Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 198
Filtrar
2.
Biomed Pharmacother ; 147: 112673, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35123231

RESUMO

Prasachandaeng (PSD) remedy from the Thailand National List of Essential Medicines (NLEM) has been used as an antipyretic for chronic fever in both adults and children for centuries. Its therapeutic effect in treating fever and its safety have not been studied in animal models. We evaluated its antipyretic activity on lipopolysaccharide (LPS)-induced fever and safety in the liver in comparison with acetaminophen (ACP). Correlation between biochemistry of liver function and the level of cytochrome P450 (CYP2E1) was also evaluated using an ELISA kit. All doses of PSD powder (PSDP) and a 95% ethanol extract of PSD (PSDE) (50, 200, and 400 mg/kg) showed a significant antipyretic effect (* p < 0.05) as compared to ACP. We investigated clinical biochemistry of liver and kidney functions, histopathology, and concentrations of CYP2E1. All treatment groups demonstrated a normal range of clinical biochemistry of liver and kidney functions in comparison with ACP on days 1, 3, 7, and 10. Serum AST, ALP, and LDH levels of PSDE and PSDP showed mean values less than that of ACP on the corresponding days (* p < 0.05). None of the treatment groups showed evidence of hepatocellular damage, nor did they affect CYPE21. The results of histopathology on liver tissue correlated with the biochemistry of liver functions which indicated no hepatotoxicity effect in liver tissue during the seven day treatment. These findings suggest that both forms of PSD remedy possessed marked antipyretic activity and were not hepatotoxic during the seven days of administration in rats.


Assuntos
Antipiréticos/farmacologia , Febre/tratamento farmacológico , Fitoterapia/métodos , Acetaminofen/farmacologia , Animais , Antipiréticos/administração & dosagem , Antipiréticos/efeitos adversos , Citocromo P-450 CYP2E1/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Febre/induzido quimicamente , Testes de Função Renal , Lipopolissacarídeos/farmacologia , Fígado/efeitos dos fármacos , Testes de Função Hepática , Masculino , Ratos , Ratos Sprague-Dawley , Tailândia
3.
J Ethnopharmacol ; 284: 114811, 2022 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763042

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Rhynchospora nervosa (Vahl) Boeckeler (Cyperaceae), popularly known as "capim-estrela", is a native species widely distributed in Brazil. The whole plant has been used in local traditional medicine in the form of teas or syrups to treat inflammation, flu, nasal congestion, fever, swelling, and venereal disease. This is the first study to investigate the pharmacological properties of this species. AIM OF THE STUDY: The present study aimed to evaluate the in vivo anti-inflammatory, antipyretic and antinociceptive potential of the lyophilized hydroalcoholic extract of R. nervosa in heterogenic Swiss mice. In addition to pharmacological studies, the total phenol and flavonoid contents of the extract were determined. MATERIAL AND METHODS: The anti-inflammatory effect was evaluated through carrageenan-induced paw edema and peritonitis models. For the antinociceptive assay, the number of acetic acid-induced writhing responses in the animals was counted. Antipyretic activity was tested by yeast-induced pyrexia in mice and evaluated for 4 h. Nitric oxide (NO) concentration and leukocyte migration in the peritoneal fluid were quantified. The acute toxicity of the extract was also calculated. Quantitative analyses of total phenols and flavonoids in the extract were performed by spectrophotometric methods. RESULTS: In short, the lyophilized hydroalcoholic extract of R. nervosa showed low acute toxicity in the preclinical tests (LD50 = 3807 mg/kg). A significant anti-inflammatory effect was observed, with an average reduction of carrageenan-induced paw edema of 96.37%. Comparatively, indomethacin inhibited the development of the carrageenin paw edema by 97.52%. In the peritonitis test, a significant reduction in NO levels was recorded. A reduction in the number of white cells, notably monocytes, was also observed, confirming the anti-inflammatory effect. Writhing was reduced by 86.53%, which indicates antinociceptive activity. As for antipyretic activity, no positive effects of the extract were observed. The lyophilized hydroalcoholic extract of R. nervosa presented a high content of phenolic compounds (322.47 µg GAE/mg) and total flavonoids (440.50 µg QE/mg). CONCLUSION: The lyophilized hydroalcoholic extract of R. nervosa showed significant in vivo anti-inflammatory and antinociceptive activity in mice. These preliminary findings support the indication of the use of this species in folk medicine in Brazil for the treatment of inflammation.


