Browsing by master's degree program "Utbildningsprogrammet för provisorexamen"
Now showing items 81-86 of 86
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(2021)Subanesthetic-dose ketamine, an N-methyl-D-aspartate receptor (NMDAR) blocker, exerts rapid antidepressant effects that sustain long after its elimination from the body. The precise mechanism remains unknown, but regulation of TrkB (tropomyosin receptor kinase B), ERK (extracellular-regulated kinase 1 and 2), GSK3β (glycogen synthase kinase 3β) and mTOR (mammalian target of rapamycin) signaling within the prefrontal cortex (PFC) have been deemed important for its antidepressant-like effects in rodents. In addition, activation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) is thought to be an important step in its mechanism. Nitrous oxide (N2O), another NMDAR antagonist and a putative rapid-acting antidepressant, regulates the same molecular pathways as ketamine in the rodent PFC. The fast pharmacokinetics of N2O have been exploited to show that markers of neuronal excitation, including phosphorylation of ERK, are upregulated in the PFC during its acute pharmacological effects (NMDAR blockade), while regulation of TrkB, GSK3β and P70S6K emerges only upon N2O withdrawal. In the first part of this study, we investigated the N2O-induced biochemical changes associated with neuronal excitation and BDNF-TrkB signaling in the PFC and further, the requirement for AMPAR activation in inducing them. We focused on the effects seen after the acute pharmacological effects of N2O. N2O (65% for 20 min) was administered to adult male C57BL/6 mice with or without pretreatment with AMPAR antagonist (NBQX, 10 mg/kg) and PFC samples were collected 15 minutes after stopping N2O delivery. Within this time N2O is expected to be completely eliminated. The brain samples were analyzed using western blot, enzyme-linked immunosorbent assay and quantitative reverse transcription PCR. We observed that N2O increased levels of phosphorylated TrkB, GSK3β and P70S6K, and these effects were not attenuated by NBQX pretreatment. At the same time, we observed a decrease in the levels of phosphorylated ERK, which was attenuated in mice that received NBQX prior to N2O. Tissue levels of BDNF protein or messenger RNA (exon IV) were not different between control and experimental groups. These results indicate that the mechanism of N2O is associated with TrkB and ERK signaling that are regulated independently of each other. It appears that AMPAR activation is not required for TrkB signaling, although it might play a role in ERK signaling. Further, N2O-induced TrkB phosphorylation in the PFC is not associated with changes in total levels of BDNF. In the second part of the study, we aimed to search for new ketamine-like NMDAR blockers with antidepressant potential. Ketamine was used as a query compound for in silico substructure search to find commercial ketamine analogs. The retrieved ketamine analogs were filtered by their computed ADMET properties and then further screened virtually by docking them to the pore region of NMDAR complex (protein data bank code: 4TLM), around the predicted binding site of ketamine. Finally, we sought to study if selected ketamine analogs could elicit ketamine-like effects on TrkB and ERK signaling in mouse primary cortical neurons. However, we did not proceed to test the analogs since ketamine (positive control) did not show any effects on TrkB or ERK phosphorylation in our culture. Overall, this study advances the understanding of the mechanism of N2O, possibly giving new insight of the antidepressant mechanisms of NMDAR-blocking agents more generally. Additionally, we found promising ketamine analogs that await experimental testing.
