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Annals of Palliative Medicine Sep 2021To date, guidelines on the impact and value of atropine combined with omeprazole in the treatment of acute gastritis have not been well established or well defined. This... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To date, guidelines on the impact and value of atropine combined with omeprazole in the treatment of acute gastritis have not been well established or well defined. This study aimed to clarify the efficacy and safety of combined atropine and omeprazole therapy for the management of patients with acute gastritis.
METHODS
Through searching the electronic database, the related literature of the combination of atropine with omeprazole in the treatment of acute gastritis were reviewed. A meta-analysis was performed after literature selection according to inclusion criteria. The treatment efficiency and the incidence of adverse reactions were used as the main outcome indicators. The odds ratios (ORs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) of the two treatment regimens were analyzed.
RESULTS
This study analyzed 11 articles from the literature with a total of 1,053 subjects. The combination of atropine and omeprazole significantly improved the clinical outcomes of patients with acute gastritis compared to patients treated with combined anisodamine and omeprazole (control group). The effective rate of combined atropine and omeprazole treatment was 1.21 times higher than that observed with the control group, and the incidence of adverse reactions was 0.41 times that of the control group. Atropine combined with omeprazole significantly alleviated the clinical symptoms of the patients. The total treatment time was shortened by 0.57 days, duration of abdominal pain was shortened by 2.82 days, duration of diarrhea was reduced by 1.99 days, and the duration of nausea and vomiting was shortened by 2.68 days compared to the control group.
DISCUSSION
The combination of atropine with omeprazole in the treatment of acute gastritis demonstrated a high effective rate with few adverse reactions than. It was effective at alleviating the clinical symptoms associated with acute gastritis. The results of this study provide support for the clinical implementation of combined atropine and omeprazole in the treatment of patients with acute gastritis.
Topics: Atropine; Gastritis; Humans; Omeprazole; Treatment Outcome
PubMed: 34628879
DOI: 10.21037/apm-21-1868 -
Acta Cirurgica Brasileira 2020To investigate the role of omeprazole and nitrites on the gastric mucosa of rats submitted to specific techniques to induce duodenogastric reflux.
PURPOSE
To investigate the role of omeprazole and nitrites on the gastric mucosa of rats submitted to specific techniques to induce duodenogastric reflux.
METHODS
One hundred and twenty Wistar rats were divided into three groups: Group I (n=40) -gastrotomy; Group II (n=40) - duodenogastric reflux after gastrojejunoanastomosis latero-lateral (DGR); Group III (n=40) - retrograde duodenogastric reflux through the pylorus (DGR-P). The groups were divided into 4 subgroups of 10 animals, respectively treated for 16 weeks with water, omeprazole 1.6 mg / rat / day, nitrite 600 mg / kg / day and omeprazole plus nitrite simultaneously.
RESULTS
The proliferative lesions found were: squamous hyperplasia - 69.1%, adenomatous hyperplasia in the anastomosis - 29.1% and prepyloric adenomatous hyperplasia - 42.5%. Adenocarcinomas were registered in 7 animals (5.8%): one in Group I (omeprazole plus nitrite), two in Group II (omeprazole and nitrite plus omeprazole) and four in Group III (water, nitrite, omeprazole and omeprazole plus nitrite).
CONCLUSIONS
The occurrence of squamous hyperplasia, adenomatous hyperplasia and adenocarcinoma increased after gastrojejunal anastomoses, which cause duodenogastric reflux. The association of omeprazole did not protect the development of proliferative lesions and cancer induced by duodenogastric reflux in rats.
Topics: Adenocarcinoma; Animals; Duodenogastric Reflux; Gastric Mucosa; Humans; Omeprazole; Proton Pump Inhibitors; Rats; Rats, Wistar
PubMed: 33027361
DOI: 10.1590/s0102-865020200090000004 -
BMC Pharmacology & Toxicology Jul 2022The effects of age and gender were explored on pharmacokinetics study of omeprazole enteric-coated tablets in Chinese population and a plasma concentration prediction...
Development of a particle swarm optimization-backpropagation artificial neural network model and effects of age and gender on pharmacokinetics study of omeprazole enteric-coated tablets in Chinese population.
