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At least 847 records · Page 47Linked to original sources
PubMed2000

Studies on antidiarrhoeal activity of Jatropha curcus root extract in albino mice.

Use of Jatropha curcus L. roots in the treatment of diarrhoea is a common ethnobotanical practice in Konkan, a part of the Western coastal area of India. Roots of this species were undertaken for pharmacognostic studies and evaluation of antidiarrhoeal activity in albino mice. Successive solvent extraction was carried out using petroleum ether (60-80 degrees C) and methanol. The methanol extract showed activity against castor oil induced diarrhoea and intraluminal accumulation of fluid. It also reduced gastrointestinal motility after charcoal meal administration in albino mice. The results indicate that action of J. curcus root methanol extract could be through a combination of inhibition of elevated prostaglandin biosynthesis and reduced propulsive movement of the small intestine.

Animals↗
PubMed2000

Antispasmodic and anti-diarrhoeal effect of Satureja hortensis L. essential oil.

Satureja hortensis L. (Lamiaceae) is an annual herb that is used in the traditional medicine of Iran for treating stomach and intestinal disorders. The antispasmodic activity of S. hortensis essential oil (SHEO) was assessed on contractions of isolated ileum, induced by KCl and acetylcholine, and compared with the effect of atropine and dicyclomine. SHEO inhibited the response to 80 mM KCl in a concentration-dependent manner (pD(2)=1.55+/-0.09 microg/ml; this is negative log concentration of SHEO causing 50% of maximum inhibition) and attenuating the maximum inducible response of acetylcholine concentration-response curve. Effect of SHEO on KCl was similar to that of dicyclomine. Dicyclomine (3.46 and 34.6 ng/ml) also reduced the response to acetylcholine on rat isolated ileum without altering the maximum response and shifted the acetylcholine concentration-response curve to the right by 16-fold at 34.6 ng/ml (100 nM) bath concentration, while atropine only inhibited the response to acetylcholine. This study shows that SHEO is a relaxant of rat isolated ileum. In addition to antispasmodic activity in vitro, essential oil of this plant at a dose of 0.1 ml/100 g inhibited castor oil induced diarrhoea in mice. As the inhibition of contractile overactivity of the ileum is the base of the treatment of some gastrointestinal disorders such as colic, SHEO may have clinical benefits for treatment of these conditions.

Animals↗
PubMedDate not supplied

Anal incontinence: the role of medical management.

BACKGROUND AND AIMS: Consensus recommendations suggest that patients with anal incontinence (AI) should be managed by medical treatment when indicated. Our aims were to prospectively evaluate from two different populations of patients: (1) the proportion of incontinent patients referred to a specialized center who were candidates for first line medical treatment (study 1); (2) the results of medical treatment in incontinent patients (study 2). METHODS: In study 1, standardized management of AI based on an algorithmic decision tree was applied to 287 incontinent patients (209 women, ranging from 16 to 84 years old). In study 2, 36 other incontinent patients with transit disorders (28 women, ranging from 29 to 86 years old) seen consecutively, were treated by a medical treatment of their transit disorders. The result of the medical treatment was objectively and subjectively evaluated after 2 months. RESULTS: Study 1: medical treatment was indicated in 126 of 287 patients (43.9%) (62 for diarrhea and 64 for constipation) while biofeedback was indicated in 52 patients (18.1%) and surgery specific for AI in 99 patients (34.5%). Eighty percent of the patients who were proposed conservative medical treatment were referred by their gastroenterologist or their general practitioner. Study 2: the continence score decreased from a median of 12 to 6.5 (P<0.001). 61% of patients regarded themselves as cured or improved after medical treatment. CONCLUSION: Conservative treatment can be proposed as a first line treatment in more than 50% of patients with anal incontinence referred to a specialized center. Medical treatment for anal incontinence associated with transit disorders improves continence.

Adolescent↗
PubMed2000

Spectrophotometric determination of loperamide hydrochloride by acid-dye and charge-transfer complexation methods in the presence of its degradation products.

