1
|
Coelho MM, Costa I, de Albuquerque ACF, Santos Junior FMD, Silva B, Silva R, Fernandes C, Remião F, Tiritan ME. Milligram scale enantioresolution of promethazine and its main metabolites, determination of their absolute configuration and assessment of enantioselective effects on human SY-SY5Y cells. J Pharm Biomed Anal 2024; 245:116152. [PMID: 38643704 DOI: 10.1016/j.jpba.2024.116152] [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: 03/03/2024] [Revised: 04/07/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024]
Abstract
The misuse of pharmaceuticals has significantly increased in recent decades, becoming a major public health concern. The risks associated with medication misuse are particularly high in cases of overdose, especially when the active substances are chiral, as enantioselectivity plays an important role in toxicity. Promethazine (PMZ) is a chiral antihistamine marketed as a racemate and it is misused in "Purple Drank", a recreational drug beverage, that combines codeine and/or PMZ, with soda or alcohol leading to serious health consequences and fatalities in consumers around the world, particularly among teenagers. Information regarding the enantioselectivity in the toxicity of (R,S)-PMZ and its main metabolites, namely promethazine sulfoxide (PMZSO) and desmonomethyl promethazine (DMPMZ), is unknown. This work reported, for the first time, the enantioseparation, in milligram scale, of (R,S)-PMZ, (R,S)-DMPMZ, (R,S)- PMZSO and the determination of their absolute configurations by electronic circular dichroism (ECD). The enantioseparation of all the six enantiomers was accomplished in a homemade semi-preparative column with amylose tris-3,5-dimethylphenylcarbamate (AD) coated with aminopropyl Nucleosil silica. The enantiomeric purity was evaluated using the analytical Lux® 3 µm i-Amylose-3 column, yielding enantiomeric purity values ranging between 94.4% and 99.7%. The elution order of all the enantiomers was accomplished combining the ECD results with an optical rotation detector. The elution order of the enantiomers was influenced only by the chiral selector, rather than the mobile phase. The cytotoxicity of the racemates and the isolated enantiomers towards differentiated SH-SY5Y cells was evaluated. (R,S)-DMPMZ exhibited a significantly higher cytotoxicity than (R,S)-PMZ, suggesting the metabolic bioactivation of (R,S)-PMZ. Conversely, no significant cytotoxicity was found for (R,S)-PMZSO, underscoring a metabolic detoxification pathway. Remarkably, enantioselectivity was observed for the cytotoxicity of PMZ; (R)-PMZ was significantly more cytotoxic than (S)-PMZ. The results underscore the importance to isolate the enantiomers in their enantiomerically form and their correct identification for toxicity enantioselectivity studies, which are vital to understand the drug's behaviour and safety, especially in case of overdoses.
Collapse
Affiliation(s)
- Maria Miguel Coelho
- Laboratory of Organic Chemistry and Pharmaceuticals, Department of Chemical Sciences, Faculty of Pharmacy of the University of Porto, Porto 4050-313, Portugal; CIIMAR-Interdisciplinary Center of Marine and Environmental Research University of Porto, Porto de Leixões Cruise Terminal, Matosinhos 4450-208, Portugal; Associate Laboratory i4HB-Insitute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal
| | - Inês Costa
- Associate Laboratory i4HB-Insitute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal; UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal
| | | | | | - Bárbara Silva
- Associate Laboratory i4HB-Insitute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal; UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal
| | - Renata Silva
- Associate Laboratory i4HB-Insitute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal; UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal
| | - Carla Fernandes
- Laboratory of Organic Chemistry and Pharmaceuticals, Department of Chemical Sciences, Faculty of Pharmacy of the University of Porto, Porto 4050-313, Portugal; CIIMAR-Interdisciplinary Center of Marine and Environmental Research University of Porto, Porto de Leixões Cruise Terminal, Matosinhos 4450-208, Portugal
| | - Fernando Remião
- Associate Laboratory i4HB-Insitute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal; UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Porto 4050-313, Portugal
| | - Maria Elizabeth Tiritan
- Laboratory of Organic Chemistry and Pharmaceuticals, Department of Chemical Sciences, Faculty of Pharmacy of the University of Porto, Porto 4050-313, Portugal; CIIMAR-Interdisciplinary Center of Marine and Environmental Research University of Porto, Porto de Leixões Cruise Terminal, Matosinhos 4450-208, Portugal; 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra 4585-116, Portugal.
| |
Collapse
|
2
|
Vedha Vivigdha A, Senthil Murugan P, Santhosh Kumar MP, Khuntia S. Effectiveness of promethazine on preoperative and intraoperative sequelae in cleft palate surgeries. Orthod Craniofac Res 2024; 27 Suppl 1:109-114. [PMID: 38265116 DOI: 10.1111/ocr.12743] [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] [Accepted: 12/07/2023] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Anxiety and nosocomial infection are the most common reported problems in children undergoing cleft surgeries. Research shows that there is an enigma in the use of antihistamine therapy in children for the management of upper respiratory tract infection. 'Promethazine' is a first-generation H1 receptor antagonist, and antihistamine also has strong sedative effects. Our study aims at evaluating the Effectiveness of Promethazine (Phenergan) in preoperative and intra operative sequelae in cleft surgeries. MATERIALS AND METHODS This is a single-centre, parallel, randomized, double-blinded randomized control clinical trial, which was conducted among 128 children between 2 and 4 years of age undergoing cleft palate surgery under general anaesthesia. After randomization, the case group was subjected to promethazine syrup 1 mg/kg body weight twice a day, orally for 3 days. The primary outcomes were preoperative anxiety levels which were recorded by children fear scale. The secondary outcomes include preoperative sleep quality and cough rate of children which are recorded by using sleep and cough objective scale respectively. The intraoperative heart rate is monitored with an ECG connected to a monitor. RESULTS Promethazine causes a reduction in the anxiety level by 70%, 64% reduction in cold and cough, improvement in sleep score by 70% and the heart rate was found to be stable throughout the surgery when compared to the control group. CONCLUSION As the benefits of promethazine in cleft palate surgery rule over its adverse effects, promethazine is considered safe to be used as premedication for children undergoing cleft palate surgeries.
Collapse
Affiliation(s)
- A Vedha Vivigdha
- Department of Oral and Maxillofacial Surgery, Saveetha Oral Cancer Institute, Saveetha Institute of Medical And Technical Sciences (SIMATS), Saveetha University, Chennai, Tamli Nadu, India
| | - P Senthil Murugan
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical And Technical Sciences (SIMATS), Saveetha University, Chennai, Tamli Nadu, India
| | - M P Santhosh Kumar
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical And Technical Sciences (SIMATS), Saveetha University, Chennai, Tamli Nadu, India
| | - Sibasish Khuntia
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical And Technical Sciences (SIMATS), Saveetha University, Chennai, Tamli Nadu, India
| |
Collapse
|
3
|
Liu J, Guo L, Chen Z, Guo Y, Zhang W, Peng X, Wang Z, Zeng YF. Photoredox-catalyzed unsymmetrical diamination of alkenes for access to vicinal diamines. Chem Commun (Camb) 2024; 60:3413-3416. [PMID: 38441256 DOI: 10.1039/d4cc00330f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
A photoredox-catalyzed unsymmetrical diamination of alkenes by using N-aminopyridinium salts and nitriles as the amination reagents has been developed. Various vicinal diamines were obtained in moderate to excellent yields under mild reaction conditions. Furthermore, this protocol could be applied in the late-stage modification of pharmaceuticals and natural products. Preliminary mechanistic studies suggested that this methodology may undergo a radical pathway followed by a Ritter-type reaction.
