RESUMO
Background: Impaired glucose and energy metabolism has been suggested as a pathogenic mechanism underlying Parkinson's disease (PD). In recent cohorts, phosphoglycerate kinase 1 activators (PGK1a) have been associated with a lower incidence of PD when compared with other antiprostatic agents that do not activate PGK1. Objective: We aimed to perform a systematic review and meta-analysis comparing the incidence of PD in patients taking PGK1a versus tamsulosin. Methods: We searched PubMed, Embase, and Cochrane Library for studies comparing PGK1a vs. tamsulosin in adults and elderly. The primary outcome was the incidence of PD. We computed hazard ratios (HR) for binary endpoints, with 95% confidence intervals (CIs). Statistical analysis was performed using Review Manager 5.4 and R (version 4.3.1). Results: A total of 678,433 participants from four cohort studies were included, of whom 287,080 (42.3%) received PGK1a. Mean age ranged from 62 to 74.7 years and nearly all patients were male. Patients taking PGK1a had a lower incidence of PD (PGK1a 1.04% vs. tamsulosin 1.31%; HR 0.80; 95% CI 0.71-0.90; pâ<â0.01). This result remained consistent in a sensitivity analysis excluding patients of age 60 years old or younger (PGK1a 1.21% vs. tamsulosin 1.42%; HR 0.82; 95% CI 0.71-0.95; pâ<â0.01). Conclusions: Glycolysis-enhancing drugs are associated with a lower incidence of PD when compared with tamsulosin in adults and elderly individuals with prostatic disease in use of alpha-blockers. Our findings support the notion of glycolysis as a potential neuroprotective mechanism in PD. Future investigations with randomized controlled trials are needed.
It has been suggested that impairment in glucose and energy metabolism is one of the mechanisms underlying the development of Parkinson's disease. In recent studies, medications traditionally prescribed for prostate diseases, called phosphoglycerate kinase 1 activators (PGK1a), have been associated with a lower incidence of Parkinson's disease when compared to other medications for the same purpose that do not activate the same energetic pathway. Therefore, we thoroughly reviewed the literature and combined the results of studies that compared both medications (PGK1a versus another medicationâ thatâ does not activate this energetic pathway, called tamsulosin), evaluating the incidence of Parkinson's disease in both groups. We included a total of 678,433 individuals, of whom 42.3% received PGK1a and 57.7% received tamsulosin. In our analysis, patients taking PGK1a had a lower incidence of Parkinson's disease when compared to the other group, even when we excluded patients younger than 60 years of age. As a result, our findings support the notion that the increase of energy metabolism is a potential neuroprotective mechanism in Parkinson's disease and future investigations are needed.
Assuntos
Doença de Parkinson , Fosfoglicerato Quinase , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Glicólise/efeitos dos fármacos , Incidência , Doença de Parkinson/epidemiologia , Doença de Parkinson/metabolismo , Doença de Parkinson/prevenção & controle , Fosfoglicerato Quinase/metabolismo , Tansulosina/administração & dosagem , FemininoRESUMO
Introduction: The use of a ureteral access sheath (UAS) during ureteroscopy (URS) has been associated with the risk for ureteral injuries. Preoperative administration of α1-blockers presents a potential mitigator of such lesions by inducing ureteral relaxation, which may also contribute to improving other surgical outcomes. Methods: A comprehensive literature search was conducted across MEDLINE, Embase, and Cochrane databases for studies comparing preoperative α1-blockers administration vs its non-use in adult patients without pre-stenting undergoing URS. Binary outcomes were evaluated using risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was measured with the Cochran's Q test, I2 statistics, and prediction intervals (PIs). A DerSimonian and Laird random-effects model was utilized for all outcomes. Results: Eleven studies encompassing 1074 patients undergoing URS were included, of whom 522 (48.60%) received α1-blockers before the procedure. Preoperative α1-blockers were associated with a reduction in significant ureteral injuries (RR 0.30; 95% CI 0.17-0.53; I2 = 6%; PI 0.10-0.88) and an increase in mean successful UAS insertion (OR 2.14; 95% CI 1.08-4.23; I2 = 23%; PI 0.51-8.93). In patients undergoing exclusively ureteroscopy lithotripsy (URSL), the medications also reduced total complications (RR 0.62; 95% CI 0.46-0.84; I2 = 0%) and complications graded Clavien-Dindo III or higher (RR 0.16; 95% CI 0.04-0.69; I2 = 0%), but no significant difference between groups was found in the stone-free rate (RR 1.10; 95% CI 0.86-1.40; I2 = 91%; PI 0.47-2.59). Conclusion: Preoperative α1-blockers were linked to a decrease in significant ureteral injuries with UAS use and fewer complications during URSL procedures. However, their impact on the successful insertion of a UAS remains uncertain. Consideration of administering preoperative α1-blockers in non-stented adult patients undergoing URS with UAS is advisable.
