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Goraya MHN, Inayat F, Taj S, Awan JR, Mohyudin A, Ali SH, Afzal A, Ashraf MJ, Zaman MA, Akhtar Z, Nawaz G, Tarar ZI. Acute ischemic colitis associated with oral decongestant use: a systematic review. J Clin Transl Res 2023; 9:195-205. [PMID: 37275581 PMCID: PMC10238105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/26/2022] [Accepted: 04/10/2023] [Indexed: 06/07/2023] Open
Abstract
Background and Aim Acute ischemic colitis (IC) has been linked with the use of oral decongestants. However, clinical evidence on this association remains limited. We aim to evaluate the occurrence and clinical outcomes of acute IC following over-the-counter (OTC) use of pseudoephedrine and phenylephrine. Methods We conducted a systematic review of the MEDLINE, Google Scholar, Scopus, and Embase databases between inception and July 20, 2022. Specific search terms were used. The inclusion criteria consisted of English-language articles describing acute IC secondary to pseudoephedrine or phenylephrine. Results A total of 18 case reports (level of clinical evidence: IV) fulfilled our inclusion criteria. The mean age of patients was 51.6 ± 15.3 years, with 14 (77.8%) cases reported in women. The clinical presentation was mainly related to abdominal pain 16 (88.9%), hematochezia 15 (83.3%), and/or abdominal tenderness 10 (55.6%). The medical background showed that 5 (27.8%) patients were previously healthy. In the 13 (72.2%) patients with comorbidities, hypertension 6 (46.2%), a history of tobacco use 5 (38.5%), and psychiatric illnesses 4 (30.8%) were commonly reported. Leukocytosis was encountered in 13 (72.2%) patients. Diagnostic investigations included a combination of computed tomography scan and colonoscopy in 10 (55.6%), colonoscopy alone in 6 (33.3%), and flexible sigmoidoscopy in 1 (5.6%) patient. Colonoscopic biopsy was the mainstay of diagnosis in 15 (83.3%) patients. Treatment was based on supportive care in 18 (100%), concurrent antibiotic use in 2 (11.1%), and surgical intervention in 1 (5.6%) patient. Recurrent episodes of IC occurred in 4 (22.2%) patients. Conclusions Acute IC secondary to oral decongestants remains a rare but important clinical phenomenon. Clinical suspicion and imaging findings are important for the early diagnosis. Relevance to Patients In unexplained cases of IC, clinicians should specifically inquire about oral decongestants since they are OTC and patients commonly fail to reveal their usage. These drugs should be avoided for transient cold symptoms, especially in women.
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Affiliation(s)
| | - Faisal Inayat
- Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan
| | - Sobaan Taj
- Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Junaid Rasul Awan
- Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan
| | - Adil Mohyudin
- Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Syed Hasan Ali
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Arslan Afzal
- Department of Internal Medicine, Woodhull Medical Center, Brooklyn, NY, USA
| | | | | | - Zahra Akhtar
- Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan
| | - Gul Nawaz
- Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan
| | - Zahid Ijaz Tarar
- Department of Gastroenterology, University of Missouri School of Medicine, Columbia, MO, USA
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Alattiya MK, Joudeh AI, Hammamy RA. Seizures provoked by over-the-counter cough and cold medications in an elderly patient: a case report. J Med Case Rep 2023; 17:170. [PMID: 37118829 PMCID: PMC10148391 DOI: 10.1186/s13256-023-03912-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/28/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Seizures are common neurological emergencies in the elderly that are frequently provoked. Geriatrics have higher rates of neurological disorders and other comorbidities that could affect seizure threshold. CASE PRESENTATION An 83-year-old male Arabic patient presented to the emergency department with an acute confusional state and urinary incontinence followed by a witnessed tonic-clonic seizure in the hospital. Thorough investigations and imaging were positive only for nonspecific magnetic resonant imaging findings with a negative electroencephalogram. The patient was diagnosed with provoked seizure due to over-the-counter cold medications that included pseudoephedrine and caffeine. He was not prescribed antiepileptic medications at discharge and did not develop subsequent seizures up to this date. CONCLUSION Over-the-counter cough and cold medications with sympathomimetic ingredients can be associated with provoked seizures in the elderly. Physicians should be aware of the potentially serious adverse events associated with commonly used nonprescription sympathomimetics such as pseudoephedrine and caffeine in elderly patients.
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Affiliation(s)
- Mohammed Kays Alattiya
- Department of Internal Medicine, Al-Khor Hospital, Hamad Medical Corporation, 3050, Doha, Qatar
| | - Anwar I Joudeh
- Department of Internal Medicine, Al-Khor Hospital, Hamad Medical Corporation, 3050, Doha, Qatar.
| | - Riyadh Ali Hammamy
- Department of Internal Medicine, Al-Khor Hospital, Hamad Medical Corporation, 3050, Doha, Qatar
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Kudo Y, Ando H, Kaneda A, Ito H, Umemoto K, Ni SR, Mikage M, Sasaki Y. Evaluation of rooting characteristics of Ephedra cuttings by anatomy and promising strain selection based on rooting characteristics and alkaloid content. J Nat Med 2023; 77:327-342. [PMID: 36680565 PMCID: PMC10987359 DOI: 10.1007/s11418-023-01680-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023]
Abstract
The differences in rooting characteristics of cuttings prepared from E. sinica strains were investigated and found that cuttings prepared from strains with high rooting characteristics showed approximately 90% of the cuttings were rooted, whereas cuttings prepared from low rooting characteristics did not root. To understand the reason for this substantial difference, the anatomy of nodes was examined and found that adventitious roots were generated from the cortex and parenchyma in pith. Calculations of the correlation coefficients between the rooting rate and the value of anatomy indicated that the rooting rate was positively correlated with the parenchyma in pith in the node. On the basis of the positive correlation, it is possible to estimate the rooting characteristics of new strains without having to prepare cuttings. Next, we conducted a screening for E. sinica strains on the basis of total alkaloids content [ephedrine (E) + pseudoephedrine (PE)] and selected strains having no less than 0.7% total alkaloids content as defined by the Japanese Pharmacopoeia 18th edition. Strains having characteristic E or PE content were uncovered: E-rich strains had 100% E content and PE-rich strains had 99% PE content. We were able to select E. sinica strains on the basis of two factors: high rooting rate of cuttings and high or characteristic alkaloid content. These strains are valuable for breeding.
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Affiliation(s)
- Yoshitomi Kudo
- Laboratory of Molecular Pharmacognosy, Graduate School of Medical Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan
| | - Hirokazu Ando
- Laboratory of Molecular Pharmacognosy, Graduate School of Medical Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan.
| | - Ai Kaneda
- Laboratory of Molecular Pharmacognosy, Graduate School of Medical Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan
| | - Honoka Ito
- Laboratory of Molecular Pharmacognosy, Graduate School of Medical Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan
| | - Kazuki Umemoto
- Laboratory of Molecular Pharmacognosy, Graduate School of Medical Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan
| | - Si-Ran Ni
- Laboratory of Medicinal Plant Resources, Department of Bio-Resource Development, Faculty of Agriculture, Tokyo University of Agriculture, 1737 Funako, Atsugi, Kanagawa, 243-0034, Japan
| | - Masayuki Mikage
- Laboratory of Medicinal Plant Resources, Department of Bio-Resource Development, Faculty of Agriculture, Tokyo University of Agriculture, 1737 Funako, Atsugi, Kanagawa, 243-0034, Japan
| | - Yohei Sasaki
- Laboratory of Molecular Pharmacognosy, Graduate School of Medical Sciences, Kanazawa University, Kakuma-Machi, Kanazawa, Ishikawa, 920-1192, Japan
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Nose M, Kobayashi R, Tada M, Hisaka S, Masada S, Homma M, Hakamatsuka T. Comparison of ephedrine and pseudoephedrine contents in 34 Kampo extracts containing Ephedrae Herba used clinically in Japan. J Nat Med 2023. [PMID: 36854954 DOI: 10.1007/s11418-023-01687-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 02/15/2023] [Indexed: 03/02/2023]
Abstract
Ephedrae Herba is among the important crude drugs prescribed in Kampo medicine for the treatment of cold, flue, rhinitis, nasal congestion, cough, and asthma. The active ingredients of Ephedrae Herba, ephedrine (E) and pseudoephedrine (PE), are potent sympathomimetic compounds that stimulate α-, β1-, and β2-adrenoceptors resulting in dilatation and alleviation of nasal mucosal hyperemia. Hypertension, palpitations, insomnia, and dysuria are the main adverse effects of E and PE, which can be avoided by determining the actual contents of these alkaloids in Kampo extracts containing Ephedrae Herba. However, the extraction efficiencies of E and PE from Ephedrae Herba contained in Kampo formulas in combination with other crude drugs remain unknown. Therefore, we comprehensively determined the E and PE contents of 34 Kampo extracts containing Ephedrae Herba used clinically in Japan. The E and PE contents per daily dosage in Kampo extracts were generally proportional to the compounding amount of Ephedrae Herba. In contrast, the extraction efficiencies of E or PE were not constant and not influenced by the pH of the extracts. We assume that the extraction efficiencies of E and PE may be independently affected by other constituent crude drugs. Thus, it is necessary to investigate the cause and mechanism in the future. In conclusion, these results show that the E and PE content of each Kampo formulation can be estimated from the compounding amount of Ephedrae Herba. Therefore, the amount of Ephedrae Herba should be carefully considered to ensure the safe use of Kampo formulations containing Ephedrae Herba.
