DOCSLIB.ORG

Risks of Inflammatory Bowel Disease Treatment with Glucocorticosteroids and Aminosalicylates

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Risks of Inflammatory Bowel Disease Treatment with Glucocorticosteroids and Aminosalicylates Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2013 Risks of inflammatory bowel disease treatment with glucocorticosteroids and aminosalicylates Curkovic, Ivanka ; Egbring, Marco ; Kullak-Ublick, Gerd A Abstract: BACKGROUND: Glucocorticosteroids and aminosalicylates, mainly mesalazine (5-ASA), are both standard therapeutics in the treatment of inflammatory bowel disease (IBD) patients. The gluco- corticosteroids are highly effective in inducing remission in both ulcerative colitis and Crohn’s disease, but their use is limited by the high incidence and the potentially serious nature of adverse events. In an attempt to limit systemic side effects, rapidly metabolized corticosteroids such as budesonide have been introduced. The safety profile of aminosalicylates differs between the formulations. METHODS: We summarize the potential risks associated with glucocorticosteroid and aminosalicylate therapy in IBDs. RESULTS: The numerous adverse events of glucocorticosteroids, particularly at high doses and prolonged treatment, include opportunistic infections, diabetes mellitus, hypertension, ocular effects (glaucoma and cataracts), psychiatric complications, hypothalamic-pituitary-adrenal axis suppression and increased frac- ture risk. Partially, these systemic adverse events occur with budesonide, which only has a low systemic exposure. The safety profile of 5-ASA is comparable to placebo and superior to the old aminosalicylate prodrug sulfasalazine, which had a significantly higher incidence of intolerance reactions including allergic rashes. Only in rare cases has nephrotoxicity such as interstitial nephritis been associated with 5-ASA. CONCLUSION: Considering the toxicity profile of conventional glucocorticosteroids, one primary goal of treatment in IBD should be corticosteroid-free remission. Therapy with budesonide may result in a better safety profile. 5-ASA treatment is usually well tolerated, but with regard to the rare nephrotoxic events, it is advisable to assess renal function before and during treatment with 5-ASA. DOI: https://doi.org/10.1159/000354699 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-93477 Journal Article Published Version Originally published at: Curkovic, Ivanka; Egbring, Marco; Kullak-Ublick, Gerd A (2013). Risks of inflammatory bowel disease treatment with glucocorticosteroids and aminosalicylates. Digestive Diseases, 31(3-4):368-373. DOI: https://doi.org/10.1159/000354699 Adverse Events Dig Dis 2013;31:368–373 DOI: 10.1159/000354699 Risks of Inflammatory Bowel Disease Treatment with Glucocorticosteroids and Aminosalicylates Ivanka Curkovic Marco Egbring Gerd A. Kullak-Ublick Department of Clinical Pharmacology and Toxicology, University Hospital Zürich, Zürich , Switzerland Key Words ic exposure. The safety profile of 5-ASA is comparable to pla- Glucocorticosteroids · Mesalazine · Inflammatory bowel cebo and superior to the old aminosalicylate prodrug sul- disease · Adverse events fasalazine, which had a significantly higher incidence of in- tolerance reactions including allergic rashes. Only in rare cases has nephrotoxicity such as interstitial nephritis been Abstract associated with 5-ASA. Conclusion: Considering the toxicity Background: Glucocorticosteroids and aminosalicylates, profile of conventional glucocorticosteroids, one primary mainly mesalazine (5-ASA), are both standard therapeutics goal of treatment in IBD should be corticosteroid-free remis- in the treatment of inflammatory bowel disease (IBD) pa- sion. Therapy with budesonide may result in a better safety tients. The glucocorticosteroids are highly effective in induc- profile. 