Assuntos
Antagonistas de Receptores Adrenérgicos alfa 1 , Ureter , Ureteroscopia , Humanos , Antagonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Cuidados Pré-Operatórios/métodos , Resultado do Tratamento , Ureter/efeitos dos fármacos , Ureter/lesões , Ureter/cirurgia , Ureteroscopia/efeitos adversos , Ureteroscopia/instrumentação , Ureteroscopia/métodosRESUMO
ABSTRACT Purpose: Medical expulsive therapy (MET) is recommended for distal ureteral stones from 5 to 10 mm. The best drug for MET is still uncertain. In this review, we aim to compare the effectiveness of tadalafil and tamsulosin for distal ureteral stones from 5 to 10 mm in terms of stone expulsion rate (SER), stone expulsion time (SET) and the side effect profile. Materials and methods: A comprehensive literature search was conducted on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus and Web of Science, from inception until April 2023. Only randomized controlled trials were included in the analysis. Results: Eleven publications with 1,330 patients were included. We observed that tadalafil has a higher SER (OR 0.55, CI 95% 0.38;0.80, p=0.02, I2=52%) and the same efficacy in SET (MD 1.07, CI 95% -0.25; 2.39, p=0.11, I2=84%). No differences were found when comparing side effects as headache, backache, dizziness, and orthostatic hypotension. Conclusion: Tadalafil has a higher stone expulsion rate than tamsulosin as a medical expulsive therapy for patients with distal stones from 5 to 10 mm without differences in side effects.
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La tamsulosina y dutasterida son medicamentos ampliamente usados como tratamiento de la hipertrofia benigna de próstata. teniendo un buen perfil de seguridad. Existen escasos reportes de injuria hepática asociado al uso de tamsulosina; sin embargo, no hay reportes de toxicidad hepática por el uso de dutasterida y del uso combinado de tamsulosina/dutasterida. Se presenta el caso de un varón de 64 años quien desarrolla injuria hepática tras el uso combinado de tamsulosina/dutasterida, desarrollando un patrón de daño hepatocelular y clínica de hepatitis aguda. Se realizo descarte de patología hepática viral, autoinmune y enfermedades metabólicas de depósito, así como de patología biliar mediante ecografía abdominal y colangioresonancia. En la evaluación de causalidad, presentó CIOMS-RUCAM: 6 puntos (probable) y Naranjo: 4 puntos (posible). El paciente presentó respuesta clínica y laboratorial luego de suspender el medicamento.
Tamsulosin and dutasteride are drugs widely used to treat benign prostatic hypertrophy. having a good safety profile. There are few reports of liver injury associated with the use of tamsulosin; however, there are no reports of hepatic toxicity from the use of dutasteride and the combined use of tamsulosin/dutasteride. We present the case of a 64-year-old man who developed liver injury after the combined use of tamsulosin/dutasteride, developing a pattern of hepatocellular damage and acute hepatitis symptoms. Viral, autoimmune, and metabolic storage diseases of the liver were ruled out, as well as biliary pathology by means of abdominal ultrasound and resonance cholangiography. In the causality evaluation, CIOMS-RUCAM presented: 6 points (probable) and Naranjo: 4 points (possible). The patient presented a clinical and laboratory response after discontinuing the drug.
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The benign prostatic hyperplasia (BPH) is the main source of lower urinary tract symptoms. The BPH is a common age-dependent disease and tamsulosin is an α1-adrenoceptor blocker widely prescribed for BPH. Beyond the common adverse effects of tamsulosin, increased diagnosis of dementia after prescription was observed. Importantly, a clinical study suggested that tamsulosin may exert antidepressant effects in BPH patients. Considering the expression of α1-adrenoceptors in the brain, this study aimed to investigate the effects of tamsulosin in the forced swimming and open field tests in mice. For this, tamsulosin (0.001-1 mg/kg) was orally administered subacutely (1, 5 and 23 hr) and acutely (60 min) before tests. Mifepristone (10 mg/kg), a glucocorticoid receptor antagonist, and aminoglutethimide (10 mg/kg), a streoidogenesis inhibitor, were intraperitoneally injected before tamsulosin to investigate the role of the hypothalamic-pituitary-adrenal axis in the mediation of tamsulosin-induced effects. Subacute and acute administrations of tamsulosin increased the immobility time in the first exposition to an inescapable stressful situation. In the re-exposition to the swim task, controls displayed a natural increase in the immobility time, and the treatment with tamsulosin further increased this behavioral parameter. Tamsuslosin did not affect spontaneous locomotion neither in naïve nor in stressed mice. Our findings also showed that mifepristone and aminoglutethimide prevented the tamsulosin-induced increase in the immobility time in the first and second swimming sessions, respectively. In conclusion, tamsulosin may contribute to increased susceptibility to depressive-like behaviors, by facilitating the acquisition of a passive stress-copying strategy. These effects seem to be dependent on endogenous glucocorticoids.
