A new multiple dose powder inhaler, (Turbuhaler), compared with a pressurized inhaler in a study of terbutaline in asthmatics

Twelve adult asthmatic patients participated in an open, randomized, cross-over comparison between cumulatively increasing doses of terbutaline sulphate administered via the multiple dose powder inhaler (Turbuhaler) or via a pressurized inhaler. Turbuhaler and the pressurized inhaler showed equipotency both with respect to bronchodilatation and side effects. Both treatments produced a significant increase in pulmonary function measurements, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). No increase in pulse rate was seen with either treatment but there was an increase in tremor at higher doses with both treatments. Inhalation of beta-agonists via Turbuhaler seems to be an effective way of treating asthma.

Tolerability and pharmacokinetics of L-648,051. A leukotriene D4-receptor antagonist, in healthy volunteers

Two formulations of L-648,051 (L) were studied [intravenous (i.v.) and aerosol (A)] in two separate trials. Study I (i.v.) involved 4 normal male subjects in a single blind dose ranging study where good systemic tolerability and safety was shown. However, dose dependent local irritation at the injection site was observed at all dose levels (35, 52.5 and 70 mg/5 min infusion). L has a high systemic clearance rate (1.2 1/min), a small volume of distribution (4.41) and a short plasma half-life (2.4 min). Study II (A) involved 16 normal male volunteers who received incremental aerosolized doses of L from 0.1 to 1.6 mg in a double-blind, placebo controlled, dose ranging study. Complaints of mild local irritation or discomfort in the upper respiratory tract were the only significant findings. No dose relationship of these complaints could be shown. In conclusion, L is a safe and well tolerated drug when administered by aerosol. It causes dose related local, but not systemic, adverse experiences when administered i.v. In view of this tolerability and of its demonstrated activity against LTD4-challenge in animals, clinical efficacy studies with the aerosol formulation are warranted.

Effect of Clinoril (sulindac, MSD), piroxicam and placebo on the hypotensive effect of propranolol in patients with mild to moderate essential hypertension

One hundred ten patients of both sexes with mild to moderate essential hypertension were studied in this double-blind, multicenter study. In the double-blind portion of this study, which covered weeks 11 to 14, 71 patients were evaluated to determine the effect of Clinoril (sulindac, MSD), piroxicam, and placebo on the hypotensive effect of propranolol. All 110 patients were considered for safety evaluation. Patients treated with propranolol alone were distributed randomly into three groups (Clinoril, piroxicam and placebo) and compared in a 15-week study with four periods (I through IV). Having fulfilled the criteria for hypertension (I) and having been successfully controlled with propranolol alone (II), patients were entered into a double-blind period (III) comparing the three drug treatments during four weeks followed by one week of propranolol alone (IV). During period III, patients treated with piroxicam had significantly greater (p less than 0.05) increases in supine and standing diastolic blood pressure than patients treated with Clinoril. No clinical difference was shown between patients treated with Clinoril and placebo. At the end of period IV patients treated with piroxicam maintained the increase in their diastolic blood pressure, in contrast to Clinoril and placebo where no clinical difference was noted. Significantly more patients treated with piroxicam than Clinoril had a 10 mmHg or greater increase of their supine diastolic blood pressure. These results show that Clinoril does not blunt the antihypertensive effect of propranolol in patients with mild to moderate hypertension in contrast to piroxicam. This is an extension of a report previously published in Advances in Therapy, Vol. 2, No. 4, July/August 1985.(ABSTRACT TRUNCATED AT 250 WORDS)

Extraction of natural substances with dense gases

An overview of the solvent power of dense gases is given. The properties of these novel solvents are described and the specific advantages of carbon dioxide discussed. New qualitative and quantitative procedures for the rapid determination of solubilities are described for several interesting classes of natural substances. These include fatty oils, steroids, alkaloids, flavor and aroma substances, which documents the versatility of the new extraction procedure in many practical applications.

Decontamination of insecticides in natural drugs with supercritical carbon dioxide

The lipophilic insecticides DDT and HCH in sennae leaves and pods are removable by extraction with supercritical carbon dioxide in the pressure region at 100 bar. The effective ingredients, the sennosides, are not extracted and remain in the drug of which they can be easily extracted with water.

The essential oil from Thymus praecox ssp. arcticus growing in Iceland

The essential oil from THYMUS PRAECOX Opiz ssp. arcticus (E. Durand), Jalas, a widely distributed plant in Iceland, was proved to contain linalyl acetate as main component (70%). Within the sesquiterpene fraction, beta-caryophyllene (4%), germacrene D (3%), beta-bisabolene (2%), beta-sesquiphellandrene (1%), gamma-cadinene (0.5%), and a couple of oxygenated sesquiterpenes (13%) were found by means of GLC-MS. Additionally four such compounds were isolated and identified by means of IR and NMR spectroscopy as nerolidol (3%), T-cadinol (1%), hedycaryol (7%), and 7-hydroxygermacrene (about 2%).

[Extraction of thermolabile compounds with supercritical gases.]