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(2019)Kasvavan antibioottiresistenssin vuoksi terveydenhuollossa tarvitaan uusia antibiootteja ja antibioottien apuaineita. Tästä syystä tässä työssä tutkittiin Combretaceae- ja Annonaceae-heimoihin kuuluvien tansanialaisten lääkekasvien antibakteerisia vaikutuksia. Kansanlääketieteessä näitä kasveja on perinteisesti käytetty mm. bakteerien aiheuttamien sairauksien ja oireiden hoitoon, mikä antaa viitteitä siitä, että ne sisältävät antibakteerisia yhdisteitä. Tutkimuksen tarkoituksena oli pyrkiä löytämään raakauutteita ja neste-nesteuutolla saatuja fraktioita, joilla on mahdollisimman hyvät estovaikutukset bakteerien kasvuun. Lisäksi oli tarkoitus selvittää Annonaceae-heimon lajien sisältämiä yhdisteitä, mikä voi osaltaan auttaa löytämään uusia antibiootteja. Antibakteerisia tutkimuksia tehtiin Combretaceae- ja Annonaceae-heimoihin kuuluvien Combretum-, Terminalia-, Friesodielsia- ja Hexalobus-sukujen lajien uutteille ja fraktioille käyttäen agardiffuusio- ja mikrodiluutiomenetelmiä. Yhteensä 45 eri uutteen ja fraktion estovaikutuksia tutkittiin ruokamyrkytyksiä aiheuttavien Bacillus cereus - ja Salmonella enterica -bakteerien kasvuun. Lisäksi tutkittiin Annonaceae-heimoon kuuluvien Friesodielsia obovata - ja Hexalobus monopetalus -lajien uutteiden ja fraktioiden sisältämiä yhdisteitä käyttäen HPLC-DAD - ja UHPLC/Q-TOF-MS -menetelmiä. Tutkimustulosten perusteella useilla Combretaceae- ja Annonaceae -heimoihin kuuluvilla lajeilla on antibakteerisia vaikutuksia grampositiivista B. cereus -bakteeria vastaan, mutta ei niinkään gramnegatiivista S. enterica -bakteeria vastaan. Aiemmissakin tutkimuksissa on usein, ei kuitenkaan aina, saatu parempia estovaikutuksia grampositiivisten kuin gramnegatiivisten bakteerien kasvuun. Tässä tutkimuksessa parhaimmat tulokset (MIC = 156 µg/ml) saatiin mikrodiluutiomenetelmällä B. cereus -bakteerin kasvun estoon Combretum fragrans -lajin lehtien kuumalla Soxhlet-metanoliuutteella ja Friesodielsia obovata -lajin lehtien metanoliuutteen veteen liukenemattomalla fraktiolla. Tarvitaan kuitenkin vielä paljon lisätutkimuksia, varsinkin H. monopetalus - ja F. obovata -lajien kohdalla, jotta voidaan selvittää, voidaanko tutkituista kasviuutteista ja niiden fraktioista eristää mahdollisia uusia antibiootteja tai antibioottien apuaineita ihmisten ja eläinten infektioiden lääkintään. Annonaceae-heimon lajeista löydettiin samantapaisia yhdisteitä kuin on löydetty aiemmissa tutkimuksissa, mutta 6,8-dimetyyli-monohydroksi-pinosembriiniä karakterisoitiin ensimmäistä kertaa F. obovata -lajista. F. obovata -lajin lehdistä tunnistettiin ensimmäistä kertaa (-)-krotepoksidi ja krotepoksidin johdannaisia. Lisäksi H. monopetalus -lajin juuresta karakterisoitiin ensimmäistä kertaa 3-(2',3'-dihydroksi-3'-metyylibutyyli)-5-(3''-metyylikrotonyyli)indolia, 3-(1,3-dihydroksi-3-metyylibut-2-yyli)-6-(2-hydroksi-3-metyyli-3-butenyyli)indolia sekä heksalobiini C:tä ja D:tä.
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(2021)Oxygen has been used as a medicine since the 18th century and is widely used as prescription and over-the-counter (OTC) medicine. Especially with global COVID-19 pandemic, which started in 2020, the demand for medicinal oxygen has increased significantly and the quality of medicinal oxygen has become increasingly important. Only few studies have been published on the critical process and quality parameters of gases and their impact on product quality. Because oxygen is classified as a medical product, it must be manufactured in accordance with good manufacturing practices regulations (GMP). One part of EU and other GMP guidelines is mandatory annual product quality review (PQR) which must assess the critical quality and process parameters as well as their trends. The aim of the study was to define the critical process and quality parameters for the medicinal oxygen filling process and to analyze the process control, stability, and capability for annual PQR using process data. Process stability and the state of control of processes were assessed using statistical quality and process management tools, such as the Shewhart control diagram and process capability index. Studied process parameters included vacuum level and pressure measured by the filling equipment. Evaluated quality parameters included analysis pressure, O2 and H2O contents. The results of the study showed that the process is not stable and there was a lot of variation between the parameters. Most variation was detected between different cylinder volumes and filling and analysis ramps in all parameters and between different weekdays in H2O content. However, all parameters remained within the specification limits and the Cpk values of all critical parameters were good. By analyzing the data, many variables that can affect the parameters and add variation to the process data can be identified. Based on the results, the necessary measures to improve and optimize the process and quality was identified. In order to stabilize processes and improve performance, the demonstrable variation in process data should be reduced, for example by harmonizing operating methods. According to the study, it was also possible to assess the revalidations required for the process.