Assuntos
Adaptação Psicológica/efeitos dos fármacos , Antagonistas de Receptores Adrenérgicos alfa 1/farmacologia , Inibidores da Aromatase/farmacologia , Depressão/induzido quimicamente , Antagonistas de Hormônios/farmacologia , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Receptores de Glucocorticoides/antagonistas & inibidores , Tansulosina/farmacologia , Antagonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Aminoglutetimida/farmacologia , Animais , Inibidores da Aromatase/administração & dosagem , Comportamento Animal/efeitos dos fármacos , Modelos Animais de Doenças , Antagonistas de Hormônios/administração & dosagem , Camundongos , Mifepristona/farmacologia , Tansulosina/administração & dosagemRESUMO
The aim of the present study was to compare the bioavailability and to demonstrate the bioequivalence between a dutasteride-tamsulosin 0.5 mg/0.4 mg capsule formulation and the regulatory reference drug (Combodart®, GlaxoSmithKline). A randomized, single-blind, single-dose, 2-way crossover study under fasting conditions, with at least a 28-day washout period was carried out in healthy volunteers. Plasma concentrations of drugs were determined by high-performance liquid chromatography-tandem mass spectrometry. The pharmacokinetic analysis included maximum plasma concentration (Cmax ), area under the plasma concentration-time curve (AUC) from time 0 to 72 hours, and AUC from baseline to infinity. The test formulation was considered bioequivalent if the geometric mean ratios (test/reference) were within the predetermined range of 80% to 125%. Safety and tolerability were evaluated by clinical assessment. The confidence intervals for the log-transformed test/reference ratios for dutasteride, Cmax (95.4-109.2) and AUC from baseline to 72 hours (93.2-109.1), and for tamsulosin, Cmax (101.9-119.8), AUC from baseline to the last quantifiable concentration (91.4-106.3) and AUC from baseline to infinity (90.9-103.3), were within the allowed limit specified by the regulatory authorities (80%-125%). In addition, both test and reference drugs were safe and tolerated. These results demonstrated the bioequivalence of test product (Dakart®) compared with Combodart®.
Assuntos
Jejum , Área Sob a Curva , Estudos Cross-Over , Dutasterida/efeitos adversos , Dutasterida/farmacocinética , Humanos , Método Simples-Cego , Comprimidos , Tansulosina , Equivalência TerapêuticaRESUMO
ABSTRACT Purpose: To compare the effects of tadalafil, tamsulosin, and placebo as a medical expulsive therapy (MET) for distal ureteral calculi. Materials and Methods: This prospective randomized double-blind clinical trial was conducted on 132 renal colic patients with distal ureteric stones (≤10mm) over a period of 12 months. Patients were randomly divided into three groups. Patients in group A received tamsulosin 0.4mg, in group B received tadalafil 10mg, and in group C received placebo. Therapy was given for a maximum of 4 weeks. The rate of stone expulsion, duration of stone expulsion, the dose and the duration of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesic use, and adverse effects of drugs were recorded. Results: Demographic profiles were comparable between the 3 groups. Although the stone expulsion rate in group A (72.7%) was higher in comparison to group B(63.6%) and group C(56.8%), it was not considered statistically significant (P=0.294). Shorter mean time to stone expulsion was significantly observed in group A (17.75±75), than group B(21.13±1.17) and group C(22.25±1.18) (P=0.47). The mean number of analgesic use was 9.8±5.09 days in group A, 14.6±7.9 days in group B, and 12.6±22.25 days in group C, this difference was significant (P=0.004). The analgesic requirement (doses of NSAIDs and pethidine) in group A was significantly lower than other groups (P<0.05). Also, patients in group A reported fewer headaches compared to other groups (P=0.011). Conclusion: Tamsulosin as medical expulsive therapy is more effective for distal ureteric stones with less need for analgesics and less stone expulsion time than tadalafil.
Assuntos
Humanos , Cálculos Ureterais/tratamento farmacológico , Sulfonamidas/uso terapêutico , Estudos Prospectivos , Resultado do Tratamento , Tadalafila/uso terapêutico , Tansulosina/uso terapêuticoRESUMO
PURPOSE: To compare the effects of tadalafil, tamsulosin, and placebo as a medical expulsive therapy (MET) for distal ureteral calculi. MATERIALS AND METHODS: This prospective randomized double-blind clinical trial was conducted on 132 renal colic patients with distal ureteric stones (≤10mm) over a period of 12 months. Patients were randomly divided into three groups. Patients in group A received tamsulosin 0.4mg, in group B received tadalafil 10mg, and in group C received placebo. Therapy was given for a maximum of 4 weeks. The rate of stone expulsion, duration of stone expulsion, the dose and the duration of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesic use, and adverse effects of drugs were recorded. RESULTS: Demographic profiles were comparable between the 3 groups. Although the stone expulsion rate in group A (72.7%) was higher in comparison to group B(63.6%) and group C(56.8%), it was not considered statistically significant (P=0.294). Shorter mean time to stone expulsion was significantly observed in group A (17.75±75), than group B(21.13±1.17) and group C(22.25±1.18) (P=0.47). The mean number of analgesic use was 9.8±5.09 days in group A, 14.6±7.9 days in group B, and 12.6±22.25 days in group C, this difference was significant (P=0.004). The analgesic requirement (doses of NSAIDs and pethidine) in group A was significantly lower than other groups (P< 0.05). Also, patients in group A reported fewer headaches compared to other groups (P=0.011). CONCLUSION: Tamsulosin as medical expulsive therapy is more effective for distal ureteric stones with less need for analgesics and less stone expulsion time than tadalafil.