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Huang X, Hyuga S, Amakura Y, Hyuga M, Uchiyama N, Hakamatsuka T, Goda Y, Odaguchi H, Hanawa T, Kobayashi Y. Overlooked switch from transient sedation to sustained excitement in the Biphasic effects of Ephedra Herb extract administered orally to mice. J Ethnopharmacol 2023; 301:115827. [PMID: 36240977 DOI: 10.1016/j.jep.2022.115827] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/29/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE In our previous study, we reported that Ephedra Herb extract (EHE) increased the locomotor activity of mice in the open-field test and reduced the immobility time in the forced swim test. Ephedrine alkaloids (EAs) are thought to be responsible for the adverse effects of Ephedra Herb. However, there are no reports to verify that the adverse effects of Ephedra Herb are caused by the amount of EAs in the herb. Therefore, we investigated whether these adverse effects of EHE are caused by the amounts of ephedrine (Eph) and pseudoephedrine (Pse) in the herbal extract. In a preliminary study of the time course analysis of the open field test, we newly observed that EHE evoked switching from transient sedation to sustained excitement. AIM OF THE STUDY We aimed to confirm whether EHE evokes switching from transient sedation to sustained excitement, investigate whether these actions of EHE are caused by the amount of ephedrine (Eph) and pseudoephedrine (Pse) in the herbal extract, and clarify the molecular mechanism of the transient sedative effect. MATERIALS AND METHODS The locomotor activity of mice was tested using the open-field test. The immobility times were measured using a forced swim test, and the motor dysfunction in mice was tested using the rotarod test. RESULTS EHE, Eph, and Pse induced transient motionlessness between 0 and 15 min after oral administration, however, they did not induce depression-like behavior and motor dysfunction in mice, suggesting that the motionlessness induced by EHE, Eph, or Pse resulted from sedation. The α2a adrenoceptor inhibitor, atipamezole, decreased their sedative effects. Thus, immediately after EHE administration, the transient sedative effect is mediated through the activation of the α2a adrenoreceptor by Eph and Pse. EHE and Eph increased total locomotor activity for 15-120 min after oral administration; however, Pse had no effect. Therefore, the slow-onset and sustained excitatory effects of EHE are mediated by Eph. CONCLUSIONS We discovered for the first time that EHE evokes diphasic action by switching from transient sedation to sustained excitement. The transient sedation was evoked by the Eph and Pse in the herbal extract via activation of the α2a adrenoceptor and the sustained excitement was caused by the Eph in the herbal extract.
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Affiliation(s)
- Xuedan Huang
- Department of Pharmacognosy, School of Pharmacy, Kitasato University, Tokyo, Japan; Oriental Medicine Research Center of Kitasato University, Tokyo, Japan.
| | - Sumiko Hyuga
- Oriental Medicine Research Center of Kitasato University, Tokyo, Japan.
| | - Yoshiaki Amakura
- Department of Pharmacognosy, College of Pharmaceutical Sciences, Matsuyama University, Ehime, Japan.
| | - Masashi Hyuga
- National Institute of Health Sciences, Kanagawa, Japan.
| | | | | | - Yukihiro Goda
- National Institute of Health Sciences, Kanagawa, Japan.
| | - Hiroshi Odaguchi
- Oriental Medicine Research Center of Kitasato University, Tokyo, Japan.
| | - Toshihiko Hanawa
- Oriental Medicine Research Center of Kitasato University, Tokyo, Japan.
| | - Yoshinori Kobayashi
- Department of Pharmacognosy, School of Pharmacy, Kitasato University, Tokyo, Japan; Oriental Medicine Research Center of Kitasato University, Tokyo, Japan.
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Simpson BS, Jaunay EL, Ghetia M, Nguyen L, Bade R, White JM, Gerber C. Methcathinone in wastewater: Drug of choice, or artefact? Sci Total Environ 2022; 836:155696. [PMID: 35525340 DOI: 10.1016/j.scitotenv.2022.155696] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 06/14/2023]
Abstract
Methcathinone is a prevalent Novel Psychoactive Substance (NPS) used illicitly in some countries. Routine analysis of wastewater sampled from catchments in South Australia has shown a consistent low-level presence of the compound, inconsistent with NPS use. This raised the question was the occurrence due to regular use as a drug of choice or was it an artefact being produced from other sources in the sewer system? NPS consumption is generally sporadic and would therefore point to the origin of methcathinone in wastewater being due to in-sewer oxidation of its legal precursor, pseudoephedrine. The present study tested this hypothesis by comparing the levels of pseudoephedrine and methcathinone in wastewater samples collected bimonthly from 8 catchment sites in South Australia. Laboratory experiments exposing pseudoephedrine to common household oxidizing agents (hypochlorite and percarbonate) were also performed and the production of methcathinone was demonstrated and monitored. The results of this study showed that the level of pseudoephedrine and methcathinone measured in wastewater followed a similar pattern. However, there were periods when the levels of each compound diverged. Laboratory experiments showed that when exposed to various oxidizing agents, pseudoephedrine is oxidised to non-stoichiometric quantities of methcathinone. Although the use of methcathinone as a drug of choice remains possible, the results of this study indicate that the low and persistent level of methcathinone found in wastewater may arise in part from the oxidation of pseudoephedrine in the sewer system.
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Affiliation(s)
- Bradley S Simpson
- University of South Australia, Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5001, South Australia, Australia.
| | - Emma L Jaunay
- University of South Australia, Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5001, South Australia, Australia
| | - Maulik Ghetia
- University of South Australia, Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5001, South Australia, Australia
| | - Lynn Nguyen
- University of South Australia, Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5001, South Australia, Australia
| | - Richard Bade
- University of Queensland, Queensland Alliance for Environmental Health Sciences (QAEHS), Woolloongabba 4102, Queensland, Australia
| | - Jason M White
- University of South Australia, Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5001, South Australia, Australia
| | - Cobus Gerber
- University of South Australia, Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide 5001, South Australia, Australia
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Tuncer I, Unsal U. Acute effect of pseudoephedrine on macular microcirculation in healthy subjects: an optical coherence tomography angiography study. Jpn J Ophthalmol 2021; 66:94-100. [PMID: 34279747 DOI: 10.1007/s10384-021-00859-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To quantitatively evaluate the acute effects of pseudoephedrine on the macular microvasculature using optical coherence tomography angiography (OCTA). STUDY DESIGN Randomized placebo-controlled clinical study. METHODS In this study, 60 right eyes of 60 healthy subjects were divided into 2 groups. The study group received 60 mg of pseudoephedrine and the control group received a placebo. All participants underwent OCTA at baseline and 1 h after oral intake. Superficial macular flow area, foveal avascular zone (FAZ), superficial macular vessel density, central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) were analyzed. RESULTS Baseline superficial macular flow area, FAZ area, superficial macular vessel density, CFT and SFCT measurements in the study and control groups showed no significant difference (p > 0.05 for all). Oral pseudoephedrine intake caused a significant reduction in superficial macular flow area, FAZ area, superficial macular vessel density and SFCT measurements when compared with baseline (p < 0.05 for all). However, there was no significant difference in CFT after oral pseudoephedrine intake (p > 0.05). CONCLUSION Oral pseudoephedrine intake causes a significant decrease in superficial macular blood flow and SFCT. Impairmant of macular microcirculation can be detected noninvasively and quantitavitely by OCTA.