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(2021)Membraanipyrofosfataasit eli mPPaasit katalysoivat pyrofosfaatin hydrolyysiä kahdeksi ortofosfaattimolekyyliksi vapauttaen samalla energiaa. mPPaasit ovat merkittävässä roolissa useiden patogeenisten alkueläinloisten mahdollisuudessa selvitä ulkoisesta osmoottisesta stressistä ja pH:n vaihteluista, joiden lisäksi mPPaasit vaikuttavat niiden kasvuun ja virulenssiin. mPPaaseja ei toistaiseksi ole löydetty ihmisistä eikä eläimistä, jonka vuoksi ne ovat mielenkiintoisia lääkevaikutuksen kohteita. Tässä työssä syntetisoitiin 9 uutta yhdistettä, joita ei ole aiemmin raportoitu kirjallisuudessa. Johtomolekyyleinä käytettiin aiemmassa tutkimuksessa löydettyjä isoksatsolijohdannaisa, jotka inhiboivat T. maritiman mPPaasia IC50-arvoilla 6‒7 μM (Johansson ym. 2020). Uusiin yhdisteisiin liitettiin formyyliryhmiä useaan eri kohtaan, joiden avulla toivotaan saavan lisää tietoa niiden sitoutumisesta mPPaasiin ja niiden rakenne-aktiivisuussuhteista. Uudet yhdisteet tullaan testaamaan aktiivisuuden varalta in vitro T. maritiman mPPaasissa ja tarvittaessa myös P. falciparumissa. Formyyliryhmät liitettiin isoksatsolirenkaiden 3-, 4- ja 5-asemiin erilaisten substituenttien välityksellä. Isoksatsolirenkaan 3-aseman karboksylaattiryhmään esteröitiin kolme eri bromiformyylifenolia formyyliryhmän paikkaa vaihdellen. Isoksatsolirenkaan 4-asema halogenoitiin mikroaaltoavusteisesti, jonka jälkeen liitettiin formyyliryhmiä sisältäviä heterosyklisiä booriyhdisteitä Suzuki-reaktioilla. Myös isoksatsolirenkaan 5-asemaan sitoutuneeseen fenyylirenkaaseen liitettiin formyyliryhmän sisältävän yhdisteen Suzuki-reaktiolla. Uusien yhdisteiden aktiivisuuskokeiden tulokset julkaistaan myöhemmin. Yhdisteiden rakenne-aktiivisuussuhteisiin tai tehokkuuksiin ei ole tässä työssä vielä mahdollista ottaa kantaa.
