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EN
A simple, rapid reversed-phase high-performance liquid chromatographic method has been developed and validated for simultaneous estimation of drotaverine and omeprazole in a tablet dosage form. A C 18 column was used with a 60:40 ( v/v ) mixture of methanol and ammonium acetate (0.1 M , pH 5, adjusted with orthophosphoric acid) as mobile phase at a flow rate of 1.5 mL min -1 . UV detection was performed at 319 nm. The method was validated for accuracy, precision, linearity, specificity and sensitivity in accordance with International Conference on Harmonisation guidelines. The method was successfully used for quantitative analysis of Ranipas-DV tablets. Total run time was 10 min, drotaverine and omeprazole were eluted with retention times of 7.969 and 6.538 min respectively. Validation revealed that the method is specific, accurate, precise, reliable and reproducible. Calibration plots were linear over the concentration ranges 5-40 µg mL -1 for drotaverine and 5-50 µg mL -1 for omeprazole, respectively. Limits of detection were 16.2 and 4.8 ng mL -1 and limits of quantification were 49.0 and 14.5 ng mL -1 for drotaverine and omeprazole, respectively. Recovery was in the range 100.66-100.94% and 102.42-102.89% for drotaverine and omeprazole, respectively, and the coefficient of variance was <2.0% for both. The high percentage recovery and low co-efficient of variation confirm the suitability of the method for simultaneous analysis of drotaverine and omeprazole in tablets.
EN
We examined the local effect of several drugs against secretagogue-stimulated acid secretion in dogs. Test drugs were applied to denervated gastric pouches in conscious dogs either for 5 to 30 min beginning 1 hr after or for 30 min before intravenous infusion of gastric secretagogues (histamine, pentagastrin, or carbachol). The antisecretory effect of test drugs delivered by an intravenous or oral route was also examined. Local application of acid pump inhibitors (omeprazole, leminoprazole) for 30 min beginning l hr after histamine infusion significantly inhibited gastric acid secretion. The effect of leminoprazole persisted for more than 8 hr after a 30 min application. A mast cell stabilizer (FPL 52694) applied to pouches for 15 to 30 min also potently inhibited histamine-stimulated gastric acid secretion in a time-dependent manner. The duration of the antisecretory effect of such drugs after a 30 min application was greater than 4 hr. Locally applied leminoprazole and FPL 52694 for 30 min also significantly inhibited pentagastrin- and carbachol-stimulated gastric acid secretion. Although intravenous omeprazole and leminoprazole exerted a potent antisecretory effect on histamine-induced acid secretion FPL 52694 had little or no antisecretory effect following intravenous or oral administration. 16, 16-dimethyl prostagladin E2 also locally inhibited histamine-stimulated acid secretion. Acid stable local anesthetics (tetracaine, ethyl-4-aminobenzoate), histamine H2-receptor blockers (cimetidine, ranitidine, and famotidine), and a muscarinic M1-receptor antagonist (pirenzepine) did not exhibit local antisecretory effects. Such results strongly suggest that the apical membrane of parietal cells possesses a pharmacologically sensitive portion similar to the basolateral membrane, which usually mediates gastric acid secretion. The apical membrane represents an intriguing target for new antisecretory drugs, as well as a new medium for further elucidating the functional features of parietal cells.
EN
Background. The interrelation between omeprazole use and the possibility of developing nosocomial pneumonia, acute kidney damage and Clostridium difficile-induced diarrhea in patients with sepsis requires further study. Material and methods. 200 patients with severe craniocerebral injury that underwent surgery for the pathology and developed sepsis in the postoperative period were examined in a blind, randomized placebo-controlled research study. The patients were divided into two groups. Patients in Group 1, as part of their therapy regimen for sepsis, received a daily dose of 0.2 mg/kg omeprazole as an intravenous infusion; patients in Group 2 received placebo instead of omeprazole, in addition to a similar therapy regimen as Group 1. Results. Among patients receiving omeprazole, the number of concomitant ventilatorassociated pneumonia cases increased by 1.32 times, the number of acute kidney damage cases by 1.33 times and the number of cases of Clostridium difficile toxin secretion with feces by 1.75 times. Conclusions. The routine use of omeprazole in the management of patients with sepsis may worsen treatment results.
PL
Wprowadzenie. Kwestia korelacji stosowania omeprazolu z możliwym rozwojem szpitalnego zapalenia płuc, ostrego uszkodzenia nerek czy biegunki wywołanej przez Clostridium difficile u pacjentów z sepsą wymaga dalszych badań. Materiał i metody. W ślepym i randomizowanym badaniu kontrolowanym placebo przebadano 200 pacjentów z poważnymi obrażeniami czaszkowo-mózgowymi, którzy w wyniku tej patologii przeszli operację, i u których w okresie pooperacyjnym rozwinęła się sepsa. Zostali oni podzieleni na dwie grupy. Grupa 1 przyjmowała omeprazol w formie wlewu dożylnego w dziennej dawce 0,2 mg/kg jako część kompleksowego leczenia sepsy; grupa 2 przyjmowała placebo zamiast omeprazolu jako dodatek do głównej terapii, podobnej do tej stosowanej w przypadku grupy 1. Wyniki. Wśród pacjentów przyjmujących omeprazol liczba przypadków towarzyszącego respiratorowego zapalenia płuc wzrosła o 1,32 raza, ostrego uszkodzenia nerek – o 1,33 raza, a wydalenia toksyn Clostridium difficile w kale – o 1,75 raza. Wnioski. Rutynowe stosowanie omeprazolu w leczeniu pacjentów z sepsą może pogorszyć wyniki terapii.
