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Fertility and Sterility May 2007The embryo transfer is a critical part of in vitro fertilization. When performed under abdominal ultrasound guidance, the embryo transfer procedure requires a full... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
The embryo transfer is a critical part of in vitro fertilization. When performed under abdominal ultrasound guidance, the embryo transfer procedure requires a full bladder. Patients often state that the discomfort of the distended bladder causes more pain than the actual transfer procedure. Phenazopyridine HCl is a bladder analgesic. The objective of this study was to determine if a single dose of phenazopyridine prior to embryo transfer reduces patient discomfort during that procedure.
DESIGN
Prospective randomized double-blinded clinical trial.
SETTING
University-based Reproductive Medicine practice.
PATIENT(S)
Eighty-five reproductive age infertile women undergoing in vitro fertilization.
INTERVENTION(S)
Phenazopyridine (200 mg) or placebo taken 1 hour prior to embryo transfer utilizing transabdominal sonography.
MAIN OUTCOME MEASURE(S)
Pain as assessed by visual analogue pain scale and physician and nurse assessment of patient discomfort.
RESULT(S)
Study groups were similar in their demographic background. Mean pain score as assessed by a visual analogue pain scale during the procedure was 2.95 +/- 2.4 in the placebo group, and 3.03 +/- 2.6 in the active medication group (NS). There were also no significant differences in the observations of pain assessments.
CONCLUSION(S)
Phenazopyridine used in a single dose prior to embryo transfer does not alleviate patient discomfort.
Topics: Adult; Double-Blind Method; Embryo Transfer; Female; Humans; Pain; Pain Measurement; Phenazopyridine; Prospective Studies
PubMed: 17239870
DOI: 10.1016/j.fertnstert.2006.08.097 -
The Journal of Biological Chemistry Jun 2024Menstrual toxic shock syndrome (mTSS) is a rare but severe disorder associated with the use of menstrual products such as high-absorbency tampons and is caused by...
Menstrual toxic shock syndrome (mTSS) is a rare but severe disorder associated with the use of menstrual products such as high-absorbency tampons and is caused by Staphylococcus aureus strains that produce the toxic shock syndrome toxin-1 (TSST-1) superantigen. Herein, we screened a library of 3920 small bioactive molecules for the ability to inhibit transcription of the TSST-1 gene without inhibiting growth of S. aureus. The dominant positive regulator of TSST-1 is the SaeRS two-component system (TCS), and we identified phenazopyridine hydrochloride (PP-HCl) that repressed production of TSST-1 by inhibiting the kinase function of SaeS. PP-HCl competed with ATP for binding of the kinase SaeS leading to decreased phosphorylation of SaeR and reduced expression of TSST-1 as well as several other secreted virulence factors known to be regulated by SaeRS. PP-HCl targets virulence of S. aureus, and it also decreases the impact of TSST-1 on human lymphocytes without affecting the healthy vaginal microbiota. Our findings demonstrate the promising potential of PP-HCl as a therapeutic strategy against mTSS.
PubMed: 38852884
DOI: 10.1016/j.jbc.2024.107455 -
Canadian Urological Association Journal... Jan 2018We sought to determine if patients' perceptions of success or failure of interstitial cystitis/bladder pain syndrome (IC/BPS) therapies proposed in treatment guidelines...
INTRODUCTION
We sought to determine if patients' perceptions of success or failure of interstitial cystitis/bladder pain syndrome (IC/BPS) therapies proposed in treatment guidelines align with the evidence from available clinical trial treatment data.
METHODS
A total of 1628 adult females with a self-reported diagnosis of IC completed a web-based survey in which patients described their perceived outcomes with the therapies they were exposed to. Previously published literature, used in part to develop IC/BPS guidelines, provided the clinical trial data outcomes. Patient-reported outcomes were compared to available clinical trial outcomes and published treatment guidelines.
