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Drug Research Dec 2017Intraperitoneal drug administration applies treatment at the site of diseases with gynaecological, urological, or gastrointestinal origin. The objective of this... (Review)
Review
Intraperitoneal drug administration applies treatment at the site of diseases with gynaecological, urological, or gastrointestinal origin. The objective of this systematic review was to investigate perioperative intraperitoneal administration of antibacterial agents to characterise the drugs used and their safety profile. A protocol was registered at PROSPERO (CRD42016038956). A systematic review was conducted and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A search was performed in PubMed and EMBASE on the 22 of April 2016. The inclusion criteria were original articles involving at least 5 patients where antibacterial agents were administered intraperitoneally during or after abdominal surgery as prophylaxis or treatment of infection. Languages were limited to English, German, Danish, Norwegian, or Swedish articles. 79 studies were included which used a total of 12 different antibacterial classes. Aminoglycosides, 1 and 2 generation cephalosporins, tetracyclines, and penicillins were most commonly administered intraperitoneally during or after surgery. The antibacterial agent was usually administered intraperitoneally as monotherapy. However, some studies administered combination regimens with heparin or with another antibacterial agent. The most frequent combination was aminoglycosides and lincosamides. In total, 43% of studies lacked information regarding adverse events. The most frequently reported adverse event was discomfort or pain during administration, especially with use of oxytetracycline. At least 12 different classes of antibacterial agents have been administered intraperitoneally during or after surgery as prophylaxis or treatment of intraabdominal infections. Intraperitoneal administration seems safe although use of oxytetracycline may cause discomfort or pain.
Topics: Anti-Bacterial Agents; Humans; Injections, Intraperitoneal; Perioperative Care
PubMed: 28847021
DOI: 10.1055/s-0043-109565 -
Basic & Clinical Pharmacology &... Jun 2022There is increasing scientific evidence to substantiate using low-dose glucagon as a supplement to insulin therapy in artificial pancreata for diabetes mellitus type 1....
INTRODUCTION
There is increasing scientific evidence to substantiate using low-dose glucagon as a supplement to insulin therapy in artificial pancreata for diabetes mellitus type 1. The delivery of both these hormones intraperitoneally would mimic normal physiology. However, our knowledge of the pharmacological properties of glucagon after intraperitoneal administration is limited. This study compared the pharmacokinetics of glucagon after intraperitoneal, subcutaneous and intravenous administration and the pharmacodynamic effects of glucagon on glucose metabolism after intraperitoneal and subcutaneous administration in a pig model.
MATERIALS AND METHODS
Twelve pigs were included. Glucagon was administered intraperitoneally, subcutaneously and intravenously in a randomised order. Arterial samples were collected every 2-10 min for 150 min to determine plasma glucagon and blood glucose concentrations.
RESULTS
The bioavailability of glucagon was significantly lower after intraperitoneal compared with subcutaneous administration with a median difference (95% confidence interval) of 13% (4-22). The effect of glucagon on glucose metabolism was equal after intraperitoneal and subcutaneous administration.
CONCLUSIONS
Intraperitoneal glucagon administration resulted in lower systemic glucagon exposure than subcutaneous administration without loss of efficiency. We interpret this as evidence of a major first-pass metabolism of glucagon in the liver.
Topics: Administration, Intravenous; Animals; Blood Glucose; Diabetes Mellitus, Type 1; Glucagon; Insulin; Insulin Infusion Systems; Swine
PubMed: 35416407
DOI: 10.1111/bcpt.13731 -
Anesthesiology and Pain Medicine Dec 2021Postoperative pain following laparoscopic cholecystectomy (LC) arises from incision sites and residual intraperitoneal CO gas. Opioids as a class of pain-relieving drugs...
BACKGROUND
Postoperative pain following laparoscopic cholecystectomy (LC) arises from incision sites and residual intraperitoneal CO gas. Opioids as a class of pain-relieving drugs are broadly used to control pain after LC; however, these drugs can cause various side effects.
OBJECTIVES
The purpose of this study was to compare the efficacy of intraperitoneal injection of bupivacaine with that of intravenous ketorolac in managing postoperative pain in patients who had undergone LC.
METHODS
This randomized, double-blind clinical trial was carried out on patients who had undergone LC. Ninety patients who had undergone elective LC were randomly divided into 3 groups (n = 30 for each group). Group A received 40 mL of 0.25% bupivacaine solution intraperitoneally at the end of the operation; group B received 30 mg of ketorolac intravenously 30 minutes before surgery and every 8 hours after surgery, and patients in group C received normal saline intraperitoneally and intravenous injection. The patients were postoperatively assessed for Visual Analog Scale (VAS) scores, postoperative opioid consumption, shoulder pain, side effects (sedation, nausea, and vomiting), and satisfaction. The data were analyzed using SPSS. P values < 0.05 were considered significant.
