RESUMEN
BACKGROUND: Redotex™ is a Mexican weight-loss supplement that is not U.S. Food and Drug Administration-approved. It consists of the following five ingredients: tri-iodothyronine 75 µg, atropine 0.36 mg, diazepam 8 mg, aloin 16 mg, and d-norpseudoephedrine 50 mg per tablet. There are few case reports with clinically severe ingestions. We report two cases of clinical thyrotoxicosis due to use of Redotex. CASE REPORTS: A 29-year-old woman presented to the emergency department (ED) with anxiety and palpitations. She reported taking Redotex daily for 1 week. Her temperature was 37.1°C, blood pressure (BP) was 166/104 mm Hg, and heart rate (HR) was 140 beats/min. Laboratory analysis was significant for a bicarbonate level of 20 mmol/L (reference 22-29 mmol/L), free T4 0.75 ng/dL (reference 0.93-1.70 ng/dL), and thyroid-stimulating hormone (TSH) 0.05 uIU/mL (reference 0.27-4.20 uIU/mL). She was treated with 2 mg i.v. lorazepam and 20 mg oral propranolol. A 37-year-old woman presented with chest pain, palpitations, and nausea after taking Redotex 1 to 2 tablets daily for 6 weeks. Her HR was 134 beats/min and BP was 130/66 mm Hg. Thyroid function tests on initial presentation showed a TSH of 0.013 uU/mL, free T4 of 0.24 ng/dL, and free T3 of >30 pg/mL. She was treated with propranolol 1 mg i.v. twice per day and 2 doses of lorazepam 1 mg. Both patients had resolution of their symptoms. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: When taken chronically and at recommended doses, Redotex can present with clinically significant T3 thyrotoxicosis. This has not been seen in prior reports.
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Tirotoxicosis , Pérdida de Peso , Adulto , Atropina , Diazepam , Combinación de Medicamentos , Ingestión de Alimentos , Emodina/análogos & derivados , Femenino , Humanos , Fenilpropanolamina , Tirotoxicosis/inducido químicamente , Tirotoxicosis/diagnóstico , Tirotoxicosis/tratamiento farmacológico , TriyodotironinaRESUMEN
Obesity is a public health problem caused by excessive consumption of high caloric diets and/or lack of physical activity. Although treatments for obesity include low caloric diets and exercise programs, these activities frequently are supplemented with appetite suppressants. For the short-term treatment of weight loss, diethylpropion (DEP) is a commonly used appetite suppressant. However, little is known with regard to how to improve its weight loss efficacy. We therefore evaluated, in rats, two administration protocols where the animals received daily injections of DEP. First, when these nocturnal animals were normally active (at night) and when they were normally inactive (daytime), and second, with or without high fat dietary restriction (HFDR). We observed that DEP induced a greater weight-loss administered when the animals were in their active phase than in their inactive phase. Moreover, DEP's administration during the inactive phase (and to a lesser degree in the active phase) promotes the consumption of food during normal sleeping time. In addition, we found that DEP-induced weight loss under ad libitum access to a HF diet, but its efficacy significantly improved under conditions of HFDR. In summary, the efficacy of DEP, and presumably other like appetite suppressants, is enhanced by carefully controlling the time it is administered and under dietary restriction of HF diets.
