Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new axid research articles will be listed here shortly after becoming available to us.
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Pharmacological management of atypical antipsychotic-induced weight gain.
CNS Drugs. 2008; 22(6): 477-95
Baptista T, Elfakih Y, Uzcátegui E, Sandia I, Tálamo E, Araujo de Baptista E, Beaulieu S
Excessive bodyweight gain was reported during the 1950s as an adverse effect of typical antipsychotic drug treatment, but the magnitude of bodyweight gain was found to be higher with the atypical antipsychotic drugs that were introduced after 1990. Clozapine and olanzapine produce the greatest bodyweight gain, ziprasidone and aripiprazole have a neutral influence, and quetiapine and risperidone cause an intermediate effect. In the CATIE study, the percentage of patients with bodyweight gain of >7% compared with baseline differed significantly between the antipsychotic drugs, i.e. 30%, 16%, 14%, 12% and 7% for olanzapine, quetiapine, risperidone, perphenazine (a typical antipsychotic) and ziprasidone, respectively (p < 0.001).Appetite stimulation is probably a key cause of bodyweight gain, but genetic polymorphisms modify the bodyweight response during treatment with atypical antipsychotics.In addition to nutritional advice, programmed physical activity, cognitive-behavioural training and atypical antipsychotic switching, pharmacological adjunctive treatments have been assessed to counteract excessive bodyweight gain. In some clinical trials, nizatidine, amantadine, reboxetine, topiramate, sibutramine and metformin proved effective in preventing or reversing atypical antipsychotic-induced bodyweight gain; however, the results are inconclusive since few randomized, placebo-controlled clinical trials have been conducted. Indeed, most studies were short-term trials without adequate statistical power and, in the case of metformin, nizatidine and sibutramine, the results are contradictory. The tolerability profile of these agents is adequate.More studies are needed before formal recommendations on the use of these drugs can be made. Meanwhile, clinicians are advised to use any of these adjunctive treatments according to their individual pharmacological and tolerability profiles, and the patient's personal and family history of bodyweight gain and metabolic dysfunction.
Mod Rheumatol. 2008 May 14;
Kasama T, Shiozawa F, Isozaki T, Matsunawa M, Wakabayashi K, Odai T, Yajima N, Miwa Y, Negishi M, Ide H
In Sjögren's syndrome (SS), oral dryness (xerostomia) is frequently the most bothersome symptom. An H2 histamine receptor antagonist is often administered to SS patients to treat associated superficial gastritis. The aim of the present study was to assess the ability of nizatidine, an H2 receptor antagonist, to also relieve xerostomia in patients with primary SS. Twenty-seven patients with primary SS were randomly assigned to receive nizatidine (n = 14, 300 mg a day) or another H2 blocker, famotidine (n = 13, 40 mg a day; control), were followed for eight weeks, and were asked for both subjective and objective assessments of oral dryness using a visual analog scale (VAS; 1-100 mm) and the Saxon's test, respectively. Patients receiving oral nizatidine, but not famotidine, obtained significant objective relief from their xerostomia (Saxon's test; baseline, 0.57 g/2 min; after eight weeks, 0.90 g/2 min, P < 0.05). VAS scores indicated that nizatidine also provides mild improvement (20% improvement over baseline) of xerostomia-related clinical conditions, including mouth dryness and difficulty in chewing, tasting and swallowing food. Both drugs were generally well tolerated, without adverse effects. The present preliminary study suggests that nizatidine may represent a new option for the treatment of xerostomia in SS.
J Chromatogr B Analyt Technol Biomed Life Sci. 2008 May 15; 867(2): 172-8
Parekh SA, Pudage A, Joshi SS, Vaidya VV, Gomes NA
A rapid and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method has been developed and validated for the estimation of clonidine in human plasma. Clonidine was extracted from human plasma by using solid-phase extraction technique. Nizatidine was used as the internal standard. A Hypurity C18 (50 mm x 4.6 mm i.d., 5 microm particle size) column provided chromatographic separation of analyte followed by detection with mass spectrometry. The method involves a rapid solid-phase extraction from plasma, simple isocratic chromatography conditions and mass spectrometric detection that enables detection up to picogram levels with a total run time of 3.0 min only. The method was validated over the range of 50-2500 pg/mL. The absolute recoveries for clonidine (71.86%) and IS (69.44%) achieved from spiked plasma samples were consistent and reproducible.