5-ASA treatment is usually well tolerated, but with ing remission in both ulcerative colitis and Crohn’s disease, regard to the rare nephrotoxic events, it is advisable to assess but their use is limited by the high incidence and the poten- renal function before and during treatment with 5-ASA. tially serious nature of adverse events. In an attempt to limit © 2013 S. Karger AG, Basel systemic side effects, rapidly metabolized corticosteroids such as budesonide have been introduced. The safety profile of aminosalicylates differs between the formulations. Meth- Glucocorticosteroids ods: We summarize the potential risks associated with glu- cocorticosteroid and aminosalicylate therapy in IBDs. Re- Introduction sults: The numerous adverse events of glucocorticosteroids, Systemic glucocorticoids are effective at inducing re- particularly at high doses and prolonged treatment, include mission in both ulcerative colitis (UC) and Crohn’s dis- opportunistic infections, diabetes mellitus, hypertension, ease (CD) [1–4] , whereas they are ineffective in the main- ocular effects (glaucoma and cataracts), psychiatric compli- tenance of remission in either illness [5] . However, their cations, hypothalamic-pituitary-adrenal axis suppression use is limited by their frequent, various and sometimes and increased fracture risk. Partially, these systemic adverse serious side effects: the most frequent and most typical events occur with budesonide, which only has a low system- side effects concern the skin, such as thinning of the skin © 2013 S. Karger AG, Basel Prof. Dr. med. Gerd A. Kullak-Ublick 0257–2753/13/0314–0368$38.00/0 Department of Clinical Pharmacology and Toxicology University Hospital Zürich, Rämistrasse 91 E-Mail [email protected] CH–8091 Zürich (Switzerland) www.karger.com/ddi E-Mail gerd.kullak @ usz.ch Downloaded by: Universität Zürich, Zentralbibliothek Zürich 130.60.47.22 - 6/8/2016 3:47:43 PM or purpura. Steroids affect bone and can induce both os- and 6 mg) than in those who received placebo (RR 2.73; teonecrosis and osteoporosis [6] . They increase suscepti- 95% CI 1.34–5.57 and RR 2.88; 95% CI 1.72–4.82) [15] bility to various fungal, viral and bacterial infections [7] . but less common than in patients who received conven- Myopathy is an infrequent complication, typically pre- tional glucocorticosteroids for the induction of remission senting as proximal weakness of both the upper and low- in CD (RR 0.65; 95% CI 0.55–0.78) [15] . er extremities and sometimes with atrophy and paresis [8] . Furthermore, steroids predispose to a range of psy- Glucocorticosteroids and Hyperglycemia chiatric complications such as depression, insomnia or Glucocorticosteroids are the most common cause of euphoria [9] . Cushingoid features with weight gain and drug-induced diabetes mellitus. More than 50% of pa- redistribution of body fat are often quite troubling to the tients who receive glucocorticosteroids at a dose equiva- patients. Besides, a relevant proportion of patients devel- lent of 40 mg prednisolone or more per day develop hy- op hyperglycemia. Especially if glucocorticosteroids are perglycemia [16, 17] . The odds ratio for the development used in combination with nonsteroidal anti-inflammato- of a new-onset diabetes mellitus is 1.36–2.31 [18] . Predis- ry drugs, the risk for peptic ulcer disease is significantly posing factors are a family history of diabetes, a hospital- increased. The impact of glucocorticosteroids on athero- ization in the preceding 4 months, a preexisting glucose sclerotic disease is supposed to be partly mediated by intolerance, obesity, higher age and most importantly changes in lipoprotein levels [10] . Ophthalmologic ad- dose and duration of glucocorticoid therapy. Glucocor- verse effects include both glaucoma and cataract (poste- ticosteroids induce hyperglycemia mainly through in- rior subcapsular cataracts are typical). Finally, if systemic creased insulin resistance. Typically, postprandial glu- glucocorticoids are stopped without adequate tapering, cose is elevated while fasting glucose concentrations are adrenal insufficiency may develop. often normal if glucocorticosteroids are administered In order to limit systemic toxicity, novel steroids with once daily. It is recommended to monitor random plasma limited oral bioavailability such as the second-generation glucose, typically in the afternoon or 1–2 h postprandi- glucocorticosteroid budesonide have been developed