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Affiliation(s)
- Ibrahim Tuncer
- Alfa Medical Center, 6244 St. No:1, Bornova, 35040, Izmir, Turkey.
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Zhang Y, Tan X, Xing L, Wu H, Yang J. Detection of the chiral drug Ephedrine by resonance Rayleigh scattering based on Ce 3+ functionalized gold nanoparticles. Spectrochim Acta A Mol Biomol Spectrosc 2021; 255:119695. [PMID: 33774414 DOI: 10.1016/j.saa.2021.119695] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
Two chiral drugs, ephedrine (EH) and pseudoephedrine (PEH), were commonly used in clinical treatment. Ephedrine (EH) and pseudoephedrine (PEH) could make different changes in resonance Rayleigh scattering spectrum of the detection system which use Ce3+ functionalized gold nanoparticles as probe. Therefore, a new method of detecting EH and PEH separately was developed. The RRS spectrum and UV-Vis absorption spectrum of AuNPs-Ce3+ detection system was analyzed in order to discuss the mechanism. Under optimal experimental conditions, the linear range of EH and PEH were 20-920 ng/mL and 40-520 ng/mL, respectively. The detection limit were 1.9 ng/mL and 3.8 ng/mL, respectively. Last used for actual testing, this method had obtained good results.
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Affiliation(s)
- Yuhui Zhang
- Chongqing Three Gorges University, Wanzhou, Chongqing 404100, China
| | - Xuanping Tan
- Chongqing Three Gorges University, Wanzhou, Chongqing 404100, China
| | - Ligang Xing
- Yangtze Normal University, Fuling, Chongqing 408100, China
| | - Huan Wu
- Chongqing Three Gorges Vocational College, Wanzhou, Chongqing 404100, China
| | - Jidong Yang
- Chongqing Three Gorges University, Wanzhou, Chongqing 404100, China.
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Ahsan H, Irfan HM, Alamgeer, Shahzad M, Asim MH, Akram M, Zafar MS. Anti-rheumatic activity of pseudoephedrine (a substituted phenethylamine) in complete Freund's adjuvant-induced arthritic rats by down regulating IL-1β, IL-6 and TNF-α as well as upregulating IL-4 and IL-10. Inflammopharmacology 2021; 29:673-682. [PMID: 33772383 DOI: 10.1007/s10787-021-00804-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
Pseudoephedrine (substituted phenethylamine) is well known as psychotic and bronchodilator. Numerous studies on phenethylamine derivatives indicated that these agents have the potential to abolish inflammatory responses in the non-biological and biological systems. These facts provided the basis to conduct a study on pseudoephedrine to explore its therapeutics in Complete Freund's Adjuvant (CFA)-induced arthritis. Furthermore, existing treatment approaches for RA associated with limited effect on chronic immunological models. Real-time polymerase chain reaction (q-PCR) was performed to execute the expression of pro and anti-inflammatory cytokines in treated and non-treated arthritic rats. These findings were further co investigate by histological observations. The paw volume, paw diameter, weight variations and arthritic score were determined at specific days throughout the experiment of 28 days. Pseudoephedrine at all doses significantly (p < 0.001) suppressed the expression of PGE2, TNF-α, IL-1β and IL-6. Moreover, pseudoephedrine (20 and 40 mg/kg) caused significant augmentation of IL-4 and IL-10. Similarly, the drug expressed a significant anti-arthritic effect by reducing the paw volume, paw diameter and arthritic score. Similarly, it also reverts the reduction in body weight of arthritic rats at all above-mentioned doses. These findings supported the anti-arthritic potential of pseudoephedrine and recommended it for clinical trials.
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Affiliation(s)
- Haseeb Ahsan
- College of Pharmacy, University of Sargodha, Sargodha, 40100, Pakistan
| | | | - Alamgeer
- Department of Pharmacology, University College of Pharmacy, University of the Punjab, Lahore, 54000, Pakistan
| | - Muhammad Shahzad
- Department of Pharmacology, University of Health Sciences, Lahore, 54000, Pakistan
| | | | - Muhammad Akram
- College of Pharmacy, University of Sargodha, Sargodha, 40100, Pakistan
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Guselnikova O, Lim H, Na J, Eguchi M, Kim HJ, Elashnikov R, Postnikov P, Svorcik V, Semyonov O, Miliutina E, Lyutakov O, Yamauchi Y. Enantioselective SERS sensing of pseudoephedrine in blood plasma biomatrix by hierarchical mesoporous Au films coated with a homochiral MOF. Biosens Bioelectron 2021; 180:113109. [PMID: 33677356 DOI: 10.1016/j.bios.2021.113109] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/05/2021] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
Here, we present a new family of hierarchical porous hybrid materials as an innovative tool for ultrasensitive and selective sensing of enantiomeric drugs in complex biosamples via chiral surface-enhanced Raman spectroscopy (SERS). Hierarchical porous hybrid films were prepared by the combination of mesoporous plasmonic Au films and microporous homochiral metal-organic frameworks (HMOFs). The proposed hierarchical porous substrates enable extremely low limit of detection values (10-12 M) for pseudoephedrine in undiluted blood plasma due to dual enhancement mechanisms (physical enhancement by the mesoporous Au nanostructures and chemical enhancement by HMOF), chemical recognition by HMOF, and a discriminant function for bio-samples containing large biomolecules, such as blood components. We demonstrate the effect of each component (mesoporous Au and microporous AlaZnCl (HMOF)) on the analytical performance for sensing. The growth of AlaZnCl leads to an increase in the SERS signal (by around 17 times), while the use of mesoporous Au leads to an increase in the signal (by up to 40%). In the presence of a complex biomatrix (blood serum or plasma), the hybrid hierarchical porous substrate provides control over the transport of the molecules inside the pores and prevents blood protein infiltration, provoking competition with existing plasmonic materials at the limit of detection and enantioselectivity in the presence of a multicomponent biomatrix.
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Affiliation(s)
- Olga Guselnikova
- Department of Solid State Engineering, University of Chemistry and Technology, 16628, Prague, Czech Republic; Research School of Chemistry and Applied Biomedical Sciences, Tomsk Polytechnic University, 634049, Tomsk, Russian Federation.
| | - Hyunsoo Lim
- Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia; New & Renewable Energy Research Center, Korea Electronics Technology Institute (KETI), 25, Saenari-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13509, Republic of Korea
| | - Jongbeom Na
- Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Miharu Eguchi
- Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia; JST-ERATO Yamauchi Materials Space-Tectonics Project and International Center for Materials Nanoarchitectonics (WPI-MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki, 305-0044, Japan
| | - Hyun-Jong Kim
- Surface Technology Group, Korea Institute of Industrial Technology (KITECH), Incheon, 21999, Republic of Korea
| | - Roman Elashnikov
- Department of Solid State Engineering, University of Chemistry and Technology, 16628, Prague, Czech Republic
| | - Pavel Postnikov
- Department of Solid State Engineering, University of Chemistry and Technology, 16628, Prague, Czech Republic; Research School of Chemistry and Applied Biomedical Sciences, Tomsk Polytechnic University, 634049, Tomsk, Russian Federation
| | - Vaclav Svorcik
- Department of Solid State Engineering, University of Chemistry and Technology, 16628, Prague, Czech Republic
| | - Oleg Semyonov
- Research School of Chemistry and Applied Biomedical Sciences, Tomsk Polytechnic University, 634049, Tomsk, Russian Federation
| | - Elena Miliutina
- Department of Solid State Engineering, University of Chemistry and Technology, 16628, Prague, Czech Republic; Research School of Chemistry and Applied Biomedical Sciences, Tomsk Polytechnic University, 634049, Tomsk, Russian Federation
| | - Oleksiy Lyutakov
- Department of Solid State Engineering, University of Chemistry and Technology, 16628, Prague, Czech Republic; Research School of Chemistry and Applied Biomedical Sciences, Tomsk Polytechnic University, 634049, Tomsk, Russian Federation
| | - Yusuke Yamauchi
- Australian Institute for Bioengineering and Nanotechnology (AIBN), The University of Queensland, Brisbane, QLD, 4072, Australia; JST-ERATO Yamauchi Materials Space-Tectonics Project and International Center for Materials Nanoarchitectonics (WPI-MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki, 305-0044, Japan.
