Serum metronidazole levels following rectal administration.
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Three kinds of suppositories were constructed with oleaginous base material (Witepsol H-15): a conventional type suppository containing propranolol (PPL) hydrochloride mixed with a base material (I), a hollow type suppository containing PPL in a form of aqueous solution (PPL was dissolved in isotonic NaCl solution) in its cavity (II), a hollow type suppository containing PPL as powder (hydrochloride salt) in its cavity (III). Bioavailability was estimated after rectal administration of each suppository in rabbits and compared with oral administration. The peak plasma PPL concentration (Cmax) and the area under the plasma concentration-time curve (AUC) were lower with I than with II or III. The Cmax and the AUC measured after rectal administration of III were significantly higher than those in the case of oral administration. By using III, the highest values of the mean Cmax (795 +/- 160 ng/ml) and of the mean AUC (459 +/- 21 h X ng/ml) were obtained. It was found that systemic availability was increased by rectal administration of PPL hollow type suppositories. These data on bioavailability suggested that PPL was absorbed more efficiently with the hollow type suppository than with the conventional one. PPL was released faster from II and III than from I. It was concluded that the hollow type suppository was a suitable device for absorption of PPL into the rectum.
This report presents the results of two treatment cross-over investigations on 20 healthy male volunteers to assess the bioequivalence of two suppository products of diclofenac sodium. The study was carried out under US Food and Drug Administration Guidelines. The two products were voltaren (100 mg) suppository (Ciba-Giegy), as a reference product, and Inflaban (100 mg) suppository (The Arab Pharmaceutical Manufacturing Company, Ltd. "APM"), as a test product. Both products were administered rectally as a single dose (100 mg) separated by a one-week wash-out period. Following drug administration, blood samples were collected over 12 hr, and serum harvested from the blood was analyzed for diclofenac sodium using a sensitive and specific high performance liquid chromatographic assay. The results of this investigation indicated that there were no statistically significant differences between the two products in either the mean concentration-time profiles or in the obtained pharmacokinetic parameters, including area under the serum concentration-time curve for 12 hr (AUC(0-12h)), lag time between product administration and first appearance of the drug in serum (T(lag)), peak serum concentration (C(max)), and time to reach this peak serum concentration (T(max)). Concerning the relative extent of absorption, assessed by the AUC ratio (Inflaban/Voltaren) for 12 hr, the average value was found to be 1.00+/-0.09 with a 95% confidence limits (C.L.) of 0.82-1.18. Thus, these findings clearly indicate that the two products are bioequivalent in terms of rate and extent of drug absorption.
Many surgical methods have been described for the treatment of full-thickness rectal prolapse. Rarely, unusually large lengths of colon must be excised, thus resulting in a significant loss of the absorptive function of the remaining colon. We present an unusual case in which an extraordinary length of the colon was excised and a perineal reservoir was created in the form of a colonic J-pouch to improve continence.
PURPOSE: The present study was conducted to characterize the pharmacokinetics of eplerenone (EP), a selective aldosterone receptor antagonist, and its open lactone ring form in the dog. METHODS: Pharmacokinetic studies of EP were conducted in dogs following i.v., oral, and rectal dosing (15 mg/kg) and following intragastric, intraduodenal, intrajejunal, and intracolonic dosing (7.5 mg/kg). RESULTS: After oral administration, the systemic availability of EP was 79.2%. Systemic availabilities following administration via other routes were similar to that following oral administration. The half-life and plasma clearance of EP were 2.21 hr and 0.329 l/kg/hr, respectively. Plasma concentrations of the open lactone ring form were lower than EP concentrations regardless of the route of administration. The C-14 AUC in red blood cells was approximately 64% and 68% of the plasma AUC for i.v. and oral doses. Percentages of the dose excreted as total radioactivity in urine and feces were 54.2% and 40.6%, respectively, after i.v. administration, and 40.7% and 52.3%, respectively, after oral administration. The percentages of the dose excreted in urine and feces as EP were 13.7% and 2.5%, respectively, after i.v. administration, and 2.1% and 4.6% after oral administration, respectively. Approximately 11% and 15% of the doses were excreted as the open form following i.v. and oral doses. CONCLUSIONS: EP was rapidly and efficiently absorbed throughout the gastrointestinal tract, resulting in a good systemic availability. The drug did not preferentially accumulate in red blood cells. EP was extensively metabolized; however, first-pass metabolism after oral and rectal administration was minimal. EP and its metabolites appear to be highly excreted in the bile.
