• Title/Summary/Keyword: Gastrointestinal drugs

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Effect of Cimetidine and Phenobarbital on Metabolite Kinetics of Omeprazole in Rats

  • Park Eun-Ja;Cho Hea-Young;Lee Yong-Bok
    • Archives of Pharmacal Research
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    • v.28 no.10
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    • pp.1196-1202
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    • 2005
  • Omeprazole (OMP) is a proton pump inhibitor used as an oral treatment for acid-related gastrointestinal disorders. In the liver, it is primarily metabolized by cytochrome P-450 (CYP450) isoenzymes such as CYP2C19 and CYP3A4. 5-Hyroxyomeprazole (5-OHOMP) and omeprazole sulfone (OMP-SFN) are the two major metabolites of OMP in human. Cimetidine (CMT) inhibits the breakdown of drugs metabolized by CYP450 and reduces, the clearance of coad-ministered drug resulted from both the CMT binding to CYP450 and the decreased hepatic blood flow due to CMT. Phenobarbital (PB) induces drug metabolism in laboratory animals and human. PB induction mainly involves mammalian CYP forms in gene families 2B and 3A. PB has been widely used as a prototype inducer for biochemical investigations of drug metabolism and the enzymes catalyzing this metabolism, as well as for genetic, pharmacological, and toxicological investigations. In order to investigate the influence of CMT and PB on the metabolite kinetics of OMP, we intravenously administered OMP (30 mg/kg) to rats intraperitoneally pretreated with normal saline (5 mL/kg), CMT (100 mg/kg) or PB (75 mg/kg) once a day for four days, and compared the pharmacokinetic parameters of OMP. The systemic clearance ($CL_{t}$) of OMP was significantly (p<0.05) decreased in CMT-pretreated rats and significantly (p<0.05) increased in PB-pretreated rats. These results indicate that CMT inhibits the OMP metabolism due to both decreased hepatic blood flow and inhibited enzyme activity of CYP2C19 and 3A4 and that PB increases the OMP metabolism due to stimulation of the liver blood flow and/or bile flow, due not to induction of the enzyme activity of CYP3A4.

Analysis of Prescriptions for Asthma at Primary Health Care Using National Health Insurance Database (건강보험자료를 이용한 의원의 천식처방 분석)

  • 이의경;박은자;배은영;이숙향
    • YAKHAK HOEJI
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    • v.47 no.4
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    • pp.244-251
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    • 2003
  • Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20% of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3%, and that for oral theophylline was 46.9%. Oral steroids were prescribed for the 28.2% of the claims. Utilization of inhalers was low for both bronchodilators (20.3%, beta-2 agonists inhalers), and steroids (8.4% steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0% for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0%, antitussives 65.3%, antihistamines 25.3% and analgesics 29.4%, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

A Case of Henoch-Schönlein Purpura Developed during Treatment of Lung Cancer (원발성 폐암 치료 중 발생한 Henoch-Schönlein Purpura 1예)

  • Kang, Min Soo;Noh, Geum Yeub;Jang, Young Joo;Cho, Soo Youn;Rhim, Kyung Jin;Noh, Hee Sun;Kim, Hye-Ryoun;Kim, Cheol Hyeon;Lee, Jae Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.234-238
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    • 2009
  • Henoch-$Sch\ddot{o}nlein$ Purpura (HSP) is a systemic vasculitis involving small vessels with the deposition of immune complexes containing IgA and C3, which is characterized by associated skin, joint, renal, and gastrointestinal manifestations. Although there were several causes such as autoimmunity, infection, and drugs, it also can be presented as a form of vasculitidies associated with malignancies. We report a case of HSP developed during treatment for non-small cell lung cancer in a 66-year-old man. Multiple purpuric skin lesions occurred in both legs after the first cycle of chemotherapy, which was diagnosed as HSP by clinical and pathologic examinations. Due to the itching sensation, topical steroid was applied and the patient was improved 3 weeks later without a scheduled change in chemotherapy.

Prediction model of peptic ulcer diseases in middle-aged and elderly adults based on machine learning (머신러닝 기반 중노년층의 기능성 위장장애 예측 모델 구현)

  • Lee, Bum Ju
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.289-294
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    • 2020
  • Peptic ulcer disease is a gastrointestinal disorder caused by Helicobacter pylori infection and the use of nonsteroid anti-inflammatory drugs. While many studies have been conducted to find the risk factors of peptic ulcers, there are no studies on the suggestion of peptic ulcer prediction models for Koreans. Therefore, the purpose of this study is to implement peptic ulcer prediction model using machine learning based on demographic information, obesity information, blood information, and nutritional information for middle-aged and elderly people. For model building, wrapper-based variable selection method and naive Bayes algorithm were used. The classification accuracy of the female prediction model was the area under the receiver operating characteristics curve (AUC) of 0.712, and males showed an AUC of 0.674, which is lower than that of females. These results can be used for prediction and prevention of peptic ulcers in the middle and elderly people.

