ABSTRACT
Meclizine and caffeine combination is used for the treatment of morning sickness. Both compounds are teratogenic and caffeine is known to possess anti-fertility activity also. The present study was undertaken to evaluate the reproductive toxic effect of meclizine and caffeine combination. Three doses were taken for the study; low dose (LD; meclizine 3.7 mg/kg and caffeine 3 mg/kg) was selected from commercially available formulation, middle dose (MD; meclizine 37 mg/kg and caffeine 30 mg/kg) and high dose (HD; meclizine 370 mg/kg and caffeine 300 mg/kg). The mixture was administered 1-7 days and 8-14 days for fertility and embryotoxic studies respectively. Laparotomy was done on 10t day of gestation period. Number of implants and corpora lutea were counted, pre and post-implantation losses were determined. In embryo toxicity study fetuses were evaluated for external, skeletal and visceral examination. High dose was removed from both fertility and embryotoxicity studies due to its severe toxicity to the dam. Significant anti-fertility activity was observed at middle dose. Embryotoxicity study showed significant reduction in fetal body weight, body length and body mass index, dam body weight gain on gestation day 14. Absolute kidney weight in MD and absolute and relative spleen weight in both LD and MD were significantly reduced. There was no increase in external or internal congenital anomalies at both LD and MD. The, results suggest that prescription of meclizine and caffeine for morning sickness in early pregnancy should be reviewed carefully.
Subject(s)
Body Weight/drug effects , Caffeine/toxicity , Eating/drug effects , Fertility/drug effects , Meclizine/toxicity , Weight Gain/drug effects , Abnormalities, Drug-Induced/etiology , Administration, Oral , Animals , Caffeine/administration & dosage , Dose-Response Relationship, Drug , Drug Combinations , Embryonic Development/drug effects , Female , Fetal Weight/drug effects , Gestational Age , Histamine H1 Antagonists/administration & dosage , Histamine H1 Antagonists/toxicity , Kidney/drug effects , Kidney/pathology , Liver/drug effects , Liver/pathology , Male , Meclizine/administration & dosage , Organ Size/drug effects , Purinergic P1 Receptor Antagonists/administration & dosage , Purinergic P1 Receptor Antagonists/toxicity , Rats, Wistar , Spleen/drug effects , Spleen/pathologyABSTRACT
The prevalence of diabetes in India has grown over the past decade. Diabetic patients develop complications due to poor awareness regarding the disease and inadequate glycemic control. Patient education is the most effective way to lessen the complications of diabetes and its management. A total of 207 (85 males and 122 females) type 2 diabetes mellitus patients were enrolled and randomized into test and control groups. Patients in the test group received counseling at each visit and information leaflets from the pharmacist; the control group patients received counseling and information leaflets only at the end of the study. A validated knowledge, attitude, and practice (KAP) questionnaire was administered to both test and control group patients at baseline and at final follow-up to assess awareness regarding disease management. Glucose and lipid levels were also evaluated at baseline and final follow-up in both the groups. At the end of the study, the KAP score of test group patients improved significantly (P<0.0001), whereas no significant changes were observed in control group patients. The postprandial blood glucose (PPBG) levels decreased significantly in the test group. Total cholesterol (TC), triglycerides (TGL), and low density lipoprotein levels (LDL) also showed a decrease in the test group. Thus, our study reveals that pharmacist counseling might be an important element in diabetes management programs.
ABSTRACT
OBJECTIVE: To evaluate the anti-implantation activity of H(2) receptor blockers ranitidine and famotidine, and Cox-inhibitor meloxicam, alone and in combination, considering the role of histamine and prostaglandins in implantation. METHOD: The drugs were administered orally to female albino Wistar rats at different dose levels for 1 to 7 days, immediately after confirming copulation by observing sperm in the vaginal smear. A laparotomy was done on the 10th day of pregnancy, the implants and corpora lutea were counted, and the pre- and post implantation losses determined. The mast cell stabilising activity was studied using both in vitro and in vivo methods. RESULTS: Ranitidine 70 mg/kg (75.41%; p < 0.01), and famotidine 80 mg/kg (74.30%; p < 0.001) showed significant anti-fertility activity. No increase in activity was seen at higher doses. Meloxicam showed significant activity at doses of 3, 4, and 5 mg/kg. The combination of meloxicam (4 mg/kg) with ranitidine (70 mg) and famotidine (80 mg/kg) showed 100% anti-fertility activity. CONCLUSION: Our results indirectly confirm the combined involvement of histamine and prostaglandins in the implantation process. The mast cell stabilising property of H(2) blockers appears to be a possible mechanism for their anti-implantation activity.
