ADMINISTRATION OF H2 BLOCKERS IN NSAID INDUCED GASTROPATHY IN RATS: effect on histopathological changes in gastric, hepatic and renal tissues

ABSTRACT Background Nonsteroidal anti-inflammatory drugs induces gastric mucosal lesions because of its acidic properties. Ranitidine, an H2 receptor antagonist, has proved beneficial in patients with gastric ulcers. Objective The present study was performed to assess the effect of administering ranitidine in Nonsteroidal anti-inflammatory drugs (diclofenac, nimesulide) induced gastropathy, and their effect on the histopathology of stomach, kidney and liver. Methods Diclofenac, nimesulide, and ranitidine were administered in doses of 2, 4, and 6 mg/kg, p.o. once daily for 14 days, and their effect on gastric volume, acidity, mean ulcer number, and gastric pH. In addition, histopathological examination was also performed on sections of stomach, kidney and liver. Results Following the administration of diclofenac or nimesulide, all the gastric parameters were significantly altered as well as the histopathology of stomach, liver and kidney. In the control group, the renal sections showed normal glomeruli with no thickening of glomerular basement membrane, while in diclofenac alone, nimesulide alone, and ranitidine with nimesulide groups, the thickening of glomerular basement membrane was observed. These alterations were observed to be reversed in the ranitidine with diclofenac group. In the sections from the liver, the control group showed anastomosing plates and cords of cuboidal hepatocytes with round well stained nuclei and abundant cytoplasm. In the ranitidine with diclofenac, and ranitidine with nimesulide groups, mild dilatation of sinusoids is seen coupled with prominence of central vein. In the diclofenac alone and nimesulide alone groups, the proximal and distal convoluted tubules show mild focal tubular necrosis. In the gastric sections, the control group showed several folds forming villi, and the epithelial lining surface of the mucosa. In the ranitidine with diclofenac, and ranitidine with nimesulide groups, the duodenum showed scattered inflammatory cells composed predominantly of lymphocytes. In diclofenac alone and nimesulide alone group, the sections from the gastric areas showed partial necrosis and mild chronic inflammation respectively. Conclusion The study, therefore, has provided therapeutic rationale towards simultaneous administration of H2 receptor blocker ranitidine with diclofenac to be more beneficial as compared to ranitidine with nimesulide, to minimise the gastric intolerance of diclofenac in long term treatment of inflammatory conditions.

RESUMO Contexto Anti-inflamatórios não esteroidais induzem lesões da mucosa gástrica devido às suas propriedades ácidas. Ranitidina, um antagonista dos receptores H2, revelou-se benéfico em pacientes com úlceras gástricas. Objetivo - O presente estudo foi realizado para avaliar o efeito da administração de ranitidina em gastropatia induzida por anti-inflamatórios não esteroidais (diclofenaco, nimesulida) e seu efeito sobre a histopatologia do estômago, dos rins e fígado. Métodos Diclofenaco, nimesulida e ranitidina foram administradas em doses de 2, 4 e 6 mg/kg, p.o. uma vez diariamente por 14 dias e seu efeito sobre o volume gástrico, acidez, significam o número de úlcera e o pH gástrico. Além disso, o exame histopatológico também foi realizado em seções do estômago, dos rins e fígado. Resultados Após a administração de diclofenaco ou nimesulida, todos os parâmetros gástricos foram significativamente alterados assim como a histopatologia do estômago, fígado e rim. No grupo controle, as seções renais mostraram glomérulos normais sem espessamento da membrana basal glomerular, enquanto em diclofenaco isolado, nimesulida isolado e grupos com ranitidina e nimesulida, foi observado espessamento da membrana basal glomerular. Estas alterações observou-se serem revertidas no grupo ranitidina com diclofenaco. As seções do fígado, o grupo controle mostrou placas e cordões de hepatócitos cuboidais anastomosados com núcleos bem demarcados e citoplasma abundante. Nos grupos ranitidina com diclofenaco e ranitidina com nimesulida, leve dilatação dos sinusoides é vista acoplados com proeminência de veia central. Nos grupos diclofenaco e nimesulida sozinhos, túbulos proximais e distais contorcidos mostram necrose tubular focal leve. Nas secções gástricas, o grupo controle mostrou várias dobras formando vilosidades e a superfície do revestimento epitelial da mucosa. Nos grupos ranitidina com diclofenaco e ranitidina com nimesulida, o duodeno mostrou dispersas células inflamatórias predominantemente compostas por linfócitos. Nos grupos diclofenaco e nimesulida sozinhos, as secções de áreas gástricas mostraram necrose parcial e inflamação crônica moderada respectivamente. Conclusão - O estudo, portanto, forneceu o fundamento terapêutico para administração simultânea de bloqueador de receptor H2 (ranitidina) com diclofenaco, sendo mais benéfica em comparação com ranitidina com nimesulida para minimizar a intolerância gástrica de diclofenaco no tratamento a longo prazo de condições inflamatórias.

