RESUMO
Indications for aspirin during pregnancy are a matter of debate and there is a recent trend to an extended prescription and an overuse of aspirin in pregnancy. Aspirin is efficient in secondary prevention of preeclampsia essentially in patients with a personal history of preeclampsia. The effect of aspirin on platelet aggregation and on the TXA2/PGI2 balance is dose-dependent. The optimum dosage, from 75mg/day to 150mg/day, needs to be determined. Fetal safety data at 150mg/day are still limited. The efficacy of aspirin seems to be subject to a chronobiological effect. It is recommended to prescribe an evening or bedtime intake. Aspirin, in primary prevention of preeclampsia, given to high-risk patients identified in the first trimester by screening tests, seems to reduce the occurrence of early-onset preeclampsia. Nevertheless, there are insufficient data for the implementation of such screening procedures in practice.
Assuntos
Aspirina/uso terapêutico , Inibidores da Agregação Plaquetária/uso terapêutico , Pré-Eclâmpsia/prevenção & controle , Aspirina/administração & dosagem , Aspirina/efeitos adversos , Aspirina/farmacocinética , Fenômenos Cronobiológicos , Contraindicações de Medicamentos , Inibidores de Ciclo-Oxigenase/administração & dosagem , Inibidores de Ciclo-Oxigenase/efeitos adversos , Inibidores de Ciclo-Oxigenase/farmacocinética , Inibidores de Ciclo-Oxigenase/uso terapêutico , Uso de Medicamentos , Diagnóstico Precoce , Feminino , Doenças Fetais/induzido quimicamente , França/epidemiologia , Humanos , Programas de Rastreamento , Metanálise como Assunto , Placenta/metabolismo , Inibidores da Agregação Plaquetária/administração & dosagem , Inibidores da Agregação Plaquetária/efeitos adversos , Inibidores da Agregação Plaquetária/farmacocinética , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/epidemiologia , Gravidez , Complicações na Gravidez/induzido quimicamente , Primeiro Trimestre da Gravidez , Prevenção Primária , Antagonistas de Prostaglandina/administração & dosagem , Antagonistas de Prostaglandina/efeitos adversos , Antagonistas de Prostaglandina/farmacocinética , Antagonistas de Prostaglandina/uso terapêutico , Fatores de Risco , Prevenção SecundáriaRESUMO
Starting from acylsufonamide HTS hit 2, a novel series of para-N-acylaminomethylbenzoic acids was identified and developed as selective prostaglandin EP4 receptor antagonists. Structural modifications on lead compound 4a were explored with the aim of improving potency, physicochemical properties, and animal PK predictive of QD (once a day) dosing regimen in human. These efforts led to the discovery of the clinical candidate AAT-008 (4j), which exhibited significantly improved pharmacological profiles over grapiprant (1).
Assuntos
Benzoatos/farmacologia , Niacinamida/análogos & derivados , Antagonistas de Prostaglandina/farmacologia , Receptores de Prostaglandina E Subtipo EP4/antagonistas & inibidores , Animais , Benzoatos/química , Benzoatos/farmacocinética , Descoberta de Drogas , Humanos , Niacinamida/química , Niacinamida/farmacocinética , Niacinamida/farmacologia , Antagonistas de Prostaglandina/química , Antagonistas de Prostaglandina/farmacocinética , Relação Estrutura-AtividadeRESUMO
OBJECTIVES: To emphasize the safety and efficacy of theophylline in chronic inflammatory respiratory diseases. To mention its immunomodulatory effects. DATA SOURCES: PubMed search using the keywords: theophylline, histone deacetylase, antiinflammatory, asthma, chronic obstructive pulmonary disease (COPD), corticoresistance. RESULTS: Theophylline is a methylxantine, that inhibits phosphodiesterase (PDE), induces histone deacetylase and antagonizes adenosine. Its main effect is to relax airway smooth muscle. The immunomodulatory effects of theophylline are obtained at low plasma concentrations (less than 10 mg/L). The combination of inhaled corticoesteroids and theophylline exerts a synergistic antiinflammatory effect that improves asthma control and reduces COPD exacerbations. Histones are a group of transcriptional cofactors involved in chromatin remodeling. Histone deacetylases (HDACs) suppress inflammatory gene expression. In patients with COPD and severe asthma there is a reduction in HDAC-2 secondary to the increased oxidative and nitrative stress. HDAC-2 is required by corticosteroids to switch off activated inflammatory genes, then its reduction favors corticosteroid resistance. Theophylline via HDAC-2 induction and PDE inhibition, suppresses inflammatory gene expression, and inhibits free oxygen radicals production. CONCLUSIONS: Theophylline at low plasma concentrations exerts antiinflammatory effects, restoring corticosteroid sensitivity in COPD and severe asthma.