Assuntos
Analgésicos/farmacologia , Anti-Inflamatórios/farmacologia , Antipiréticos/farmacologia , Cyperaceae/química , Fitoterapia , Extratos Vegetais/farmacologia , Analgésicos/administração & dosagem , Animais , Anti-Inflamatórios/administração & dosagem , Antipiréticos/administração & dosagem , Carragenina/toxicidade , Relação Dose-Resposta a Droga , Edema/induzido quimicamente , Edema/tratamento farmacológico , Feminino , Masculino , Camundongos , Peritonite/induzido quimicamente , Peritonite/tratamento farmacológico , Componentes Aéreos da Planta , Extratos Vegetais/química , Extratos Vegetais/toxicidade , Ratos , Ratos Wistar
5.
Am J Emerg Med ; 50: 202-206, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34390903

RESUMO

AIM OF THE STUDY: Targeted temperature management is a class I indication in comatose patients after a cardiac arrest. While the literature has primarily focused on innovative methods to achieve target temperatures, pharmacologic therapy has received little attention. We sought to examine whether pharmacologic therapy using antipyretics is effective in maintaining normothermia in post cardiac arrest patients. MATERIALS AND METHODS: Patients ≥18 years who were resuscitated after an in-hospital or out-of-hospital cardiac arrest and admitted at our institution from January 2012 to September 2015 were retrospectively included. Patients were divided into groups based on the method of temperature control that was utilized. The primary outcome was temperature control <38 °C during the first 48 h after the cardiac arrest. RESULTS: 671 patients were identified in Group 1 (no hypothermia), 647 in Group 2 (antipyretics), 44 in Group 3 (invasive hypothermia), and 51 in Group 4 (invasive hypothermia and antipyretics). Mean patient age was 59 (SD ±15.7) years with 40.6% being female. Using Group 1 as the control arm, 57.7% of patients maintained target temperature with antipyretics alone (p < 0.001), compared to 69.3% in the control group and 82.1% in the combined hypothermia groups 3&4 (p = 0.01). Patients receiving both invasive hypothermia and antipyretics (Group 4), had the greatest mean temperature decrease of 5.2 °C. CONCLUSIONS: Among patients undergoing targeted temperature management, relying solely on as needed use of antipyretics is not sufficient to maintain temperatures <38 °C. However, antipyretics could be used as an initial strategy if given regularly and/or in conjunction with more aggressive cooling techniques.


Assuntos
Antipiréticos/administração & dosagem , Hipotermia Induzida , Parada Cardíaca Extra-Hospitalar/terapia , Coma , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
J Ethnopharmacol ; 278: 114259, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34058314