RESULTS
Based on patient perceived outcomes (benefit:risk ratio), the most effective treatments were opioids, phenazopyridine, and alkalizing agents, with amitriptyline and antihistamines reported as moderately effective. The only surgical procedure with any effectiveness was electrocautery of Hunner's lesions. In order of efficacy reported in the literature, the therapies for IC/BPS with predicted superior outcomes should be: cyclosporine A, amitriptyline, hyperbaric oxygen, pentosan polysulfate plus subcutaneous heparin, botulinum toxin A plus hydrodistension, and L-arginine. While some of the guideline recommendations aligned with patient-reported effectiveness data, there was a general disconnect between guidelines and effectiveness reported in clinical practice.
CONCLUSIONS
There is a disconnect between real-world patient perceived effectiveness of IC/BPS treatments compared to the efficacy reported from clinical trial data and subsequent guidelines developed from this efficacy data. Optimal therapy must include the best evidence from clinical research, but should also include real-life clinical practice implementation and effectiveness.
PubMed: 29173267
DOI: 10.5489/cuaj.4505 -
WMJ : Official Publication of the State... Sep 2023Trimethoprim-sulfamethoxazole (TMP-SMX) and phenazopyridine are individually associated with methemoglobinemia through a series of altered reduction-oxidation reactions....
A Case That Will Take Your Breath Away: Acquired Methemoglobinemia Related to Trimethoprim-Sulfamethoxazole and Phenazopyridine Ingestion for Treatment of Urinary Tract Infection.
Trimethoprim-sulfamethoxazole (TMP-SMX) and phenazopyridine are individually associated with methemoglobinemia through a series of altered reduction-oxidation reactions. We report a case of methemoglobinemia associated with concurrent use of TMP/SMX and phenazopyridine in a 70-year-old woman with recurrent urinary tract infections. She presented to the emergency department for worsening back pain in the setting of recurrent urinary tract infections, concerning for pyelonephritis. During her workup, she became acutely hypoxic. The emergency department provider suspected the presence of abnormal hemoglobin. An arterial blood gas showing elevated levels of methemoglobinemia confirmed the suspicion. The combined use of TMP/SMX and phenazopyridine was thought to be the likely etiology of hypoxia. This case highlights the importance of medication management in the geriatric population, as well as the judicious use of antibiotics for urinary tract infections-a common chief complaint in the primary care setting.
Topics: Aged; Female; Humans; Trimethoprim, Sulfamethoxazole Drug Combination; Phenazopyridine; Methemoglobinemia; Urinary Tract Infections; Eating
PubMed: 37768772
DOI: No ID Found -
Journal of Chromatographic Science 2016In this study, two analytical approaches were exploited for the resolution of binary mixtures of ciprofloxacin HCl (CIP) or norfloxacin (NOR) and phenazopyridine HCl...
Derivative Quotient Spectrophotometry and an Eco-Friendly Micellar Chromatographic Approach with Time-Programmed UV-Detection for the Separation of Two Fluoroquinolones and Phenazopyridine.
In this study, two analytical approaches were exploited for the resolution of binary mixtures of ciprofloxacin HCl (CIP) or norfloxacin (NOR) and phenazopyridine HCl (PHZ). In the first approach, the amplitudes of the first derivative of the ratio spectra were measured at 267 or 287 nm for CIP and at 268 or 291 nm for NOR. PHZ could be directly determined in the presence of CIP or NOR at 405 nm. The calibration graphs were rectilinear over the ranges of 1.0-16.0 µg/mL for CIP or NOR and 1.0-10.0 µg/mL for PHZ. In the second approach, an accurate, reliable and environmentally nontoxic micellar liquid chromatographic (MLC) method was developed. A good chromatographic separation was achieved using a 150 mm × 4.6 mm i.d., 5 µm particle size Spherisorb ODS-2 column. Eco-friendly mobile phase containing 0.12 M sodium dodecyl sulphate, 0.3% triethylamine and 6%n-butanol in 0.02 M orthophosphoric acid of pH 3.0 was pumped at a flow rate of 1 mL/min. Time programmed UV-detection was applied to allow sensitive determination of the studied drugs. The analytes were eluted without interferences in <10 min. Methocarbamol was used as an internal standard. The MLC method was found to be rectilinear over the concentration range of 0.5-20.0 μg/mL for CIP, NOR or PHZ. These optimized and validated methods were successfully applied for the simultaneous analysis of the studied drugs in their synthetic mixtures and co-formulated tablets. Moreover, the second method was further extended to the determination of these drugs in human urine with direct injection and without any pretreatment.
