DOCSLIB.ORG

Effect of Caffeine on Histamine Bronchoprovocation in Asthma Thorax: First Published As 10.1136/Thx.45.8.630 on 1 August 1990

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Effect of Caffeine on Histamine Bronchoprovocation in Asthma Thorax: First Published As 10.1136/Thx.45.8.630 on 1 August 1990 630 Thorax 1990;45:630-632 Effect of caffeine on histamine bronchoprovocation in asthma Thorax: first published as 10.1136/thx.45.8.630 on 1 August 1990. Downloaded from Antoinette Colacone, Luisa Bertolo, Norman Wolkove, Carol Cohen, Harvey Kreisman Abstract nosis of asthma sometimes include testing for It was recently reported that caffeine bronchial hyperreactivity to specific or non- may reduce the clinical symptoms of specific stimuli. Histamine broncho- asthma and may prevent the clinical provocation challenge is often used to measure manifestations of this disease. The effect non-specific airway reactivity in the of caffeine on histamine responsiveness laboratory or in population surveys.2 Anti- is unknown. The effect of caffeine (5 mg/ asthmatic medication, including theophylline, kg) and placebo on histamine respon- may attenuate the bronchoconstriction siveness (the provocation concentration induced by histamine and specific recommen- causing a 20% fall in FEVy, PC20) was dations exist for withholding these medica- studied in 10 subjects with mild asthma tions before bronchoprovocation testing.-4 (prechallenge FEV, 84% of predicted There are no specific guidelines, however, for value). The PC20 for histamine caffeine intake before testing. bronchoprovocation after caffeine inges- The purpose of this investigation was to tion was 2 65 (95% confidence limits 0 99, study whether caffeine at a dose of 5 mg/kg 7-10) mg/ml. After placebo the PC20 was (about 3 cups of coffee) would alter histamine 189 (0-96, 3-71) mg/ml. It is concluded reactivity in adults with mild bronchial that caffeine in a dose equivalent to asthma. We chose this dose because the about three cups of coffee has a very average caffeine content in a cup of coffee is small effect, if any, on histamine about 150 mg and only 1900 of the population bronchoprovocation in those with mild have more than three cups a day.' 8 asthma. Specific instructions about not having drinks containing caffeine before are not histamine challenge therefore Methods http://thorax.bmj.com/ necessary. SUBJECTS We studied 10 symptom free asthmatic subjects (seven male) with a mean age of 46 An inverse correlation between coffee intake (SD 17) years. Nine subjects had previously and the prevalence of asthma was reported documented increased airway reactivity (a recently.' The risk of asthma was 20% less in provocative concentration of histamine caus- those who consumed two or more cups a day ing a 20% fall in FEV, (PC20) less than 8 mg/ than in those who drank none. The broncho- ml), and the other had a history of seasonal on September 25, 2021 by guest. Protected copyright. dilator effect of caffeine may reduce the clin- asthma and a PC20 of less than 16 mg/ml. ical symptoms of asthma or prevent the clin- Before the study seven subjects used an ical manifestations of the disease.' Asthma inhaled beta agonist, five theophylline and may be underdiagnosed therefore in a coffee four an inhaled corticosteroid; two required consuming population. no medication. The four patients taking Current guidelines for the laboratory diag- inhaled steroids (Nos 2, 5, 7, 8 in the table) Pulmonary Division, Individual caffeine doses, serum concentrations, and their effect on bronchial responsiveness to histamine (PC20) Department of Medicine, Sir Serum caffeine PC20 (mg/ml) %AFEV, slope (mg/ml) Mortimer B Davis- Caffeine concentration Jewish General Patient No Weight (kg) dose (mg) (,g/ml) Placebo Caffeine Placebo Caffeine Hospital, Mount Sinai Hospital and McGill 1 73 365 2-5 0-6 4 1-7 3-0 University, Montreal, 2 95-5 477 4-5 1-4 0-4 3-6 3-0 Quebec, Canada 3 110 550 6-7 2-3 16 17-8 47-2 A Colacone 4 70 350 5-4 6 11 10-2 0-5 L Bertolo 5 84-5 425 6-0 0-6 0-6 3-6 1-8 N Wolkove 6 57-5 289 6-5 2-5 2-2 38-6 41-4 C Cohen 7 107 535 5-7 1-5 1-5 8-7 14-3 H Kreisman 8 65 325 5-7 6 8-8 2-6 2-2 Address for reprint requests: 9 71 355 63 0-7 0-6 11-0 9-1 Dr Harvey Kreisman, c/o 10 76 380 4-7 5-8 6-8 12-2 16-5 Pulmonary Division, Sir 81 405-1 5-4 Mortimer B Davis-Jewish Mean 1.9*t 2.7*t 7.4*t 6-1*1 General Hospital, 3755 Cote SD 17-8 88-9 1-2 (1-0,3-7) (1-0,7-1) (2-1,17-5) (3-7,14-7) St Catherine Road, Montreal, Quebec, Canada *Geometric means with 95% confidence intervals in parentheses. H3T 1E2. tP = 0-31 in the comparison of PC2. after placebo and after caffeine. Accepted 3 April 1990 $p = 0-61 in the comparison of slope after placebo and after caffeine. Effiect of caffeine on histamine bronchoprovocation in asthma 631 Figure 1 Identity plot FEV1 (1) the same time of day on two days within two showing prechallenge placebo weeks. FEV, (I) of individual 12oar^,r, 'aA.o.bones-.a-rRy nolr,= +^ subjects on the two study 5 ;Viore eac1s-ELUUy SUUJDiecLi We1r as^eU LU days. Mean (SD) FEV, Mean (SD) refrain from consuming products containing Thorax: first published as 10.1136/thx.45.8.630 on 1 August 1990. Downloaded from caffeine 2 65 (0 73) 1, caffeine for 48 hours and to fast for eight placebo 2 67 (0 78) 1. Caffeine 2/65(0.73) * 4 Caffeine 2.65 (0.73) hours. Antiasthmatic medications were with- Placebo 2.67 (0.78) held according to standard guidelines for his- tamine bronchoprovocation testing.4 Beta 3 agonists and anticholinergic drugs were with- 0. held for 8-12 hours and theophylline for 24 hours before testing. Slow release theo- phylline and antihistamines were not con- 2 sumed for 48 hours before testing. Steroids were continued as usual. Spirometry was performed with a recording 1 spirometer (Vitalograph, Model S, Kansas City, Missouri). Baseline spirometric tests were carried out in triplicate and the FEVy C was recorded from the best spirogram (sum of 0 1 2 3 4 5 FEVy and forced vital capacity). Subjects then FEV, (1) caffeine ingested either caffeine (5 mg/kg body weight) in aqueous solution or an equivalent volume of placebo. tooik the same doses before and during the Blood for serum caffeine and theophylline stuidy. determination was drawn 105 minutes after StIrhe protocol was approved by the ethics ingestion of the test medication. The blood connmittee of the Sir Mortimer B Davis-Jew- samples were then centrifuged and stored at ish General Hospital. Informed consent was -20°C. Caffeine and theophylline concentra- obtained from each subject. tions were later determined by high pressure liquid chromatography.5 TEST MEDICATIONS Spirometry was repeated two hours after Calffeine and corresponding placebo were ingestion and followed by a histamine prepared in solution and coded by the hospital challenge test performed according to the phairmacy. The former contained caffeine method of Cockcroft et al.6 A Wright nebul- citr-ate in a concentration of 50 mg/ml. Both iser was filled with 3 ml of solution and soliations contained amaranta colorant and operated at a flow of 9 1/min 50 lb/in2. The vantilla essence diluted with distilled water and nebuliser output had been calibrated to http://thorax.bmj.com/ werre indistinguishable by taste, colour, and deliver a mean of 0-26 (SD 0 008) ml over two smcell. minutes. Increasing doses of histamine were given until a 20% fall in FEVy had occurred. STUDY PROTOCOL STATISTICAL ANALYSIS The subjects were randomised to receive caf- Arithmetic means and standard deviations