PHARMA PULSE

PHARMA PULSE BY    Linu Mohan.P,Asst professor, Dept of Pharmacy practice.

DEVICE THAT TREATS DIALYSIS RELATED AMYLOIDOSIS.

Renal failure may be due to glomerular or tubular damage of the kidney by prerenal factors, such as parenteral obstruction or neoplasm. Renal failure may also develop secondary to systemic disease or result from exposure to toxic substances. Progressive renal failure ultimately results in disturbances in electrolyte and water balance and also accumulation of nitrogenous waste products in body.

The principal purpose of dialysis is to serve as an artificial kidney and restore to normal concentrations of electrolyte and waste products with in the blood stream. Although the dialysis can mimic the filtration functions of the kidney, it does not replace the renal tubular absorptive and secretive function. Also it does not compensate in any way for the endocrinologic and metabolic activities of kidney. Despite of these limitations the maintenance of life after the development of end stage renal disease can be achieved by the use of dialysis.

Muscle cramps, itching, sleep problem, anaemia, bone disease, high blood pressure, fluid over load, pericarditis, hyperkalaemia, and amyloidosis are some of the common complications with dialysis. Amyloidosis is a disabling disease characterized by accumulation and tissue deposition of amyloid fibrils consisting of beta2-microglobulin (beta2-m) in the bone. The condition is more common in people who have undergone haemodialysis for more than five years. In severe cases, amyloid deposits destroying paravertebral ligaments and intervertebral discs, which can result in paraplegia.

Considering these issues recently the scientists has come with a device known as Beta 2-microglobulin apheresis column for which FDA has given approval. This device is useful to treats dialysis-related amyloidosis, which is a major complication of kidney failure. The protein called Beta 2-microglobulin will be removed with the help of specialized beads present in the column and the column is added to the blood-tubing set during dialysis treatment. As the blood passes through the column, the beads remove Beta 2-microglobulin. These beads contain tiny pores that can remove Beta 2-microglobulin from the blood while keeping essential proteins which is the main advantage of the device. Usually the physician advices three times a week treatment regimen. But this device should not be used in patients who are allergic to heparin, and also in patients with severe cardiac insufficiency.

VARICOSE VEIN- NEW SEALING MANAGEMENT

Veins are blood vessels that return deoxygenated blood from the outer parts of the body back to the heart and lungs. When veins become abnormally thick, full of twists and turns, or enlarged, they are called varicose vein. This occurs most commonly in the veins in the legs and thighs.

In the legs, there are mainly two different systems of veins. First one is deep veins, and these are the veins which return blood back to heart during walking and second one is superficial veins under the skin. All of these veins contain one-way valves to safeguard that the blood flows towards the heart.   Failure of these valves allows blood to flow backwards down the veins and results in an overload of pressure.  This excess pressure leads to widening of the veins so that they do not close properly.  Blood then flows back into the leg along these veins and results in development of varicose veins.

Most people who have varicose veins will not develop complications, but sometimes it may cause complications like extremely painful ulcers on the skin near varicose veins, particularly near the ankles because of long-term fluid build-up in these tissues, and thrombophlebitis which is swelling and inflammation of the veins in the leg.

Recently the scientists has come up with a vena seal closure system wilful  to permanently treat varicose veins of the legs by sealing the affected veins that are closest to the skin ,with a cyanoacrylate-based adhesive. It also consists of a catheter, guide wire, dispenser gun, dispenser tips, and syringes.

In this method a catheter is inserted through the skin into the diseased vein and injects the clear liquid. Now the placement of the catheter is monitored and the delivery of the adhesive is done with the help of ultrasound imaging technique. Once the adhesive is injected inside the diseased vein, the area is manually compressed, and the adhesive changes into a solid to seal the varicose vein. This treatment method is used for patients with symptoms of venous reflux disease which occurs when the valves have stopped working properly, allowing blood to flow backwards and collect in the leg veins.