Topics: Chromatography, High Pressure Liquid; Fluoroquinolones; Micelles; Phenazopyridine; Spectrophotometry, Ultraviolet
PubMed: 26867555
DOI: 10.1093/chromsci/bmw010 -
Clinical Case Reports Mar 2023Hemorrhagic cystitis is a common complication following the use of cyclophosphamide. Associated dysuria can be painful and there are few good options to relieve pain....
Hemorrhagic cystitis is a common complication following the use of cyclophosphamide. Associated dysuria can be painful and there are few good options to relieve pain. Phenazopyridine has historically been utilized for dysuria and is available over the counter. However, it is associated with hematologic side effects with prolonged use. Here we present a case of a patient who developed Heinz body hemolysis following prolonged administration of phenazopyridine to treat cyclophosphamide-induced hemorrhagic cystitis following hematopoietic stem cell transplant.
PubMed: 36911643
DOI: 10.1002/ccr3.7012 -
Nature Communications Sep 2021Chiral bridged [2,2,1] bicyclic lactones are privileged structural units in pharmaceutics and bioactive nature products. However, the synthetic methods for these...
Chiral bridged [2,2,1] bicyclic lactones are privileged structural units in pharmaceutics and bioactive nature products. However, the synthetic methods for these compounds are rare. Here we report an efficient method for enantioselective construction of bridged [2,2,1] bicyclic lactones bearing a quaternary stereocenter via Rh-catalyzed asymmetric hydroformylation/intramolecular cyclization/pyridium chlorochromate (PCC) oxidation. By employing a hybrid phosphine-phosphite chiral ligand, a series of cyclopent-3-en-1-ols are transformed into corresponding γ-hydroxyl aldehydes with specific syn-selectivity. Then, hemiacetals form in situ and oxidation with PCC in one-pot affords bridged [2,2,1] bicyclic lactones in high yields and excellent enantiomeric excess. Replacing the hydroxyl group by an ester group, cyclopentanecarbaldehydes with a chiral all-carbon quaternary stereocenter in the γ-position can be generated efficiently.
Topics: Aldehydes; Bridged Bicyclo Compounds, Heterocyclic; Cyclization; Cyclopentanes; Formates; Humans; Lactones; Oxidation-Reduction; Phenazopyridine; Phosphines; Phosphites; Stereoisomerism; Water
PubMed: 34489434
DOI: 10.1038/s41467-021-25569-5 -
Brain : a Journal of Neurology Mar 2017Diverse neurodegenerative disorders are characterized by deposition of tau fibrils composed of conformers (i.e. strains) unique to each illness. The development of tau...