feine and placebo first in a double blind were computed for FEV,. PC20 values were crossover study. The study was carried out at log transformed before analysis; geometric on September 25, 2021 by guest. Protected copyright. mean values and 95% confidence intervals are given. The slope of the histamine dose-res- Figure 2 Bronchial ponse curve was calculated by linear regres- responsiveness to histamine 100 (PC20, mg/ml) on caffeine sion and log transformed before analysis by and placebo days. Two paired t test. Student's paired t test was used subjects had a two to compare differences between placebo and concentration increase in PC20 and another had a caffeine data. A p value below 0 05 was con- similar reduction in PC20 sidered statistically significant. on the day. placebo 10 - _ Results - Mean (SD) FEVy values before histamine C challenge did not differ significantly on the 0 *,v caffeine and placebo days (2-65 (0 73) and 2-67 I, v(0 78) litres; fig 1); both values were 84% ofthe PL4 I1 predicted FEVy.7 Mean (SD) FEVy increased by 0 10 (0 09) 1 after caffeine compared with 0 05 (0 06) after placebo (p = 0 38). The mean (SD) serum caffeine concentration was 5-4 ((1 -23) Mg/ml after caffeine; none was detected after placebo (table). Theophylline was not detected in the serum of any patient on either .1 I study day. All subjects had a of 16 or less Placebo Caffeine after both caffeine andPC20placebo. mg/mlThere was no 632 Colacone, Bertolo, Wolkove, Cohen, Kreisman significant difference in PC20 values or in the study were lower than expected from a dose of slope of the dose-response relationship be- 5 mg/kg caffeine.814 A given dose of caffeine, tween caffeine and placebo (table and fig 1). like theophylline, may produce a wide range of The PC20 increased by more than two dose serum concentrations in different individuals.
Load more

Recommended publications
  • Effect of Theophylline and Enprofylline on Bronchial Hyperresponsiveness
    Thorax: first published as 10.1136/thx.44.12.1022 on 1 December 1989. Downloaded from Thorax 1989;44:1022-1026 Effect of theophylline and enprofylline on bronchial hyperresponsiveness G H KOETER, J KRAAN, M BOORSMA, J H G JONKMAN, TH W VAN DER MARK From the Department ofPulmonology and Lung Function, University Hospital, Groningen; Pharma Bio Research, Assen; and Astra Pharmaceutica, Rijswijk, The Netherlands ABSTRACT The effect of increasing intravenous doses of theophylline and enprofylline, a new xanthine derivative, on bronchial responsiveness to methacholine was studied in eight asthmatic patients. Methacholine provocations were carried out on three days before and after increasing doses of theophylline, enprofylline, and placebo, a double blind study design being used. Methacholine responsiveness was determined as the provocative concentration of methacholine causing a fall of 20% in FEV, (PC20). The patients were characterised pharmacokinetically before the main study to provide an individual dosage scheme for each patient that would provide rapid steady state plasma concentration plateaus of 5, 10, and 15 mg/l for theophylline and 1 25, 2 5, and 3-75 mg/l for enprofylline. Dose increments in the main study were given at 90 minute intervals. FEV, showed a small progressive decrease after placebo; it remained high in relation to placebo after both drugs and this effect was dose related. Methacholine PC20 values decreased after placebo; mean values were (maximum difference 2-0 and 1 7 higher after theophylline and enprofylline than after placebo copyright. doubling doses of methacholine); the effect of both drugs was dose related. Thus enprofylline and theophylline when given intravenously cause a small dose related increase in FEV1 and methacholine PC20 when compared with placebo.
