant reactions could not be ruled out. A provocation test with acetylsalicylic acid (ASA) showed no adverse reactions. Skin tests with ibuprofen were negative, and provocation tests confirmed its tolerance. A diagnosis of LTP allergy and selective ketoprofen allergy was made, with the recommendation to avoid ketoprofen and follow a diet excluding foods from the LTP group. Full article

Removal of micropollutants using biological treatment systems remains a challenge, since conventional bioprocess systems require adaptations to provide more advanced treatment. An ambient temperature upflow anaerobic sludge blanket (UASB) reactor was employed, followed by a two-stage (saturated and unsaturated) vertical subsurface flow (VSSF) constructed wetland (CW) system, to treat domestic wastewater from a nearby settlement and investigate the occurrence and fate of 10 contaminants of emerging concern (CECs) in decentralized, non-conventional treatment systems. The integrated UASB—two-stage CW system achieved high performance regarding abatement of target CECs across all periods. Removal efficiencies ranged from 78% ± 21% (ketoprofen) to practically 100% (2-hydroxybenzothiazole). The pilot system was found to be robust performance-wise and provided enhanced treatment in comparison to a conventional wastewater treatment plant operating in parallel. Most of the target CECs were successfully treated by UASB, saturated and unsaturated CWs, while ibuprofen, bisphenol A and diclofenac were mostly removed in the unsaturated CW. Environmental risk assessment revealed that triclosan poses a significant ecological risk to algae during treated wastewater disposal into the aquatic environment. Additionally, cumulative risk quotient indicated that the potential for mixture toxicity should be carefully considered across all trophic levels. Full article

To address the dual clinical challenges of poor osseointegration and inadequate analgesia caused by postoperative infections in traditional titanium implants, this study proposes a multifunctional synergistic strategy based on metal—organic frameworks (MOFs). By integrating drug-controlled release and ionic microenvironment regulation, it constructs a titanium-based implant coating system with antibacterial and bone-regenerative properties. Ketoprofen, a drug with excellent analgesic properties, was loaded into MgCu-MOF74 powder, and the Ket@MgCu-MOF74 powder was successfully anchored onto the surface of the titanium alloy through dopamine-mediated adhesion. The maximum load of ketoprofen to MgCu-MOF74 is 18.55%, and it has a good controllable release effect. The results showed that MgCu-MOF74/Ti and Ket@MgCu-MOF74/Ti coatings enhanced osteogenic performance by promoting alkaline phosphatase activity, collagen secretion, and extracellular matrix mineralization. Additionally, the release of Mg²⁺ and Cu²⁺ created an alkaline environment, providing antibacterial properties. In summary, the MOF enabled the controlled release of ketoprofen, and the composite coating can improve osteogenic differentiation of osteoblasts and enhance the antibacterial properties of titanium alloy implants. Full article

The work aimed to investigate the presence of pharmaceutical compounds from the anti-inflammatory class in seawater from the Romanian Black Sea coast and to assess the ecological risk of these substances on the most sensitive organisms. Using the solid-phase extraction technique (SPE) followed by liquid chromatography separation and mass spectrometry detection (LC-MS/MS) of the compounds, the concentrations of these contaminants in selected seawater samples were determined. Ibuprofen was the most commonly detected compound with a frequency of 42.9%, followed by ketoprofen at 31.0.%, diclofenac at 23.8%, and naproxen at 21.4%. The maximum concentrations of pharmaceutical products varied between 13.4 ng/L ketoprofen and 13,575 ng/L caffeine. The order of decreasing maximum concentrations of pharmaceutical compounds in the water of the Black Sea was CAF > IBU > NAP > DIC > KET. The dominant and ubiquitous compound that was determined with the maximum concentration values was caffeine. Strong correlations were observed between three compounds (naproxen: diclofenac, diclofenac: ketoprofen) suggesting the same pollution source. Through the ecological risk assessment, it was observed that both caffeine and ibuprofen can generate high ecological risks for some echinoderms, crustaceans, and fish. Full article