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EN
Omeprazole is a proton pump inhibition and ranitidine is an H2 histamine receptor antagonist widely used in the treatment of gastroesophageal reflex disease, peptic ulcer disease, Zollinger-Ellison syndrome and as a protector of the gastric mucosae. We report a case of occupational contact allergy to omeprazole and ranitidine. A 48-year-old man, with no pre-existing history of atopy or lifestyle factors. He neither had any medical history of consumption of drugs such as ranitidine and omeprazole. He worked for 19 months in the pharmaceutical company that manufactured ranitidine base. He presented rash in the face and eczema on the dorsum of the hands with itching. The study by prick tests with ranitidine gave negative response. Patch testing with ranitidine base and ranitidine hydrochloride gave positive response. A month later, when the patient was asymptomatic he returned to the pharmaceutical company, being switched from this previous job to the reactor manufacturing omeprazole. A few days after that, he presented erythematous eruptions involving face and neck with itching. Prick tests, path tests and in vitro laboratories studies with omeprazole gave positives. In this case the patient presented hypersensitivity type I at omeprazole and hypersensitivity type IV at omeprazole and ranitidine. Our aportation indicates the importance of careful analysis of the occupational exposure histories of patients with the suspected type I or type IV hypersensitivity to allergens, to determine whether work exposure is the cause. Med Pr 2017;68(3):433–435
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Content available remote Prostaglandins and ulcer healing
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EN
Exogenous prostaglandins (PG) applied in small gastroprotective doses fail to affect healing of gastro-duodenal ulcers but accelerate the healing when used in larger gastric inhibitory doses that appear to enhance COX-2 expression and PGE2 generation in the ulcer area. COX-1 and COX-inhibitors delay ulcer healing, particularly when both COX isoforms are suppressed such e.g. by indomethacin. Dexamethasone, that decreases the expression of COX-2 and mucosal generation of PGE2, delays ulcer healing that can be reversed by the addition of small dose of exogenous PGE2. Proton pump inhibitors (PPI) such as omeprazole and PGE analogs, accelerate ulcer healing mainly due to potent inhibition of gastric acid secretion, but they also augment the COX-2 expression and enzyme activity in the ulcerated mucosa. Endogenous PG generated at ulcer margin appear to be involved in ulcer healing promoted by growth factors and gut hormones such as gastrin or CCK and melatonin acting, at least in part, through increase of induction of COX-2 and local release of PGE2 in the ulcer area . The ulcer healing activity of growth factors (e.g. EGF, TGFalpha, HGF) and certain gut hormones (gastrin, CCK) as well as melatonin, can be attenuated by treatment with COX-1 or COX-2 inhibitors which suppress the release of PGE2 but enhance the expression of COX-2. It is concluded that endogenous PG originating mainly from upregulated COX-2 at the ulcer margin play crucial role in ulcer healing by exogenous PG, PPI, growth factors, gut hormones and melatonin, while COX-1 and COX-2 inhibitors delay ulcer healing by suppressing PG generation, and increasing COX-2 expression in the ulcer area.
EN
The need for new mechanistic classes of broad spectrum antifungal agents has prompted development of the membrane sector and ectodomain of the plasma membrane proton pumping ATPase as an antifungal target. The fungal proton pump is a highly abundant, essential enzyme in Saccharomyces cerevisiae. It belongs to the family of P-type ATPases, a class of enzymes that includes the Na+,K+-ATPase and the gastric H+,K+-ATPase. These enzymes are cell surface therapeutic targets for the cardiac glycosides and several anti-ulcer drugs, respectively. The effects of acid- -activated omeprazole show that extensive inhibition of the S. cerevisiae ATPase is fungicidal. Fungal proton pumps possess elements within their transmembrane loops that distinguish them from other P-type ATPases. These loops, such as the conformationally sensitive transmembrane loop 1+2, can attenuate the activity of the enzyme. Expression in S. cerevisiae of fully functional chimeric ATPases that contain a foreign target comprising transmembrane loops 1+2 and/or 3+4 from the fungal pathogen Candida albicans suggests that these loops operate as a domain. The chimera containing C. albicans transmembrane loops 1+2 and 3+4 provides a prototype for mutational analysis of the target region and the screening of inhibitors directed against opportunistic fungal pathogens. Panels of mutants with modified ATPase regulation or with altered cell surface cysteine residues are also described. Information about the ATPase membrane sector and ectodomain has been integrated into a model of this region.
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