as ally. There are currently no published guidelines for the an alternative to classic corticosteroids. Budesonide ex- monitoring of plasma glucose in patients with inflamma- erts its local effects due to its high affinity to the glucocor- tory bowel disease (IBD) with glucocorticosteroid thera- ticoid receptor, which is approximately 200 times that of py, but at least at the start of therapy, it may be advisable prednisolone [11] . Budesonide has a limited systemic to check glucose not less than once weekly in patients who bioavailability of only 10–15% due to extensive first-pass receive high doses of corticosteroids and who have no or metabolism by cytochrome P-450 enzymes. But, potent only few risk factors for the development of steroid-in- CYP3A4 inhibitors such as macrolide antibiotics (cla- duced diabetes. In patients with several risk factors, glu- rithromycin, erythromycin) or azole antifungals (keto- cose concentrations should be tested at least once weekly. conazole, itraconazole) can increase plasma concentra- To treat hyperglycemia, oral antidiabetics such as metfor- tions to a relevant extent [12, 13] and consequently may min or sulfonylureas may be used if glucose concentra- increase the risk for systemic budesonide-associated side tions are <12–15 mmol/l. If concentrations are higher, effects. insulin therapy should
Load more

Recommended publications
  • Inflammatory Bowel Disease Irritable Bowel Syndrome
    Inflammatory Bowel Disease and Irritable Bowel Syndrome Similarities and Differences 2 www.ccfa.org IBD Help Center: 888.MY.GUT.PAIN 888.694.8872 Important Differences Between IBD and IBS Many diseases and conditions can affect the gastrointestinal (GI) tract, which is part of the digestive system and includes the esophagus, stomach, small intestine and large intestine. These diseases and conditions include inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). IBD Help Center: 888.MY.GUT.PAIN 888.694.8872 www.ccfa.org 3 Inflammatory bowel diseases are a group of inflammatory conditions in which the body’s own immune system attacks parts of the digestive system. Inflammatory Bowel Disease Inflammatory bowel diseases are a group of inflamma- Causes tory conditions in which the body’s own immune system attacks parts of the digestive system. The two most com- The exact cause of IBD remains unknown. Researchers mon inflammatory bowel diseases are Crohn’s disease believe that a combination of four factors lead to IBD: a (CD) and ulcerative colitis (UC). IBD affects as many as 1.4 genetic component, an environmental trigger, an imbal- million Americans, most of whom are diagnosed before ance of intestinal bacteria and an inappropriate reaction age 35. There is no cure for IBD but there are treatments to from the immune system. Immune cells normally protect reduce and control the symptoms of the disease. the body from infection, but in people with IBD, the immune system mistakes harmless substances in the CD and UC cause chronic inflammation of the GI tract. CD intestine for foreign substances and launches an attack, can affect any part of the GI tract, but frequently affects the resulting in inflammation.
    [Show full text]
  • Prediction of Premature Termination Codon Suppressing Compounds for Treatment of Duchenne Muscular Dystrophy Using Machine Learning
    Prediction of Premature Termination Codon Suppressing Compounds for Treatment of Duchenne Muscular Dystrophy using Machine Learning Kate Wang et al. Supplemental Table S1. Drugs selected by Pharmacophore-based, ML-based and DL- based search in the FDA-approved drugs database Pharmacophore WEKA TF 1-Palmitoyl-2-oleoyl-sn-glycero-3- 5-O-phosphono-alpha-D- (phospho-rac-(1-glycerol)) ribofuranosyl diphosphate Acarbose Amikacin Acetylcarnitine Acetarsol Arbutamine Acetylcholine Adenosine Aldehydo-N-Acetyl-D- Benserazide Acyclovir Glucosamine Bisoprolol Adefovir dipivoxil Alendronic acid Brivudine Alfentanil Alginic acid Cefamandole Alitretinoin alpha-Arbutin Cefdinir Azithromycin Amikacin Cefixime Balsalazide Amiloride Cefonicid Bethanechol Arbutin Ceforanide Bicalutamide Ascorbic acid calcium salt Cefotetan Calcium glubionate Auranofin