Collapse
Affiliation(s)
- Jie Liu
- School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| | - Lu Guo
- Department of Sports Medicine, Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Zhang Chen
- School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| | - Yu Guo
- School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| | - Wei Zhang
- School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| | - Xue Peng
- School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| | - Zhen Wang
- School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
- MOE Key Lab of Rare Pediatric Diseases, University of South China, Hengyang, Hunan, 421001, China
| | - Yao-Fu Zeng
- School of Pharmaceutical Science, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
| |
Collapse
|
4
|
Hammood MK, Jeber JN, Khalaf MA, Abdul Hadi Kharaba H. Rapid colorimetric sensing of chlorpromazine HCl antipsychotic through in situ growth of gold nanoparticles. RSC Adv 2024; 14:2327-2339. [PMID: 38213959 PMCID: PMC10782504 DOI: 10.1039/d3ra05516g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/03/2024] [Indexed: 01/13/2024] Open
Abstract
Antipsychotic drugs like chlorpromazine hydrochloride (CPZ) are widely used to treat mental illnesses but can accumulate in the environment if not properly disposed of. Long-term exposure to trace levels of such pharmaceuticals may pose health risks. This study reports a colorimetric assay for detection of the antipsychotic drug chlorpromazine hydrochloride (CPZ) based on its ability to reduce gold ions and form gold nanoparticles (AuNPs). Optimization of reaction conditions such as pH, temperature and reagent concentrations enabled quantitative analysis of CPZ concentrations from 0.1-30 μg mL-1, with a detection limit of 0.06 μg mL-1, 0.23 μg mL-1 quantification limit and less than 3.5% RSD. The AuNPs exhibited a characteristic surface plasmon resonance band at 527 nm detectable by UV-vis spectrophotometry. Method validation with spiked serum, urine and environmental water samples demonstrated acceptable accuracy and precision. Interfering substances showed minimal impact, indicating resilience and specificity. This rapid, inexpensive colorimetric assay could facilitate environmental monitoring and biomedical analysis of antipsychotic drugs.
Collapse
Affiliation(s)
- Mohammad K Hammood
- Department of Chemistry, College of Science, University of Baghdad 10071 Baghdad Iraq +9647702519630
| | - Jalal N Jeber
- Department of Chemistry, College of Science, University of Baghdad 10071 Baghdad Iraq +9647702519630
| | - Maryam A Khalaf
- Ministry of Education Karkh Education Directorate 1 Baghdad Iraq
| | | |
Collapse
|
5
|
Fiorentino F, Nocentini A, Rotili D, Supuran CT, Mai A. Antihistamines, phenothiazine-based antipsychotics, and tricyclic antidepressants potently activate pharmacologically relevant human carbonic anhydrase isoforms II and VII. J Enzyme Inhib Med Chem 2023; 38:2188147. [PMID: 36912265 PMCID: PMC10013323 DOI: 10.1080/14756366.2023.2188147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
Carbonic anhydrases (CAs) are important regulators of pH homeostasis and participate in many physiological and pathological processes. CA activators (CAAs) are becoming increasingly important in the biomedical field since enhancing CA activity may have beneficial effects at neurological level. Here, we investigate selected antihistamines, phenothiazine-based antipsychotics, and tricyclic antidepressants (TCAs) as potential activators of human CAs I, II, IV, and VII. Our findings indicate that these compounds are more effective at activating hCA II and VII compared to hCA I and IV. Overall, hCA VII was the most efficiently activated isoform, particularly by phenothiazines and TCAs. This is especially relevant since hCA VII is the most abundant isoform in the central nervous system (CNS) and is implicated in neuronal signalling and bicarbonate balance regulation. This study offers additional insights into the pharmacological profiles of clinically employed drugs and sets the ground for the development of novel optimised CAAs.
Collapse
Affiliation(s)
- Francesco Fiorentino
- Department of Drug Chemistry and Technologies, Sapienza University of Rome, Rome, Italy
| | - Alessio Nocentini
- Department of NEUROFARBA, Section of Pharmaceutical and Nutraceutical Sciences, Polo Scientifico, University of Florence, Firenze, Italy
| | - Dante Rotili
- Department of Drug Chemistry and Technologies, Sapienza University of Rome, Rome, Italy
| | - Claudiu T Supuran
- Department of NEUROFARBA, Section of Pharmaceutical and Nutraceutical Sciences, Polo Scientifico, University of Florence, Firenze, Italy
| | - Antonello Mai
- Department of Drug Chemistry and Technologies, Sapienza University of Rome, Rome, Italy.,Pasteur Institute, Cenci-Bolognetti Foundation, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
6
|
Guedes GMDM, Freitas AS, Pinheiro RM, Pereira VC, Melgarejo CMA, de Araujo ES, Ribeiro KVC, Bandeira SP, Cordeiro RDA, Rocha MFG, Sidrim JJC, Castelo-Branco DDSCM. Antibiofilm activity of promethazine, deferiprone, and Manuka honey in an ex vivo wound model. Lett Appl Microbiol 2023; 76:ovad119. [PMID: 37791895 DOI: 10.1093/lambio/ovad119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/08/2023] [Accepted: 10/02/2023] [Indexed: 10/05/2023]
Abstract
This study evaluated the antibiofilm activity of promethazine, deferiprone, and Manuka honey against Staphylococcus aureus and Pseudomonas aeruginosa in vitro and ex vivo in a wound model on porcine skin. The minimum inhibitory concentrations (MICs) and the effects of the compounds on biofilms were evaluated. Then, counting colony-forming units (CFUs) and confocal microscopy were performed on biofilms cultivated on porcine skin for evaluation of the compounds. For promethazine, MICs ranging from 97.66 to 781.25 µg/ml and minimum biofilm eradication concentration (MBEC) values ranging from 195.31 to 1562.5 µg/ml were found. In addition to reducing the biomass of both species' biofilms. As for deferiprone, the MICs were 512 and >1024 µg/ml, the MBECs were ≥1024 µg/ml, and it reduced the biomass of biofilms. Manuka honey had MICs of 10%-40%, MBECs of 20 to >40% and reduced the biomass of S. aureus biofilms only. Concerning the analyses in the ex vivo model, the compounds reduced (P < .05) CFU counts for both bacterial species, altering the biofilm architecture. The action of the compounds on biofilms in in vitro and ex vivo tests raises the possibility of using them against biofilm-associated wounds. However, further studies are needed to characterize the mechanisms of action and their effectiveness on biofilms in vivo.
