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Romo-Perez A, Domínguez-Gómez G, Chávez-Blanco AD, González-Fierro A, Correa-Basurto J, Dueñas-González A. PaSTe. Blockade of the Lipid Phenotype of Prostate Cancer as Metabolic Therapy: A Theoretical Proposal. Curr Med Chem 2024; 31:3265-3285. [PMID: 37287286 DOI: 10.2174/0929867330666230607104441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/10/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Prostate cancer is the most frequently diagnosed malignancy in 112 countries and is the leading cause of death in eighteen. In addition to continuing research on prevention and early diagnosis, improving treatments and making them more affordable is imperative. In this sense, the therapeutic repurposing of low-cost and widely available drugs could reduce global mortality from this disease. The malignant metabolic phenotype is becoming increasingly important due to its therapeutic implications. Cancer generally is characterized by hyperactivation of glycolysis, glutaminolysis, and fatty acid synthesis. However, prostate cancer is particularly lipidic; it exhibits increased activity in the pathways for synthesizing fatty acids, cholesterol, and fatty acid oxidation (FAO). OBJECTIVE Based on a literature review, we propose the PaSTe regimen (Pantoprazole, Simvastatin, Trimetazidine) as a metabolic therapy for prostate cancer. Pantoprazole and simvastatin inhibit the enzymes fatty acid synthase (FASN) and 3-hydroxy-3-methylglutaryl- coenzyme A reductase (HMGCR), therefore, blocking the synthesis of fatty acids and cholesterol, respectively. In contrast, trimetazidine inhibits the enzyme 3-β-Ketoacyl- CoA thiolase (3-KAT), an enzyme that catalyzes the oxidation of fatty acids (FAO). It is known that the pharmacological or genetic depletion of any of these enzymes has antitumor effects in prostatic cancer. RESULTS Based on this information, we hypothesize that the PaSTe regimen will have increased antitumor effects and may impede the metabolic reprogramming shift. Existing knowledge shows that enzyme inhibition occurs at molar concentrations achieved in plasma at standard doses of these drugs. CONCLUSION We conclude that this regimen deserves to be preclinically evaluated because of its clinical potential for the treatment of prostate cancer.
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Affiliation(s)
- Adriana Romo-Perez
- Instituto de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Alma D Chávez-Blanco
- Subdirección de Investigación Básica, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - Aurora González-Fierro
- Subdirección de Investigación Básica, Instituto Nacional de Cancerologia, Mexico City, Mexico
| | - José Correa-Basurto
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Alfonso Dueñas-González
- Subdirección de Investigación Básica, Instituto Nacional de Cancerologia, Mexico City, Mexico
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
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2
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Fawzy MA, Maher SA, El-Rehany MA, Welson NN, Albezrah NKA, Batiha GES, Fathy M. Vincamine Modulates the Effect of Pantoprazole in Renal Ischemia/Reperfusion Injury by Attenuating MAPK and Apoptosis Signaling Pathways. Molecules 2022; 27:1383. [PMID: 35209172 PMCID: PMC8879001 DOI: 10.3390/molecules27041383] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 02/06/2023] Open
Abstract
Pantoprazole has an antioxidant function against reactive oxygen species (ROS). Vincamine, a herbal candidate, is an indole alkaloid of clinical use against brain sclerosis. The aim of the present experiment is to evaluate, on a molecular level for the first time, the value of vincamine in addition to pantoprazole in treating experimentally induced renal ischemia/reperfusion injury (IRI). One-hundred-and-twenty-eight healthy male Wistar albino rats were included. Serum creatinine, blood urea nitrogen, and malondialdehyde levels were assessed. ELISA was used to estimate the pro-inflammatory cytokines. The expression of Bcl-2 and Bax genes was assessed by quantitative real-time PCR. ERK1/2, JNK1/2, p38, cleaved caspase-3, and NF-κB proteins expressions were estimated using western blot assay. The kidneys were also histopathologically studied. The IRI resulted in impaired cellular functions with increased creatinine, urea nitrogen, malondialdehyde, TNF-α, IL-6, and IL-1β serum levels, and up-regulated NF-ĸB, JNK1/2, ERK1/2, p38, and cleaved caspase-3 proteins. Furthermore, it down-regulated the expression of the Bcl-2 gene and upregulated the Bax gene. The treatment with vincamine, in addition to pantoprazole multiple doses, significantly alleviated the biochemical and histopathological changes more than pantoprazole or vincamine alone, whether the dose is single or multiple, declaring their synergistic effect. In conclusion, vincamine with pantoprazole multiple doses mitigated the renal IRI through the inhibition of apoptosis, attenuation of the extracellular signaling pathways through proinflammatory cytokines' levels, and suppression of the MAPK (ERK1/2, JNK, p38)-NF-κB intracellular signaling pathway.
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Affiliation(s)
- Michael A. Fawzy
- Department of Biochemistry, Faculty of Pharmacy, Minia University, Minia 61519, Egypt;
| | - Sherif A. Maher
- Department of Biochemistry, Faculty of Pharmacy, Deraya University, Minia 61111, Egypt; (S.A.M.); (M.A.E.-R.)
| | - Mahmoud A. El-Rehany
- Department of Biochemistry, Faculty of Pharmacy, Deraya University, Minia 61111, Egypt; (S.A.M.); (M.A.E.-R.)
| | - Nermeen N. Welson
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt;
| | - Nisreen K. A. Albezrah
- Department of Obstetrics and Gynecology, College of Medicine, Taif University, Taif 21944, Saudi Arabia;
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt;
| | - Moustafa Fathy
- Department of Biochemistry, Faculty of Pharmacy, Minia University, Minia 61519, Egypt;
- Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
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3
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Sadeghpour N, Vadi M, Bagheri N. Engineering delivery of pantaprazole drug using multi-walled carbon nanotubes: an experimental and theoretical study. Struct Chem 2022. [DOI: 10.1007/s11224-022-01883-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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4
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Fawzy MA, Maher SA, Bakkar SM, El-Rehany MA, Fathy M. Pantoprazole Attenuates MAPK (ERK1/2, JNK, p38)-NF-κB and Apoptosis Signaling Pathways after Renal Ischemia/Reperfusion Injury in Rats. Int J Mol Sci 2021; 22:ijms221910669. [PMID: 34639009 PMCID: PMC8508698 DOI: 10.3390/ijms221910669] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 01/01/2023] Open
Abstract
Ischemia/reperfusion injury (IRI) in the kidney is the most common cause of acute renal dysfunction through different cell damage mechanisms. This study aimed to investigate, on molecular basics for the first time, the effect of pantoprazole on renal IRI in rats. Different biochemical parameters and oxidative stress markers were assessed. ELISA was used to estimate proinflammatory cytokines. qRT-PCR and western blot were used to investigate the gene and protein expression. Renal histopathological examination was also performed. IRI resulted in tissue damage, elevation of serum levels of creatinine, urea nitrogen, malondialdehyde, TNF-α, IL-6, IL-1β, up-regulation of NF-κB, JNK1/2, ERK1/2, p38, and cleaved caspase-3 proteins. Furthermore, it up-regulated the expression of the Bax gene and down-regulated the expression of the Bcl-2 gene. Treatment of the injured rats with pantoprazole, either single dose or multiple doses, significantly alleviated IRI-induced biochemical and histopathological changes, attenuated the levels of proinflammatory cytokines, down-regulated the expression of NF-κB, JNK1/2, ERK1/2, p38, and cleaved caspase-3 proteins, and the Bax gene, and up-regulated Bcl-2 gene expression. Moreover, treatment with pantoprazole multiple doses has an ameliorative effect that is greater than pantoprazole single-dose. In conclusion, pantoprazole diminished renal IRI via suppression of apoptosis, attenuation of the pro-inflammatory cytokines’ levels, and inhibition of the intracellular signaling pathway MAPK (ERK1/2, JNK, p38)–NF-κB.