Two simple, sensitive and accurate spectrophotometric methods for the determination of loperamide hydrochloride (lop. HCl) are described. The first method is based on the formation of ion-pair association complex (1:1) with bromothymol blue (BTB), bromophenol blue (BPB) and naphthol blue black B (NBB). The coloured products are extracted into chloroform, and measured spectrophotometrically at 414 (BTB), 415 (BPB) and 627 nm (NBB). Beer's law was obeyed in the ranges of 5-35, 5-30 and 0.8-11.2 microg ml(-1) for BTB, BPB and NBB methods, respectively. The method was found to be specific for the analysis of the drug in presence of its degradation products which can be detected by HPLC procedure. The second method is based on the reaction of the basic loperamide with iodine in chloroform to give molecular charge-transfer complex with intense bands at 295 and 363 nm. Beer's law was obeyed in the ranges 2.5-17.5 and 2.5-22.5 microg ml(-1) for the method at 295 and 363 nm, respectively. Optimization of the different experimental conditions are described for both methods. The proposed methods have been applied successfully for the analysis of the drug in pure form and in its dosage forms. The methods have the advantage of being highly sensitive and simple for the determination of a small dose drug, which is also a weak UV-absorbing compound.

Acids↗
PubMed2000

Determination of loperamide in rat plasma and bovine serum albumin by LC.

A rapid, isocratic liquid chromatographic (LC) method was developed for the determination of loperamide (Lop) in solutions of bovine serum albumin (BSA) and rat plasma. Prior to LC analysis, BSA solutions or rat plasma samples were treated with metaphosphoric acid to precipitate protein. Supernatant was directly injected onto a C18 reverse phase column and loperamide was monitored by a UV detector set at 195 nm. The concentrations of Lop in both rat plasma and BSA solution samples were determined by comparison with their calibration curves, which were generated from the peak area ratio of Lop to internal standard, clomipramine versus loperamide concentration. The calibration curves were linear in the range 0-3.0 microg ml(-1) of Lop for the BSA solution sample and 0-1.0 microg ml(-1)for the rat plasma sample. Overall recoveries of loperamide added to BSA and rat plasma samples were 101.4 and 95.5%, respectively. The method is simple (no extraction), rapid (22 min separation time), sensitive (the detection limit of loperamide is 50 ng ml(-1) for the BSA solution sample and 100 ng ml(-1) for the rat plasma sample), reproducible (within-day R.S.D. of 2.59-7.11%, among-day R.S.D. of 1.25-5.97%), and suitable for routine analysis of loperamide in rat plasma and BSA solution samples.

Animals↗
PubMed1997

Traveler's diarrhea.

Traveler's diarrhea occurs with considerable frequency in individuals traveling to underdeveloped countries. It is acquired through the ingestion of fecally contaminated food and water. Traveler's diarrhea is caused by a variety of bacterial, protozoal, viral, and parasitic organisms. Typically self-limiting, traveler's diarrhea is more of an inconvenience than a life-threatening process. Patient education is an important element in the management of traveler's diarrhea; the well-informed traveler can manage most cases empirically without sophisticated medical technology. The presence of fever, bloody stool, abdominal pain, or profound dehydration indicates a more severe infection requiring medical attention.

Anti-Bacterial Agents↗
PubMed1999

Pharmacologic considerations in the treatment of neonatal septicemia and its complications.

This article focuses on the pharmacologic properties of drugs commonly used in the treatment of neonatal septicemia and its complications. Rational therapy demands an awareness of not only the pharmacology of individual drugs but also the interactions and anticipated fate of such drugs in the rapidly changing physiologic environment of the neonate. Further research in the area of equine neonatal pharmacology should greatly assist our understanding of the impact of the disease state on the unique physiology of the newborn and should allow us to better predict the ultimate fate of drugs commonly used for such purposes. Careful dosing and close monitoring of pharmacologic effects are critical for a successful outcome. In the future, newer therapeutic strategies that are safe and efficacious may provide a means to circumvent many of the problems currently encountered with treating the septicemic newborn foal.