Assuntos
Cálculos Ureterais , Humanos , Estudos Prospectivos , Sulfonamidas/uso terapêutico , Tadalafila/uso terapêutico , Tansulosina/uso terapêutico , Resultado do Tratamento , Cálculos Ureterais/tratamento farmacológicoRESUMO
ABSTRACT Purpose: To evaluate the efficacy of adjunctive medical expulsive therapy (MET) with tamsulosin for the promotion of stone fragments clearance for repeated extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: This meta-analysis was conducted by systematic search for randomized controlled trial (RCT) studies in PubMed/Medline, Scopus, Cochrane Library, Web of Science databases in January 2020, which compared tamsulosin with either placebo or non-placebo control for repeated ESWL. The primary endpoint was stone-free rate (SFR), the second endpoints were stone clearance time and complications. The quality assessment of included studies was performed by using the Cochrane System and Jadad score. Results: 7 RCTs were included in this meta-analysis. Tamsulosin provided higher SFR (for stones larger than 1cm, OR: 5.56, p=0.0003), except for patients with stones less than 1cm. For patients with renal stones (OR: 2.97, p=0.0005) or upper ureteral stones (OR: 3.10, p=0.004), tamsulosin can also provide a higher SFR. In addition, tamsulosin provided a shorter stone clearance time (WMD: −9.40, p=0.03) and lower pain intensity (WMD=-17.01, p <0.0001) and incidences of steinstrasse (OR: 0.37, p=0.0002). Conclusion: Adjunctive MET with tamsulosin is effective in patients with specific stone size or location that received repeated ESWL. However, no well-designed RCT that used computed tomography for the detection and assessment of residual stone fragments was found. More studies with high quality and the comparison between tamsulosin and secondary ESWL are needed in the future.
Assuntos
Humanos , Litotripsia , Cálculos Renais/terapia , Cálculos Ureterais/tratamento farmacológico , Sulfonamidas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , TansulosinaRESUMO
PURPOSE: To evaluate the efficacy of adjunctive medical expulsive therapy (MET) with tamsulosin for the promotion of stone fragments clearance for repeated extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: This meta-analysis was conducted by systematic search for randomized controlled trial (RCT) studies in PubMed/Medline, Scopus, Cochrane Library, Web of Science databases in January 2020, which compared tamsulosin with either placebo or non-placebo control for repeated ESWL. The primary endpoint was stone-free rate (SFR), the second endpoints were stone clearance time and complications. The quality assessment of included studies was performed by using the Cochrane System and Jadad score. RESULTS: 7 RCTs were included in this meta-analysis. Tamsulosin provided higher SFR (for stones larger than 1cm, OR: 5.56, p=0.0003), except for patients with stones less than 1cm. For patients with renal stones (OR: 2.97, p=0.0005) or upper ureteral stones (OR: 3.10, p=0.004), tamsulosin can also provide a higher SFR. In addition, tamsulosin provided a shorter stone clearance time (WMD: -9.40, p=0.03) and lower pain intensity (WMD=-17.01, p< 0.0001) and incidences of steinstrasse (OR: 0.37, p=0.0002). CONCLUSION: Adjunctive MET with tamsulosin is effective in patients with specific stone size or location that received repeated ESWL. However, no well-designed RCT that used computed tomography for the detection and assessment of residual stone fragments was found. More studies with high quality and the comparison between tamsulosin and secondary ESWL are needed in the future.
Assuntos
Cálculos Renais , Litotripsia , Cálculos Ureterais , Humanos , Cálculos Renais/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Sulfonamidas/uso terapêutico , Tansulosina , Resultado do Tratamento , Cálculos Ureterais/tratamento farmacológicoRESUMO
Benign prostatic hyperplasia (BPH) is a condition characterized by a benign enlargement of the prostate that interferes with the normal flow of urine. This disease is treated with the oral administration of combination therapy comprising α-blockers (tamsulosin) and 5α-reductase inhibitors (dutasteride). However, these compounds have low bioavailability. Thus, transdermal microemulsions aimed at promoting permeation and efficient targeted drug delivery through the skin are used. The objectives of this study were to obtain microemulsions of the combined doses of dutasteride and tamsulosin and evaluate their anti-hyperplastic activity in vivo. A phase diagram (4:1) was obtained for the choice of microemulsions. The microemulsions were characterized in terms of the droplet size, rheology, pH, conductivity, refractive index, in vitro release profile, and antihyperplastic effect in vivo. A method for the simultaneous quantification of drugs was developed using UV-vis spectroscopy. The microemulsions had an average size less than 116â¯nm, an acidic pH and low viscosity. The conductivity ranged from 6.18 to 185.2 µS/cm. The in vitro release profile was sustained for 6â¯h. Microemulsions promoted the reduction in the size of testosterone-dependent organs (prostate and seminal vesicles). Transdermal formulations for the treatment of BPH were obtained as a therapeutic alternative to conventional treatments.