Effect of histamine H1 and H2 receptor antagonists, microinjected into cerebellar vermis, on emotional memory consolidation in mice

This study investigated the effects of histamine H1 or H2 receptor antagonists on emotional memory consolidation in mice submitted to the elevated plus maze (EPM). The cerebellar vermis of male mice (Swiss albino) was implanted using a cannula guide. Three days after recovery, behavioral tests were performed in the EPM on 2 consecutive days (T1 and T2). Immediately after exposure to the EPM (T1), animals received a microinjection of saline (SAL) or the H1 antagonist chlorpheniramine (CPA; 0.016, 0.052, or 0.16 nmol/0.1 µL) in Experiment 1, and SAL or the H2 antagonist ranitidine (RA; 0.57, 2.85, or 5.7 nmol/0.1 µL) in Experiment 2. Twenty-four hours later, mice were reexposed to the EPM (T2) under the same experimental conditions but they did not receive any injection. Data were analyzed using one-way ANOVA and the Duncan test. In Experiment 1, mice microinjected with SAL and with CPA entered the open arms less often (%OAE) and spent less time in the open arms (%OAT) in T2, and there was no difference among groups. The results of Experiment 2 demonstrated that the values of %OAE and %OAT in T2 were lower compared to T1 for the groups that were microinjected with SAL and 2.85 nmol/0.1 µL RA. However, when animals were microinjected with 5.7 nmol/0.1 µL RA, they did not show a reduction in %OAE and %OAT. These results demonstrate that CPA did not affect behavior at the doses used in this study, while 5.7 nmol/0.1 µL RA induced impairment of memory consolidation in the EPM.

Effect of Gongronema latifolium ethanol leaf extract on gastric acid secretion and cytoprotection in streptozotocin-induced diabetic rats / Efecto del extracto de etanol de las hojas de Gongronema latifolium sobre la secreción del ácido gástrico y la citoprotección en ratas con diabetes inducida por estreptozotocina

OBJECTIVES: Gongronema latifolium leaves have been used in folklore medicine to manage diabetes mellitus and alleviate dyspepsia. This study aimed to provide a pharmacological basis to the medicinal use of Gongronema latifolium as an antidiabetic and antiulcerogenic agent in diabetes mellitus. METHODS: Ethanol extract from the leaf (200 mg/kg bodyweight) of Gongronema latifolium was administered to both streptozotocin-induced diabetic and control groups orally for 14 days. Gastric acid secretion was measured and ulcer was induced using ethanol and fourhour pyloric ligation. RESULTS: The mean bodyweight was significantly lower (p < 0.01), while the mean weight of the stomach, liver and small intestine to bodyweight ratio was increased significantly (p < 0.05) in the two diabetic groups compared to control. Extract significantly (p < 0.01) reduced the blood glucose level similar to the nondiabetic control. Basal and stimulated acid secretion in diabetic control rats was significantly (p < 0.01) decreased when compared to control. Extract administration increased the stimulated gastric acid secretion to a level significantly (p < 0.05) higher than control while reduction in gastric secretion by ranitidine was similar compared with control. Gongronema latifolium treatment significantly (p < 0.05) reduced ulcer scores in both ulcer models and increased mucus weight in the diabetic group. CONCLUSION: These results suggest that Gongronema latifolium antiulcerative activity is due to its prevention of chemicalinduced stomach injury.