The role of specialized regions of insect rectal papillae in the regulation of water and ion uptake is well documented. Although the apparatus for active uptake of water or ions is located in various cell membranes, the absorbed molecules must first pass through the cuticle which lines the rectal epithelium. Most cuticle (e.g. abdominal) has been shown to be permeable only to molecules soluble in wax, and to be impermeable to water and ions. Obviously if such cuticle lined the rectum, absorption of water and ions would be severely restricted. The present freeze-fracture and lanthanum tracer study was undertaken to investigate in more detail both the morphological features of the rectal papillae cuticle which could be responsible for its anomalous permeability and the various cell membranes involved in this transport. It has been suggested from permeability studies that the anomalous permeability of rectal papillae cuticle could be due to the lack of a complete wax layer over the surface of the rectal cuticle. The present study strongly supports this suggestion. Thus, the freeze-fracture micrographs have shown that a surface layer of the cuticle reacts during fracturing like a lipid bilayer. However, in rectal papilla cuticle this surface bilayer is interrupted at each epicuticular depression by areas of different fracturing behaviour. These discontinuities in the surface bilayer probably allow the rectal contents to contact directly the true cuticular matrix. They could, therefore, explain the case with which water and ions penetrate the rectal cuticle and so gain access to the underlying epithelial cells. Although similar discontinuities are present on some of the rectal cuticle surface external to the rectal papillae, they appear to be filled in by plugs of lipid-like material. The lateral plasma membranes of the rectal papillae cells are generally considered to be the main site of active transport. The present lanthanum tracer and freeze-fracture study has shown that the lateral plasma membranes contain 3 distinct differentiations. Septate junctions are present at the apical and basal surfaces of the epithelial layer; a further membrane differentiation is found adjacent to the septate junctions; and thirdly, an array of short, variable length, non-anastomosing linear structures covers most of the lateral plasma membrane surface. These latter structures, unlike known types of cell junctions do not show equivalent arrays in apposing membranes even when the lateral plasma membranes of adjacent cells are closely apposed. The possible function of these structures is discussed.
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The effect of fasting on the hydrolysis of salicyluric acid in rabbit intestinal microorganisms was investigated. The blood concentration of salicyluric acid and salicylic acid following oral, intracecal and rectal administration of salicyluric acid was determined. In fasted rabbits (24 and 48 h), the blood concentration of salicylic acid after oral administration was changed compared to the control. However, a significant effect of fasting was not observed in the blood concentration of salicylic acid after rectal administration. Following intracecal administration, the blood concentration of salicylic acid was increased in fasted rabbits compared to the control. From these results, it seems that the slow rate of stomach emptying due to coprophagy during fasting is the principal reason for the change of blood concentration of salicylic acid following oral administration of salicyluric acid.
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Rhesus monkeys were anesthetized and rendered hypothermic by icewater immersion. Rewarming by radio frequency (RF) energy at 13.56 MHz or by a surgical heating pad was initiated either immediately after removal from the icewater or after a delay of 20-26 min. Rectal temperature (Tre) was monitored during each experiment, and RF energy, initially applied at a specific absorption rate (SAR) of 10 W.kg-1, was able to raise Tre an average of 3 degrees C in 20 min. For an equivalent period of rewarming with the heating pad, Tre had not yet recovered from the immersion-induced afterdrop. It is concluded that RF rewarming offers a special advantage when applied to the treatment of immersion hypothermia.
Insect Malpighian tubules secrete an isosmotic, KCl-rich primary urine containing low concentrations of most other blood solutes. Neuropeptide diuretic hormones (DH), possibly related to vasopressin, stimulate tubular fluid secretion by 2- to 200-fold in response to water loading, e.g., feeding. DH acts on tubules through cyclic AMP (cAMP) to stimulate salt transport without measurable change in osmotic permeability. Changes in composition of tubular secretion after stimulation and the possible control of DH release are discussed. Most of the water, ions, and metabolites in tubular secretion are normally reabsorbed by active mechanisms in the rectum, where the urine may finally become either hyposmotic or strongly hyperosmotic to the blood. A newly discovered neuropeptide, chloride transport-stimulating hormone, controls (via cAMP) reabsorption of the principal salt by stimulating K-dependent, electrogenic transport of Cl- across the apical cell border. Passive net absorption of K+ is thereby enhanced. Diuretic and antidiuretic factors may control osmotic permeability of the rectal wall and thereby influence the osmotic concentrations of the rectal absorbate and final urine. The increased recycling of a KCl-rich fluid through the Malpighian tubule-rectal system after feeding probably serves to clear the body of unwanted substances ingested with, and produced by, metabolism of the meal.
