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Gastrointestinal diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Murtaza Arif, Anjana Sathyamurthy, Jessica Winn, Jamal A. Ibdah
PPIs effectively suppress gastric acid secretion by inhibiting the H+/K+ ATPase on the surface of the parietal cell. PPIs are highly effective in the treatment of PUD. Omeprazole is rated as category C during pregnancy because of embryotoxicity without teratogenicity in animal studies (19). All other PPIs, including lansoprazole, rabeprazole, pantoprazole, and esomeprazole, are classified as FDA pregnancy category B drugs. Lansoprazole is the preferred PPI during pregnancy because of lack of clinical data regarding the safety of newer PPIs. Treatment with PPIs during pregnancy should be reserved only for patients with refractory or complicated PUD, which does not respond to alternative medical therapies, including H2RAs.
Immunosuppressants, rheumatic and gastrointestinal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
These include histamine-2-receptor antagonists (H2RA) and proton pump inhibitors (PPIs). They are recommended for oesophagitis diagnosed by endos-copy The efficacy of H2RA appears better in mild oesophagitis and side effects are uncommon (1 to 6%): dizziness, headhache, dyspepsia, abdominal pain and diarrhoea. PPIs have been shown to be more effective than H2RA [14]. The effects of lansoprazole and omeprazole have been studied in children. Lansoprazole has shown its efficacy in reducing symptoms and healing oesophagitis in children. The availability of a liquid formulation or fast disintegrating tablets facilitates its use in most countries [15]. There is no placebo-controlled trial with omeprazole, but acute and chronic acid-related disorders are well treated in children aged 2 months to 18 years [16].
Stomas
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
John R.T. Monson, Iain Andrew Hunter
The stomach will secrete about 1.5 to 2 L a day. This volume can be reduced either with a proton pump inhibitor or a H2 receptor antagonist. The use of acid suppression can be titrated to stoma output pH, which should be maintained above six. Lansoprazole Fastabs at a dose of 30–60 mg a day can be employed. In a very short gut, intravenous pantoprazole may be required.
A γ-cyclodextrin-based metal–organic framework (γ-CD-MOF): a review of recent advances for drug delivery application
Published in Journal of Drug Targeting, 2022
Asma Hamedi, Anastasia Anceschi, Alessia Patrucco, Mahdi Hasanzadeh
Lansoprazole (LPZ) is a proton pump inhibitor and is largely employed to reduce gastric acid secretory healing gastric ulcers and reflux esophagitis in treated patients [47]. Anyway, the administration of this drug has many drawbacks mainly due to its instability. Li et al. [32] loaded LPZ in CD-MOF-1 mixing LPZ, γ-CD, and KOH in an aqueous solution. Then, the loaded crystals are washed with ethanol and dried at 50 °C overnight. They also tested the CD-MOF-2 that are synthesised like CD-MOF-1, but in this case, the supernatant is transferred in a tube and CTAB is added. After that, the sample is incubated at room temperature for 3 h and washed with ethanol and dried at 50 °C overnight. The SEM characterisation underlines that all the synthesised CD-MOF show cubic crystals, but the addition of CTAB during the synthesis lead to CD-MOF cubes with regular sizes of around 6 μm.
In vitro evaluation of enteral tube administration of lansoprazole orally disintegrating tablets
Published in Pharmaceutical Development and Technology, 2021
Alicia Hoover, Priyanka Chitranshi, Magdalene Momot, Katherine Tyner, Anna Wokovich
Lansoprazole is an acid labile compound and degrades quickly at low pH. To protect lansoprazole from degradation in the stomach, the lansoprazole microgranules are formulated with an enteric coating. The coating is a pH sensitive polymer which dissolves at pH greater than 5.5. The coating layer minimizes release and subsequent degradation of drug in the stomach and allows for release, dissolution, and absorption in the small intestine (Baldi and Malfertheiner 2003; Howden 2005). There is a concern that the enteric coating can be damaged during suspension in water or during enteral tube administration. Previous work revealed another PPI, esomeprazole, demonstrated significant drug release during acid dissolution after a 15 min incubation period in water, indicating the integrity of the enteric coating was compromised (Hoover et al. 2017).
CYP2C19 and CYP3A4 activity and ADP-induced platelet reactivity in prasugrel- or ticagrelor-treated STEMI patients: monocentric study in PRAGUE-18 trial participants
Published in Xenobiotica, 2020
J. Máchal, O. Hlinomaz, K. Kostolanská, O. Peš, A. Máchalová, Z. Šplíchal, Z. Mot'ovská, J. Juřica
The basic characteristics of the study group are shown in Table 1. Out of the total number of 173 patients, plasma concentration of lansoprazole and its metabolites was determined in 97 patients (51 in the prasugrel group and 46 in the ticagrelor group). These patients did not significantly differ in their basic characteristics from the original study population. In 44 patients the plasma samples were not collected in the appropriate time period after the lansoprazole administration or met other technical difficulties in pre-analytic phase and the remaining 32 samples failed the HPLC, mostly due to insufficient sample quality. While the value of ADP test was the same in both the prasugrel group and the ticagrelor group 1 h after administration (median values 368 and 379 AU*min, respectively), they significantly differed 24 h after administration, with prasugrel showing stronger antiplatelet effect (median values 147 vs. 206 AU*min, p = 0.014).