Collapse
Affiliation(s)
- Gláucia Morgana de Melo Guedes
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Alyne Soares Freitas
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Rodrigo Machado Pinheiro
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Vinicius Carvalho Pereira
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Carliane Melo Alves Melgarejo
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Emanuela Silva de Araujo
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Késia Veras Costa Ribeiro
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Silviane Praciano Bandeira
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Rossana de Aguiar Cordeiro
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Marcos Fábio Gadelha Rocha
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
- Postgraduate Program in Veterinary Sciences, School of Veterinary, State University of Ceará, Avenida Dr. Silas Munguba, 1700 - Itaperi - CEP 60714-903, Fortaleza, Ceará, Brazil
| | - José Júlio Costa Sidrim
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| | - Débora de Souza Collares Maia Castelo-Branco
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Group of Applied Medical Microbiology, Federal University of Ceará, Rua Coronel Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
- Department of Pathology & Legal Medicine, Postgraduate Program in Medical Microbiology, Specialized Medical Mycology Center, Federal University of Ceará, Rua Coronel, Nunes de Melo, 1315 - Rodolfo Teófilo - CEP 60430-275, Fortaleza, Ceará, Brazil
| |
Collapse
|
7
|
Cannon CG, Klusener PAA, Brandon NP, Kucernak ARJ. Aqueous Redox Flow Batteries: Small Organic Molecules for the Positive Electrolyte Species. CHEMSUSCHEM 2023; 16:e202300303. [PMID: 37205628 DOI: 10.1002/cssc.202300303] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/25/2023] [Accepted: 05/19/2023] [Indexed: 05/21/2023]
Abstract
There are a number of critical requirements for electrolytes in aqueous redox flow batteries. This paper reviews organic molecules that have been used as the redox-active electrolyte for the positive cell reaction in aqueous redox flow batteries. These organic compounds are centred around different organic redox-active moieties such as the aminoxyl radical (TEMPO and N-hydroxyphthalimide), carbonyl (quinones and biphenols), amine (e. g., indigo carmine), ether and thioether (e. g., thianthrene) groups. We consider the key metrics that can be used to assess their performance: redox potential, operating pH, solubility, redox kinetics, diffusivity, stability, and cost. We develop a new figure of merit - the theoretical intrinsic power density - which combines the first four of the aforementioned metrics to allow ranking of different redox couples on just one side of the battery. The organic electrolytes show theoretical intrinsic power densities which are 2-100 times larger than that of the VO2+ /VO2 + couple, with TEMPO-derivatives showing the highest performance. Finally, we survey organic positive electrolytes in the literature on the basis of their redox-active moieties and the aforementioned figure of merit.
Collapse
Affiliation(s)
- Christopher G Cannon
- Department of Chemistry, Imperial College London MSRH, White City, London, W12 0BZ, United Kingdom
| | - Peter A A Klusener
- Shell Global Solutions International B.V., Energy Transition Campus Amsterdam, Grasweg 31, 1031 HW Amsterdam, The Netherlands
| | - Nigel P Brandon
- Department of Earth Science and Engineering, Imperial College London South Kensington, London, SW7 2AZ, United Kingdom
| | - Anthony R J Kucernak
- Department of Chemistry, Imperial College London MSRH, White City, London, W12 0BZ, United Kingdom
| |
Collapse
|
8
|
A VV, P SM, MP SK, Krishnan M, Alladi S. Effect of promethazine in cleft surgeries among Indian children. Bioinformation 2023; 19:790-794. [PMID: 37885787 PMCID: PMC10598356 DOI: 10.6026/97320630019790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 10/28/2023] Open
Abstract
The use of antihistamine therapy in children for the management of upper respiratory tract infections remains a topic of debate. In this study, we focused on evaluating the effectiveness of promethazine (Phenergan), a first-generation H1 receptor antagonist and sedative, in addressing preoperative and intra-operative sequelae in cleft surgeries. A single-centered, parallel, randomized, double-blinded controlled clinical trial was conducted on 128 children aged 2 to 4 years undergoing cleft palate surgery under general anesthesia. The case group received Phenergan syrup orally twice a day for three days, while the control group received a placebo. Primary outcomes measured preoperative anxiety levels using a children's fear scale, while secondary outcomes assessed preoperative sleep quality and cough rate through objective scales. Intraoperative heart rate was monitored using an ECG connected to a monitor. The results demonstrated that the administration of promethazine resulted in a 34% reduction in anxiety levels, a 46% reduction in cold and cough, a 38% improvement in sleep score, and stable heart rates throughout the surgery compared to the control group. Based on these findings, promethazine is considered a safe premedication option for children undergoing cleft palate surgeries; given its benefits outweigh its adverse effects.
Collapse
Affiliation(s)
- Vedha Vivigdha A
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Senthil Murugan P
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Santhosh Kumar MP
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Murugesan Krishnan
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Sneha Alladi
- Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| |
Collapse
|
9
|
Li Y, Li B, Chen WD, Wang YD. Role of G-protein coupled receptors in cardiovascular diseases. Front Cardiovasc Med 2023; 10:1130312. [PMID: 37342437 PMCID: PMC10277692 DOI: 10.3389/fcvm.2023.1130312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/09/2023] [Indexed: 06/22/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death globally, with CVDs accounting for nearly 30% of deaths worldwide each year. G-protein-coupled receptors (GPCRs) are the most prominent family of receptors on the cell surface, and play an essential regulating cellular physiology and pathology. Some GPCR antagonists, such as β-blockers, are standard therapy for the treatment of CVDs. In addition, nearly one-third of the drugs used to treat CVDs target GPCRs. All the evidence demonstrates the crucial role of GPCRs in CVDs. Over the past decades, studies on the structure and function of GPCRs have identified many targets for the treatment of CVDs. In this review, we summarize and discuss the role of GPCRs in the function of the cardiovascular system from both vascular and heart perspectives, then analyze the complex ways in which multiple GPCRs exert regulatory functions in vascular and heart diseases. We hope to provide new ideas for the treatment of CVDs and the development of novel drugs.
Collapse
Affiliation(s)
- Yuanqiang Li
- State Key Laboratory of Chemical Resource Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Boyu Li
- Department of Gastroenterology and Hematology, The People's Hospital of Hebi, Henan, China
| | - Wei-Dong Chen
- Key Laboratory of Receptors-Mediated Gene Regulation and Drug Discovery, School of Basic Medical Science, Inner Mongolia Medical University, Hohhot, China
- Key Laboratory of Receptors-Mediated Gene Regulation, School of Medicine, The People’s Hospital of Hebi, Henan University, Kaifeng, China
| | - Yan-Dong Wang
- State Key Laboratory of Chemical Resource Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| |
Collapse
|
10
|
Rahimzadeh G, Tay A, Travica N, Lacy K, Mohamed S, Nahavandi D, Pławiak P, Qazani MC, Asadi H. Nutritional and Behavioral Countermeasures as Medication Approaches to Relieve Motion Sickness: A Comprehensive Review. Nutrients 2023; 15:nu15061320. [PMID: 36986050 PMCID: PMC10052985 DOI: 10.3390/nu15061320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/01/2023] [Accepted: 03/04/2023] [Indexed: 03/11/2023] Open
Abstract
The mismatch in signals perceived by the vestibular and visual systems to the brain, also referred to as motion sickness syndrome, has been diagnosed as a challenging condition with no clear mechanism. Motion sickness causes undesirable symptoms during travel and in virtual environments that affect people negatively. Treatments are directed toward reducing conflicting sensory inputs, accelerating the process of adaptation, and controlling nausea and vomiting. The long-term use of current medications is often hindered by their various side effects. Hence, this review aims to identify non-pharmacological strategies that can be employed to reduce or prevent motion sickness in both real and virtual environments. Research suggests that activation of the parasympathetic nervous system using pleasant music and diaphragmatic breathing can help alleviate symptoms of motion sickness. Certain micronutrients such as hesperidin, menthol, vitamin C, and gingerol were shown to have a positive impact on alleviating motion sickness. However, the effects of macronutrients are more complex and can be influenced by factors such as the food matrix and composition. Herbal dietary formulations such as Tianxian and Tamzin were shown to be as effective as medications. Therefore, nutritional interventions along with behavioral countermeasures could be considered as inexpensive and simple approaches to mitigate motion sickness. Finally, we discussed possible mechanisms underlying these interventions, the most significant limitations, research gaps, and future research directions for motion sickness.