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Fuchino H, Iida O, Kawano N, Kawahara N, Yoshimatsu K. One-pot discriminant LC/MS quantitative analysis of ephedrine and pseudoephedrine using Finger Masher and their distribution in the aerial stems of Ephedra plants. J Nat Med 2021; 75:707-716. [PMID: 33599897 DOI: 10.1007/s11418-021-01494-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
A discriminant LC/MS quantitative analysis of ephedrine (EP) and pseudoephedrine (PEP) in Ephedrae herba was performed. Aerial parts of three Ephedra species were separated into internodes and extracted using Finger Masher with minimum loss. The contents of EP and PEP were measured by LC/MS/MS using the multiple reaction monitoring (MRM) method. Their contents in old-year branches were lower than those current-year branches and tended to be higher in the middle part than in the tip of each branch. The content ratio of EP and PEP was reversed in some branches depending on their extent of growth. In E. sinica, the contents were low at the first internode closest to the central main stem at each branch. The contents drastically increased from the second internode and were highest at the third internode. There was a strong correlation between the internode distance and alkaloid (EP + PEP) contents. The distribution of alkaloids in one internode was examined and the results showed that the part closest to the node had the lowest contents.
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Affiliation(s)
- Hiroyuki Fuchino
- Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, 1-2 Hachimandai, Tsukuba, Ibaraki, 305-0843, Japan.
| | - Osamu Iida
- Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, 1-2 Hachimandai, Tsukuba, Ibaraki, 305-0843, Japan
| | - Noriaki Kawano
- Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, 1-2 Hachimandai, Tsukuba, Ibaraki, 305-0843, Japan
| | - Nobuo Kawahara
- Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, 1-2 Hachimandai, Tsukuba, Ibaraki, 305-0843, Japan
| | - Kayo Yoshimatsu
- Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, 1-2 Hachimandai, Tsukuba, Ibaraki, 305-0843, Japan
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12
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Tran JQ, Zhang P, Walker S, Ghosh A, Syto M, Wang X, Harris S, Palmisano M. Multiple-Dose Pharmacokinetics of Ozanimod and its Major Active Metabolites and the Pharmacodynamic and Pharmacokinetic Interactions with Pseudoephedrine, a Sympathomimetic Agent, in Healthy Subjects. Adv Ther 2020; 37:4944-58. [PMID: 33025342 DOI: 10.1007/s12325-020-01500-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/05/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The aims of this study were to characterize the multiple-dose pharmacokinetics (PK) of ozanimod's major active metabolites (CC112273 and CC1084037) and to evaluate the pharmacodynamic and PK interactions with pseudoephedrine (PSE). METHODS In this phase 1, single-center, randomized, double-blind, placebo-controlled study, 56 healthy adult subjects were randomized to receive either placebo or ozanimod once daily for 30 days (0.23 mg on days 1-4, 0.46 mg on days 5-7, 0.92 mg on days 8-10, and 1.84 mg on days 11-30). On day 30, a single oral dose of PSE 60 mg was co-administered with placebo or ozanimod. Maximum time-matched change in systolic blood pressure (SBP) from baseline (day 29) following PSE administration on day 30 was calculated. Plasma PK parameters for ozanimod, CC112273, CC1084037, and PSE were estimated using noncompartmental methods. RESULTS Fifty-two subjects (92.9%) completed the study. Following multiple dosing, approximately 94% of circulating total active drug exposure was represented by ozanimod (6%), CC112273 (73%), and CC1084037 (15%). Exposures of CC112273 and CC1084037 were highly correlated. Mean maximum time-matched change from baseline for SBP was not significantly different between ozanimod + PSE and placebo + PSE. Ozanimod also had no effect on the PK of PSE. Co-administration of ozanimod with a single dose of PSE in healthy subjects was generally well tolerated. While CC112273 and CC1084037 selectively inhibited monoamine oxidase (MAO)-B in vitro, both active metabolites do not inhibit platelet MAO-B activity in vivo. CONCLUSION Concomitant administration of ozanimod with PSE, a sympathomimetic agent, did not potentiate the effects on blood pressure. TRIAL REGISTRATION NCT03644576.
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Chen X, Lin J, Liang Q, Chen X, Wu Z. Pseudoephedrine alleviates atopic dermatitis-like inflammatory responses in vivo and in vitro. Life Sci 2020; 258:118139. [PMID: 32721463 DOI: 10.1016/j.lfs.2020.118139] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 02/07/2023]
Abstract
AIMS Atopic dermatitis is a chronic inflammatory disease characterized by eczematous lesions and has become a serious health problem worldwide. Pseudoephedrine (PSE) is a nasal decongestant to treat the common cold. PSE has been reported that is beneficial to allergic diseases. However, whether PSE has the potential in atopic dermatitis remains to be elucidated. MAIN METHODS Male BALB/c mice were challenged with 2,4-dinitrochlorobenzene (DNCB) to induce atopic dermatitis-like lesion and orally administrated with PSE for two weeks. The skin hydration and the scratching behavior were detected. The skin lesions and histopathological changes were evaluated and inflammatory factors levels were detected. Human Keratinocytes (HaCaT cells) were stimulated by TNF-α/IFN-γ after PSE-pretreatment. The transcriptions of inflammatory factors were detected. KEY FINDINGS PSE decreased skin lesion area and skin thickness in atopic dermatitis mice. PSE improved skin hydration and scratching. Histologically, PSE reduced mast cell and CD4+ cell infiltration. PSE suppressed serum TNF-α and IgE levels, reducing cytokines (IL-1β, IL-4, IL-6, IL-13, IL-33, TSLP, and IL-23) and neutrophil migration factors (CCL2 and MMP-9) in skin tissues. In addition, PSE inhibited TNF-α/IFN-γ-induced release of inflammatory factors (TNF-α, IL-1β, and IL-23) in HaCaT cells. Furthermore, PSE suppressed the activation of MAPKs and NF-κB signaling pathways in vivo and in vitro. SIGNIFICANCE These results demonstrate that PSE could inhibit inflammatory responses in atopic dermatitis models. PSE may serve as a viable alternatives drug for the treatment of atopic dermatitis.
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Affiliation(s)
- Xiaolei Chen
- School of Basic Medicine Science, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, China
| | - Jiacheng Lin
- School of Basic Medicine Science, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, China; Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, 528 Zhangheng Road, Shanghai, China
| | - Qingsong Liang
- Department of Dermatology, Bengbu Hospital of Traditional Chinese Medicine, 4339 Huaishangdadao Road, Bengbu, Anhui, China
| | - Xiaoyin Chen
- College of Traditional Chinese Medicine, Jinan University, 601 Huangpu avenue Road, Guangzhou, Guangdong, China.
| | - Zhongping Wu
- School of Basic Medicine Science, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, China.
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14
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Spencer BG, Baskin J, Giarola BF, Craig JE. Single Dose of Pseudoephedrine Induces Simultaneous Bilateral Acute Angle Closure Crisis. Case Rep Ophthalmol 2019; 10:365-368. [PMID: 31762769 PMCID: PMC6873066 DOI: 10.1159/000503854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 10/02/2019] [Indexed: 11/26/2022] Open
Abstract
Simultaneous bilateral acute angle closure crisis (AACC) is a sight-threatening ocular emergency. Many “cold and flu” preparations contain compounds with sympathomimetic or anticholinergic qualities that confer a risk of inducing AACC. We present a review of cold and flu preparation-induced AACC, and present a case of simultaneous bilateral AACC triggered by a single oral dose of pseudoephedrine. The challenges facing the clinician in recognizing simultaneous bilateral AACC in the context of an upper respiratory tract infection are addressed. An awareness of this uncommon clinical entity, its pertinent clinical features, risk factors, and the drug classes that may precipitate an attack is critical for the timely diagnosis and management of this ocular emergency. Notably, clinicians must be aware that even a single dose of an implicated medication may trigger an attack of AACC.