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Many studies are performed with the aerial parts of Cannabis sativa L. (Cannabaceae). However, roots remain poorly studied, despite citations in the scientific literature. The C. sativa roots are indicated for the treatment of pain, inflammation, fever, among other health problems. AIM OF THE STUDY: This study aimed to evaluate the antinociceptive, antipyretic, antiasthmatic, and spasmolytic activities of C. sativa roots in experimental models using mice and rats. MATERIAL AND METHODS: The chemical composition of the aqueous extract of C. sativa roots (AECsR) was evaluated by LC-MS. The antinociceptive activity was assessed in mice by the induction of writhing with acetic acid, paw licking with formalin, and reactivity in the hot plate test. Fever was induced by the administration of a suspension of Saccharomyces cerevisiae in young rats. The asthmatic activity was performed with ovalbumin (OVA)-immunized mice with cellular and histological analysis. Finally, the spasmolytic activity was performed using mice isolated trachea. For in vivo studies, the doses were 12.5, 25, or 50 mg/kg whereas for in vitro, the concentration of AECsR was 729 µg/mL. RESULTS: From the LC-MS data, we identified p-coumaroyltyramine, feruloyltyramine canabissativine in AECsR. The extract promoted a reduction of writhing in all tested doses (12.5, 25, or 50 mg/kg). Similarly, it reduced the pain in the formalin test at doses of 12.5 and 50 mg/kg (first phase) and 12.5 and 25 mg/kg (second phase). In the hot plate test, the doses of 12.5, 25, and 50 mg/kg promoted antinociceptive effect at different times, and the lowest dose maintained its action in the analyzes performed at 60, 90, and 120 min after administration. The anti-inflammatory activity of AECsR was observed in the mouse model of asthma, reducing the total leukocyte count in the bronchoalveolar fluid (BALF) at a dose of 25 mg/kg, as well as reducing eosinophilia in all tested doses (12.5, 25, and 50 mg/kg). Histological analysis of lungs stained with H&E and PAS showed a reduction in the number of inflammatory cells in the perivascular and peribronchial region, as well as reduced mucus production. CONCLUSION: The results suggest that AECsR promotes pain control, either by a central or inflammatory mechanism, and has antiasthmatic activity. However, there was no antipyretic or spasmolytic effect.


Assuntos
Analgésicos/farmacologia , Antiasmáticos/farmacologia , Cannabis/química , Extratos Vegetais/farmacologia , Analgésicos/administração & dosagem , Analgésicos/isolamento & purificação , Animais , Antiasmáticos/administração & dosagem , Antiasmáticos/isolamento & purificação , Antipiréticos/administração & dosagem , Antipiréticos/isolamento & purificação , Antipiréticos/farmacologia , Brasil , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Febre/tratamento farmacológico , Inflamação/tratamento farmacológico , Masculino , Camundongos , Dor/tratamento farmacológico , Parassimpatolíticos/administração & dosagem , Parassimpatolíticos/isolamento & purificação , Parassimpatolíticos/farmacologia , Extratos Vegetais/administração & dosagem , Raízes de Plantas , Ratos , Ratos Wistar
8.
Am J Emerg Med ; 46: 102-106, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33740568

RESUMO

OBJECTIVE: Fever is one of the frequent reasons for admission to the emergency department. Studies comparing oral forms of non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol with intravenous (IV) forms for fever are common in the literature. Our study is the first emergency department study comparing IV forms of ibuprofen and paracetamol in the treatment of febrile patients. METHODS: A randomized, double-blind study was conducted in a tertiary university emergency department for a six-month period. Patients aged 18-65 years who had a fever of ≥38.0 °C were included. Patients were administered 400 mg of IV ibuprofen and 1000 mg of IV paracetamol. The primary aim of the study was to determine whether there was a difference in the effect of the two drugs on fever. The secondary aim was to investigate whether there was a difference in terms of numeric rating scale (NRS) measurements and the need for additional antipyretic therapy. RESULTS: A total of 200 people, 100 of whom were female, were included in the study. The mean age was 30.77 ± 10.61 years. The mean initial temperature for ibuprofen and paracetamol was 38.79 ± 0.470 °C and 38.70 ± 0.520 °C, respectively, with no difference noted between the groups (p = 0.380). It was found that both drugs significantly provided fever control in the first 30 min (p < 0.001), with no difference between them in terms of fever reduction (p = 0.980). Both drugs significantly improved in accompanying symptoms, although both drugs did not show superiority to each other (p = 0.0226). When evaluated in terms of a need for rescue medication, no significant difference was found between the two drugs (p = 0.404). No side effects were encountered during the study. CONCLUSION: In adult age group patients admitted to the emergency department with high fever, the IV forms of 1000 mg paracetamol and 400 mg ibuprofen effectively and equally reduce complaints, such as fever and accompanying pain. They can be effectively used as each other's rescue medicine and as an alternative to each other in patients with comorbid diseases.