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Affiliation(s)
- Michael A. Fawzy
- Department of Biochemistry, Faculty of Pharmacy, Minia University, Minia 61519, Egypt;
| | - Sherif A. Maher
- Department of Biochemistry, Faculty of Pharmacy, Deraya University, Minia 61111, Egypt; (S.A.M.); (M.A.E.-R.)
| | - Sally M. Bakkar
- Department of Biochemistry, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;
| | - Mahmoud A. El-Rehany
- Department of Biochemistry, Faculty of Pharmacy, Deraya University, Minia 61111, Egypt; (S.A.M.); (M.A.E.-R.)
| | - Moustafa Fathy
- Department of Biochemistry, Faculty of Pharmacy, Minia University, Minia 61519, Egypt;
- Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan
- Correspondence: or
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5
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Wen X, Zhou X, Li W, Du C, Ke Z, Zhao C. Mechanism of Counterion-Controlled Regioselective Hydrothiolation of 1,3-Dienes: Insights from a Density Functional Theory Study. ACS Catal 2021. [DOI: 10.1021/acscatal.1c00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Xiuling Wen
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Sun Yat-sen University, Guangzhou 510275, P. R. China
| | - Xiaoyu Zhou
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou 510275, P. R. China
| | - Weikang Li
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou 510275, P. R. China
| | - Chao Du
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Sun Yat-sen University, Guangzhou 510275, P. R. China
| | - Zhuofeng Ke
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, School of Materials Science and Engineering, Sun Yat-sen University, Guangzhou 510275, P. R. China
| | - Cunyuan Zhao
- MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Sun Yat-sen University, Guangzhou 510275, P. R. China
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6
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Khan MS, Asghar M, Yaqoob M. Lansoprazole Determination in Pharmaceutical Formulations by Flow Injection Coupled with Acidic KMnO 4-Quinine Chemiluminescence System. ANAL SCI 2019; 35:861-867. [PMID: 30982798 DOI: 10.2116/analsci.19p039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A simple and rapid flow injection chemiluminescence (FI-CL) method based on the reaction of potassium permanganate (KMnO4) and quinine was established for the determination of lansoprazole in pharmaceutical formulations. A linear calibration curve was achieved over the range from 0.01 to 20.0 mg L-1 LNP (R2 = 0.9997 (n = 8); RSD = 1.1 - 3.7% (n = 4)) with a limit of detection of 3.0 × 10-3 mg L-1 (S/N = 3) and injection throughput of 150 h-1. By applying the Student t-test (calculated t-test value: t = 1.059907664, and tabulated t-distributed (95%) = 2.200985) it was found that the proposed method and reported spectrophotometric method were not significantly different. The LNP was efficiently extracted and the recovery of LNP from the spiked pharmaceutical formulations was in the range of 91.0 - 105.9% (%RSD = 1.6 - 3.6, n = 4). No significant interference activity was detected from the excipients commonly found in the drug samples analyzed. The possible chemiluminescence emission mechanism is discussed briefly.
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7
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A new strategy for extraction and depuration of pantoprazole in rat plasma: Vortex assisted dispersive micro-solid-phase extraction employing metal organic framework MIL-101(Cr) as sorbent followed by dispersive liquid–liquid microextraction based on solidification of a floating organic droplet. J Pharm Biomed Anal 2019; 172:86-93. [DOI: 10.1016/j.jpba.2019.04.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 04/05/2019] [Accepted: 04/08/2019] [Indexed: 01/09/2023]
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8
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Loisios-Konstantinidis I, Paraiso RLM, Fotaki N, McAllister M, Cristofoletti R, Dressman J. Application of the relationship between pharmacokinetics and pharmacodynamics in drug development and therapeutic equivalence: a PEARRL review. J Pharm Pharmacol 2019; 71:699-723. [DOI: 10.1111/jphp.13070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/19/2019] [Indexed: 12/18/2022]
Abstract
Abstract
Objectives
The objective of this review was to provide an overview of pharmacokinetic/pharmacodynamic (PK/PD) models, focusing on drug-specific PK/PD models and highlighting their value added in drug development and regulatory decision-making.
Key findings
Many PK/PD models, with varying degrees of complexity and physiological understanding have been developed to evaluate the safety and efficacy of drug products. In special populations (e.g. paediatrics), in cases where there is genetic polymorphism and in other instances where therapeutic outcomes are not well described solely by PK metrics, the implementation of PK/PD models is crucial to assure the desired clinical outcome. Since dissociation between the pharmacokinetic and pharmacodynamic profiles is often observed, it is proposed that physiologically based pharmacokinetic and PK/PD models be given more weight by regulatory authorities when assessing the therapeutic equivalence of drug products.
Summary
Modelling and simulation approaches already play an important role in drug development. While slowly moving away from ‘one-size fits all’ PK methodologies to assess therapeutic outcomes, further work is required to increase confidence in PK/PD models in translatability and prediction of various clinical scenarios to encourage more widespread implementation in regulatory decision-making.
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Affiliation(s)
| | - Rafael L M Paraiso
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt am Main, Germany
| | - Nikoletta Fotaki
- Department of Pharmacy and Pharmacology, Faculty of Science, University of Bath, Bath, UK
| | | | - Rodrigo Cristofoletti
- Division of Therapeutic Equivalence, Brazilian Health Surveillance Agency (ANVISA), Brasilia, Brazil
| | - Jennifer Dressman
- Institute of Pharmaceutical Technology, Goethe University, Frankfurt am Main, Germany
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9
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Srinandan V, Nagappan K, Patel S, Yamjala K, Byran G, Babu B. Simultaneous Quantification of Pantoprazole and Levosulpiride in Spiked Human Plasma Using High Performance Liquid Chromatography Tandem Mass Spectrometry. CURR PHARM ANAL 2018. [DOI: 10.2174/1573412914666180101142646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Pantoprazole (PTZ) and Levosulpiride (LS) were proven as effective agents for
the treatment of Gastro-Esophageal Reflux Disease (GERD). It is a complex motor disorder that results
in regurgitation of the gastric contents into the lower esophagus with consequent symptoms such as
heart burn, retrosternal pain, dysphagia and belching.
Methods:
A rapid, sensitive, selective and specific liquid chromatography- electro spray ionization
tandem mass spectrometry (LC-MS/MS) method was developed for the simultaneous quantification of
Pantoprazole (PTZ) and Levosulpiride (LS) in spiked Human Plasma. The method utilized SPE as sample
preparation technique and the analysis was carried out on a HPLC system utilizing electro spray
ionization as interface and triple quadrupole mass analyzer for quantification in MRM possitive mode.
Iloperidone was used as internal standard (IS). Chromatographic separation was performed on a Phenomenex
C-18 Column (4.6 mm x 50 mm, 5µ) with an isocratic elution mode utilizing a mobile phase
composition of Solution containing a mixture of 70 volumes of acetonitrile: 30 volumes of methanol
and 10mM ammonium formate (pH 4.0) at the ratio of 80:20 % v/v. The flow rate was maintained at
0.3 mL/min.
Results:
PTZ, LS and IS were detected and quantified with proton adducts at m/z 383.37→200.00, m/z
341.42→112.15 and 426.48→261.00 respectively. The linearity and range was established by fortifying
blank plasma samples in the concentration range of 3.5-2000 ng/mL for PTZ and 3.0-2400 ng/mL for
LS. The correlation coefficient (r2) was found to be ≥ 0.993 for PTZ and (r2) ≥ 0.990 for LS. The lower
limit of quantification for PTZ was 3.5 ng/mL and LS was 3.0 ng/mL. The intra and inter day precision
and accuracy for PTZ and LS were within the limits fulfilling the international acceptance criteria. PTZ
and LS were found to be stable throughout three freeze-thaw cycles, bench top and short term stability
studies.
Conclusion:
The proposed validated LC-MS/MS method offers a sensitive quantification of PTZ and
LS in spiked human plasma and can be utilized for the quantification of PTZ and LS in real-time
samples.
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Affiliation(s)
- Vulli Srinandan
- Department of Pharmaceutical Analysis, JSS College of Pharmacy, A Constituent College of Jagadguru Sri Shivarathreeshwara University, Mysuru, Udhagamandalam, India
| | - Krishnaveni Nagappan
- Department of Pharmaceutical Analysis, JSS College of Pharmacy, A Constituent College of Jagadguru Sri Shivarathreeshwara University, Mysuru, Udhagamandalam, India
| | - Sonam Patel
- Department of Pharmaceutical Analysis, JSS College of Pharmacy, A Constituent College of Jagadguru Sri Shivarathreeshwara University, Mysuru, Udhagamandalam, India
| | - Karthik Yamjala
- Department of Pharmaceutical Analysis, JSS College of Pharmacy, A Constituent College of Jagadguru Sri Shivarathreeshwara University, Mysuru, Udhagamandalam, India
| | - Gowramma Byran
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, A Constituent College of Jagadguru Sri Shivarathreeshwara University, Mysuru, Udhagamandalam, India
| | - Basavan Babu
- Department of Pharmaceutical Analysis, JSS College of Pharmacy, A Constituent College of Jagadguru Sri Shivarathreeshwara University, Mysuru, Udhagamandalam, India
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Horta RP, do Amaral B, Peralta-Zamora PG, Silva BJG. Evaluation of a Hollow-Fiber Liquid-Phase Microextraction Technique for the Simultaneous Determination of PPI Drugs in Human Plasma by LC-DAD. J Chromatogr Sci 2018; 56:564-573. [PMID: 29608667 DOI: 10.1093/chromsci/bmy023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 03/12/2018] [Indexed: 12/13/2022]
Abstract
This study involved the development, validation and application of a three-phase hollow-fiber liquid-phase microextraction (HF-LPME) and liquid chromatography with diode array detection (LC-DAD) method for the simultaneous determination of the proton pump inhibitor (PPI) drugs omeprazole, pantoprazole and lansoprazole in human plasma. The evaluation of the HF-LPME parameters was crucial for the determination of the drugs and the conditions selected were: 1-octanol as solvent; phosphate buffer at pH 5 as donor phase; borate buffer at pH 10 as acceptor phase; extraction time of 15 min; stirring at 750 rpm and NaCl was added at 5% (w/v). Validation of the method according to US-FDA recommendations showed a good linear range (0.2-2.0 μg/mL) for all analytes, with a determination coefficient >0.9910. Precision was evaluated using intra- and inter-day assays, which showed relative standard deviations (RSD), <15% for all concentrations, with a limit of quantification (LOQ) of 0.2 μg/mL. Accuracy was also assessed at these concentration levels and was in the range from 80 to 130%. Finally, the sensitive, selective and reproducible HF-LPME/LC-DAD developed method was successfully applied to human plasma samples from patients undergoing therapy with the PPI drugs.
