Evaluation of intranasal oxygen supplementation in mules anesthetized with the combination of ketamine, butorphanol, and guaifenesin / Avaliação da suplementação intranasal de oxigênio em muares anestesiados com a associação de cetamina, butorfanol e éter gliceril guaiacólico

Hypoxemia is a major complication of field anesthesia and no studies regarding this occurrence in mules has been done. Thus, the aim of this study was to evaluate intranasal oxygen supplementation (IOS) in mules (Equus caballus x Equus asinus) anesthetized with ketamine/butorphanol/guaifenesin combination. For this, we used six male, adult mules (322±29kg) which underwent premedication (MPA) with 0.2mg/kg of midazolam intramuscularly after 15 minutes, 0.02mg/kg detomidine IV 5 minutes after, induction IV with combination of ketamine (2mg/mL), butorphanol (22.5mg/mL), and guaifenesin (50mg/mL) (K/B/G) until lateral decumbency. Maintenance was done with the same anesthetic combination. The animals were submitted twice to the protocol described above, 20 days apart, forming two groups. CG: MPA, induction (0.92±0.24mL/kg (mean±SD)), and maintenance (2.2±0.2mL/kg/h) without SIO; TG: MPA, induction (0.98±0.17mL/kg), and maintenance (2.3±0.4mL/kg/h) with IOS flow 40mL/kg/h. During anesthesia arterial blood was collected every 20 minutes (T0, T20, T40, and T60) for blood gas analysis. Data analyzed by ANOVA followed by the Bonferroni test. P<0.05 was considered significant. Hypoxemia of the animals in the CG in periods (59±5; 55±5; 53±7; 49±8) with lower averages than the TG (160±4, 115±34, 92±25, 81±19) was observed, demonstrating that IOS increases PaO2 avoiding the occurrence of hypoxemia.(AU)

A hipoxemia é uma das principais complicações da anestesia a campo, e em muares não existem estudos a respeito dessa ocorrência. Assim, objetivou-se avaliar a suplementação intranasal de oxigênio (SIO) em muares (Equus caballus x Equus asinus) anestesiados com cetamina/butorfanol/guaifenesina associados. Para isso, foram utilizados seis muares, macho e adultos (322±29kg), submetidos à medicação pré-anestésica (MPA) com 0,2mg/kg de midazolam por via intramuscular, após 15 minutos, 0,02mg/kg de detomidina por via intravenosa, após cinco minutos, indução com administração intravenosa da associação de cetamina (2mg/mL), butorfanol (22,5 µg/mL) e guaifenesina (50mg/mL) em solução de glicose a 5% (C/B/G) até o animal assumir o decúbito lateral. A manutenção foi realizada com a mesma associação anestésica. Os animais foram submetidos duas vezes ao protocolo descrito anteriormente, com intervalo de 20 dias, formando dois grupos experimentais. GC -MPA, indução (0,92±0,24mL/kg (média±DP)) e manutenção (2,2±0,2mL/kg/h) sem SIO; GT - MPA, indução (0,98±0,17mL/kg) e manutenção (2,3±0,4mL/kg/h) com SIO, fluxo de 40mL/kg/h. Durante a anestesia, foi colhido sangue arterial a cada 20 minutos (T0, T20, T40 e T60) para hemogasometria. Os dados foram analisados pela ANOVA, seguidos pelo teste de Bonferroni. Valores de P<0,05 foram considerados significativos. Foi observada hipoxemia (PaO2<60mmHg) dos animais no GC nos tempos avaliados (T0= 59±5; T20= 55±5; T40= 53±7; T60= 49±8), com médias menores que as do GT, (160±4; 115±34; 92±25; 81±19, respectivamente), o que demonstrou que a suplementação intranasal de oxigênio aumenta a PaO2, evitando a ocorrência de hipoxemia.

A case of levocetirizine-induced fixed drug eruption and cross-reaction with piperazine derivatives

Fixed drug eruption is an uncommon adverse drug reaction caused by delayed cell-mediated hypersensitivity. Levocetirizine is an active (R)-enatiomer of cetirizine and there have been a few reports of fixed drug eruption related to these antihistamines. We experienced a case of levocetirizine-induced fixed drug eruption and cross-reaction with other piperazine derivatives confirmed by patch test. A 73-year-old female patient presented with recurrent generalized itching, cutaneous bullae formation, rash and multiple pigmentation at fixed sites after taking drugs for common cold. She took bepotastine besilate (Talion®) and levocetirizine (Xyzal®) as antihistamine. She took acetaminophen, pseudoephedrine 60 mg / triprolidine 2.5 mg (Actifed®), dihydrocodeinebitartrate 5 mg / di-methylephedrine hydrochloride 17.5 mg / chlorpheniramine maleate 1.5 mg / guaifenesin 50 mg (Codening®) and aluminium hydroxide 200 mg / magnesium carbonate 120 mg (Antad®) at the same time. Patch test was done with suspected drugs and the result was positive with levocetirizine. We additionally performed patch test for other antihistamines such as cetirizine, hydroxyzine, fexofenadine and loratadine. Piperazine derivatives (cetirizine and hydroxyzine) were positive, but piperidine derivatives (fexofenadine and loratadine) were negative to patch test. There was no adverse drug reaction when she was challenged with fexofenadine. We report a case of levocetirizine-induced fixed drug eruption confirmed by patch test. Cross-reactions were only observed in the piperazine derivatives and piperidine antihistamine was tolerant to the patient.

