Gastroprotective effect of the ethanolic extract of Parkia platycephala Benth. leaves against acute gastric lesion models in rodents

Parkia platycephala Benth. (Leguminosae - Mimosoideae), popularly known as "visgueira", fava bean tree or "fava-de-bolota", is widely found in the Northern and Northeastern regions of Brazil. Its pods are used as cattle food supplement in the drought period. Compounds with a gastroprotective activity were obtained from the genus Parkia. Therefore, this study aimed at investigating the gastroprotective effect of the ethanolic extract of Parkia platycephala Benth. leaves (Pp-EtOH), as well as evaluating its possible mechanisms of action in experimental ulcer induction models. Lesions were induced by absolute ethanol, ethanol-HCl, ischemia-reperfusion and indomethacin in rodents. Pp-EtOH showed a protective effect in the lesion models (66, 48 and 52 percent, respectively), but it was not able to protect gastric mucosa against indomethacin-induced lesions. Results show a possible participation of the NO-synthase pathway in the gastroprotection and an antioxidant activity, by the increase of the catalase activity. The participation of prostaglandins and potassium channels sensitive to ATP in the gastroprotective effect of Pp-EtOH seems less likely to occur. More comprehensive studies, therefore, should be carried out to elucidate the antiulcerative effects of this promising natural product against this gastrointestinal disorder.

Possíveis interações medicamentosas com psicotrópicos encontradas em pacientes da Zona Leste de São Paulo / Possible drug interactions with psychotropics found in patients in East São Paulo

Interação medicamentosa é o resultado de uma interferência no efeito de um medicamento por outros agentes. Dentre os fatores que resultam nas interações medicamentosas destacam-se a automedicação e a prática da polifarmácia. O objetivo deste trabalho foi realizar um levantamento de interações medicamentosas que ocorrem com fármacos que atuam no sistema nervoso central, suas possíveis consequências, bem como os motivos que propiciam tal situação. Foi realizado um estudo observacional transversal de 60 indivíduos da zona leste de São Paulo que utilizam medicamentos psicotrópicos, maiores de 21 anos e de ambos os sexos, por meio de um questionário entre junho e agosto de 2008. Os principais psicotrópicos utilizados pelos indivíduos foram benzodiazepínicos e antidepressivos (54 indivíduos), sendo que estes fármacos apresentam alto índice de interações medicamentosas. Cerca de 77% utilizam outros medicamentos em paralelo ao tratamento com psicotrópicos, sendo que destes apenas 35% o fazem com supervisão médica e 27% dos indivíduos utilizaram bebidas alcoólicas concomitantemente. As principais interações encontradas envolveram antidepressivos com benzodiazepínicos, antiulcerogênicos, anticonvulsivantes e álcool. Conclui-se que a automedicação e o uso inadequado de medicamentos são fatores que podem propiciar a ocorrência das interações medicamentosas encontradas, algumas com consequências graves.

A drug interaction is the interference in the effect of a drug by another substance. Outstanding among the factors that result in drug interactions are selfmedication and the practice of polypharmacy. The aim of this work was to conduct a survey of drug interactions that occur with drugs that act on the central nervous system, their possible consequences and the reasons for their occurrence. An observational cross-sectional study was performed on 60 subjects from East Sao Paulo who take psychotropic drugs (over 21 years old and of both genders), by means of a questionnaire applied from June to August 2008. The main drugs taken by those interviewed were benzodiazepines and antidepressants (54 subjects), which are drugs that have high rates of drug interactions. About 77% took other drugs, in parallel with the psychotropic drug treatment, of which only 35% were under medical supervision, and 27% of subjects drank alcohol while taking psychotropic drugs. The main interactions found involved antidepressants with benzodiazepines, antiulcerogenics, anticonvulsants and alcohol. We concluded that self-medication and inadequate drug usage are factors that favor the occurrence of the drug interactions found, some of them with dangerous consequences.

Atividades antiúlcera e antioxidante de Syzygium jambos(L. ) Alston / Antiulcer and antioxidant activities of Syzygium jambos(L. ) Alston

O jambeiro (Syzygium jambos (L.) Alston) constitui uma das diversas espécies frutíferas e medicinais pertencentes à família Myrtaceae. O extrato hidroetanólico a 70 ´POR CENTO´ liofilizado de folhas de S. jambos apresentou atividade dose-dependente em modelo de úlcera gástrica induzida por etanol acidificado, sendo que a dose de 400 mg/kg reduziu significativamente a Área Total de Lesão (81,64%) e a Área Relativa de Lesão (65,11%), em comparação ao grupo controle. Nesta dose, o extrato apresentou-se mais eficaz que o fármaco empregado como referência (Iansoprazol 30 mg/kg). No modelo de indução de úlcera gástrica por ácido acético, o extrato (400 mg/kg) não apresentou resultados significativos na cura das lesões. A atividade antioxidante do mesmo extrato e de quatro frações foi avaliada através da medida da capacidade seqüestrante de radicais 1, 1-difenil-2-picrilidrazila. O extrato hidroetanólico a 70% liofilizado apresentou CE `IND.50´ de 5,36 ± 0,06 µg/mL, valor comparável ao do Trolox (CE `IND.50´ = 4,98 ± 0,04 µg/mL), substância antioxidante de referência...

