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Domperidone plus magnesium hydroxide and aluminum hydroxide: a valid therapy in children with gastroesophageal reflux. A double-blind randomized study versus placebo.

To evaluate the efficacy of different drug combinations in treating severe gastroesophageal reflux (GER), we studied 80 children with GER. The patients were randomly divided into four groups: group A was treated with domperidone plus magnesium hydroxide and aluminum hydroxide, group B with domperidone plus alginate, group C with domperidone alone, and group D received placebo. At the time of diagnosis and 8 weeks after treatment the patients were clinically evaluated and underwent 24-h continuous esophageal pH monitoring. After treatment a complete regression of symptoms was observed in 16 of 20 patients in group A, in 8 of 20 in group B (A versus B, p < 0.018), in 9 of 20 in group C (A versus C, p < 0.034), and in 7 of 20 in group D (A versus D, p < 0.001). Moreover, there was a statistically significant improvement in several pH-metric variables studied in all treatment groups; in addition, a comparison of the pH-metric data of the four groups after treatment indicated that reflux variables were significantly lower in group A than in the other groups. We conclude that the domperidone plus magnesium hydroxide and aluminum hydroxide combination was more effective than the other drugs we used in treating GER and in modifying the objective pH-metric variables in pediatric patients.

Aluminum Hydroxide↗

Decrease of serum triglyceride in normal rat fed with 2000 ppm aluminum diet for 67 days. II. Feeding young and adult rats a sucrose diet with addition of aluminum hydroxide and aluminum potassium sulfate.

To confirm the hypotriglyceridemic effect of aluminum (Al), male weanling and adult Wistar rats were fed sucrose diets with the addition of aluminum hydroxide (Al(OH)3) or aluminum potassium sulfate (AlK(SO4)2) for 67 days. As in the foregoing report (C. Sugawara, N. Sugawara, H. Kiyosawa, and H. Miyake, Fundam. Appl. Toxicol. 10, 607-615), no Al-induced anemia or hypophosphatemia was observed and serum Al did not exceed 20 ng/ml. Serum triglyceride (TG) was decreased by aluminum. Serum TG was significantly correlated with the serum nonesterified fatty acid (NEFA) concentration in both the Young groups (R = 0.757, n = 22, p less than 0.01) and the Adult groups (R = 0.727, n = 19, p less than 0.01). Neither serum cholesterol nor phospholipids was affected by Al ingestion. Aluminum caused a decrease in hepatic glycogen in all groups, but the decrease was significant only in Adult groups. Glycerol tri[9,10(n)-3H]oleate was administered by gastric tube into rats fed for 81 days with experimental diets. In all the Al-treated groups serum 3H was significantly greater than in control groups at 3 hr after intubation. At 24 hr after intubation, serum 3H did not differ between Control and Al-treated groups. Total 3H at 24 hr found in serum, liver, and epididymal adipose tissue was not changed significantly by Al feeding. These effects were observed without measurable increase of Al in the serum.(ABSTRACT TRUNCATED AT 250 WORDS)

Alum Compounds↗

[Magnesium hydroxide and aluminum hydroxide in the treatment of gastroesophageal reflux].

Fifteen children with gastro-esophageal reflux took part in a treatment trial with a regimen of magnesium hydroxide and aluminium hydroxide for 8 weeks period (700 mmol/1.73 mq/die). All children were evaluated clinically and underwent a 24-hour continuous esophageal pH-monitoring both at diagnosis and after 8 weeks of treatment. After therapy 12/15 children were cured and 3/15 improved. Moreover the total percentage of time during which pH was less than 4, the number of reflux episodes and the number of refluxes lasting than 5' recorded during 24-hour continuous esophageal pH-monitoring were significantly reduced after treatment. The Authors conclude that antacids in large quantities are effective in medical treatment of gastro-esophageal reflux.

Aluminum Hydroxide↗

[Dynamic comparative study of the intraalveolar cell population after intratracheal injection of beryllium hydroxide and aluminum hydroxide in the rat].

A sequential quantitative analysis of free alveolar cells was performed on S.P.F. rats after intratracheal injection of Be (OH)2 and Al (OH)3. The induced lesions were entirely restored 20 days after the initial injection. Beryllium hydroxide inhibited DNA synthesis in the free alveolar macrophages and the transeptal cellular flow could be evidenced. Aluminium hydroxide increased the number of free cells without inhibiting DNA synthesis. Quantitative variations of polymorphonuclears, lymphocytes and macrophages were correlated with changes in the alveolar environment. A strong direct correlation between the number of lymphocytes and DNA synthetizing macrophages was shown out. This reaction was not observed in beryllium treated rats.

Aluminum↗

Reversal of aluminum-related bone disease after substituting calcium carbonate for aluminum hydroxide.

Aluminum-related osteodystrophy, a crippling disease in patients with renal failure, can develop from the long-term ingestion of aluminum hydroxide gels. We present a diabetic patient treated with continuous ambulatory peritoneal dialysis (CAPD) who developed markedly elevated plasma aluminum levels but no musculoskeletal symptoms. Bone biopsy revealed features of the aplastic form of aluminum-related disease with significant aluminum staining, decreased osteoblastic osteoid, and decreased bone formation by double tetracycline labeling, but no excess accumulation of unmineralized osteoid. Aluminum hydroxide gels were discontinued and the patient received calcium carbonate to control hyperphosphatemia; 9 months later, a bone biopsy showed marked improvement of the aluminum-related bone disease, and at 2 to 10 months, plasma aluminum had decreased from 208.7 +/- 10.3 (SE) to 55.7 +/- 3.9 micrograms/L.