Rapid identification 15 effective components of anti common cold medicine with MRM by LC-MS/MS / 药学学报

This paper reports the establishment of a method for rapid identification 15 effective components of anti common cold medicine (paracetamol, aminophenazone, pseudoephedrine hydrochloride, methylephedrine hydrochloride, caffeine, amantadine hydrochloride, phenazone, guaifenesin, chlorphenamine maleate, dextromethorphen hydrobromide, diphenhydramine hydrochloride, promethazine hydrochloride, propyphenazone, benorilate and diclofenac sodium) with MRM by LC-MS/MS. The samples were extracted by methanol and were separated from a Altantis T3 column within 15 min with a gradient of acetonitrile-ammonium acetate (containing 0.25% glacial acetic acid), a tandem quadrupole mass spectrometer equipped with electrospray ionization source (ESI) was used in positive ion mode, and multiple reaction monitoring (MRM) was performed for qualitative analysis of these compounds. The minimum detectable quantity were 0.33-2.5 microg x kg(-1) of the 15 compounds. The method is simple, accurate and with good reproducibility for rapid identification many components in the same chromatographic condition, and provides a reference for qualitative analysis illegally added chemicals in anti common cold medicine.

Application of artificial neural networks for response surface modeling in HPLC method development

This paper discusses the usefulness of artificial neural networks [ANNs] for response surface modeling in HPLC method development. In this study, the combined effect of pH and mobile phase composition on the reversed-phase liquid chromatographic behavior of a mixture of salbuta-mol [SAL] and guaiphenesin [GUA], combination I, and a mixture of ascorbic acid [ASC], paracetamol [PAR] and guaiphenesin [GUA], combination II, was investigated. The results were compared with those produced using multiple regression [REG] analysis. To examine the respective predictive power of the regression model and the neural network model, experimental and predicted response factor values, mean of squares error [MSE], average error percentage [E[[r%], and coefficients of correlation [r] were compared. It was clear that the best networks were able to predict the experimental responses more accurately than the multiple regression analysis

Simultaneous determination of multi drug components theophylline, etofylline, guaiphenesine and ambroxol hydrochloride by validated RP-HPLC method in liquid dosage form

The RP-HPLC [reverse phase high performance liquid chromatography] method was developed and validated for simultaneous determination of Multi drug components i.e., Theophylline, Etofylline, Guaiphenesine and Ambroxol Hydrochloride in a liquid dosage form. Chromatographic separation of the four drugs was performed on a Hypersil Phenyl BDS [25cmX4.6mm, 5um]. The mobile phase constituted of triethylamine pH 3.0 buffer: methanol [85:15] v/v was delivered at the flow rate 1.5 mL/min. Detection was performed at 235 nm. The peak purity of Theophylline, Etofylline, Guaiphenesine and Ambroxol Hydrochloride were 0.99970, 0.99979, 0.99986 and 0.99949 respectively. Calibration curves were linear with correlation coefficient between 0.99995 to 0.99997 over a concentration range of 5 to 37 micro g/mL for Theophylline, 19 to 140 micro g/mL for Etofylline, 20 to 149 micro g/mL for Guaiphenesine and 6 to 45 micro g/mL for Ambroxol hydrochloride. The relative standard deviation [RSD] was found < 2.0%. The percentage recovery was found between th e range of 98.6% and 100.5% at three different levels. Robustness and ruggedness were performed and result found within the RSD of 2%. All the parameters of validation were found in the acceptance range of ICH guideline

Efficacy and safety of Ascoril in the management of cough--National Study Group report.

A total of 768 patients were recruited by 81 physicians and paediatricians all over the country in this National Study Group of 'Ascoril + Expectorant'. The results of this first large scale study of a cough formula indicates that 'Ascoril + Expectorant' is effective in controlling cough, breathlessness and decreasing the volume of sputum. No serious adverse events were noted. Ascoril was well accepted by the patients and its efficacy was rated very high by the physician. The National Study Group concludes that 'Ascoril + Expectorant' is highly effective in the management of cough associated with lower respiratory tract infection and COPDs.

