ABSTRACT
We postulated omeprazole inhibition of the neutrophil proton pump, impairing phagocytosis and phagolysosomal acidification. Neutrophils from healthy human beings were treated with omeprazole prodrug 0.5 mM/l or acid activated omeprazole 0.5 mM/l, then incubated with killed Saccharomyces cerevisiae stained with bromcresol purple. Wet mounts were done at 10, 30 and 60 minutes. Percent neutrophils phagocytosing, percent yeast phagocytosed, and yeast per phagocytosing neutrophil were significantly decreased in acid activated omeprazole compared to controls and omeprazole prodrug. In contrast, percent acidification of intracellular yeast was significantly lower in both omeprazole prodrug and acid activated omeprazole compared to controls. Over time, control neutrophils showed an increase in percent yeast phagocytosed and yeast per phagocytosing neutrophil. When treated with acid activated omeprazole, the percent of neutrophils phagocytosing progressively decreased over time. We observed 1) omeprazole prodrug does not inhibit neutrophil phagocytosis but does inhibit phagolysosomal acidification, whereas 2) acid activated omeprazole inhibits both neutrophil phagocytosis and phagolysosome acidification. We conclude that omeprazole impairs these neutrophil functions in vitro.
Subject(s)
Neutrophils/drug effects , Neutrophils/physiology , Omeprazole/pharmacology , Phagocytosis/drug effects , Phagosomes/drug effects , Phagosomes/metabolism , Adult , Enzyme Inhibitors/pharmacology , Female , Humans , Hydrogen-Ion Concentration , In Vitro Techniques , Male , Neutrophils/immunology , Prodrugs/pharmacology , Proton Pump Inhibitors , Saccharomyces cerevisiae/immunologyABSTRACT
Cocaine, used intravenously, increases the risk of infections, but its effects on neutrophil phagocytosis have not been examined in vitro. Human neutrophils were suspended in cocaine hydrochloride 0, 1, 10, 50, 100 or 200 microg/ml in Hank's balanced salt solution to which was added a phagocytic meal of killed Saccharomyces cerevisiae stained with the pH indicator dye bromcresol purple. Yeast per phagocytosing neutrophil and the percent neutrophils phagocytosing yeast were reduced in neutrophils treated with cocaine 100 and 200 microg/ml (P < 0.05). When examined for percent of yeast phagocytosed after 10 minutes, neutrophils treated with cocaine 1-200 microg/ml demonstrated a decrease (P < 0.05). However, at 60 minutes only neutrophils treated with cocaine 50 and 100 microg/ml still showed a decrease in percent of yeast phagocytosed. Phagolysosomal acidification was impaired in neutrophils treated with 50, 100 and 200 microg/ml cocaine. Thus, cocaine inhibits neutrophil phagocytosis and phagolysosomal acidification in vitro, offering a reason for cocaine users/abusers to have impaired host defense and to be potentially at higher risk for infections.
Subject(s)
Cocaine/toxicity , Neutrophils/drug effects , Neutrophils/physiology , Phagocytosis/drug effects , Phagosomes/drug effects , Phagosomes/metabolism , Cocaine/administration & dosage , Cocaine-Related Disorders/immunology , Dose-Response Relationship, Drug , Humans , Hydrogen-Ion Concentration , Immune Tolerance/drug effects , In Vitro Techniques , Neutrophils/immunology , Saccharomyces cerevisiae/immunologySubject(s)
Anesthetics, Local/therapeutic use , Catheterization, Peripheral/methods , Child , Female , Humans , Male , Retrospective Studies , Time FactorsABSTRACT
OBJECTIVE: To investigate the potential for pediatric emergency department (ED) triage nurses to apply a topical anesthetic (ie, eutectic mixture of local anesthetic) for intravenous catheter (IV) insertion. METHODS: Prospective cross-sectional survey over a 2-month period, with post hoc application of internally developed prediction rules. Eligible patients were children presenting to the ED triage area of an urban children's hospital. RESULTS: A total of 2596 (86.7% of eligible children) had a triage nursing prediction performed. Nurse prediction of IV insertion had a sensitivity of 72% (95% CI: 66,78), a specificity of 90% (88,91), and a positive predictive value (PPV) of 49% (44,54). Objective factors such as high-risk medical history (chronic neurologic, hematologic, cardiac, endocrine, or gastrointestinal illness) and high-risk chief complaint (gastrointestinal illness, skin infection, and previous seizure) were incorporated into a predictive score used to predict IV insertion independently with a sensitivity of 33% (27,39) and a PPV of 43% (44,54). Addition of the objective predictors to nursing prediction increased the sensitivity to 76% (70,81) with a PPV of 43% (38,47). Of the patients, 95% received an IV insertion
Subject(s)
Anesthesia, Local , Anesthetics, Local , Catheterization, Peripheral/statistics & numerical data , Lidocaine , Prilocaine , Triage , Administration, Topical , Child , Child, Preschool , Cross-Sectional Studies , Emergency Nursing , Female , Humans , Infant , Lidocaine, Prilocaine Drug Combination , Logistic Models , Male , Predictive Value of Tests , Prospective Studies , Sensitivity and SpecificityABSTRACT
Uncertainty exists regarding the ability of catnip (Nepeta cataria) to affect human consciousness. We report a case of a toddler exhibiting central nervous system depression after consuming a large quantity of catnip. His obtundation was not attributable to another cause. We review the published literature describing the alleged psychoactive capabilities of catnip and present our case as further information for use in this ongoing controversy.