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(2019)Medication safety is a part of patient safety, and means safety related to the use of medicines. Medication safety covers the principles and functions of individuals and organizations working in the healthcare sector to ensure the safety of drug treatment and to protects patient from harm. Medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient or consumer. Medication errors are the leading cause of preventable harm in health care across the world. Therefore, improving medication safety is important from the point of view of the promotion of patient safety. The aim of this study was to gather information about serious medication errors at national level by utilizing data from Valvira to learn from the cases outside the organizations where they occurred. The data of this study consisted of complaints and regulatory statements resolved by Valvira in 2013–2017, in which drug treatment were identified as a main reason and where inappropriateness was found (n=58). Cases were classified with predetermined classification system, and inductive content analysis was used to identify the causes and contributing factors of medication errors. The theoretical framework of the study was the Human Error Theory by James Reason (1990). According its systems-based approach, this study focused on the processes and circumstances of organizations. Of the included 58 cases, medication errors caused patient’s death in 21 cases (36 %) and severe harm in nine cases (16 %). A majority (n=53; 91%) of the errors were estimated to be either definitely or possibly preventable. Most of the patients were older adults (mean age 74 years). The most commonly related drugs in medication errors were enoxaparin (n=7; 6%) and oxycodone (n=7; 6%). The most common therapeutic group causing medication errors was antithrombotic agents (n=17; 13%). Most errors occurred in hospital settings (n=29; 45%) and in elderly care units. Doctors (n=37; 50%) were most often involved in the errors. Most of the medication errors occurred in the prescribing (n=38; 47%), administrating (n=15; 19%) and monitoring stage (n=14; 17%), drug-related problems being most often connected to the drug selection. In severe and fatal cases, there are often several drug related problems identified at different stages of the patient’s drug treatment process. The data of Valvira provide valuable information about medication errors at national level. Qualitative analysis is important especially for learning purposes as it provides better understanding of the causes and contributing factors of medication errors, as well as the complexity of drug treatment processes. Based on this study, it seems that healthcare organizations involved in severe medication error cases have taken into consideration the importance of process development and focused on identifying latent risks in organizational conditions and processes rather than blaming individuals.
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(2020)Many pharmacies sell medicines through digital online pharmacy services but studies have shown that only a small fraction of the population are aware of and are using these. There is a need to investigate online pharmacy services and the obstacles they are facing. What should be considered are e.g. the legislation online pharmacies operate under, how the health competency of the population is taken into account in the design of the services, the skills and attitudes of the professionals toward digitalization and distance communication as well as practical circumstances. The aim of this study is to examine the online pharmacy operators' perceptions of the services they provide and how they are organized in Finland and Sweden. How the national regulations that exist regarding online pharmacies, and especially regarding medicine counseling at online pharmacies, are implemented in practice are also examined. The study was targeted to all pharmacy actors in Finland (72) and Sweden (11) who offer online pharmacy services and have reported this to the authorities. Of these, 20 (28 %) responded in Finland and 4 (36 %) in Sweden. The study was designed as a survey consisting of closed/structured- and open-ended questions. The survey questions were developed from previous literature on the subject and a background analysis of the online pharmacies' web pages to ensure the baseline and the relevance of the questions. The survey was available to respondents in digital format and the link was distributed through e-mail in Winter 2020. Data from the closed-ended questions were compiled and analyzed using Microsoft Office Excel, while data from the open-ended questions were analyzed through qualitative content analysis. In Finland, only a small fraction of the total turnover of pharmacies comes from the online pharmacy business. Many believe in an increased importance of online pharmacies when younger age groups begin to use pharmacy services more frequently and technology enables more versatile solutions. In both countries, the main age group using online pharmacies were 36-45 years. The goods that were purchased were mainly cosmetics, skincare and non-prescription drugs. In Sweden, customers suffering of long-term illness were also reported to be a large customer group. As distance communication methods, telephone and e-mail were mostly offered, but in Sweden also chat. About half of the staff had received special communication training for distance communication. Many respondents stated being unaware of the fraction of customers asking for medication counseling and whether this counseling is appreciated. In most cases, the operators stated that the legislation on online pharmacy services was adequate. There are differences in the possibilities of operating online pharmacies in different markets. In Finland, the online pharmacy business's share of pharmacies' total sales is very limited. In Finland there is hope that online pharmacies will become more important to younger customer groups in the future and that the technology is developed to enable more versatile services. Operators in Finland believe that the services should be more beneficial to customers in the future. In both countries an increase in the sale of prescription medication is expected. Online pharmacies have great opportunities to offer customers versatile means of communication for medication counseling, but there is still a need to investigate employees' skills in distance communication. The counseling situation at online pharmacies should be evaluated to ensure equivalency with the one at physical pharmacies.
Now showing items 81-86 of 86