Drug Overdoses during Pregnancy
“Bert” Bertis Britt Little in Drugs and Pregnancy, 2022
Ibuprofen overdose during pregnancy has not been described in case studies and no specific antidote exists. Therefore, nonspecific antidote and supportive therapy should be given. Symptoms of ibuprofen toxicity include nausea, epigastric pain, diarrhea, vomiting, dizziness, blurred vision, and edema. The half-life of ibuprofen is 0.9–2.5 hours in the post-absorptive period (Baselt, 2017). Among 67 cases of ibuprofen overdose, 36 percent occurred among children. Fifty reports of ibuprofen overdose during pregnancy were published, with mothers and infants suffering no untoward effects (i.e., hepatorenal failure, etc.) among those followed prospectively (Barry et al., 1984). Forty-three cases of ibuprofen overdose during pregnancy were followed prospectively in post-marketing surveillance, and 23 live birth normal infants were born after maternal supportive therapy because no antidote exists. Nine elective terminations and one spontaneous abortion occurred, and one stillbirth. Nine were still pregnant at the time of publication (Barry et al., 1984). More than 150 infants born following ibuprofen overdose in pregnancy were reported to have no increased frequency of birth defects, although the course of pregnancy was not reported in detail (Schaefer, 2007). These cases are from the UK TIS, and were followed prospectively, but no details were published.
Communications
Emmanuel Tsekleves, Rachel Cooper in Design for Health, 2017
The description in the first two sections provides some background of older patients who need to take medicines. In order to see if factors (diminishing abilities, literacy, personal regimens) are taken into consideration when information about medicines is developed, standard packaging for over-the-counter painkillers was analysed and tested. The research question is:Do the contents and design of information about ibuprofen take notice of the functional abilities of older patients, the likelihood that a painkiller needs to be integrated in an existing daily schedule, and a range of functional literacy? Ibuprofen is one of the most often used medicines (Kaufman et al., 2002) and it is used for the relief of symptoms of pain, inflammation and fever (Rainsford, 2013). However, it is by no means harmless because side effects include kidney damage and ibuprofen can cause gastrointestinal bleeding. Across the European continent, there are very substantial differences in information provided about ibuprofen. Figure 18.4 shows some of this variation. It is available as an over-the-counter product that can be purchased without a prescription, and as a prescription-only medicine. A complete review of all ibuprofen packaging in all EU countries would be interesting because it is likely to show a substantial variation in the traditions, interpretations of the regulations and a variety in marketing approaches. This article limits itself to a single British example. The focus of the analysis is only on the contents and the design of the information on the packaging. The quality of the medicine itself, or the way in which it is advertised and sold are not part of this analysis. It has long been known that trust in a specific brand affects the effects of a medicine. People believe that a specific brand provides effective medicines (Branthwaite and Cooper, 1981).
Ayurveda Renaissance – Quo Vadis?
D. Suresh Kumar in Ayurveda in the New Millennium, 2020
Ibuprofen is a non-steroidal potent modulator of inflammation and analgesia. It is a non-selective inhibitor of the cyclooxygenase enzymes COX-1 and COX-2, but not of lipoxygenase, which catalyzes steps in the biochemical inflammation pathways derived from arachidonic acid (Vane and Botting 1995). Newly pressed extra virgin olive oil contains the aldehyde oleocanthal, whose pungency induces a strong stinging sensation in the throat, very similar to that caused by solutions of ibuprofen (Breslin et al. 2001) (Figure 11.3). Like ibuprofen, oleocanthal caused dose-dependent inhibition of COX-1 and COX-2 activities. But it had no effect on lipoxygenase in vitro (Beauchamp et al. 2005). This finding has striking similarity with the teachings of Ayurveda and is one of the rare scientific reports noting common pharmacological activity for compounds with similar taste. As such, it is consistent with the tenet of Ayurveda that the similarity of taste of substances indicates similar pharmacological activity. Figure 11.3 Though dissimilar in chemical structure, both (-) oleocanthal (left) and ibuprofen (right) are pungent and have anti-inflammatory activity. It is often asked whether it is possible to identify the rasa, guṇa, vīrya, vipāka and prabhāva of herbal drugs outside the formulary of Ayurveda. In addition to vegetables like cabbage (Brassica oleracea), carrot (Daucus carota), potato (Solanum tuberosum), lady’s finger (Abelmoschus esculentus) and tomato (Lycopersicon lycopersicum), many fruits like pineapple (Ananas sativa), mangosteen (Garcinia mangostana), papaya (Carica papaya), custard apple (Annona squamosa), guava (Psidium guayava), sapodilla (Manikara achras) and litchi (Niphelium litchi) were introduced into India by the Portuguese and English (Sen 1997). Though they have medicinal value, all of them are alien to Ayurveda.