    [Show full text]
  • 12.2% 122,000 135M Top 1% 154 4,800
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE We are IntechOpen, provided by IntechOpen the world’s leading publisher of Open Access books Built by scientists, for scientists 4,800 122,000 135M Open access books available International authors and editors Downloads Our authors are among the 154 TOP 1% 12.2% Countries delivered to most cited scientists Contributors from top 500 universities Selection of our books indexed in the Book Citation Index in Web of Science™ Core Collection (BKCI) Interested in publishing with us? Contact [email protected] Numbers displayed above are based on latest data collected. For more information visit www.intechopen.com Chapter A Detail Chemistry of Coffee and Its Analysis Hemraj Sharma Abstract This review article highlights the detailed chemistry of coffee including its components; chemical constituents like carbohydrates, proteins, lipids, and caf- feine; aromatic principles; oil and waxes; and minerals and acids. The high extent of caffeine can be found in the coffee plants; hence, in the second part of the study, various analytical methods are designed for the proper identification, separation, optimization, purification, and determination of caffeine present in coffee, tea, and marketed coffee. These analytical methods are appropriated for the separation and quantification of caffeine. The various analytical methods include spectroscopy methods like UV, IR, and NMR spectroscopy; chromatographic methods like paper, TLC, column, HPLC, and gas chromatography; and hyphenated techniques like LC–MS, GC–MS, and GC–MS/MS. This article compares and contrasts the amount of caffeine by various analytical methods. Keywords: caffeine, spectrophotometer, chromatography, hyphenated techniques, electrochemical methods 1.
    [Show full text]
  • Effect of Practical Timing of Dosage on Theophylline Blood Levels In
    Arch Dis Child: first published as 10.1136/adc.53.2.167 on 1 February 1978. Downloaded from Archives of Disease in Childhood, 1978, 53, 167-182 Short reports Effect of practical timing of dosage Methods on theophylline blood levels in For the period of the study, the children did not asthmatic children treated with receive tea, which contains theophylline. choline theophyllinate GroupA. These childrenwere given choline theophyll- The bronchodilator effect of theophylline has been inate in a dosage of as near as possible 8 mg/kg per known for over 50 years, but although it has been dose qds (mean 7 9 mg/kg, range 7-2-8 7 mg/kg), widely used both intravenously and rectally in the starting with half the dose on the first day to try and treatment ofacute asthma, its use as an oral broncho- minimise nausea. The doses were given at 0800 h, dilator has been limited by inadequate knowledge of 1300 h, 1700 h, and 2100 h, times considered suitable the correct dosage of the oral preparations. The for administration outside hospital. On the third day therapeutic level of theophylline is generally con- ofthe study serum levels were measured 2 hours after sidered to be between 10 and 20 ,ug/ml (Turner- each dose and before the 0800 h dose the following Warwick, 1957; Jenne et al., 1972), although sub- morning. optimal bronchodilation can be achieved with levels of 5 ,ug/ml or less (Maselli et al., 1970; Nicholson and Group B. These children were given cholinetheophyll- Chick, 1973). Serious toxicity with levels of less than inate in a dosage of as near as possible 10 mg/kg per copyright.
    [Show full text]
  • Pharmaceuticals 2010, 3, 725-747; Doi:10.3390/Ph3030725
    Pharmaceuticals 2010, 3, 725-747; doi:10.3390/ph3030725 OPEN ACCESS pharmaceuticals ISSN 1424-8247 www.mdpi.com/journal/pharmaceuticals Review Theophylline Peter J. Barnes National Heart and Lung Institute, Imperial College, London, UK; E-Mail: [email protected]; Tel.: +44-207-351-8174; Fax: +44-207-351-5675. Received: 14 January 2010 / Accepted: 18 March 2010 / Published: 18 March 2010 Abstract: Theophylline (3-methyxanthine) has been used to treat airway diseases for over 70 years. It was originally used as a bronchodilator but the relatively high doses required are associated with frequent side effects, so its use declined as inhaled β2-agonists became more widely used. More recently it has been shown to have anti-inflammatory effects in asthma and COPD at lower concentrations. The molecular mechanism of bronchodilatation is inhibition of phosphodiesterase(PDE)3 and PDE4, but the anti-inflammatory effect may be due to histone deacetylase (HDAC) activation, resulting in switching off of activated inflammatory genes. Through this mechanism theophylline also reverses corticosteroid resistance and this may be of particular value in severe asthma and COPD where HDAC2 activity is markedly reduced. Theophylline is given systemically (orally as slow-release preparations for chronic treatment and intravenously for acute exacerbations of asthma) and blood concentrations are determined mainly by hepatic metabolism, which may be increased or decreased in several diseases and by concomitant drug therapy. Theophylline is now usually used as an add-on therapy in asthma patients not well controlled on inhaled corticosteroids and in COPD patients with severe disease not controlled by bronchodilator therapy.