BACKGROUND
The effects of age and gender were explored on pharmacokinetics study of omeprazole enteric-coated tablets in Chinese population and a plasma concentration prediction model was developed. All the data (demographic characteristics and results of clinical laboratory tests) were collected from healthy Chinese subjects in pharmacokinetics study using 20 mg omeprazole enteric-coated tablets. A noncompartmental method was used to calculate pharmacokinetic parameters, and 47 subjects were divided into two groups based on the calculation of the median age. Pharmacokinetic data from the low-age and high-age groups or male and female groups were compared by Student t-test. After a total of 12 variables were reconstruct and convert into independent or irrelative variables by principal component analysis, particle swarm optimization (PSO) was used to construct a backpropagation artificial neural network (BPANN) model.
RESULT
The model was fully validated and used to predict the plasma concentration in Chinese population. It was noticed that the C, AUC, AUC and t values have significant differences when omeprazole was administered by low-age groups or high-age groups while there were slight or no significant differences of pharmacokinetic data were found between male and female subjects. The PSO-BPANN model was fully validated and there was 0.000355 for MSE, 0.000133 for the magnitude of the gradient, 50 for the number of validation checks. The correlation coefficient of training, validation, test groups were 0.949, 0.903 and 0.874.
CONCLUSION
It is necessary to pay attention to the age and gender effects on omeprazole and PSO-BPANN model could be used to predict omeprazole concentration in Chinese subjects to minimize the associated morbidity and mortality with peptic ulcer.
TRIAL REGISTRATION
The study was registered in China Drug Clinical Trial Registration and Information Publicity Platform ( http://www.chinadrugtrials.org.cn ), the registration number was CTR20170876, and the full date of registration was 04/AUG/2017.
Topics: Area Under Curve; Asian People; Cross-Over Studies; Female; Humans; Male; Neural Networks, Computer; Omeprazole; Tablets; Tablets, Enteric-Coated
PubMed: 35851436
DOI: 10.1186/s40360-022-00594-2 -
Drug Design, Development and Therapy 2021Loratadine (LTD) is a Biopharmaceutical Classification System II basic drug with pH-sensitive aqueous solubility and dissolution is a speed-limiting step of its...
Simultaneous Determination of Loratadine and Its Metabolite Desloratadine in Beagle Plasma by LC-MS/MS and Application for Pharmacokinetics Study of Loratadine Tablets and Omeprazole‑Induced Drug-Drug Interaction.
BACKGROUND
Loratadine (LTD) is a Biopharmaceutical Classification System II basic drug with pH-sensitive aqueous solubility and dissolution is a speed-limiting step of its absorption. The drug dissolution and the gastrointestinal tract pH conditions are likely to influence the in vivo pharmacokinetic behavior of LTD tablets.
MATERIALS AND METHOD
A rapid, sensitive, and reliable bioanalytical method for simultaneous quantitation of LTD and its active metabolite desloratadine (DL) in beagle plasma was developed and validated based on liquid chromatography tandem mass spectrometry (LC-MS/MS). Sample preparation in low plasma consumption was accomplished by liquid-liquid extraction. The chromatographic separation was achieved on a Phenomenex Kinetex C8 column using acetonitrile and 5 mM ammonium formate as the mobile phase. A comparative pharmacokinetics study of three LTD tablets with different dissolution rates was conducted in male beagles in fasting state and an omeprazole-induced drug-drug interaction (DDI) study was subsequently performed under pretreatment of omeprazole.
RESULTS AND CONCLUSION
The method showed a good linear correlation over the concentration ranges of 0.008-24 ng/mL for LTD and 0.8-800 ng/mL for DL, and was successfully applied to analyze the two compounds in beagle plasma. Pharmacokinetic results showed in the fasting state the three LTD tablets were equivalent in beagles in terms of effective components. DL of the three tablets were equivalent, indicating metabolite was less susceptible to pharmaceutic preparation factors for LTD tablets in beagles. Moreover, significant changes in LTD and DL pharmacokinetics parameters were observed under the effect of omeprazole-induced pH increase in gastrointestinal tract, suggesting that DDI effects are of concern for the curative effect of LTD when combined with omeprazole. The findings will contribute to the future pharmaceutical preparations research as well as the clinical application of LTD.
Topics: Administration, Oral; Animals; Chromatography, Liquid; Dogs; Drug Interactions; Loratadine; Male; Omeprazole; Tandem Mass Spectrometry
PubMed: 34992347
DOI: 10.2147/DDDT.S328106 -
International Journal of Implant... Apr 2021This study aimed to investigate the effects of systemic omeprazole treatment on the osseointegration of titanium implants.
BACKGROUND
This study aimed to investigate the effects of systemic omeprazole treatment on the osseointegration of titanium implants.