Reversible Lansoprazole-Induced Interstitial Lung Disease Showing Improvement after Drug Cessation

Lansoprazole is an acid proton-pump inhibiting drug that is used for the treatment of duodenal or gastric ulcers, H. pylori infection, gastroesophageal reflux disease or Zollinger-Ellison syndrome. Although lansoprazole is well known for its gastrointestinal and dermatologic adverse effects, mild pulmonary symptoms are also known to develop from taking this drug. There have been no reports about lansoprazole-induced interstitial lung disease. We report here a case of lansoprazole-induced interstitial lung disease that developed in a 66-year-old man.

Experimental model in the qualitative and quantitative assessment of non-Helicobacter gastric microflora under proton pump inhibitors action / Modelo experimental na avaliação qualitativa e quantitativa da microflora gástrica não-Helicobacter sob ação de inibidores de bomba de próton

PURPOSE: To evaluate models of gastric material collection from Wistar rats with and without using proton pump inhibitors(PPIs). METHODS: Twenty-four rats underwent intraperitoneal omeprazol treatment, and other 12 received similar treatment with 0.9 percent saline. All animals underwent collection of gastric material samples, after stomach removal, by either biopsies, or aspirates, or swabs. Samples were bacteriologically processed in order to identify species and strains. Values are described as natural logarithm of colony former units per mL [Ln(CFU/mL)]. Kruskal-Wallis and Mann-Whitney non-parametric tests were used, and p<0.05 was set as statistically significant. RESULTS: Significant difference was not seen for Ln (UFC/mL) values among the three methods of collection irrespective of using or not omeprazol. Also, significant difference was not seen in Ln (UFC/mL) values when comparing a method with each others, either using omeprazol or placebo. A significant increase of bacteria strains occurred when PPI was used, and this was seen on the three ways of collection, mainly in biopsy and swab. CONCLUSION: No difference occurred among the three methods of collecting bacteria samples from stomachs of rats, either when using placebo or omeprazol. A remarkable change is seen on animals bacterial microflora when PPIs are used, and bacteria are better identified when swab and biopsy are used.

OBJETIVO: Avaliar modelos de coleta de material gástrico de ratos da linhagem Wistar, com e sem o uso de inibidores de bomba de próton (IBPs). MÉTODOS: 24 ratos foram submetidos a tratamento com omeprazol intraperitoneal e 12 outros ratos receberam tratamento semelhante com solução salina a 0,9 por cento. Os animais foram submetidos a coleta de amostras de material gástrico, após retirada do estômago, utilizando-se de biópsias, aspirados ou swabs. Os materiais obtidos foram processados bacteriologicamente para identificação de espécimes quanto ao gênero. Os valores são descritos em logaritmo natural das unidades formadoras de colônias por mL [Ln(UFC/mL)]. Utilizou-se os testes não-paramétricos de Kruskal-Wallis e Mann-Whitney, considerando-se p<0,05 como estatisticamente significativo. RESULTADOS: Não se observou diferença significativa da quantidade de Ln(UFC/mL) entre os três métodos de coleta, independente do uso de omeprazol. Também não se observou diferença significativa de Ln(UFC/mL) ao comparar-se os métodos individualmente entre si nas condições de uso de omeprazol ou placebo. Houve aumento significativo da variedade de gêneros de bactérias com o uso de IBP, nos 3 métodos de coleta, sendo isto mais perceptível na biópsia e swab. CONCLUSÃO: Não houve diferença entre os três métodos de coleta de amostras bacterianas de estômago de ratos, tanto em uso de placebo quanto em uso de omeprazol. Nota-se uma mudança evidente da microflora bacteriana nos animais em uso de IBPs, sendo melhor identificado pelos métodos de swab e biópsia.

An open non-comparative clinical study for the evaluation of safety and efficacy of esomeprazole in patients of reflux oesophagitis in Indian population.

The proton pump inhibitors have consistently been shown to be far more effective than the others are in gastro-oesophageal reflux disease (GERD) as proton pump inhibitors (PPIs) block the final and rate-limiting step of parietal acid production. The primary objective of the study was to assess the efficacy and tolerability of esomeprazole 40 mg given once a day for 4 weeks in patients with reflux oesophagitis. An open, non-comparative study was done with 103 patients in 4 centres with endoscopic erosive oesophagitis. Symptoms of reflux oesophagitis such as heartburn/retrosternal pain and regurgitation recorded on a 4-point scale, dysphagia being marked as present or absent. Oesophagitis was graded as 5-point scale. There was a significant decrease in mean score of heartburn (60.8% and 86%), retrosternal pain (60.84% and 86.75%), mean score of regurgitation (65% and 90%) at second and fourth week respectively. Global assessment of overall symptoms by patients showed complete resolution of symptoms in 86.4% patients at week 4. At the end of treatment 93 out of 103 patients showed complete healing, 13.6% of total cases had side effects. Esomeprazole was found effective and safe in the treatment of GERD.