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2002/0137785 A1 Kindness Et Al
    US 2002.0137785A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2002/0137785 A1 Kindness et al. (43) Pub. Date: Sep. 26, 2002 (54) INFLAMMATORY MECHANISM Related U.S. Application Data MODULATOR COMPOSITION AND METHODS WITH ANTI-ASTHMATIC (60) Provisional application No. 60/278,725, filed on Mar. PROPERTIES 26, 2001. (76) Inventors: George Kindness, Middletown, OH Publication Classification (US); Brooke Schumm III, Ellicott (51) Int. Cl." ....................... A61K 31/496; A61K 31/47; City, MD (US); F. Timothy Guilford, A61K 31/433; A61K 31/417; Palo Alto, CA (US) A61K 31/341; A61K 31/198 (52) U.S. Cl. .................... 514,400; 514/362; 514/255.04; Correspondence Address: 514/311; 514/562 BROOKE SCHUMM, III (57) ABSTRACT DANEKER, MCINTIRE, SCHUMM, PRINCE, GOLDSTEIN, ETA The invention proposes the use of a leukotriene antagonist, 210 N CHARLES ST particularly a montelukast Sodium compound Such as SIN SUTE 800 GULAIR, in combination with cystine to combat inflam BALTIMORE, MD 21201 (US) matory disease and hopefully reduce the necessary use of SINGULAIR. Combination with other anti-inflammatory (21) Appl. No.: 10/106,625 agents and anti-asthmatic agents is proposed. Selenium to assure glutathione pathway benefit is Suggested. The addi (22) Filed: Mar. 26, 2002 tion of a selective COX-2 inhibitor is suggested. US 2002/0137785 A1 Sep. 26, 2002 INFLAMMATORY MECHANISM MODULATOR ing mechanisms, particularly the notable response from Th2 COMPOSITION AND METHODS WITH to Th1, are particularly efficacious in ameliorating the dis ANT-ASTHMATIC PROPERTIES easeS referenced. 0005 For the preferred mode, the first objective is to CONTINUATION DATA inhibit the initiation of asthmatic response.
    [Show full text]
  • Clinical Applications of Serum Theophylline Measurement by High Pressure Liquid Chromatography
    Arch Dis Child: first published as 10.1136/adc.53.4.322 on 1 April 1978. Downloaded from Archives of Disease in Childhood, 1978, 53, 322-325 Clinical applications of serum theophylline measurement by high pressure liquid chromatography SHEILA A. McKENZIE, A. T. EDMUNDS, EIVOR BAILLIE, AND J. H. MEEK From the Department ofPaediatrics and Neonatal Medicine, Institute ofChild Health, Hammersmith Hospital, London SUMMARY Serum theophylline concentration was measured in children both during treatment of status asthmaticus with intravenous aminophylline, and as outpatients while they were taking oral theophylline compounds for long-term management of asthma. The clinical value of the measure- ments was assessed. Measurement using high-pressure liquid chromatography is simple and requires only a small volume of blood. Knowledge of serum theophylline concentration facilitates careful control of dosage of both intravenous aminophylline during treatment of status asthmaticus, and of oral theophylline in outpatients. It is useful in the evaluation of symptoms which may be due to toxic side effects of treatment. It also makes possible an assessment of patient compliance with prescribed treatment among those whose symptoms have not improved. Aminophylline has for many years been widely used Method for the treatment of status asthmaticus. Oral theo- phylline compounds have not, however, enjoyed 50 ,g of serum was mixed with 100 0d 1-0 M trich- the same popularity in the long-term treatment of loracetic acid to precipitate proteins, and after Recent trials and 40 of the was asthma. (Weinberger Bronsky, centrifugation [L supernatant injected http://adc.bmj.com/ 1974; Hambleton et al., 1977) have shown that into the chromatograph.
