"Pós de doliarina e ferro": um dos remédios importantes da Farmácia Peckolt / "Doliarina and iron powder": an important medicine at Peckolt Pharmacy

Resumo O farmacêutico Theodoro Peckolt é uma das mais importantes figuras da história da química de produtos naturais brasileira. Como outros farmacêuticos do século XIX que atuavam no Brasil, desenvolveu formulações que comercializava em sua farmácia, localizada no Rio de Janeiro, e que tiveram grande prestígio junto à população e à classe médica. O texto apresenta a relação entre a doença identificada inicialmente como opilação e a terapêutica utilizada no século XIX, destacando uma das formulações da Farmácia Peckolt – “Pós de doliarina e ferro”. O produto tem sua origem no látex da espécie Ficus gomelleira(figueira-branca ou gameleira). O artigo tem entre seus objetivos revelar a composição química, feita por métodos modernos de análise do látex deFicus gomelleira.

Abstract The pharmacist Theodoro Peckolt was one of the most important figures in the history of the chemistry of natural Brazilian products. Like other nineteenth-century pharmacists in Brazil, he developed formulations and sold them at his pharmacy in Rio de Janeiro, and these enjoyed great prestige in the eyes both of the public and the medical community. The article discusses the relation between the illness originally called “opilação” (ancylostomiasis, or hookworm) and nineteenth-century treatment. It focuses especially on Peckolt Pharmacy’s “Doliarina and iron powder,” a formulation extracted from the Ficus gomelleira rubber plant. One of the article’s goals is to use modern methods to analyze Ficus gomelleira and identify the chemical composition of the drug.

Cure and reinfection patterns of geohelminthic infections after treatment in communities inhabiting the tropical rainforest of Assam, India.

Mass de-worming targeted at socio-economically poor communities can be considered as an option for communities living in the tropical forests of Assam who do not have access to safe drinking water and proper sanitation, and consequently have a higher risk of suffering from geohelminthic infection and associated morbidity. A random sample of 265 subjects was included in this study (134 males and 131 females). The chemotherapeutic regimen followed was a single dose of albendazole 400 mg. Stools samples were collected in 10% formol-saline for detection of infection before treatment. Post-treatment stool samples were collected 10 to 14 days after treatment to determine the cure rate. Stool samples were again collected 3 to 6 months post-treatment to study the rate of reinfection. Multiple logistic regression was used to find possible associations between age, sex and treatment failure. The chi-square test was used wherever appropriate. The cure rates for Ascaris lumbricoides, Trichuris trichiura and hookworms were 70.8%, 68.7% and 93.0%, respectively. Logistic regression revealed that age was associated with treatment failure in A. lumbricoides infection. Re-infection rates after 3 months of successful treatment were 19.6% for A. lumbricoides, 30.9% for T. trichiura and 11.3% for hookworms. Six months post-treatment, the prevalence of re-infection was highest with T. trichiura (43.6%); followed by A. lumbricoides (35.3%). The rate of reinfection with hookworms was lower (11.3%) six months post-treatment. The rates of re-infection with A. lumbricoides and T. trichiura was higher in children below 15 years of age, compared with adults. Hookworm reinfection was higher in the adult age group (15 to 39 years). The rates of new infection in previously uninfected subjects were lower compared with the rates for re-infection.

Epidemiology of human intestinal nematode infections in Wujiang and Pizhou counties, Jiangsu Province, China.

