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At least 235 records · Page 13Linked to original sources
PubMed2005

Oral absorption kinetics of levetiracetam: the effect of mixing with food or enteral nutrition formulas.

BACKGROUND: Levetiracetam (LEV) is an antiepileptic drug with a favorable pharmacokinetic profile, including negligible protein binding and linear elimination kinetics. Because LEV is likely to be used in populations that include children and the elderly, alternative techniques of administration, such as crushing the tablet and mixing its contents with semisolid food or enteral nutrition formulas (ENFs), may be required in some clinical settings. Although previous studies have suggested that administration with food does not affect the overall absorption of LEV, there is a lack of data regarding concomitant administration with ENFs. OBJECTIVE: The objective of this study was to evaluate the oral absorption of LEV after concomitant administration with food or ENFs. METHODS: This was an unblinded, 3-way crossover study. After an overnight fast, subjects received a single dose of LEV 500 mg administered either as an intact tablet with 120 mL water (control, treatment A) or crushed and mixed with 4 oz applesauce (treatment B) or 120 mL of a common ENF (treatment C). All subjects received each treatment in a randomized sequence; there was a 7-day washout period between treatments. Serial blood samples were obtained over 24 hours for determination of the LEV serum concentration-time profile using gas chromatography with nitrogen phosphorus detection. AUC(0-24), C(max), and T(max) were calculated using noncompartmental methods and analyzed using analysis of variance. RESULTS: Ten healthy adult volunteers (6 men, 4 women) participated in the study (mean [SD] age, 28.9 [6.5] years; mean body weight, 78.6 [12.9] kg). No significant differences were noted between control and any other study treatment. Mean AUC values were 191.9 (50.2), 165.7 (43.4), and 168.3 (43.9) microg/mL . h for treatments A, B, and C, respectively. Mean T(max) values were 1.08 (0.65), 1.32 (0.75), and 1.62 (0.73) hours, respectively. Mean C(max) values were 14.8 (5.6), 12.1 (2.8), and 10.8 (2.0) microg/mL for the respective treatments. Mean LEV serum concentrations at 12 hours after dosing were similar for all study treatments (3.9, 4.1, and 4.0 microg/mL). The long-term stability of LEV in the various combinations was not assessed. CONCLUSIONS: In these healthy volunteers, the overall rate and extent of absorption of oral LEV were not significantly impaired after crushing and mixing of the tablet with either a food vehicle or a typical ENF product. The data suggest that peak serum concentrations of LEV may be slightly reduced after mixing with ENFs, although the difference was not significant compared with control values.

Administration, Oral↗
PubMed2001

Warfarin resistance and enteral feedings: 2 case reports and a supporting in vitro study.

This study investigated whether an interaction between common enteral feeding products and warfarin exists. Two clinical cases of apparent interaction spurred a supporting in vitro study. Both the clinical cases and the in vitro study showed that several enteral feeding products bind warfarin, reducing the bioavailability of the drug. The binding appears to occur between warfarin and the protein component of the feeding product. This clinically important interaction is likely when warfarin and enteral feeding products are used concurrently. Clinicians should be aware of this potential interaction and monitor the therapy closely, particularly when enteral feeding is discontinued.

Adult↗
PubMed1991

Saturated and hydrogenated fats in food in relation to health.

The report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults published in 1988 evoked great interest from the medical profession, the public, and food manufacturers. The merits of different dietary interventions to lower plasma cholesterol are debated in advertising, popular publications, and research publications. The present paper is a review of the contributions of saturated and trans fatty acids (FA) to the US diet, their metabolism, and effects upon plasma cholesterol. Saturated (SFA) and trans FA are metabolized to yield energy. They are not dietary essentials; SFA can be biosynthesized, and trans FA are not naturally occurring in plants, with only very small amounts in animals. Trans FA are produced in hydrogenation of liquid vegetable oils and are estimated to contribute 3-7% of the fat consumed. Most of the SFA in the US diet (35% of total fat consumed) is obtained from meat, poultry, fish, and dairy products (approximately 60%). The fats and oils consumed directly or as components of food products, mostly baked goods, contribute approximately 20% of the SFA. More than 30 years of research led the NCEP to conclude that SFA was the most potent dietary component in increasing plasma cholesterol, and that no more than 10% of the energy (en%) of the diet should be SFA. Trans FA are metabolized similarly to SFA, but no recommendation has been made about their consumption. Reduction of consumption of SFA should be practiced in a prudent manner, by reducing consumption of foods high in SFA, and not by eliminating classes of foods. Some changes in formulations of foods or preparation practices (type of frying fat) can be made. These modifications may decrease the palatability of the food, thereby presenting a challenge to the food industry. Substitution of fats hydrogenated to contain trans FA for fats high in SFA may not be beneficial to health. Labeling of foods would improve the ability of the consumer to make appropriate choices.