Ceftibuten Cangrelor Azacitidine Ceftolozane Capecitabine Benserazide Cerivastatin Carbamoylcholine Besifloxacin Chlortetracycline Carisoprodol beta-L-fructofuranose Cilastatin Chlorobutanol Bictegravir Citicoline Cidofovir Bismuth subgallate Cladribine Clodronic acid Bleomycin Clarithromycin Colistimethate Bortezomib Clindamycin Cyclandelate Bromotheophylline Clofarabine Dexpanthenol Calcium threonate Cromoglicic acid Edoxudine Capecitabine Demeclocycline Elbasvir Capreomycin Diaminopropanol tetraacetic acid Erdosteine Carbidopa Diazolidinylurea Ethchlorvynol Carbocisteine Dibekacin Ethinamate Carboplatin Dinoprostone Famotidine Cefotetan Dipyridamole Fidaxomicin Chlormerodrin Doripenem Flavin adenine dinucleotide
    [Show full text]
  • Stems for Nonproprietary Drug Names
    USAN STEM LIST STEM DEFINITION EXAMPLES -abine (see -arabine, -citabine) -ac anti-inflammatory agents (acetic acid derivatives) bromfenac dexpemedolac -acetam (see -racetam) -adol or analgesics (mixed opiate receptor agonists/ tazadolene -adol- antagonists) spiradolene levonantradol -adox antibacterials (quinoline dioxide derivatives) carbadox -afenone antiarrhythmics (propafenone derivatives) alprafenone diprafenonex -afil PDE5 inhibitors tadalafil -aj- antiarrhythmics (ajmaline derivatives) lorajmine -aldrate antacid aluminum salts magaldrate -algron alpha1 - and alpha2 - adrenoreceptor agonists dabuzalgron -alol combined alpha and beta blockers labetalol medroxalol -amidis antimyloidotics tafamidis -amivir (see -vir) -ampa ionotropic non-NMDA glutamate receptors (AMPA and/or KA receptors) subgroup: -ampanel antagonists becampanel -ampator modulators forampator -anib angiogenesis inhibitors pegaptanib cediranib 1 subgroup: -siranib siRNA bevasiranib -andr- androgens nandrolone -anserin serotonin 5-HT2 receptor antagonists altanserin tropanserin adatanserin -antel anthelmintics (undefined group) carbantel subgroup: -quantel 2-deoxoparaherquamide A derivatives derquantel -antrone antineoplastics; anthraquinone derivatives pixantrone -apsel P-selectin antagonists torapsel -arabine antineoplastics (arabinofuranosyl derivatives) fazarabine fludarabine aril-, -aril, -aril- antiviral (arildone derivatives) pleconaril arildone fosarilate -arit antirheumatics (lobenzarit type) lobenzarit clobuzarit -arol anticoagulants (dicumarol type) dicumarol
    [Show full text]
  • Sulfasalazine (Azulfidine)
    Sulfasalazine (Azulfidine) Description Sulfasalazine (Azulfidine), used to treat pain and swelling in arthritis, belongs to a class of drugs called sulfa drugs. It is a combination of salicylate (the main ingredient in aspirin) and a sulfa antibiotic. Sulfasalazine is also known as a disease modifying antirheumatic drug (DMARD) because it not only decreases the pain and swelling of arthritis, but also may prevent damage to joints. In addition, it may reduce the risk of long term loss of function. Uses Sulfasalazine was first used over 70 years ago to treat rheumatoid arthritis which, at one time, was thought to be caused by a bacterial infection. Sulfasalazine was designed as a combination of an aspirin- like anti-inflammatory medicine with a sulfa containing antibiotic. While a bacterial infectious cause for rheumatoid arthritis is longer believed to be true, sulfasalazine continues to be useful for treating for mild to moderate symptoms, or may be given with other drugs for more severe symptoms of rheumatoid arthritis. It is also used for other conditions, including juvenile idiopathic arthritis (also called juvenile rheumatoid arthritis), ankylosing spondylitis, psoriatic arthritis, and ulcerative colitis. How it works Sulfasalazine treats swelling, pain, and stiffness in arthritis. However, it is not entirely clear how this medication works for rheumatoid arthritis. Dosing Sulfasalazine comes in a 500 milligram tablet, and should be taken with food and a full glass of water to prevent stomach upset. The medication is often started at low doses to treat rheumatoid arthritis, typically one to two tablets a day, to prevent side effects. After the first week, the dose may be increased slowly to the usual 2 tablets (1 gram) taken twice a day.