Resposta hematológica, respiratória e cardiocirculatória de eqüinos submetidos a três protocolos de induçäo anestésica / Hematological, respiratory and cardiovascular response of equine submitted to three anesthetic protocols

O presente trabalho investigou os efeitos hematológicos, respiratórios e cardiocirculatórios de eqüinos PSI submetidos a três diferentes protocolos de induçäo anestésica. Os grupos (G1, G2 e G3), constituídos de 10 animais cada, receberam: acepromazina 0,1 mg/kg, guaifenesina 113 mg/kg e tiopental sódico 2 g (G1); levomepromazina 0,2 mg/kg, midazolam 0,1 mg/kg e cloridrato de cetamina 2,0 mg/kg (G2); e cloridrato de detomidina 20 µg/kg e tiletamina-zolazepam 1,1 mg/kg (G3). As avaliaçöes realizadas constaram de exame clínico, análise hematológica, hemogasometria arterial e avaliaçäo eletrocardiográfica. As colheitas de dados foram procedidas antes da administraçäo de qualquer fármaco e quinze minutos após a administraçäo do último. Os resultados mostraram que os três protocolos utilizados sao efetivos como indutores da anestesia geral em eqüinos. A avaliaçäo da funçäo respiratória nao permite destaque positivo ou negativo para nenhum dos protocolos. As alteraçöes cardiocirculatórias observadas foram de caráter temporário e sem significado clínico. As principais diferenças observadas foram a preparaçäo laboriosa da combinaçäo usada no G1, a necessidade mais freqüente de suplementaçäo anestésica no G2 e a ocorrência de dificuldade de manejo do animal após a pré-anestesia no G3, em virtude das dificuldades de deambulaçäo

Efficacy and safety of Ascoril expectorant and other cough formula in the treatment of cough management in paediatric and adult patients--a randomised double-blind comparative trial.

The present study was undertaken to study the comparative safety and efficacy of two cough formulas viz, Ascoril expectorant and other cough formula in the management of cough associated with respiratory disorders. Fifty patients having cough associated with various respiratory disorders like bronchitis and upper or lower respiratory tract infections were randomly divided into 2 equal groups and were treated with one of the two cough formulas viz, Ascoril cough formula and other cough formula in double-blind manner over a period of 15 days. The evaluation of improvement was carried out by a rating scale using three clinical parameters--cough, sputum and breathlessness. The physicians were asked to rate the effectiveness of the therapy and patients were asked to rate the acceptability of therapy using pre-defined operational criteria. It was observed that the improvement and symptom relief was almost immediate, quicker and better in the group receiving Ascoril as compared to other group. On effectiveness parameter, 96% of the physicians rated Ascoril as having either 'very high effectiveness or high effectiveness' as opposed to only 34% of the physicians who rated other cough formula as having 'high' or 'very high effectiveness'. While on parameter of acceptability, 96% of the patients rated acceptability of Ascoril as 'high' or 'good' as opposed to only 24% of the patients who rated other cough formula 'high' or 'good'. The findings of this study suggests that Ascoril cough formula has better efficacy as well as better patient acceptability. Thus, Ascoril cough formula is superior to other cough formula in management of cough associated with respiratory disorders.

Stability indicating methods for the quantitative determination of pseudoephedrine HCl and guaifenesin and dextromethorphan HBR in a cough syrup using HPLC

The determination of three active ingredients in a multicomponent pharmaceutical product by HPLC using two columns is reported. Guaifenesin and dextromethorphan HBr were separated and quantitated simultaneously in a cough syrup using an isocratic reversed phase system. The mobile phase was 45% [v/v] aqueous methanol with ammonium formate as buffer [PH 4.3]. the range of concentrations used in the determination of guaifenesin and dextromethorphan HBr were 202-363 mg/100ml and 30-54 mg/100 ml, respectively. A separate method was developed for the determination of pseudoephedrine HCI using a normal phase system. The mobile phase was 80% [v/v] aqueous ethanol with ammonium acetate as buffer [pH 7.3]. the range of concentrations used in the determination of pseudoephedrine HC1 was 60-108 mg/100 ml. Both methods proved to be repeatable, reproducible and stability indicating

Anestesia em cães utilizando éter glicerol guaiacol, quetamina e fentanil em infusão contínua intravenosa / Anaesthesia in dogs using continuous intravenous infusion of guaiphenesin, ketamine and fentanyl

Onze cães, sem raça definida, receberam como medicação pré-anestésica a anestesia induzida e mantida por infusão contínua intravenosa de quetamina e fentanil em solução de éter gliceril guaiacol a 5% em glicose a 5%, através de bomba de infusão. Em seis animais foram mensuradas frequência cardíaca e respiratória, ventilometria (volume corrente e volume minuto), pressão arterial (sistólica, média e diastólica), temperatura retal, hemogasometria arterial, saturação de 02 na hemogoblina, anion residual, osmolalidade sérica, concentração sérica total de 02, hematócrito, hemoglobina, glicose e eletrólitos. Avaliou-se também a analgesia através de pinçamento da pele da região glabra. Em outro grupo de cinco animais, onde foram realizadas três ovários-salpingo-histerectomias e duas osteossínteses, foram mensuradas a frequência cardíaca e respiratória e a resposta ao estímulo cirúrgico. Em ambos os grupos observou-se, principalmente, depressão respiratória dose-dependente, agravada com o uso de velocidade de infusão elevada, no caso de manobras cirúrgicas muito cruentas, como manipulação de periósteo.