Animals↗
PubMed2003

Sodium pentobarbital anesthesia transiently enhances the severity of infection following intragastric, but not intravenous, inoculation of Listeria monocytogenes in mice.

In the present study we observed that mice anesthetized with sodium pentobarbital were far more susceptible to gastrointestinal challenge with Listeria monocytogenes than were unanaesthetized mice. The effect of pentobarbital anesthesia was transient (gone within 2 h) and did not alter the severity of infection following i.v. challenge with L. monocytogenes. Treatment with pharmacological inhibitors of gastric acidity (i.e. cimetidine and omeprazole), or intestinal motility (loperamide), did not duplicate the effect of pentobarbital on gastrointestinal listeriosis. These findings suggest that sodium pentobarbital anesthesia causes a short-lived but striking diminution in resistance to gastrointestinal listeriosis in mice, via an undefined mechanism.

Anesthesia↗
PubMed2003

Pharmacotherapy for intestinal motor and sensory disorders.

Motor disorders of the gastrointestinal tract are characterized by definable impairments of gut contractile function. Other conditions exhibit specific disturbances of visceral afferent and efferent activity, which may underlie selected symptom complexes. Medications in several classes have been developed to treat these disorders of gastrointestinal function. Prokinetic agents are effective therapies for ailments with reduced motor function, whereas antispasmodic drugs reduce symptoms in conditions with exaggerated pressure wave activity. Recently, medications designed to blunt transmission in visceral sensory pathways have been proposed for use in the functional bowel disorders. Finally, some patients may benefit from initiation of nonspecific therapies, which have no appreciable effect on gut motor or sensory function.

Antidepressive Agents↗
PubMed2001

Clinical evaluation and management of acute infectious diarrhea in adults.

Acute infectious diarrhea is a major global health problem. Issues for the developed and developing regions of the world differ. Awareness of disease pathophysiology and epidemiology are essential, however, for clinical evaluation and management. The immense human and economic burden imposed by acute diarrhea illness can be addressed only by thoughtful strategies aimed at prevention as well as cost-efficient evaluation and treatment.

Acute Disease↗
PubMed2001

Traveler's diarrhea.

This article presents a review of causes, presentation, and diagnosis of traveler's diarrhea. Treatment and prevention of this common problem is described in some detail. Finally, a practical and cost-effective approach to evaluating and treating a returning traveler is presented.

Adolescent↗
PubMed1998

Travelers' diarrhea. Epidemiology, prevention, and self-treatment.

Risk factors for travelers' diarrhea include adventurous behavior, consumption of unclean water or food, and special hosts like those taking long acting H2 blockers. Approaches to prevention include education about risk factors, which often fails to lead to modification of risky behavior, and chemoprophylaxis with bismuth subsalicylate-containing compounds or antimicrobial agents. Chemoprophylaxis is generally discouraged except in special circumstances and in high-risk hosts. Self-treatment of travelers' diarrhea is successful in limiting the course of diarrhea and minimizing losses of vacation and business time. Current therapeutic options, in order of increasing effectiveness, include attapulgite, BSS-containing compounds, loperamide, antimicrobial agents such as the fluoroquinolones, and the combination of loperamide and an antimicrobial agent. Under study are a nonabsorbed antimicrobial agent, rifaximin, and a novel calmodulin inhibitor, zaldaride. Development and evaluation of vaccines against enterotoxigenic Escherichia coli and Shigella are proceeding apace but are not yet available for routine use.

Antidiarrheals↗
PubMed2004

Risk of hospitalization for upper gastrointestinal tract bleeding.