RESULTS
The intraperitoneal injection of bupivacaine and intravenous injection of ketorolac were significantly effective in reducing postoperative abdominal pain, shoulder pain, and incidence of nausea and vomiting compared to the placebo group (P < 0.001). Although intraperitoneal bupivacaine and intravenous ketorolac had no significant difference in pain relief compared with each other, patients in both bupivacaine and ketorolac groups were significantly more satisfied with their analgesia compared to the control group (P < 0.001).
CONCLUSIONS
Intraperitoneal injection of bupivacaine and intravenous injection of ketorolac both are safe and effective methods to control pain, nausea, and vomiting after LC.
PubMed: 35291402
DOI: 10.5812/aapm.114623 -
Acta Obstetricia Et Gynecologica... 1992The field of immunotargeting, and the challenges met when this technique is applied in experimental animals or in patients, are reviewed. Even with highly specific... (Review)
Review
The field of immunotargeting, and the challenges met when this technique is applied in experimental animals or in patients, are reviewed. Even with highly specific monoclonal antibodies, non-specific uptake in normal tissues and high background level of unbound radioactivity in blood and extravascular body fluids remain significant problems. Further experimental work in animal model systems is needed to bring this technique from the state of being an experimental method, with limited clinical application, to a routine diagnostic or therapeutic method. Different animal models are available, and their potential for elucidation of the various methodological problems in radio-immunotargeting are discussed in the present paper. In our laboratory, two intraperitoneal models were devised, having relevance for gynecologic and other forms of intraperitoneal malignancies. These models were elaborated with special emphasis on the possibility for exact measurement of important parameters in immunotargeting reactions. In the first model, hybridoma cells are inoculated intraperitoneally to mimic intraperitoneal carcinomatosis, and the monoclonal antibody produced by the hybridoma is used as serum tumor marker. In the second model the tumor cells are contained within intraperitoneally implanted micropore chambers, resembling a localized tumor. An artificial tumor like this allows control with the antigen load in the target, and measurement of the concentration of the injected antibody in the fluid within the target.
Topics: Animals; Biomarkers, Tumor; Diffusion Chambers, Culture; Female; Hybridomas; In Vitro Techniques; Mice; Mice, Nude; Neoplasm Transplantation; Ovarian Neoplasms; Peritoneal Neoplasms; Radioimmunodetection; Radioimmunotherapy; Rats
PubMed: 1502887
DOI: 10.1111/j.1600-0412.1992.tb00015.x -
Anesthesia, Essays and Researches 2018Intraperitoneal instillation of local anesthetics in laparoscopic cholecystectomy (LC) has been used to reduce postoperative pain and to decrease the need for...
BACKGROUND
Intraperitoneal instillation of local anesthetics in laparoscopic cholecystectomy (LC) has been used to reduce postoperative pain and to decrease the need for postoperative analgesics.
AIMS
This study aimed to compare intraperitoneal instillation of bupivacaine and ropivacaine for postoperative analgesia in patients undergoing LC.
SETTINGS AND DESIGN
This was a prospective, randomized, double-blind study.
MATERIALS AND METHODS
After obtaining ethical committee's clearance and informed consent, sixty patients, aged 18-65 years, of either gender, and American Society of Anesthesiologists physical status I to III scheduled for LC were included and categorized into two groups ( = 30). Group A patients received 20 mL of 0.5% bupivacaine intraperitoneally after cholecystectomy and Group B patients received 20 mL of 0.5% ropivacaine intraperitoneally after cholecystectomy.
STATISTICAL ANALYSIS
The data were analyzed using paired -test. The results were analyzed and compared to previous studies. SPSS software version 22 was used, released 2013 (IBM Corp., Armonk, NY, USA).
RESULTS
Pulse rate, systolic blood pressure, and diastolic blood pressure were comparatively lower in Group B than in Group A. The visual analog scale (VAS) score was significantly lower in Group B. Rescue analgesia was given when VAS was >6. Verbal rating scale score was significantly lower in Group B, showing longer duration of analgesia in this group. Rescue analgesic requirement was also less in Group B.
CONCLUSION
The instillation of bupivacaine and ropivacaine intraperitoneally was an effective method of postoperative pain relief in LC. It provided good analgesia in immediate postoperative period with ropivacaine, providing longer duration of analgesia.