Investigation of the tableting behavior of Ibuprofen DC 85 W
Published in Drug Development and Industrial Pharmacy, 2018
Claudia Al-Karawi, Thorsten Cech, Florian Bang, Claudia S. Leopold
The aim of the present study was to investigate the tableting behavior of Ibuprofen DC 85 W with special focus on the tablet disintegration time, the tablet crushing strength, and the sticking tendency to punch surfaces. To simulate production conditions, tableting was conducted on a rotary press, equipped with three compaction stations. An I-optimal design of experiments was used to analyze the influence of the pre-compaction, the intermediate compaction, and the main compaction force on the two responses: tablet disintegration time and crushing strength. It was shown that Ibuprofen DC 85 W showed a good tableting behavior with regard to both responses. The tablet disintegration was considerably affected by the maximum compaction force applied, but was also slightly affected by preceding compaction events. The tablet crushing strength was mainly affected by the maximum applied compaction force independent of the order of these forces. The sticking tendency of Ibuprofen DC 85 W was compared with that two other ibuprofen powder formulations in long-term tableting runs. Compared to the other two formulations, sticking was considerably lower with Ibuprofen DC 85 W. The sticking tendency was not influenced by the addition of an intermediate compaction force, but was remarkably reduced by the choice of the punch tip coating.
Renal and mesenteric tissue oxygenation in preterm infants treated with oral ibuprofen
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2014
Nilufer Guzoglu, Fatma Nur Sari, Ramazan Ozdemir, Serife Suna Oguz, Nurdan Uras, Nahide Altug, Ugur Dilmen
Background: Hemodynamically significant patent ductus arteriosus (PDA) is a common problem in preterm infants which often causes significant morbidities. Although PDA induces alterations in various tissue perfusion, there is scarce information about the effect of oral ibuprofen on hemodynamics of regional tissues. Objective: To investigate, using near-infrared spectroscopy, the effect of oral ibuprofen on renal and mesenteric tissue oxygenation and oxygen extraction in preterm infants with a diagnosis of hemodynamically significant PDA. Patients and methods: Fifteen infants (gestational age 0.05). Conclusion: Renal and mesenteric tissue oxygenation and oxygen extraction were preserved in preterm infants with a diagnosis of hemodynamically significant PDA treated with oral ibuprofen.
Synthesis and Hydrolytic Behavior of Ibuprofen Prodrugs and their PEGylated Derivatives
Published in Drug Delivery, 2006
Soodabeh Davaran, Mohammad Reza Rashidi, Jalal Hanaee, Ali A. Hamidi, Mahdi Hashemi
Polyethylene glycol (PEG) derivatives of ibuprofen were prepared by esterification of PEG monosuccinate with hydroxy ethyl ester (HEE), hydroxy ethylamide (HEA), and hydroxy ethyl thioester (HET) of ibuprofen. Hydrolysis of HEE-PEG, HEA-PEG, and HET-PEG were studied in vitro with or without esterases to investigate the applicability of these PEGylated prodrugs. The polymeric prodrugs released major fraction of the parent drug (ibuprofen) and a small fraction of hydroxy ethyl derivatives after 48 hr. In HET-PEG, the amount of drug release was higher than HEE-PEG and HEA-PEG. The difference between acidic and alkali buffered solutions was considerable. In human plasma, 50% of drug was released after 150 hr incubation at 37°C from HET-PEG.
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