OBJETIVOS: Las hojas de la gongronema latifolium han sido usadas en la medicina tradicional para tratar la diabetes mellitus y aliviar la dispepsia. Este estudio estuvo dirigido a proporcionar una base farmacológica al uso medicinal de la gongronema latifolium como agente antidiabético y antiulcerogénico en la diabetes mellitus. MÉTODOS: El extracto de etanol de la hoja (200 mg/kg peso corporal) de la Gongronema latifolium se administró oralmente durante 14 días a grupos con diabetes inducida por estreptozotocina, y grupos de control. La secreción ácida gástrica fue moderada y la úlcera fue inducida usando etanol, y ligazón pilórica de cuatro horas. RESULTADOS: El peso corporal promedio fue significativamente más bajo (p < 0.01), mientras que el peso promedio del estómago, el hígado y el intestino delgado con respecto a la proporción del peso corporal aumentó significativamente (p < 0.05) en los dos grupos diabéticos comparados con los controles. El extracto redujo significativamente (p < 0.01) el nivel de glucosa de la sangre, de manera similar al control no diabético. La secreción ácida basal y estimulada en las ratas diabéticas control disminuyó significativamente (p < 0.01) en comparación con el control. La administración del extracto aumentó la secreción ácida gástrica estimulada a un nivel significativamente (p < 0.05) superior al control, en tanto que la reducción de secreción gástrica mediante ranitidina fue similar comparada con el control. El tratamiento con Gongronema latifolium redujo significativamente (p < 0.05) las puntuaciones de las úlceras, tanto en los modelos de la úlcera como en el peso de mucosidad aumentado en el grupo diabético. CONCLUSIÓN: Estos resultados sugieren que la actividad antiulcerosa de la Gongronema latifolium se debe a que previene las lesiones de estómago inducidas por medios químicos.

Profilaxia para úlcera de estresse em pacientes internados em UTI pediátrica / Stress ulcer prophylaxis in pediatric intensive care units

OBJETIVO: Avaliar a utilização de profilaxia para úlcera de estresse (UE), em pacientes internados, de cinco unidades de terapia intensiva pediátrica (UTIP) de Porto Alegre (RS). MÉTODOS: Estudo multicêntrico, prospectivo, transversal, observacional. Foram avaliados os prontuários dos pacientes internados em dia definido para visitação, entre abril de 2006 e fevereiro de 2007, excluindo os avaliados em visitas anteriores e aqueles com hemorragia digestiva alta na admissão. Foram avaliados a idade, o gênero, o diagnóstico na admissão, a gravidade da doença, o uso de profilaxia para UE, a sua justificativa e o medicamento profilático utilizado como primeira escolha. As variáveis foram descritas como frequências absoluta e relativa, ou média e desvio padrão/mediana, e intervalo interquartil (IQ). Os testes qui-quadrado de Pearson, de tendência linear, ou exato de Fisher foram utilizados para avaliar as associações. O nível de significância adotado foi de 5 por cento, sendo estatisticamente significativo p < 0,05. RESULTADOS: Foram avaliados 398 pacientes, sendo 57 por cento do gênero masculino. A mediana de idade foi de 16 meses (IQ4-65) e mediana de permanência em UTIP foi de 4 dias (IQ1-9). O principal motivo de internação foi doença respiratória (32,7 por cento). Usaram profilaxia 77,5 por cento dos pacientes, variando de 66 a 91 por cento; a ventilação mecânica (22,3 por cento) foi a justificativa mais prevalente, seguida de rotina informal do serviço (21,4 por cento). Apenas uma das UTIP tinha protocolo assistencial para profilaxia de UE. A ranitidina foi o medicamento mais empregado (84,5 por cento). CONCLUSÕES: O uso de profilaxia para UE foi prática frequente nas UTIP avaliadas, sendo a ranitidina a droga de escolha. Entre as justificativas, a ventilação mecânica e o uso baseado em rotinas institucionais foram as mais prevalentes.