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Depresores del Apetito/uso terapéutico , Regulación del Apetito/efectos de los fármacos , Dieta con Restricción de Grasas , Dieta Reductora , Dietilpropión/uso terapéutico , Sobrepeso/tratamiento farmacológico , Pérdida de Peso/efectos de los fármacos , Animales , Depresores del Apetito/administración & dosificación , Depresores del Apetito/efectos adversos , Depresores del Apetito/farmacocinética , Biotransformación , Ritmo Circadiano/efectos de los fármacos , Terapia Combinada/efectos adversos , Dieta Alta en Grasa/efectos adversos , Dietilpropión/administración & dosificación , Dietilpropión/efectos adversos , Dietilpropión/análogos & derivados , Dietilpropión/sangre , Dietilpropión/farmacocinética , Esquema de Medicación , Ingestión de Energía/efectos de los fármacos , Semivida , Inyecciones Intraperitoneales , Masculino , Sobrepeso/sangre , Sobrepeso/dietoterapia , Sobrepeso/etiología , Fenilpropanolamina/análogos & derivados , Fenilpropanolamina/sangre , Ratas Sprague-DawleyRESUMEN
AIMS: To determine whether transcutaneous foot stimulation combined with a lower dose tolterodine would inhibit bladder overactivity more effectively than either treatment alone. METHODS: Cystometrograms were performed on α-chloralose anesthetized cats (N = 6) by infusing 0.25% acetic acid (AA) to induce bladder overactivity. Foot stimulation (5 Hz) was applied at 2 and 4 times the threshold (T) intensity in volts (i.e., 2T or 4T) for inducing toe movement to inhibit bladder overactivity. Cumulative doses of tolterodine (0.003-0.3 mg/kg, i.v.) were also administered to determine the effect of combination treatment. RESULTS: AA irritation of the bladder significantly (P < 0.0001) reduced bladder capacity to 23.6 ± 7.1% of saline control capacity. Foot stimulation alone at 2T and 4T inhibited bladder overactivity and significantly (P < 0.0001) increased bladder capacity to 50.7 ± 6.8% and 79.0 ± 11.6% of saline control, respectively. Tolterodine alone at 0.3 mg/kg significantly (P < 0.05) increased bladder capacity to 65.6 ± 15.5% of saline control. However, when tolterodine at a threshold dose (0.3 mg/kg) was combined with foot stimulation, the bladder capacity was significantly (P < 0.05) increased to 86.2 ± 6.2% and 107.9 ± 10.6% by 2T and 4T stimulation, respectively. Complete inhibition of bladder overactivity could be achieved at a lower tolterodine dose (0.1 mg/kg) when combined with 4T stimulation (97.0 ± 11.2% of saline control). The amplitude of micturition contraction was not changed by tolterodine treatment. CONCLUSIONS: This study suggests a novel, efficacious, non-invasive therapy by combining foot stimulation with a lower dose tolterodine to treat bladder overactivity. It also provides the first objective evidence supporting an additive therapeutic benefit of neuromodulation and antimuscarinic combination treatment.
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Compuestos de Bencidrilo/uso terapéutico , Cresoles/uso terapéutico , Antagonistas Muscarínicos/uso terapéutico , Fenilpropanolamina/uso terapéutico , Estimulación Eléctrica Transcutánea del Nervio , Vejiga Urinaria Hiperactiva/terapia , Animales , Gatos , Terapia Combinada , Femenino , Pie , Masculino , Tartrato de TolterodinaRESUMEN
Objective To evaluate the effects of terazosin and tolterodine on ureteral stent discomfort. Materials and Methods Of 163 patients assessed for eligibility, 104 patients were randomly assigned to receive placebo, 2 mg of terazosin twice daily, 2 mg of tolterodine daily, or both terazosin plus tolterodine during the stenting period. Prior to stenting and at stent removal, the International Prostate Symptom Score (IPSS), the IPSS quality of life (QoL) subscore and the Visual Analog Scale for Pain were determined. The patients also reported their analgesic use during the stenting period. Results Ninety-four patients completed the study. We noted significant decreases in the total IPSS scores (p = 0.002), irritative subscore (p = 0.039), QoL (p = 0.001), flank pain (p = 0.013), voiding pain (p = 0.01) and amount of analgesics used (p = 0.02) in the groups. However, neither the obstructive subscore nor the suprapubic pain improved significantly (p = 0.251 and p = 0.522, respectively). The patients receiving terazosin plus tolterodine experienced significant reductions in the total IPSS, irritative symptoms, QoL, flank pain, voiding pain and decreased analgesics use compared with those patients receiving placebo. However, compared with placebo, terazosin monotherapy did not affect pain levels, and tolterodine monotherapy did not improve QoL, flank pain or analgesics use. Conclusions Terazosin plus tolterodine improves ureteral stent-related complications, including irritative symptoms, the amount of analgesics used, QoL, flank pain and voiding pain but does not decrease obstructive symptoms or suprapubic pain. This trial was registered at www.clinicaltrials.gov as NCT01530243. .
