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Introdução: A crença de que o uso de Inibidores de Bomba de Prótons (IBPs) apresenta baixo risco de toxicidade, resultou em um aumento significativo na sua prescrição em nível mundial, esse fator juntamente com a baixa divulgação de orientações, têm contribuído para o aumento das indicações desnecessárias de inibidores de bomba de prótons em nível hospitalar, principalmente para profilaxia. Objetivo: Analisar a utilização dos inibidores de bomba de prótons em pacientes internados nas enfermarias de clínica médica de um Hospital Universitário, visando avaliar suas indicações, tempo de uso, efeitos adversos e impacto financeiro gerado pelo uso inadequado. Métodos: Foram analisados prontuários de pacientes que estiveram internados nas enfermarias de clínica médica do Hospital Municipal Universitário de Taubaté (HMUT) durante os meses de maio a julho de 2020. As indicações adequadas do uso de inibidores de bomba de prótons foram baseadas em diretrizes internacionais do American Journal of Gastroenterology e do American Society of Health-System Pharmacy. Resultados: Identificamos que 297 pacientes (79,6%) usaram inibidores de bomba de prótons em algum momento da internação. O uso desse medicamento foi adequadamente prescrito em 49,8% dos casos. Foi encontrado maior prevalência de pneumonia e diarreia nos pacientes que fizeram uso de inibidores de bomba de prótons a longo prazo. O custo anual associado as prescrições indevidas foram de R$24.736,40. Conclusão: Observamos alta prevalência de indicações incorretas dos inibidores de bomba de prótons em ambiente hospitalar, ocasionando gasto desnecessário e possíveis complicações. Faz-se necessário, portanto, elaboração de novos protocolos e maior rigidez nas indicações desses medicamentos no Hospital Municipal Universitário de Taubaté.
Introduction: The belief that the use of Proton Pump Inhibitors (PPIs) presents a low risk of toxicity, resulted in a significant increase in its prescription worldwide, this factor combined with the low disclosure of guidelines, have contributed to the increase in unnecessary indications of at the hospital level, especially for prophylaxis. Objective: To analyze the use of proton pump inhibitors in patients hospitalized in the medical clinic wards of a University Hospital, in order to evaluate their indications, time of use, adverse effects and financial impact generated by inadequate use. Methods: Medical records of patients who were admitted at the Municipal University Hospital of Taubaté during the months of May to July 2020 were analyzed. The appropriate indications for the use of proton pump inhibitors were based on the international guidelines of the American Journal of Gastroenterology and the American Society of Health-System Pharmacy. Results: We identified that 297 patients (79.6%) used proton pump inhibitors at some point in hospitalization. The use of this drug was adequately prescribed in 49.8% of the cases. A higher prevalence of pneumonia and diarrhea was found in patients who used proton pump inhibitors in the long term. The annual cost associated with undue prescriptions was R$24,736.40. Conclusion: We observed a high prevalence of incorrect indications of proton pump inhibitors s in the hospital environment, causing unnecessary expenses and possible complications. It is necessary, therefore, the elaboration of new protocols and greater rigidity in the indications of these drugs at the Municipal University Hospital of Taubaté.
Subject(s)
Humans , Peptic Ulcer Hemorrhage , Proton Pump Inhibitors/adverse effects , Inappropriate Prescribing/adverse effects , Anti-Ulcer Agents/administration & dosage , Drug Prescriptions/statistics & numerical data , Costs and Cost Analysis , Hospitalization , InpatientsABSTRACT
RESUMO Objetivo: Avaliar a adesão ao protocolo de profilaxia de úlcera de estresse em pacientes críticos de um hospital universitário terciário. Métodos: Neste estudo de coorte prospectiva, incluímos todos os pacientes adultos admitidos às unidades de terapia intensiva clínica e cirúrgica de um hospital terciário acadêmico. Nosso único critério de exclusão foi a presença de sangramento gastrointestinal alto quando da admissão à unidade de terapia intensiva. Colhemos as variáveis basais e indicações de profilaxia de úlcera de estresse, segundo o protocolo institucional, assim como o uso de profilaxia. Nosso desfecho primário foi a adesão ao protocolo de profilaxia de úlcera de estresse. Os desfechos secundários foram uso apropriado da profilaxia de úlcera de estresse, incidência de sangramento gastrointestinal superior e fatores associados com o uso apropriado da profilaxia de úlcera de estresse. Resultados: Foram incluídos 234 pacientes no período compreendido entre 2 de julho e 31 de julho de 2018. Os pacientes tinham idade de 52 ± 20 anos, sendo 125 (53%) deles cirúrgicos, e o SAPS 3 médio foi de 52 ± 20. No seguimento longitudinal, foram estudados 1.499 pacientes-dias; 1.069 pacientes-dias tiveram indicação de profilaxia de úlcera de estresse, e 777 pacientes-dias tiveram uso profilático (73% de adesão ao protocolo de profilaxia de úlcera de estresse). Dentre os 430 pacientes-dias sem indicações de profilaxia de úlcera de estresse, 242 envolveram profilaxia (56% de uso impróprio de profilaxia de úlcera de estresse). O total de uso apropriado de profilaxia de úlcera de estresse foi de 64%. Fatores associados com prescrição adequada de profilaxia de úlcera de estresse foram ventilação mecânica, com RC 2,13 (IC95% 1,64 - 2,75), e coagulopatia, com RC 2,77 (IC95% 1,66 - 4,60). A incidência de sangramento do trato gastrointestinal superior foi de 12,8%. Conclusão: A adesão ao protocolo de profilaxia de úlcera de estresse foi baixa, e o uso inadequado de profilaxia de úlcera de estresse foi frequente nesta coorte de pacientes críticos.