Effect of Fruit-Vegetable Juices Containing Angelica keiskei on Alcohol Metabolizing Enzyme Activities in vitro (신선초를 혼합한 과채주스의 알코올 대사 효소 활성에 미치는 영향)

  • Kim, Min-Ju;Lim, Sang-Wook;Ahn, Hye-Jin;Jun, Junggyu;Kang, Min-Jung
    • KSBB Journal
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    • v.31 no.1
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    • pp.8-13
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    • 2016
  • Excessive alcohol consumption can cause hangover symptoms, such as headache, drowsiness, dizziness, gastrointestinal distress, and anxiety. The aim of this study was to investigate alcohol metabolizing enzyme activities and antioxidant activities of fruit-vegetable juices containing Angelica keiskei prepared using a low speed masticating juicer in vitro. The acceleration rate of alcohol dehydrogenase (ADH) by A. keiskei-cherry tomato juice (ACJ) and A. keiskei-green grape juice (AGJ) were $163.8{\pm}4.3%$ and $148.2{\pm}6.9%$, respectively. The acceleration rate of aldehyde dehydrogenase (ALDH) by ACJ and AGJ were $185.6{\pm}9.5%$ and $161.1{\pm}4.8%$, respectively. Total polyphenol of ACJ and AGJ were $111.1{\pm}1.6mg/dL$ and $100.8{\pm}2.9mg/dL$, respectively. DPPH radical scavenging activities of ACJ and AGJ were $62.0{\pm}0.5%$ and $61.3{\pm}0.4%$, respectively. Thus, these results indicate that alcohol degrading enzyme activities can be enhanced by fruitvegetable juices containing A. keiskei.

The Safety Guidelines for use of Ma-huang in Obesity Treatment (비만처방에서의 안전한 마황사용 지침)

  • Song, Mi-Young;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Korean Medicine for Obesity Research
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    • v.6 no.2
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    • pp.17-27
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    • 2006
  • Objectives : Ma-huang (Ephedra sinica) is frequently prescribed for obesity management in oriental medicine. The main component is ephedrine alkaloids which can have serious adverse side effects such as heart attack, stroke, sudden death. There are no scientific guidelines for Ma-huang usage in the safe treatment of obesity in oriental medicine. We reviewed published studies on its safety to make evidence based guidelines. Methods : We searched electronic databases up to May 2006. We limited evidence to controlled trials for efficacy or safety, case reports for safety, and studies for Ma-huang contents analysis. Results and Conclusions : In clinical trials for weight loss, Ma-huang and ephedrine promote modest short-term weight loss but have no serious adverse effects, have only a few adverse effects associated with increased risk of psychiatric, autonomic, gastrointestinal symptoms and heart palpitations. In case reports, there have been serious adverse effects including stroke, heart attack, and death using typical doses of ephedrine or no associated illness. There are factors related to serious adverse effects, such as overuse, lack of standardization, individual sensitivity, and interactions with other drugs. Studies relating to these factors should be analyzed for safe use of Ma-huang and ephedrine. After analyzing related studies, we suggest guidelines for Ma-huang usage. We propose that the dosage should be within 4.5-7.5g per day for up to 6 months for generally healthy individual. It's use is contraindicated in individuals with heart disease, thyroid disease, diabetes mellitus, hypertension, psychiatric disorders, glaucoma, urination disorders, enlarged prostate, persons using MAOIs, methyldopa and sympathomimetic agents.

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Anti-obesity Activity of Extract from Saussurea lappa (목향 추출물의 항비만 활성 효과)

  • Yoon, Tae-Sook;Sung, Yoon-Young;Jang, Ja-Young;Yang, Won-Kyung;Ji, Yun-Ui;Kim, Ho-Kyoung
    • Korean Journal of Medicinal Crop Science
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    • v.18 no.3
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    • pp.151-156
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    • 2010
  • Obesity has become one of the main public health problems. Saussurea lappa (Asteraceae), syn Aucklandia lappa and Saussurea costus, is a well-known herbal medicine that has been used for treating various ailments, such as inflammatory and gastrointestinal diseases. The present study examined the anti-obesity effect of S. lappa extract (SLE) in 3T3-L1 adipocytes and high fat diet (HFD)-induced obese mouse model. SLE significantly inhibited the differentiation from preadipocytes to adipocytes of cultured 3T3-L1 in dose-dependent manner. In addition, SLE significantly decreased the body weight gain and the food efficiency ratio of mice fed HFD during 9 weeks. Further study must be performed for the pharmacological mechanism and safety of SLE as well as the identification of active compound in SLE. Our results revealed that S. lappa suppresses the adipogenesis in cultured cells and the obesity in rodent models. Therefore, S. lappa may be useful toward the development of new potent anti-obesity drugs.

