Coronavirus disease 2019 (COVID‐19) is a new infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) that belongs to the coronavirus family. The first case was reported in December 2019, and the disease has become a pandemic. Impaired immune regulation is one of the factors that play a role in its pathogenesis and results in poor outcomes of COVID‐19 patients. There have been many studies with drug candidates used as antivirals or immunomodulators. However, the results of these investigations showed that the drug candidates were not significantly effective against the disease. Meanwhile, people believe that consuming herbal immunomodulators can prevent or even cure COVID‐19. Unfortunately, specific preclinical and clinical trials to evaluate the effects of herbal immunoregulators have not been conducted. Certain natural compounds might be effective for the treatment of COVID‐19 based on general concepts from previous experiments. This review discusses some herbal agents extracted from various plants, including Echinacea, Cinchona, Curcuma longa, and Curcuma xanthorrhiza, which are considered for the treatment of COVID‐19. In addition, we discuss the pros and cons of utilising herbal medicine during the COVID‐19 pandemic, draw some conclusions, and make recommendations at the end of the session.

Volumetric absorptive microsampling (VAMS) is the newest and most promising sample-collection technique for quantitatively analyzing drugs, especially for routine therapeutic drug monitoring (TDM) and pharmacokinetic studies. This technique uses an absorbent white tip to absorb a fixed volume of a sample (10–50 µL) within a few seconds (2–4 s), is more flexible, practical, and more straightforward to be applied in the field, and is probably more cost-effective than conventional venous sampling (CVS). After optimization and validation of an analytical method of a drug taken by VAMS, a clinical validation study is needed to show that the results by VAMS can substitute what is gained from CVS and to justify implementation in routine practice. This narrative review aimed to assess and present studies about optimization and analytical validation of assays for drugs taken by VAMS, considering their physicochemical drug properties, extraction conditions, validation results, and studies on clinical validation of VAMS compared to CVS. The review revealed that the bio-analysis of many drugs taken with the VAMS technique was optimized and validated. However, only a few clinical validation studies have been performed so far. All drugs that underwent a clinical validation study demonstrated good agreement between the two techniques (VAMS and CVS), but only by Bland–Altman analysis. Only for tacrolimus and mycophenolic acid were three measurements of agreement evaluated. Therefore, VAMS can be considered an alternative to CVS in routine practice, especially for tacrolimus and mycophenolic acid. Still, more extensive clinical validation studies need to be performed for other drugs.

Multidrug-resistant tuberculosis (MDR-TB) is an infectious disease caused by Mycobacterium tuberculosis which is resistant to at least isoniazid and rifampicin. This disease is a worldwide threat and complicates the control of tuberculosis (TB). Long treatment duration, a combination of several drugs, and the adverse effects of these drugs are the factors that play a role in the poor outcomes of MDR-TB patients. There have been many studies with repurposed drugs to improve MDR-TB outcomes, including clofazimine. Clofazimine recently moved from group 5 to group B of drugs that are used to treat MDR-TB. This drug belongs to the riminophenazine class, which has lipophilic characteristics and was previously discovered to treat TB and approved for leprosy. This review discusses the role of clofazimine as a treatment component in patients with MDR-TB, and the drug’s properties. In addition, we discuss the efficacy, safety, and tolerability of clofazimine for treating MDR-TB. This study concludes that the clofazimine-containing regimen has better efficacy compared with the standard one and is also well-tolerated. Clofazimine has the potential to shorten the duration of MDR-TB treatment.

Halotherapy (HT) is part of salt therapy derived from speleotherapy/speleoclimate, which comes from using a micro size of dry salt in aerosol form (such as sodium, potassium, magnesium, calcium, and sodium chloride) with stable air temperature (18–24ºC) and moderate to high humidity (40–60%) for inhalation inside a cave/imitation cave since the nineteenth century. The benefits of HT as an adjuvant may help patients with many medical conditions, especially respiratory and dermatology diseases. This therapy is believed to alleviate inflammation and the immune response and improve respiratory function, etc. The clinical benefits of HT are advocated, but the mechanisms still need to be explicitly elucidated. This study’s main objective is to critically review and evaluate the evidence from existing literature of HT efficacy as an adjuvant therapy for respiratory disease in a narrative review. This review used a systematic approach and narrative synthesis. PubMed, Google Scholar, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. Based on preset selection criteria, two reviewers separately looked over abstracts and chose relevant papers. HT improves mucociliary elimination, diminishes airway inflammation, and improves pulmonary function. This adjuvant therapy is safe and does not cause serious adverse events. Therefore, this therapy should be considered an adjuvant therapy for respiratory diseases because of its potential effects. However, scientific evidence of the effectiveness of HT is limited. High-quality further research is required to ascertain the effectiveness of this treatment for respiratory conditions. Keywords: adjuvant, halotherapy, respiratory diseases, salt therapy, therapy

Multidrug-resistant tuberculosis (MDR-TB) emerges when Mycobacterium tuberculosis develops resistance to both rifampicin and isoniazid, representing a significant threat that undermines global efforts to combat tuberculosis. The unfavorable prognosis of MDR-TB can be attributed to prolonged treatment duration, the utilization of multiple medications, and the adverse effects associated with drug therapy. This drug moved from Group C (third line) in 2016 and Group 5 (unclear efficacy) in 2011. This is a synthetic oxazolidinone antimicrobial drug and a non-selective mono oxidase inhibitor. Antimicrobials that are both vulnerable to and resistant to gram-positive bacteria can be effectively combatted by linezolid. This study investigates and appraises the utilization of linezolid as a therapeutic intervention in individuals afflicted with MDR-TB, while also scrutinizing the pharmacological attributes of the drug. We also discuss Linezolid’s safety, efficacy, and tolerability for treating MDR-TB. Linezolid medication should be utilized for most patients and is a part of more recent short-course regimens since it has been known to increase the success rate of treatment of DR-TB by increasing the conversion sputum rate. However, primarily hematologic and neurologic, linezolid toxicity is typically treatment-limiting yet should be monitored. Recent studies suggest that dose modification and intermittency can reduce linezolid toxicity. Also, using linezolid in the regimen potentially reduces the treatment duration, but it needs further research. Keywords: efficacy, linezolid, safety, MDR-TB, tolerability

Hypertension is known to affect more than one billion people globally and is estimated to increase to 1.5 billion by 2025. It is considered one of the leading causes of death and cardiovascular disease worldwide. The safety of long-term antihypertensive use is also a concern. Through a narrative or literature review, this study evaluated antihypertensive agents based on the results of various literature searches. Researchers reviewed the safety and tolerability of five classes of antihypertensive agents such as Diuretics, Angiotensin-Converting Enzyme Inhibitors (ACEI), Angiotensin Receptor Blockers (ARB), Beta-Blockers, and Calcium Channel Blockers (CCB). The use of ARB antihypertensive drugs like valsartan is well tolerated and safe. Moreover, the mortality rate associated with enalapril was 16% lower (95% CI 0.76-0.93; P < 0.001). Captopril and lisinopril of Angiotensin-converting Enzyme Inhibitors (ACEIs) have significant side effects (SEs) compared to any antihypertensive drug. Therefore, this study recommends using the ACEIs group, especially captopril and lisinopril, due to the minimal side effects produced compared to other antihypertensive drugs. In addition, the CCBs or Ca antagonists class like amlodipine is potentially well tolerated and safe as a first-line drug for hypertension treatment. Keywords: antihypertensive drugs, hypertension, safety, side effect, tolerability