J AOAC Int. 2008 Jan-Feb; 91(1): 73-82
Youssef RM
Four new selective, precise, and accurate methods are described for the determination of nizatidine (NIZ) in the presence of its sulfoxide derivative in both the raw material and pharmaceutical preparations. Method A is based on zero-order (0D), first-derivative (1D), and second-derivative (2D) spectrophotometric measurement of NIZ in aqueous solution at the zero-crossing point of its sulfoxide derivative (at 314, 295-334, and 318-348 nm, respectively). Method B is a 1DD spectrophotometric method based on the simultaneous use of the first derivative of the ratio spectra and the measurement of peak amplitude at 297 nm. Method C uses a solvent-induced derivative-difference spectrophotometry with deltaD1 measurement from peak to peak at 315-345 nm. Method D involves quantitative densitometric evaluation of a mixture of the drug and its sulfoxide derivative after separation by high-performance thin-layer chromatography on silica gel plates with chloroform-methanol (9 + 1, v/v) as the mobile phase; Rf values for NIZ and its sulfoxide derivative were 0.4 and 0.2, respectively. The spot was scanned at 254 nm. The first-derivative spectrophotometric method was used to investigate the kinetics of the hydrogen peroxide degradation process at different temperatures. The apparent pseudo-first-order rate constant, half-life, and activation energy were calculated. The results obtained by the proposed methods were analyzed statistically and compared with those obtained by the official method. These methods are suitable as stability-indicating for the determination of NIZ in the presence of its oxidation-induced degradation product (sulfoxide derivative) either in the bulk powder or in pharmaceutical preparations.
Acta Pharm. 2008 Mar 1; 58(1): 87-97
Darwish IA, Hussein SA, Mahmoud AM, Hassan AI
A simple, accurate and sensitive spectrophotometric method for determination of H2-receptor antagonists: cimetidine (CIM), famotidine (FAM), nizatidine (NIZ), and ranitidine hydrochloride (RAN) has been fully developed and validated. The method was based on the reaction of these drugs with NBS and subsequent measurement of the excess N-bromosuccinimide by its reaction with p-aminophenol to give a violet colored product (lambdamax at 552 nm). Decrease in the absorption intensity (DeltaA) of the colored product, due to the presence of the drug, was correlated with its concentration in the sample solution. Different variables affecting the reaction were carefully studied and optimized. Under optimal conditions, linear relationships with good correlation coefficients (0.9988--0.9998) were found between DeltaA values and the corresponding concentrations of the drugs in a concentration range of 8--30, 6--22, 6--25, and 4--20 mug mL-1 for CIM, FAM, NIZ, and RAN, respectively. Limits of detection were 1.22, 1.01, 1.08, and 0.74 mug mL-1 for CIM, FAM, NIZ, and RAN, respectively. The method was validated in terms of accuracy, precision, ruggedness, and robustness; the results were satisfactory. The proposed method was successfully applied to the analysis of the above mentioned drugs in bulk substance and in pharmaceutical dosage forms; percent recoveries ranged from 98.5 +/- 0.9 to 102.4 +/- 0.8% without interference from the common excipients. The results obtained by the proposed method were comparable with those obtained by the official methods.
Treating common problems of the nose and throat in pregnancy: what is safe?
Eur Arch Otorhinolaryngol. 2008 May; 265(5): 499-508
Vlastarakos PV, Manolopoulos L, Ferekidis E, Antsaklis A, Nikolopoulos TP
Although all kinds of medications should be avoided during pregnancy, the majority of pregnant women receive at least one drug and 6% of them during the high-risk period of the first trimester. The aim of the present paper is to discuss the appropriate management of rhinologic and laryngeal conditions that may be encountered during pregnancy. A literature review from Medline and database sources was carried out. Related books and written guidelines were also included. Controlled clinical trials, prospective and retrospective studies, case-control studies, laboratory studies, clinical and systematic reviews, metanalyses, and case reports were analysed. The following drugs are considered relatively safe: beta-lactam antibiotics (with dose adjustment), macrolides (although the use of erythromycin and clarithromycin carries a certain risk), clindamycin, metronidazole (better avoided in the first trimester), amphotericin-B (especially in immunocompromised situations during the second and third trimester) and acyclovir. First-line antituberculous agents isoniazid, ethambutol, pyrazinamide, and ciprofloxacine in drug-resistant tuberculosis can be also used. Non-selective NSAIDs (until the 32nd week), nasal decongestants (with caution and up to 7 days), intranasal corticosteroids, with budesonide as the treatment of choice, second generation antihistamines (cetirizine in the third trimester, or loratadine in the second and third trimester), H2 receptor antagonists (except nizatidine) and proton pump inhibitors (except omeprazole) can be used to relieve patients from the related symptoms. In cases of emergencies, epinephrine, prednisone, prednisolone, methylprednisolone, dimetindene and nebulised b(2) agonists can be used with extreme caution. By contrast, selective COX-2 inhibitors and BCG vaccination are contraindicated in pregnancy. When prescribing to a pregnant woman, the safety of the materno-foetal unit is considered paramount. Although medications are potentially hazardous, misconceptions and suboptimal treatment of the mother might be more harmful to the unborn child. Knowledge update is necessary to avoid unjustified hesitations and provide appropriate counselling and treatment for pregnant women.