MATERIAL AND METHODS
After surgical insertion of titanium implants into the metaphyseal part of rats' both right and left tibial bones, the animals were randomly divided into three equal groups: control (n = 8), omeprazole dosage-1 (n = 8) (OME-1), and omeprazole dosage-2 (n = 8) (OME-2) and totally 48 implants were surgically integrated. The rats in the control group received no treatment during the four-week postoperative experimental period. In the OME-1 and OME-2 groups, the rats received omeprazole in doses of 5 and 10 mg/kg, respectively, every 3 days for 4 weeks. After the experimental period, the rats were euthanized. One rat died in each group and the study was completed with seven rats in each group. Blood serum was collected for biochemical analysis, and the implants and surrounding bone tissue were used for biomechanical reverse-torque analysis. In the biomechanical analysis, implants that were not properly placed and were not osseointegrated were excluded from the evaluation.
RESULTS
One-way analysis of variance and Tukey's honestly significant difference test and Student's t test were used for statistical analysis. The reverse-torque test (control (n = 9), OME-1 (N = 7), and OME-2 (n = 7)) analysis of biochemical parameters (alkaline phosphatase, calcium, phosphorus, aspartate aminotransferase, alanine amino transferase, urea, and creatinine) revealed no significant differences between the groups (control (n = 7), OME-1 (N = 7), and OME-2 (n = 7)) (P > 0.05).
CONCLUSIONS
Omeprazole had no biomechanical or biochemical effects on the osseointegration process of titanium implants.
Topics: Animals; Omeprazole; Osseointegration; Prostheses and Implants; Rats; Tibia; Titanium
PubMed: 33843027
DOI: 10.1186/s40729-021-00310-5 -
Medicine Apr 2021Gastric ulcer (GU) is a common digestive system disease, and the main clinical manifestations are nausea and epigastric pain. In recent years, due to increased life...
BACKGROUND
Gastric ulcer (GU) is a common digestive system disease, and the main clinical manifestations are nausea and epigastric pain. In recent years, due to increased life pressure, unhealthy eating habits and environment, the incidence of gastric ulcer has increased year by year. Because the disease has a long treatment cycle and is prone to relapse, if it cannot be controlled in time, it can cause the disease to prolong, affect the daily life and health of the patient, and even cause complications such as upper gastrointestinal bleeding, ulcer perforation, and pyloric obstruction. Helicobacter pylori infection is one of the main causes of GU. Clinically, the curative effect of western medicine or traditional Chinese medicine cannot reach the ideal level, so in recent years, the combination of traditional Chinese and western medicine has been highly praised. The aim of this systematic review is to evaluate the effectiveness and safety of Chinese medicine combined with omeprazole for GU.
METHODS
The data and information will be retrieved from the databases of PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang data. Literature search is limited to Chinese and English. The search time range is from the establishment of the database to April 7, 2021. The search strategy uses a combination of subject terms and free words to search. In order to avoid omissions, the search scope includes subject terms, keywords, or full text. Two reviewers will independently exclude substandard articles and extract eligible data. The risk of bias will be assessed using the Cochrane Handbook 5.1.0 for Systematic Reviews of Interventions. RevMan 5.3 will be used for systematic review and meta-analysis. This protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported with the PRISMA statement.
RESULTS AND CONCLUSION
The efficacy and safety of Chinese medicine combined with omeprazole for the treatment of GU will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with GU.
Topics: Combined Modality Therapy; Humans; Medicine, Chinese Traditional; Meta-Analysis as Topic; Omeprazole; Proton Pump Inhibitors; Research Design; Stomach Ulcer; Systematic Reviews as Topic; Treatment Outcome
PubMed: 33907169
DOI: 10.1097/MD.0000000000025744 -
Alternative Therapies in Health and... Nov 2022The frequency of gastric-cancer (GC) diagnosis has been increasing in recent years and often has no obvious symptoms at an early stage. Upon clinical diagnosis of early...
CONTEXT
The frequency of gastric-cancer (GC) diagnosis has been increasing in recent years and often has no obvious symptoms at an early stage. Upon clinical diagnosis of early GC (EGC), surgical treatment is generally recommended but as an invasive operation, surgical resection can't avoid postoperative gastrointestinal dysfunction (GID) and other problems.
OBJECTIVE
The study intended to evaluate the clinical benefits for EGC patients of auricular point-pressing with beans, combined with esomeprazole magnesium (EM), for relieving gastrointestinal dysfunction (GID) after endoscopic submucosal dissection (ESD), aiming to provide accurate and effective reference opinions for future clinical treatment.