Cholesterol↗
PubMed1977

The protein quality of instant blends for infants and children based on milk or cereals and milk.

The protein quality of industrially produced and home prepared milk or cereal-milk based foods for infants and children were evaluated by means of biological assays. The net protein utilization (NPU) values of human milk substitutes based on cow's milk varied between 75 and 78 and the NPU of a soy-based product was found to be 70. Cereal-milk based precooked gruel powders had NPU values of 69 to 77. Furthermore, a comparison between industrially processed products and their corresponding home prepared alternatives was made. Although the protein nutritional products, i.e., including the vitamine and mineral content, is more standardized due to supplementation. The NPU assays of some cereal-milk based porridge powders revealed a wide variations (28 to 69); the lowest NPU values reflect the influence of the processing technique. This illustrates the necessity of performing biological evaluations of processed foods.

Animals↗
PubMedDate not supplied

A model for the prediction of osmolalities of modular formulas.

A model is proposed for evaluation of osmolality of multicomponent formulas composed of modular ingredients. Nonlinear curve-fitting techniques applied to empirical data result in prediction of the osmolality of ingredients for any concentration desired. Osmolality of a multicomponent formula can be obtained by adding osmolalities of ingredients. Data handling is made possible by the use of simple microcomputer programs. The model is tested with products available for construction of amino acid-restricted diets.

Amino Acids↗
PubMed2004

Media to simulate the postprandial stomach I. Matching the physicochemical characteristics of standard breakfasts.

To better predict food effects on the bioavailability/bioequivalence of drugs and drug products from in-vitro data, a dissolution medium that simulates the initial composition of the postprandial stomach was developed. First, the physical parameters of two homogenized standard breakfasts often administered to assess food effects in pharmacokinetic studies were measured. These included pH, buffer capacity, osmolality, surface tension and viscosity. Subsequently, the match of the physical parameters of several commercially available liquid meals, including long-life milk, Ensure and Ensure Plus to those of the breakfasts was evaluated. Of the three liquid meals studied, Ensure Plus had the closest physicochemical behaviour to that of homogenized standard breakfasts. By increasing the viscosity of Ensure Plus with 0.45% pectin, it was possible to obtain a medium that closely resembles the FDA standard breakfast.

Animals↗
PubMedDate not supplied

Analysis of all-rac-alpha-tocopheryl acetate and retinyl palmitate in medical foods using a zero control reference material (ZRM) as a method development tool.

A liquid chromatographic method is described for analysis of all- rac-alpha-tocopheryl acetate and retinyl palmitate in medical food. The vitamins are extracted in isopropyl alcohol and hexane-ethyl acetate without saponification and quantitated by normal-phase chromatography with fluorescence detection. All rac-alpha-tocopheryl acetate and retinyl palmitate are chromatographed isocratically with a mobile phase of 0.5% (v/v) and 0.125% (v/v) isopropyl alcohol in hexane, respectively. Recovery studies performed on a medical food zero control reference material (ZRM) fortified with the analytes averaged 99.7% (n = 25) for retinyl palmitate and 101% (n = 25) for all- rac-alpha-tocopheryl acetate. Coefficients of variation were 0.87-2.63% for retinyl palmitate and 1.42-3.20% for all-rac-alpha-tocopheryl acetate. The method provides a rapid, specific, and easily controlled assay for analysis of vitamin A and vitamin E in medical foods. Use of chlorinated solvents is avoided.

Chromatography↗
PubMed2000

Malnutrition: role of the TwoCal HN Med Pass program.

Malnutrition is common in older adults and is associated with poor outcomes. The causes and outcomes of malnutrition are discussed, and the TwoCal HN Med Pass program, designed to overcome poor dietary intake, is described. Benefits of the program, role of the pharmacist, identification of candidates for the TwoCal HN Med Pass program, and health care team roles and responsibilities are reviewed.

Aged↗