    [Show full text]
  • Effect of IBD Medications on COVID-19 Outcomes: Results from an International Registry
    Inflammatory bowel disease ORIGINAL RESEARCH Gut: first published as 10.1136/gutjnl-2020-322539 on 20 October 2020. Downloaded from Effect of IBD medications on COVID-19 outcomes: results from an international registry Ryan C Ungaro ,1 Erica J Brenner,2 Richard B Gearry,3 Gilaad G Kaplan ,4 Michele Kissous- Hunt,1,5 James D Lewis,6 Siew C Ng ,7 Jean- Francois Rahier,8 Walter Reinisch ,9 Flávio Steinwurz,10 Fox E Underwood,4 Xian Zhang,2 Jean- Frederic Colombel,1 Michael D Kappelman2 ► Additional material is ABSTRACT Significance of this study published online only. To view Objective We sought to evaluate COVID-19 clinical please visit the journal online course in patients with IBD treated with different (http:// dx. doi. org/ 10. 1136/ What is already known on this subject? gutjnl- 2020- 322539). medication classes and combinations. Design Surveillance Epidemiology of Coronavirus Under ► Patients with IBD who are older, have For numbered affiliations see additional comorbidities and are on oral end of article. Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) is a large, international registry created corticosteroids appear to be at increased risk of adverse outcomes from COVID-19. Correspondence to to monitor outcomes of IBD patients with confirmed Dr Ryan C Ungaro, The COVID-19. We used multivariable regression with a ► Prior data have suggested that patients with Henry D. Janowitz Division of generalised estimating equation accounting for country IBD on mesalamine/sulfasalazine may be at Gastroenterology, Icahn School as a random effect to analyse the association of different increased risk for severe COVID-19, while of Medicine at Mount Sinai, medication classes with severe COVID-19, defined as patients on tumour necrosis factor (TNF) New York, NY 10029, USA; antagonists do not appear to be at increased ryan.
    [Show full text]
  • Supplementary Materials Supplementary Methods Propensity Scores Were Calculated for Use As Weights Within the Inverse Probabilit
    BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s) Ann Rheum Dis Supplementary Materials Supplementary Methods Propensity scores were calculated for use as weights within the inverse probability weighted Cox proportional hazards models1. These propensity scores were estimated separately for treatment cohorts within the 1) all inflammatory joint diseases, and 2) RA cohorts. Note that due to low number of events, and balance not being achieved, between treatment cohort analyses using inverse propensity score weighting was not performed in the other IJD cohort. Propensity scores were also calculated separately when comparing the csDMARD to the b/tsDMARD groups in each of the three inflammatory joint disease cohorts. Multinomial logistic (for the estimation of propensity scores within the six DMARD cohorts), and logistic regression models (for the estimation of propensity score within the csDMARD/b-tsDMARD cohorts) were fitted. All models contained the same covariates: history of cancer, diabetes, heart failure, ischemic heart disease, hospitalisation listing infection, lung disease, stroke, venous thromboembolic events, kidney failure, and surgery, age, sex, disease duration, DAS28, an indicator variable specifying whether the individual had received a different b/tsDMARD in the 180 days before start of follow-up, the number of previous b/tsDMARDs, days in hospital (both in the previous 10 years, and 1 year), region of domicile, educational level, civil status, and country of birth. See Supplementary Table 4 for definitions and the functional form of each of the covariates included in the propensity score model.
    [Show full text]
  • With Thanks & Gratitude
    WITH THANKS & GRATITUDE Th is patient guide was made possible thanks to a donation by the Tabor Family in loving memory their daughter, sister and friend, Tracy Tabor Finstad. CONTENTS ..................................................................................................................1 WELCOME! Welcome Letter ...............................................................................................................3 Important Th ings to Know Up Front ...............................................................................4 Meet Your Crohn’s & Colitis Team ................................................................................6 HOW TO CONTACT US IBD Clinic Schedule .......................................................................................................9 Physician and Nurse Contact Information ....................................................................10 Appointment Scheduling and Other Contact Information ............................................11 THE BASICS OF IBD Basic Information about Infl ammatory Bowel Disease (IBD) ........................................12 Frequently Asked Questions about Infl ammatory Bowel Disease (IBD ..........................15 20 Questions to Ask Your Doctor about Infl ammatory Bowel Disease (IBD) ...............17 TESTING IN IBD Colonoscopy and Flexible Sigmoidoscopy ......................................................................18 Upper Endoscopy ..........................................................................................................19
    [Show full text]
  • PATIENT FACT SHEET Sulfasalazine
    Sulfasalazine PATIENT FACT SHEET (Azulfidine) Sulfasalazine (Azulfidine) is considered a disease- take it if you have a sulfa allergy. Sulfasalazine is used in modifying anti-rheumatic drug (DMARD). It can the treatment of rheumatoid arthritis (RA), inflammatory decrease the pain and swelling of arthritis, prevent joint bowel disease, and some other autoimmune conditions. damage and reduce the risk of long-term disability. It works to lower inflammation in the body. Sulfasalazine is in a type of sulfa drug. You should not WHAT IS IT? Sulfasalazine comes in a 500mg tablet and should be stomach-coated) preparation is available that may lessen taken with food and a full glass of water to avoid an some of the side effects associated with sulfasalazine, upset stomach. The medication is often started at low particularly stomach upset. This form of sulfasalazine doses when treating RA to prevent side effects, typically should not be crushed or chewed. Adequate fluid intake 1 to 2 tablets a day. After the first week, the dose may is required to prevent kidney stones. It usually takes be slowly increased to the usual dosage of 2 tablets between 2 to 3 months to notice any improvement in HOW TO (1g) twice a day. This dose can be increased to up to 6 RA symptoms after starting sulfasalazine. TAKE IT pills (3g) a day in some situations. An Enteric-coated (or In general, most patients can take sulfasalazine colored urine and even orange skin. This should not with few side effects. The most common side effects cause alarm. It is usually harmless and goes away after are nausea and abdominal discomfort, which occurs medication is stopped.