Diverse neurodegenerative disorders are characterized by deposition of tau fibrils composed of conformers (i.e. strains) unique to each illness. The development of tau imaging agents has enabled visualization of tau lesions in tauopathy patients, but the modes of their binding to different tau strains remain elusive. Here we compared binding of tau positron emission tomography ligands, PBB3 and AV-1451, by fluorescence, autoradiography and homogenate binding assays with homologous and heterologous blockades using tauopathy brain samples. Fluorescence microscopy demonstrated intense labelling of non-ghost and ghost tangles with PBB3 and AV-1451, while dystrophic neurites were more clearly detected by PBB3 in brains of Alzheimer's disease and diffuse neurofibrillary tangles with calcification, characterized by accumulation of all six tau isoforms. Correspondingly, partially distinct distributions of autoradiographic labelling of Alzheimer's disease slices with 11C-PBB3 and 18F-AV-1451 were noted. Neuronal and glial tau lesions comprised of 4-repeat isoforms in brains of progressive supranuclear palsy, corticobasal degeneration and familial tauopathy due to N279K tau mutation and 3-repeat isoforms in brains of Pick's disease and familial tauopathy due to G272V tau mutation were sensitively detected by PBB3 fluorescence in contrast to very weak AV-1451 signals. This was in line with moderate 11C-PBB3 versus faint 18F-AV-1451 autoradiographic labelling of these tissues. Radioligand binding to brain homogenates revealed multiple binding components with differential affinities for 11C-PBB3 and 18F-AV-1451, and higher availability of binding sites on progressive supranuclear palsy tau deposits for 11C-PBB3 than 18F-AV-1451. Our data indicate distinct selectivity of PBB3 compared to AV-1451 for diverse tau fibril strains. This highlights the more robust ability of PBB3 to capture wide-range tau pathologies.
Topics: Autoradiography; Benzothiazoles; Brain; Butadienes; Carbolines; Diagnosis; Female; Fluorescence; Humans; Male; Neurofibrillary Tangles; Phenazopyridine; Positron-Emission Tomography; Radioligand Assay; Radiopharmaceuticals; Tauopathies; Thiadiazoles; tau Proteins
PubMed: 28087578
DOI: 10.1093/brain/aww339 -
Journal of Family Medicine and Primary... Jun 2019We present here a case of severe dyspnea after a percutaneous nephrostolithotomy, which resulted from an urinothorax, an uncommon complication of posturological...
We present here a case of severe dyspnea after a percutaneous nephrostolithotomy, which resulted from an urinothorax, an uncommon complication of posturological procedures. Chest X-ray indicated a significant left pleural effusion, and a diagnosis was confirmed by the pleural fluid analysis. Chest tube placement did not improve the patient's clinical status; retrograde pyelogram was performed, and a stent was placed in the left ureter orifice where a narrowing was discovered. Correcting the cause of the urinothorax is the key in such cases of severe pleural effusions as seen in our case.
PubMed: 31334200
DOI: 10.4103/jfmpc.jfmpc_28_17 -
Pharmaceutical Research Nov 2019The intracellular fraction of unbound compound (f) is an important parameter for accurate prediction of drug binding to intracellular targets. f is the result of a...
PURPOSE
The intracellular fraction of unbound compound (f) is an important parameter for accurate prediction of drug binding to intracellular targets. f is the result of a passive distribution process of drug molecules partitioning into cellular structures. Initial observations in our laboratory showed an up to 10-fold difference in the f of a given drug for different cell types. We hypothesized that these differences could be explained by the phospholipid (PL) composition of the cells, since the PL cell membrane is the major sink of unspecific drug binding. Therefore, we determined the f of 19 drugs in cell types of different origin.
METHOD
The cells were characterized for their total PL content and we used mass spectrometric PL profiling to delineate the impact of each of the four major cellular PL subspecies: phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylserine (PS) and phosphatidylinositol (PI). The cell-based experiments were compared to cell-free experiments that used beads covered by PL bilayers consisting of the most abundant PL subspecies.
RESULTS
PC was found to give the largest contribution to the drug binding. Improved correlations between the cell-based and cell-free assays were obtained when affinities to all four major PL subspecies were considered. Together, our data indicate that f is influenced by PL composition of cells.
CONCLUSION
We conclude that cellular PL composition varies between cell types and that cell-specific mixtures of PLs can replace cellular assays for determination of f as a rapid, small-scale assay covering a broad dynamic range. Graphical Abstract.
Topics: Biological Availability; Biological Transport; Caffeine; Cell Line; Cell Membrane; Computer Simulation; Cytoplasm; Drug Interactions; Humans; Models, Biological; Phenazopyridine; Phospholipids
PubMed: 31701258
DOI: 10.1007/s11095-019-2717-1