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Affiliation(s)
- Benjamin G Spencer
- Training Medical Officer Unit, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Jonathan Baskin
- Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Blake F Giarola
- Neurology Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Jamie E Craig
- Ophthalmology Department, Flinders Medical Centre, Adelaide, South Australia, Australia
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15
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Chiarugi A, Camaioni A. Update on the pathophysiology and treatment of rhinogenic headache: focus on the ibuprofen/ pseudoephedrine combination. ACTA ACUST UNITED AC 2019; 39:22-27. [PMID: 30936575 PMCID: PMC6444167 DOI: 10.14639/0392-100x-1882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 11/23/2017] [Indexed: 12/18/2022]
Abstract
Rhinogenic headache is frequently encountered in clinical practice. Treatment of this condition should be based on a proper evaluation of its underlying pathophysiology. Fixed-dose combinations of two or more active agents, and specifically the combination of ibuprofen plus pseudoephedrine, have been shown to be more efficacious than either monotherapy. At present, an ibuprofen/pseudoephedrine fixed-dose combination is available as an over-the-counter drug. This paper reviews in detail the pathophysiology of rhinogenic headache and discusses the rationale for treatment of this condition with a fixed-dose ibuprofen/pseudoephedrine combination.
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Affiliation(s)
- A Chiarugi
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Italy
| | - A Camaioni
- Ear, Nose and Throat Department, San Giovanni Addolorata Hospital, Rome, Italy
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16
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Savanovitch C, Prunet-Spano C, Davoust N, Werhlé C, Amouroux F, Gourou A, Housieaux E, Comby F, Pereira B, Catala O, Vennat B. IPADAM "Pharmaceutical interventions on the issue of pharmaceutical records and self-medication" quanti survey in 482 French pharmacies. Ann Pharm Fr 2019; 77:198-204. [PMID: 30685061 DOI: 10.1016/j.pharma.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study aims to: (i) quantify the number of pharmaceutical interventions (PIs) linked to spontaneous requests for the two oral target molecules, ibuprofen and pseudoephedrine (ii) analyse the causes and proposed solutions (iii) quantify the number of registrations in the patient's pharmaceutical record and identify the various causes of non-registration. METHODS The study was conducted over a 2 weeks' period in the months of February and April 2014 in 482 pharmacies affiliated to the training supervisor associations of 8 French Faculties of Pharmacy. Data regarding spontaneous requests for the target molecules was collected, with due respect to a patient care flow chart at the pharmacy, by incorporating the systematic proposal for registration of the medication in the patient's pharmaceutical record. Each PI was the subject of a notification made with reference to a standardized grid. RESULTS A total of 12,160 dispensations were made over the two weeks of the study. Overall 815 of them gave rise to an PI (6.7%), justified in almost half of the cases by a contraindication. The alternative proposed by the dispensing pharmacist was accepted in more than 9 out of 10 cases. In half of the cases, the dispensing pharmacist had access to the patient's French healthcare card; more than 2/3 of the dispensations thus led to the registration of the medication in the patient's pharmaceutical record. CONCLUSION The pairing of the two tools, these being the notification grid and the pharmaceutical record, aims to maximize dispensation security while patients are being guided in their approach to self-medication.
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Affiliation(s)
- C Savanovitch
- UFR Pharmacie - UCA, 28, place Henri-Dunant, 63001 Clermont-Ferrand, France.
| | - C Prunet-Spano
- UPU ACCePPT, Pharmacy UFR, the University of Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - N Davoust
- Pharmaceutical mathematics and physics laboratory, Faculty of pharmaceutical and biological sciences, University of Rennes 1, 35043 Rennes, France
| | - C Werhlé
- UMR 7213 CNRS, Pharmacy UFR, University of Strasbourg, 67401 Illkirch, France
| | - F Amouroux
- Inserm U 1219, Medecine UFR, University of Bordeaux, 33000 Bordeaux, France
| | - A Gourou
- EA 2415, Faculty of Pharmacy, University of Montpellier, 34096 Montpellier, France
| | - E Housieaux
- Inserm U 1088 Unit, Pharmacy UFR, University of Picardy Jules Verne, 80000 Amiens, France
| | - F Comby
- Therapeutic and organic chemistry laboratory, Faculty of Pharmacy, University of Limoges, 87025 Limoges, France
| | - B Pereira
- Department of Clinical Research and Innovation, CHU (University Hospital), 63000 Clermont-Ferrand, France
| | - O Catala
- UPU ACCePPT, Pharmacy UFR, the University of Clermont Auvergne, 63000 Clermont-Ferrand, France
| | - B Vennat
- UPU ACCePPT, Pharmacy UFR, the University of Clermont Auvergne, 63000 Clermont-Ferrand, France
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17
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Gheorghiev MD, Hosseini F, Moran J, Cooper CE. Effects of pseudoephedrine on parameters affecting exercise performance: a meta-analysis. Sports Med Open 2018; 4:44. [PMID: 30291523 PMCID: PMC6173670 DOI: 10.1186/s40798-018-0159-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/25/2018] [Indexed: 11/23/2022]
Abstract
Background Pseudoephedrine (PSE), a sympathomimetic drug, commonly used in nasal decongestants, is currently banned in sports by the World Anti-Doping Agency (WADA), as its stimulant activity is claimed to enhance performance. This meta-analysis described the effects of PSE on factors relating to sport performance. Methods All included studies were randomised placebo-controlled trials and were conducted in a double blind crossover fashion. All participants (males and females) were deemed to be healthy. For the primary analysis, standardised mean difference effect sizes (ES) were calculated for heart rate (HR), time trial (TT) performance, rating of perceived exertion, blood glucose, and blood lactate. Results Across all parameters, effects were trivial with the exception of HR, which showed a small positive increase in favour of PSE ingestion (ES = 0.43; 95% confidence interval: − 0.01 to 0.88). However, subgroup analyses revealed important trends. Effect sizes for HR (increase) and TT (quicker) were larger in well-trained (VO2 max (maximal oxygen consumption) ≥ 65 ml/kg/min) and younger (< 28 years) participants, for shorter (< 25 mins) bouts of exercise and when PSE was administered less than 90 min prior to performance. There was evidence of a dose-response effect for TT and HR with larger doses (> 170 mg) resulting in small (ES = − 0.24) and moderate (ES = 0.85) effect sizes respectively for these variables. Conclusions We conclude, however, that the performance benefit of pseudoephedrine is marginal and likely to be less than that obtained from permitted stimulants such as caffeine.
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Affiliation(s)
- Maria D Gheorghiev
- Centre for Sports and Exercise Science, School of Biological Sciences, University of Essex, Colchester, UK.,Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Farzad Hosseini
- Centre for Sports and Exercise Science, School of Biological Sciences, University of Essex, Colchester, UK
| | - Jason Moran
- Centre for Sports and Exercise Science, School of Biological Sciences, University of Essex, Colchester, UK. .,Department of Sport, Hartpury University, Gloucestershire, UK.
| | - Chris E Cooper
- Centre for Sports and Exercise Science, School of Biological Sciences, University of Essex, Colchester, UK. .,School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK.
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18
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Dakay K, McTaggart RA, Jayaraman MV, Yaghi S, Wendell LC. Reversible cerebral vasoconstriction syndrome presenting as an isolated primary intraventricular hemorrhage. Chin Neurosurg J 2018; 4:11. [PMID: 32922872 PMCID: PMC7398312 DOI: 10.1186/s41016-018-0118-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 04/25/2018] [Indexed: 11/24/2022] Open
Abstract
Background Primary intraventricular hemorrhage is an uncommon cause of stroke and is often associated with longstanding, uncontrolled hypertension. Reversible cerebral vasoconstriction is also an uncommon condition characterized by reversible constriction of intracerebral vessels, which can lead to ischemic or hemorrhagic strokes. Case presentation We describe a case of isolated primary intraventricular hemorrhage secondary to reversible cerebral vasoconstriction syndrome triggered by pseudoephedrine. Conclusions Reversible cerebral vasoconstriction syndrome is a rare cause of primary intraventricular hemorrhage and should be considered in the differential in angiography-negative IVH when there is a history of vasoactive substance use.