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Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Compuestos de Bencidrilo/uso terapéutico , Cresoles/uso terapéutico , Fenilpropanolamina/uso terapéutico , Prazosina/análogos & derivados , Stents/efectos adversos , Uréter/efectos de los fármacos , Agentes Urológicos/uso terapéutico , Método Doble Ciego , Remoción de Dispositivos/efectos adversos , Dolor en el Flanco/tratamiento farmacológico , Estudios Prospectivos , Prazosina/uso terapéutico , Calidad de Vida , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Escala Visual AnalógicaRESUMEN
BACKGROUND: Inadequate nutrition support is common among critically ill patients, and identification of risk factors for such inadequacy might help in improving nutrition support. OBJECTIVE: To determine how often daily calorie goals are met and the factors responsible for inadequate nutrition support. Methods A single-center prospective cohort study. Each patient's demographic and clinical characteristics, the need for ventilatory support, the use and dosage of medications, the number of nursing staff per bed, the time elapsed from admission to the intensive care unit until the effective start of enteral feeding, and the causes for nonadministration were recorded. Achievement of daily calorie goals was determined and correlated with risk factors. RESULTS: A total of 262 daily evaluations were done in 40 patients. Daily calorie goal was achieved in only 46.2% of the evaluations (n = 121), with a mean of 74.8% of the prescribed volume of enteral nutrition infused daily. Risk factors for inadequate nutrition support were the use of midazolam (odds ratio, 1.58; 95% CI, 1.18-2.11) and fewer nursing professionals per bed (odds ratio, 2.56; 95% CI, 1.43-4.57). Conclusion Achievement of daily calorie goals was inadequate, and the main factors associated with this failure were the use and dosage of midazolam and the number of nurses available.
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Enfermedad Crítica/enfermería , Unidades de Cuidados Intensivos , Midazolam/efectos adversos , Personal de Enfermería en Hospital/provisión & distribución , Apoyo Nutricional/normas , APACHE , Anciano , Analgésicos Opioides/efectos adversos , Analgésicos Opioides/uso terapéutico , Comorbilidad , Enfermedad Crítica/terapia , Ingestión de Energía , Nutrición Enteral/métodos , Nutrición Enteral/normas , Nutrición Enteral/estadística & datos numéricos , Femenino , Fentanilo/efectos adversos , Fentanilo/uso terapéutico , Humanos , Hipnóticos y Sedantes/efectos adversos , Hipnóticos y Sedantes/uso terapéutico , Unidades de Cuidados Intensivos/normas , Unidades de Cuidados Intensivos/estadística & datos numéricos , Modelos Logísticos , Masculino , Midazolam/uso terapéutico , Persona de Mediana Edad , Personal de Enfermería en Hospital/normas , Apoyo Nutricional/métodos , Apoyo Nutricional/estadística & datos numéricos , Fenilpropanolamina/efectos adversos , Fenilpropanolamina/uso terapéutico , Estudios Prospectivos , Simpatomiméticos/efectos adversos , Simpatomiméticos/uso terapéutico , Tramadol/efectos adversos , Tramadol/uso terapéutico , Recursos Humanos , Carga de Trabajo/normas , Carga de Trabajo/estadística & datos numéricosRESUMEN
PURPOSE: The objective of the study was to evaluate the synergistic transdermal permeation effect of chemical enhancers and iontophoresis technique on tolterodine tartrate (TT) transdermal gel and to evaluate its pharmacokinetic properties. MATERIALS AND METHODS: Taguchi robust design was used for optimization of formulations. Skin permeation rates were evaluated using the Keshary-chein type diffusion cells in order to optimize the gel formulation. In-vivo studies of the optimized formulation were performed in a rabbit model and histopathology studies of optimized formulation were performed on rats. RESULTS: Transdermal gels were formulated successfully using Taguchi robust design method. The type of penetration enhancer, concentration of penetration enhancer, current density and pulse on/off ratio were chosen as independent variables. Type of penetration enhancer was found to be the significant factor for all the responses. Permeation parameters were evaluated when maximum cumulative amount permeated in 24 hours (Q24) was 145.71 ± 2.00µg/cm² by CIT4 formulation over control (91.89 ± 2.30µg/cm²). Permeation was enhanced by 1.75 fold by CIT4 formulation. Formulation CIT4 containing nerolidol (5%) and iontophoretic variables applied (0.5mA/cm² and pulse on/off ratio 3:1) was optimized. In vivo studies with optimized formulation CIT4 showed increase in AUC and T1/2 when compared to oral suspension in rabbits. The histological studies showed changes in dermis indicating the effect of penetration enhancers and as iontophoresis was continued only for two cycles in periodic fashion so it did not cause any skin damage observed in the slides. CONCLUSION: Results indicated that iontophoresis in combination with chemical enhancers is an effective method for transdermal administration of TT in the treatment of overactive bladder.