Collapse
Affiliation(s)
- Ghazal Rahimzadeh
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
| | - Abdullatif Tay
- PepsiCo Inc., Food Safety and Global Process Authority, 433 W Van Buren St., Chicago, IL 60607, USA
- Correspondence: (A.T.); (S.M.); Tel.: +61-3-522-72599 (S.M.)
| | - Nikolaj Travica
- Food & Mood Centre, IMPACT—The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, VIC 3220, Australia
| | - Kathleen Lacy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3220, Australia
| | - Shady Mohamed
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
- Correspondence: (A.T.); (S.M.); Tel.: +61-3-522-72599 (S.M.)
| | - Darius Nahavandi
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
| | - Paweł Pławiak
- Department of Computer Science, Faculty of Computer Science and Telecommunications, Cracow University of Technology, Warszawska 24, 31-155 Krakow, Poland
- Institute of Theoretical and Applied Informatics, Polish Academy of Sciences, Bałtycka 5, 44-100 Gliwice, Poland
| | - Mohammadreza Chalak Qazani
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
| | - Houshyar Asadi
- Institute for Intelligent Systems Research and Innovation (IISRI), Deakin University, Geelong, VIC 3216, Australia
| |
Collapse
|
11
|
Samardžić M, Peršić M, Széchenyi A, Jozanović M, Pukleš I, Budetić M. Development of the New Sensor Based on Functionalized Carbon Nanomaterials for Promethazine Hydrochloride Determination. SENSORS (BASEL, SWITZERLAND) 2023; 23:2641. [PMID: 36904844 PMCID: PMC10007115 DOI: 10.3390/s23052641] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Promethazine hydrochloride (PM) is a widely used drug so its determination is important. Solid-contact potentiometric sensors could be an appropriate solution for that purpose due to their analytical properties. The aim of this research was to develop solid-contact sensor for potentiometric determination of PM. It had a liquid membrane containing hybrid sensing material based on functionalized carbon nanomaterials and PM ions. The membrane composition for the new PM sensor was optimized by varying different membrane plasticizers and the content of the sensing material. The plasticizer was selected based on calculations of Hansen solubility parameters (HSP) and experimental data. The best analytical performances were obtained using a sensor with 2-nitrophenyl phenyl ether (NPPE) as the plasticizer and 4% of the sensing material. It had a Nernstian slope (59.4 mV/decade of activity), a wide working range (6.2 × 10-7 M-5.0 × 10-3 M), a low limit of detection (1.5 × 10-7 M), fast response time (6 s), low signal drift (-1.2 mV/h), and good selectivity. The working pH range of the sensor was between 2 and 7. The new PM sensor was successfully used for accurate PM determination in a pure aqueous PM solution and pharmaceutical products. For that purpose, the Gran method and potentiometric titration were used.
Collapse
Affiliation(s)
- Mirela Samardžić
- Department of Chemistry, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 8/A, 31000 Osijek, Croatia
| | - Mateja Peršić
- Department of Chemistry, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 8/A, 31000 Osijek, Croatia
| | - Aleksandar Széchenyi
- Department of Chemistry, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 8/A, 31000 Osijek, Croatia
| | - Marija Jozanović
- Department of Chemistry, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 8/A, 31000 Osijek, Croatia
| | - Iva Pukleš
- Doctoral School of Chemistry, University of Pécs, Ifjúság útja, 7624 Pécs, Hungary
| | - Mateja Budetić
- Department of Chemistry, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 8/A, 31000 Osijek, Croatia
| |
Collapse
|
12
|
Ghiasi Z, Validad MH, Ostadkelayeh SM, Mazloom S, Avval JO, Moshari M, Dahi M, Gharehbeglou M, Khosravi M. Promethazine hydrochloride reduces children's agitation during ocular examination for trauma. Eur J Transl Myol 2022; 33. [PMID: 36073862 DOI: 10.4081/ejtm.2022.10808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 08/26/2022] [Indexed: 11/23/2022] Open
Abstract
Examination and intervention are always the causes of agitation, anxiety, and fear in children's lives. This study aimed to investigate the effectiveness of promethazine hydrochloride in reducing children's agitation during the ocular examination for trauma. In this interventional-clinical trial study, a total of 62 children referred to Al-Zahra Ophthalmology Hospital in Zahedan, Iran, were evaluated in two matched groups (case (n = 31) and control (n = 31)) for an initial examination of ocular trauma. Finally, the intervention was performed (giving placebo or promethazine hydrochloride cough syrup 20 minutes before the initial ocular examination at 0.5 mg/kg), and the demographic information form and researcher-made questionnaire modeled on the Cohen-Mansfield Agitation Inventory (CMAI) were completed. The obtained results revealed that the mean scores of physical/aggressive behaviors (p ˂ 0.001), physical/nonaggressive behaviors (p = 0.013), verbal/aggressive behaviors (p ˂ 0.001), and hiding behaviors (p ˂ 0.001) were significantly lower in the promethazine hydrochloride-receiving group than the placebo group. These findings demonstrated that promethazine hydrochloride cough syrup facilitated the examination among the pediatric patients who suffered from traumatic ocular injuries. However, further studies in this field need to be carried out through randomized controlled trials.
Collapse
Affiliation(s)
- Zahra Ghiasi
- Department of Psychiatry and Clinical Psychology, School of Medicine, Zahedan University of Medical Sciences, Zahedan.
| | - Mohammad Hosein Validad
- Department of Ophthalmology, School of Medicine, Zahedan University of Medical Sciences, Zahedan.
| | | | - Sakineh Mazloom
- Department of Nursing, Zahedan Branch, Islamic Azad University, Zahedan.
| | - Jamshid Ordoni Avval
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan.
| | - Mohammadreza Moshari
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran.
| | - Mastaneh Dahi
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran.
| | - Mohammad Gharehbeglou
- Department of Anesthesiology and Critical Care Medicine, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Anesthesiology and Critical Care Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran .
| | - Mohsen Khosravi
- Department of Psychiatry and Clinical Psychology, School of Medicine, Zahedan University of Medical Sciences, Zahedan.
| |
Collapse
|
13
|
Raja DA, Shah MR, Malik MI. Polyethyleneimine stabilized silver nanoparticles as an efficient and selective colorimetric assay for promethazine. Anal Chim Acta 2022; 1223:340216. [DOI: 10.1016/j.aca.2022.340216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/12/2022] [Accepted: 07/26/2022] [Indexed: 11/15/2022]
|
14
|
Han K, Ahn Y, Hong KB, Suh HJ, Yu KW, Kim H. Ameliorating the efficacy of galacto-oligosaccharides on ovalumin-induced allergic dermatitis symptoms in Balb/c mice by regulating Th2 immune response and the ecosystem of gut microbiota. Food Funct 2022; 13:6271-6281. [PMID: 35604005 DOI: 10.1039/d2fo00157h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In this study, we evaluated the effect of oral administration of galacto-oligosaccharide (GOS), famous biological molecules that are comprised of galactose and lactose, on ovalbumin (OVA)-induced allergic dermatitis. OVA-induced mice were divided into the OVA-administered group (OVA-C), promethazine hydrochloride-administered group (PC), and 100 and 200 mg kg-1 GOS-administered groups (GL and GH, respectively). GOS administration significantly improved epidermal thickness and decreased CD4+ cell numbers. The concentrations of IgE, OVA-specific IgE, and inflammatory cytokines (IL-4, IL-5, and INF-γ) in GH group mice were significantly lower than those in OVA-C group mice. Firmicutes and Bacteroidetes were identified as the major phyla in the intestinal microbiota in mice, and the relative abundance of Deferribacteres was significantly lower in the GH group than in the OVA-C group. Deferribacteraceae and Mucispirillum species were significantly lower in the GH group than in the OVA-C group. The relative abundance of Muribaculum species was significantly lower, but those of Lachnospira and Lactococcus species were significantly higher in the GH group than in the OVA-C group. Our results suggest that the alleviation effect of GOS on allergic dermatitis induced by OVA sensitization was achieved by regulating hypersensitive immune responses by improving the intestinal microbial ecosystem.