DESIGN
The research team designed a retrospective analysis.
SETTING
The study took place at the Jiangsu Province Hospital of Chinese Medicine in Nanjing, Jiangsu, China.
PARTICIPANTS
Participants were 78 EGC patients who underwent ESD at the hospital between January 2019 and January 2021 and who had developed postoperative GID.
INTERVENTION
Thirty-seven patients chose to receive routine EM treatment, and they served as a control group. 41 patients chose to receive auricular point-pressing with bean plus EM intervention, and they served as a intervention group.
OUTCOME MEASURES
At baseline and postintervention, the research team measured the levels of serum motilin (MOT), substance P (SP), prealbumin (PAB), transferrin (TF), and albumin (ALB). They also recorded the time of intestinal peristalsis recovery, first exhaust, first defecation, normal food intake, and resolution of abdominal distension symptoms. Finally, they counted the incidence of adverse events during treatment.
RESULTS
The levels of MOT, SP, PAB, TF, and ALB significantly changed between baseline and postintervention in both groups (P < .05). In the intervention group as compared to the control group postintervention, the decreases in the levels of MOT PAB, TF, and ALB and the increase in the SP level were significantly greater in the control group than those of the intervention group (all P < .05). In addition, the intervention group showed a shorter recovery time related to postoperative intestinal function and normal food intake and resolution of abdominal distension symptoms than did the control group (all P < .05), with a lower incidence of adverse events.
CONCLUSIONS
Auricular point-pressing with beans plus EM can effectively alleviate the GID of EGC patients after ESD and help them to maintain normal gastrointestinal function, and its use is worth popularizing in clinical settings.
Topics: Humans; Retrospective Studies; Esomeprazole; Endoscopic Mucosal Resection; Stomach Neoplasms; China; Treatment Outcome
PubMed: 35839117
DOI: No ID Found -
Journal of Cachexia, Sarcopenia and... Feb 2022Cancer cachexia, characterized by muscle and fat tissue wasting, is a major determinant of cancer-related mortality without established treatment. Recent animal data...
BACKGROUND
Cancer cachexia, characterized by muscle and fat tissue wasting, is a major determinant of cancer-related mortality without established treatment. Recent animal data revealed that cancer cells induce muscle wasting by releasing Hsp70 and Hsp90 as surface proteins on extracellular vesicles (EVs). Here, we test a therapeutic strategy for ameliorating cancer cachexia by inhibiting the release of Hsp70 and Hsp90 using proton pump inhibitor omeprazole.
METHODS
Omeprazole effect on Hsp70/90 release through EVs by Lewis lung carcinoma (LLC) cells in vitro, serum levels of Hsp70/90 and Hsp70/90-carrying EVs in LLC tumour-bearing mice, and LLC-induced muscle protein degradation pathways in C2C12 myotubes and mice were determined. Omeprazole effect on endolysosomal pH and Rab27b expression in LLC cells were analysed.
RESULTS
Omeprazole treatment of LLC cells inhibited Hsp70/90 and Hsp70/90-carrying EV release in a dose-dependent manner (1 to 10 μM) and attenuated the catabolic activity of LLC cell-conditioned medium on C2C12 myotubes. Systemic omeprazole administration to LLC tumour-bearing mice (5 mg/kg/day subcutaneously) for 2 weeks blocked elevation of serum Hsp70, Hsp90, and Hsp70/90-carrying EVs, abrogated skeletal muscle catabolism, and prevented loss of muscle function as well as muscle and epididymal fat mass without altering tumour growth. Consequently, median survival increased by 23.3%. Mechanistically, omeprazole increased cancer cell endolysosomal pH level dose-dependently (0.1 to 1 μM) by inhibiting vacuolar H -ATPase. Further, omeprazole suppressed the highly elevated expression of Rab27b, a key regulator of EV release, in LLC cells.
CONCLUSIONS
Omeprazole ameliorates cancer cachexia by inhibiting cancer cell release of Hsp70 and Hsp90.
Topics: Animals; Cachexia; Carcinoma, Lewis Lung; Mice; Muscle Fibers, Skeletal; Muscular Atrophy; Omeprazole
PubMed: 34729960
DOI: 10.1002/jcsm.12851 -
Clinical Pharmacokinetics Apr 2023CYP2C19-mediated drug interactions of acid-reducing agents are clinically important given the high possibility of concomitant administration with CYP2C19 substrates.... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND AND OBJECTIVE
CYP2C19-mediated drug interactions of acid-reducing agents are clinically important given the high possibility of concomitant administration with CYP2C19 substrates. This study aimed to evaluate the effect of tegoprazan on the pharmacokinetics (PK) of a CYP2C19 substrate, proguanil, compared with vonoprazan or esomeprazole.