OBJECTIVE: To assess use of stress ulcer prophylaxis in patients admitted to five pediatric intensive care units (PICUs) in Porto Alegre, Brazil. METHODS: This was a multicenter, prospective, cross-sectional observational study. PICUs were visited on randomly defined days between April 2006 and February 2007, and the medical records of admitted patients were reviewed. Patients whose records had been previously assessed were excluded, as were those with upper gastrointestinal bleeding on admission. Data were collected on age, gender, admission diagnosis, severity of illness, administration of stress ulcer prophylaxis, rationale for prophylaxis, and first-line prophylactic agent of choice. Variables were described as absolute and relative frequencies, mean and standard deviation, or median and interquartile range as appropriate. Pearson's chi-square test for linear trend or Fisher's exact test were used to assess possible associations. The level of significance was set at 5 percent (p < 0.05). RESULTS: 398 patients (57 percent male) were assessed [median age, 16 months (IQR 4-65); median length of PICU stay, 4 days (IQR 1-9)]. Respiratory illness was the main reason for admission (32.7 percent). Most patients received stress ulcer prophylaxis (77.5 percent; range, 66-91 percent). Mechanical ventilation (22.3 percent) was the most common rationale provided, followed by informal routine use of prophylaxis (21.4 percent). Only one of the participating PICUs had a specific care protocol for use of stress ulcer prophylaxis. Ranitidine was the most commonly used drug (84.5 percent of cases). Evidence of minor gastrointestinal bleeding was found in 3 percent of patients; none had clinically significant bleeds. CONCLUSIONS: Administration of stress ulcer prophylaxis is a common practice in the participating PICUs, with ranitidine the most commonly used drug. Among the various rationales provided, mechanical ventilation and informal routine use were the most prevalent.

Comparison between sucralfate and ranitidine effects on gavage tolerance in ICU patients

The absolute rest of Gastrointestinal tract is leading to mucousal destitution and atrophy because of intestinal mucous dependent on luminal feeding for life. The important of prophylactic treatment against stress ulcer in ICU patients was obvious. This study have done to evaluate effects of drugs on gastric feeding tolerance in ICU patients. In this clinical trial study, 50 patients were randomly divided in two groups and received ranitidine or sucralfate for stress ulcer. The demographic variables [age, sex, weight], APACHE II score, TISS, episodes of dairrhea, emesis and gastric retention > 250 CC/6h have been determined in both groups. The data was analyzed by SPSS software using Chi2and T-test and fisher exact test and Mann-Whitney U tests. There were no statistical differences about demographic variables in both groups [P>0.05]. Comparison about the important difference wasn't between APACHE II and TISS scores. The rate of diarrhea and emesis in sacralfate group were lesser than ranitidine group [P<0.05]. Against stress ulcer, prophylaxis with sucralfate has better effect on gastric gavage tolerance than ranitidine

Comparative study of oral erythromycin-ranitidine combination and metoclopramide-ranitidine combination in reducing residual gastric fluid volume and acidity in elective surgery

Prokinetic agents and H-2 receptor antagonists are commonly used to decrease the volume and increase the pH of the gastric fluid. This study was conducted to compare the effect of oral erythromycin-ranitidine combination and metoclopramide-ranitidine combination in reducing gastric fluid volume and acidity in patients undergoing elective surgery. 80 patients were divided into two groups by convenient sampling technique after meeting inclusion criteria; Group A was given oral erythromycin 250 mg-ranitidine 150 mg while group B was given oral metoclopramide 10 mg-ranitidine 150 mg two hours before surgery. Gastric fluid was aspirated with orogastric tube after induction. Volume and pH of the gastric fluid were determined. Data analysis of our study showed statistically significant reduction in mean gastric fluid aspirate volume in group A [3.4ml+2.3 vs. 7.2m1+3.1]. [P-value = 0.001 and T-value = 6.24]. There was no statistically significant difference between the two groups as far as increase in gastric pH was concerned [6.5+1.6 vs. 6.2+1.3]. [T-value = 0.925 / Two tailed P-value = 0.36]. In both the groups' gastric pH was increased from the average normal value [0.3-2.9]. Combination of erythromycin-ranitidine is more effective than metoclopramide-ranitidine in reducing the gastric aspirate fluid volume and thus in prevention of acid aspiration syndrome

Effects of a single low dose of ranitidine and effervescent antacids on intragastric acidity in healthy volunteers / Efectos de bajas dosis de ranitidina y antiácidos efervescentes sobre la acidez intragástrica en voluntarios sanos