Collapse
Affiliation(s)
- Kisoo Han
- Department of Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul 02841, Republic of Korea.
| | - Yejin Ahn
- Department of Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul 02841, Republic of Korea.
| | - Ki-Bae Hong
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea.
| | - Hyung Joo Suh
- Department of Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul 02841, Republic of Korea. .,Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Republic of Korea
| | - Kwang-Won Yu
- Division of Food and Nutrition, Korea National University of Transportation, Republic of Korea.
| | - Hoon Kim
- Department of Food and Nutrition, Chung-Ang University, Anseong 17546, Republic of Korea.
| |
Collapse
|
15
|
Kumar DGS, Vadgaonkar D, Purunaik DS, Shelatkar R, Vaidya VG, Ganu DG, Vadgaonkar DA, Joshi S. Efficacy and Safety of Aspirin, Promethazine, and Micronutrients for Rapid Clinical Recovery in Mild to Moderate COVID-19 Patients: A Randomized Controlled Clinical Trial. Cureus 2022; 14:e25467. [PMID: 35783877 PMCID: PMC9240808 DOI: 10.7759/cureus.25467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction In the present study, the combination of two tablets, one with Aspirin and Promethazine and the other with vitamin D3, C, and B3 along with zinc and selenium supplementation was proposed as an intervention (APMV2020). The ingredients in the formulation represent a precise, tailored therapy for the symptoms of COVID-19, combined with natural constituents to help the body itself build immunity to recover from infection. The present study was conducted to clinically validate the safety and efficacy of the APMV2020 tablets. Trial design The present trial is a randomized, multicentric, controlled clinical trial involving 260 mild to moderate COVID-19 patients. The treatment duration was of 10 days. Methodology The subjects were randomized to receive either the control intervention (clinical management protocol for COVID-19 advocated by the Indian Council of Medical Research (ICMR) or the test intervention (treatment with APMV2020 tablets along with the standard control treatment. The assessment days were baseline, days five and 10. Results APMV2020 significantly (<0.05) improved symptoms of COVID-19 like cough, myalgia, headache, and anosmia as compared to the control group. APMV2020 treatment also reduced inflammatory markers like lactate dehydrogenase (LDH), ferritin, and C-reactive protein (CRP). Conclusion APMV2020 can prove as a good candidate to be integrated into the COVID-19 management protocol. As it can offer speedy clinical recovery to reduce the burden on healthcare infrastructure, second, the combination shows significant anti-inflammatory potential to improve prognosis, and lastly, the immunomodulatory properties offer long-term protection that can help in combating long COVID symptoms and complications.
Collapse
|
16
|
Abeysundera H, Craig B, Pullich Z. Promethazine-induced delirium with perceptual abnormalities: are we thinking broadly when assessing patients? BMJ Case Rep 2021; 14:e241784. [PMID: 33858904 PMCID: PMC8054040 DOI: 10.1136/bcr-2021-241784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2021] [Indexed: 11/04/2022] Open
Abstract
There is limited information about promethazine-induced delirium with psychotic symptoms. The aim is to highlight the importance of taking a detailed history including medication use/abuse of both prescribed, illicit and over-the-counter preparations. This paper describes a patient who presented with delirium in the context of overuse of promethazine (Phenergan) which was initially missed. The patient was treated successfully, following the diagnosis of promethazine-induced delirium. Clinicians should be aware of assessing patients presenting with delirium to explore the possibility of over-the-counter medication misuse.
Collapse
Affiliation(s)
- Hesitha Abeysundera
- Psychiatry, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Bailey Craig
- Psychiatry, Bond University, Robina, Queensland, Australia
| | - Zelle Pullich
- Psychiatry, Gold Coast University Hospital, Southport, Queensland, Australia
| |
Collapse
|
17
|
Romano A, Di Stasio D, Lauritano D, Lajolo C, Fiori F, Gentile E, Lucchese A. Topical photodynamic therapy in the treatment of benign oral mucosal lesions: A systematic review. J Oral Pathol Med 2020; 50:639-648. [PMID: 33314331 DOI: 10.1111/jop.13152] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The introduction of photodynamic therapy (PDT) in various branches of the dental field such as endodontics, implantology, periodontology, and restorative dentistry and oral medicine has become useful in recent decades. This systematic review presents an overview of the literature to evaluate the usefulness of topical PDT for the treatment of benign oral soft tissue lesions and to identify limitations in prior studies to improve PDT applications. METHODS We performed a review of the literature using different search engines (PubMed, ISI Web of Science, and the Cochrane Library) employing MeSH terms such as "Photodynamic therapy" and "PDT" in conjunction with other terms. We utilized the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) method to define our study eligibility criteria. RESULTS Initial results were 1513. Finally, there were only 21 studies that met our selection criteria. We divided the 21 selected items into two groups: inflammatory diseases and infective diseases. CONCLUSIONS Although topical PDT is an easy to perform and well-tolerated treatment and appears to be a valid method with promising results in the treatment of benign lesions of the oral cavity's soft tissues, further studies are needed to complete the current knowledge of this technique.
Collapse
Affiliation(s)
- Antonio Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania- Luigi Vanvitelli, Naples, Italy
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania- Luigi Vanvitelli, Naples, Italy
| | - Dorina Lauritano
- Medicine and Surgery Department, University of Milan - Bicocca, Monza, Italy
| | - Carlo Lajolo
- Head and Neck Department, School of Dentistry, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fausto Fiori
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania- Luigi Vanvitelli, Naples, Italy
| | - Enrica Gentile
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania- Luigi Vanvitelli, Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania- Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
18
|
Gangwar A, Singh D. Re: Preliminary experience with promethazine hydrochloride injection in the sclerotherapy of oral mucosa. Int J Oral Maxillofac Surg 2020; 50:979. [PMID: 33054993 DOI: 10.1016/j.ijom.2020.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/24/2020] [Indexed: 10/23/2022]
Affiliation(s)
- A Gangwar
- Department of Oral and Maxillofacial Surgery, Maharana Pratap Dental College, Kanpur, UP, India; Department of Periodontology, Maharana Pratap Dental College, Kanpur, UP, India.