Intestinal nematode infections are considered highly endemic in the Chinese province of Jiangsu. In May 1997, the prevalence of intestinal nematodes infections was determined among all of the inhabitants aged 5 to 65 of the southern Jiangsu village of Yaojiakon (Wujiang County) and the northern Jiangsu village of Jianmiao (Pizhou County). It was determined that the prevalence of ascariasis, trichuriasis and hook worm infection was greatly reduced compared to when it was last measured in 1990. The reduction was noted to be particularly impressive in Yaojiakon village where the prevalence of ascariasis and trichiuriasis fell to 2% and 1.5% respectively. Much of this reduction was attributed to improvements in economic development which have occurred in southern Jiangsu Province at a rapid pace. In contrast, the reduction in nematode infections among villagers living in northern Jiangsu was more modest. The most striking reduction in both villages was in school-aged children who since 1988 have received yearly treatments with anthelminthic drugs. The intensity of nematode infections was investigated for hookworm where 70% of hookworm-infected Yaojiakon villagers were found to harbor light infections (< 400 eggs per gram) compared to 83% of hookworm-infected Jianmiao villagers. Necator americanus was the predominant hookworm in Yaojiakon village (South), whereas Ancylostoma duodenale predominated in Jianmiao village (North). The majority (76%) of hookworm-infected patients developed IgG antibodies against N. americanus antigen, although 20% of uninfected patients living in the village also had circulating antibodies. Intestinal nematode infections continue to be a significant public health problem in Jiangsu Province although their prevalence has decreased since 1990.

Efficacy of single dose albendazole on the prevalence and intensity of infection of soil-transmitted helminths in Orang Asli children in Malaysia.

The efficacy of a single-dose 400 mg albendazole to treat Ascaris, Trichuris and hookworm infection was studied in Orang Asli community. Kato-Katz examination was performed on fecal samples which were collected before treatment, 1 and 4 months after treatment. A total of 123 children were involved in all three surveys. The cure rate of Ascaris infection was 97.4% and the egg reduction after treatment was 99.9%. The cure rate for hookworm infection was 93.1% with 96.6% egg reduction. Although the cure rate was low in Trichuris infection (5.5%), egg reduction was more evident (49.1%). The reinfection rate at 4 months after treatment was 54.5%, 3.6% and 10.3% for Ascaris, Trichuris and hookworm infection, respectively. Within 4 months after treatment almost one-fifth children with Ascaris and hookworm infection reached pre-treatment intensity infection. In Trichuris infection, however more than half of the children reached their pre-treatment intensity infection at 4 months after treatment. Findings suggest that 4-monthly targeted periodic treatment with 400 mg single-dose albendazole in highly endemic areas can have a significant impact on intensity infection of Ascaris and hookworm, but not on Trichuris infection.

Comparative trials using albendazole and mebendazole in the treatment of soil-transmitted helminths in schoolchildren on Penang, Malaysia.

Trials using albendazole and mebendazole, as single 400 mg dose treatments, against soil-transmitted helminths, were carried out in 7-9 and 10-12 years-old schoolchildren living in urban and rural environments in Penang, Malaysia. Both drugs were equally effective in treating trichuriasis and ascariasis in both age groups and environments. However, mebendazole is not so effective in the treatment for hookworms when compared to albendazole. It is suggested that albendazole should be considered the drug of choice for mass chemotherapy for Penang.

Efficacy of common broad spectrum anthelmintics against hook worm, Ascaris and Trichiuris in Hat Yai district, Songkhla Province, Thailand.

1. The third therapeutic scheme should be used in the hospital. 2. The second and third therapeutic scheme may be used in mass treatment. 3. The 4th-6th therapeutic scheme is to be considered, reviewed, and evaluated. 4. Model and technology of permanent worms control is to be studied. 5. The treatment and control of Ascaris were simple. Cure with low reinfection rate and long reinfection period was remarkable. 6. The prevalence rate and reinfection rate of Trichiuris was high, and not so sensitive to any antelmintics. 7. The reinfection rate in the second group was not superior to the first group and the third group. This revealed no effectiveness of ovicidal and larvicidal on the helminthiasis. 8. Reinfection rate in the third therapeutic scheme was the least group. 9. Toxicity and side effect were not found in any anthelmintics. 10. Broad Spectrum Anthelmintics are necessary in mass treatment or blind treatment.

A comparative study on the efficacy of albendazole and mebendazole in the treatment of ascariasis, hookworm infection and trichuriasis.