Introduction/aims: We hypothesized that a combination of an effervescent antacid and ranitidine could allow immediate and long-lasting increase intragastric acidity. Our aim was to determine the effect of the combined intake of both, of a low dose ranitidine (OTC) and 5g of antacid on gastric pH. Material and methods: Twenty healthy Helicobacter pylori negative volunteers were enrolled. The study consisted in a fasting 6-hour gastric ph-metric procedure performed in two different periods: baseline (1-hour before drug) and post-drug (5-hours) after oral administration of a single dose of ranitidine (75 mg) plus 5 g of a commercial composed alkaline (sodium bicarbonate, citric acid, sodium carbonate). Results: While two subjects did not complete the pH-metry analysis due to technical reasons, 18 volunteers were finally assessed. Baseline intragastric pH (1.3±0.1) (mean±SD) rose significantly after administration of the drug (mean pH value for the whole period: 5.1±0.3; p<0.00001). The pH increased after administration of the study combination and values higher than pH 3 and pH 4 were reached immediately (median time: 27 sec, range: 0- 189 and 54 sec, range 27-3,600 sec, respectively). Gastric pH was initially maintained above 4 for 23.0±5 minutes. The mean time lapsed with pH<4 during the post-drug period was 96±17 min (32% of the total time). Conclusion: Our study confirms the fast and persistent effect produced by the administration of a combination of antacid salts plus low dose of ranitidine. We suggest that the given combination could be effeceffective, fast and safe for sporadic pyrosis or mild grastroesophageal reflux symptoms.

Introducción/objetivos: la combinación de un antiácido efervescente y ranitidina podría brindar un descenso inmediato y prolongado de la acidez intragástrica. Nuestro objetivo fue determinar el efecto de la ingesta conjunta de ambos (75 mg de ranitidina y 5 g de antiácidos) sobre el pH gástrico. Material y métodos: se incluyeron 20 voluntarios sanos, con anticuerpos anti- Helicobacter pylori negativos. Se realizó, en condiciones de ayuno, una pH-metría gástrica de 6 horas en dos períodos: basal (1 hora antes del medicamento) y post-droga (5 horas) luego de la administración oral de una dosis única de ranitidina (75 mg) + 5 g de antiácidos efervescentes (bicarbonato sódico, ácido cítrico, carbonato sódico). Resultados: dado que dos pacientes no completaron el estudio de pH por razones técnicas, se analizaron los resultados de 18 voluntarios. El pH intragástrico basal fue de 1.33±0.12 (promedio ± DS) y se elevó a 5.1±0.3 como promedio de todo el período post-droga (p<0.00001). El incremento de pH fue inmediato; así los valores de pH=3 y pH=4 fueron alcanzados en 27 seg, rango: 0-189 y 54 seg, rango 27- 3.600, respectivamente (mediana, rango). El pH se mantuvo inicialmente por encima de 4 durante 23.0±5 minutos. El tiempo con pH < 4 durante las 5 horas post-droga fue de 96± 17 minutos (32% del tiempo total). Conclusión: nuestro estudio confirma el efecto rápido y persistente determinado por la combinación de sales antiácidas y bajas dosis de ranitidina. De este modo esta asociación podría ser efectiva, rápida y segura frente a pirosis esporádica o síntomas de reflujo gastro-esofágico leve.

Histamine and spontaneously released mast cell granules ffect the cell growth of human hepatocellular carcinoma cells

The role of mast cells in tumor growth is still controversial. In this study we analyzed the effects of both histamine and pre-formed mediators spontaneously released by mast cells on the growth of two human hepatocellular carcinoma cell lines, HA22T/VGH and HuH-6, with different characteristics of differentiation, biological behavior and genetic defects. We showed that total mast cell releasate, exocytosed granules (granule remnants) and histamine reduced cell viability and proliferation in HuH-6 cells. In contrast, in HA22T/VGH cells granule remnants and histamine induced a weak but significant increase in cell growth. We showed that both cell lines expressed histamine receptors H1 and H2 and that the selective H1 antagonist terfenadine reverted the histamine-induced inhibition of HuH-6 cell growth, whereas the selective H2 antagonist ranitidine inhibited the histamine-induced cell growth of HA22T/VGH cells. We demonstrated that histamine down-regulated the expression of beta-catenin, COX-2 and survivin in HuH-6 cells and that this was associated with caspase-3 activation and PARP cleavage. On the contrary, in HA22T/VGH cells expression of survivin and beta-catenin increased after treatment with granule remnants and histamine. Overall, our results suggest that mediators stored in mast cell granules and histamine may affect the growth of liver cancer cells. However, mast cells and histamine may play different roles depending on the tumor cell features. Finally, these data suggest that histamine and histamine receptor agonists/antagonists might be considered as "new therapeutic" drugs to inhibit liver tumor growth.