ABSTRACT Objective: To evaluate adherence to the stress ulcer prophylaxis protocol in critically ill patients at a tertiary university hospital. Methods: In this prospective cohort study, we included all adult patients admitted to the medical and surgical intensive care units of an academic tertiary hospital. Our sole exclusion criterion was upper gastrointestinal bleeding at intensive care unit admission. We collected baseline variables and stress ulcer prophylaxis indications according to the institutional protocol and use of prophylaxis. Our primary outcome was adherence to the stress ulcer prophylaxis protocol. Secondary outcomes were appropriate use of stress ulcer prophylaxis, upper gastrointestinal bleeding incidence and factors associated with appropriate use of stress ulcer prophylaxis. Results: Two hundred thirty-four patients were enrolled from July 2nd through July 31st, 2018. Patients were 52 ± 20 years old, 125 (53%) were surgical patients, and the mean SAPS 3 was 52 ± 20. In the longitudinal follow-up, 1499 patient-days were studied; 1069 patient-days had stress ulcer prophylaxis indications, and 777 patient-days contained prophylaxis use (73% stress ulcer prophylaxis protocol adherence). Of the 430 patient-days without stress ulcer prophylaxis indications, 242 involved prophylaxis (56% inappropriate stress ulcer prophylaxis use). The overall appropriate use of stress ulcer prophylaxis was 64%. Factors associated with proper stress ulcer prophylaxis prescription were mechanical ventilation OR 2.13 (95%CI 1.64 - 2.75) and coagulopathy OR 2.77 (95%CI 1.66 - 4.60). The upper gastrointestinal bleeding incidence was 12.8%. Conclusion: Adherence to the stress ulcer prophylaxis protocol was low and inappropriate use of stress ulcer prophylaxis was frequent in this cohort of critically ill patients.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Peptic Ulcer/prevention & control , Guideline Adherence/statistics & numerical data , Peptic Ulcer/complications , Prospective Studies , Cohort Studies , Critical Illness , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/epidemiologyABSTRACT
Acid peptic disorders, especially hyperacidity is not uncommon in the current era because of altered life style of human being. In India prevalence of H. Pyloric infection in young age is 83.8%. Peptic ulcer occurs at young age with highest incidence between 20-40 years, men are affected more than women. If these Acid peptic disorders are not treated in time, it may lead to peptic ulcer, haematemasis, malena and perforation of duodenal ulcer which are common now a day with 50% mortality. Generally it is accepted that gastric ulcers result from an imbalance between aggressive factors and the maintenance of the mucosal integrity through endogenous defense mechanisms. Use of synthetic antiulcer drugs may damage to the cell membrane of mucosal, parietal and endothelial cells. To avoid such hazards, it is essential to find out some antiulcer agents from Ayurvedic treasure of therapeutics. Ancient sages have explained many herbal preparations which are beneficial in pain in abdomen (Shoola) and/or hyperacidity (Amlapitta) etc. Jambira (Citrus limon Linn.), mentioned as Shoola-hara (pain relieving) drug in Ayurvedic classics, is abundantly available and cost effective drug and may satisfy the need of present day situation by acting as potent herbal antacid drug. With this perspective, the study was taken for the critical assessment of gastric anti-secretory and anti-ulcer activity of Jambira (Citrus limon Linn.) as an experimental study but the results of experimental study did not support that Jambira (Citrus limon Linn.) fruit juice is a potent antisecretory and antiulcer natural source compared to control in pylorus ligation rat model.