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Compuestos de Bencidrilo/farmacocinética , Cresoles/farmacocinética , Iontoforesis/métodos , Fenilpropanolamina/farmacocinética , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Agentes Urológicos/farmacocinética , Administración Cutánea , Animales , Compuestos de Bencidrilo/administración & dosificación , Compuestos de Bencidrilo/sangre , Cresoles/administración & dosificación , Cresoles/sangre , Sinergismo Farmacológico , Geles , Masculino , Modelos Animales , Fenilpropanolamina/administración & dosificación , Fenilpropanolamina/sangre , Conejos , Ratas , Ratas Wistar , Reproducibilidad de los Resultados , Absorción Cutánea , Factores de Tiempo , Tartrato de Tolterodina , Resultado del Tratamiento , Agentes Urológicos/administración & dosificación , Agentes Urológicos/sangreRESUMEN
Purpose The objective of the study was to evaluate the synergistic transdermal permeation effect of chemical enhancers and iontophoresis technique on tolterodine tartrate (TT) transdermal gel and to evaluate its pharmacokinetic properties. Materials and Methods Taguchi robust design was used for optimization of formulations. Skin permeation rates were evaluated using the Keshary-chein type diffusion cells in order to optimize the gel formulation. In-vivo studies of the optimized formulation were performed in a rabbit model and histopathology studies of optimized formulation were performed on rats. Results Transdermal gels were formulated successfully using Taguchi robust design method. The type of penetration enhancer, concentration of penetration enhancer, current density and pulse on/off ratio were chosen as independent variables. Type of penetration enhancer was found to be the significant factor for all the responses. Permeation parameters were evaluated when maximum cumulative amount permeated in 24 hours (Q24) was 145.71 ± 2.00µg/cm2 by CIT4 formulation over control (91.89 ± 2.30µg/cm2). Permeation was enhanced by 1.75 fold by CIT4 formulation. Formulation CIT4 containing nerolidol (5%) and iontophoretic variables applied (0.5mA/cm2 and pulse on/off ratio 3:1) was optimized. In vivo studies with optimized formulation CIT4 showed increase in AUC and T1/2 when compared to oral suspension in rabbits. The histological studies showed changes in dermis indicating the effect of penetration enhancers and as iontophoresis was continued only for two cycles in periodic fashion so it did not cause any skin damage observed in the slides. Conclusion Results indicated that iontophoresis in combination with chemical enhancers is an effective method for transdermal administration of TT in the treatment of overactive bladder. .
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Animales , Masculino , Conejos , Ratas , Compuestos de Bencidrilo/farmacocinética , Cresoles/farmacocinética , Iontoforesis/métodos , Fenilpropanolamina/farmacocinética , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Agentes Urológicos/farmacocinética , Administración Cutánea , Compuestos de Bencidrilo/administración & dosificación , Compuestos de Bencidrilo/sangre , Cresoles/administración & dosificación , Cresoles/sangre , Sinergismo Farmacológico , Geles , Modelos Animales , Fenilpropanolamina/administración & dosificación , Fenilpropanolamina/sangre , Ratas Wistar , Reproducibilidad de los Resultados , Absorción Cutánea , Factores de Tiempo , Resultado del Tratamiento , Agentes Urológicos/administración & dosificación , Agentes Urológicos/sangreRESUMEN
OBJECTIVE: To evaluate the effects of terazosin and tolterodine on ureteral stent discomfort. MATERIALS AND METHODS: Of 163 patients assessed for eligibility, 104 patients were randomly assigned to receive placebo, 2 mg of terazosin twice daily, 2 mg of tolterodine daily, or both terazosin plus tolterodine during the stenting period. Prior to stenting and at stent removal, the International Prostate Symptom Score (IPSS), the IPSS quality of life (QoL) subscore and the Visual Analog Scale for Pain were determined. The patients also reported their analgesic use during the stenting period. RESULTS: Ninety-four patients completed the study. We noted significant decreases in the total IPSS scores (p = 0.002), irritative subscore (p = 0.039), QoL (p = 0.001), flank pain (p = 0.013), voiding pain (p = 0.01) and amount of analgesics used (p = 0.02) in the groups. However, neither the obstructive subscore nor the suprapubic pain improved significantly (p = 0.251 and p = 0.522, respectively). The patients receiving terazosin plus tolterodine experienced significant reductions in the total IPSS, irritative symptoms, QoL, flank pain, voiding pain and decreased analgesics use compared with those patients receiving placebo. However, compared with placebo, terazosin monotherapy did not affect pain levels, and tolterodine monotherapy did not improve QoL, flank pain or analgesics use. CONCLUSIONS: Terazosin plus tolterodine improves ureteral stent-related complications, including irritative symptoms, the amount of analgesics used, QoL, flank pain and voiding pain but does not decrease obstructive symptoms or suprapubic pain. This trial was registered at www.clinicaltrials.gov as NCT01530243.