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Affiliation(s)
- Katarina Dakay
- Department of Neurology, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Ryan A McTaggart
- Departments of Radiology, Neurology, and Neurosurgery, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Mahesh V Jayaraman
- Departments of Radiology, Neurology, and Neurosurgery, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Shadi Yaghi
- Department of Neurology, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Linda C Wendell
- Department of Neurology, Neurosurgery and Medical Education, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, 593 Eddy St APC 712, Providence, RI 02903 USA
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19
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Youssef SH, Hegazy MAM, Mohamed D, Badawey AM. Analysis of paracetamol, pseudoephedrine and cetirizine in Allercet Cold ® capsules using spectrophotometric techniques. Chem Cent J 2018; 12:67. [PMID: 29858703 PMCID: PMC5984616 DOI: 10.1186/s13065-018-0436-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/25/2018] [Indexed: 11/16/2022] Open
Abstract
Paracetamol (PAR), Pseudoephedrine hydrochloride (PSE) and cetirizine dihydrochloride (CET) is a ternary mixture that composes tablets which are popular for the relief of flu in Egypt. The spectra of the drugs were overlapped and no spectrophotometric methods were reported to resolve the mixture. This research proposes four spectrophotometric methods that are efficient and require water only as a solvent. The first method was ratio subtraction-ratio difference method (RSDM) where PAR was initially removed from the mixture by ratio subtraction and determined at 292.4 nm, then PSE and CET were quantified by subtracting the amplitudes of their ratio spectra between 257.0 and 230.0 nm for PSE and between 228.0 and 257.0 nm for CET. The second method was derivative ratio spectra—zero crossing (DRZC) which was based on determining both PSE and CET from the zero-crossing points of the first and third derivative of their ratio spectra at 252.0 and 237.0 nm, respectively while PAR was determined using its first derivative at 292.4 nm. Moreover, the ternary mixture was resolved using successive derivative ratio (SDR) method where PAR, PSE and CET were determined at 310.2, 257.0 and 242.4 nm, respectively. The fourth proposed method was pure component contribution algorithm (PCCA) which was applied to quantify the drugs at their λmax. Recovery percentages for RSDM were 100.7 ± 1.890, 99.69 ± 0.8400 and 99.38 ± 1.550; DRZC were 101.8 ± 0.8600, 99.04 ± 1.200 and 98.95 ± 1.300; SDR were 101.9 ± 1.060, 99.59 ± 1.010 and 100.2 ± 0.6300; PCCA were 101.6 ± 1.240, 99.10 ± 0.5400 and 100.4 ± 1.800 for PAR, PSE and BRM; respectively. The suggested methods were effectively applied to analyze laboratory prepared mixtures and their combined dosage form. ![]()
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Affiliation(s)
- Souha H Youssef
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, October University for Modern Sciences and Arts, 6 October City, 11787, Egypt.
| | - Maha Abdel-Monem Hegazy
- Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, Kasr El-Aini Street, Cairo, 11562, Egypt
| | - Dalia Mohamed
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, October University for Modern Sciences and Arts, 6 October City, 11787, Egypt.,Analytical Chemistry Department, Faculty of Pharmacy, Helwan University, Ein Helwan, Cairo, 11795, Egypt
| | - Amr Mohamed Badawey
- Pharmaceutical Chemistry Department, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt (FUE), Cairo, 12311, Egypt
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20
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Savanovitch C, Bedhomme S, Van Lander A, Prunet-Spano C, Vennat B. [IPADAM quali study. Intervention of the Pharmacist in the Issue of Self-medication: Experience of pharmacy team focus groups and patients' perceptions]. Ann Pharm Fr 2018; 76:399-407. [PMID: 29801716 DOI: 10.1016/j.pharma.2018.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/09/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study had two main aims: (i) document the experience of community pharmacists receiving a spontaneous request for ibuprofen and oral pseudoephedrine, and their use of pharmaceutical records, and (ii) explore patients' perceptions of pharmaceutical records and pharmaceutical interventions. METHODS The study was conducted over two weeks between February and April 2014 in 482 community pharmacies and 8 French faculties of pharmacy. It was based on data collected by pharmacy team focus groups during patient telephone interviews using standardized question grids. Textual and thematic analyses were made of the patient responses. RESULTS Four pharmacy team focus groups carried out 49 telephone interviews. Examination of the practice of the groups showed that pharmaceutical interventions, although incompletely registered, are performed on a daily basis and enhance the value of the pharmacist's function. Analysis of the telephone interviews also showed the importance of the advisory role of the pharmacist in dispensing an optional medical prescription. The thematic analysis of the results identified a positive response of patients to pharmaceutical interventions if made by their regular pharmacist and accompanied by explanatory information. The focus groups and patients agreed that pharmaceutical records were not consulted often enough. CONCLUSION This study underlines the need for greater safety in the use of optional medical prescription drugs. Promoting responsible self-medication in compliance with proper use should include systematic reference to a PR and informed dialogue with the patient.
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Affiliation(s)
- C Savanovitch
- UPU ACCePPT, université Clermont-Auvergne, 63000 Clermont-Ferrand, France.
| | - S Bedhomme
- UPU ACCePPT, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - A Van Lander
- UPU ACCePPT, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - C Prunet-Spano
- UPU ACCePPT, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
| | - B Vennat
- UPU ACCePPT, université Clermont-Auvergne, 63000 Clermont-Ferrand, France
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21
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Doughty D, Kent E, Painter B, Pigou PE, Johnston MR. Detailed investigations into the Akabori-Momotani reaction for the synthesis of amphetamine type stimulants: Part 2. Forensic Sci Int 2018; 287:207-216. [PMID: 29459189 DOI: 10.1016/j.forsciint.2018.01.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/22/2018] [Accepted: 01/27/2018] [Indexed: 11/28/2022]
Abstract
The Akabori-Momotani reaction can be used to synthesise pseudoephedrine in 50% yield from N-methylalanine and benzaldehyde. This paper investigates electronic effects of substituted benzaldehydes on the reaction to synthesise amphetamine type stimulants and identifies several new Akabori-Momotani by-products, 1-[(4-methoxybenzyl)(methyl)amino]ethanol (11c), 2-(4-methoxyphenyl)-3,4-dimethyl-1,3-oxazolidine (12c), 1,2,3,4-tetramethyl-5,6-di-(4-methoxyphenyl)piperazine (13c) and 1,2,4,5-tetramethyl-3,6-di-(4-methoxyphenyl)piperazine (14c). This paper also investigates pseudoephedrine and methamphetamine isomeric distribution from the Akabori-Momotani reaction with the aid of molecular modelling to understand why more pseudoephedrine than ephedrine is produced.
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Affiliation(s)
- David Doughty
- Flinders Centre for Nanoscale Science and Technology, College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia
| | - Emma Kent
- Flinders Centre for Nanoscale Science and Technology, College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia
| | - Ben Painter
- Flinders Centre for Nanoscale Science and Technology, College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia
| | - Paul E Pigou
- Flinders Centre for Nanoscale Science and Technology, College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia
| | - Martin R Johnston
- Flinders Centre for Nanoscale Science and Technology, College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, South Australia 5001, Australia.
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22
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Ovet G, Alpfidan I, Sakarya Y, Sakarya R, Ozcimen M, Göktaş S, Erdoğan E. The acute effect of pseudoephedrine on choroidal thickness. Clin Ter 2017; 167:63-6. [PMID: 27424504 DOI: 10.7417/ct.2016.1927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the acute effects of pseudoephedrine (PE) on choroidal thickness in healthy young patients. METHODS Fifty patients with nasal and sinus congestion who were prescribed 60 mg oral PE at the otolaryngology department were recruited for this study. The enhanced depth imaging (EDI) optic coherence tomography (OCT) (Spectralis OCT; Heidelberg Engineering, Heidelberg, Germany) choroidal thickness measurements were performed at baseline and 1, 3 and 6 hours at 7 points. RESULTS The right eyes of 50 healthy subjects (22 women and 28 men) were included in this study. The mean choroidal thickness at fovea was 293.12 μm, 279.80 μm, 295.80 μm, and 294.52 μm at baseline, 1, 3 and 6 hours respectively. A significant reduction in choroidal thickness versus baseline was observed at all points at 1 hour. CONCLUSIONS The choroidal thickness decreased 1 hour after oral administration of PE and returned to baseline thickness at 3 hours. We suppose that this transient decrease might be associated with vasoconstriction due to activation of sympathetic alpha adrenoceptors.