Assuntos
Dutasterida/uso terapêutico , Emulsões/química , Hiperplasia Prostática/tratamento farmacológico , Tansulosina/uso terapêutico , Animais , Liberação Controlada de Fármacos , Masculino , Transição de Fase , Próstata/efeitos dos fármacos , Próstata/patologia , Ratos Wistar , Reprodutibilidade dos TestesRESUMO
OBJECTIVES: To assess the effectiveness of medical expulsive therapy with tamsulosin. MATERIAL AND METHODS: Randomized double-blind controlled trial in an emergency department. We enrolled adults with uncomplicated distal ureterolithiasis and no other complaint. Patients were randomized to take either tamsulosin (0.4 mg/d) plus a nonsteroidal anti-inflammatory drug (NSAID) or placebo plus the NSAID for 21 days. RESULTS: The stone expulsion rate did not differ statistically between the 2 groups (P=.29). Time until expulsion was also similar (P=.91). CONCLUSION: Medical expulsive therapy with tamsulosin does not improve the rate of distal ureteral stone expulsion.
OBJETIVO: Evaluar la efectividad del tratamiento médico expulsivo con tamsulosina. METODO: Ensayo clínico prospectivo aleatorizado doble ciego realizado en un servicio de urgencias. Se incluyen adultos con ureterolitiasis distal única no complicada, que fueron asignados aleatoriamente a tamsulosina 0,4 mg/día más antiinflamatorio no esteroideo (AINE) (grupo A), o con placebo más AINE (grupo B), durante 21 días. RESULTADOS: No se observaron diferencias estadísticamente significativas en la tasa de expulsión de litiasis entre ambos grupos (p = 0,29) ni en el tiempo de expulsión de esta (p = 0,91). CONCLUSIONES: La terapia expulsiva con tamsulosina no se asocia a una mayor tasa de expulsión de litiasis ureteral.
Assuntos
Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Tansulosina/uso terapêutico , Cálculos Ureterais/tratamento farmacológico , Agentes Urológicos/uso terapêutico , Acetaminofen/administração & dosagem , Acetaminofen/uso terapêutico , Antagonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Adulto , Idoso , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Chile , Método Duplo-Cego , Serviço Hospitalar de Emergência , Feminino , Humanos , Cetorolaco/administração & dosagem , Cetorolaco/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tansulosina/administração & dosagem , Agentes Urológicos/administração & dosagemRESUMO
A tansulosina é um dos medicamentos mais prescritos no mundo para o tratamento da hiperplasia prostática benigna. Ela se liga aos receptores α-1-adrenérgicos impedindo a contração do músculo liso no estroma da próstata, consequentemente melhorando a micção. Existem alguns efeitos adversos ligados ao tratamento com a tansulosina. Entretanto, ainda não foi relatado na literatura o desenvolvimento de um fibrossarcoma após a utilização deste medicamento. O fibrossarcoma é um tipo de neoplasia maligna que ocorre no tecido conjuntivo. Geralmente é um tipo deneoplasia infiltrada, que pode ser encapsulada. O objetivo deste estudo foi identificar os componentes histopatológicos e o perfil de progressão de uma neoplasia em um animal Wistar tratado com a tansulosina. Foi utilizado um animal macho Wistar, que foi gavado com tansulosina 0,4mg/Kg/dia durante 21 dias. Após o 21ª dia o animaldesenvolveu uma massa tumoral foi sacrificado seis dias depois. Após dissecção do animal foi coletada da massa tumoral e o material foi fixado em formaldeído a 3,7% respeitando um tempo mínimo de 24 horas. A massa tumoral foi clivada em quatro pedaços e dividida em zonas: Zn1, Zn2, Zn3 e Zn4. Foram realizadas técnicas de histoquímicas para identificação das estruturas: Tricrômico de Masson, Picro Sirius Red, Azul de Toluidina e Fucsina-resorcina de Weigert com prévia oxidação. Ainda existem poucas evidências para corroborar se o tratamento farmacológico com a tansulosina tenha sido responsável pelo desenvolvimento do fibrossarcoma. Contudo, mais estudos serão feitos para identificar a origem e a progressão dessa neoplasia neste animal.