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Compuestos de Bencidrilo/uso terapéutico , Cresoles/uso terapéutico , Fenilpropanolamina/uso terapéutico , Prazosina/análogos & derivados , Stents/efectos adversos , Uréter/efectos de los fármacos , Agentes Urológicos/uso terapéutico , Adolescente , Adulto , Remoción de Dispositivos/efectos adversos , Método Doble Ciego , Femenino , Dolor en el Flanco/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Prazosina/uso terapéutico , Estudios Prospectivos , Calidad de Vida , Encuestas y Cuestionarios , Factores de Tiempo , Tartrato de Tolterodina , Resultado del Tratamiento , Escala Visual Analógica , Adulto JovenRESUMEN
Free ortho-hydroxy cinnamate ester derivatives are evaluated in the synthesis of structurally diverse 4-aryl-coumarins via a tandem Heck-Matsuda cyclization reaction. Free phenolic groups were considered incompatible with such a reaction, which usually provide the corresponding diazo dyes. A concise and scalable route employing a ligand-free, Pd-catalyzed Heck-Matsuda arylation under aerobic conditions for the preparation of (R)-Tolterodine in high overall yield and ee is also presented.
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Compuestos de Bencidrilo/síntesis química , Cinamatos/química , Cumarinas/síntesis química , Cresoles/síntesis química , Fenilpropanolamina/síntesis química , Compuestos de Bencidrilo/química , Catálisis , Cumarinas/química , Cresoles/química , Ciclización , Ésteres , Estructura Molecular , Paladio/química , Fenilpropanolamina/química , Estereoisomerismo , Tartrato de TolterodinaRESUMEN
Norephedrine, also called phenylpropanolamine (PPA), is a synthetic form of the ephedrine alkaloid. After reports of the occurrence of intracranial hemorrhage and other adverse effects, including several deaths, PPA is no longer sold in USA and Canada. Despite the extensive information about PPA toxicity, reports on its effects on cell membranes are scarce. With the aim to better understand the molecular mechanisms of the interaction of PPA with cell membranes, ranges of concentrations were incubated with intact human erythrocytes, isolated unsealed human erythrocyte membranes (IUM), and molecular models of cell membranes. The latter consisted in bilayers built-up of dimyristoylphosphatidylcholine (DMPC) and dimyristoylphosphatidylethanolamine (DMPE), phospholipid classes present in the outer and inner monolayers of most plasmatic cell membranes, respectively. The capacity of PPA to perturb the bilayer structures of DMPC and DMPE was assessed by X-ray diffraction, DMPC large unilamellar vesicles (LUV) and IUM were studied by fluorescence spectroscopy, and intact human erythrocytes were observed by scanning electron microscopy (SEM). This study presents evidence that PPA affects human red cell membranes as follows: (a) in SEM studies on human erythrocytes it was observed that 0.5 mM PPA induced shape changes; (b) in IUM PPA induced a sharp decrease in the fluorescence anisotropy in the lipid bilayer acyl chains in a concentration range lower than 100 µM; (c) X-ray diffraction studies showed that PPA in the 0.1-0.5 mM range induced increasing structural perturbation to DMPC, but no effects on DMPE multibilayers were detected.
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Membrana Eritrocítica/efectos de los fármacos , Fenilpropanolamina/farmacología , Dimiristoilfosfatidilcolina/química , Membrana Eritrocítica/química , Membrana Eritrocítica/ultraestructura , Fluorescencia , Humanos , Membrana Dobles de Lípidos/química , Microscopía Electrónica de Rastreo , Modelos Moleculares , Difracción de Rayos XRESUMEN
Khat (Catha edulis Forsk.) is a flowering perennial shrub cultivated for its neurostimulant properties resulting mainly from the occurrence of (S)-cathinone in young leaves. The biosynthesis of (S)-cathinone and the related phenylpropylamino alkaloids (1S,2S)-cathine and (1R,2S)-norephedrine is not well characterized in plants. We prepared a cDNA library from young khat leaves and sequenced 4,896 random clones, generating an expressed sequence tag (EST) library of 3,293 unigenes. Putative functions were assigned to > 98 percent of the ESTs, providing a key resource for gene discovery. Candidates potentially involved at various stages of phenylpropylamino alkaloid biosynthesis from L-phenylalanine to (1S,2S)-cathine were identified.