Eleven mongrel dogs were premedicated with methotrimeprazine. Anaesthesia was induced and main-tained by continuous intravenous infusion of a 5% glucose solution containing guaiphenesin, ketamine and fentanyl. Heart and respiratory rates, tidal and minute volume, systolic, mean and diastolic blood pressure, temperature, arterial blood gases, hemoglobin oxygen saturation, anion gap, serum osmolality, serum oxygen concentration, packed cell volume, hemoglobin, glucose and electrolytes were measured in six dogs. Analgesia was investigated usind a forceps in the skin. In the other five dogs heart and respiratory rates and response to surgical stimulus were investigated. Respiratory acidosis, hypoximia and hypoventilation were observed. Respiratory depression was proportional to the infusion rate, particulary when high infusion rates were used for bone repair.

Evaluación clínico-espirométrica comparativa de la combinación ambroxol-clenbuteron vs terbutalina-guaifenesina en pacientes con neumopatía aguda / Clinical-sperometric evaluation comparing ambroxol-clenbuteron vs terbutaline-guaifenesine in patients with pneumopathy

Se efectuó una evaluación clínico-espirométrica comparativa en 30 pacientes con diagnóstico de neumopatía aguda ingresados en el departamento de neumología del Hospital General "Dr. Aurelio Valdivieso" de la S.S.A. en la Ciudad de Oaxaca, Oax., tratados con la asociación medicamentosa ambroxol-clenbuterol y con la asociación terbutalina-guaifenesina. Ambos tratamientos se administraron durante una semana. Se observó claramente una mejoría funcional comparativamente mayor, reflejada en el incremento de los volúmenes pulmonares, en los pacientes tratados con la asociación ambroxol-clenbuterol, por lo que se incluye que dicha asociación ese más benéfica en el tratamiento de este tipo de talología pulmonar.

Emprego do éter gliceril guaiacol isolado ou associado à levomepromazina e benzodiazepínicos na orquiectomia em equinos / Use of the glyceryl guaiacolate alone and associated with levomepromazine and benzodiazepines in gelding of horses

Visou-se averiguar a utilizaçäo do éter gliceril guaiacol isoladamente (G1) ou associado à levomepromazina e benzodiazepínicos, empregando-se o flunitrazepan (G2) e o midazolam (G3) em 10 eqüinos para cada grupo, submetidos à orquiectomia bilateral. Observou-se que a qualidade de induçäo e decúbito, bem como a analgesia, foram superiores nos grupos em que se realizou a associaçäo de éter gliceril guaiacol com levomepromazina e benzodiazepínicos (G2 e G3), porém, o período de recuperaçäo (estaçäo) destes últimos foi o dobro em relaçäo ao grupo do éter gliceril guaiacol usado isoladamente. A temperatura retal näo apresentou alteraçäo significativa apenas com o uso do éter gliceril guaiacol, porém, houve uma tendência à reduçäo desta, nos grupos que receberam a associaçäo do mesmo com levomepromazina e benzodiazepínicos. Verificou-se, nos três grupos, uma taquicardia nos momentos iniciais, com normalizaçäo após 60 minutos, sendo esta mais acentuada em G2 e G3, observando-se paralelamente bradipnéia nos três grupos, apesar do grupo do éter gliceril guaiacol, usado isoladamente, caracterizar-se por valores maiores de freqüência respiratória que os demais grupos. As três técnicas anestésicas mostraram-se satisfatórias, pela estabilidade de parâmetros fisiológicos e induçäo e recuperaçäo suaves, sendo que a associaçäo da levomepromazina com o flunitrazepan ou midazolam proporcionou prostraçäo mais eficaz, bem como maior miorrelaxamento, sedaçäo e hipoalgesia

Estudo farmacocinético comparativo de apresentaçöes em suspensäo de ampicilina pura e de ampicilina associada a balsâmicos / Pharmacokinetic comparative study of suspension forms of pure ampicillin and ampicillin associated with balsamics

Os autores compararam as concentraçöes sangüíneas de ampicilina, após a administraçäo de uma suspensäo oral de ampicilina associada a balsâmicos e uma suspensäo oral pura de ampicilina. Näo foram observadas diferenças estatisticamente significativas nos valores obtidos