Profilaxis del sangrado de tubo digestivo en el paciente crítico UIC HALF enero-diciembre 2005 serie de casos / Prevention of the one bled of alimentary canal in the critical patient UIC HALF January-December 2005 series of cases

El estudio tuvo como propóstio determinar el fármaco más utilizado y poder identificar si existen o no diferencias entre los pacientes y permitir pautas a investigaciones posteriores con el fin de evaluar la eficacia de ambas drogas. Se realizó un estudio descriptivo a través de revisión de casos, con un total de 82 pacientes, se revisaron los expedientes clínicos para el llenado de una ficha previamente elaborada. El sexo predominante fue el masculino en un 67 porciento y el grupo etáreo predominante fue de 47-57 años. Las principales patologías o factores de riesgo ingresados en UCI del hospital fueron: sepsis, cirugia mayor, ventilación mecanica politrauma. Los fármacos utilizados para profilaxis de sangrado digestivo fueron ranitidina y omeprazol. El 20.7 porciento de los pacientes presentaron sangrado y correspondió a aquellos que se les administró ranitidina. A ningún paciente se le realizó diagnóstico por endoscopia. Los hallazgos encontrados no difieren de lo reportado de la literatura referente a factores de riesgo y aunque no se trate de un estudio analítico se demuestra que los inhibidores de bomba tiene un mejor efecto protector de la mucosa gástrica que los bloqueadores H2, por lo que se recomienda realizar estudios posteriores que evaluén la eficacia de los fármacos ranitidina e inhibdores de bomba, mientras tanto en los pocientes críticos con uno o múltiples factores de riesgo utilizar inhibidores de bomba como profilaxis...

Modulation of ulcerogenicity of Ibuprofen and Indomethacin via blocking the H[2] receptors in the stomach

Among the commonest side effects of NSAIDs are the gastrointestinal manifestations, which could reach gastric erosions, ulcerations, or recurrent liberations in people using NSAID for long durations. This provided idea of accomplishing this work in order to study the possibility of avoiding these side effects, which stand as a strong barrier against the regular use of these drugs. This study aimed at finding a way out from these serious side effects such as gastric ulcers, so that a member of the H[2] receptor antagonists; namely ranitidine, was thought to accompany the treatment with indomethacin being the classic example of the NSAIDs, and ibuprofen; which is one of the most commonly used NSAIDs. The ulcer index was the measure to reach a fair judgment comparing the use and the non-use of ranitidine with indomethacin and ibuprofen therapies. Results were much better when ranitidine was taken as an adjuvant treatment to indomethacin and ibuprofen, a situation indicating the necessity of considering prescribing one of the H[2] receptor antagonists with the NSAIDs therapy, especially in prolonged use

Evaluation of combined effect of verapamil and ranitidine on the volume and acidity of carbachol induced gastric secretion

This study was conducted to observe the effect of H2-receptor antagonist Ranitidine and calcium channel blocker Verapamil on the volume, free and total acidity of carbachol induced gastric secretion. Twenty four albino rats of Sprangue Dawley strain weighing 150-200 grams were used. Animals were divided into Four groups. After fasting for 48 hours, pylorus of each animal was ligated, verapamil 10mg/Kg, ranitidine 0.5 mg/Kg and carbachol 600 micro g/Kg body weight were administered intraperitoneally. It was observed that ranitidine significantly reduced both the volume and acidity [p<0.001]. Similarly Verapamil also significantly reduced the volume, free and total acidity when compared to carbachol alone. When verapamil was used in combination with ranitidine 15 minutes before carbachol, there was further inhibition of volume and acidity as compared to ranitidine alone. This reduction was statistically highly significant [p<0.001]. Our study suggests that combined therapy of verapamil and ranitidine may have clinical usefulness in the management of severe peptic ulcer and Zollinger Ellison Syndrome

