Background: Loop diuretics help to manage the patients with edema associated with congestive heart failure, liver cirrhosis, and renal disease and hypertension. The patients taking loop diuretics may receive other medications to treat comorbidities leading to drug interactions. Methodology: The literature was searched in databases such as Medline/PMC/PubMed, Google Scholar, Cochrane Library, Science Direct, EMBASE, Web of science, Ebsco, Directory of open access journals (DOAJ) and reference lists to spot relevant articles using the keywords Drug interactions, Pharmacodynamic interactions, Loop diuretics, Bumetanide, Ethacrynic acid, Furosemide, and Torsemide. Results: Loop diuretics are associated with hypokalemia, ototoxicity and other adverse effects. The drugs affected by hypokalemia, and having the potential of inducing ototoxicity could interact with loop diuretics pharmacodynamically. Loop diuretics can interact with drugs such as amphotericin B, digoxin, angiotensin-converting enzyme inhibitors (ACE inhibitors), antidiabetic drugs, antifungal agents, dobutamine, gossypoland sotalol due to diuretic associated hypokalemia. In addition, the risk of ototoxicity could be enhanced by the concomitant use of loop diuretics and cisplatin, aminoglycoside antibiotics or phosphodiesterase 5 (PDE 5) inhibitors. Loop diuretics may also interact pharmacodynamically with drugs like cephalosporins, ceritinib, levothyroxine, pixantrone, probenecid, lithium, non-steroidal anti-inflammatory drugs (NSAIDs), sulfonylureas and herbal drugs. Conclusion: Clinicians, pharmacists and other health care providers should take responsibility for the safe use of medications. In addition, they are required to be aware of the drugs interacting with loop diuretics, to prevent adverse drug interactions.

Introduction: Hypertension is a leading cause of cardiovascular disease and chronic kidney disease resulting in premature death and disability. The Renin-Angiotensin-Aldosterone system (RAAS) blockers including Angiotensin Converting Enzyme (ACE) Inhibitors or Angiotensin Receptor Blockers (ARBs) are used as first-line antihypertensive therapy to treat hypertensive patients with comorbidities, including diabetes, ischemic heart disease, heart failure, and chronic kidney disease. The use of RAS blockers is associated with the risks such as hyperkalemia, angioedema, etc. and the drugs potentiating them interact pharmacodynamically resulting in adverse consequences. This review article focuses on the clinically important drug interactions of RAAS blockers. Materials and Methods: The electronic databases such as Medline/PubMed Central/PubMed, Google Scholar, Science Direct, Cochrane Library, Directory of open access journals (DOAJ), Embase, and reference lists were searched to identify relevant articles. Results: The risk of hyperkalemia may be enhanced potentially in patients receiving a RAS blocker and a potassium sparing diuretic, potassium supplement, trimethoprim, adrenergic beta-blocker, antifungal agents, calcineurin inhibitor, pentamidine, heparins or a NSAID, concomitantly. The patients taking ACE inhibitors and mTOR inhibitor, DPP4 inhibitor, Alteplase or Sacubitril/valsartan concurrently, may be at heightened risk of developing angioedema. Conclusion: Clinicians, pharmacists, and other health-care practitioners should be accountable for medication safety. To avoid adverse implications, prescribers and pharmacists must be aware of the drugs that interact with RAAS blockers.

: Adrenergic β-blockers are used to treat many conditions, including hypertension, cardiac arrhythmias, heart failure, angina pectoris, migraine, and tremors. The majority of the β-blockers, including propranolol, metoprolol, acebutolol, alprenolol, betaxolol, carvedilol, nebivolol, and oxprenolol are metabolised majorly by CYP2D6, and bisoprolol is primarily metabolised by CYP3A4 enzymes. The drugs inhibiting or inducing them may alter the pharmacokinetics of those β-blockers. The plasma concentrations of propranolol might be elevated by the concomitant use of drugs such as SSRIs (Fluoxetine, Paroxetine), SNRIs (Duloxetine), and cimetidine, while the plasma concentrations of metoprolol are increased by the concurrent use of SSRIs (Fluoxetine, Paroxetine), amiodarone, celecoxib, cimetidine, terbinafine, and diphenhydramine. β-blockers can also interact pharmacodynamically with drugs, including fluoroquinolones, antidiabetic agents, and NSAIDs. In addition, β-blockers may interact with herbs such as curcumin, Ginkgo biloba, Schisandra chinensis, green tea, guggul, hawthorn, St. John’s wort, and Yohimbine . This article focuses on clinically relevant drug interactions of β-blockers with commonly prescribed medications. In addition to pharmacokinetics and pharmacodynamics of the drug interactions, recommendations for clinical practice are highlighted. The prescribers and the pharmacists are needed to be aware of the drugs interacting with β-blockers to prevent possible adverse drug interactions.

Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) and patients with COVID-19 may be treated primarily with SARS CoV-2-targeting drugs and the therapeutic agents assisting in the management of COVID-19 complications. This review focuses on the supplements like vitamins, minerals, herbal constituents, and others that help prevent or manage negative outcomes among COVID-19 patients. The literature was searched in databases such as Medline/PubMed Central/PubMed, Google Scholar, Science Direct, EBSCO, Scopus, EMBASE, the Directory of Open Access Journals (DOAJ), and reference lists to identify relevant articles. The vitamins, including vitamin C, and vitamin D, minerals such as zinc, selenium, and copper, herbal constituents like thymoquinone, curcumin, naringenin, quercetin, and glycyrrhizin, and other supplements, including N-acetylcysteine and melatonin. Melatonin have been identified as having the potential to manage patients with COVID-19 along with standard care. Some of the ongoing clinical trials are investigating the effectiveness of different supplements among COVID-19 patients.

Background: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS, CoV-2), and patients with COVID-19 are managed mainly using repurposed conventional drugs, which target the viral entry and viral replication of SARS CoV-2 along with standard care and supportive therapy. Objective: This review article focuses on the potential benefits of black seeds (Nigella sativa) observed in clinical and in silico molecular docking studies of COVID-19. Methods: The literature was searched using databases such as LitCOVID, Web of Science, Google Scholar, bioRxiv, medRxiv, Science Direct, EBSCO, Scopus, EMBASE, and reference lists to identify published manuscripts or preprints related to the prevention or treatment of COVID-19 with black seeds (N. sativa) or their phytoconstituents. Results: Various clinical studies and in silico molecular docking studies determined that black seeds (N. sativa) and their bioactive phytoconstituents have potential activity against SARS CoV-2 infection. Conclusion: Patients with COVID-19 could be managed using black seeds (N. sativa) along with supportive care, which would speed up the recovery and decrease the mortality rate. More randomized controlled clinical trials would further establish the safety and efficacy of N. sativa in COVID-19 patients.