    [Show full text]
  • Study Protocol 1
    IRB of The Catholic University of Korea/Catholic Medical Center Form 1_v4_141125 Revised Clinical Study Protocol 1. Title and Phase of Study Title: Study regarding the clinical efficacy of Synatura® in patients with chronic bronchitis type COPD Phase: Interventional, single center, single group, open-label study 2. Name and Address of Study Site Site Name: The Catholic University of Korea Seoul St. Mary’s Hospital Address: 222, Banpo-daero, Seocho-gu, Seoul, Republic of Korea 3. Name and Title of Principal Investigator, Subinvestigator and co-investigator Contact Role Name Affiliation Title (Mobile) Principal Pulmonology Chin Kook Rhee Associate Professor 82-10-2285-9601 Investigator and Allergy 4. Name and Title of Clinical Research Pharmacist Not applicable: the study drug (Synatura®) is currently approved by Korean Ministry of Food and Drug Safety (MFDS) and prescribed for patients with chronic bronchitis, and this is an open-label study with no placebo. 5. Name and Address of Sponsor Ahngook Pharm(613, Siheung-daero, Yeongdeungpo-gu, Seoul, Republic of Korea) 6. Background and objectives of Study Synatura® is a drug commonly used to suppress cough and sputum in patients with acute upper respiratory tract infection and chronic inflammatory bronchitis. According to the Phase III studies conducted in Korea, the safety and efficacy of Synatura® on antitussive and expectorant effects were confirmed in patients with acute upper respiratory infection and chronic inflammatory bronchitis. However, no studies have been conducted for the effects of Synatura® in patients with COPD. COPD is divided into emphysema type and chronic bronchitis type, while typical clinical symptoms of chronic bronchitis are cough and sputum.
    [Show full text]
  • Choledyl-Expect-PM-E
    PRESCRIBING INFORMATION CHOLEDYL* EXPECTORANT ELIXIR (Oxtriphylline - Guaifenesin MANUFACTURER STANDARD) 100 mg Oxtriphylline and 50 mg Guaifenesin / 5 mL BRONCHODILATOR - EXPECTORANT DATE OF PREPARATION 11-Jul-2005 8250 Décarie Blvd, suite 110 DATE OF REVISION: Montréal, QC Canada, H4P 2P5 Control No. 099744 2 PRESCRIBING INFORMATION CHOLEDYL EXPECTORANT ELIXIR (Oxtriphylline-Guaifenesin MANUFACTURER STANDARD) 100 mg Oxtriphylline and 50 mg Guaifenesin / 5 mL THERAPEUTIC CLASSIFICATION Bronchodilator-Expectorant ACTION AND CLINICAL PHARMACOLOGY CHOLEDYL EXPECTORANT ELIXIR (oxtriphylline-guaifenesin) contains 64% theophylline and has the properties attributed to theophylline. As with other xanthine derivatives, the precise mechanism of action of CHOLEDYL ELIXIR (Oxtriphylline Oral Solution U.S.P.) has not been determined. Oxtriphylline stimulates the central nervous system and skeletal muscles, stimulates cardiac muscle, relaxes certain smooth muscles including those of the bronchi, produces diuresis, and causes an increase in gastric secretion. Oxtriphylline's pharmacologic action is essentially the same as that of theophylline. Its pharmacologic effects include stimulation of respiration, augmentation of cardiac inotropy and chronotropy, relaxation of smooth muscle, including that in the bronchi and blood vessels other than cerebral vessels, and diuresis. Following oral administration, theophylline is usually readily absorbed. Compared to aminophylline, oxtriphylline is reported to be more soluble, more stable, better absorbed from the GI tract and less irritating to the gastric mucosa. The drug is 55 to 65% bound to plasma proteins in the therapeutic plasma concentration range of 8 to 20 mcg/ml; it is not likely to be subject to pronounced displacement effects. Theophylline has a mean plasma half-life of 4.5 hours in adults (range 3.0 to 9.5 hours) and a slightly shorter mean half-life of 3.6 hours in 3 children (range 1.5 to 9.5 hours), with great variability between individual patients.
