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[Double-contrast examination of the small bowel without intubation (author's transl)].

A method for tubeless, double-contrast examination of the small bowel is described. Oral contrast medium and capsules which effervesce in the small bowel resulted in double-contrast demonstration of the small bowel in 90 out of 130 patients. Transit through the small bowel was reduced to an average of 78 minutes, due to increased peristalsis resulting from distension by the intralumental gas. For comparison, average transit time in a control group of 83 patients was found to be 126 minutes. The differential diagnosis of stenosing processes and additional information concerning space-occupying lesions was furthered by small bowel hypotonia induced by the intravenous injection of 15 to 45 mg. propantheline bromide (Probanthine) or 1 to 2 mg. glucagon. The method has the following advantages: 1. Improved demonstration of detailed mucosal pattern, 2. Reduced examination time and 3. Simultaneous visualisation of the entire small bowel.

Administration, Oral↗

Comparative steady state serum levels of valproic acid administered as two different formulations--Deprakine and Orfiril.

Plain tablets of sodium valproate (VPA), a useful antiepileptic drug, are bitter tasting and produce gastric irritation which leads to poor patient compliance. We have studied the steady state serum levels of VPA which can be produced in epileptic patients before and after a 1 week treatment with a plain tablet (Deprakine) versus an enteric coated tablet (Orfiril). The latter drug produced in most patients a higher drug fasting blood level than the uncoated preparation (22%). The enteric coated tablets appeared also better tolerated.

Absorption↗

Comparison of plasma lithium levels and their interindividual variations with coated lithium carbonate tablets and a medium-slow-release lithium sulphate preparation (Lithionit Duretter).

In a cross-over study in 10 subjects, rapidly dissolving coated lithium carbonate tablets and medium-slow-release lithium sulphate tablets were compared. Both preparations were administered twice a day. They gave similar post-absorptive concentrations of lithium in plasma and similar standard deviations of these concentrations. The medium-slow-release tablets gave smaller increases of lithium in plasma, and postponed the absorption peaks. They also gave less interindividual variation of lithium in plasma during the first few hours after administration.

Adult↗

Comparison of side effects with coated lithium carbonate tablets and lithium sulphate preparations giving medium-slow and slow-release.

Side effects with coated, rapidly dissolving lithium carbonate tablets, medium-slow-release and slow release lithium sulphate tablets, all administered twice a day, were compared in a double-blind, cross-over study in 27 patients who had only used lithium carbonate tablets. The relation between medication and meals was not standardized. The repidly dissolving tablets and the medium-slow-release tablets had a similar tendency to produce side effects, while slow-release tablets more often produced purgative side effects than the other two preparations did.

Adult↗

Aspirin.

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Aspirin↗

[On the influence of a special preparation of oxytetracycline and sodiumbituminosulfonates on amount and composition of skin surface lipids in acne vulgaris (author's transl)].

Two groups of 27 and 23 patients with acne vulgaris were first treated for a period of one week with 1 g oxytetracycline a day p.o. In a second treatment period of 6 weeks the first group received 100 mg oxytetracycline a day p.o. and the second group a combination of 100 mg oxytetracycline and 1.2 g sodiumbituminosulfonates a day p.o. In the third treatment period, similarly continued for 6 weeks, the method was reversed. Gastric juice-insoluble preparations were used for the investigation. All criteria for a double-blind study were considered. Amount and composition of the skin surface lipids were analysed before beginning the treatment, at the end of the 2nd and at the end of the 3rd treatment period. The combination of both agents in gastric juice-insoluble preparations suppresses to a great extent the known effects brought about by the substances separately, namely the reduction in free fatty acids and the decrease in the skin surface lipids. The findings also show that the reduction of the free fatty acids was in a limited time observed only in patients treated with 100 mg oxytetracycline a day p.o. if they had been treated in the beginning of this therapy with a higher dosage of tetracycline.

Acne Vulgaris↗

[Test of the safety, reactogeneity and immunogeneity of live Flexner 2a and Sonne dysentery vaccine from spontaneous mutants, prepared in dragee form, in a controlled experiment on adults].

Controlled experiment was conducted on 428 adult persons. A study was made of the reaktogenic properties and the immunological activity of live enteral dysentery vaccine Flexner 2a and Sonne from the spontaneous mutants developed at the N.F. Gamaleya Institute of Epidemiology and Microbiology. The vaccine is prepared in the form of sugar-coated pills covered with an acid-fast substance protecting from the gastric juice action. A single administration of the vaccine in a dose of up to 4 pills (6 to 8 X 10(9) live microbial cells) induced no general or local reactions. At the same time enteral administration of such low vaccine doses of the vaccine caused a significant accretion of specific hemagglutinins, including IgA, IgG, IgM antibodies in the serum, this pointing to the marked general and local immunological activity of the vaccine. Vaccine strains Flexner 2a and Sonne were isolated from 16 to 40% of the persons vaccinated, for the maximum period of 5 to 8 days. The isolated strains were avirulent when checked by the keratoconjuctival test.

Administration, Oral↗

[Galenical possibilities and problems in protraction of drug effects (author's transl)].

In recent years, dosage forms with sustained release have obtained a significant importance. The technological possibilities for manufacturing are described as coating, embedding and matrix procedures. The range of auxiliary substances, which are responsible for the retardation of drug activity, reaches from lipophilic compounds as lipoids, fatty alcohols and compounds which are forming hydrogels as cellulose derivatives and natural polysaccharides to synthetic polymers derived from acrylic acid. The formulation of the dosage forms requires particular care in respect to the amount of initial and maintenance doses. On account of technological processes, for example during manufacturing of tablets, under certain circumstances the liberation rate is altered. In vitro test methods allow comparisons only then when the results can be counter-checked by in vitro experiments. The release of drug follows different mechanisms, which are described, entirely or in part, to be reactions following the time law of zero or first order. In special cases, a linear correlation is observed as a function of square root of time. The calculation of given special equations for events within the dosage form is feasible from blood-level values.

Biological Availability↗

Medical treatment of pancreatic insufficiency.

Treatment of exocrine pancreatic insufficiency with the use of eight tablets of pancreatin with meals consisting of 25 g of fat per meal will generally abolish azotorrhea. Although steatorrhea is not totally corrected, satisfactory nutritional status and relative relief of symptoms are usually achieved. For the occasional patient who continues to lose weight or remains symptomatic even after reduction of dietary fat, the addition of cimetidine to the standard pancreatin treatment will usually provide relief from the steatorrhea and alleviate troublesome diarrhea. In certain circumstances in which gastric pH is more than 4 for 1 hour after a meal, altering the dosage schedule to two tablets hourly may be effective in alleviating the steatorrhea. Conversely, in patients whose upper gastrointestinal tract is acidic for long periods postprandially (gastric pH less than 5, duodenal pH less than 4), Pancrease, an enteric-coated preparation, may be effective. In difficult cases in which symptoms and steatorrhea continue, special intraluminal studies need to be performed to ensure that intraluminal conditions are, in fact, present for certain dosage schedules to be effective or that intraluminal conditions have been altered by adjunctive therapy.

Celiac Disease↗