    [Show full text]
  • Simultaneous HPLC Assay of Paracetamol and Sulfapyridine As
    Journal of Bioequivalence Studies Volume 1 | Issue 1 ISSN: 2575-551X Research Article Open Access Simultaneous HPLC Assay of Paracetamol and Sulfapyridine as Markers for Estimating Gastrointestinal Transit of Amphotericin B-containing Nanoparticles in Rat Plasma Hilda A1, Nashiru B*1 and Kah-Hay Y2 1School of Pharmacy, University of Nottingham, Malaysia Campus, 43500 Selangor, Malaysia 2School of Pharmacy, University of Science, Malaysia 11800, Minden, Penang Malaysia *Corresponding author: Nashiru B, School of Pharmacy, University of Nottingham, Malaysia Campus, 43500 Selangor, Malaysia, Fax: +60389248018, Tel: +6038924821, Email: [email protected] Citation: Hilda A, Nashiru B, Kah-Hay Y (2015) Simultaneous HPLC Assay of Paracetamol and Sulfapyridine as Markers for Estimating Gastrointestinal Transit of Amphotericin B-containing Nanoparticles in Rat Plasma. J Bioequiv 1(1): 104. doi: 10.15744/2575-551X.1.104 Received Date: May 18, 2015 Accepted Date: September 02, 2015 Published Date: September 04, 2015 Abstract A simple and sensitive two-step reversed-phase HPLC method was developed and validated for determining amphotericin B, paracetamol and sulfapyridine in rat plasma using piroxicam as internal standard. This was subsequently employed in a pharmacokinetic study in rats following simultaneous oral administration of solid lipid nanoparticle formulations of amphotericin B, paracetamol and sulfasalazine. The paracetamol and sulfapyridine served as markers for estimating gastric emptying and cecal arrival times. A gradient elution was employed in the analysis and detection at 405 nm for amphotericin B and 254 nm for paracetamol and sulfapyridine. The internal standard was detectable at both wavelengths. The gastrointestinal study was conducted on male Sprague-Dawley rats.
    [Show full text]
  • Effect of Sulfasalazine and Prednisolone Against Dextran Induced Ulcerative Colitis in Female Balb/C Mice
    M.V.Ramana et al. / Journal of Pharmacy Research 2012,5(9),4808-4811 Research Article Available online through ISSN: 0974-6943 http://jprsolutions.info Effect of Sulfasalazine and Prednisolone against dextran induced ulcerative colitis in female balb/c mice Dr. M.V.Ramana2, N.S.V.Mukharjee1, Dr. A. Ramesh, M.Manohar, N.Hindu, T.Vanaja, B.Pavani, N.Santhosh, E.Srikanth, M.Venkatesh, K.Phaneendra, *VVSPC Rao.M *Research scholar, BITS PILANI, Hyderabad campus, Hyderabad,India 1. Assistant professor, G.B.N.Institute of Pharmacy, Hyderabad,India 2. Principal, G.B.N.Institute of Pharmacy, Hyderabad,India Received on:12-06-2012; Revised on: 17-07-2012; Accepted on:26-08-2012 ABSTRACT Sulfasalazine is the most widely prescribed drug for ulcerative colitis (1) (5). Following oral administration of sulfasalazine (5) practically unabsorbed reaches the colon where it is split by colonic bacteria to 5-aminosalicylic acid and sulphapyridine. Prednisolone is absorbed into the blood stream so act indiscriminately throughout whole body. Prednisolone is a corticosteroid which is used in ulcerative colitis. Prednisolone works by preventing or reducing inflammation (4). It is used to treat a number of conditions that are characterized by excessive inflammation. Prednisolone suppresses the immune system (6) (4) and so can be used to treat autoimmune diseases (3) (4). If prolong usage of corticosteroids also leads to their immune system can become weak. The objective of this study was to determine effect of sulfasalazine and Prednisolone against dextran sodium sulphate induced colitis in balb/c mice. We observed the parameters like body weight, colon length, colon weight and IL-6 estimation.