Tansulin is one of the most commonly prescribed drugs in the world for the treatment of benign prostatic hyperplasia. It binds α-1-adrenergic receptors preventing smooth muscle contraction in prostate aroma, thereby improving urination. There are someadverse effects linked to treatment with tamsulosin. However, it has not been reported in the literature or development of a fibrosarcoma after the use of this drug. The fibrosarcoma is a type of malignant neoplasm that occurs in connective tissue. It may be a type of infiltrated neoplasia that can be encapsulated. The aim of this study was to identify the histopathological components and the progression profile of a neoplasia in a tamsulosin treated Wistar animal. A male Wistar animal was used, which was removed with tamsulosin 0.4mg / kg / day for 21 days. After the 21st day the animal developed a tumor mass was sacrificed six days later. After dissecting the animal, the tumor mass was collected and the material was fixed in 3.7% formaldehyde, respecting a minimumtime of 24 hours. A tumor mass was divided into four pieces and divided into zones: Zn1, Zn2, Zn3 and Zn4. Histochemical techniques were performed to identify structures:Massons trichrome, Picro Sirius Red, Toluidine Blue and Weigert Fuchsin-resorcin with prior oxidation. There are still few that corroborate the pharmacological treatment withtamsulosin, being responsible for the development of fibrosarcoma. However, further studies will be done to identify the origin and progress of this neoplasia in this animal.
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Animais , Ratos , Fibrossarcoma/induzido quimicamente , Fibrossarcoma/veterinária , Hiperplasia Prostática/veterinária , Neoplasias da Próstata/veterinária , Tansulosina/efeitos adversos , Modelos AnimaisRESUMO
A tansulosina é um dos medicamentos mais prescritos no mundo para o tratamento da hiperplasia prostática benigna. Ela se liga aos receptores α-1-adrenérgicos impedindo a contração do músculo liso no estroma da próstata, consequentemente melhorando a micção. Existem alguns efeitos adversos ligados ao tratamento com a tansulosina. Entretanto, ainda não foi relatado na literatura o desenvolvimento de um fibrossarcoma após a utilização deste medicamento. O fibrossarcoma é um tipo de neoplasia maligna que ocorre no tecido conjuntivo. Geralmente é um tipo deneoplasia infiltrada, que pode ser encapsulada. O objetivo deste estudo foi identificar os componentes histopatológicos e o perfil de progressão de uma neoplasia em um animal Wistar tratado com a tansulosina. Foi utilizado um animal macho Wistar, que foi gavado com tansulosina 0,4mg/Kg/dia durante 21 dias. Após o 21ª dia o animaldesenvolveu uma massa tumoral foi sacrificado seis dias depois. Após dissecção do animal foi coletada da massa tumoral e o material foi fixado em formaldeído a 3,7% respeitando um tempo mínimo de 24 horas. A massa tumoral foi clivada em quatro pedaços e dividida em zonas: Zn1, Zn2, Zn3 e Zn4. Foram realizadas técnicas de histoquímicas para identificação das estruturas: Tricrômico de Masson, Picro Sirius Red, Azul de Toluidina e Fucsina-resorcina de Weigert com prévia oxidação. Ainda existem poucas evidências para corroborar se o tratamento farmacológico com a tansulosina tenha sido responsável pelo desenvolvimento do fibrossarcoma. Contudo, mais estudos serão feitos para identificar a origem e a progressão dessa neoplasia neste animal.(AU)
Tansulin is one of the most commonly prescribed drugs in the world for the treatment of benign prostatic hyperplasia. It binds α-1-adrenergic receptors preventing smooth muscle contraction in prostate aroma, thereby improving urination. There are someadverse effects linked to treatment with tamsulosin. However, it has not been reported in the literature or development of a fibrosarcoma after the use of this drug. The fibrosarcoma is a type of malignant neoplasm that occurs in connective tissue. It may be a type of infiltrated neoplasia that can be encapsulated. The aim of this study was to identify the histopathological components and the progression profile of a neoplasia in a tamsulosin treated Wistar animal. A male Wistar animal was used, which was removed with tamsulosin 0.4mg / kg / day for 21 days. After the 21st day the animal developed a tumor mass was sacrificed six days later. After dissecting the animal, the tumor mass was collected and the material was fixed in 3.7% formaldehyde, respecting a minimumtime of 24 hours. A tumor mass was divided into four pieces and divided into zones: Zn1, Zn2, Zn3 and Zn4. Histochemical techniques were performed to identify structures:Massons trichrome, Picro Sirius Red, Toluidine Blue and Weigert Fuchsin-resorcin with prior oxidation. There are still few that corroborate the pharmacological treatment withtamsulosin, being responsible for the development of fibrosarcoma. However, further studies will be done to identify the origin and progress of this neoplasia in this animal.(AU)
