Database : HANSEN Search on : INTERACOES DE MEDICAMENTOS [Subject descriptor] References found : 6 [refine] Displaying: 1 .. 6   in format [Detailed]

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Id: 18426 Author: Teo, Steve K; Colburn, Wayne A; Tracewell, William G; Kook, Karin A; Stirling, David I; Jaworsky, Markian S; Scheffer, Michael A; Thomas, Steve D; Laskin, Oscar L Title: Clinical pharmacokinetics of thalidomide ..- Source: s.l; s.n; 2004. 17 p. ilus, tab, graf. Abstract: Thalidomide is a racemic glutamic acid derivative approved in the US for erythema nodosum leprosum, a complication of leprosy. In addition, its use in various inflammatory and oncologic conditions in being investigated. Thalidomide interconverts between the (R)- and (S)-enantiomers in plasma, with protein binding of 55% and 65%, respectively. More than 90% of the absorbed drug is excreted in the urine and faeces within 48 hours. Thalidomide is minimally metabolised by the liver, but is spontaneously hydrolysed into numerous renally excreted products. After a single oral dose of thalidomide 200mg (as the US-approved capsule formulation) in healthy volunteers, absorption is slow and extensive, resulting in a peak concentration (Cmax) of 1-2mg/L at 3-4 hours after administration, absorption lag time of 30 minutes, total exposure (AUCoo) of 18mg - h/L, apparent elimination half-life of 6 hours and apparent systemic clearence of 10 L/H. Thalidomide pharmacokinetics are best described by a one-comportment model with first-order absorption and elimination. Because of the low solubility of the drug in the gastrointestinal tract, thalidomide exhibits absorption rate-limited pharmacolinetics (the 'flip-flop' phenomenon), with its elimination rate being faster than in absorption rate. The apparent elimination half-life of 6 hours therefore represents absorption, not elimination. The 'true' apparent volume of distribution was estimated to be 16L by use of the faster elimination-rate half-life. Multiple doses of thalidomide 200 mg/day over 21 days cause no change in the pharmacokinetics, with a steady-state Cmax (Cssmax) of 1.2 mg/L. Simulation of 400 and 800 mg/day also shows no accululation, with Css of 3.5 and 6.0 mg/L, respectively. Multiple-dose studies in cancer patients show pharmacokinetics comparable with those in healthy populations at similar dosages. Thalidomide exhibits a dose-proportional increase in AUC at doses from 50 to 400mg. Because of the low solubility of thalidomide Cmax is less than proportional to dose, and tmax is prolonged with increasing dose. Age, sex and smoking have no effect on the pharmacokinetics of thalidomide, and the effect of food is minimal. Thalidomide does not alter the pharmacokinetics of oral contraceptives, and is also unlikely to interact with warfarin and grapefruit juice. Since thalidomide is mainly hydrolysed and passively excreted, its pharmacokonetics are not expected to change in patients with impaired liver...(AU). Descriptors: TALIDOMIDA/admin TALIDOMIDA/sint quim TALIDOMIDA/contra TALIDOMIDA/hist TALIDOMIDA/isol TALIDOMIDA/farmacocin TALIDOMIDA/normas TALIDOMIDA/tox TALIDOMIDA/uso terap TALIDOMIDA/metab - ERITEMA NODOSO HANSENICO/quimioter  ERITEMA NODOSO/etiol  SINDROME DE IMUNODEFICIÊNCIA ADQUIRIDA FELINA/terap  ADMINISTRACAO ORAL  INTERACOES DE MEDICAMENTOS/fisiol  RIFAMPINA/antag  FENOBARBITAL/antag  CIMETIDINA/antag  DILTIAZEM/antag  WARFARIN/antag Limits: HUMANO Location: BR191.1; 00948/s

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Id: 13728 Author: DeRossi, Scott S; Hersh, Elliot V Title: Antibiotics and oral contraceptives ..- Source: s.l; s.n; 2002. 7 p. ilus, graf. Abstract: With the exception of rifampin-like drugs, there is a lack of scientific evidence supporting the ability of commonly prescribed antibiotics, including all those routinely employed in outpatient dentistry, to either reduce blood levels and/or the effectiveness of oral contraceptives. To date, all clinical trials studying the effects of concomitant antibiotic therapy (with the exception of rifampin and rifabutin) have failed to demonstrate an interaction. Like all drugs, oral contraceptives are not 100 per cent effective with the failure rate in the typical United States population reported to be as high as 3 per cent. It is thus possible that the case reports of unintended pregnancies during antibiotic therapy may simply represent the normal failure rate of these drugs. Considering that both drug classes are prescribed frequently to women of childbearing potential, one would expect a much higher rate of oral contraceptive failure in this group of patients if a true drug:drug interaction existed. On the other hand, if the interaction does exist but is a relatively rare event, occurring in, say, 1 in 5000 women, clinical studies such as those described in this article would not detect the interaction. The pharmacokinetic studies of simultaneous antibiotic and oral contraceptive ingestion, and the retrospective studies of pregnancy rates among oral contraceptive users exposed to antibiotics, all suffer from one potential common weakness, i.e., their relatively small sample size. Sample sizes in the pharmacokinetic trials ranged from 7 to 24 participants, whereas the largest retrospective study of pregnancy rates still evaluated less than 800 total contraceptive users. Still, the incidence of such a rare interaction would not differ from the accepted normal failure rate of oral contraceptive therapy. The medico-legal ramifications of what looks like at best a rare interaction remains somewhat "murky." On one hand, we have medico-legal experts advising the profession to exercise caution and warn all oral contraceptive users of a potential reduction in efficacy during antibiotic therapy. These opinions are not evidence-based and rely heavily on one or two legal proceedings that cannot even be substantiated. On the other hand, there is one recently published legal proceeding in which the outcome was in favor of the oral surgeon. There is clearly...(AU). Descriptors: VIES (EPIDEMIOLOGIA) DISPONIBILIDADE BIOLOGICA ANTIBIOTICOS/farmacocin ANTIBIOTICOS/uso terap ESTUDOS RETROSPECTIVOS ABSORCAO INTESTINAL/ef drogas RIFABUTINA/uso terap RIFAMPINA/uso terap ANTICONCEPCIONAIS ORAIS/antag ANTICONCEPCIONAIS ORAIS/farmacocin ANTICONCEPCIONAIS ORAIS/uso terap - INTERACOES DE MEDICAMENTOS  ENSAIOS CLINICOS  JURISPRUDÊNCIA  TAMANHO DA AMOSTRA Limits: HUMANO FEMININO GRAVIDEZ Electronic Medium: http://www.ilsl.br Location: BR191.1; 09018/s