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ABSTRACT BACKGROUND: Extracts obtained from plants and fruits provide a relatively safe and practical alternative for the conventional medicine of gastrointestinal diseases. The specie Eugenia mattosii, popularly known in Brazil as "cerejinha", belongs to Myrtaceae family. Species of this family present pharmacological properties, and can be used in the treatment of gastrointestinal disorders. OBJECTIVE: The aim of this study was to determine the phytochemical profile and evaluate the gastroprotective activity of Eugenia mattosii fruits. METHODS: Phytochemical analysis was carried out by thin layer chromatography and gastroprotective assays were performed using two experimental models: acute ulcer model induced by ethanol/HCl and acute ulcer model induced by non-steroidal anti-inflammatory drug (indomethacin). Total lesion area (mm2) and relative lesion area (%) were determined. RESULTS: The results of the phytochemical analysis indicated that the bark and pulp and seeds of E. mattosii present phenolic compounds, terpenes and/or steroids. In gastric ulcer model induced by ethanol was evidenced significant reduction of damaged areas for doses of 50 and 250 mg/ kg of seeds methanol extract, while in the indomethacin-induced ulcer model, all parts of the fruit presented defense capability of the gastric mucosa by reducing lesions at doses of 50, 125 and 250 mg/kg. CONCLUSION: The results demonstrate that the specie E. mattosii has bioactive compounds that provide gastroprotective activity, presenting possible therapeutic potential.
RESUMO CONTEXTO: Extratos obtidos de plantas e frutos fornecem uma alternativa relativamente segura e prática para os remédios convencionais de doenças gastrointestinais. A espécie Eugenia mattosii, popularmente conhecida no Brasil como "cerejinha", pertence à família Myrtaceae. Espécies desta família apresentam propriedades farmacológicas e podem ser utilizadas no tratamento de distúrbios gastrointestinais. OBJETIVO: O objetivo deste estudo foi determinar o perfil fitoquímico e avaliar a atividade gastroprotetora dos frutos de Eugenia mattosii. MÉTODOS: A análise fitoquímica foi realizada por cromatografia em camada delgada e dois modelos experimentais foram utilizados para avaliação da atividade gastroprotetora em camundongos: modelo de úlcera gástrica induzida por anti-inflamatório não-esteroidal (indometacina) e modelo de úlcera gástrica induzida por etanol/HCl. RESULTADOS: Os resultados da análise fitoquímica indicaram que a casca e polpa e as sementes de E. mattosii apresentam compostos fenólicos, terpenos e/ou esteroides. No modelo de úlcera gástrica induzido pelo etanol, foi evidenciada redução significativa de áreas danificadas para doses de 50 e 250 mg/kg do extrato das sementes, enquanto no modelo de úlcera induzida por indometacina, todas as partes do fruto apresentaram capacidade de defesa da mucosa gástrica ao reduzir as lesões nas doses de 50, 125 e 250 mg/kg. CONCLUSÃO: Os resultados demonstram que a espécie E. mattosii possui compostos bioativos com atividade gastroprotetora, apresentando possível potencial terapêutico.
Subject(s)
Animals , Female , Mice , Stomach Ulcer/prevention & control , Plant Extracts/pharmacology , Protective Agents/pharmacology , Eugenia/chemistry , Fruit/chemistry , Gastric Mucosa/drug effects , Anti-Ulcer Agents/pharmacology , Seeds/chemistry , Stomach Ulcer/chemically induced , Brazil , Plant Extracts/administration & dosage , Indomethacin , Disease Models, Animal , Ethanol , Phytochemicals/pharmacology , Phytotherapy , Anti-Ulcer Agents/administration & dosage , Antioxidants/analysis , Antioxidants/pharmacologyABSTRACT
Objective To investigate the short-term efficacy of compound gargle solution chlorhexidine giuconatie and kangfuxin liquid in treatment of recurrent aphthous ulcer (RAU).Methods Eighty patients clinically diagnosed with RAU were chosen and randomly divided into two groups.Test group 1 (40 cases) and Test group 2 (40 cases) were treated with compound gargle solution chlorhexidine giuconatie and kangfuxin liquid respectively until ulcer has been healed completely to evaluate the difference of two groups in clinical efficacy.Return visit and follow-up visit were conducted 7 days and 30 days after the initial treatment,respectively.Results The analgesic onset time of Test group 1 [(6.24 ± 1.09) min] was shorter than that of Test group 2 [(8.62 ± 1.04) min],with statistically significant difference (P ＜ 0.01).The analgesic maintenance time of Test group 1 [(29.47 ± 3.45) min] was longer than that of Test group 2 [(21.61 ±2.18) min],with statistically significant difference (all P ＜ 0.01).The duration of ulcer of Test groups 1 and 2 was (5.97-± 0.87)days and (4.76 ± 1.14)days,with statistically significant difference (P ＜0.01).Conclusions Compound gargle solution chlorhexidine giuconatie and kangfuxin liquid both have a certain level of clinical efficacy for RAU,with the former featuring shorter analgesic onset time and longer duration and the latter advantageous in promoting RAU healing short-term usage of compound gargle solution chlorhexidine giuconatie and kangfuxin liquid cannot prolong RAU dormancy.