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 7438,929 B2 Beckert Et Al
    US007438929B2 (12) United States Patent (10) Patent No.: US 7438,929 B2 Beckert et al. (45) Date of Patent: *Oct. 21, 2008 (54) MULTI-PARTICULATE FORM OF (56) References Cited MEDICAMENT, COMPRISING AT LEAST U.S. PATENT DOCUMENTS TWO DIFFERENTLY COATED FORMS OF PELLET 4,600,577 A 7/1986 Didriksen 4,720,387 A 1/1988 Sakamoto et al. (75) Inventors: Thomas Beckert, Warthausen (DE): 6,897.205 B2 * 5/2005 Beckert et al. .............. 514f159 Hans-Ulrich Petereit, Darmstadt (DE): Jennifer Dressman, Frankfurt (DE); Markus Rudolph, Neu-Isenburg (DE) OTHER PUBLICATIONS (73) Assignee: Roehm GmbH & Co. KG, Darmstadt Schmidt, C., "A Multiparticulate Drug-delivery System Based on (DE) Pellets Incorporated into Congealable Polyethylene Glycol Carrier (*) Notice: Subject to any disclaimer, the term of this Materials'. International Journal of Pharmaceutics 216 (2001) 9-16, patent is extended or adjusted under 35 Elsevier. U.S.C. 154(b) by 614 days. * cited by examiner This patent is Subject to a terminal dis claimer. Primary Examiner Johann Richter Assistant Examiner Danielle Sullivan (21) Appl. No.: 10/949,323 (74) Attorney, Agent, or Firm Oblon, Spivak, McClelland, (22) Filed: Sep. 27, 2004 Maier & Neustadt, P.C. (65) Prior Publication Data (57) ABSTRACT US 2005/OO53660 A1 Mar. 10, 2005 The invention relates to a multiparticulate drug form suitable Related U.S. Application Data for uniform release of an active pharmaceutical ingredient in the Small intestine and in the large intestine, comprising at (63) Continuation of application No. 10/239.209, filed as least two forms of pellets A and B which comprise an active application No.
    [Show full text]
  • WHO Drug Information Vol. 03, No. 4, 1989
    WHO DRUG INFORMATION VOLUME 3 • NUMBER 4 • 1989 PROPOSED INN LIST 62 INTERNATIONAL NONPROPRIETARY NAMES FOR PHARMACEUTICAL SUBSTANCES WORLD HEALTH ORGANIZATION • GENEVA WHO Drug Information WHO Drug Information provides an cerned with the rational use of overview of topics relating to drug drugs. In effect, the journal seeks development and regulation that to relate regulatory activity to are of current relevance and im­ therapeutic practice. It also aims to portance, and will include the lists provide an open forum for debate. of proposed and recommended In­ Invited contributions will portray a ternational Nonproprietary Names variety of viewpoints on matters of for Pharmaceutical Substances general policy with the aim of (INN). Its contents reflect, but do stimulating discussion not only not present, WHO policies and ac­ in these columns but wherever tivities and they embrace socio­ relevant decisions on this subject economic as well as technical mat­ have to be taken. ters. WHO Drug Information is pub­ The objective is to bring issues that lished 4 times a year in English and are of primary concern to drug French. regulators and pharmaceutical manufacturers to the attention of a Annual subscription: Sw.fr. 50.— wide audience of health profes­ Airmail rate: Sw.fr. 60.— sionals and policy-makers con­ Price per copy: Sw.fr. 15.— © World Health Organization 1989 Authors alone are responsible for views expressed Publications of the World Health Organization in signed contributions. enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal The mention of specific companies or of certain Copyright Convention. For rights of reproduc­ manufacturers' products does not imply that they are tion or translation, in part or In toto, applica­ endorsed or recommended by the World Health tion should be made to: Chief, Office of Organization in preference to others of a similar na­ Publications, World Health Organization, ture which are not mentioned.
    [Show full text]