METHODS
A two-part, randomized, open-label, two-sequence, three-period crossover study was conducted in 16 healthy CYP2C19 extensive metabolizers (eight subjects per part). In each period, a single oral dose of atovaquone/proguanil 250/100 mg was administered alone or co-administered with tegoprazan 50 mg, esomeprazole 40 mg (Part 1 only) or vonoprazan 20 mg (Part 2 only). The plasma and urine concentrations of proguanil and its metabolite, cycloguanil, were measured up to 48 h post-dose. PK parameters were calculated using a non-compartmental method and compared between administered alone and co-administered with tegoprazan, vonoprazan or esomeprazole.
RESULTS
Co-administration of tegoprazan did not significantly affect the systemic exposure of proguanil and cycloguanil. In contrast, co-administration of vonoprazan or esomeprazole increased proguanil systemic exposure and decreased cycloguanil systemic exposure, and the magnitude of the corresponding change was greater with esomeprazole co-administration than vonoprazan co-administration.
CONCLUSION
Tegoprazan, unlike vonoprazan and esomeprazole, exhibited negligible CYP2C19-mediated PK interaction. It suggests that as an alternative to other acid-reducing agents, tegoprazan can be used concomitantly with CYP2C19 substrates in clinical settings.
TRIAL REGISTRATION
Clinicaltrials.gov identifier: NCT04568772 (Registered on September 29, 2020).
Topics: Humans; Atovaquone; Cross-Over Studies; Cytochrome P-450 CYP2C19; Drug Interactions; Esomeprazole; Proguanil; Reducing Agents
PubMed: 36897544
DOI: 10.1007/s40262-023-01228-4 -
European Journal of Drug Metabolism and... Oct 2020Omeprazole is a proton pump inhibitor that is used in acid suppression therapy in infants. Infants cannot swallow the oral tablets or capsules. Since, infants require a... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND AND OBJECTIVE
Omeprazole is a proton pump inhibitor that is used in acid suppression therapy in infants. Infants cannot swallow the oral tablets or capsules. Since, infants require a non-standard dose of omeprazole, the granules or tablets are often crushed or suspended in water or sodium bicarbonate, which may destroy the enteric coating. In this study we explore the efficacy and pharmacokinetics of rectally administered omeprazole in infants with gastroesophageal reflux disease (GERD) due to esophageal atresia (EA) or congenital diaphragmatic hernia (CDH) and compare these with orally administered omeprazole.
METHODS
Infants (6-12 weeks postnatal and bodyweight > 3 kg) with EA or CDH and GERD were randomized to receive a single dose of 1 mg/kg omeprazole rectally or orally. The primary outcome was the percentage of infants for whom omeprazole was effective according to predefined criteria for 24-h intraesophageal pH. Secondary outcomes were the percentages of time that gastric pH was < 3 or < 4, as well as the pharmacokinetic parameters.
RESULTS
Seventeen infants, 4 with EA and 13 with CDH, were included. The proportion of infants for whom omeprazole was effective was 56% (5 of 9 infants) after rectal administration and 50% (4 of 8 infants) after oral administration. The total reflux time in minutes and percentages and the number of reflux episodes of pH < 4 decreased statistically significantly after both rectal and oral omeprazole administration. Rectal and oral administration of omeprazole resulted in similar serum exposure.
CONCLUSIONS
A single rectal omeprazole dose (1 mg/kg) results in consistent increases in intraesophageal and gastric pH in infants with EA- or CDH-related GERD, similar to an oral dose. Considering the challenges with existing oral formulations, rectal omeprazole presents as an innovative, promising alternative for infants with pathological GERD.
CLINICAL TRIAL REGISTER
ClinicalTrials.gov Identifier: NCT00226044.
Topics: Administration, Oral; Administration, Rectal; Esophageal Atresia; Esophageal pH Monitoring; Female; Gastroesophageal Reflux; Hernias, Diaphragmatic, Congenital; Humans; Infant; Male; Omeprazole; Pilot Projects; Proton Pump Inhibitors; Treatment Outcome
PubMed: 32594305
DOI: 10.1007/s13318-020-00630-8