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Catha , Fenilpropanolamina , Secuencia de Bases , Plantas Medicinales , Lugares Marcados de SecuenciaRESUMEN
This study evaluated the effects of acidic medicines (Dimetapp and Claritin), under pH-cycling conditions, on the surface degradation of four composite resins (microhybrid: TPH, Concept, Opallis and Nanofilled: Supreme). Thirty disc-shaped specimens ([symbol: see text] = 5.0 mm/thickness = 2.0 mm) of each composite were randomly assigned to 3 groups (n = 10): a control and two experimental groups, according to the acidic medicines evaluated. The specimens were finished and polished with aluminum oxide discs, and the surface roughness was measured by using a profilometer. After the specimens were submitted to a pH-cycling regimen and immersion in acidic medicines for 12 days, the surface roughness was measured again. Two specimens for each material and group were analyzed by scanning electron microscopy (SEM) before and after pH-cycling. Data were analyzed by the Student's-t test, ANOVA, Duncan's multiple range test and paired t-test (alpha=0.05). Significant increase in roughness was found only for TPH in the control group and TPH and Supreme immersed in Claritin (p<0.05). SEM analyses showed that the 4 composite resins underwent erosion and surface degradation after being subjected to the experimental conditions. In conclusion, although the roughness was slightly affected, the pH-cycling and acidic medicines caused surface degradation of the composite resins evaluated. Titratable acidity seemed to play a more crucial role on surface degradation of composite resins than pH.
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Ácidos/química , Resinas Compuestas/química , Alisadura de la Restauración Dental , Bromofeniramina/química , Restauración Dental Permanente , Análisis del Estrés Dental , Combinación de Medicamentos , Antagonistas de los Receptores Histamínicos H1/química , Concentración de Iones de Hidrógeno , Loratadina/química , Microscopía Electrónica de Rastreo , Fenilefrina/química , Fenilpropanolamina/química , Seudoefedrina , Distribución Aleatoria , Propiedades de SuperficieRESUMEN
This study evaluated the effects of acidic medicines (Dimetapp® and Claritin®), under pH-cycling conditions, on the surface degradation of four composite resins (microhybrid: TPH, Concept, Opallis and Nanofilled: Supreme). Thirty disc-shaped specimens (Ø = 5.0 mm / thickness = 2.0 mm) of each composite were randomly assigned to 3 groups (n = 10): a control and two experimental groups, according to the acidic medicines evaluated. The specimens were finished and polished with aluminum oxide discs, and the surface roughness was measured by using a profilometer. After the specimens were submitted to a pH-cycling regimen and immersion in acidic medicines for 12 days, the surface roughness was measured again. Two specimens for each material and group were analyzed by scanning electron microscopy (SEM) before and after pH-cycling. Data were analyzed by the Student's-t test, ANOVA, Duncan's multiple range test and paired t-test (α=0.05). Significant increase in roughness was found only for TPH in the control group and TPH and Supreme immersed in Claritin® (p<0.05). SEM analyses showed that the 4 composite resins underwent erosion and surface degradation after being subjected to the experimental conditions. In conclusion, although the roughness was slightly affected, the pH-cycling and acidic medicines caused surface degradation of the composite resins evaluated. Titratable acidity seemed to play a more crucial role on surface degradation of composite resins than pH.