OBJECTIVE: This study evaluates the hospitalization risk for upper gastrointestinal bleeding (UGIB) with reference to the clinical characteristics of patients and drugs taken before admission. METHODS: This study is based on the GIFA (Italian Group for the Pharmacosurveillance in the Elderly) database. Cases with an ICD-9 code of esophagus, stomach or duodenum bleeding, or acute esophago-gastroduodenal disease associated with anemia have been classified as UGIB. Sex, age, year of observation, drugs taken at home, comorbidity, smoking, alcohol, and use of gastroprotectants have been also taken into account. Statistical analysis has been conducted using multivariate logistic regression models. RESULTS: 32,388 patients have been enrolled, 940 of which presented UGIB. Age, comorbidity, use of smoke and alcohol, hospitalization duration, and mortality during hospitalization were significantly higher in UGIB than nonUGIB patients. Increased UGIB risk has been found in patients taking NSAIDs (both when aspirin was included or excluded), acetaminophen, constipating agents, iron, ethacrynic acid, propranolol. Reduced UGIB risk has been found in patients taking nitrates. CONCLUSIONS: UGIB risk appears to correlate with clinical characteristics of the patient: it increases with age, comorbidity, and smoke and alcohol consumption. Among drugs, NSAIDs are associated with the highest UGIB risk, while nitrates with a reduction of risk.

Aged↗
PubMed2000

Loperamide therapy in a patient with diarrhea and resistant hypertension.

A 65-year-old man was admitted to our hospital for resistant essential hypertension. He had a past history of bowel resections due to Crohn's disease. We assumed that in this patient insufficient drug absorption might be a cause of resistant hypertension and that even increased antihypertensive regimens would fail to decrease blood pressure. We administered loperamide, which may increase drug absorption from the residual intestine. Blood pressure was successfully decreased, with a concomitant increase in blood concentration of antihypertensive drugs. In patients with impaired drug absorption, we should make an effort to restore drug obstruction before considering increased drug regimens.

Aged↗
PubMed2000

Racecadotril: a new approach to the treatment of diarrhoea.

Since enkephalins were discovered in 1975, it has become clear that they play an antisecretory role in the gastrointestinal tract. Hence a rational research programme was directed at the development of a drug that would preserve these neurotransmitter peptides in the gut by preventing their inactivation. This research programme has resulted in the development of the enkephalinase inhibitor, racecadotril. Preclinical studies have demonstrated the efficacy of racecadotril in two models of hypersecretory diarrhoea: infusion of cholera toxin and castor oil-induced diarrhoea. Moreover, unlike loperamide, racecadotril did not prolong transit time in the small intestine or colon. Further experiments have shown that racecadotril does not promote bacterial overgrowth in the small intestine. Racecadotril lacks any potential for neurotoxicity, and radiolabelled studies have demonstrated that the drug does not enter the brain after oral administration. No potential for abuse or physical dependence has been seen. It is concluded that racecadotril demonstrates specificity of antisecretory action on the gastrointestinal tract without any adverse effect on gastrointestinal motility, and that the results of the preclinical studies indicate the potential usefulness in the treatment of hypersecretory diarrhoea in man.

Animals↗
PubMed2000

An overview of clinical studies with racecadotril in adults.

Since preclinical studies had indicated the potential efficacy and tolerability of racecadotril for the treatment of diarrhoea in man, a series of studies was carried out to assess the clinical effects of racecadotril. These studies were also designed to evaluate whether racecadotril possessed the clinical properties that had been previously identified for an ideal agent to treat infectious diarrhoea. The pure antisecretory action of racecadotril was confirmed in these clinical studies, as was the drug's rapid onset of action. The high therapeutic index of racecadotril was combined with a lack of effect on the central nervous system. Finally, racecadotril was found to be effective in treating acute diarrhoea in double-blind studies against both placebo and the mu opiate receptor agonist, loperamide. The efficacy of racecadotril in acute diarrhoea was not associated with adverse gastrointestinal effects, and its adverse events profile was similar to that of placebo. It was concluded that racecadotril offers a new approach to the treatment of diarrhoea via its mechanism of action as a true antisecretory agent.

Adult↗