| | - D Singh
- Department of Oral and Maxillofacial Surgery, Maharana Pratap Dental College, Kanpur, UP, India; Department of Periodontology, Maharana Pratap Dental College, Kanpur, UP, India
| |
Collapse
|
19
|
Preliminary experience with promethazine hydrochloride injection in the sclerotherapy of oral mucocele. Int J Oral Maxillofac Surg 2020; 50:980. [PMID: 33041165 DOI: 10.1016/j.ijom.2020.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 09/24/2020] [Indexed: 10/23/2022]
|
20
|
Miuli A, Stigliano G, Lalli A, Coladonato M, D’Angelo L, Esposito F, Cappello C, Pettorruso M, Martinotti G, Schifano F, Di Giannantonio M. “Purple Drank” (Codeine and Promethazine Cough Syrup): A Systematic Review of a Social Phenomenon with Medical Implications. J Psychoactive Drugs 2020; 52:453-462. [DOI: 10.1080/02791072.2020.1797250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- A. Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - G. Stigliano
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - A. Lalli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - M. Coladonato
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - L. D’Angelo
- Department of Business Administration, “G. d’Annunzio” University, Chieti, Italy
| | - F. Esposito
- Department of Legal and Social Science, “G. d’Annunzio” University, Chieti, Italy
| | - C. Cappello
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - M. Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - G. Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
- Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Herts, UK
| | - F Schifano
- Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Herts, UK
| | - M. Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| |
Collapse
|
21
|
Cariou C, Droitcourt C, Osmont MN, Marguery MC, Dutartre H, Delaunay J, Avenel‐Audran M, Dupuy A, Adamski H. Photodermatitis from topical phenothiazines: A case series. Contact Dermatitis 2020; 83:19-24. [DOI: 10.1111/cod.13509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/24/2020] [Accepted: 03/01/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Claire Cariou
- Department of DermatologyCHU Pontchaillou Rennes France
| | - Catherine Droitcourt
- Department of DermatologyCHU Pontchaillou Rennes France
- EA 7449 REPERES Pharmacoepidemiology and Health Services Research Rennes France
| | | | | | | | | | | | - Alain Dupuy
- Department of DermatologyCHU Pontchaillou Rennes France
- EA 7449 REPERES Pharmacoepidemiology and Health Services Research Rennes France
| | - Henri Adamski
- Department of DermatologyCHU Pontchaillou Rennes France
| |
Collapse
|
22
|
Aneke CI, Rhimi W, Otranto D, Cafarchia C. Synergistic Effects of Efflux Pump Modulators on the Azole Antifungal Susceptibility of Microsporum canis. Mycopathologia 2020; 185:279-288. [PMID: 31894500 DOI: 10.1007/s11046-019-00419-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 12/14/2019] [Indexed: 02/07/2023]
Abstract
The microbiologic and clinical resistance of dermatophytes is seldom reported, and the mechanisms associated with resistance are not well known. This study investigated the effect of efflux pump modulators (EPMs) (i.e., haloperidol HAL and promethazine PTZ) and their inhibiting activity on the minimum inhibitory concentrations of itraconazole (ITZ) and fluconazole (FLZ) against selected M. canis strains. M. canis strains with low (≤ 1 μg/ml itraconazole and < 64 μg/ml fluconazole) and high (> 1 μg/ml itraconazole and ≥ 64 μg/ml fluconazole) azole MIC values were tested using Checkerboard microdilution assay. The disk diffusion assay, the minimum fungicidal concentration and the time-kill assay were also performed in order to confirm the results of checkerboard microdilution assay. The MIC values of ITZ and FLZ of M. canis decreased in the presence of subinhibitory concentrations of HAL and PTZ, the latter being more effective with a greater increased susceptibility. Synergism was observed in all strains with high azole MICs (FICI < 0.5) and no synergism in the strains with low azole MICs. A fungicidal activity was observed after 48 h of incubation when ITZ and FLZ were tested in combination with HAL or PTZ. These results suggest that the drug efflux pumps are involved in the defense mechanisms to azole drugs in M. canis strains. The synergism might be related to an increased expression of efflux pump genes, eventually resulting in azole resistance phenomena. Complementary studies on M. canis resistance are advocated in order to investigate the molecular mechanisms of this phenomenon.
Collapse
Affiliation(s)
- Chioma Inyang Aneke
- Dipartimento Di Medicina Veterinaria, Università Degli Studi "Aldo Moro", 70010, Valenzano (Bari), Italy.,Department of Veterinary Pathology and Microbiology, University of Nigeria, Nsukka, 410001, Nigeria
| | - Wafa Rhimi
- Dipartimento Di Medicina Veterinaria, Università Degli Studi "Aldo Moro", 70010, Valenzano (Bari), Italy.,Faculté Des Sciences de Bizerte, Université de Carthage, Zarzouna, Tunisia
| | - Domenico Otranto
- Dipartimento Di Medicina Veterinaria, Università Degli Studi "Aldo Moro", 70010, Valenzano (Bari), Italy
| | - Claudia Cafarchia
- Dipartimento Di Medicina Veterinaria, Università Degli Studi "Aldo Moro", 70010, Valenzano (Bari), Italy.
| |
Collapse
|
23
|
Promethazine exhibits antiparasitic properties in vitro and reduces worm burden, egg production, hepato-, and splenomegaly in a schistosomiasis animal model. Antimicrob Agents Chemother 2019:AAC.01208-19. [PMID: 31527034 DOI: 10.1128/aac.01208-19] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The treatment and control of schistosomiasis, a neglected disease that affects more than 200 million people worldwide, rely on the use of a single drug, praziquantel. A vaccine has yet to be developed and since new drug design and development is a lengthy and costly process, drug repurposing is a promising strategy. In this study, the efficacy of promethazine, a first-generation antihistamine, was evaluated against Schistosoma mansoni ex vivo and in a murine model of schistosomiasis. In vitro assays demonstrated that promethazine affected parasite motility, viability, and it induced severe tegumental damage in schistosomes. The LC50 of the drug was 5.84 μM. Similar to promethazine, schistosomes incubated with atropine, a classical anticholinergic drug, displayed reduced motor activity. In an animal model, promethazine treatment was introduced at an oral dose of 100 mg/kg for five successive days at different intervals from the time of infection, for the evaluation of the stage-specific susceptibility (pre-patent and patent infections). Various parasitological criteria indicated the in vivo antischistosomal effects of promethazine: there were significant reductions in worm burden, egg production, and hepato- and splenomegaly. The highest worm burden reduction was achieved with promethazine in patent infections (> 90%). Taken together, considering the importance of the repositioning of drugs in infectious diseases, especially those related to poverty, our data revealed the possibility of promethazine repositioning as an antischistosomal agent.
Collapse
|
24
|
Manzur ME, Brandán SA. S(-) and R(+) species derived from antihistaminic promethazine agent: structural and vibrational studies. Heliyon 2019; 5:e02322. [PMID: 31535039 PMCID: PMC6744594 DOI: 10.1016/j.heliyon.2019.e02322] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/19/2019] [Accepted: 08/13/2019] [Indexed: 01/18/2023] Open
Abstract
Structural and vibrational properties of free base, cationic and hydrochloride species derived from both S(-) and R(+) enantiomers of antihistaminic promethazine (PTZ) agent have been theoretically evaluated in gas phase and in aqueous solution by using the hybrid B3LYP/6-31G* calculations. The initial structures of S(-) and R(+) enantiomers of hydrochloride PTZ were those polymorphic forms 1 and 2 experimentally determined by X-ray diffraction. Here, all structures in aqueous solution were optimized at the same level of theory by using the polarized continuum (PCM) and the universal solvation model. As was experimentally reported, variations in the unit cell lead to slight energy, density, and melting point differences between the two forms but, this behavior is not carried through in isotropic condition, like in solution with non-chiral solvents. Hence, the N-C distances, Mulliken, atomic natural population (NPA) and Merz-Kollman (MK) charges, bond orders, stabilization and solvation energies, frontier orbitals, some descriptors and their topological properties were compared with the antihistaminic cyclizine agent. The frontier orbitals studies show that the free base species of both forms in solution are more reactive than cyclizine. Higher electrophilicity indexes are observed in the cationic and hydrochloride species of PTZ than cyclizine while the cationic species of cyclizine have higher nucleophilicity index than both species of PTZ. The presences of bands attributed to cationic species of both enantiomers are clearly supported by the infrared and Raman spectra in the solid phase. The expected 114, 117 and 120 vibration normal modes for the free base, cationic and hydrochloride species of both forms were completely assigned and the force constants reported. Reasonable concordances among the predicted infrared, Raman, UV-Vis and Electronic Circular Dichroism (ECD) with the corresponding experimental ones were found.