Assuntos
Animais , Ratos , Tansulosina/efeitos adversos , Fibrossarcoma/veterinária , Fibrossarcoma/induzido quimicamente , Neoplasias da Próstata/veterinária , Hiperplasia Prostática/veterinária , Modelos AnimaisRESUMO
Resumen Introducción La hiperplasia prostática benigna es el padecimiento urológico más frecuente en hombres mayores de 50 años; sus síntomas afectan la calidad de vida. Los bloqueadores alfa-adrenérgicos son una opción para mejorarla. Objetivo Determinar la calidad de vida de pacientes con hiperplasia prostática benigna antes y después del tratamiento con un bloqueador alfa-adrenérgico. Material y métodos Estudio pretest-retest en hombres de 45 a 75 años con hiperplasia prostática benigna. Se administró tamsulosina (0.4 mg/día) por tres meses y se evaluó la severidad de los síntomas y la calidad de vida con el International Prostate Symptom Score (IPSS) y EuroQol 5-D. Se usaron X2 y prueba de rangos y signos de Wilcoxon. Resultados Se incluyeron 50 pacientes de 63.3 ± 10.3 años, 34 (68.0%) tenían síntomas severos antes del tratamiento y 19 (38.0%) después de tres meses (p < 0.05). Con el IPSS, 33 (66.0%) pacientes estaban en categorías de «tan insatisfecho como insatisfecho¼ a «muy insatisfecho¼ antes de la intervención y seis (12.0%) después de ella. La escala visual análoga (EVA) del EuroQol 5-D mostró puntuación basal de 72.9 ± 11.2 versus 83.4 ± 7.6 después (p < 0.05). Conclusión La tamsulosina reduce la severidad de los síntomas y mejora la calidad en de vida en la hiperplasia prostática benigna después de administrarla tres meses.
Abstract Introduction Benign prostatic hyperplasia is an urological disorder most common in men over 50 years old; the symptoms affect the quality of life. Alpha-adrenergic blockers are an option to improve it. Objective To determine the quality of life of patients with benign prostatic hyperplasia before and after treatment with an alphaadrenergic blocker. Material and methods Pretest-retest study in men of 45 to 75 years with benign prostatic hyperplasia. Tamsulosin was administered (0.4 mg/day) for three months; the severity of symptoms and quality of life were assessed with IPSS and EuroQol 5-D. Ranges and sign of Wilcoxon test and X2 were used. Results Fifty patients were included of 63.3 ± 10.3 years of age, 34 (68.0%) had severe symptoms before the treatment and 19 (38.0%) after three months (p < 0.05). With IPSS, 33 (66.0%) patients were in the categories of «as dissatisfied as unsatisfied¼ and «very dissatisfied¼ before the intervention and six (12.0%) after. The VAS of the EuroQol 5-D showed a baseline score of 72.9 ± 11.2 versus 83.4 ± 7.6 after (p < 0.05). Conclusion Tamsulosin reduces severity of symptoms and improves quality of life in benign prostatic hyperplasia after giving it three months.
RESUMO
Benign prostatic hyperplasia (BPH) is one of the most common diseases of the urogenital tract. Thisstudy aimed to obtain one transdermal microemulsion of dutasteride and tamsulosin, drugs used in the treatmentof BPH, characterize them and study your in vitro release, evaluating through in vivo studies the antiandrogenicactivity of transdermal microemulsion. The preparation of the formulation involved obtaining the microemulsionwith Dutasteride and Tamsulosin in the equivalent percentage of 0.2% for each drug. To carry out theantiandrogenic activity, were used 32 rats (Wistar) in four groups experimental. The characterization performedall formulations showed good results, in which the evaluation of anti-hyperplastic the microemulsiondemonstrated one reducing the organs testosterone-dependent (prostate and seminal vesicles) corroborated forthe study in question enabling then obtaining promising transdermal formulations for BPH treatment, presentingthus a therapeutic alternative to conventional treatments.
