Current Drug Therapy - Volume 8, Issue 1, 2013

Benzimidazoles exhibit a broad range of biological activities. Several benzimidazoles are used in therapy such as albendazole, mebendazole, flubendazole, fenbendazole, omeprazole, lansoprazole,clofazimine. Benzimidazole derivatives play a vital role in the biological field such as antimicrobial, antiviral, antidiabetic, antiulcer and anticancer activities. The present review highlights the recently synthesized benzimidazoles possessing important potential biological activities as chemotherapeutic agents.

Cancer is a worldwide leading cause of death. Multiple genetic mutations or environmental influences lead to the change of cellular functions that result in malignant transformation. Therapeutic approaches, such as surgery, chemotherapy and radiotherapy have harmful side effects due to their inability to specifically target particular tumors. Each therapeutic strategy is aimed to affect the target tumor cells with minimum toxic effects on the function of the normal cells. Specific targeted therapy offers the hope of improving the treatment of cancer resistant to conventional therapy. A better understanding of the molecular pathogenesis of cancer has contributed to the development of specific novel drugs, including monoclonal antibodies, small molecule inhibitors, mimetic, antisense and small interference RNA. The use of cancer vaccines for the specific treatment of cancer has recently increased, as they are able to generate an active tumor-specific immune response. However, the treatment of cancer with specific peptides/proteins, genes, and short interfering RNA (siRNA) is very promising, using cell penetrating peptides for their delivery into the cells. These compounds act on specific targets that are believed to contribute to the development and progression of cancers and the resistance of tumors to conventional therapies. Delivered individually or in combination with chemo- and/or radiotherapy, such novel drugs have produced significant responses in certain types of tumors. This review describes these different strategies which provide some insight into the future direction of the eradication of cancer cells altogether.

More than 90% of cancer deaths are caused by cancer metastasis. Since cancer metastasis is the main cause of human deaths, so in this article more attention will be paid to it than ever before. Presently, clinical cancer chemotherapies have been targeting on primary tumors rather than on metastatic processes. Since the antimetastatic drugs are different from antiproliferative drugs and underinvestigated, cancer patients’ survival has been improved on a small scale now. To change this stalemate, this problem is reiterated by an analysis of the relationship between pathology, pharmacology and clinical therapy of neoplasm metastasis and it is suggested to improve the outcome of chemotherapy of cancer patients from different possible ways; e.g. to make more efforts to manufacture new types of antimetastatic drugs and optimize use of these drugs in clinics.

Background: Early treatment for infertile women with polycystic ovary syndrome (PCOS) is likely crucial and includes mainly clomiphene citrate (CC) and metformin. Objectives: To review the literature data regarding the use of CC, metformin, or both for the treatment of infertility in anovulatory patients with PCOS. Materials and Methods: Using PubMed database, all main relevant articles studying therapy naive patients with PCOS who received CC, metformin or both were searched, reviewed and analyzed. Main Results and Conclusions: In infertile obese PCOS patients, CC is the therapy of choice for inducing ovulation. Combining CC and metformin is not more effective than CC alone. Further studies are needed to define the best first line treatment in non-obese PCOS patients.

In July 2007, all peritoneal dialysis (PD) patients in our hospital were switched from mupirocin to gentamicin ointment for daily application to the PD catheter exit site (CES). Our objective was to compare the efficacy of gentamicin and mupirocin in the prevention of catheter-related PD infections. We conducted an observational sequential cohort study to compare infectious outcomes with the 2 ointments. Mupirocin patients were followed retrospectively from January 2004 to June 2006 and gentamicin patients prospectively from July 2007 to December 2008. All patients were followed for 18 months following catheter insertion. Fifty-nine patients were included in the mupirocin arm and 37 patients in the gentamicin arm. Time to first infection (either CES or peritonitis) was similar between arms, with a probability of being infection-free at 12 months of 67% versus 53%, respectively (p=0.34). There were no differences in rates of overall infection (0.54 vs 0.56 infections per patient-year, respectively (p=0.94)) or peritonitis (0.41 vs 0.37 per patient-year, respectively (p=0.84). There were 5 pseudomonal infections in the mupirocin arm and none with gentamicin. It was concluded that topical gentamicin has comparable effectiveness to mupirocin for prevention of PD catheter-related infections.

Psoriasis is a chronic, often difficult to control condition which accounts for significant morbidity worldwide. The United States Food and Drug Administration (FDA) approved multiple TNF alpha blockers in the 21st century for the treatment of psoriasis. These agents provide an alternative treatment approach for those with moderate to severe psoriasis, who fail to respond adequately to traditional therapies. The increasing use of these agents in women of childbearing age raises questions concerning their safety in the pregnant psoriatic patient. A review of case reports and registry data was performed on the outcomes of pregnancies in psoriatic patients and in those with other inflammatory conditions who were exposed to these biologic agents. To date, it remains inadvisable to continue pregnant patients on these medications if alternative, well-established therapies are effective. However, for those women unable to tolerate alternative treatments or who are inadvertently exposed to TNF-alpha inhibitors during pregnancy, the published data do not indicate an increased risk of fetal malformation or a need to recommend pregnancy termination. Transplacental transfer of these drugs is greatest during the last two trimesters of pregnancy, which may result in persistent detectable drug levels in the newborn infant. If a fetus is exposed to TNF alpha blockers toward the end of pregnancy, then live vaccinations in these infants should be delayed until drug levels in infant serum are undetectable, or for at least 6-7 months if levels cannot be measured.

Microbicides as a potential intervention strategy for preventing human immunodeficiency virus (HIV) transmission, provide women with a preventive option against HIV. For more than two decades, various studies have endeavored to find effective and safe microbicides, which would provide defense against HIV/AIDS. Microbicides include various agents having different mechanisms such as, disruption of cellular and microbial membranes (surfactants), restoration of the natural acidic protective pH of the vagina (acid buffers), interference interactions between HIV envelope proteins and cellular receptors (anionic polymers), and anti retroviral agents. This review presents the progress in development of microbicides in prevention of spread of HIV.