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Affiliation(s)
- Rayta Paim Horta
- Departamento de Química, Universidade Federal do Paraná, C.P. 19081, Curitiba, Brazil
| | - Bianca do Amaral
- Departamento de Química, Universidade Federal do Paraná, C.P. 19081, Curitiba, Brazil
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Formulation and in-vitro evaluation of pantoprazole loaded pH-sensitive polymeric nanoparticles. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2017. [DOI: 10.1016/j.fjps.2017.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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12
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Strand DS, Kim D, Peura DA. 25 Years of Proton Pump Inhibitors: A Comprehensive Review. Gut Liver 2017; 11:27-37. [PMID: 27840364 PMCID: PMC5221858 DOI: 10.5009/gnl15502] [Citation(s) in RCA: 343] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 02/07/2016] [Indexed: 12/13/2022] Open
Abstract
Proton pump inhibitors (PPIs) were clinically introduced more than 25 years ago and have since proven to be invaluable, safe, and effective agents for the management of a variety of acid-related disorders. Although all members in this class act in a similar fashion, inhibiting active parietal cell acid secretion, there are slight differences among PPIs relating to their pharmacokinetic properties, metabolism, and Food and Drug Administration (FDA)-approved clinical indications. Nevertheless, each is effective in managing gastroesophageal reflux disease and uncomplicated or complicated peptic ulcer disease. Despite their overall efficacy, PPIs do have some limitations related to their short plasma half-lives and requirement for meal-associated dosing, which can lead to breakthrough symptoms in some individuals, especially at night. Longer-acting PPIs and technology to prolong conventional PPI activity have been developed to specifically address these limitations and may improve clinical outcomes.
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Affiliation(s)
- Daniel S Strand
- Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA, USA
| | - Daejin Kim
- Division of Gastroenterology, Daegu Fatima Hospital, Daegu, Korea
| | - David A Peura
- Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA, USA
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13
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Batchelor R, Gilmartin JFM, Kemp W, Hopper I, Liew D. Dementia, cognitive impairment and proton pump inhibitor therapy: A systematic review. J Gastroenterol Hepatol 2017; 32:1426-1435. [PMID: 28128476 DOI: 10.1111/jgh.13750] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/16/2017] [Accepted: 01/21/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM Proton pump inhibitors (PPIs) are among the most widely used medications worldwide. Dementia is an increasingly common cause of disability in older populations. Recent studies have suggested an increased risk of cognitive impairment and dementia diagnosis among people who consume PPIs. This systematic review explores dementia, cognitive impairment, and the use of PPIs. METHODS Systematic searches were conducted in the databases of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PSYCinfo, Scopus, Web of Science, and ClinicalTrials.gov for articles published from inception to June 30, 2016. Primary outcomes of interest were the use of PPIs and diagnosis of dementia or acute cognitive impairment. Studies conducted on people aged less than 18 years old were excluded. All study designs were eligible for inclusion. Two reviewers independently assessed study quality and extracted data from included studies. RESULTS The systematic search strategy and screening process yielded 11 studies for inclusion in the systematic review. Four studies explored PPI use and dementia, and seven studies explored PPI use and acute cognitive impairment. Three of the four studies exploring dementia identified a positive association with PPI use. A positive association was also observed in the majority of studies exploring acute cognitive impairment. CONCLUSIONS Based on the current published literature, this systematic review has identified that the reported association between PPI use and dementia is limited by methodological issues and conflicting results. Further longitudinal studies with robust bias limitation are required to explore the use of PPIs and dementia or acute cognitive impairment, and to ascertain the existence of any causal relationships.
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Affiliation(s)
- Riley Batchelor
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Julia Fiona-Maree Gilmartin
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Research Department of Practice and Policy, University College London School of Pharmacy, London, UK
| | - William Kemp
- Department of Gastroenterology, Alfred Hospital, Melbourne, Australia
| | - Ingrid Hopper
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Danny Liew
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Khotavivattana T, Calderwood S, Verhoog S, Pfeifer L, Preshlock S, Vasdev N, Collier TL, Gouverneur V. Synthesis and Reactivity of 18F-Labeled α,α-Difluoro-α-(aryloxy)acetic Acids. Org Lett 2017; 19:568-571. [DOI: 10.1021/acs.orglett.6b03730] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Samuel Calderwood
- Chemistry
Research Laboratory, University of Oxford, Mansfield Road, Oxford OX1 3TA, U.K
| | - Stefan Verhoog
- Chemistry
Research Laboratory, University of Oxford, Mansfield Road, Oxford OX1 3TA, U.K
| | - Lukas Pfeifer
- Chemistry
Research Laboratory, University of Oxford, Mansfield Road, Oxford OX1 3TA, U.K
| | - Sean Preshlock
- Chemistry
Research Laboratory, University of Oxford, Mansfield Road, Oxford OX1 3TA, U.K
| | - Neil Vasdev
- Division
of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston 02114, United States
- Department
of Radiology, Harvard Medical School, 55 Fruit Street, Boston 02114, United States
| | - Thomas L. Collier
- Division
of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston 02114, United States
- Department
of Radiology, Harvard Medical School, 55 Fruit Street, Boston 02114, United States
- Advion BioSystems, 10
Brown Road, Suite 101, Ithaca, New York 14850, United States
| | - Véronique Gouverneur
- Chemistry
Research Laboratory, University of Oxford, Mansfield Road, Oxford OX1 3TA, U.K
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15
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Li S, Jiang H, Wang Y, Liu Y, Shen X, Liang W, Hong Z. High-Throughput Chiral LC-MS/MS Method Using Overlapping Injection Mode for the Determination of Pantoprazole Enantiomers in Human Plasma with Application to Pharmacokinetic Study. Chirality 2016; 28:569-75. [DOI: 10.1002/chir.22616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/15/2016] [Accepted: 05/25/2016] [Indexed: 01/20/2023]
Affiliation(s)
- Shengni Li
- Department of Pharmaceutical Analysis, School of Pharmacy; Second Military Medical University; People's Republic of China
- Bioanalytical Services; WuXi AppTec Co., Ltd., Waigaoqiao Free Trade Zone; Shanghai People's Republic of China
| | - Huafang Jiang
- Bioanalytical Services; WuXi AppTec Co., Ltd., Waigaoqiao Free Trade Zone; Shanghai People's Republic of China
| | - Yiya Wang
- Bioanalytical Services; WuXi AppTec Co., Ltd., Waigaoqiao Free Trade Zone; Shanghai People's Republic of China
| | - Yinli Liu
- Department of Pharmaceutical Analysis, School of Pharmacy; Second Military Medical University; People's Republic of China
| | - Xiaohang Shen
- Bioanalytical Services; WuXi AppTec Co., Ltd., Waigaoqiao Free Trade Zone; Shanghai People's Republic of China
| | - Wenzhong Liang
- Bioanalytical Services; WuXi AppTec Co., Ltd., Waigaoqiao Free Trade Zone; Shanghai People's Republic of China
| | - Zhanying Hong
- Department of Pharmaceutical Analysis, School of Pharmacy; Second Military Medical University; People's Republic of China
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Jackson MA, Goodrich JK, Maxan ME, Freedberg DE, Abrams JA, Poole AC, Sutter JL, Welter D, Ley RE, Bell JT, Spector TD, Steves CJ. Proton pump inhibitors alter the composition of the gut microbiota. Gut 2016; 65:749-56. [PMID: 26719299 PMCID: PMC4853574 DOI: 10.1136/gutjnl-2015-310861] [Citation(s) in RCA: 584] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 11/25/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Proton pump inhibitors (PPIs) are drugs used to suppress gastric acid production and treat GI disorders such as peptic ulcers and gastro-oesophageal reflux. They have been considered low risk, have been widely adopted, and are often over-prescribed. Recent studies have identified an increased risk of enteric and other infections with their use. Small studies have identified possible associations between PPI use and GI microbiota, but this has yet to be carried out on a large population-based cohort. DESIGN We investigated the association between PPI usage and the gut microbiome using 16S ribosomal RNA amplification from faecal samples of 1827 healthy twins, replicating results within unpublished data from an interventional study. RESULTS We identified a significantly lower abundance in gut commensals and lower microbial diversity in PPI users, with an associated significant increase in the abundance of oral and upper GI tract commensals. In particular, significant increases were observed in Streptococcaceae. These associations were replicated in an independent interventional study and in a paired analysis between 70 monozygotic twin pairs who were discordant for PPI use. We propose that the observed changes result from the removal of the low pH barrier between upper GI tract bacteria and the lower gut. CONCLUSIONS Our findings describe a significant impact of PPIs on the gut microbiome and should caution over-use of PPIs, and warrant further investigation into the mechanisms and their clinical consequences.