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Objective To investigate the short-term efficacy of compound gargle solution chlorhexidine giuconatie and kangfuxin liquid in treatment of recurrent aphthous ulcer (RAU).Methods Eighty patients clinically diagnosed with RAU were chosen and randomly divided into two groups.Test group 1 (40 cases) and Test group 2 (40 cases) were treated with compound gargle solution chlorhexidine giuconatie and kangfuxin liquid respectively until ulcer has been healed completely to evaluate the difference of two groups in clinical efficacy.Return visit and follow-up visit were conducted 7 days and 30 days after the initial treatment,respectively.Results The analgesic onset time of Test group 1 [(6.24 ± 1.09) min] was shorter than that of Test group 2 [(8.62 ± 1.04) min],with statistically significant difference (P ＜ 0.01).The analgesic maintenance time of Test group 1 [(29.47 ± 3.45) min] was longer than that of Test group 2 [(21.61 ±2.18) min],with statistically significant difference (all P ＜ 0.01).The duration of ulcer of Test groups 1 and 2 was (5.97-± 0.87)days and (4.76 ± 1.14)days,with statistically significant difference (P ＜0.01).Conclusions Compound gargle solution chlorhexidine giuconatie and kangfuxin liquid both have a certain level of clinical efficacy for RAU,with the former featuring shorter analgesic onset time and longer duration and the latter advantageous in promoting RAU healing short-term usage of compound gargle solution chlorhexidine giuconatie and kangfuxin liquid cannot prolong RAU dormancy.
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The pharmacologic action of Atractylodis Rhizoma and its effective constituents in digestive system includes mainly anti-ulcer activity,acceleration of gastric emptying,regulation of gastrointestinal propellant movement,antidiarrheat effect,choleretic effect,hepatoprotection,and promotion of digestive and absorptive function.Atractylodis Rhizoma decreases gastric acid secretion via blockade of H2-receptor,and inhibits overexpression of inflammatory cytokines in gastric tissues to produce anti-ulcer effect.Atractylodis Rhizoma increases gastric mucosal blood flow,and improves growth and reparation of gastric mucosa to produce anti-ulcer effect by blockade of 5-TH receptor,and elevating levels of gastrin and trefoil factor in serum and gastric tissues.Atractylodis Rhizoma accelerating gastric emptying and gastrointestinal propellant movement is relative to decreasing release of central corticotropin-releasing factor,and stimulating vagal nerve,and promoting secretion of gastrin and motilin,and inhibiting secretion of vasoactive intestinal peptide,and blocking 5-HT-3receptor,and increasing amount of interstitial cell of Cajal.
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Objective: To synthesize roxatidine acetate and its salt. Methods: Using orthogonal test method, reactant ratio was made. Roxatidine acetate was synthesized. Excel was used to synthesize data and make statistics chart. Result: Salt of roxatidine ac?etate was synthesized in four steps with overall yield of 28?8%. Conclusion: The process is moderate and simple and the production cost is low.
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Background: Peptic ulcer disease is a worldwide problem. Currently, there is no cost-effective treatment to relieve pain, heal the ulcer and prevent ulcer recurrence. Hence, there is a dire need to search and fi nd a suitable treatment from natural sources. The present study was designed to investigate the anti-ulcer activity of ethanol extract of the leaves of Cymbopogon fl exuosus. Methods: The ethanol extract of the leaves of Cymbopogon fl exuosus was prepared by hot extraction method. Anti-ulcer activity was evaluated in rats and method employed was pylorus ligation. Animals were divided into four groups of six animals each. The animals of Group I served as normal control (vehicle) which received normal saline (5 ml/kg b.wt., p.o). Group II and III received 200 and 400 mg/kg b.wt. of ethanol extract, respectively. The animals of Group IV served as standard control which received ranitidine (15 mg/kg bd.wt.). At the end of study parameters like ulcer index, free acidity, total acidity, acid volume, and pH were determined. Results: The ethanol extract showed a signifi cant reduction in the total acidity, free acidity, and acid volume. The effi cacy of plant extract at high dose was comparable with the standard drug - ranitidine. Conclusion: Our study results support the ethnomedical use of leaves of C. fl exuosus.