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Affiliation(s)
- G Ovet
- Medical Sciences University Training and Research Hospital, Department of Otorhinolaryngolgy, Konya,Turkey
| | - I Alpfidan
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - Y Sakarya
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - R Sakarya
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - M Ozcimen
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - S Göktaş
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
| | - E Erdoğan
- Medical Sciences University Training and Research Hospital, Department of Ophthalmology, Konya,Turkey
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23
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Taghvimi A, Hamishehkar H, Ebrahimi M. Magnetic nano graphene oxide as solid phase extraction adsorbent coupled with liquid chromatography to determine pseudoephedrine in urine samples. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 1009-1010:66-72. [PMID: 26708626 DOI: 10.1016/j.jchromb.2015.12.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 11/28/2015] [Accepted: 12/04/2015] [Indexed: 11/27/2022]
Abstract
This paper reports on a method based on magnetic solid phase extraction (MSPE) for the determination of pseudoephedrine. Magnetic nanographene oxide (MNGO) was applied as a new adsorbent for the extraction of pseudoephedrine from urine samples. Synthesis of MNGO was characterized by Fourier transform infrared (FT-IR) spectroscopy, scanning electron microscopy (SEM), powder X-ray diffraction (XRD), and vibrating sample magnetometer (VSM). The main factors influencing extraction efficiency, including the amounts of sample volume, amount of adsorbent, type and amount of extraction organic solvent, time of extraction and desorption, pH, ionic strength of extraction medium, and agitation rate, were investigated and optimized. Under optimized extraction conditions, a good linearity was observed in the range of 100-2000ng/mL with a correlation coefficient of 0.9908 (r(2)). Limit of detection (LOD) and limit of quantification (LOQ) were 25 and 82.7ng/mL, respectively. Inter-day and intra-day precision and accuracy were 6.01 and 0.34 (%), and 8.70 and 0.29 (%), respectively. The method was applied for the determination of pseudoephedrine in urine samples of volunteers receiving pseudoephedrine with the recovery of 96.42. It was concluded that the proposed method can be applied in diagnostic clinics.
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Affiliation(s)
- Arezou Taghvimi
- Department of Analytical Chemistry, Faculty of Chemistry, Islamic Azad University Of Mashhad branch, Mashhad, Iran
| | - Hamed Hamishehkar
- Drug Applied Research Center, Tabriz University of Medical science, Tabriz, Iran.
| | - Mahmoud Ebrahimi
- Department of Analytical Chemistry, Faculty of Chemistry, Islamic Azad University Of Mashhad branch, Mashhad, Iran.
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24
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Zhou J, Gao G, Chu Q, Wang H, Rao P, Ke L. Chromatographic isolation of nanoparticles from Ma-Xing-Shi-Gan-Tang decoction and their characterization. J Ethnopharmacol 2014; 151:1116-1123. [PMID: 24384378 DOI: 10.1016/j.jep.2013.12.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 12/09/2013] [Accepted: 12/18/2013] [Indexed: 05/19/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The herbal decoction is a complex dispersion system containing solutes, colloid, aggregates, emulsions and precipitates. In which phase bioactive phytochemicals are dispersed determines their delivery, action and metabolism. This study took ephedrine, a well-studied and widely used phytochemical, as an example to elucidate its exact distribution in the phases of Ma-Xing-Shi-Gan-Tang decoction (MXSGT), which is an Ephedra sinica Stapf. containing traditional Chinese medicinal formula, and the biological meaning of this distribution correspondingly. It may provide an important update to the safety and efficacy assessment of the herbal decoction and its active phytochemicals. MATERIALS AND METHODS In this study, the decoction was fractionated with size-exclusion chromatography coupled with multi-angle laser light scattering detector. The morphology of fractionated nanoparticles was observed with AFM and SEM. The bioactivities of the decoction, the ephedrine alkaloids loaded NPs (prepared by chromatography isolation) and the synthetic ephedrine were assessed by cell proliferation tests using five cell lines, namely Caco-2, L-02, Hep-G2, NR-8383, and Hela-229. RESULTS Nanoparticles with radii of gyration ranged from 50 to 150 nm were isolated, in spherical shape. Further analysis of nanoparticles on the subsequent reversed phase chromatography revealed that the majority of ephedrine (99.7%) and pseudoephedrine (95.5%) were associated with these nanoparticles, rather than dispersed freely in the real solution. The addition of both the herbal decoction and the separated ephedrine-loaded nanoparticles reserved higher cell viability/proliferation than that of the sole synthetic ephedrine among the Caco-2, L-02, Hep-G2, and NR-8383 cells. In contrast, the nanoparticles reduced the proliferating power of ephedrine on Hela-229 cells. In general, the ephedrine-loaded NPs conducted the intermediate influences on the cell viability, in either way. CONCLUSIONS The colloidal nanoparticles were separated from the decoction. The association of ephedrine alkaloids with nanoparticles was demonstrated and may have changed the bioactivity of the alkaloids. The naturally occurred colloidal nanoparticles may play an important role in the pharmacological properties of both the decoction and its active phytochemicals, therefore warrant further studies.
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Affiliation(s)
- Jianwu Zhou
- CAS.SIBS-Zhejiang Gongshang University Joint Centre for Food and Nutrition Sciences, Zhejiang Gongshang University, Hangzhou 310035, China; Institute of Biotechnology, Fuzhou University, Fuzhou 350002, China
| | - Guanzhen Gao
- CAS.SIBS-Zhejiang Gongshang University Joint Centre for Food and Nutrition Sciences, Zhejiang Gongshang University, Hangzhou 310035, China; Institute of Biotechnology, Fuzhou University, Fuzhou 350002, China
| | - Qiuping Chu
- Institute of Biotechnology, Fuzhou University, Fuzhou 350002, China
| | - Huiqin Wang
- CAS.SIBS-Zhejiang Gongshang University Joint Centre for Food and Nutrition Sciences, Zhejiang Gongshang University, Hangzhou 310035, China; Institute of Biotechnology, Fuzhou University, Fuzhou 350002, China
| | - Pingfan Rao
- CAS.SIBS-Zhejiang Gongshang University Joint Centre for Food and Nutrition Sciences, Zhejiang Gongshang University, Hangzhou 310035, China; Institute of Biotechnology, Fuzhou University, Fuzhou 350002, China
| | - Lijing Ke
- CAS.SIBS-Zhejiang Gongshang University Joint Centre for Food and Nutrition Sciences, Zhejiang Gongshang University, Hangzhou 310035, China; Institute of Biotechnology, Fuzhou University, Fuzhou 350002, China.
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25
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Song Y, Su D, Lu T, Mao C, Ji D, Liu Y, Wei B, Fan R. Differential pharmacokinetics and the brain distribution of morphine and ephedrine constitutional isomers in rats after oral administration with Keke capsule using rapid-resolution LC-MS/MS. J Sep Sci 2014; 37:352-9. [PMID: 24318005 DOI: 10.1002/jssc.201300886] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 10/21/2013] [Accepted: 11/25/2013] [Indexed: 11/09/2022]
Abstract
Opioid and ephedra alkaloids known as the active ingredients for Keke capsule, which is used to treat coughs and bronchial asthma, could have potential adverse effects on the central nervous system. Therefore, an efficient, sensitive rapid-resolution LC-MS/MS method for the simultaneous determination of morphine, ephedrine, and pseudoephedrine in rat plasma and brain tissue homogenate has been developed. The method was validated in the plasma and brain tissue samples, showed good linearity over a wide concentration range (r(2) > 0.99). The intra- and interday assay variability was less than 15% for all analytes, and the accuracy was between -8.8 and 5.7%. The study provided the pharmacokinetics profiles and the brain regional distribution of the three active alkaloids after oral administration of Keke capsule. The results also indicated that significant difference in pharmacokinetics parameters of the epimers was observed between ephedrine and pseudoephedrine.