PubMed: 29962601
DOI: 10.4103/aer.AER_6_18 -
BMJ Open Diabetes Research & Care 2018Hypoglycemia is a frequent and potentially dangerous event among patients with diabetes mellitus type 1. Subcutaneous glucagon is an emergency treatment to counteract...
OBJECTIVE
Hypoglycemia is a frequent and potentially dangerous event among patients with diabetes mellitus type 1. Subcutaneous glucagon is an emergency treatment to counteract severe hypoglycemia. The effect of intraperitoneal glucagon delivery is sparsely studied. We performed a direct comparison of the blood glucose response following intraperitoneally, subcutaneously and intravenously administered glucagon.
RESEARCH DESIGN AND METHODS
This is a prospective, randomized, controlled, open-label, crossover trial in 20 octreotide-treated rats. Three interventions, 1 week apart, in a randomized order, were done in each rat. All 20 rats were given intraperitoneal and subcutaneous glucagon injections, from which 5 rats were given intravenous glucagon injections and 15 rats received placebo (intraperitoneal isotonic saline) injection. The dose of glucagon was 5 µg/kg body weight for all routes of administration. Blood glucose levels were measured before and until 60 min after the glucagon/placebo injections.
RESULTS
Compared with placebo-treated rats, a significant increase in blood glucose was observed 4 min after intraperitoneal glucagon administration (p=0.009), whereas after subcutaneous and intravenous glucagon administration significant increases were seen after 8 min (p=0.002 and p<0.001, respectively). In intraperitoneally treated compared with subcutaneously treated rats, the increase in blood glucose was higher after 4 min (p=0.019) and lower after 40 min (p=0.005) and 50 min (p=0.011). The maximum glucose response occurred earlier after intraperitoneal compared with subcutaneous glucagon injection (25 min vs 35 min; p=0.003).
CONCLUSIONS
Glucagon administered intraperitoneally gives a faster glucose response compared with subcutaneously administered glucagon in rats. If repeatable in humans, the more rapid glucose response may be of importance in a dual-hormone artificial pancreas using the intraperitoneal route for administration of insulin and glucagon.
PubMed: 30487972
DOI: 10.1136/bmjdrc-2018-000560 -
ACS Applied Materials & Interfaces May 2022Ovarian cancer is a common gynecologic malignancy with a high fatality rate. Intraperitoneal chemotherapy has been proved as an efficient clinical treatment for...
Ovarian cancer is a common gynecologic malignancy with a high fatality rate. Intraperitoneal chemotherapy has been proved as an efficient clinical treatment for disseminated ovarian cancer. However, there are limitations for conventional small molecule drugs to achieve an ideal therapeutic effect. Herein, a synergistic treatment for intraperitoneally disseminated ovarian cancer was achieved by Arg-Gly-Asp (RGD)-modified amorphous calcium phosphate loading with doxorubicin (designated as RGD-CaPO/DOX). The engineered calcium-involved nanomedicine augmented the therapeutic effect of DOX by aggravating endoplasmic reticulum stress, calcium overload, and mitochondrial dysfunction, ultimately triggering mitochondrial apoptosis in the SKOV3 (human ovarian cancer) cell line. In an intraperitoneally disseminated tumor model, RGD modification and the weak negative surface potential of the NPs were beneficial for intraperitoneal retention and tumor targeting. Moreover, intraperitoneal injection of RGD-CaPO/DOX NPs resulted in a favorable antitumor effect. The mean survival time of SKOV3-bearing mice was significantly extended from 29 to 59 days with negligible toxicity. Therefore, this study has been designed to provide an effective chemotherapeutic-augmented treatment for intraperitoneally disseminated ovarian cancer.
Topics: Animals; Calcium; Calcium Phosphates; Cell Line, Tumor; Doxorubicin; Female; Humans; Mice; Nanoparticles; Oligopeptides; Ovarian Neoplasms; Phosphates
PubMed: 35508299
DOI: 10.1021/acsami.2c02552 -
Gynecologic Oncology Mar 1999Hypersensitivity reactions to intravenous administration of carboplatin (CP) have been previously reported. However, hypersensitivity reaction to intraperitoneal... (Review)
Review
Hypersensitivity reactions to intravenous administration of carboplatin (CP) have been previously reported. However, hypersensitivity reaction to intraperitoneal administration of CP has not yet been reported. A 66-year-old woman diagnosed with ovarian carcinoma underwent six courses of intraperitoneal administration of carboplatin. During the seventh course of chemotherapy, delivered intraperitoneally, she developed hypersensitivity reactions with hypotension to carboplatin. Etoposide was used for the further chemotherapy. To the best of our knowledge, this is the first case report of hypersensitivity reactions to intraperitoneal administration of carboplatin.