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Las enfermedades del aparato digestivo son frecuentes y en ocasiones incapacitantes para la vida diaria y laboral. Dentro de ellas la gastritis es una de las que más incidencia tiene en el mundo entero. En gran parte de los casos la gastritis está acompañada de la infección por Helicobacter Pylori, bacteria que está relacionada con el cáncer de estómago. Los tratamientos que actualmente se llevan a cabo en la medicina tradicional, además de que son muy agresivos, todavía dejan muchas dudas sobre sus efectos secundarios y los daños que pueden llegar a provocar en el organismo, dentro de ellos el cáncer. Por eso mismo se ha visto el incremento en la utilización de las terapias alternativas para el manejo de la gastritis, dentro de ellas la homeopatía, la cual ha tenido una muy buena aceptación y resultados, pero desafortunadamente, todos estos avances no están lo suficientemente documentados. Para la realización de éste trabajo primero se hizo una Revisión Narrativa de la Literatura existente en los últimos 20 años, encontrando en las bases de datos que algunos remedios homeopáticos han demostrado resultados favorables en el manejo de la gastritis y tienen publicaciones muy interesantes en la literatura, pero la gran mayoría de remedios sólo se encuentran relacionados en las materias médicas. Sin embargo, este trabajo logró establecer los medicamentos homeopáticos útiles en la gastritis basándose en los síntomas que reportan las principales Medicinas Internas conocidas, como son las de: Harrison, Cecil y Farreras. Tomando éstos síntomas se pasaron al lenguaje repertorial homeopático, luego se realizó un ejercicio repertorial que nos revela varios remedios policrestos muy valiosos para el manejo de los síntomas de la gastritis. Además se realizó otra repertorización buscando sólo remedios pequeños, que nos pone delante de los ojos, opciones medicamentosas muy útiles que probablemente nunca habríamos pensado. Dentro de los remedios policrestos y semipolicrestos que se encontró tenían la mejor cobertura de síntomas de gastritis están: Arsenicum álbum, Nux vómica, Sulphuricumacidum, Sulphur, Magnesia carbónica, Lycopodium, KaliBichromicum, Iris Versicolor, Graphites, Crocus sativa, Carbovegetabilis, ArgentumNitricum, Bismuthum, Anacardiumorientale, Phosphorus, Plumbummetallicum, Bryonia, NatrumMuriaticum, Lachesis, China officinalis y Pulsatilla. Dentro de los pequeños remedios se encontraron en los primeros 5 lugares: ArsenicumIodatum, Tabacum, SecaleCornutum, FerrumPhosphoricum y Oxalicumacidum; los cuales son incluidos en la tabla de resultados de medicamentos para gastritis, junto con los policrestos y otros remedios de gran valor en el manejo de la gastritis. Este trabajo será de gran ayuda y motivación especialmente para los médicos que trabajamos con la homeopatía, para seguir publicando cada vez con mayor dedicación y detalle con el fin de dar a conocer todas las maravillas que la homeopatía nos demuestra día a día.
Subject(s)
Humans , Gastritis/therapy , Homeopathy , Homeopathic Repertory , Physicians' OfficesABSTRACT
Objective To analyze the therapeutic effect ofShengji-Yuhong ointment in the treatment of patients with pressure ulcer.Methods 86 patients of pressure ulcer were randomly divided into a control group and an observation group, with 43 cases in each. After debridement, the wound was covered with vaseline gauze in the control group, whileShengji-Yuhong ointment in the treatment group. 10 days constituted 1 course of treatment, and both groups were treated for 3 courses. The blood supply of the whole blood viscosity, plasma viscosity, erythrocyte aggregation index detection; white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and C reactive protein (CRP) were observed in order to observe the control condition of the patients with wound infection.Results The total effective rate was 95.3% (41/43) and 74.4% (32/43) in the observation group and control group respectively, with significant difference between two groups (χ2=5.800,P=0.016). After treatment, the whole blood viscosity (high-shea) (4.06 ± 1.38 mPa?svs. 4.74 ± 1.62 mPa?s,t=2.095), the whole blood viscosity (medium-shea) (3.71 ± 1.22 mPa?svs. 4.34 ± 1.41 mPa?s,t =2.216), blood reduction viscosity (1.13 ± 0.22 mPa?svs.1.44 ± 0.51 mPa?s,t=3.660), the whole blood viscosity (medium-shea) (4.16 ± 0.48 mPa?svs. 4.51 ± 0.89 mPa?s,t=2.270) obviously compared with group before treatment decreased (P<0.05). The patients in the observation group in the whole blood viscosity (medium-shea) (3.71 ± 1.22 mPa?svs. 4.16 ± 0.48 mPa?s,t=2.251), and blood reduction viscosity (1.13 ± 0.22 mPa?svs. 1.32 + 0.31 mPa?s,t=3.278) in the observation group were obvious better than the control group (P<0.05). After the treatment the WBC, CRP, ESR in the observation group were decreased significantly than the control group (t=5.947, 7.198, 12.064,P<0.01).ConclusionShengji-Yuhong ointment can effectively control the PU infection in the wound, improve wound tissue under the blood circulation, and promote wound healing.
