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Croton macrostachys seeds are widely used in Somalia as a purgative. In the present study, pharmacologic and chemical investigations confirm the laxative effect of the seeds and indicate the presence of phorbolesters. There appears to be no direct correlation between phorbolester content and laxative effect.
The purgative principles in Croton penduliflorus seed oil were isolated as white crystals by a bioassay-guided chromatographic separation process. The crystals were recovered in 7% w/w yield and identified (IR, 1H-NMR, GC-MS) as a mixture of palmitic, stearic and arachidic acids in approximately equimolar concentration.
Crystals from Croton penduliflorus seeds (CPC) were administered at weekly intervals in two doses (7 mg/kg and 21 mg/kg) by gastric intubation to mice over 12 weeks. CPC induced purgation in the treated mice, with the higher dose having a more profound effect. Mice treated with CPC developed skin lesions with swollen scrotums. There were significant changes in the PCV, Hb and plasma proteins of treated mice. Gangrene of the tail with subsequent sloughing was observed, particularly in the low dose group. Mice in the low dose group also experienced retarded growth. A significant clinical finding in the treated mice was abortion during late pregnancy and 100% fetal mortality. It was concluded that, apart from its purgative effect, CPC can cause toxic effects in chronic administration. Use in pregnant women should be discouraged.
Some preliminary studies were conducted on the biological activities of Icacina trichantha in mice. In vitro tests performed with the 70% ethanol, petroleum ether and aqueous extracts of tubers, roots, stems and leaves did not show contraction of isolated guinea pig ileum up to a bath concentration of 40.5 mg/ml. Graded oral doses (100, 200, 400 and 800 mg/kg) of the aqueous extract of tubers produced wet faeces in mice with the number of wet faeces increasing with increasing dose up to 400 mg/kg. A time-course study of the purgative effect showed the maximum purgative response to be 7-8 h after oral dosing. The aqueous extract of tubers significantly potentiated pentobarbital-induced loss of righting reflex at a dose of 80 mg/kg i.p. but this dose did not protect mice from strychnine or leptazole convulsions and death.
A survey of medicinal plants used in Thailand has been made from Thai books on traditional herbal medicine. In this part of the survey, 326 plants with antidiarrheal, laxative and/or carminative properties are described. Information provided for each species includes plant part used, methods of preparation and administration and literature references to Thai books, together with indications of usage in other Southeast Asian countries and of phytochemical work which has been performed.
Thirty-six patients were evaluated concerning the visibility of the pancreas under different conditions. One group (12 patients) was prepared with fasting for 4 hours, the second group (12 patients) was additionally given laxatives for one day prior to the examination together with a small enema (preparation for IVP). The third group (12 patients) received laxative treatment for 2 days (preparation for barium enema) but was otherwise treated in the same fashion as group 2. The study did not reveal any difference in visibility between the three groups thus indicating that routine preparation with 4 hours fasting alone can still be recommended when examining the upper part of the abdomen (except the gallbladder) with ultrasound.
The leaves of 10 Cassia species (Leguminosae), cultivated in Nigeria, were assayed spectrophotometrically for combined anthraquinone content and also pharmacologically for their laxative properties in male albino rats using official senna leaves (Cassia acutifolia Del.) as the reference standard. Leaves of C. podocarpa Guill, and Perr. and of senna had identical laxative potency. The results of both the chemical and the biological experiments suggested that C. alata L. and C. podocarpa are the most likely candidates for drug development in Nigeria. The use of a laxative index is proposed for the comparative study of Cassia (or any plant species) and its possible application to the quality control of these drugs is discussed.
The high-performance liquid chromatography (HPLC) method of the United States Pharmacopeia has been compared with the colorimetric method of the British Pharmacopoeia for the assay of phenolphthalein in various preparations. Results are presented for the linearity, sensitivity and reproducibility of the two methods. The HPLC method was considered to be more convenient for routine analysis of the preparations of phenolphthalein.
HPLC methods have been developed for the assay of bisacodyl in various pharmaceutical forms. The extraction procedures are simple and the HPLC conditions separate bisacodyl from its degradation products. The chromatography was performed using a Merck LiChrospher RP-select B column, a mobile phase of 55% acetonitrile/45% 0.05 M KH2PO4 and detection by UV at 214 nm.
Activated charcoal has found a renewed role in the management of overdosed patients. Routinely administered to reduce the gastrointestinal (GI) absorption of many drugs, growing evidence indicates that repeated doses of charcoal also may enhance drug elimination. Some drugs are excreted into the bile or gastric fluids (phencyclidine, digoxin) and are reabsorbed. Other drugs (theophylline, phenobarbital) can diffuse from the plasma into the lumen of the GI tract. Activated charcoal is administered at regular intervals to sequester these toxins in the GI tract, eventually causing their excretion in feces. This article reviews the evidence for the safety and efficacy of repetitive charcoal therapy. While supportive management remains the mainstay of therapy in poisoned patients, activated charcoal is inexpensive, effective, simple to administer, and may obviate the need for more invasive methods of toxin removal.