    [Show full text]
  • Dr. Duke's Phytochemical and Ethnobotanical Databases List of Chemicals for Tuberculosis
    Dr. Duke's Phytochemical and Ethnobotanical Databases List of Chemicals for Tuberculosis Chemical Activity Count (+)-3-HYDROXY-9-METHOXYPTEROCARPAN 1 (+)-8HYDROXYCALAMENENE 1 (+)-ALLOMATRINE 1 (+)-ALPHA-VINIFERIN 3 (+)-AROMOLINE 1 (+)-CASSYTHICINE 1 (+)-CATECHIN 10 (+)-CATECHIN-7-O-GALLATE 1 (+)-CATECHOL 1 (+)-CEPHARANTHINE 1 (+)-CYANIDANOL-3 1 (+)-EPIPINORESINOL 1 (+)-EUDESMA-4(14),7(11)-DIENE-3-ONE 1 (+)-GALBACIN 2 (+)-GALLOCATECHIN 3 (+)-HERNANDEZINE 1 (+)-ISOCORYDINE 2 (+)-PSEUDOEPHEDRINE 1 (+)-SYRINGARESINOL 1 (+)-SYRINGARESINOL-DI-O-BETA-D-GLUCOSIDE 2 (+)-T-CADINOL 1 (+)-VESTITONE 1 (-)-16,17-DIHYDROXY-16BETA-KAURAN-19-OIC 1 (-)-3-HYDROXY-9-METHOXYPTEROCARPAN 1 (-)-ACANTHOCARPAN 1 (-)-ALPHA-BISABOLOL 2 (-)-ALPHA-HYDRASTINE 1 Chemical Activity Count (-)-APIOCARPIN 1 (-)-ARGEMONINE 1 (-)-BETONICINE 1 (-)-BISPARTHENOLIDINE 1 (-)-BORNYL-CAFFEATE 2 (-)-BORNYL-FERULATE 2 (-)-BORNYL-P-COUMARATE 2 (-)-CANESCACARPIN 1 (-)-CENTROLOBINE 1 (-)-CLANDESTACARPIN 1 (-)-CRISTACARPIN 1 (-)-DEMETHYLMEDICARPIN 1 (-)-DICENTRINE 1 (-)-DOLICHIN-A 1 (-)-DOLICHIN-B 1 (-)-EPIAFZELECHIN 2 (-)-EPICATECHIN 6 (-)-EPICATECHIN-3-O-GALLATE 2 (-)-EPICATECHIN-GALLATE 1 (-)-EPIGALLOCATECHIN 4 (-)-EPIGALLOCATECHIN-3-O-GALLATE 1 (-)-EPIGALLOCATECHIN-GALLATE 9 (-)-EUDESMIN 1 (-)-GLYCEOCARPIN 1 (-)-GLYCEOFURAN 1 (-)-GLYCEOLLIN-I 1 (-)-GLYCEOLLIN-II 1 2 Chemical Activity Count (-)-GLYCEOLLIN-III 1 (-)-GLYCEOLLIN-IV 1 (-)-GLYCINOL 1 (-)-HYDROXYJASMONIC-ACID 1 (-)-ISOSATIVAN 1 (-)-JASMONIC-ACID 1 (-)-KAUR-16-EN-19-OIC-ACID 1 (-)-MEDICARPIN 1 (-)-VESTITOL 1 (-)-VESTITONE 1
    [Show full text]
  • Clinical Trial of Berberine in Acute Watery Diarrhoea
    BRITISH MEDICAL JOURNAL VOLUME 291 7 DECEMBER 1985 1601 Br Med J (Clin Res Ed): first published as 10.1136/bmj.291.6509.1601 on 7 December 1985. Downloaded from PAPERS AND SHORT REPORTS Clinical trial of berberine in acute watery diarrhoea KHIN-MAUNG-U, MYO-KHIN, NYUNT-NYUNT-WAI, AYE-KYAW, TIN-U Abstract E coli, proteus, protozoa such as Entamoeba histolytica,3 tricho- monas,4 giardia,5 leishmania,6 and fungi. Extracts ofthis plant have Four hundred adults presenting with acute watery diarrhoea were been used in antidiarrhoeal medication in Ayurvedic medicine in entered into a randomised, placebo controlled, double blind India and in the traditional medicine of China for the past 3000 clinical trial of berberine, tetracycline, and tetracycline and years. More recently berberine has been shown to inhibit the action berberine to study the antisecretory and vibriostatic effects of of V cholerae toxin when administered before or with the enterotoxin berberine. Of 185 patients with cholera, those given tetracycline in animals,8 "to have an antisecretory effect in the ligated intestinal or tetracycline and berberine had considerably reduced volume loop of the rabbit even when administered after the enterotoxin has and frequency of diarrhoeal stools, duration of diarrhoea, and been bound to intestinal mucosa,'2 and also to inhibit the secretory volumes of required intravenous and oral rehydration fluid. response ofE coli ST (heat stable) toxin in the infant mouse. 12 Berberine did not produce an antisecretory effect. Analysis by Few clinical trials of berberine to date have shown it to be factorial design equations, however, showed a reduction in effective in treating acute diarrhoea.'3"'9 No clinical trial studying diarrhoeal stools by one litre and a reduction in cyclic adenosine the antisecretory effect of berberine in diarrhoea has been reported.