Assuntos
Acetaminofen/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Antipiréticos/uso terapêutico , Febre/tratamento farmacológico , Ibuprofeno/uso terapêutico , Acetaminofen/administração & dosagem , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Antipiréticos/administração & dosagem , Método Duplo-Cego , Serviço Hospitalar de Emergência , Feminino , Humanos , Ibuprofeno/administração & dosagem , Infusões Intravenosas , Masculino
9.
Pan Afr Med J ; 36: 350, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33224416

RESUMO

INTRODUCTION: fever is the primary symptom of most childhood illnesses and a cause of concern to their caregivers. The antipyretics commonly used to treat fever are ibuprofen and paracetamol. Most studies on the effectiveness of ibuprofen and paracetamol in treating fever in under-fives were conducted in Europe and North America with very few in African children. This study was aimed at assessing the effectiveness and safety of a single dose therapy of ibuprofen versus paracetamol for treating childhood fever in Nigeria. METHODS: a randomized, controlled clinical trial was conducted in the University of Calabar Teaching Hospital, in Nigeria. A total of 140 eligible children aged 6-59 months with tympanic temperature of 38°C-40°C were enrolled, and 70 of them were assigned to one arm that received a single dose of ibuprofen (10mg/kg) and 70 had paracetamol (15mg/kg). After drug administration, the children were admitted and observed in the hospital for six hours during which period a half-hourly temperature measurement and monitoring for adverse events were done. RESULTS: the overall result showed that ibuprofen had a better fever reducing effect compared to paracetamol. The proportion of afebrile children in the ibuprofen versus paracetamol group at 1.5-2.5 hours of administration of the drugs was statistically significant (p = 0.04). The adverse events of both drugs were mild and quite comparable with vomiting being the commonest. CONCLUSION: ibuprofen is more effective in the treating fever in under-fives compared to paracetamol. The adverse events of both drugs were mild and comparable.


Assuntos
Acetaminofen/administração & dosagem , Antipiréticos/administração & dosagem , Febre/tratamento farmacológico , Ibuprofeno/administração & dosagem , Acetaminofen/efeitos adversos , Antipiréticos/efeitos adversos , Temperatura Corporal/efeitos dos fármacos , Pré-Escolar , Feminino , Hospitais de Ensino , Humanos , Ibuprofeno/efeitos adversos , Lactente , Masculino , Nigéria , Vômito/induzido quimicamente
10.
Cochrane Database Syst Rev ; 10: CD006811, 2020 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-33126293

RESUMO

BACKGROUND: Traumatic brain injury (TBI) is a major cause of death and disability, with an estimated 5.5 million people experiencing severe TBI worldwide every year. Observational clinical studies of people with TBI suggest an association between raised body temperature and unfavourable outcome, although this relationship is inconsistent. Additionally, preclinical models suggest that reducing temperature to 35 °C to 37.5 °C improves biochemical and histopathological outcomes compared to reducing temperature to a lower threshold of 33 °C to 35 °C. It is unknown whether reducing body temperature to 35 °C to 37.5 °C in people admitted to hospital with TBI is beneficial, has no effect, or causes harm. This is an update of a review last published in 2014. OBJECTIVES: To assess the effects of pharmacological interventions or physical interventions given with the intention of reducing body temperature to 35 °C to 37.5 °C in adults and children admitted to hospital after TBI. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, and PubMed on 28 November 2019. We searched clinical trials registers, grey literature and references lists of reviews, and we carried out forward citation searches of included studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) with participants of any age admitted to hospital following TBI. We included interventions that aimed to reduce body temperature to 35 °C to 37.5 °C: these included pharmacological interventions (such as paracetamol, or non-steroidal anti-inflammatory drugs), or physical interventions (such as surface cooling devices, bedside fans, or cooled intravenous fluids). Eligible comparators were placebo or usual care. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion, extracted data, and assessed risks of bias. We assessed the certainty of the evidence with GRADE. MAIN RESULTS: We included one RCT with 41 participants. This study recruited adult participants admitted to two intensive care units in Australia, and evaluated a pharmacological intervention. Researchers gave participants 1 g paracetamol or a placebo intravenously at four-hourly intervals for 72 hours. We could not be certain whether intravenous paracetamol influenced mortality at 28 days (risk ratio 2.86, 95% confidence interval 0.32 to 25.24). We judged the evidence for this outcome to be very low certainty, meaning we have very little confidence in this effect estimate, and the true result may be substantially different to this effect. We downgraded the certainty for imprecision (because the evidence was from a single study with very few participants), and study limitations (because we noted a high risk of selective reporting bias). This study was otherwise at low risk of bias. The included study did not report the primary outcome for this review, which was the number of people with a poor outcome at the end of follow-up (defined as death or dependency, as measured on a scale such as the Glasgow Outcome Score), or any of our secondary outcomes, which included the number of people with further intracranial haemorrhage, extracranial haemorrhage, abnormal intracranial pressure, or pneumonia or other serious infections. The only other completed trial that we found was of a physical intervention that compared advanced fever control (using a surface cooling device) versus conventional fever control in 12 participants. The trial was published as an abstract only, with insufficient details to allow inclusion, so we have added this to the 'studies awaiting classification' section, pending further information from the study authors or publication of the full study report. We identified four ongoing studies that will contribute evidence to future updates of the review if they measure relevant outcomes and, in studies with a mixed population, report data separately for participants with TBI. AUTHORS' CONCLUSIONS: One small study contributed very low-certainty evidence for mortality to this review. The uncertainty is largely driven by limited research into reduction of body temperature to 35 °C to 37.5 °C in people with TBI. Further research that evaluates pharmacological or physical interventions, or both, may increase certainty in this field. We propose that future updates of the review, and ongoing and future research in this field, incorporate outcomes that are important to the people receiving the interventions, including side effects of any pharmacological agent (e.g. nausea or vomiting), and discomfort caused by physical therapies.