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Peptic ulcer disease is a common condition of present day life, and its incidence is markedly increasing. The available drugs for the treatment are associated with adverse effects. Hence, there is a need for newer and better treatment for the same. Objectives: To evaluate the anti-ulcer activity of ethanolic extract of Vitis Vinifera (seed) by Water Immersion stress induced gastric ulcer model in Wistar albino rats using two doses (100, 200mg/kg body weight.) Methods: The antiulcer activity was assessed by estimating gastric volume, pH, free and total acidity; ulcer number and its inhibition, gastric lesion, ulcer severity and ulcer index; and comparing it with the control groups. Results: The present study revealed that grape seed extract of 100mg/kg and 200mg/kg showed a significant (p<0.05) reduction in the gastric volume, ulcer number, gastric lesion and severity. The ulcer index was 45.33 and 36.66 for 100 and 200mg/kg respectively. Ulcer inhibition for 100 and 200 mg/kg group was 32.79% and 44.86% when compared with the control group. Ulcer protection with 100 and 200mg/kg was 29.21% and 39.82% when compared with the control group. Conclusion: This present study indicates that Vitis vinifera seed extract have potential anti-ulcer activity in the model tested.
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Peptic ulcer is a disease of the Gastro-intestinal tract (GIT), which includes both gastric and duodenal ulcers. The occurrence of peptic ulcer disease has been attributed to the imbalance between aggressive factors like acid, pepsin, and Helicobacter infection on one hand and the local mucosa defenses like bicarbonate and mucus secretion and prostaglandins synthesis on the other hand. The most serious complications of peptic ulcer disease include hemorrhage, perforation, penetration, and gastric outlet obstruction. Ulcerative colitis is a form of inflammatory bowel disease (IBD). It is a form of colitis, a disease of the colon that includes characteristic ulcers, or open sores. IBD is often confused with irritable bowel syndrome. Ulcerative colitis is associated with a general inflammatory process that affects many parts of the body. Sometimes these associated extra-intestinal symptoms are the initial signs of the disease, such as painful arthritic knees in a teenager and may be seen in adults also. Several classes of pharmacological agents have proved to be effective in the management of the acid peptic disorders viz., antacids, acid suppressive agents, anticholinergic, cytoprotective agents, etc. A widespread search has been launched to identify new anti-ulcer therapies from natural sources to replace currently used drugs of doubtful efficacy and safety. Herbs, medicinal plants, spices, vegetables and crude drug substances are considered to be a potential source to control various diseases including gastric ulcer and ulcerative colitis. In the scientific literature, a large number of medicinal plants and their secondary metabolites with anti-ulcer potential have been reported. As the gastro protective effect can be linked to different mechanisms, once demonstrated the activity, the extracts and more appropriately the active compounds should be assessed for action mechanisms to elucidate their mode of action. Besides, new action mechanisms may be discovered.
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Aims: The aim of the present study was to investigate the possible effects of garlic juice, as well as feed supplemented with Allium sativum, on gastric ulceration, antioxidant activity and gastric mucus cell count in wistar rats. Study Design: The albino rats were divided into six groups each group containing eight animals and treated for 30 days. A low dose (250mg/kg body weight) and high dose (500mg/kg) of garlic juice was orally administered to two of the experimental groups, while two other groups were fed with 5% and 10% Allium sativum/standard feed mix. The control group was fed on the standard rats’ feed and water only, while a positive control group was given Misoprostol (10μgkg-1) orally as a standard drug. Place and Duration of Study: Department of Physiology, University of Ibadan between September 2011 and June 2012. Methodology: Forty eight adult albino rats were divided equally into six groups. Groups I, II, III, IV, V and VI received fed standard, 250 mg Allium sativum /kg body weight, 500mg of Allium sativum/kg body weight, 5% supplement of Allium sativum, 10% supplement of Allium sativum and 10 ug of Misoprostol / kg body weight, respectively for 30 days. At the end of the study period, experimental ulceration was induced by administering 40mg/kg-1 body weight Indomethacin and six hours later the animals were sacrificed. The stomachs were excised and macroscopically examined for ulcers. Gastric mucous cell count (MCC) and antioxidant activity were subsequently assayed for. Results: The result showed that pre-treatment with garlic was significantly effective in reducing gastric ulceration incidence in animals (p < 0.05) as mean ulcer score decreased significantly in all groups treated with garlic. Superoxide dismutase (SOD) and catalase (CAT) increased significantly, especially in animals in the high dose group. No significant variation in the lipid per oxidation in all groups, while gastric mucus cell count was also significantly increased in most treatment groups. Conclusion: These results suggest that garlic decreases ulcerogenesis in experimental animals. This can be attributed to its effects of increasing antioxidant activity and gastric mucous cell count.