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Ácidos/química , Resinas Compuestas/química , Alisadura de la Restauración Dental , Bromofeniramina/química , Restauración Dental Permanente , Análisis del Estrés Dental , Combinación de Medicamentos , Concentración de Iones de Hidrógeno , Antagonistas de los Receptores Histamínicos H1/química , Loratadina/química , Microscopía Electrónica de Rastreo , Fenilefrina/química , Fenilpropanolamina/química , Distribución Aleatoria , Propiedades de SuperficieRESUMEN
Legume proteins as a potential source of valuable nutrients, are the object of several studies in order to obtain the best use. A basic knowledge becomes more important for those proteins from species not wholly utilized, before using them as food ingredients. The objective of this work was to determine several structural and nutritional characteristics of the protein fractions from Phaseolus lunatus, separated in different solvents. The relative amount of extraction for the albumins (ALB), globulins (GLB), prolamines (PRL), and glutelins (GLT) was 62.3, 34.8, 1.4 and 1.5%, respectively. The SDS-PAGE electrophoretic profile of both ALB and GLB, showed seven common bands in intervals from 10 to 95 kDa, and 14 to 99 kDa, respectively; the amino acids profile showed that PRL was the rich fraction in sulfurated amino acids (11.5 g/100 g protein); the content of lysine in the fraction of ALB was smaller than expected but the requirement of the FAO in the fractions of GLB and GLT was covered. In general, the fraction of GLB had the best balance of amino acids and digestibility (80%); however, it had a relationship of calculated protein efficiency ratio (C-PER) of 0.11, smaller than the ratio in ALB (0.97). The calorimetric analysis showed denatured temperatures around 90 degrees C for the ALB, GLB, and GLU fractions. The PRL fraction probably did not present a thermal transition because the proteins were denaturalized by the extraction conditions.
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Proteínas en la Dieta/análisis , Phaseolus/química , Aminoácidos/análisis , Electroforesis en Gel de Poliacrilamida , Harina , Fenilpropanolamina/análisis , Proteínas de Plantas/análisisRESUMEN
BACKGROUND AND PURPOSE: Phenylpropanolamine (PPA) and pseudoephedrine are sympathomimetics contained in over-the-counter cold preparations. A case-control study linked PPA use with hemorrhagic stroke in women. Twenty-two patients with stroke associated with use of these drugs are described. METHODS: In a consecutive stroke registry since 1988, 22 patients had stroke associated with over-the-counter sympathomimetics. Sympathomimetic dosage and type, time interval until stroke onset, and neuroimaging findings are described. RESULTS: Ten male and 12 female patients were included. Intracerebral hemorrhage occurred in 17 patients, subarachnoid hemorrhage in 4, and ischemic stroke in 1. Stroke was associated with PPA use in 16 patients (dose 75 to 675 mg), with pseudoephedrine in 4 (dose 60 to 300 mg), and with others administered by the nasal route in 2 (oxymetazoline and phenylephrine). Stroke occurred after a single dose in 17 patients and after daily use during several days in 5. The interval between drug exposure and clinical onset varied from 30 minutes to 24 hours. Stroke occurred after recommended doses of PPA (50 to 75 mg) in 32% and pseudoephedrine (60 mg) in 50% of patients. Eight patients had acute hypertension at stroke onset. Cerebral angiography was normal in 8 cases and showed diffuse vasospasm or beading in 10 patients. CONCLUSIONS: Stroke related to over-the-counter sympathomimetics was associated with acute hypertension and/or vasospasm or angiitis mechanisms, most related to the use of PPA; however, stroke also occurred with the use of other sympathomimetics, particularly pseudoephedrine. Although stroke complications occurred when doses were used that were higher than recommended doses, apparently there is also a stroke risk when these agents are taken properly.
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Efedrina/efectos adversos , Medicamentos sin Prescripción/efectos adversos , Fenilpropanolamina/efectos adversos , Accidente Cerebrovascular/inducido químicamente , Simpatomiméticos/efectos adversos , Adolescente , Adulto , Anciano , Isquemia Encefálica/inducido químicamente , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/epidemiología , Estudios de Casos y Controles , Causalidad , Hemorragia Cerebral/inducido químicamente , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/epidemiología , Comorbilidad , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Oximetazolina/efectos adversos , Pronóstico , Estudios Prospectivos , Sistema de Registros , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/epidemiología , Hemorragia Subaracnoidea/inducido químicamente , Hemorragia Subaracnoidea/diagnóstico , Hemorragia Subaracnoidea/epidemiologíaRESUMEN
BACKGROUND AND PURPOSE: Phenylpropanolamine (PPA) has been associated with an increased risk of intracranial hemorrhage (ICH). The aim of this study was to assess the association between PPA intake and ICH in a Mexican population. METHODS: We included all patients with ICH aged 18 to 51 years, with no known structural etiology, diagnosed from January 1991 to December 2000. Three to 4 controls per patient matched by sex, age (within 5 years) and place of residence were included. Patients and controls were asked about use of cold medication or appetite suppressant medications within the previous year before the interview. We considered a PPA related hemorrhage when there was a temporal relationship between the use of medication and the development of the hemorrhage, and when other causes could be ruled out. Associated risks for PPA use and other possibly related variables were estimated. RESULTS: 177 patients (mean age 39 +/- 12 years) were included; 58 (33%) were diagnosed with subarachnoid hemorrhage (SAH) and 119 (67%) with ICH. 41.2% (73 of 177) of patients had documented use of PPA within the past year and 10 (5.7%) of them had a temporal relationship between ingestion of PPA and ICH. In control subjects 42.4% (422 of 996) had been exposed to PPA and none of them developed hemorrhage. The time from PPA exposure to the onset of ICH varied from 30 minutes to 24 hours. The risk of PPA exposure for hemorrhage was not significant in cases or controls, OR 0.95 (95% CI, 0.68 to 1.34; p = 0.77). No subjects (cases or controls) reported use of PPA as an appetite suppressant. CONCLUSIONS: We found no association between ingestion of PPA and cerebral hemorrhage with respect to ingestion of PPA in the previous year. When recent use was looked at an apparent risk was evident.