Assuntos
Acetaminofen/administração & dosagem , Antipiréticos/administração & dosagem , Temperatura Corporal , Lesões Encefálicas Traumáticas/terapia , Hipotermia Induzida/métodos , Adulto , Viés , Temperatura Corporal/efeitos dos fármacos , Lesões Encefálicas Traumáticas/mortalidade , Humanos , Hipotermia Induzida/mortalidade , Injeções Intravenosas , Placebos
12.
J Ethnopharmacol ; 258: 112909, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32360802

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Bencha-loga-wichian (BLW), a Thai traditional antipyretic formulation, has been reported to have promising antiplasmodial activity, and it was previously revealed that tiliacorinine and yanangcorinine, isolated from Tiliacora triandra, were the active compounds. However, the mechanisms of action of BLW have not been investigated. In addition, these active compounds are bisbenzylisoquinoline alkaloids, many compounds of which have been reported to potentiate the efficacy of chloroquine. AIMS OF THE STUDY: To investigate the antiplasmodial mechanisms of action of BLW and evaluate the effects of chloroquine combined with tiliacorinine or yanangcorinine. MATERIALS AND METHODS: Chloroquine-resistant Plasmodium falciparum (PfW2) strains at the ring, trophozoite, and schizont stages were exposed to the extracts or compounds for 2, 4, 6, 8, 10, 12, 24 or 48 h. The percentages of parasitemia were determined by flow cytometry, and their morphologies were examined by Giemsa-stained smear to evaluate the speed of action and stage specificity. For the drug combination assay, a modified fixed-ratio isobologram method was used. RESULTS: The antiplasmodial activity of BLW possessed a slow onset of action and was the most effective against ring-stage parasites. After 48 h of extracts or compounds exposure, most of the treated parasites, at all stages, turned to the pyknotic form and could not recover even after extracts or compounds removal. The results suggested that these extracts and compounds could kill the parasites or possess parasiticidal effects. In addition, the combination of chloroquine with tiliacorinine or yanangcorinine demonstrated a synergistic effect, indicating that these compounds could potentiate chloroquine efficacy against chloroquine-resistant parasites. CONCLUSION: The antiplasmodial mechanisms of action of BLW appeared to differ from that of chloroquine and other current antimalarial drugs. In addition, tiliacorinine and yanangcorinine, the active compounds of BLW, could potentiate the efficacy of chloroquine. Accordingly, BLW was shown to be a good candidate for development as a new antimalarial and useful for drug combination therapy.