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Affiliation(s)
- Matthew A Jackson
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Julia K Goodrich
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA,Department of Microbiology, Cornell University, Ithaca, New York, USA
| | | | - Daniel E Freedberg
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Julian A Abrams
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Angela C Poole
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA,Department of Microbiology, Cornell University, Ithaca, New York, USA
| | - Jessica L Sutter
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA,Department of Microbiology, Cornell University, Ithaca, New York, USA
| | - Daphne Welter
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA,Department of Microbiology, Cornell University, Ithaca, New York, USA
| | - Ruth E Ley
- Department of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA,Department of Microbiology, Cornell University, Ithaca, New York, USA
| | - Jordana T Bell
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
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17
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Di Giuseppe A, Castarlenas R, Oro LA. Rhodium Catalysts for C–S Bond Formation. TOP ORGANOMETAL CHEM 2016. [DOI: 10.1007/3418_2016_171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Gallucci G, Tartarone A, Lombardi L, Aieta M. When crizotinib-induced bradycardia becomes symptomatic: role of concomitant drugs. Expert Rev Anticancer Ther 2015; 15:761-3. [DOI: 10.1586/14737140.2015.1045493] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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19
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Dabiri Y, Fahimi F, Jamaati H, Hashemian SMR. The comparison of extemporaneous preparations of omeprazole, pantoprazole oral suspension and intravenous pantoprazole on the gastric pH of critically ill-patients. Indian J Crit Care Med 2015; 19:21-6. [PMID: 25624646 PMCID: PMC4296406 DOI: 10.4103/0972-5229.148635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Stress-related mucosal disease occurs in many critically ill-patients within 24 h of admission. Proton pump inhibitor therapy has been documented to produce more potent inhibition of gastric acid secretion than histamine 2 receptor antagonists. This study aimed to compare extemporaneous preparations of omeprazole, pantoprazole oral suspension and intravenous (IV) pantoprazole on the gastric pH in intensive care unit patients. Materials and Methods: This was a randomized single-blind-study. Patients of ≥ 16 years of age with a nasogastric tube, who required mechanical ventilation for ≥ 48 h, were eligible for inclusion. The excluded patients were those with active gastrointestinal bleeding, known allergy to omeprazole and pantoprazole and those intolerant to the nasogastric tube. Fifty-six patients were randomized to treatment with omeprazole suspension 2 mg/ml (40 mg every day), pantoprazole suspension 2 mg/ml (40 mg every day) and IV pantoprazole (40 mg every day) for up to 14 days. Gastric aspirates were sampled before and 1-2.5 h after the drug administration for the pH measurement using an external pH meter. Data were analyzed using SPSS (version 21.0). Results: In this study, 56 critically ill-patients (39 male, 17 female, mean age: 61.5 ± 15.65 years) were followed for the control of the gastric pH. On each of the 14 trial days the mean of the gastric pH alteration was significantly higher in omeprazole and pantoprazole suspension-treated patients than in IV pantoprazole-treated patients (P < 0.001). Conclusion: Omeprazole and pantoprazole oral suspension are more effective than IV pantoprazole in increasing the gastric pH.
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Affiliation(s)
- Yasamin Dabiri
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fanak Fahimi
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Jamaati
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Reza Hashemian
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Battu S, Pottabathini V. Hydrolytic Degradation Study of Lansoprazole, Identification, Isolation and Characterisation of Base Degradation Product. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ajac.2015.62013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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21
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Liang JF, Chen YT, Fuh JL, Li SY, Chen TJ, Tang CH, Wang SJ. Proton pump inhibitor-related headaches: A nationwide population-based case-crossover study in Taiwan. Cephalalgia 2014; 35:203-10. [DOI: 10.1177/0333102414535114] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Headaches resulting from proton pump inhibitor (PPI) use could cause discontinuation of PPI in as many as 40% of patients who experience such headaches. Previous studies focusing on acute headache risk from PPI use are rare and limited to clinical trials of a single PPI. Objectives To investigate the association between PPI use and headache with a nationwide population-based case-crossover study. Methods Records containing the first diagnosis of any headache, including migraine and tension-type headaches, were retrieved from Taiwan National Health Insurance Database (1998–2010). We compared the rates of PPI use for cases and controls during time windows of 7, 14, and 28 days. The adjusted self-matched odds ratios (ORs) and 95% confidence intervals (CIs) from a conditional logistic regression model were used to determine the association between PPI use and headache. Results Overall, 314,210 patients with an initial diagnosis of any headache during the study period were enrolled. The adjusted ORs for headache risk after PPI exposure were calculated for three time periods (within 7 days = 1.41, p = 0.002, 95% CI 1.14–1.74; within 14 days = 1.36, p < 0.001, 95% CI 1.16–1.59; within 28 days = 1.20, p = 0.002, 95% CI 1.07–1.35). Subgroup analyses showed female patients had an increased risk of headache. Among PPIs, lansoprazole and esomeprazole had the highest risks of headache incidence, which were similar to that of nitrates. Conclusion PPI usage is associated with an increased risk for acute headache. Female patients and use of lansoprazole or esomeprazole present the greatest risks of headache.
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Affiliation(s)
- Jen-Feng Liang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan
- Department of Medical Education, Taipei Veterans General Hospital, Taiwan
- School of Medicine, National Yang-Ming University, Taiwan
| | - Yung-Tai Chen
- School of Medicine, National Yang-Ming University, Taiwan
- Department of Nephrology, Taipei City Hospital Heping Fuyou Branch, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan
- School of Medicine, National Yang-Ming University, Taiwan
| | - Szu-Yuan Li
- School of Medicine, National Yang-Ming University, Taiwan
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Taiwan
| | - Chao-Hsiun Tang
- School of Health Care Administration, Taipei Medical University, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan
- School of Medicine, National Yang-Ming University, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taiwan
- Brain Research Center, National Yang-Ming University, Taiwan
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22
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Zhang S, Wang Y, Li SJ. Lansoprazole induces apoptosis of breast cancer cells through inhibition of intracellular proton extrusion. Biochem Biophys Res Commun 2014; 448:424-9. [PMID: 24802401 DOI: 10.1016/j.bbrc.2014.04.127] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 04/24/2014] [Indexed: 11/29/2022]
Abstract
The increased glycolysis and proton secretion in tumors is proposed to contribute to the proliferation and invasion of cancer cells during the process of tumorigenesis and metastasis. Here, treatment of human breast cancer cells with proton pump inhibitor (PPI) lansoprazole (LPZ) induces cell apoptosis in a dose-dependent manner. In the implantation of the MDA-MB-231 xenografts in nude mice, administration of LPZ significantly inhibits tumorigenesis and induces large-scale apopotosis of tumor cells. LPZ markedly inhibits intracellular proton extrusion, induces an increase in intracellular ATP level, lysosomal alkalinization and accumulation of reactive oxygen species (ROS) in breast cancer cells. The ROS scavenger N-acetyl-l-cysteine (NAC) and diphenyleneiodonium (DPI), a specific pharmacological inhibitor of NADPH oxidases (NOX), significantly abolish LPZ-induced ROS accumulation in breast cancer cells. Our results suggested that LPZ may be used as a new therapeutic drug for breast tumor.
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Affiliation(s)
- Shangrong Zhang
- Department of Biophysics, School of Physics Science, The Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, Tianjin 300071, PR China
| | - Yifan Wang
- Department of Biophysics, School of Physics Science, The Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, Tianjin 300071, PR China
| | - Shu Jie Li
- Department of Biophysics, School of Physics Science, The Key Laboratory of Bioactive Materials, Ministry of Education, Nankai University, Tianjin 300071, PR China.