A comparative study of the efficacy of albendazole and mebendazole was carried out in Pattani Province in the southern part of Thailand. One hundred and ninety-six patients with single or multiple infections with Ascaris, hookworm, and Trichuris were randomized into 4 groups for different treatments. Stool examination by Kato-Katz technique were done before and on day 14 after treatment. Results of the study showed that (1) a single dose of 300 mg mebendazole (locally produced) resulted in cure rates of 50%, 0% and 0% and egg reduction rates of 87.3%, -15.3%, and 28.3%, for ascariasis, hookworm infection and Trichuris respectively; (2) a single dose of 300 mg mebendazole (original) resulted in cure rates of 100.0%, 9.1%, and 43.3%, and egg reduction rates of 100.0%, 72.0%, and 77.9%, for Ascaris, hookworm, and Trichuris respectively; (3) a single dose 500 mg mebendazole (original) resulted in cure rates of 100.0%, 30.2%, and 70.3%, and egg reduction rates of 100.0%, 70.4% and 89.9%, for Ascaris, hookworm, and Trichuris respectively and (4) a single dose of 400 mg albendazole (original) resulted in cure rates of 100.0%, 84.3%, and 67.4%, and egg reduction rates of 100.0%, 96.0% and 87.0%, for Ascaris, hookworm, and Trichuris respectively. Both mebendazole and albendazole are safe and no side effects were observed. The results of this study suggested that albendazole is the preferred benzimidazole derivative for mass treatment of multiple infections with Ascaris, hookworm, and Trichuris.

Efficacy of single-dose mebendazole, polymorphic forms A and C, in the treatment of hookworm and Trichuris infections.

A therapeutic trial of single mebendazole, 300 mg polymorph A, 300 mg polymorph C and 500 mg polymorph C, in the treatment of hookworm and Trichuris infections was carried out at primary schools in Southern Thailand. The total of 958 children were randomly allocated in seven treatment groups including the placebo control and the standard dose control (100 mg polymorph C bid for 3 days). The egg reduction rates and the cure rates of 300 mg and 500 mg polymorph C were similar, but inferior to those of the standard dose in both hookworm and Trichuris infections. The efficacy of single dose 300 mg polymorph A was not different from that of the placebo control (alpha = 0.05) in both infections.

Studies on the control of hookworm and other soil-transmitted helminthiases in farmers in Zhejiang Province, China.

Different periodic selective chemotherapeutic schemes were used to control hookworm and other soil-transmitted helminthiases in eight villages in five counties in Zhejiang Province, China, 1985-1988. The results showed that the prevalence rates of hookworm, ascariasis, and trichuriasis decreased from 35.0-74.4%, 47.0-.76% and 22.9-47.5% to 3.2-15.8%, 9.9-47.8%, and 3.5-31.2%, respectively, using pyrantel pamoate (10 mg/kg for 1-2 days) or albendazole (400 mg for 1-2 days, once or twice a year for 2-3 years). The eggs per gram of feces of hookworm and Trichuris trichiura also dropped markedly after control. Moreover, the mean hemoglobin levels of sampled populations increased after several treatments. The authors recommend periodic selective chemotherapy as the main method to control soil-transmitted helminthiases, especially hookworm infections.

Incidence of helminthic infections and comparative study of pyrantel pamoate with levamisole and mebendazole in hospital patients at Barisal, Bangladesh.

A study was carried out to find out the incidence of helminthic infections in hospitalized patients at Sher-e-Bangla Medical College, Barisal and to determine the comparative efficacy of pyrantel pamoate, levamisole, and mebendazole. It was observed that 76.2 per cent of total hospitalized patients were infected with intestinal helminths. Polyparasitism (52.6 per cent) was more frequent than single infection (21.8 per cent). Amongst these, 47.5 per cent was suffering from Asearis lumbricoides (AL), 42.5 per cent from Hookworm (H.W) and 65.8 per cent from trichuris trichura (TT). Out of 255 cases examined separately, 40 per cent was suffering from Enterobious vermicularis (EV) infection. The comparative study showed that mebendazole produced egg negative stool in 90.9 per cent of AL, 95.6 per cent of HW and 86.8 per cent of TT after eight days of treatment. On the other hand, pyrantel pamoate cured AL in 93.3 per cent, HW in 78.5 per cent and TT in 34.2 per cent eases. Levamisole cured 75 per cent AL, 4.1 per cent H.W. and 22.2 per cent TT within the same period.