Metabolic studies were conducted with cephradine administred by the oral, subcutaneous, intravenous, or rectal routes to mice, rats, and dogs. Peak blood levels were usually attained in 30 to 150 min after dosing, depending on the animal species studied. Based on urinary excretion, cephradine appeared to be well absorbed after oral or subcutaneous administration; after rectal doses, cephradine was absorbed poorly. In rats and dogs given oral or intravenous doses of cephradine, about 70 to 100% of the administered dose was recovered during a 24-h collection period. Cephradine was excreted unchanged. After the oral or intravenous administration of [(3)H]cephradine to rats and dogs, respectively, its plasma half-life was about 1 h. After oral administration to rats, cephradine was distributed widely throughout the body tissues, with the greatest concentrations in the kidneys and liver; at 45 min to 6 h postdose, cephradine concentrations in the kidneys and liver were about 8 and 3 times higher, respectively, than those in plasma.
Colorectal epithelium is composed of polarised absorptive enterocytes, mucus-producing goblet cells and enteroendocrine cells. All these cell lineages are thought to arise from multipotential stem cells located near the base of the crypt, but the mechanisms which control differentiation and commitment of cells to a particular lineage are poorly understood. We have used the human rectal adenocarcinoma cell line, HRA-19, to investigate the regulation of expression of lineage-specific markers. HRA-19 cells have multipotential characteristics, forming absorptive, mucous and endocrine cells when grown as xenografts. However, HRA-19 cells grown in vitro in culture medium containing 10% foetal calf serum show negligible expression of the differentiated phenotypes observed in vivo. These findings initially suggested that the absence of positive stimuli from extracellular matrix, stromal cells and/or soluble factors present in vivo resulted in the lack of differentiation in vitro. The subsequent demonstration of a marked inhibitory effect of foetal calf serum on differentiation provided an alternative explanation for the differences between in vivo and in vitro differentiation. In addition, the inhibition of differentiation differed widely between batches of foetal calf serum and limited the usefulness of the system for studying the regulation of differentiation. This manuscript describes the development of chemically defined culture conditions (Dulbecco's Eagles medium supplemented with insulin, transferrin and ascorbic acid) which reproducibly induced the multilineage differentiation of HRA-19 cells into absorptive, mucous and endocrine cells. Morphological characteristics and the expression of lineage-specific markers, as determined by immunocytochemistry, identified absorptive, goblet and endocrine cells in HRA-19 monolayers grown in this serum-free medium. Differentiation of cloned HRA-19 cells in to the three cell lineages proceeds in the absence of stromal cells and without exogenous extracellular matrix, although these factors may subsequently be shown to modulate the rate of cell differentiation. These chemically defined culture conditions will facilitate the study of differentiation in the HRA-19 cell line in the absence of the complex mixture of growth factors, hormones and differentiation inhibitory factor(s) present in foetal calf serum.
New types of diclofenac sodium suppositories known to control a drug release function for hospital preparations were developed based on a concept of the drug delivery system. Hard fat (Witepsol) used as a base of the suppository consists of a mixture of triglycerides, diglycerides and monoglycerides, and each Witepsol is characterized by its physicochemical properties. Authors disclosed that the amount of drug release measured in the commercially available diclofenac sodium suppositories decreased at a low temperature (36 degrees C). Mixed types of diclofenac sodium suppositories consisting of Witepsol W35 and Witepsol E85 as a base were also prepared and their drug release functions investigated in vitro and in vivo. The in vitro drug release properties changed with the mixing ratios of the two bases and with the temperature of the fluid tested. The amount of released diclofenac sodium increased with increases of both the ratio of Witepsol W35 in the suppository and the temperature of the test fluid. Moreover, several processes causing these phenomena were evidenced by the image analysis. The in vivo absorption of diclofenac sodium was found to be also influenced by these factors. Consequently, it is predicted that such factors as the ratio of Witepsol W35 in the suppository and the temperature will influence the drug absorption and the pharmacological effect of diclofenac sodium suppositories.