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23
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Cea Soriano L, Ruigómez A, Johansson S, García Rodríguez LA. Study of the Association Between Hip Fracture and Acid-Suppressive Drug Use in a UK Primary Care Setting. Pharmacotherapy 2014; 34:570-81. [DOI: 10.1002/phar.1410] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Lucia Cea Soriano
- Spanish Centre for Pharmacoepidemiologic Research (CEIFE); Madrid Spain
| | - Ana Ruigómez
- Spanish Centre for Pharmacoepidemiologic Research (CEIFE); Madrid Spain
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Chimirri S, Aiello R, Mazzitello C, Mumoli L, Palleria C, Altomonte M, Citraro R, De Sarro G. Vertigo/dizziness as a Drugs' adverse reaction. J Pharmacol Pharmacother 2013; 4:S104-9. [PMID: 24347974 PMCID: PMC3853661 DOI: 10.4103/0976-500x.120969] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Vertigo, dizziness, and nausea encompass a spectrum of balance-related symptoms caused by a variety of etiologies. Balance is affected by many systems: Proprioceptive pathways and visual, cerebellar, vestibulocochlear, and vascular / vasovagal systems. Vertigo is a subtype of dizziness, in which a subject, as a result to a dysfunction of the vestibular system, improperly experiments the perception of motion. The most useful clinical subdivision is to categorize vertigo into true vertigo and pseudovertigo, whereas from a pathophysiological point of view, vertigo can be classified into central, peripheral, and psychogenic. It is not easy to identify the cause of vertigo since the patients often are not able to precisely describe their symptoms. An impressive list of drugs may cause vertigo or dizziness. MATERIALS AND METHODS The aim of the present study was to analyze the data extracted from the reporting cards of the ADRs (adverse drug reactions), received at our Pharmacovigilance Regional Center (Calabria, Italy) in 2012. In particular, the data concerning the occurrence of vertigo and dizziness, after taking certain classes of drugs, have been considered. RESULTS Our results show that, among the side-effects of different classes of drugs such as anti-convulsants, anti-hypertensives, antibiotics, anti-depressants, anti-psychotics, and anti-inflammatory, also vertigo or dizziness are included. CONCLUSIONS Spontaneous reports of vertigo or dizziness, as side-effect of certain drugs, received at our Pharmacovigilance Center, represented the 5% of all reports in 2012. Considering the high incidence of such an ADR for several drugs' classes, it can be speculated that under-reporting also affect vertigo and dizziness. Despite the fact that these ADRs might not represent a direct threaten for life, indirectly they can cause secondary damage to patients such as falls, fractures etc. Balance should be accurately monitored during drug use and particularly in fragile patients.
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Affiliation(s)
- Serafina Chimirri
- Department of Science of Health, School of Medicine, University of Catanzaro, Italy and Pharmacovigilance's Center Calabria Region, University Hospital Mater Domini, Catanzaro, Italy
| | - Rossana Aiello
- Department of Science of Health, School of Medicine, University of Catanzaro, Italy and Pharmacovigilance's Center Calabria Region, University Hospital Mater Domini, Catanzaro, Italy
| | - Carmela Mazzitello
- Department of Science of Health, School of Medicine, University of Catanzaro, Italy and Pharmacovigilance's Center Calabria Region, University Hospital Mater Domini, Catanzaro, Italy
| | - Laura Mumoli
- Department of Science of Health, School of Medicine, University of Catanzaro, Italy and Pharmacovigilance's Center Calabria Region, University Hospital Mater Domini, Catanzaro, Italy
| | - Caterina Palleria
- Department of Science of Health, School of Medicine, University of Catanzaro, Italy and Pharmacovigilance's Center Calabria Region, University Hospital Mater Domini, Catanzaro, Italy
| | | | - Rita Citraro
- Department of Science of Health, School of Medicine, University of Catanzaro, Italy and Pharmacovigilance's Center Calabria Region, University Hospital Mater Domini, Catanzaro, Italy
| | - Giovambattista De Sarro
- Department of Science of Health, School of Medicine, University of Catanzaro, Italy and Pharmacovigilance's Center Calabria Region, University Hospital Mater Domini, Catanzaro, Italy
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25
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Yehia AM. Development and validation of new spectrophotometric ratio H-point standard addition method and application to gastrointestinal acting drugs mixtures. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2013; 109:193-200. [PMID: 23523762 DOI: 10.1016/j.saa.2013.02.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Revised: 02/05/2013] [Accepted: 02/18/2013] [Indexed: 06/02/2023]
Abstract
New, simple, specific, accurate and precise spectrophotometric technique utilizing ratio spectra is developed for simultaneous determination of two different binary mixtures. The developed ratio H-point standard addition method (RHPSAM) was managed successfully to resolve the spectral overlap in itopride hydrochloride (ITO) and pantoprazole sodium (PAN) binary mixture, as well as, mosapride citrate (MOS) and PAN binary mixture. The theoretical background and advantages of the newly proposed method are presented. The calibration curves are linear over the concentration range of 5-60 μg/mL, 5-40 μg/mL and 4-24 μg/mL for ITO, MOS and PAN, respectively. Specificity of the method was investigated and relative standard deviations were less than 1.5. The accuracy, precision and repeatability were also investigated for the proposed method according to ICH guidelines.
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Affiliation(s)
- Ali M Yehia
- Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, El-Kasr El-Aini Street, 11562 Cairo, Egypt.
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26
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Kianmehr E, Shamsaei Zafarghandi N, Ghanbari M. A simple route for the synthesis of novel N-alkyl-2-(alkylthio)-1H-imidazole derivatives. Mol Divers 2013; 17:383-8. [PMID: 23456639 DOI: 10.1007/s11030-013-9430-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 02/12/2013] [Indexed: 11/28/2022]
Abstract
Novel N-alkyl-2-(alkylthio)-1H-imidazole derivatives were synthesized in a single step by an efficient and simple method in high yields. Readily available starting materials, mild reaction conditions, operational simplicity and novelty are the key advantages of this method. Besides their novel structures, these compounds may have important biological activities and industrial applications.
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Affiliation(s)
- Ebrahim Kianmehr
- School of Chemistry, College of Science, University of Tehran, Tehran, Iran.
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Brunner G, Athmann C, Schneider A. Long-term, open-label trial: safety and efficacy of continuous maintenance treatment with pantoprazole for up to 15 years in severe acid-peptic disease. Aliment Pharmacol Ther 2012; 36:37-47. [PMID: 22531114 DOI: 10.1111/j.1365-2036.2012.05106.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 12/09/2011] [Accepted: 04/03/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND To date, the safety and tolerability of proton pump inhibitors (PPIs) have been demonstrated in studies of up to 10 years. AIM To report on the tolerability, safety and efficacy of up to 15 years' continuous treatment with pantoprazole in patients with severe acid-peptic disease. METHODS Following healing of endoscopically confirmed peptic ulcer or reflux oesophagitis during 4-12 weeks' treatment with pantoprazole (40-80 mg/day), adult patients received open-label maintenance treatment with pantoprazole (40-160 mg/day) for up to 15 years in a single centre combined study (10-year initial study; 5-year extension study). Safety assessments were carried out using endoscopy, clinical examination, clinical laboratory investigations, serum gastrin determination, gastric mucosal histology and mucosal endocrine cell quantification. RESULTS The safety set comprised 142 patients. At 12 weeks, healing rates were 95.8%. During long-term treatment, mean fasting gastrin levels rose from baseline to moderate levels throughout the study. Mean enterochromaffin-like cell density showed a moderate initial increase during the first 3 years, remaining stable thereafter. These changes were not associated with any clinically relevant changes of the gastric mucosa. Patients with successful Helicobacter pylori eradication showed long-term regression of antral and corpus gastritis during continued pantoprazole treatment. CONCLUSIONS Daily pantoprazole maintenance therapy for up to 15 years for severe acid-peptic disease is effective and well tolerated, with no identified safety concerns. The longest study to date, these data provide reassuring evidence for the long-term safety of pantoprazole.
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Affiliation(s)
- G Brunner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Medical School, Hannover, Germany.