Nizatidine enhances salivary secretion in patients with dry mouth.
Auris Nasus Larynx. 2008 Jun; 35(2): 224-9
Nin T, Umemoto M, Negoro A, Miuchi S, Sakagami M
OBJECTIVE: It was reported that salivary secretion increased in 30 volunteers with administered nizatidine. The aim of the present study was to investigate whether or not nizatidine enhances salivary secretion and improves the function of salivary glands in patients with dry mouth. METHODS: Both basal and stimulated salivary secretions were measured before and after the administration of nizatidine for a month in 18 healthy adult volunteers and 38 patients with dry mouth. In 6/38 patients, salivary gland scintigraphy was performed. RESULTS: After the administration of nizatidine for a month, salivary secretions significantly increased in the control and dry mouth patient groups compared to the pretreatment baseline. In addition, 25 of 38 dry mouth patients showed subjective improvements of oral dryness. In 3/4 patients, the function of salivary glands was improved on salivary gland scintigraphy. CONCLUSION: Nizatidine may reactivate salivary gland cells and be useful in the treatment of patients with dry month.
Treating common ear problems in pregnancy: what is safe?
Eur Arch Otorhinolaryngol. 2008 Feb; 265(2): 139-45
Vlastarakos PV, Nikolopoulos TP, Manolopoulos L, Ferekidis E, Kreatsas G
In everyday practise, more than 80% of pregnant women receive one at least medication, often for ENT causes. The aim of the present paper is to review the literature on safety and administration of medical treatment for ear diseases, in pregnant women. The literature review includes Medline and database sources. Electronic links, related books and written guidelines were also included. The study selection was as follows: controlled clinical trials, prospective trials, case-control studies, laboratory studies, clinical reviews, systematic reviews, metanalyses, and case reports. The following drugs are considered relatively safe: beta-lactam antibiotics (with dose adjustment), macrolides (although the use of erythromycin and clarithromycin carries a certain risk), and acyclovir. Non-selective NSAIDs (until the 32nd week), nasal decongestants (with caution and up to 7 days), intranasal corticosteroids, with budesonide as the treatment of choice, first generation antihistamines, or cetirizine (third trimester) and loratadine (second and third trimester) from the second generation, H(2) receptor antagonists (except nizatidine) and proton pump inhibitors (except omeprazole), can be used to relieve patients from the related symptoms. Meclizine and dimenhydrinate, as antiemetics in vertigo attacks; metoclopramide, vitamin B(6) and ginger rhizome, alternatively. Low-dose diazepam and diuretics in severe cases of Meniere's disease (with caution). Systemic administration of prednisone and prednisolone can be considered in selected cases. By contrast, selective COX-2 inhibitors, betahistine and vasodilating agents are contraindicated in pregnancy. Since otologic and neurotologic manifestations during pregnancy tend to seriously affect the quality of life of the expectant mothers, ENT surgeons should familiarise themselves with the basic guidelines and safety precautions for any related medication, in order to provide appropriate treatment.
J Chromatogr B Analyt Technol Biomed Life Sci. 2007 Dec 15; 860(2): 235-40
Ashiru DA, Patel R, Basit AW
A validated, simple and universal HPLC-UV method for the determination of cimetidine, famotidine, nizatidine and ranitidine in human urine is presented. This is the first single HPLC method reported for the analysis of all four H(2) antagonists in human biological samples. This method was also utilized for the analysis of ranitidine and its metabolites in human urine. All calibration curves showed good linear regression (r(2)>0.9960) within test ranges. The method showed good precision and accuracy with overall intra- and inter-day variations of 0.2-13.6% and 0.2-12.1%, respectively. Separation of ranitidine and its metabolites using this assay provided significantly improved resolution, precision and accuracy compared to previously reported methods. The assay was successfully applied to a human volunteer study using ranitidine as the model compound.
[Analytical application of phosphotungstic acid complexes. Synthesis and characterisation]
Rev Med Chir Soc Med Nat Iasi. 2007 Apr-Jun; 111(2): 530-4
Apostu M, Dorneanu V, Bibire N
Phosphotungstic acid forms salt type ionic association complexes with a large number of medicinal drugs that contain cation forming proton acceptor moieties. MATERIAL AND METHOD: Ranitidine, nizatidine and famotidine complexes with phosphotungstic acid were synthesized and subsequently characterized by their melting point, water solubility, specific absorbance, UV spectra and IR spectra. RESULTS: These sparingly soluble complexes were applied for the fabrication of membrane selective electrodes for quantitative potentiometric determination of ranitidine, nizatidine and famotidine. CONCLUSIONS: There have been synthesized phosphotungstic acid complexes with uses in fabrication of membrane selective electrodes for quantitative potentiometric determination of ranitidine, nizatidine and famotidine.