IntroductionAlthough combination therapies are generally used to achieve better therapeutic results, drug-drug interactions (DDIs) can lead to life-threatening adverse reactions (ADRs) or therapeutic failure by changing the therapeutic efficacy of drugs. DDIs have been reported to cause 4% of drug-related emergency visits (1). Changes in the pharmacokinetic properties of drugs may produce adverse drug reactions or therapeutic failure. The pharmacodynamics of DDIs can produce additive, synergistic, or antagonistic pharmacological effects (2).ADRs can be considered an important public health problem, particularly in the elderly patients (3). Polypharmacy and DDIs play critical roles in the production of ADRs and are related to an increased risk of mortality (4,5). Among identified adverse drug events, preventable adverse drug events have been reported to be 27% in primary care and 42% in long-term care, where prescribing and monitoring stages of pharmaceutical care were emphasized for prevention of adverse drug events (6,7). Potentially inappropriate medications have been identified in Beers Criteria (8), which aimed to prevent poor outcomes in elderly patients such as ADRs, hospitalization, morbidity, or mortality (8). In the elderly population DDIs can be diagnosed as severe adverse outcomes (9). Increased sensitivity to DDIs in elderly patients and the most frequent ADRs experienced by this age group have been shown in many studies (10-12). Elderly patients exposed to polypharmacy are at high risk of DDIs that depend on agerelated changes in pharmacokinetics or pharmacodynamics of drugs, and multiple co-morbidities.Another important factor for the increased vulnerability of elderly patients to DDIs can be poor compliance, underuse, overuse, or misuse of the medications (13). Moreover, elderly patients who will undergo surgical treatment or treatment in an intensive care unit have been reported to have a high risk for the occurrence of DDIs ( 14). Although there are publications investigating the use of inappropriate drugs in Turkish elderly patients (15,16), there are no data evaluating potential DDIs in Turkish elderly patients.Background/aim: Elderly patients are at high risk from drug-drug interactions (DDIs). This study evaluates the potential DDIs in Turkish elderly patients at a primary health care outpatient clinic. Materials and methods:Online database systems were used to examine DDIs on the prescriptions of patients (n = 1206). The clinical severity of DDIs was classified by the Lexi-Interact Online database.Results: Of the 5059 prescriptions, 33% were found to have DDIs. We detected 29 (0.9%) A, 380 (11.8%) B, 2494 (77.7%) C, 289 (9%) D, and 18 (0.6%) X risk rating category DDIs among the prescriptions. Prescriptions of female patients and patients aged between 65 and 72 years showed significantly higher number of DDIs. The frequency of DDIs increased both with the number of drugs and combined preparations per prescription. Acetylsalicylic acid and salbutamol were the most frequently prescribed drugs ...

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Aim:The aim of this study was to investigate the effects of estrogen plus progesterone treatment administered after surgical menopause on morphological and muscarinic receptor sensitivity in detrusor muscle bands of rats. Materials and Methods: A total of 40 female Albino-Wistar rats were assigned into two groups to undergo surgical menopause with sham operation (n = 10) and bilateral oophorectomy (n = 30). Thirty oophorectomized rats were assigned into three groups for different treatments administered for 8 weeks beginning from the 7th postoperative day. At the end of the 8th postoperative week, laparotomy was performed in all of them and the urinary bladders were excised and investigated with light microscope. All statistical analysis and graphs were performed using GraphPad Prism version 4. P < 0.05 was considered to be statistically significant. Results: It was determined that average bodyweights were increased to some extent in oophorectomized and sham groups after treatment and while it was more marked in the group receiving estrogen therapy, bodyweights were decreased in the group receiving estrogen plus progesterone therapy. However, this was not statistically significant. No statistically significant difference was determined between the sham, placebo and 17-b estradiol treatment groups regarding contractile response of urinary bladder tapes to carbachol (P > 0.05). Contractile responses of urinary bladder tapes of the estrogen plus progesterone treatment group were found to be statistically lower than the placebo group (P < 0.05). Conclusion: Our in vitro findings demonstrate that treatment with estrogen plus progesterone decreases muscarinic activity in oophorectomized rats, whereas estrogen-only treatment does not. Our study establishes the basis for further studies to answer whether combination of estrogen and progesterone treatment can restore detrusor overactivity associated with sex hormone defects seen at menopause.

Gamma-aminobutyric acid (GABA) plays an important role in the central control of cardiovascular functions. Previous evidence indicates that a tonically active GABAergic system exists in forebrain structures. The purpose of this study was to examine the role of the unilateral lesion of the central nucleus of amygdala, paraventricular or dorsomedial nuclei of the hypothalamus on muscimol-induced cardiovascular responses. Electrolytic ablation of nuclei was made by a monopolar isolated electrode under a stereotaxic instrument, 3-5 days before the experiments. Effects of intracerebroventricular injections of muscimol were investigated in intact, lesioned and sham-lesioned rats. On the day of the experiments, blood pressure and heart rate recordings were carried out in male Sprague-Dawley conscious rats. Muscimol produced decreases in arterial blood pressure and heart rate. The hypotensive effect of muscimol was completely inhibited in rats with dorsomedial nucleus lesions, whereas the bradycardic effect was partially prevented. The results indicate that the dorsomedial nucleus of the hypothalamus plays an important role on muscimol-induced blood pressure and heart rate responses.

Some thiazolo[4,5-d]pyrimidine-7(6H)-one derivatives were evaluated in vivo for their analgesic and anti-inflammatory activities. The results were compared with that of acetyl salicylic acid and phenylbutazone. Compounds 3b and 3h were the most active in the anti-inflammatory paw edema inhibition test. In terms of the analgesic activity (acetic acid writhing test), the most active compound was 2a followed by 31. The most active members of the series were investigated for their ED50 values and ulcerogenic potential.