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28
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A randomized controlled trial of adding intravenous pantoprazole to conventional treatment for the immediate relief of dyspeptic pain. Am J Emerg Med 2012; 30:1737-42. [PMID: 22463973 DOI: 10.1016/j.ajem.2012.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 01/30/2012] [Accepted: 02/01/2012] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Acute, severe dyspeptic pain is a common condition in the emergency department. Despite the traditional "GI cocktail" (GI indicates gastrointestinal), an intravenous (IV) proton pump inhibitor (PPI), a novel acid-lowering drug, has recently been used to treat this condition. The aim of this study was to evaluate the immediate effect of IV pantoprazole in addition to the conventional GI cocktail in the relief of severe dyspeptic pain. METHODS This double-blind, randomized, controlled study was conducted in the emergency department of an urban tertiary-care hospital from January 2011 to October 2011. Selected patients with severe dyspeptic pain were randomized to treatment with a placebo, antacid, and antispasmodic (conventional group) or IV pantoprazole, antacid, and antispasmodic (pantoprazole group). The self-reported 100-mm visual analog scale score, adverse effects, and overall satisfaction were evaluated in 15-minute intervals for 60 minutes. RESULTS Eighty-seven eligible cases were enrolled in the study. Forty-four and 43 patients were randomized in the conventional group and pantoprazole group, respectively. There was no difference in the mean 60-minute visual analog scale scores between the treatment groups. The rate of "responders," additional drug use, adverse effects, and patient satisfaction were similar between the groups. CONCLUSION Intravenous PPI provides no additional benefit over the conventional GI cocktail in the relief of acute, severe dyspeptic pain. Because of its neutral effect and higher cost, the use of IV PPI to treat such conditions should be discouraged in general clinical practice.
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van Rensburg CJ, Cheer S. Pantoprazole for the treatment of peptic ulcer bleeding and prevention of rebleeding. CLINICAL MEDICINE INSIGHTS. GASTROENTEROLOGY 2012; 5:51-60. [PMID: 24833934 PMCID: PMC3987766 DOI: 10.4137/cgast.s9893] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Adding proton pump inhibitors (PPIs) to endoscopic therapy has become the mainstay of treatment for peptic ulcer bleeding, with current consensus guidelines recommending high-dose intravenous (IV) PPI therapy (IV bolus followed by continuous therapy). However, whether or not high-dose PPI therapy is more effective than low-dose PPI therapy is still debated. Furthermore, maintaining pH ≥ 4 appears to prevent mucosal bleeding in patients with acute stress ulcers; thus, stress ulcer prophylaxis with acid-suppressing therapy has been increasingly recommended in intensive care units (ICUs). This review evaluates the evidence for the efficacy of IV pantoprazole, a PPI, in preventing ulcer rebleeding after endoscopic hemostasis, and in controlling gastric pH and protecting against upper gastrointestinal (GI) bleeding in high-risk ICU patients. The review concludes that IV pantoprazole provides an effective option in the treatment of upper GI bleeding, the prevention of rebleeding, and for the prophylaxis of acute bleeding stress ulcers.
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Affiliation(s)
| | - Susan Cheer
- Director, Freelance Writing Works: a division of Creative Ink Ltd, Queenstown 9348, New Zealand
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SUD DHRUV, JOSEPH IANMP, KIRSCHNER DENISE. PREDICTING EFFICACY OF PROTON PUMP INHIBITORS IN REGULATING GASTRIC ACID SECRETION. J BIOL SYST 2011. [DOI: 10.1142/s0218339004000999] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Developing drugs to treat gastric acid related illnesses such as ulcers and acid reflux disease is the leading focus of pharmaceutical companies. In fact, expenditure for treating these disorders is highest among all illnesses in the US. Over the last few decades, a class of drugs known as a proton pump inhibitors (PPIs) appeared on the market and are highly effective at abating gastric illnesses by raising stomach pH (reducing gastric acid levels). While much is known about the action of PPIs , there are still open questions regarding their efficacy, dosing and long-term effects. Here we extend a previous gastric acid secretion model developed by our group to incorporate a pharmacodynamic/pharmacokinetic model to study proton pump inhibitor (PPI) action. Model-relevant parameters for specific drugs such as omeprazole (OPZ) , lansoprazole (LPZ) and pantoprazole (PPZ) were used from published data, and we conducted simulations to study various aspects of PPI treatment. Clinical data suggests that duration of acid suppression is dependent on proton pump turnover rates and this is supported by our model. We found the order of efficacy of the different PPIs to be OPZ>PPZ>LPZ for clinically recommended dose values, and OPZ>PPZ=LPZ for equal doses. Our results indicate that a breakfast dose for once-daily dosing regimens and a breakfast-lunch dose for twice-daily dosing regimens is recommended. Simulation of other gastric disorders using our model provides atypical applications for the study of drug treatment on homeostatic systems and identification of potential side-effects.
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Affiliation(s)
- DHRUV SUD
- Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, Michigan, USA
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - IAN M. P. JOSEPH
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - DENISE KIRSCHNER
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Hagymási K, Müllner K, Herszényi L, Tulassay Z. Update on the pharmacogenomics of proton pump inhibitors. Pharmacogenomics 2011; 12:873-88. [PMID: 21692617 DOI: 10.2217/pgs.11.4] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Proton pump inhibitors (PPIs) are widely used for the treatment of gastroesophageal reflux disease as well as other acid-related disorders. PPIs are metabolized primarily via the CYP2C19 and CYP3A4 isoenzymes; their activity is influenced both by exogenous and endogenous (pharmacogenetic) factors. The CYP2C19 polymorphism affects the metabolism of PPIs, causing large individual pharmacokinetic variations. Differences in the CYP2C19-mediated metabolism can produce marked interpatient variability in acid suppression, in drug-interaction potential and in clinical efficacy. Understanding the pharmacokinetic properties of PPIs and examining the pharmacogenetic alterations may help clinicians optimize PPI therapy and administer individual treatment, especially to nonresponder patients with gastroesophageal reflux disease or ulcer or after failed eradication therapy.
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Affiliation(s)
- Krisztina Hagymási
- Semmelweis University, II. Department of Internal Medicine, 1088 Budapest, Szentkirályi u. 46., Hungary.
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Hegazy MA, Yehia AM, Mostafa AA. Stability-Indicating Chromatographic Methods for Simultaneous Determination of Mosapride and Pantoprazole in Pharmaceutical Dosage Form and Plasma Samples. Chromatographia 2011. [DOI: 10.1007/s10337-011-2144-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Patel TK, Patel PB, Tripathi CB. Effect of pantoprazole and its interactions with vecuronium on the neuromuscular junction. Indian J Pharmacol 2011; 42:36-9. [PMID: 20606835 PMCID: PMC2885638 DOI: 10.4103/0253-7613.62410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Revised: 07/01/2009] [Accepted: 02/03/2010] [Indexed: 02/02/2023] Open
Abstract
Objective: To study the effect of pantoprazole on neuromuscular transmission and its interactions with vecuronium at the neuromuscular junction (NMJ). Materials and Methods: Effect of pantoprazole on neuromuscular transmission (2 μM – 16 mM) and reversal of neuromuscular blockade by pantoprazole and vecuronium with neostigmine (3.3 μM), 3,4-diaminopyridine (0.25 mM), KCl (6 mM), and CaCl2 (10 mM) were studied by the indirect and direct stimulated preparation of rat phrenic nerve hemidiaphragm. Cumulative reponse curves (CRC) of vecuronium (1 μM to 32 μM) were studied in the absence and presence of 32 μM, 64 μM, and 128 μM pantoprazole. Time for head drop by vecuronium infusion was recorded in the absence and presence of acute and chronic administration of pantoprazole (1.9 mg/kg) in rabbits. Results: Pantoprazole potentiated the basal contractile twitch responses at a lower concentration followed by neuromuscular blockade at a higher concentration. The neuromuscular blockade was not reversed by neostigmine (3.3 μM), 3,4-diaminopyridine (0.25 mM), KCl (6 mM), and CaCl2 (10 mM). Pantoprazole potentiated the vecuronium-induced neuromuscular blockade. It decreased the total time for complete blockade in rat phrenic nerve hemidiaphragm preparation (P < 0.05) and decreased the time for the head drop in rabbits with vecuronium infusion (P < 0.0001). Conclusion: Pantoprazole has a direct neuromuscular blocking action. It has the potential to interact with vecuronium.