The thermolabile acoragermacrone and other sesquiterpenes could be extracted with supercritical carbon dioxide from beta-asarone free calamus rhizomes ( Acorus calamus L. var. americanus Wulff. A usual steam distillation lets this substance partly decompose into shyobunone. By using high pressure extraction with fractionated separation a higher yield of the bitter principles of calamus, acorone and isoacorone, is obtained.

[Composition of the essential oil from beta-Asarone free calamus.]

The study of the essential oil extracted from american diploid calamus rhizomes proved that this variety does not contain the cancerogenic cis-isoasarone (beta-asarone) nor other phenylpropane derivatives which are believed to be toxic. Typical compounds of the examined oil are sesquiterpeneketones, e. g. shyobunones and acorones which pharmaceutically used calamus oils also contain. We believe the isoasarone-free calamus rhizome to be an alternative to the triploid calamus variety often used in todays phytotherapy.

[To the classification of commercial Calamus drugs]

Acorus calamus L. yields different races depending upon the number of chromosomes in the plant cells and consequently different drug types with varying content of beta-asarone. The phenylpropane derivative proved to be carcinogenic in several animal tests. The diploid drug does not contain traceable amounts of beta-asarone, the triploid variety contains 0.3 per cent in the rhicome, the tetraploid yielded two races with a) 2 per cent and b) between 4 and 8 per cent beta-asarone. For reasons of optimal drug safety the use of asarone-rich races should be avoided. They can be distinguished by a fast and safe method of determining the extinction of the drug extract at the beta-asarone maxima of 253 and 303 nm. The determination of beta-asarone is possible using quantitative direct evaluation of thin-layer chromatograms on alumina layers with an efficient separation of the asarone. A good selectivity, obtainable at 300 nm, allows determination of beta-asarone down to 0.1 microg in drug extracts.

Neue, lipophile Benzofuranderivate aus Ratanhiawurzel

Two phenols have been isolated from the petroleum-ether extract of Ratanhiae radix Ph. Eur.; structure elucidation has been made by means of the following chemico-physical methods: UV, IR, (1)H-NMR, (13)C-NMR-spectroscopy and mass spectrometry, microhydrogenation and thermofractography. Structures are: 2-(p-methoxy-o-hydroxyphenyl) -5-propenyl (trans)-benzofurane; 2-(p-hydroxyphenyl)-3-methyl-5-propenyl-(trans)-benzofurane. Both compounds - newly discovered in Ratanhiae radix - proved to be effective UV-light filters. They could be useful in sun protection preparations.

[Diabetic gastroparesis]

It is reported on a 61-year-old patient in whom since 1959 has been existing a diabetes mellitus in need of insulin. 1973 in the endoscopic control of roentgenological findings of a stomach suspect to tumour by means of the Wolf-Schindler gastroscope the suspicion to a gastric carcinoma was expressed. In May 1975 he was again admitted to hospital on account of a hypoglycemic shock. Roentgenologically large filling defects in the stomach were found, gastroscopically macroscopically no clearly explained whitish yellow masses (Histology: remains of food, chronic superficial gastritis, extended settlement of fungi). Only after several days of food carency and daily gastric lavages gastroscopically normal findings could be made. Together with the roentgenological findings of the stomach the diagnosis gastroparesis diabeticorum was made. Therapeutically an optimum stopping of diabetes is recommended and the application of metoclopramide. A surgical intervention is not advisable.

[Morphological and clinical liver changes after taking oral contraceptives]

In 155 women of the age group 16-45 years after intake of oral contraceptives in 68.4% (106 cases) histologically provable liver changes were found. Sinusoidal ectasias of different size and drug-conditioned hepatitides most frequently occurred. An isolated intrahepatic cholestase only rarely existed. Increases of transaminase are the most frequent reference to a lesion of the liver parenchyma after intake of oral contraceptives. The author adopts a definite attitude to the differential diagnosis and its difficulties between a drug-conditioned hepatitis and the usual virus hepatitis.

[Narcotic mushrooms with LSD?]

We tested dried East-Asian mushrooms that have only recently appeared on the German drug "scene". They were impregnated with lysergic acid diethylamide (LSD) but sold as Mexican sacred hallucinogenic mushrooms, containing psilocybine. For the safe identification of psilocybine in mushrooms, TASmethod is proposed. Successful identification of LSD in mushrooms is done by tartaric acid extraction with subsequent TLC of the free base. The modified van Urk reaction in connection with hRf-values is best suited for the detection of psilocybine, psilocine and LSD.

[Urinary hydroxyproline excretion in liver cirrhosis]

In 50 patients with a laparoscopically ascertained liver cirrhosis the hydroxyproline excretion was estimated in the 24-hour-urine. There could not be found any significant differences between hydroxyprolinuria in normal persons and in patients with liver cirrhosis. The increased hydroxyproline excretion is an unspecific symptom and thus cannot contribute to the diagnosis and the observation of the course of a liver cirrhosis.

Irreversible shock in rats after injection of microspheres into the renal artery

After injection of microspheres into both renal arteries of rats, an irreversible shock syndrome develops, resulting in death within 4-12 h. Ligation of both renal pedicles after injection of microspheres prevents the shock. It is presumed that kininogenases released from the kidneys participate in the pathogenesis of the shock syndrome.