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Ivermectin is a veterinary antiparasitic medication for domestic animals. Two cases of human exposure to veterinary preparations of ivermectin are reported. Patient number one accidentally self-injected ivermectin and developed nausea, pallor, and transient pain and numbness in the affected extremity. Patient number two, a 4-year-old child, ingested an unknown amount of the paste preparation and remained asymptomatic. As ivermectin is being used with increasing frequency in veterinary medicine, more human exposures may be anticipated.
We recommend a toxicodynamic approach to the management of the poisoned patient. We define the period between ingestion and onset of toxic manifestations (clinical or laboratory) as the preclinical phase, during which the management of the patient necessarily depends solely on the history of ingestion and the predicted toxicity. In the toxic phase during which the patient shows clinical or laboratory evidence of toxicity, the history, clinical status (signs, symptoms, drug levels, laboratory parameters), and toxicodynamics should guide the therapy. In the resolution phase, when the patient shows clinical improvement and declining drug levels, treatment should be based on clinical status. Gastrointestinal decontamination is critical in the first two phases and may be of value during the resolution phase until the body drug burden declines to safe levels. We recommend an aggressive approach to gastrointestinal decontamination, especially in the preclinical phase. With a history of a potentially toxic ingestion of an absorbable drug, an observation period until passage of a charcoal-laden stool should be achieved before discharge of the patient.
Loperamide was used to provide a source of opioid-induced constipation in healthy volunteers. Each volunteer took a sequence of three dose levels of loperamide. One of three laxatives was used to counterbalance the effect of loperamide and restore bowel function to what the individual considered normal at each stage before the dose of loperamide was increased. Lactulose, senna, and codanthrusate were selected as examples of a softening, a stimulant, and a combination laxative, respectively. Outcome measures were the doses of laxative used, stool form and frequency, ease of defecation, a rating scale of subjective bowel function, and the occurrence of adverse effects. Each laxative was taken by ten volunteers, and all proved capable of maintaining normal bowel function. A combination of stimulant and softening laxatives was most likely to maintain normal bowel function at the lowest dose and least adverse effects. The mean final dose of lactulose was excessive for use in ill patients. Senna was associated with significantly more adverse effects than the other laxatives, mainly abdominal pain (P < 0.001). This model of constipation may provide a standardized means of assaying the clinical effectiveness of oral laxatives.
Concomitant bulimia nervosa and drug abuse are common in women. Drugs used by this group include diuretics, emetics, laxatives, and diet pills, as well as alcohol, cigarettes, and illicit street drugs. This paper applies principles from behavioral pharmacology to the problem of drug use by women with bulimia nervosa. The prevalence of use, primary effects, toxicity, detection, tolerance, withdrawal, and effects on appetite and weight are discussed for drugs used by bulimic women to reduce appetite or weight or to induce purging (e.g., diuretics, emetics, laxatives, and diet aids). Alternatives in the diagnosis and treatment of drug use in women with eating disorders are discussed.
Epidemiological and animal studies suggest that faecal pH may be a risk factor for colorectal cancer with low faecal pH associated with a lower incidence of the disease. The aim of this study was to determine whether faecal pH (or dietary fibre) affects the short-term risk factors for colon cancer. Sixty-nine normal volunteers were randomized into three equal groups (A-C). They provided food records, faecal specimens and submitted to rectal biopsy for thymidine labelling studies before and after a 2-week intervention. Group A received a placebo of fruit juice. Group B, approximately 3.0 g d-1 sodium sulphate in juice. Group C, 30 g d-1 supplementary dietary fibre as wheat bran in bread. Age, sex, weight, height and intake of macronutrients and minerals were similar in the groups prior to intervention. Faecal pH was similar for the three groups before and was reduced in Group B after intervention (P = 0.001) with a relative reduction of 0.5 pH units. The labelling index for the three groups was similar prior to intervention; after, it was lowest in Group B with a relative reduction of 0.5% points, although this difference was not statistically significant. The results thus do not support the hypothesis that an acidification of faecal pH leads to a reduction in risk markers for colon cancer.
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PURPOSE: Psychologic and behavioral changes associated with frequent dieting were examined. Compared to nondieters, frequent dieters were hypothesized to show more adverse psychologic changes and increased use of unhealthy weight control behaviors, but possibly healthier eating and exercise behavior changes, over the three-year period of observation. METHODS: A prospective study of female students, in grades 7-10 at baseline completed a health behavior survey in school once a year for a total of three years. RESULTS: Restrained eating, body dissatisfaction and drive for thinness, self-induced vomiting, laxative use, diet pill use, and alcohol use, significantly increased, and physical appearance and self-concept significantly decreased among frequent dieters, compared to non-dieters. Changes in scores on five EDI subscales, eight self-esteem subscales, weight fluctuations, dietary intake, and physical activity patterns did not significantly differ over time by dieting status. CONCLUSION: Dieting may reflect a general pattern of unhealthy behaviors adopted in adolescence, rather than act as a causal factor in promoting psychologic distress.