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Affiliation(s)
- Yonggui Song
- The National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China; College of Chemistry and Chemical Engineering, Jiangxi Normal University, Nanchang, China
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26
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Wu Z, Kong X, Zhang T, Ye J, Fang Z, Yang X. Pseudoephedrine/ephedrine shows potent anti-inflammatory activity against TNF-α-mediated acute liver failure induced by lipopolysaccharide/D-galactosamine. Eur J Pharmacol 2013; 724:112-21. [PMID: 24365491 DOI: 10.1016/j.ejphar.2013.11.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 11/19/2013] [Accepted: 11/23/2013] [Indexed: 02/05/2023]
Abstract
The anti-inflammatory effects of pseudoephedrine/ephedrine were investigated using the experimental model of lipopolysaccharide (LPS)-induced acute liver failure in D-galactosamine (D-GalN)-sensitised male rats in order to elucidate effects other than sympathomimetic effects. Rats were intraperitoneally injected with D-GalN (400 mg/kg) and LPS (40 μg/kg) to induce acute liver failure. The treatment groups were then intraperitoneally administered pseudoephedrine/ephedrine at 0 h and 4 h after induction and the activation induced by treatment with pseudoephedrine and/or LPS on the primary Kupffer cells (KCs) was monitored. Compared with controls induced by GalN/LPS alone, pseudoephedrine dramatically reduced the infiltration of inflammatory cells and bile ductular hyperplasia and hepatic necrosis observed in liver sections. It inhibited both hepatocellular apoptosis and the expression of monocyte chemotactic protein-1. It lowered the production of tumour necrosis factor-α (TNF-α) in the beginning of acute liver failure induced by D-GalN/LPS. Correspondingly, levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and malondialdehyde were attenuated. Ephedrine demonstrated all these identical protective effects as well. In addition, pseudoephedrine significantly suppressed the production of p-IκB-α, reducing the degradation of sequestered nuclear factor kappa B (NF-κB) in the cytoplasm, and inhibited the translocation of NF-κB/p65 to the nucleus, the transcription of TNF-α mRNA and the production of TNF-α in primary KCs. These results suggest that pseudoephedrine and ephedrine have a potent anti-inflammatory activity against D-GalN/LPS-induced acute liver failure in rats, and this comprehensive anti-inflammatory effect may result from the inhibition of TNF-α production.
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Affiliation(s)
- Zhongping Wu
- Teaching & Research Department of Clinical and Classic Medicine, College of Basic Medical Science, Shanghai University of Traditional Chinese Medicine, 1200 Cai lun Road, Shanghai 201203, China.
| | - Xiangliang Kong
- Teaching & Research Department of Clinical and Classic Medicine, College of Basic Medical Science, Shanghai University of Traditional Chinese Medicine, 1200 Cai lun Road, Shanghai 201203, China
| | - Tong Zhang
- Teaching & Research Department of Clinical and Classic Medicine, College of Basic Medical Science, Shanghai University of Traditional Chinese Medicine, 1200 Cai lun Road, Shanghai 201203, China
| | - Jin Ye
- Teaching & Research Department of Clinical and Classic Medicine, College of Basic Medical Science, Shanghai University of Traditional Chinese Medicine, 1200 Cai lun Road, Shanghai 201203, China
| | - Zhaoqin Fang
- Teaching & Research Department of Clinical and Classic Medicine, College of Basic Medical Science, Shanghai University of Traditional Chinese Medicine, 1200 Cai lun Road, Shanghai 201203, China
| | - Xuejun Yang
- Department of Nephrology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, 528 Zhangheng Road, Shanghai 201203, China.
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Rosenbloom AL. Sudden death of a young woman attributed to diabetic ketoacidosis. J Forensic Leg Med 2013; 20:1063-5. [PMID: 24237820 DOI: 10.1016/j.jflm.2013.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 08/23/2013] [Accepted: 09/29/2013] [Indexed: 10/26/2022]
Abstract
A young woman's death at home was attributed to new onset diabetic ketoacidosis with subsequent litigation supported by several expert consultants, despite a history and postmortem findings inconsistent with this diagnosis. More thorough tissue study of the heart and analysis of the circumstances led to a credible explanation of the entire scenario.
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Affiliation(s)
- Arlan L Rosenbloom
- Division of Endocrinology, Department of Pediatrics, University of Florida College of Medicine, United States.
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28
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Pritchard-Peschek KR, Jenkins DG, Osborne MA, Slater GJ, Taaffe DR. The dose-response relationship between pseudoephedrine ingestion and exercise performance. J Sci Med Sport 2013; 17:531-4. [PMID: 23988786 DOI: 10.1016/j.jsams.2013.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 07/22/2013] [Accepted: 07/27/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of the present study was to examine a possible dose-response between pre-exercise pseudoephedrine intake and cycling time trial performance. DESIGN Randomised, double-blind, crossover trial. METHODS Ten trained male endurance cyclists (26.5 ± 6.2 years, 75.1 ± 5.9 kg, 70.6 ± 6.8 mL kg(-1)min(-1)) undertook three cycling time trials in which a fixed amount of work (7 kJ kg(-1) body mass) was completed in the shortest possible time. Sixty minutes before the start of exercise, subjects orally ingested either 2.3 mg kg(-1) or 2.8 mg kg(-1) body mass of pseudoephedrine or a placebo in a randomised and double-blind manner. Venous blood was sampled at baseline, pre- and post-warm up and post-exercise for the analysis of pH and lactate and glucose concentrations; plasma catecholamine and pseudoephedrine concentrations were measured at all times except post-warm up. RESULTS Cycling time trial performance (∼ 30 min) was not enhanced by pseudoephedrine ingestion. Plasma pseudoephedrine concentration increased from pre-warm up to post-exercise in both treatment conditions, with the 2.8 mg kg(-1) body mass dose producing the highest concentration at both time points (2.8 mg kg(-1)>2.3 mg kg(-1)>placebo; p<0.001). CONCLUSIONS There was large individual variation in plasma pseudoephedrine concentration between subjects following pseudoephedrine administration. A number of factors clearly influence the uptake and appearance of pseudoephedrine in the blood and these are not yet fully understood. Combined with subsequent differences in plasma pseudoephedrine between individuals, this may partially explain the present findings and also the inconsistencies in performance following pseudoephedrine administration in previous studies.
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Affiliation(s)
| | - David G Jenkins
- School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
| | - Mark A Osborne
- Athlete and Coach Support Services, Queensland Academy of Sport, Brisbane, Queensland, Australia
| | - Gary J Slater
- The School of Health and Sport Sciences, University of the Sunshine Coast, Maroochydore, Queensland, Australia
| | - Dennis R Taaffe
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, New South Wales, Australia
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Webster JL. Assessing community pharmacist engagement in a policing partnership strategy to reduce the illicit diversion of pseudoephedrine products. Res Social Adm Pharm 2013; 9:903-17. [PMID: 23548589 DOI: 10.1016/j.sapharm.2013.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 02/12/2013] [Accepted: 02/12/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The incidence of illicit diversion of pharmaceutical products is a worldwide problem associated with negative health consequences and with other crimes. The illicit diversion of pharmaceuticals containing the active ingredient pseudoephedrine is of concern, primarily due to the role this substance plays in the manufacture of synthetic illicit drugs such as methylamphetamine. There are a range of strategies employed to curb the problem of precursor diversion. Not least is the development of strategies involving front-line health professionals such as community pharmacists to play an important role in reducing the incidence of diversion. OBJECTIVES This study aimed to examine levels of pharmacist engagement in an intervention expected to decrease diversion of pseudoephedrine products from community pharmacies. The primary objective was to explore levels of community pharmacist engagement with the intervention and to explore their perceptions of intervention effectiveness. METHODS A survey instrument was developed to examine six main areas relating to the implementation, operation and outcomes of the intervention, in addition to the roles performed by community pharmacists in two Australian State jurisdictions. The respondent pharmacists were recruited through a combination of email and facsimile communications from the Pharmacy Guild of Australia and through an electronic pharmacy newsletter. RESULTS Thirty percent of eligible community pharmacies in the study jurisdictions responded to the survey. The results of the survey highlight that in the absence of an alternative strategy to assist community pharmacists to reduce pseudoephedrine diversion, the majority of respondents were satisfied with the effectiveness of the police-pharmacy intervention. It was found that a pharmacist's positive perception of the role police played in the intervention strongly influenced their engagement in the strategy. CONCLUSION Identifying the factors that significantly influence pharmacist engagement in this strategy has broader implications for other law enforcement-public health strategies. It is important for policy models to incorporate these significant elements in their design to enhance the implementation, operation and outcomes of prevention-type interventions.
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Affiliation(s)
- Julianne L Webster
- School of Criminology and Criminal Justice, Griffith University, 176 Messines Ridge Road, Mt. Gravatt, Queensland 4122, Australia.
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