Alteraçoes no teste ultra-rápido da urease e no exame anatomopatológico para Helicobacter pylori induzidas por drogas anti-secretoras / Changes in ultrarapid urease test and histopathological examination for Helicobacter pylori by antisecretory drugs

One of the major problems when evaluating dyspeptic patients at public hospitals is the large interval between the consultation and the endoscopy, leading to the prescription of antisecretory drugs, what can be responsible for false results on examinations. AIM: To evaluate changes in ultrarapid urease test and histopathological examination for Helicobacter pylori by antisecretory drugs. METHODS: In a prospective double-blind study, 50 patients with dyspeptic complaints and endoscopic diagnosis of peptic ulcer, erosive gastritis, esophagitis or duodenitis, with a positive urease test, were randomized to a 7-day course of treatment with either omeprazole 20 mg or ranitidine 300 mg a day. Before and after treatment, two biopsy specimens each were obtained from the antrum and corpus and an ultrarapid urease test and a histopathological examination for Helicobacter pylori were performed. RESULTS: There were no significant changes in the results of ultrarapid urease test and histopathological examination for Helicobacter pylori after treatment with ranitidine. With omeprazole, we observed a decrease in positive results in ultrarapid urease test and histopathological examination for Helicobacter pylori in the antrum, but not in the corpus. CONCLUSION: Omeprazole, used for 7 days, can lead to negative results in ultrarapid urease test and histopathological examination for Helicobacter pylori in the antrum, and should not be employed in patients before the endoscopy is performed.

Ulcera esofágica inducida por metronidazol. Informe de un caso / Metronidazole induced esophageal ulcer

Una mujer de 25 años de edad se presentó con odinofagia y dolor retroesternal de aparición súbita. Había ingerido metronidazol 500 mg cada 8 horas durante 3 días previos y la última tableta fue ingerida la noche anterior sin líquido antes de dormir. La esofagoscopía demostró dos úlceras circunferenciales en el tercio medio del esófago. El tratamiento consistió en suspender el metronidazol, tomar sucralfato pulverizado 2 g cada 12 horas y dieta líquida con curación clínica y endoscópica a los 7 días. Consideramos importante informar este caso dada la administración frecuente de este medicamento en México

Pantoprazol, novo inibidor da H+/K+- ATPase / Pantoprazole, a novel H+/K+-ATPase inhibitor

Revisäo sucinta do pantoprazol, novo inibidor da bomba protonica com características e propriedades superiores a de vários outros bloqueadores da secreçäo gástrica, descrevendo sua atividade farmacológica, mecanismo de açäo, farmacocinética, indicaçöes, posologia, contra-indicaçöes efeitos e interaçöes medicamentosas

Tratamiento médico de la úlcera péptica: ¿nuevas alternativas? / Medical treatment of peptic ulcer: new perspectives?

La úlcera péptica es una enfermedad crónica y frecuente. De origen multifactorial, obedece a un desbalance entre factores agresivos y defensivos de la mucosa gastroduodenal. Su tratamiento médico se fundamenta en reducir la concentración de HCI en el jugo gástrico, empleando fármacos que interfieren alguna de las fases de producción ácida por la célula parietal: bloqueadores de sus receptores, de mediadores intracelulares o de la bomba de protones. Se señalan las dosis y formas de administración de estos preparados, junto con destacar sus principales efectos adversos. Como alternativa, los mecanismos defensivos se pueden reforzar mediante drogas capaces de estimular la integridad de la barrera mucosa. La úlcera refractaria, se puede tratar con varios esquemas. Las dosis de mantención reducen las recidivas sintomáticas de la enfermedad. Se analiza el rol de algunos factores ambientales que intervienen en la patogenia y curso evolutivo de la enfermedad ulcerosa junto a la forma de reducir su importancia

Tratamiento de la enfermedad acidopeptica / Treatment of the acidpeptic disease

Se hace una revision del tratamiento de la enfermedad acidopeptica, definiendo para el efecto, las drogas existentes y su utilidad. Se clasifican en aquellas que modfician el factor acido (antiacidos, anticolinergicos, antogonistas de los receptores H2 y los Benzimidazoles sustitiudos), las que aumentan la resistencia (sucralfate, bismutos y carbenoxolona), y otras (tranquilizantes y neurolepticos y las prostaglandinas). Se discuten los esquemas terapeuticos utilizados. Finalmente se hacen algunas anotaciones sobre la importancia que tiene la cirugia en el tratamiento de la enfermedad acidopeptica