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AIM@#To study the gastroprotective effect and in vivo antioxidant potential of a standardized iridoid fraction from B. prionitis leaves (BPE) against different gastric ulcer models in rats.@*METHOD@#The standardized iridoid fraction from BPE at 50, 100, and 200 mg/kg body weight was administered orally, twice daily for 5 days for prevention from aspirin, ethanol, cold-restraint stress (CRS), and pylorus ligation (PL)-induced ulcers. Estimation of the antioxidant enzyme activity was carried out in a CRS-induced ulcer model, and various gastric secretion parameters including volume of gastric juice, acid output, and pH value were estimated in the PL-induced ulcer model.@*RESULTS@#BPE showed a dose-dependent ulcer protective effect in PL (18.67%-66.26% protection), aspirin (24.65%-63.25% protection), CRS (20.77%-59.42% protection), and EtOH (16.93%-77.04% protection)-induced ulcers. BPE treatment in PL-rats showed a decrease in acid-pepsin secretion, and enhanced mucin and mucosal glycoproteins. However, BPE reduced the ulcer index with significant decrease in LPO (P < 0.01-0.001), SOD (P < 0.01-0.001), and an increase in CAT (P < 0.01-0.001), activity in the CRS-induced model.@*CONCLUSION@#The data shows that the iridoid fraction from BPE possesses anti-ulcerogenic and antioxidant potential.
Subject(s)
Animals , Humans , Male , Rats , Acanthaceae , Chemistry , Anti-Ulcer Agents , Disease Models, Animal , Iridoids , Plant Extracts , Protective Agents , Rats, Wistar , Stomach Ulcer , Drug TherapyABSTRACT
Dada la frecuencia de la asociación de fármacos para el tratamiento de distintas enfermedades, se hace necesario considerar las situaciones que se derivan de la administración simultánea de medicamentos. Hoy día se reconoce la existencia de una variedad de interacciones farmacológicas que se presentan por distintos mecanismos. Por ello es importante que los profesionales de Enfermería realicen una monitorización permanente, que permita evaluar los objetivos terapéuticos trazados para prevenir aparición de reacciones adversas a medicamentos y/o toxicidad, así como el fallo terapéutico. En este sentido, el objetivo de esta revisión fue describir las principales interacciones farmacológicas que ocurren con la administración de antiácidos, protectores de la mucosa y antisecretores gástricos, las consecuencias clínicas que se derivan de estas y algunas recomendaciones para el uso de tales medicamentos. El compromiso de Enfermería y de los profesionales de la salud debe orientarse hacia el empoderamiento del conocimiento de esta temática, para enfrentar con responsabilidad la vigilancia de la terapéutica en relación con su seguridad y efectividad, reconociendo que hay muchas interacciones que se desconocen y que ocurrirán en la medida en que aparecen nuevos principios activos. Asimismo, resulta relevante considerar el impacto clínico que origina el uso de los antiácidos, protectores de la mucosa gástrica y antisecretores.
Due to the frequency of the association of drugs for the treatment of various diseases, it is necessary to consider situations arising from the simultaneous administration of drugs. Nowadays, is recognized the existence of a variety of drug interactions that occur by different mechanisms. Therefore, it is important that Nursing Professionals perform continuous monitoring to assess the therapeutic goals set, in order to prevent Adverse Drug Reactions and/or toxicity and Therapeutic Failure. For that reason, the aim of this reviewing is to present the major drug interactions that occur with the administration of antacids, mucosal protective agents, gastric antisecretory and its consequences. The compromise of Nursing and Health Care Professionals, should go towards empowerment of knowledge of this topic, in order to deal with responsibility, the monitoring of therapeutic safety and effectiveness, recognizing that there are many unknown pharmacological interactions that will occur as soon as the new active ingredient appears. At the same time, it is important to consider the clinical impact that produces the use of antacids, gastric mucosal protective and antisecretory drugs.
ABSTRACT
The objective of this study was to investigate the anti-ulcer activity of leaves of Bombax buonopozense P. Beauv. (Bombacaceae) in rats. Fresh dried leaves of B.buonopozense were extracted by cold maceration which yielded a mucilaginuous aqueous extract. Anti-ulcer effects of the aqueous extract at 100, 200 and 400 mg/kg were evaluated in rats using ethanol-induced ulcer model. Phytochemical analysis and lethality tests (LD50) were carried out using standard procedures. Results showed that the aqueous extract exhibited significant (P<0.05) and dose- dependent anti-ulcer activity in the model used. Percentage ulcer inhibitions of extract at 100, 200 and 400 mg/kg for ethanol-induced ulcers were 39.76, 62.07 and 75.73% respectively. Ulcer protection in the model used by the extract is dose-dependent and the ulcer inhibitory effects of the extract are comparable to ranitidine. Oral LD50 value is 2828.42 mg/kg in mice. Phytochemical analysis showed the presence of flavonoids, saponins, tannins, resins, balsams, carbohydrates, oligosaccharides, terpenes, reducing sugars and sterols. Therefore, results of our study suggest that the aqueous extract of B. buonopozense possesses anti-ulcer activity as claimed by its folkloric use.