Asunto(s)
Depresores del Apetito/efectos adversos , Hemorragia Cerebral/inducido químicamente , Hemorragia Cerebral/epidemiología , Descongestionantes Nasales/efectos adversos , Fenilpropanolamina/efectos adversos , Adolescente , Adulto , Envejecimiento/fisiología , Alcoholismo/epidemiología , Estudios de Casos y Controles , Hemorragia Cerebral/fisiopatología , Complicaciones de la Diabetes , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Masculino , México/epidemiología , Persona de Mediana Edad , Medición de Riesgo , Tamaño de la Muestra , Fumar/epidemiologíaRESUMEN
A rapid, reliable and specific UV spectrophotometric method was developed to determine Phenilpropanolamine Hydrochloride (I), Caffeine (II) and Diazepam (III) formulated in tablets. This method was validated and compared with a liquid chromatography (LC) procedure used for the simultaneous quantitative analysis of the drugs. The established linearity ranges by both methods for compounds I, II and III were 0.36-0.88, 0.012-0.028 and 0.036-0.084 mg/ml, respectively. The correlation coefficients by HPLC were r(I)(2)=0.997, r(II)(2)=0.999, r(III)(2)=0.999 and by the UV spectrophotometric method were r(I)(2)=0.998, r(II)(2)=0.996, r(III)(2)=0.999. LC and UV methods showed excellent precision and accuracy. As regards precision, LC showed CV values range of 0.2-0.9 and UV 0.15-0.72. On the other hand, accuracy was obtained with CV values range of 0.1-1.8 and 0.32-1.11 for LC and UV, respectively. The recoveries of I, II and III were >98.04% for both methods over the linear range. The UV and HPLC methods have been successfully used to determine the I, II and III content in tablets of different origin.
Asunto(s)
Cafeína/análisis , Cromatografía Líquida de Alta Presión/métodos , Diazepam/análisis , Fenilpropanolamina/análisis , Comprimidos/química , Espectrofotometría UltravioletaRESUMEN
A reverse phase high performance liquid chromatography assay was carried out for the simultaneous determination of three active principles present in tablets of different origin and wide commercial use in the Province of Córdoba (Argentina). Prescriptions, commercially available as appetite suppressants, very often include the active principles Phenylpropanolamine Hydrochloride (I), Caffeine (II) and Diazepam (III). Simultaneous determination of these three drugs: anorexic, central nervous stimulant and tranquilizer, respectively, in pharmaceutical dosage forms has not been reported. In this study these active principles are quantified. The only sample preparation necessary for the analysis was their dilution with acetonitrile. The resulting solution was filtered and analyzed on a column packed with Supelcosil LC-18 (5 microm) with acetonitrile:water (30:70 v/v) as initial mobile phase (0.4 ml min(-1)) and the detection was performed at 254 nm. Then a linear gradient up to 100% acetonitrile in 18 min (3.0 ml min(-1)) was applied. The procedure was simple and suitable for quality control. The calibration function was established in the ranges of 0.072-0.168 mg ml(-1) for I, 0.036-0.084 mg ml(-1) for II and 0.06-0.196 mg ml(-1) for III. The detection limits of these compounds were 12.8, 4.1 and 11.0 microg ml(-1), respectively with linear response. No chromatographic interference from the tablet excipients was found. The method described in this paper was validated following the analytical performance parameters required by the USP XXIV, and was successfully applied to the commercial tablets.