Aged↗

Microstructure of aluminum hydroxides and the formation of aluminum dye lakes.

The effect of processing variables on the type of aluminum hydroxide and the dye content of the resultant lakes were investigated. The solid-state structure of aluminum lakes in conjunction with the associated aluminum hydroxide was studied by electron microscopy, X-ray diffraction, and IR spectroscopy. The conditions under which the aluminum hydroxide was prepared were shown to govern the amorphous/crystalline character of the product, which was reflected in changes in particle size and surface area. A hypothesis for the interaction of the dye and aluminum hydroxide is formulated in which the amount of dye adsorbed on the aluminum hydroxide is dependent on the surface area of the microstructures present.

Alum Compounds↗

Effect of dilution on reactivity and structure of aluminum hydroxide gel.

Aluminum hydroxide gel loses reactivity upon aging. However, a sharp decrease in reactivity occurs when the gel is diluted with double-distilled water. The loss of reactivity is directly related to the degree of dilution, but dilution with dioxane or the mother liquor has no effect on reactivity. It is hypothesized that dilution with water causes a change in the equilibrium between stabilizing ions incorporated in the gel structure and ions in solution. As the stabilizing ions leave the gel structure to reestablish the equilibrium, a loss of reactivity is observed until a new equilibrium is established.

Aluminum Hydroxide↗

Suppression or exacerbation of experimental autoimmune uveoretinitis in Lewis rats by pretreatment with or without an autoantigenic peptide in aluminum hydroxide.

PURPOSE: Aluminum hydroxide (Al) is an adjuvant to induce Th2 immune responses. The aim of this study is to investigate the effects of pretreatment with Al on experimental autoimmune uveoretinitis (EAU), a Th1 disease model. METHODS: Lewis rats were pretreated with an uveitogenic peptide (#29)/Al, phosphate-buffered saline (PBS)/Al or PBS. EAU was then induced by immunization of #29 in complete Freund's adjuvant (CFA) with intravenous injection of Bordetella pertussis. Three weeks later, EAU was evaluated histologically and antigen-specific cellular immune responses were assessed. RESULTS: EAU was exacerbated in the PBS/Al group and attenuated in the #29/Al group, compared to the control PBS group. Antigen-specific cellular proliferation and interferon-gamma production were augmented in the PBS/Al group and suppressed in the #29/Al group. CONCLUSIONS: Suppression or exacerbation of EAU by the pretreatment in this study is related to inhibition or augmentation of antigen-specific Th1 immunity.

Adjuvants, Immunologic↗

Effect of aluminum hydroxide on fluoride metabolism.

Aluminum inhibits intestinal absorption of fluoride in animals but little information is available about man. To determine whether and to what extent aluminum affects fluoride absorption in man, effects of aluminum hydroxide on fluoride metabolism were studied under controlled dietary conditions. Relatively small amounts of aluminum hydroxide were used (30 ml three times daily, containing a total of 1.8 gm aluminum, were given for several weeks). Fluoride balances were determined in control studies and during the intake of aluminum hydroxide. The fluoride intake was the fluoride content of the diet and the drinking water. Two studies were also carried out on a high-fluoride intake. The use of aluminum hydroxide was associated with an increase in fecal fluoride excretion and a decrease in net absorption of fluoride regardless of the intake fluoride, calcium, phosphorus, or magnesium. Urinary fluoride decreased during aluminum hydroxide ingestion. Our studies show that relatively small amounts of aluminum hydroxide inhibit intestinal absorption of fluoride in man.

Aged↗

Aluminum chlorohydrate III: Conversion to aluminum hydroxide.

Bayerite, an aluminum hydroxide polymorph, readily forms when the hydroxyl to aluminum ratio of aluminum chlorohydrate is raised to 3 by titration with sodium hydroxide. Dilution of aluminum chlorhydrate solutions with water leads to the formation of gibbsite, another aluminum hydroxide polymorph. The mechanism of conversion in each instance is related to the structure of the Al13O4(OH)24(H2O)7+(12) complex.

Aluminum Hydroxide↗

The effect of aluminum hydroxide dissolution on the bleeding of aluminum lake dyes.

The effect of pH on the bleeding of FD&C yellow No. 5 aluminum lake and FD&C red No. 40 aluminum lake was investigated. The pH-bleeding profiles corresponded to the pH-solubility profile of aluminum hydroxide. The similarity of the bleeding profiles of both lake dyes and the pH-solubility profile of aluminum hydroxide indicates that pH related bleeding, other than that occurring by competition with anions, is a result of dissolution of the aluminum hydroxide substrate. This dissolution is related to the properties of the substrate rather than to the structure of adsorbed dye.

Aluminum Hydroxide↗

Acetaminophen-aluminum hydroxide interaction in rabbits.

Acetaminophen-aluminum hydroxide interaction was investigated in a crossover study using six rabbits. Blood samples were collected at various time intervals for up to 6 hr following the oral administration of acetaminophen alone or in combination with aluminum hydroxide. Aluminum hydroxide at a 40-mg/kg dose did not appear to affect the rate and extent of acetaminophen absorption. The influence of aluminum hydroxide on gastric emptying could be compromised by gastric absorption of acetaminophen, resulting in a negligible effect on the overall bioavailability of acetaminophen.

Acetaminophen↗