Pathophysiology of Potassium-competitive Acid Blocker-refractory Gastroesophageal Reflux and the Potential of Potassium-competitive Acid Blocker Test

  • Masaoka, Tatsuhiro;Kameyama, Hisako;Yamane, Tsuyoshi;Yamamoto, Yuta;Takeuchi, Hiroya;Suzuki, Hidekazu;Kitagawa, Yuko;Kanai, Takanori
    • Journal of Neurogastroenterology and Motility
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    • v.24 no.4
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    • pp.577-583
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    • 2018
  • Background/Aims Potassium-competitive acid blockers are expected to be the next generation of drugs for the treatment of diseases caused by gastric acid. In 2015, vonoprazan fumarate, a novel potassium-competitive acid blocker, was approved by the Japanese health insurance system. Since its approval, patients refractory to vonoprazan can be encountered in clinical settings. We designed this study to clarify the pathophysiology of gastroesophageal reflux disease refractory to vonoprazan. Methods In this retrospective study, we involved patients who had refractory symptoms after administration of standard-dose proton pump inhibitors or vonoprazan and underwent diagnostic testing with esophageal high-resolution manometry and 24-hour multichannel intraluminal impedance and pH monitoring while using proton pump inhibitors or vonoprazan. Patients were diagnosed based on the Rome IV criteria for functional gastrointestinal disorders and diagnostic test results. Results Twenty-seven patients were analyzed during this study. Gastric pH ${\geq}4$ was sustained for a longer period of time, and the esophageal acid exposure time and number of acid reflux events were shorter in the vonoprazan group than in the proton pump inhibitor group. The percentage of patients diagnosed with acidic gastroesophageal reflux disease in the vonoprazan group was lower than that in the proton pump inhibitor group. Conclusions Intra-gastric pH and acid reflux were strongly suppressed by 20-mg vonoprazan. When patients with gastroesophageal reflux disease present symptoms after administration of 20-mg vonoprazan, the possibility of pathophysiologies other than acid reflux should be considered.

Treatment with Extracellular Vesicles from Giardia lamblia Alleviates Dextran Sulfate Sodium-Induced Colitis in C57BL/6 Mice

  • Kim, Hyun Jung;Lee, Young-Ju;Back, Seon-Ok;Cho, Shin-Hyeong;Lee, Hee-Il;Lee, Myoung-Ro
    • Parasites, Hosts and Diseases
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    • v.60 no.5
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    • pp.309-315
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    • 2022
  • Inflammatory bowel disease (IBD) is a chronic and recurrent illness of the gastrointestinal tract. Treatment of IBD traditionally involves the use of aminosalicylic acid and steroids, while these drugs has been associated with untoward effects and refractoriness. The absence of effective treatment regimen against IBD has led to the exploration of new targets. Parasites are promising as an alternative therapy for IBD. Recent studies have highlighted the use of parasite-derived substances, such as excretory secretory products, extracellular vesicles (EVs), and exosomes, for the treatment of IBD. In this report, we examined whether EVs secreted by Giardia lamblia could prevent colitis in a mouse model. G. lamblia EVs (GlEVs) were prepared from in vitro cultures of Giardia trophozoites. Clinical signs, microscopic colon tissue inflammation, and cytokine expression levels were detected to assess the effect of GlEV treatment on dextran sulfate sodium (DSS)-induced experimental murine colitis. The administration of GlEVs prior to DSS challenge reduced the expression levels of pro-inflammatory cytokines, including tumor necrosis factor alpha, interleukin 1 beta, and interferon gamma. Our results indicate that GlEV can exert preventive effects and possess therapeutic properties against DSS-induced colitis.

Vagus Nerve Stimulation Through Electro-acupuncture for Inflammatory Bowel Disease (염증성 장 질환에서 전침을 중심으로 한 미주신경자극에 대한 고찰)

  • Minjeong Kim;Dongwon Kim;Chaehyun Park;Jae-Woo Park;Seok-Jae Ko
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.455-465
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    • 2023
  • Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with "vagus nerve stimulation", "VNS", and "inflammatory bowel disease". All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.