Assuntos
Antimaláricos/farmacologia , Benzilisoquinolinas/farmacologia , Extratos Vegetais/farmacologia , Antimaláricos/administração & dosagem , Antimaláricos/isolamento & purificação , Antipiréticos/administração & dosagem , Antipiréticos/farmacologia , Benzilisoquinolinas/administração & dosagem , Benzilisoquinolinas/isolamento & purificação , Cloroquina/administração & dosagem , Cloroquina/farmacologia , Resistência a Medicamentos , Sinergismo Farmacológico , Quimioterapia Combinada , Medicina Tradicional do Leste Asiático , Parasitemia/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Plasmodium falciparum/efeitos dos fármacos , Tailândia , Fatores de Tempo
14.
BMC Anesthesiol ; 20(1): 89, 2020 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-32312228

RESUMO

BACKGROUND: Rocuronium-associated injection pain/withdrawal response (RAIPWR) was non-ideal but occurred frequently when injection intravenously during anesthesia induction. Many studies had reported that pretreating with antipyretic analgesics (AAs) could reduce the occurrence of RAIPWR, but there was no consensus yet. Therefore, this meta-analysis was designed to systematically evaluate the benefits of AAs on RAIPWR in patients. METHODS: PubMed, Cochrane Library, Ovid, EMbase, Chinese National Knowledge Infrastructure (CNKI), Wan Fang Data were searched by January 1st 2019 for randomized controlled trials (RCTs) applying AAs to alleviate RAIPWR in patients who underwent elective surgery under general anesthesia. Two investigators assessed quality of RCTs and extracted data respectively and the meta-analysis was carried on Revman 5.3 software. Moreover, we compared AAs in pros and cons directly with lidocaine, the most reported medicine to prevent RAIPWR. RESULTS: Data were analyzed from 9 RCTs totaling 819 patients. The results of Meta-analysis showed that compared to the control group, pretreating with AAs could prevent the total occurrence of RAIPWR [Risk ratio (RR), 0.52; 95% confidence interval (CI), 0.42 to 0.66; P < 0.0001], and took effect on moderate (RR, 0.56; 95%CI, 0.43 to 0.73; P < 0.0001) and severe RAIPWR (RR = 0.14; 95%CI, 0.08 to 0.24; P < 0.00001). When compared to lidocaine, the preventive effect was not so excellent as the latter but injection pain induced by prophylactic occurred less. CONCLUSION: The currently available evidence suggested that pretreating with AAs intravenously could alleviate RAIPWR. TRIAL REGISTRATION: PROSPERO CRD42019129776.


Assuntos
Analgésicos/administração & dosagem , Dor/prevenção & controle , Rocurônio/efeitos adversos , Administração Intravenosa , Analgésicos/farmacologia , Anestésicos Locais/administração & dosagem , Anestésicos Locais/farmacologia , Antipiréticos/administração & dosagem , Antipiréticos/farmacologia , Humanos , Lidocaína/administração & dosagem , Lidocaína/farmacologia , Fármacos Neuromusculares não Despolarizantes/administração & dosagem , Fármacos Neuromusculares não Despolarizantes/efeitos adversos , Dor/induzido quimicamente , Ensaios Clínicos Controlados Aleatórios como Assunto , Rocurônio/administração & dosagem
16.
Biomed Pharmacother ; 124: 109826, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31978766