Topics: Aged; Antineoplastic Agents; Carboplatin; Drug Hypersensitivity; Female; Humans; Infusions, Parenteral; Ovarian Neoplasms
PubMed: 10053120
DOI: 10.1006/gyno.1998.5273 -
Harefuah Sep 2015Ovarian cancer is the second in incidence and the first cause of death. As much as 70% of ovarian cancer patients are diagnosed with advanced disease. The standard... (Comparative Study)
Comparative Study Review
Ovarian cancer is the second in incidence and the first cause of death. As much as 70% of ovarian cancer patients are diagnosed with advanced disease. The standard treatment of advanced ovarian cancer is a combination of primary optimal debulking (POD) followed by a combined adjuvant chemotherapy treatment. Another optional treatment includes neoadjuvant chemotherapy followed by optimal debulking and then adjuvant chemotherapy. The common adjuvant chemotherapy includes a combination of platinum and taxol compounds given intravenously. Other possible treatments which had been evaluated in the past decades include a combination of chemotherapy given intravenously and intraperitoneally. The rationale behind delivering the chemotherapy intraperitoneally is to provide a much higher concentrations of cytotoxic agents in the peritoneal cavity and to reduce the systemic side effects. A number of randomized trials have shown that the combination of IV and IP chemotherapy entails a survival advantage. Most studies included treatment based on cisplatin treatments with/ without taxol given intravenously versus a combined treatment (intravenously and intraperitoneally) of those agents. An advantage of up to 8 months in disease-free survival and 11 months in overall survival was noted in the IP group. On the other hand, this treatment led to a higher rate of side effects, including abdominal pain, electrolyte imbalance and catheter related complications. Despite the inconsistency in the treatment protocols between the different trials comparing intravenous and intra-peritoneal treatment, one cannot ignore the statistical significance between the groups, for disease-free survival and overall survival. That is why, when addressing patients who completed optimal surgery, one needs to conduct a thorough evaluation regarding the complementary chemotherapy treatment. Due to the broad side effect profile, special notice should be taken as to the patient's age, medical history, and performance status after the primary surgery and her ability to endure an aggressive chemotherapy treatment. By doing so, it will be possible to select the ovarian cancer patients who will benefit he most from combining intravenous and intraperitoneal treatment.
Topics: Administration, Intravenous; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Disease-Free Survival; Female; Humans; Injections, Intraperitoneal; Israel; Neoadjuvant Therapy; Ovarian Neoplasms; Survival Rate
PubMed: 26665753
DOI: No ID Found -
Journal of Zhejiang University.... Mar 2015Intrarectal infusion of butyrate improves colorectal disorders including ulcerative colitis (UC). However, it is not established whether systemically administered... (Comparative Study)
Comparative Study
Intrarectal infusion of butyrate improves colorectal disorders including ulcerative colitis (UC). However, it is not established whether systemically administered butyrate benefits such patients. The current study aimed at exploring and comparing the potential of intraperitoneally, intrarectally, and orally administered butyrate against acetic acid (AA)-induced UC in rats. Intrarectal administration of 2 ml of 50% AA was done after or without prior treatment of rats for 7 consecutive days with 100 mg/kg sodium butyrate (SB) intraperitoneally, intrarectally, or orally. Rats were sacrificed after 48 h of AA-treatment. Subsequently, colon sections were processed routinely for histopathological examination. We clinically observed diarrhea, loose stools, and hemoccult-positive stools, and histologically, epithelial loss and ulceration, crypt damage, goblet cell depletion, hemorrhage, and mucosal infiltration of inflammatory cells. The changes were significantly reduced by intraperitoneal, intrarectal, or oral butyrate, with intraperitoneal butyrate exhibiting the highest potency. It is concluded that intraperitoneal administration of butyrate abrogates the lesions of AA-induced UC and its potency surpasses that of intrarectal or oral butyrate.
Topics: Acetic Acid; Administration, Oral; Administration, Rectal; Animals; Butyric Acid; Colitis, Ulcerative; Disease Models, Animal; Goblet Cells; Injections, Intraperitoneal; Intestinal Mucosa; Male; Rats; Rats, Wistar
PubMed: 25743124
DOI: 10.1631/jzus.B1400191