Gastric fluid volume and pH: a comparison of effects of ranitidine alone with combination of ranitidine and metoclopramide in patients undergoing elective caesarean section

Seventy five patients undergoing elective caesarean section under general anaesthesia were randomly divided into three groups of twenty rive patients each to receive placebo [group I], H-2 receptor blocker, ranitidine [group 11] and combination of H-2 receptor blocker and prokinetic drug, metoclopramide [group III]. Gastric fluid volume >25 ml was recorded in sixteen [64%] patients in-group I, in three [12%] patients in-group 11 and in six [24%] patients in-group HL Gastric fluid pH <2.5 was recorded in sixteen [64%] patients in group I, in one [4%] patient in group H and no patient in group HL Group H and HI patients were not statistically significantly different [p-value < 0.05] regarding both the parameters but group I patients were at a high risk [60%] of aspiration pneumonitis when compared to group 11 and HI [p-value > 0.05]

Presentaciones farmacológicas optativas para el paciente pediátrico / Pharmacological presentations for pediatric patients

Para la administración de algunos medicamentos utilizados con poca frecuencia en niños, no se dispone de una presentación farmacológica adecuada en el comercio. Es necesariopor lo tanto conocer las alternativas a las que puede recurrir para lograr una buena y efectiva utilización de productos como metilprednisolona, ranitidina e hidrato de cloral. A continuación se revisa someramente la farmacología de estos medicamentos y su presentación ideada para pacientes pediátricos como prescripción magistral (presentaciones formuladas a solicitud del médico) disponibles en Chile. Es importante conocer la estabilidad de cada una de las presentaciones, para informar adecuadamente al personal de salud o a los familiares

Efeitos da ranitidina e do omeprazol sobre o pH gástrico em cäes / Effect of ranitidine and omeprazole on gastric pH in dogs

O objetivo deste trabalho foi investigar o efeito da ranitidina e omeprazol sobre o pH gástrico em 24 cães adultos, machos, sem raça definida, distribuídos em 3 grupos: grupo A - controle, grupo B - ranitidina e grupo C - omeprazol. O pH gástrico foi medido, após coleta do suco gástrico, com seringa, em cães submetidos a gastrotomia. Esta medida foi feita no grupo controle nos tempos zero, 30, 60, 90 e 120 minutos, no grupo ranitidina a medida foi feita no tempo zero, seguida de aplicação de 0,85 mg/kg de ranitidina por via endovenosa, sendo realizada nova medida nos tempos 30, 60, 90 e 120 minutos e, no grupo omeprazol a medida foi feita no tempo zero, seguida de aplicação de 0,68 mg/kg de omeprazol por via endovenosa, sendo realizada nova medida nos tempos 30,60, 90 e 120 minutos. A comparação entre os grupos mostrou um aumento significante do pH gástrico após o uso de ranitidina e omeprazol. Entretanto, os efeitos comparados da ranitidina e omeprazol não apresentaram diferenças significantes na variação do pH.

Comparative and morphologic evaluation of aspirin and ranitidine effects on wound repair of gastric mucosa

Esta investigación se realizó con el objetivo de verificar los efectos comparativos de la aspirina y de la ranitidina en la recomposición de la mucosa gástrica después de una agresión quirúrgica. La incisión quirúrgica, dentro de patrones definidos, fue efectuada en la mucosa gástrica de 12 ratones divididos en 3 grupos: placebo (PG), aspirina (AG) y ranitidina (RG). Las paredes gástricas y abdominal fueron suturadas en dos planos. A los ratones de los grupos PG, AG y RG se le administraron diariamente, por vía intragástrica, 1 ml de agua destilada, 250 mg/ka de aspirina y 25 mg/kg de ranitidina, respectivamente. Los estudios de la recomposición de la incisión en la mucosa en el 7º día pós-operatorio, a través de las microscopías de luz y electrónica de barrido, nos mostraron una reepitelización del tejido de granulación y de las células del epitelio que envuelven los bordes de la incisión quirúrgica. La importancia de las alteraciones fue observada de forma decreciente en la mucosa gástrica en los grupos AG, PG y RG

Hippocampal histamine receptors and conflictive exploration in the rat: studies using the elevated asymmetric plus-maze