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Id: 13195 Author: George, Joseph; Balakrishnan, S; Bhatia, V. N Title: Drug interaction during multidrug regimens for treatment of leprosy ..- Source: s.l; s.n; feb. 1988. 6 p. tab. Abstract: The influence of concurrently rifampicin and clofazimine on the metabolism of 4,4'-diaminodiphenyl sulfone (dapsone, DDS) has been studied in 30 subjects on multidrug regimens for treatment of leprosy. Plasma and urinary levels of drugs were determined on days 2,8 and 15 after administration of the drug, while cretinine levels in urine were also determined to overcome the effect of diuresis. During concurrent administration of rifampicin the plasma levels of DDS gradually fell from day 2 to day 15 of rifampicin administration and the decrease was most significant on day 15. Clofazimine did not exert any such influence on DDS metabolism. A comparison of urine and plasma levels of DDS during the course of treatment. The findings suggest that during concurrent administration of DDS and rifampicin, the intake of DDS shoud be regular and uninterrupted.(AU). Descriptors: HANSENIASE/quimioter QUIMIOTERAPIA COMBINADA ESQUEMA DE MEDICACAO DAPSONA/admin DAPSONA/metab INTERACOES DE MEDICAMENTOS CLOFAZIMINA/uso terapeutico RIFAMPINA/uso terapeutico Limits: HUMANO SUPPORT, NON-U.S. GOV'T Electronic Medium: http://www.ilsl.br Location: BR191.1; 02088/s

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Id: 9449 Author: Garrelts, James C Title: Clofazimine: a review of its use in leprosy and Mycobacterium avium complex infection ..- Source: s.l; s.n; 1991. 7 p. ilus, tab. Descriptors: SINDROME DE IMUNODEFICIENCIA ADQUIRIDA CLOFAZIMINA CLOFAZIMINA INTERAÇOES DE MEDICAMENTOS GASTROENTEROPATIAS HANSENIASE HANSENIASE DERMATOPATIAS INFECÇAO POR MYCOBACTERIUM AVIUM-INTRACELLULARE INFECÇAO POR MYCOBACTERIUM AVIUM-INTRACELLULARE Location: BR191.1; 06311/s

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Id: 8368 Author: Joshi, J. V; Maitra, A; Sankolli, G; Bhatki, S; Joshi, U. M Title: Norethisterone and ethinyl estradiol kinetics during dapsone therapy ..- Source: s.l; s.n; 1984. 3 p. tab, graf. Descriptors: DAPSONA INTERAÇOES DE MEDICAMENTOS ETINIL ESTRADIOL ETINIL ESTRADIOL HANSENIASE NORETINDRONA NORETINDRONA NORETINDRONA Location: BR191.1; 02415/s

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Id: 7644 Author: Fader, Darrel J; Johnson, Timothy M Title: Medical issues and emergencies in the dermatology office ..- Source: s.l; s.n; 1997. 16 p. ilus, tab. Abstract: We review the medical issues and emergencies potentially encountered in the practice of general or surgical dermatology. Traditional guidelines have largely consisted of dated extrapolations from the nondermatologic literature concerning procedures that are primarily irrelevant to dermatology. This article outlines a rational approach to organizing an office emergency plan for anaphylaxis, stroke, status epilepticus, myocardial infarction, and hypertensive crisis. We discuss the literature that has influenced current office behavior regarding endocarditis prophylaxis, the use of electrosurgery with pacemakers, arrhythmogenic drug interactions, vasovagal syncope, lidocaine "allergy," and bleeding complications from oral anticoagulants. Recommendations for managing these issues in a dermatologic context are provided.. Descriptors: ANTICOAGULANTES/efeitos adversos TRANSTORNOS CEREBROVASCULARES/terapia DERMATOLOGIA DOENCA INTERACOES DE MEDICAMENTOS HIPERSENSIBILIDADE A DROGAS/etiologia HIPERSENSIBILIDADE A DROGAS/terapia ELETROCIRURGIA/efeitos adversos EMERGENCIAS SERVICOS MEDICOS DE EMERGENCIA ENDOCARDITE BACTERIANA/prevenção e controle DIRETRIZES HEMORRAGIA/terapia HIPERTENSAO/terapia LIDOCAINA/efeitos adversos INFARTO DO MIOCARDIO/terapia MARCA-PASSO ARTIFICIAL CONSULTORIOS MEDICOS DERMATOPATIAS/cirurgia DERMATOPATIAS/terapia ESTADO EPILEPTICO/terapia SINCOPE/terapia Limits: HUMANO Location: BR191.1; 0194/cme

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