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Affiliation(s)
- Tejas K Patel
- Department of Pharmacology, Government Medical College, Bhavnagar, Gujarat, India
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Bhattacharyya T, Sarbapalli D, Pal R, Sarkar U, Kar S, Kundu KK, Zaman FA. Evaluating ranitidine, pantoprazole and placebo on gastric pH in elective surgery. Saudi J Anaesth 2011; 5:67-72. [PMID: 21655020 PMCID: PMC3101757 DOI: 10.4103/1658-354x.76508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background and Aim: Concern about the grim nature of postoperative acid aspiration syndrome grew among the anesthesiologist over the years warranting the need for pre-emptive intervention. The aim of the study is to compare the effects of preoperative oral ranitidine versus pantoprazole given in regulating gastric pH in elective surgery. Methods: This prospective, parallel group, controlled, randomized, single-blind study was conducted at a tertiary care postgraduate teaching institute at Kolkata, involving 120 participants of either sex, aged 18-60 years of American Society of Anesthesiologists physical status I and II, who were scheduled for elective surgery under general anesthesia lasting for more than 2 h. The participants were divided into three groups. In group A (n=40) participants received placebo tablet, in group B (n=40) participants received ranitidine tablet while in group C (n=40), participants received pantoprazole tablet and their gastric pH estimated serially. Results: The participants in the three groups were comparable in terms of age, sex, body weight, duration of surgery and type of surgery distribution. In regard to changes in gastric pH trends, there was no statistically significant difference between serial pH values in group A (Friedman test; P>0.05) and group C participants. (P>0.05). However, the mean preoperative gastric pH values (7.140±.7652) were significantly lower than mean pH values (7.253±.7514) after 2 h postoperatively in group B participants (P<0.05). Conclusion: From the observations and analyses of the present study, it can be inferred that ranitidine is more effective than pantoprazole to raise the gastric pH for prevention of aspiration pneumonitis.
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Affiliation(s)
- Tapas Bhattacharyya
- Department of Anaesthesiology, Institute of Postgraduate Medical Education & Research (IPGME&R), Kolkata, India
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Different antiulcer activities of pantoprazole in stress, alcohol and pylorus ligation-induced ulcer models. Lab Anim Res 2011; 27:47-52. [PMID: 21826160 PMCID: PMC3145982 DOI: 10.5625/lar.2011.27.1.47] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 02/27/2011] [Accepted: 03/04/2011] [Indexed: 11/25/2022] Open
Abstract
Antiulcer effects of pantoprazole, a proton-pump inhibitor, on water-immersion restraint stress (WIRS)-, alcohol (ethanol)- and pylorus ligation-induced gastric ulcers were investigated in male rats. Rats were orally administered with pantoprazole 30 min prior to exposure to various types of ulcer inducers. In stress-induced ulcer model, rats were subjected to WIRS at 22℃ for 4 hours, and the degree of ulcer (in mm) was evaluated. In alcohol-induced ulcer model, rats were orally administered with pure (100%) ethanol (1 mL/kg), and the ulcer lesions were measured 1 hour after ethanol challenge. In pylorus ligation-induced ulcer model, rats were subjected to pylorus ligation, and the degree of erosions and ulcers was scored 17 hours after the operation. Pantoprazole attenuated the ulcer lesions induced by WIRS in a dose-dependent manner, exhibiting a median effective dose (ED50) value of 0.78 mg/kg. By comparison, pantoprazole was effective at relatively-high doses for the improvement of ethanol-induced ulcers, showing an ED50 value of 20.5 mg/kg. Notably, pantoprazole was practically ineffective (ED50>50.0) in pylorus ligation model. Taken together, it was confirmed that pantoprazole showed inhibitory activity on gastric ulcers induced by stress and alcohol, but was ineffective on pylorus ligation-induced ulcer. Therefore, the results indicate that proton-pump inhibitors including pantoprazole might reveal highly-different effects according to the type of ulcer inducers, and that the prescription of antiulcer agents should be carefully selected.
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Abstract
Rebound acid hypersecretion is defined as an increase in gastric acid secretion above pre-treatment levels after cessation of antisecretory therapy. Proton pump inhibitors (PPIs) have been proved to be more effective than histamine-2 receptor antagonists in suppressing intragastric acidity and have therefore become the main choice for management of acid-related complaints. Recent studies have shown that PPI therapy-elicited rebound acid hypersecretion could in turn induce acid-related symptoms. This makes it difficult for patients to cease PPI therapy. Hypergastrinemia is an important mechanism that leads to rebound acid hypersecretion. To reduce the occurrence of rebound acid hypersecretion, efforts should be made to restrict indications for using PPIs.
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Abstract
The proton pump inhibitors (PPIs) as a class are remarkably safe and effective for persons with peptic ulcer disorders. Serious adverse events are extremely rare for PPIs, with case reports of interstitial nephritis with omeprazole, hepatitis with omeprazole and lansoprazole, and disputed visual disturbances with pantoprazole and omeprazole. PPI use is associated with the development of fundic gland polyps (FGP); stopping PPIs is associated with regression of FGP. In the absence of Helicobacter pylori infection, the long-term use of PPIs has not been convincingly proven to cause or be associated with the progression of pre-existing chronic gastritis or gastric atrophy or intestinal metaplasia. Mild/modest hypergastrinemia is a physiological response to the reduction in gastric acid secretion due to any cause. The long-term use of PPIs has not been convincingly proven to cause enterochromaffin-like cell hyperplasia or carcinoid tumors. PPIs increase the risk of community acquired pneumonia, but not of hospital acquired (nosocomial) pneumonia. There is no data to support particular care in prescribing PPI therapy due to concerns about risk of hip fracture with the long-term use of PPIs. Long-term use of PPIs does not lead to vitamin B12 deficiencies, except possibly in the elderly, or in persons with Zollinger-Ellison Syndrome who are on high doses of PPI for prolonged periods of time. There is no convincingly proven data that PPIs increase the risk of Clostridium difficile-associated diarrhea in persons in the community. The discontinuation of PPIs may result in rebound symptoms requiring further and even continuous PPI use for suppression of symptoms. As with all medications, the key is to use PPIs only when clearly indicated, and to reassess continued use so that long-term therapy is used judiciously. Thus, in summary, the PPIs are a safe class of medications to use long-term in persons in whom there is a clear need for the maintenance of extensive acid inhibition.
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Mathews S, Reid A, Tian C, Cai Q. An update on the use of pantoprazole as a treatment for gastroesophageal reflux disease. Clin Exp Gastroenterol 2010; 3:11-6. [PMID: 21694841 PMCID: PMC3108659 DOI: 10.2147/ceg.s6355] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Indexed: 12/22/2022] Open
Abstract
Gastroesophageal reflux disease (GERD) is a chronic, recurrent disease that affects nearly 19 million people in the US. The mainstay of therapy for GERD is acid suppression. Proton pump inhibitors (PPIs) are the most effective medication for both initial treatment and maintenance therapy of GERD. Pantoprazole, a first-generation PPI, was approved by the FDA in 2000 for the treatment of erosive esophagitis associated with GERD. It has been used in more than 100 different countries worldwide. It is one of the few PPIs available in multiple forms: a delayed-release oral capsule, oral suspension, and intravenous. Pantoprazole been shown to improve acid reflux-related symptoms, heal esophagitis, and improve health-related quality of life more effectively than histamine-2 receptor antagonists. Evaluated in over 100 clinical trials, pantoprazole has an excellent safety profile, is as efficacious as other PPIs, and has a low incidence of drug interactions. It has also been shown to be safe and effective in special patient populations, such as the elderly and those with renal or moderate liver disease.
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Affiliation(s)
- Sony Mathews
- Division of Digestive Diseases, Department of Medicine, Emory University, School of Medicine, Atlanta, GA, USA
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Comoglu T, Gonul N, Dogan A, Basci N. Development and In Vitro Evaluation of Pantoprazole-Loaded Microspheres. Drug Deliv 2008; 15:295-302. [DOI: 10.1080/10717540802006864] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Sivakumar T, Manavalan R, Valliappan K. Computer-assisted optimization of liquid-liquid extraction for HPLC analysis of domperidone and pantoprazole in human plasma. ACTA CHROMATOGR 2008. [DOI: 10.1556/achrom.20.2008.4.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Tsai JJ, Lin HJ. Intermittent intravenous pantoprazole and continuous cimetidine infusion: effect on gastric pH control in critically ill patients at risk of developing stressed related mucosal disease. THE JOURNAL OF TRAUMA 2008; 65:1203-1204. [PMID: 19001996 DOI: 10.1097/ta.0b013e318184b519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Pettersen G, Mouksassi MS, Théorêt Y, Labbé L, Faure C, Nguyen B, Litalien C. Population pharmacokinetics of intravenous pantoprazole in paediatric intensive care patients. Br J Clin Pharmacol 2008; 67:216-27. [PMID: 19173681 DOI: 10.1111/j.1365-2125.2008.03328.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT The use of intravenous pantoprazole, a proton pump inhibitor, has been increasing in the paediatric intensive care unit. Despite this increased use, data on the disposition of intravenous pantoprazole in paediatric intensive care patients are very scarce. WHAT THIS STUDY ADDS Our population approach has determined the pharmacokinetic parameters of intravenous pantoprazole in paediatric intensive care patients and the relative importance of factors influencing its disposition. Pantoprazole clearance was significantly influenced by developmental changes and by the presence of systemic inflammatory syndrome, hepatic dysfunction and CYP2C19 inhibitors. AIMS To characterize the pharmacokinetics of intravenous pantoprazole in a paediatric intensive care population and to determine the influence of demographic factors, systemic inflammatory response syndrome (SIRS), hepatic dysfunction and concomitantly used CYP2C19 inducers and inhibitors on the drug's pharmacokinetics. METHODS A total of 156 pantoprazole concentration measurements from 20 patients (10 days to 16.4 years of age) at risk for or with upper gastrointestinal bleeding, who received pantoprazole doses ranging from 19.9 to 140.6 mg/1.73 m(2)/day, were analysed using a population pharmacokinetic approach (nonmem program). RESULTS The best structural model for pantoprazole was a two-compartment model with zero order infusion and first-order elimination. Body weight, SIRS, age, hepatic dysfunction and presence of CYP2C19 inhibitors were significant covariates affecting clearance (CL), accounting for 75% of interindividual variability. Only body weight significantly influenced central volume of distribution (V(c)). In the final population model, the estimated CL and V(c) were 5.28 l h(-1) and 2.22 l, respectively, for a typical 5-year-old child weighing 20 kg. Pantoprazole CL increased with weight and age, whereas the presence of SIRS, CYP2C19 inhibitors and hepatic dysfunction, when present separately, significantly decreased pantoprazole CL by 62.3, 65.8 and 50.5%, respectively. For patients aged between 6 months and 5 years without SIRS, CYP2C19 inhibitor or hepatic dysfunction, the predicted pantoprazole CL is faster than that reported in adults. CONCLUSION These results provide important information for physicians regarding selection of a starting dose and dosing regimens of pantoprazole for paediatric intensive care patients based on factors frequently encountered in this population.