The possible role of histamine receptors in the hippocampal formation on the exploratory motivation and emotionality of the rat was studied. An elevated asymmetric plus-maze composed of 4 different arms (no walls, single high wall, high and low walls and two high walls) arranged at 90 degrees angles was used. The exploration score, considered to be an index of exploratory motivation, and the permanency score, considered to be an index of emotionality (anxiety), were determined. Histamine was administered locally into the ventral hippocampus at three different doses (9,45 and 90 nmol). Another group of rats was also microinjected with 45 nmol of pyrilamine (a histamine H1 receptor antagonist) or ranitidine (a histamine H2 receptor antagonist) in addition to 9 nmol of histamine in order to identify the possible type of histamine receptor involved. Histamine administration significantly inhibited the exploration score and increased the permanency score at the doses of 9 and 45 nmol in two of four arms. These effects were completely blocked by the administration of eitheer histamine receptor antagonist. The present results suggest that in the hippocampal formation histamine inhibits exploratory motivation and decreases emotionality by activating both types of histamine receptors. Also, the elvated asymmetric plus-maze appears to be a suitable technique to quantify exploration and possibly "anxiety".

Ulcera duodenal e helicobacter pilori: ensaio clínico randomizado, comparativo entre terapia tríplice e ranitidina / Duodenale ulcer abd helicobacter pylori: randomized clinical essay comparactive between triplice therapy and ranitidine

INTRODUÇÄO: O papel patogêno do Helicobacter pylori na doença ulcerosa péptica está estabelecido e sua erradicaçäo se reflete na queda dos índices de recidiva da úlcera duodenal. É importante a realizaçäo de estudos epidemiológicos e ensaios clínicos em nosso meio (Bahia) por se tratar de populaçäo de baixo nível sócio-econômico, fator considerado de risco na aquisiçäo da bactéria. OBJETIVOS: avaliar a cicatrizaçäo e a recidiva da úlcera duodenal, a erradicaçäo do H. pylori, o tipo e intensidade do infiltrado inflamatório da mucosa gástrica, no intervalo de 12 meses, comparando-se dois esquemas terapêuticos. MATERIAL E MÉTODOS: Foi realizado ensaio clínico prospectivo, randomizado, simples cego. Neste estudo, 60 pacientes H. pylori-positivos com úlcera em atividade foram submetidos a exame clínico, endoscópico e histológico a cada 4, 8 e 12 semanas, 6 e 12 meses. Os esquemas de tratamento foram: esquema 1: ranitidina 150mg 2x/dia durante quatro semanas; esquema 2 (terapia tríplice): subcitrato de bismuto coloidal 120mg 4x/dia durante 4 semanas + amoxicilina 500mg 3x/dia + tinidazol 500mg 2x/dia durante as duas últimas semanas. Os pacientes nos quais a úlcera näo cicatrizou com quatro semanas foram submetidos a mudança de tratamento, de um esquema para outro (cruzamento terapêutico). Foram excluídos os pacientes nos quais a úlcera näo cicatrizou após oito semanas e aqueles que näo compareceram às reavaliaçöes. RESULTADOS: Dos 21 pacientes do esquema 1 e dos 39 do esquema 2, a úlcera cicatrizou em 14 (66,7 porcento) e em 32 (82,1 porcento), respectivamente, após quatro semanas (p> 0,6). Os nove pacientes nos quais a úlcera näo cicatrizou foram submetidos ao cruzamento terapêutico e destes, três (33,3 porcento) continuaram sem que a úlcera cicatrizasse. A erradicaçäo do H. pylori foi observada em 19 (46,3 porcento) dos 41 pacientes que foram submetidos ao esquema 2. Após acompanhamento de 12 meses, foi observada recorrência da infecçäo pelo H. pylori em seis (31,6 porcento) pacientes. Desses, quatro (66,7 porcento), recidivaram a úlcera duodenal. Os 13 pacientes que se mantiveram erradicados até o final do estudo näo recidivaram a úlcera. Dos 43 pacientes positivos para o H. pylori, 21 (48,8 porcento) recidivaram a úlcera em até 12 meses. Ao final do estudo, a recidiva da úlcera foi observada em 11 (78,6 porcento) dos pacientes do esquema 1 e em 22 (68,7 porcento) do esquema 2 (p > 0,7). Houve melhora histológica nos pacientes que erradicaram o H...