Assuntos
Dutasterida/administração & dosagem , Hiperplasia Prostática/reabilitação , Hiperplasia Prostática/veterinária , Tansulosina/administração & dosagem , Administração Cutânea , Antagonistas de AndrogêniosRESUMO
Benign prostatic hyperplasia (BPH) is one of the most common diseases of the urogenital tract. Thisstudy aimed to obtain one transdermal microemulsion of dutasteride and tamsulosin, drugs used in the treatmentof BPH, characterize them and study your in vitro release, evaluating through in vivo studies the antiandrogenicactivity of transdermal microemulsion. The preparation of the formulation involved obtaining the microemulsionwith Dutasteride and Tamsulosin in the equivalent percentage of 0.2% for each drug. To carry out theantiandrogenic activity, were used 32 rats (Wistar) in four groups experimental. The characterization performedall formulations showed good results, in which the evaluation of anti-hyperplastic the microemulsiondemonstrated one reducing the organs testosterone-dependent (prostate and seminal vesicles) corroborated forthe study in question enabling then obtaining promising transdermal formulations for BPH treatment, presentingthus a therapeutic alternative to conventional treatments.(AU)
Assuntos
Hiperplasia Prostática/reabilitação , Hiperplasia Prostática/veterinária , Tansulosina/administração & dosagem , Dutasterida/administração & dosagem , Antagonistas de Androgênios , Administração CutâneaRESUMO
ABSTRACT Introduction and objective Indwelling double J ureteral stents are used routinely in the resolution of ureteral obstruction caused by different etiologies. Evaluation of urinary symptoms related to double-J stent, indicate that these affect 73-90% of patients. We conducted a prospective, randomized study, to evaluate the efficacy of tamsulosin, oxybutinin and combination therapy in improving the urinary symptoms. Methods Patients who underwent ureteral stent placement after ureterolithotripsy (total 51), were randomized into three groups: Group I: Tamsulosin 0.4 mg. once per day(17 patients), Group II: Oxybutinin 5 mg. once per day (17 patients), Group III: Tamsulosin+ oxybutynin once per day (17 patients). All the groups received the drugs for three weeks and completed a Spanish validated Ureteral Stent Symptom Questionnaire (USSQ) at day 7 and 21. Results Repeated measures ANOVA showed mean urinary symptom index score was 22.3 vs. 15.5 in group three (p<0.001) at day 7 and 21 respectively. The mean work performance index was 6.6 vs 8.1 (p=0.049) favoring tamsulosin group, the mean sexual score was 0.5 vs 1.5 (p=0.03). Among additional problems the mean was 7.2 vs 6.2 (p=0.03). No significant difference was noted among pain and general health index. No side effects were reported. Conclusions Combination therapy with tamsulosin and oxybutynin improved irritative symptoms and work performance as well as sexual matters. Combination therapy should be considered for patients who complained of stent related symptoms.
Assuntos
Humanos , Masculino , Feminino , Adulto , Sulfonamidas/uso terapêutico , Stents/efeitos adversos , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Agentes Urológicos/uso terapêutico , Ácidos Mandélicos/uso terapêutico , Qualidade de Vida , Fatores de Tempo , Ureter , Obstrução Ureteral , Obstrução Ureteral/complicações , Obstrução Ureteral/terapia , Método Simples-Cego , Estudos Prospectivos , Inquéritos e Questionários , Reprodutibilidade dos Testes , Análise de Variância , Resultado do Tratamento , Quimioterapia Combinada , Sintomas do Trato Urinário Inferior/prevenção & controle , Pessoa de Meia-IdadeRESUMO
A case of a 76 year old Colombian patient who developed an episode of postural hypotension, after using 4mg of doxazosin for treatment of benign prostatic hypertrophy (BPH) is presented. Because of his age and severity of symptoms (asthenia, weakness, adynamia), the patient was hospitalized. Changing doxazosin by tamsulosin allowed control of symptoms of BPH with no further episodes of orthostatic hypotension.
Se presenta el caso de un paciente colombiano de 76 años quien sufrió un episodio de hipotensión postural, después de tomar doxazosina de 4 mg para el manejo de la hiperplasia prostática benigna (HPB). Debido a la severidad de los síntomas (astenia, debilidad y adinamia), el paciente fue hospitalizado. El cambio de doxazosina por tamsulosina permitió el control de los síntomas de la HPB sin episodios ulteriores de hipotensión ortostática.
RESUMO
Purpose The aim of this study was to define if tadalafil causes detrusor muscle impairment and to observe the effect of combination of tadalafil with tamsulosin on the lower urinary tract of rats with bladder outlet obstruction (BOO) induced by chronic nitric oxide deficiency. Materials and Methods Thirty-one male rats were randomized to following groups: 1 - control; 2 - L-Nitroarginine methyl ester (L-NAME); 3 - Tamsulosin + L-NAME, 4 Tadalafil+L-NAME; and 5 - Tamsulosin + Tadalafil + L-NAME. At the end of the treatment period (30 days), all animals were submitted to urodynamic study. Results The administration of L-NAME increased the number of non-voiding contractions (NVC) (1.04 ± 0.22), volume threshold (VT) (1.86 ± 0.35), and micturition cycle (MC) (1.34 ± 0.11) compared with control (0.52 ± 0.06, 0.62 ± 0.06, and 0.67 ± 0.30), respectively. The administration of tamsulosin reduced the number of NVC (0.57 ± 0.42) and VT (0.76 ± 0.24 ) compared with L-NAME group. Co-treatment with tadalafil decreased the number of VT (0.85 ± 0.53) and MC (0.76 ± 0.22) compared with L-NAME group. The combination of tamsulosin with tadalafil improved the number of NVC (0.56 ± 0.18), VT (0.97 ± 0.52) and MC (0.68 ± 0.30) compared with L-NAME group. Conclusion In rats with BOO induced by chronic nitric oxide deficiency, tadalafil did not cause impairment in detrusor muscle and seems to have an addictive effect to tamsulosin because the combination decreased non voiding contractions as well the number of micturition cycles. .