ABSTRACT
Sandalwood (Santalum album L.) is used in various traditional systems of medicine, like Ayurveda, Siddha and Unani medicine to treat a wide range of ailments. In Unani medicine, Safed Sandal is used to treat gastric ulcers, hence the present study was undertaken to confirm this claim. A limit test as per OECD guidelines was conducted at a dose of 5000 mg/kg to determine the acute toxic dose of Hydro-alcoholic extract from S. album stem (SASE). Two test doses of SASE (250 and 500 mg/kg) were subjected to screening of anti-ulcer activity by three in-vivo models namely water immersion - restrain stress, ethanol and indomethacin induced gastric ulceration models in albino wistar rats. A proton-pump inhibitor, Omeprazole 10 mg/kg and H2 receptor antagonist, Ranitidine 50 mg/kg were employed as standard drugs. The results revealed an increase in gastric protection as a significant decrease (p < 0.001) in average number of ulcers, severity of ulcers and cumulative ulcer index was observed in the test groups. Histopathological evidences supported the above findings. The observed anti-ulcer effect of SASE at 500 mg/kg was comparable to that of standard drugs used in the experiments indicating significant anti-ulcer potential especially at higher concentration.
Sándalo (Santalum album L.) se utiliza en diversos sistemas de medicina tradicional, como el Ayurveda, Siddha y Unani para tratar una amplia gama de dolencias. En la medicina Unani, Safed Sandal se usa para tratar úlceras gástricas, por lo tanto, el presente estudio se realizó para confirmar esta afirmación. Una prueba de límite según las directrices de la OCDE se llevó a cabo a una dosis de 5000 mg/kg para determinar la dosis tóxica aguda del extracto hidroalcohólico del tallo de S. álbum (SASE). Dos dosis de prueba de SASE (250 y 500 mg/kg) se sometieron al estudio de la actividad anti-úlcera por tres modelos in vivo, a saber: la inmersión en agua estrés de restricción, y la ulceración gástrica inducida por etanol e indometacina, en ratas Wistar albinas. Un inhibidor de la bomba de protones, omeprazol 10 mg/kg y el antagonista de los receptores H2, ranitidina 50 mg/kg fueron empleados como fármacos estándar. Los resultados revelaron un aumento de la protección gástrica como una disminución significativa (p < 0.001) en el número promedio de úlceras, la gravedad de las úlceras y el índice de úlcera acumulativo se observó en los grupos de prueba. Evidencias histopatológicas apoyaron las conclusiones anteriores. El efecto anti úlcera observado por efecto de SASE a 500 mg/kg fue comparable a la de fármacos estándar utilizados en los experimentos que indican un significativo potencial anti-úlcera, especialmente a mayores concentraciones.
Subject(s)
Rats , Anti-Ulcer Agents/pharmacology , Plant Extracts/pharmacology , Santalum/chemistry , Disease Models, Animal , Hydroalcoholic Solution , Indomethacin , Rats, WistarABSTRACT
The aqueous and ethanol extracts of the leaves of Basella alba L. var. alba Wight, Basellaceae, were investigated for antiulcer activity on rats employing the pylorus ligation and ethanol induced ulcer models. The various gastric secretion parameters such as total acidity, free acidity, gastric acid volume, pH and histopathological parameters such as ulcer index and percent protection were comparatively examined between control, test and standard groups. The antiulcer activity of aqueous extract of B. alba (AEBA) and ethanol extract of B. alba (EEBA) were studied in rats treated with the doses of 1 mL/kg of absolute ethanol, 200 and 400 mg of test extracts and 20 mg/kg of famotidine for control, test and standard groups respectively in both the models. The animals pretreated with AEBA and EEBA showed a dose-dependent protection against gross damaging action of ethanol and pylorus ligation on gastric mucosa of animals. Histopathological evaluation also revealed that Group I treated with absolute ethanol showed severe gastric mucosal damage. The AEBA and EEBA showed 68.25 and 58.11% protection in gastric mucosal damage as compared to control group. Both the extracts of B. alba var. alba were able to decrease the gastric acidity and increase the mucosal defense in the gastric mucosal area. This study indicate that B. alba var. alba possesses significant gastroprotective effect and the same is substantiated by the histopathological examination of the ulcerated stomachs of the animals.
ABSTRACT
The present study was carried out to see the effect of two zinc salts i.e zinc sulphate and zinc chloride on gastric ulcers induced by stress, pylorus ligation and aspirin in albino rats. The rats were divided into two main groups (zinc sulphate 30, 60, 90 mg/kg i.p and zinc chloride 10 and 20mg/kg i.p). They were further sub-divided into three sub-groups dependant on ulcer model i.e stress, pylorus ligation and aspirin induced ulcers. It was found that zinc sulphate and zinc chloride had a dose dependant reduction in ulcer index in all three models of gastric ulceration. Also, both the salts had anti acid secretory effect, raised pH of gastric secretion and reduced total acidity significantly. Thus zinc salts prevent gastric ulceration. Probably this effect is mediated by anti acid secretory action.