The combination of electrocoagulation (EC) with complementary treatment methods has garnered increasing attention for wastewater remediation. This study aims to design and optimize a hybrid electrocoagulation–adsorption (EC/Ads) process for the removal of ketoprofen (KTP) from aqueous solutions. The adsorption of KTP onto activated carbon (AC) alone exhibited a low removal efficiency of approximately 27% under the following conditions: initial KTP concentration ([KTP]₀) = 23 mg·L⁻¹, pH = 6, adsorbent dose (q_AC) = 0.5 g, and contact time = 30 min. In contrast, the EC process alone achieved a removal efficiency of 59.69% under similar conditions (current density (i) = 18.6 mA·cm⁻², NaCl = 3.5 g·L⁻¹). The combined EC/Ads process significantly enhanced KTP removal, reaching 87.11% under the same operational parameters. The synergistic effect of the combined treatment was quantified with a synergy index of 1.37. Characterization techniques included FTIR analysis of both AC and KTP, as well as adsorption–desorption isotherms and pH_PZC determination for AC. To further optimize the EC/Ads process, a response surface methodology based on central composite design (CCD) was applied to assess the influence of four independent variables: pH, [KTP]₀, current density, and q_AC. Optimal conditions were identified as follows: q_AC = 0.63–0.99 g, i = 12.32–14.68 mA·cm⁻², pH = 6.5, and [KTP]₀ = 22.5 mg·L⁻¹; these conditions resulted in 100% KTP removal after 30 min of treatment. These findings demonstrate the potential of the EC/Ads hybrid process to be an efficient and sustainable alternative for pharmaceutical contaminant removal. Full article

Poloxamer-based drug delivery systems are widely used in the pharmaceutical sector. The structural characterization of these systems is crucial for the development of new drug delivery systems and for the optimization of their properties. In this study, we utilized small-angle neutron scattering (SANS) to investigate the structures of poloxamer-based drug delivery systems. The samples were measured using the SANS technique on the VSANS-V16 instrument at Helmholtz-Zentrum Berlin (HZB), Germany. The samples contained 20% poloxamer (P407) and 0.2% of a drug (ibuprofen, ketoprofen, diclofenac) in deuterated water (D₂O) for SANS. The samples varied in terms of temperature analysis (25 °C, common storage temperature; 37 °C, human body temperature; 40 °C, fever temperature). The data analysis involved modeling the data using a Python-based routine. The model used consisted of an isotropic solution of polydisperse spherical micelles. The intensity as a function of the scattering vector was modeled as the product of the form factor and the interparticle structure factor, with the latter described within the local monodisperse approximation regime. Additionally, a scattering contribution was observed, which was associated with the presence of crystalline superstructures formed by micelles that organized into a cubic structure. The data analysis provided important information about the system, such as the average radius, the size distribution, and the thickness of the layer surrounding the micellar core. The results will contribute to the development and optimization of new drug delivery systems that are more effective and safer for medical applications. Full article

This study analyzed 97 pharmaceuticals in samples of surface water, as well as influent and effluent from various wastewater treatment plants (WWTPs), during winter 2022 and spring 2023. Approximately 40% of the tested compounds were detected, at amounts ranging from below the methods’ detection limits to 5623 ng/L (2-hydroxyibuprofen in surface water) and 12,664 ng/L (caffeine in wastewater). Twelve compounds (acetaminophen, ampicillin, azithromycin, caffeine, fluoxetine, gemfibrozil, 2-hydroxyibuprofen, ibuprofen, ketoprofen, mazindol, naproxen, and salicylic acid) were detected with a 100% frequency in both surface water and wastewater samples. The observed high detection frequency of pharmaceuticals within the nonsteroidal anti-inflammatory drugs/analgesics, antibiotics, and psychiatric drug classes aligns with their high consumption. Caffeine was both the compound with the highest concentration and the most prevalent compound detected. Seasonal differences were observed, with higher concentrations detected during winter. Six of the eleven targeted metabolites and degradation products were detected in at least one sample. Risk quotient assessment revealed potential ecological risks, particularly for atorvastatin, caffeine, carbamazepine, and venlafaxine, exceeding risk thresholds for various trophic levels. The studied WWTPs showed limited removal efficiencies, with some compounds presenting higher concentrations in effluent than in influent, emphasizing the need for enhanced treatment to mitigate micropollutant risks. Full article