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Affiliation(s)
- Géraldine Pettersen
- Clinical Pharmacology Unit, Department of Paediatrics, Divisions of Paediatric Critical Care, Centre Hospitalier Universitaire Sainte-Justine, 3175 chemin de la Côte Sainte-Catherine, Montréal, Québec, Canada
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Herberg KW, Hartmann M, Neukirchen B, Lühmann R, Thomas KB, Wurst W. Pantoprazole does not affect performance in traffic-related safety tests: a double-blind, randomised, placebo-controlled, crossover study in healthy volunteers. Clin Drug Investig 2008; 16:63-70. [PMID: 18370519 DOI: 10.2165/00044011-199816010-00008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
UNLABELLED OBJECTIVE AND STUDY PARTICIPANTS: The effects of pantoprazole, a potent inhibitor of gastric acid production, were evaluated in traffic-related performance tests in 18 healthy male and female volunteers, aged 18 to 60 years, in a randomised, placebo-controlled, double-blind, crossover study. METHODS Oral pantoprazole (40mg) or a placebo tablet was taken once a day for two periods of 5 days each, with a washout period of 7 to 14 days. Drug tolerability was assessed by vital signs, clinical laboratory parameters and volunteers' own subjective appraisal of their mental condition. The computerised Viennese test system (WTS 90) was used to examine parameters related to traffic safety including visual orientation, concentration span, acoustic reaction time, multiple choice reaction, stress, tolerance, vigilance and motor coordination. The effects were tested one day before and then on the first and fifth days of each medication period. RESULTS Results showed that in comparison with placebo, neither single nor multiple doses of pantoprazole led to clinically relevant differences in the performance of standardised, traffic-related safety tests. CONCLUSION Pantoprazole did not appear to impede normal everyday activities, including car driving, and thus can be administered without special precautions in this regard.
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Affiliation(s)
- K W Herberg
- Test Centre for the Influence of Drugs on Traffic Safety and Safety at Work (TUV) Rheinland, Cologne, Germany
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Mao Y, Zhang X, Li L, Yuan B, Lu G. Subchronic toxicity and toxicokinetics of LZB, a new proton pump inhibitor, after 13-week repeated oral administration in dogs. Regul Toxicol Pharmacol 2008; 50:75-86. [DOI: 10.1016/j.yrtph.2007.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 09/07/2007] [Accepted: 10/10/2007] [Indexed: 01/21/2023]
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Yeo M, Kim DK, Park HJ, Cho SW, Cheong JY, Lee KJ. Retraction: Blockage of intracellular proton extrusion with proton pump inhibitor induces apoptosis in gastric cancer. Cancer Sci 2008; 99:185. [PMID: 17956591 PMCID: PMC11158655 DOI: 10.1111/j.1349-7006.2007.00642.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2007] [Revised: 09/06/2007] [Accepted: 09/07/2007] [Indexed: 12/20/2022] Open
Abstract
The following article from Cancer Science, 'Blockage of intracellular proton extrusion with proton pump inhibitor induces apoptosis in gastric cancer' by Marie Yeo, Dong-Kyu Kim, Hee Jin Park, Sung Won Cho, Jae Youn Cheong and Kwang Jae Lee (doi: 10.1111/j.1349-7006.2007.00642.x), published online on 23 October 2007 on Blackwell Synergy (http://www.blackwell-synergy.com), has been retracted by agreement between the authors, the journal Editor in Chief, Takashi Tsuruo, and Blackwell Publishing. All authors wish to retract this paper because of the use of RGM-1 without the prior permission of the original establisher.
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Affiliation(s)
- Marie Yeo
- Genome Research Center for Gastroenterology, Ajou University School of Medicine, San 5, Wonchon-dong, Paldal-gu, Suwon 442-749, Korea
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Thanikachalam S, Rajappan M, Kannappan V. Stability-Indicating HPLC Method for Simultaneous Determination of Pantoprazole and Domperidone from their Combination Drug Product. Chromatographia 2007. [DOI: 10.1365/s10337-007-0452-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Forrester MB. Pattern of proton pump inhibitor calls to Texas poison centers, 1998-2004. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2007; 70:705-14. [PMID: 17365625 DOI: 10.1080/15287390601188045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
There is little information on the management of potentially adverse exposures to proton pump inhibitors. This study examined the distribution of 2943 proton pump inhibitor exposures reported to Texas poison control centers during 1998-2004. In particular comparisons were made between exposures among pediatric (age < or =5 yr) and adult (age > or =20 yr) patients. Of the total exposures, 1813 (62%) were to the proton pump inhibitor alone. Of exposures to proton pump inhibitors alone, 66% were age < or =5 yr, 7% 6-19 yr, and 27% > or =20 yr. Pediatric and adult patients differed with respect to patient gender, exposure reason, exposure site, management site, final medical outcome, report of specific adverse clinical exposures, and listed treatments. Proton pump inhibitor exposures differed with patient age. In the majority of instances, potentially adverse proton pump inhibitor exposures reported to poison control centers may be successfully managed at home with favorable outcome.
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Affiliation(s)
- Mathias B Forrester
- Epidemiology and Disease Surveillance Unit, Texas Department of State Health Services, Austin, Texas 78756, USA.
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Abstract
Medications to address gastrointestinal disorders are among the most commonly dispensed somatic medications. The authors examine proton pump inhibitors, H(2) blockers, 5-HT(3) receptor-antagonists, and a few other drugs that are used to address this domain of medical concerns. The metabolic pathways, interactions with the P-glycoprotein transporter, and capabilities of inhibiting or inducing metabolic enzymes are elucidated for each drug. Specific drug-drug interactions with each agent are also detailed, including both psychotropic and non-psychotropic agents. Also, the article explores how different genotypic variants for specific cytochrome P450 enzymes have an impact on the effectiveness and likelihood of drug-drug interactions relating to specific gastro-intestinal medications.
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Affiliation(s)
- Gary H Wynn
- Walter Reed Army Medical Center, Washington, DC, USA.
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Abstract
The prevalence of gastroesophageal reflux disease (GERD) increases with age and elderly are more likely to develop severe disease. Older patients often complain of less severe or frequent heartburn than younger patients and they may present with atypical symptoms such as dysphagia, weight loss, or extraesophageal symptoms. Proton pump inhibitors (PPIs) are central in the management of GERD and are unchallenged with regards to their efficacy. They are considered safe and more effective than histamine receptor antagonists for healing esophagitis and for preventing its recurrence using a long term maintenance treatment. PPI have minimal side effects and few slight drug interactions and are considered safe for long term treatment. Pantoprazole is significantly effective both for acute and long-term treatment with excellent control of relapse and symptoms. It is well tolerated even for long-term therapy and its tolerability is optimal. Pantoprazole shows to have minimal interactions with other drugs because of a lower affinity for cytocrome P450 than older PPIs. Although the majority of elderly has concomitant illnesses and receive other drugs, this does not adversely effect the efficacy of pantoprazole because of its pharmacokinetics, which are independent of patient age. Clinical practice suggests that a low dose maintenance of PPIs should be used in older patients with GERD.
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Affiliation(s)
- Carlo Calabrese
- Department of Internal Medicine and Gastroenterology, University of Bologna, Italy.
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