    [Show full text]
  • 1 Online Supplement: Association of Asthma Severity And
    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) Thorax Online Supplement: Association of asthma severity and educational attainment at age 6-7 years in a birth cohort: Population based record-linkage Table S1: Wales Electronic Cohort for Children (WECC) and linked data sources with descriptions Table S2: Social-demographic data for Wales Table S3: General Practice diagnosis codes for Asthma and Wheeze Table S4: General Practice prescription codes for Asthma Table S5: General Practice prescription codes for Endocrine corticosteroids Table S6: General Practice respiratory diagnoses Figure S1: Changes in asthma prescriptions during the cohort by year take KS1 assessment Figure S2: Changes in asthma or wheeze severity for discrete years of the child from birth. Table S7: Multilevel multivariable models of asthma severity algorithm and asthma inpatient hospital admissions for different ages of the child and not attaining the expected level at Key Stage 1 (at 6-7 years) – repeated for wheeze severity algorithm and wheeze inpatient hospital admissions. Table S8: Sub-sample multilevel multivariable models of asthma severity, acute asthma, respiratory illness and not attaining the expected level at Key Stage 1 (at 6-7 years) adjusted for absence from school in year take KS1 assessment (Week of birth 1 September 2000 to 31 August 2004), N=46,673. 1 Evans A, et al. Thorax 2021; 76:116–125. doi:
    [Show full text]
  • Theophylline Blood Levels in Sri Lankan Asthmatics: Comparison of Two Methods of Assay
    Papers Theophylline blood levels in Sri Lankan asthmatics: comparison of two methods of assay A K E Goonetilleke1, T M J Munasinghe2, H C Cooray3, W K Balasuriya4 and N Fernando5 (Index words: Theophylline, therapeutic drug monitoring, UV spectrophotometry) Abstract and concomitant use of medications that influence the activity of the hepatic cytochrome P450 enzyme system. Objectives To assay theophylline blood levels in a sample As a result patients on fixed dosage regimes may have of Sri Lankan chronic asthmatics taking oral theophylline, widely varying blood levels indicating a need to and to evaluate a simple and cost effective ultraviolet spec- individualise dose in such patients. trophotometric assay for theophylline levels in blood. Setting Chronic asthmatics taking oral theophylline attend- ing medical clinics at the National Hospital of Sri Lanka Methods (NHSL) were recruited for the study. Blood samples were 24 patients (10 males) suffering from chronic asthma collected from recruited patients on their subsequent clinic on oral theophylline for over 3 months and attending regu- visit. lar medical clinics at the NHSL were recruited for the study over a period of four weeks. Written informed consent was Design and methods A cross-sectional study of theo- obtained from all patients. Ethical approval was obtained phylline blood levels. Blood samples were assayed for from the research committee of the Medical Research trough theophylline levels using two methods: an auto- Institute. mated homogeneous enzyme immunoassay (EMIT), and a low cost ultraviolet spectrophotometric method. The average age was 55 years (range 42 to 72) and the weight 55.4 kg (range 43 to 72).
    [Show full text]