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Teofilina/uso terapêutico , Corticosteroides/farmacocinética , Corticosteroides/uso terapêutico , Anti-Inflamatórios não Esteroides/efeitos adversos , Anti-Inflamatórios não Esteroides/farmacocinética , Anticoagulantes/efeitos adversos , Anticoagulantes/farmacocinética , Anticoagulantes/uso terapêutico , Apoptose/efeitos dos fármacos , Broncodilatadores/efeitos adversos , Broncodilatadores/farmacocinética , Broncodilatadores/uso terapêutico , Sinalização do Cálcio/efeitos dos fármacos , Doenças Cardiovasculares/induzido quimicamente , Interações Medicamentosas , Indução Enzimática/efeitos dos fármacos , Feminino , Previsões , Gastroenteropatias/induzido quimicamente , Histona Desacetilases/fisiologia , Humanos , Masculino , Músculos/efeitos dos fármacos , Inibidores de Fosfodiesterase/efeitos adversos , Inibidores de Fosfodiesterase/farmacocinética , Inibidores de Fosfodiesterase/uso terapêutico , Gravidez , Complicações na Gravidez/tratamento farmacológico , Antagonistas de Prostaglandina/efeitos adversos , Antagonistas de Prostaglandina/farmacocinética , Antagonistas de Prostaglandina/uso terapêutico , Antagonistas de Receptores Purinérgicos P1/efeitos adversos , Antagonistas de Receptores Purinérgicos P1/farmacocinética , Antagonistas de Receptores Purinérgicos P1/uso terapêutico , Transtornos Respiratórios/tratamento farmacológico , Transtornos Respiratórios/enzimologia , Transtornos Respiratórios/imunologia , Transtornos Respiratórios/fisiopatologia , Teofilina/efeitos adversos , Teofilina/farmacocinética , Transcrição Gênica/efeitos dos fármacosRESUMO
We examined the pharmacokinetic interactions of enrofloxacin and flunixin in male ICR mice that were subcutaneously (SC) administered with both or either one of the drugs. The experiments were performed on the following three groups: flunixin alone (2 mg/kg, SC), combination of flunixin (2 mg/kg, SC) and enrofloxacin (10 mg/kg, SC), and enrofloxacin alone (10 mg/kg, SC). Blood samples were collected at 5, 15 and 30 min, and 1, 2, 3, 4, 5 and 6 h after the drug administration, and the pharmacokinetic parameters of flunixin and enrofloxacin were evaluated from the plasma drug concentrations. Significant changes were detected in the pharmacokinetics of flunixin following its coadministration with enrofloxacin. Coadministration of flunixin and enrofloxacin resulted in a 41% increase of the area under the curve (AUC) and a 53% extension of the terminal half-life of flunixin; moreover, flunixin attained the maximum plasma drug concentration 2.75 times faster than when administered alone. The terminal rate constant and the maximum plasma drug concentration showed significant decreases of 34% and 33%, respectively, following the coadministration of enrofloxacin and flunixin as compared to those following the administration of flunixin alone. In contrast, no significant difference in the pharmacokinetics of enrofloxacin was detected following its coadministration with flunixin, as compared to those following the administration of enrofloxacin alone. Following the administration of enrofloxacin alone or its coadministration with flunixin, the plasma level of ciprofloxacin, the metabolite of enrofloxacin, was very low or undetectable. In conclusion, the pharmacokinetics of flunixin in ICR mice are altered by the coadministration of flunixin and enrofloxacin.
Assuntos
Anti-Inflamatórios não Esteroides/farmacocinética , Antineoplásicos/farmacocinética , Clonixina/análogos & derivados , Fluoroquinolonas/farmacocinética , Antagonistas de Prostaglandina/farmacocinética , Animais , Anti-Inflamatórios não Esteroides/sangue , Antineoplásicos/sangue , Área Sob a Curva , Clonixina/sangue , Clonixina/farmacocinética , Interações Medicamentosas , Quimioterapia Combinada , Enrofloxacina , Fluoroquinolonas/sangue , Meia-Vida , Injeções Subcutâneas , Masculino , Camundongos , Camundongos Endogâmicos ICR , Antagonistas de Prostaglandina/sangue , RatosRESUMO
Tolfenamic acid (TA) was tested in two studies to investigate its value in controlling ocular inflammation in the dog. First, TA was assayed within primary and secondary aqueous humour (AH) and in plasma 0, 4 and 24 hours after a 4 mg/kg subcutaneous injection. Secondly, an experimental ocular surgery model was set up in 10 dogs-five receiving TA two hours before surgery and five left untreated. TA was shown to diffuse into AH, reaching lower levels than in plasma: 1:126 ratio in primary AH and 1:43 in secondary AH. In the model, TA-treated dogs versus untreated dogs showed a significant reduction of miosis (P < 0.05) and a clear trend to a reduced ocular discharge and corneal oedema (P = 0.06). Prostaglandin E2 (PGE2) levels increased significantly less in AH after TA treatment (P < 0.05). These results show that TA, even if the whole concentration measured in AH is lower than in plasma, is able to limit the synthesis of the inflammatory mediator PGE2 in AH and to control ocular inflammatory symptoms induced by corneal surgery.