Collapse
Affiliation(s)
| | - Silvia Antonia Brandán
- Cátedra de Química General, Instituto de Química Inorgánica, Facultad de Bioquímica. Química y Farmacia, Universidad Nacional de Tucumán, Ayacucho 471, San Miguel de Tucumán, Tucumán, 4000, Argentina
| |
Collapse
|
25
|
Dib JE, Adams CE, Ikdais WH, Atallah E, Yaacoub HE, Merheb TJ, Kazour F, Tahan F, Haddad G, Zoghbi M, Azar J, Haddad C, Hallit S. Study protocol for a randomised controlled trial of haloperidol plus promethazine plus chlorpromazine versus haloperidol plus promethazine for rapid tranquilisation for agitated psychiatric patients in the emergency setting (TREC-Lebanon). F1000Res 2019; 8:1442. [PMID: 32528650 PMCID: PMC7262571 DOI: 10.12688/f1000research.19933.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2019] [Indexed: 01/10/2023] Open
Abstract
Background: Agitated and aggressive behaviours are common in the psychiatric setting and rapid tranquilisation is sometimes unavoidable. A survey of Lebanese practice has shown that an intramuscular haloperidol, promethazine and chlorpromazine combination is a preferred form of treatment but there are no randomised trials of this triple therapy. Methods: This is a pragmatic randomised trial. Setting - the psychiatric wards of the Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. Participants - any adult patient in the hospital who displays an aggressive episode for whom rapid tranquilisation is unavoidable, who has not been randomised before, for whom there are no known contraindications. Randomisation - stratified (by ward) randomisation and concealed in closed opaque envelope by independent parties. Procedure - if the clinical situation arises requiring rapid tranquilisation, medical residents overseeing the patient will open a TREC-Lebanon envelope in which will be notification of which group of treatments should be preferred [Haloperidol + Promethazine + Chlorpromazine (HPC) or Haloperidol + Promethazine (HP)], along with forms for primary, secondary and serious adverse effects. Treatment is not given blindly. Outcome - primary outcome is calm or tranquil at 20 minutes post intervention. Secondary outcomes are calm/tranquil at 40, 60 and 120 minutes post intervention, asleep, adverse effects, use of straitjacket and leaving the ward. Follow-up will be up to two weeks post randomisation. Discussion: Findings from this study will compare the HPC versus HP combination used in Lebanon's psychiatry emergency routine practice. Trial registration: ClinicalTrials.gov NCT03639558. Registration date, August 21, 2018.
Collapse
Affiliation(s)
- Joseph E. Dib
- Institute of Mental Health, University of Nottingham, Nottingham, Nottinghamshire, NG1 1NU, UK
| | - Clive E. Adams
- Institution of Mental Health, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Werner Henry Ikdais
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Beirut, Lebanon
| | - Elie Atallah
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
- Faculty of Sciences, Lebanese University of Beirut, Beirut, Lebanon
| | - Hiba Edward Yaacoub
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Tony Jean Merheb
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Francois Kazour
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
- Faculty of Sciences, Lebanese University of Beirut, Beirut, Lebanon
- Department of Psychology, Holy Spirit University of Kaslik, Beirut, Lebanon
- Faculty of Medicine, St Joseph's University, Beirut, Lebanon
- INSERM U930, équipe 4 “Troubles affectifs”, Université François-Rabelais de Tours, Tours, France
| | - Fouad Tahan
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
| | - Georges Haddad
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Marouan Zoghbi
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
- Faculty of Medicine, St Joseph's University, Beirut, Lebanon
| | - Jocelyn Azar
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
- Faculty of Sciences, Lebanese University of Beirut, Beirut, Lebanon
- School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Chadia Haddad
- Psychiatric Hospital of the Cross, Deir Salib, Jal l Dib, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Beirut, Lebanon
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| |
Collapse
|
26
|
Use of Promethazine and Meperidine as Premedicants in Asthmatics before Initiation of Surgery: An Interim Report. ADVANCED JOURNAL OF EMERGENCY MEDICINE 2019; 3:e35. [PMID: 31633090 PMCID: PMC6789064 DOI: 10.22114/ajem.v0i0.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
27
|
Akram M, Anwar S. Biophysical investigation of promethazine hydrochloride binding with micelles of biocompatible gemini surfactants: Combination of spectroscopic and electrochemical analysis. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2019; 215:249-259. [PMID: 30831395 DOI: 10.1016/j.saa.2019.02.082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/24/2018] [Accepted: 02/17/2019] [Indexed: 06/09/2023]
Abstract
Knowledge of binding parameters for drug and surfactant complexations is crucially vital in order to design effective drug carrier systems with requisite features. To this end, this work was designed to demonstrate the biophysical characterization of the interaction of a phenothiazine drug promethazine hydrochloride (PMT) with relatively lower cytotoxic and easily degradable biomimetic micellar self-assemblies of oxy-diester functionalized gemini surfactants (Cm-E2O-Cm, m = 12, 14 and 16), possessing different hydrophobic character. The binding propensity of Cm-E2O-Cm increases upon increasing the hydrophobic tail length as manifested through both intrinsic fluorescence and absorption spectral profiles of PMT ̶ Cm-E2O-Cm, showing 1:1 stoichiometry. Ksv values also follow the trend of increasing hydrophobic character (i.e., C12-E2O-C12 < C14-E2O-C14 < C16-E2O-C16). Moreover, the determined thermodynamic parameters, particularly the positive values of ΔHbo and ΔSbo, reveal that the involved complexations are dominated by the hydrophobic interactions. In addition, micropolarity assay was done to deduce the microenvironmental changes upon PMT ̶ Cm-E2O-Cm complexations. Beside this, comparative appraisal of all the three systems helps to underpin a reasonable knowledge of the effect of structural variation of surfactants on their binding ability with drug which, in turn, may also open new avenues for the designing of potential tunable drug carrier systems.