Clinical trial of albendazole in hookworm infection.

A clinical trial of albendazole (Zentel R) was carried out at the Hospital for Tropical Diseases in 1981. Thirty-five patients with hookworm infection were divided into 2 groups A, B and treated with a single dose of albendazole 400 mg and 600 mg respectively. The age of the patients ranged from 12 to 66 years and their weights ranged from 25 to 62 kilograms. Concentration and Stoll egg count methods were done at pretreatment, day 14 and day 21. At each interval two aliquots from each of the two faecal specimens were collected. The geometrical mean of EPG in Group A and B were 5406 and 5617 respectively. The cure rate in patients with less than 5000 EPG was 75% on day 21 in Group A and 67% in Group B. The mean percentage egg reduction was 95% in Group A and 99% in Group B. In patients with a higher egg out-put, the cure rate on day 21 was 50% in Group A and 29% in Group B. The mean percentage egg reduction was 91% in Group A and 93% in B. The side effects were mild and transient.

Epidemiological study and comparison of pyrantel and levamisole in the treatment of roundworm and hookworm infestations.

Stool examined for presence of nematodes from 467 school students in Dacca city showed 48% ova positive cases with 22% among them cases of mixed nematode infection. Highest prevalence of 58% was observed with roundworm and 5% was hookworm infestations. Among hookworm cases, Necator americana (68%) appears to be the predominant species. Two anthelmintics-pyrantel and levamisole achieved similar high cure rate (around 97%) and Egg reduction rate of 99% in roundworm infection. However, pyrantel was observed to be more effective in hookworm infestation (87% against 60%) particularly in Necator americana cases.

Clinical trial of flubendazole on hookworm, Trichuris trichiura and Ascaris lumbricoides infections.

Flubendazole, a parafluoro analoque of mebendazole, was given to 89 service men with hookworm, Trichuris trichiura and Ascaris lumbricoides infections. The drug was given either as two doses of 300 mg at 12 hour interval (regimen A) or as two doses of 300 mg at 24 hour interval (regimen B). At four weeks follow-up the mean percentage egg reduction for hookworm was 88% and 96% in regimen A and B respectively. There were too few cases of Trichuris and Ascaris infection to allow comparison of the two regimens, but flubendazole appeared to be as effective and the single day regimen more convenient than difetasone for trichuriasis and levamisole for ascariasis. Side effects were few, mild and transient.

Mebendazole and pyrantel pamoate as broad-spectrum anthelmintics.

The efficacy of mebendazole and pyrantel pamoate was studied in two groups of 59 and 58 cases, respectively, of patients with polyparasitosis. Mebendazole had a cure rate of 96%, 82.2%, 71.4% and 66.6% in A. lumbricoides, hookworm, T. trichiura and S. stercoralis, respectively, while the corresponding figures for pyrantel pamoate were 92.6%, 85.7%, 19.4% and 0%. Pyrantel pamoate is considered to have no significant effect on T. trichiura and S. stercoralis. None of the drugs had any effect on T. saginata. Both drugs have been found to be equally effective against enterobiasis by various authors. It is recommended that pyrantel pamoate be the drug of choice in cases of multiple parasitic infections excluding T. trichiura and S. stercoralis whereas those with one or both of these in addition to others should be treated with mebendazole. Mebendazole can be prescribed for patients with clinical evidence of helminthic infections even where stool examination is not possible as it covers almost the whole range of common helminthic infections. The only limitation for poorer patients however is its cost. Pyrantel pamoate has a wider applicability for the poorer patients in spite of the fact that it is ineffective against trichurids and S. stercoralis.