Collapse
Affiliation(s)
- Mohd Akram
- Department of Chemistry, Aligarh Muslim University, Aligarh 202002, India.
| | - Sana Anwar
- Department of Chemistry, Aligarh Muslim University, Aligarh 202002, India
| |
Collapse
|
28
|
Facchini G, Eberlin S, Clerici SP, Alves Pinheiro ALT, Costa A. Ultraviolet A photosensitivity profile of dexchlorpheniramine maleate and promethazine-based creams: Anti-inflammatory, antihistaminic, and skin barrier protection properties. J Cosmet Dermatol 2017; 16:e59-e67. [PMID: 28593645 DOI: 10.1111/jocd.12349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Unwanted side effects such as dryness, hypersensitivity, and cutaneous photosensitivity are challenge for adherence and therapeutical success for patients using treatments for inflammatory and allergic skin response. AIMS In this study, we compared the effects of two dermatological formulations, which are used in inflammatory and/or allergic skin conditions: dexchlorpheniramine maleate (DCP; 10 mg/g) and promethazine (PTZ; 20 mg/g). METHODS We evaluated both formulations for phototoxicity potential, skin irritation, anti-inflammatory and antihistaminic abilities, and skin barrier repair in vitro and ex vivo using the standard OECD test guideline n° 432, the ECVAM protocol n° 78, and cultured skin explants from a healthy patient. Ultraviolet A was chosen as exogenous agent to induce allergic and inflammatory response. RESULTS Both PTZ and DCP promoted increases in interleukin-1 (IL-1) synthesis in response to ultraviolet A (UVA) radiation compared to control. However, the increase observed with PTZ was significantly greater than the DCP, indicating that the latter has a lower irritant potential. DCP also demonstrated a protective effect on UVA-induced leukotriene B4 and nuclear factor kappa B (NF-κB) synthesis. Conversely, PTZ demonstrates more robust UVA antihistaminic activity. Likewise, PTZ promoted a significantly greater increase in the production of involucrin and keratin 14, both associated with protective skin barrier property. CONCLUSION In conclusion, these data suggest possible diverging UVA response mechanisms of DCP and PTZ, which gives greater insight into the contrasting photosensitizing potential between DCP and PTZ observed in the patients.
Collapse
Affiliation(s)
| | | | | | | | - Adilson Costa
- Pontifical Catholic University of Campinas - PUC Campinas, Campinas, SP, Brazil
| |
Collapse
|
29
|
Bergese SD, Puente EG, Antor MA, Viloria AL, Yildiz V, Kumar NA, Uribe AA. A Prospective, Randomized, Double-Blinded, Double-Dummy Pilot Study to Assess the Preemptive Effect of Triple Therapy with Aprepitant, Dexamethasone, and Promethazine versus Ondansetron, Dexamethasone and Promethazine on Reducing the Incidence of Postoperative Nausea and Vomiting Experienced by Patients Undergoing Craniotomy Under General Anesthesia. Front Med (Lausanne) 2016; 3:29. [PMID: 27458584 PMCID: PMC4932110 DOI: 10.3389/fmed.2016.00029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 06/23/2016] [Indexed: 11/24/2022] Open
Abstract
Introduction Postoperative nausea and vomiting (PONV) is among the most common distressing complications of surgery under anesthesia. Previous studies have demonstrated that patients who undergo craniotomy have incidences of nausea and vomiting as high as 50–70%. The main purpose of this pilot study is to assess the incidence of PONV by using two different prophylactic regimens in subjects undergoing a craniotomy. Thus, we designed this study to assess the efficacy and safety of triple therapy with the combination of dexamethasone, promethazine, and aprepitant versus ondansetron to reduce the incidence of PONV in patients undergoing craniotomy. Materials and methods This is a prospective, single center, two-armed, randomized, double-dummy, double-blind, pilot study. Subjects were randomly assigned to one of the two treatment groups. Subjects received 40 mg of aprepitant pill (or matching placebo pill) 30–60 min before induction of anesthesia and 4 mg of ondansetron IV (or 2 ml of placebo saline solution) at induction of anesthesia. In addition, all subjects received 25 mg of promethazine IV and 10 mg of dexamethasone IV at induction of anesthesia. Assessments of PONV commenced for the first 24 h after surgery and were subsequently assessed for up to 5 days. Results The overall incidence of PONV during the first 24 h after surgery was 31.0% (n = 15) in the aprepitant group and 36.2% (n = 17) for the ondansetron group. The median times to first emetic and significant nausea episodes were 7.6 (2.9, 48.7) and 14.3 (4.4, 30.7) hours, respectively, for the aprepitant group and 6.0 (2.2, 29.5) and 9.6 (0.7, 35.2) hours, respectively, for the ondansetron group. There were no statistically significant differences between these groups. No adverse events directly related to study medications were found. Conclusion This pilot study showed similar effectiveness when comparing the two PONV prophylaxis regimens. Our data showed that both treatments could be effective regimens to prevent PONV in patients undergoing craniotomy under general anesthesia. Future trials testing new PONV prophylaxis regimens in this surgical population should be performed to gain a better understanding of how to best provide prophylactic treatment.
Collapse
Affiliation(s)
- Sergio Daniel Bergese
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Neurological Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Erika G Puente
- Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| | - Maria A Antor
- Department of Anesthesiology, Jackson Memorial Hospital, University of Miami , Miami, FL , USA
| | - Adolfo L Viloria
- Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| | - Vedat Yildiz
- Center for Biostatistics, The Ohio State University , Columbus, OH , USA
| | - Nicolas Alexander Kumar
- Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| | - Alberto A Uribe
- Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH , USA
| |
Collapse
|
30
|
Hotta E, Nakai N, Katoh N. Multiple Fixed Drug Eruption Caused by Promethazine Methylene Disalicylate as One of the Components of PL(®) Combination Granules. Indian J Dermatol 2016; 61:348. [PMID: 27293277 PMCID: PMC4885210 DOI: 10.4103/0019-5154.182468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Eri Hotta
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto 602-8566, Japan. E-mail:
| | - Noriaki Nakai
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto 602-8566, Japan. E-mail:
| | - Norito Katoh
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto 602-8566, Japan. E-mail:
| |
Collapse
|
31
|
Bréhin C, Cessans C, Monchaud C, Lavit M, Majorel C, Claudet I. A pseudoencephalitis presentation of a pediatric non-intentional intoxication. Eur J Paediatr Neurol 2016; 20:418-20. [PMID: 26947545 DOI: 10.1016/j.ejpn.2016.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 02/14/2016] [Indexed: 10/22/2022]
Abstract
UNLABELLED We report a case of a pseudo encephalitis presentation of pediatric intoxication - Case report - a 7 year-old girl was admitted to our pediatric emergency unit after she developed sudden agitation, visual and tactile hallucinations. She was febrile (38.3 °C). She had not experienced any recent head trauma, infection or toxic ingestion; she did not take any medication for ADD. Her physical exam revealed tachycardia, normal pupils, reflexes and normal plantar responses. Laboratory investigations (complete blood count, basic metabolic panel, plasma lactate level, ammonia level) produced normal results. Lumbar puncture and computed tomography of the brain were normal. A serum and urine drug screening (benzodiazepines, barbiturates, cocaine, cannabis, amphetamines, methadone, ethanol) was negative. An electroencephalogram, performed during an episode of hallucinations, was compatible with benzodiazepine intoxication. A larger toxic detection by liquid chromatography/diode array detector (LC-DAD) detected promethazine and its metabolites. Symptoms lasted 20 h and she finally said she drank syrup from an over-the-counter cough suppressant medication. Comments - Anticholinergic syndrome is not well recognized or evoked in children presenting hallucinations. Promethazine is still present in several over-the-counter medications, alone or in combination with acetaminophen, carbocisteine or opiates. CONCLUSION Medications containing promethazine should not be prescribed in children. Such intoxication can mimic encephalitis.
Collapse
Affiliation(s)
- C Bréhin
- Pediatric Emergency Unit, Children Hospital, CHU Toulouse, France
| | - C Cessans
- Pediatric Emergency Unit, Children Hospital, CHU Toulouse, France
| | - C Monchaud
- Laboratory of Toxicology, Dupuytren Hospital, CHU Limoges, France
| | - M Lavit
- Laboratory of Toxicology, Purpan Hospital, CHU Toulouse, France
| | - C Majorel
- Pediatric Neurology Unit, Children Hospital, CHU Toulouse, France
| | - I Claudet
- Pediatric Emergency Unit, Children Hospital, CHU Toulouse, France.
| |
Collapse
|