RESUMO

BACKGROUND: Bai-Hu-Tang (BHT), a Chinese herbal decoction used as an antipyretic agent, results from the combination of Anemarrhena asphodeloides Bunge, Glycyrrhizae, Japonica rice, and Gypsum. In our previous study, we identified nanoaggregates in BHT. However, the present study aimed to analyze and elucidate the mechanism of nanoaggregate formation and to investigate its antipyretic effect. METHODS: A BHT decoction extract was split into 15 groups, and in each group, the extract was further separated into two solutions: Nano-phase and Decoction. The physicochemical properties of these solutions, such as particle size, salinity, conductivity, and surface tension were investigated, and analyzed the 15 groups of by transmission electron microscopy (TEM) and fingerprint chromatography. Furthermore, the antipyretic effect of nanoaggregates was evaluated through enzyme-linked immunosorbent assays, HE staining, Western Blot, and Real-time PCR. RESULTS: In the 15 groups, the salinity and conductivity results showed a promoting and stabilizing effect towards the Nano-phase formation. Analysis of the surface tension indicated good solubilization of Radix Glycyrrhizae. The TEM analysis of the BHT separated extracts revealed that only in the presence of Japonica rice the Nano-phase is formed. Sixteen common peaks were identified in the BHT fingerprint chromatogram, and the main chemical components were Neomangiferin, Mangiferin, Liquiritin, and Ammonium glycyrrhizinate. Furthermore, BHT and nanoaggregates from Bai-Hu-Tang (N-BHT) groups did not differ in the main chemical components. Additionally, the N-BHT group had the same antipyretic effect compared with the BHT group. However, the pathological analysis indicated that treatment with N-BHT could ameliorate the lung damage in the rat. At the same time, N-BHT group inhibited expression of several proteins, specifically IL-1ß, TRPV4, NF-κB, and TNF-α, which agreed with the Real-time PCR results. CONCLUSION: We identified the key factors that are involved in the nano-phase formation. Also, by Western blot and Real-time PCR methods, we investigated the N-BHT mechanism of antipyretic action. The discovery of the N-BHT formation would provide a new idea of studying traditional Chinese medicine decoction.


Assuntos
Antipiréticos/administração & dosagem , Medicamentos de Ervas Chinesas/administração & dosagem , Febre/tratamento farmacológico , Nanopartículas , Animais , Antipiréticos/farmacologia , Western Blotting , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/farmacologia , Pulmão/efeitos dos fármacos , Pulmão/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase em Tempo Real
18.
Ther Hypothermia Temp Manag ; 10(1): 27-36, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30835164

RESUMO

Intravenous nonsteroidal anti-inflammatory drugs and nonopioid analgesics are used to achieve normothermia or relieve pain in patients with aneurysmal subarachnoid hemorrhage (aSAH). We investigated the effects of paracetamol (1 g), diclofenac (75 mg) and metamizole (1 g) on systemic and cerebral hemodynamics and temperature during febrile and nonfebrile episodes after aSAH. Prospectively collected data from 77 consecutive poor-grade aSAH patients with invasive neuromonitoring were included. The burden and occurrence of hypotension (mean arterial pressure <70 mmHg), brain tissue hypoxia (PbtO2 < 20 mmHg), high intracranial pressure (>22 mmHg), low cerebral perfusion pressure (CPP <70 mmHg), and cerebral autoregulation pressure (pressure reactivity index [PRx]) during baseline (1 hour before) and 6 hours after medication were analyzed in febrile (core temperature; Tcore ≥ 38.3°C) and nonfebrile episodes. Nine hundred eighty-nine infusions (278 paracetamol, 542 diclofenac, and 169 metamizole) were administered resulting in significant reduction of core and brain temperature during febrile (49%) and nonfebrile (51%) episodes (p < 0.001). In febrile cases, temperature decreased for >1 hour below 37.5°C in 36% of interventions and ≤37°C in 11%. Hemodynamic side effects with hypotension and low CPP occurred in both febrile and nonfebrile episodes (p < 0.001) prompting increased vasopressor support in 31% of cases, even more pronounced during the vasospasm period (4-12 days postictus) (OR 5.4, 95% CI 1.8-16). The magnitude of PbtO2-decrease is directly correlated with the decrease in Tcore (p = 0.002) and higher baseline PbtO2 (p < 0.001). PRx decreased in febrile and nonfebrile episodes (p < 0.001), indicating improvement of cerebrovascular autoregulation. Antipyretics were insufficient to achieve sustained normothermia in poor-grade aSAH patients. Hemodynamic side effects were common even when given as analgesic drugs. Further studies are needed to weigh hemodynamic side effects to benefits (inter alia improved cerebral autoregulation).


Assuntos
Analgésicos não Narcóticos/administração & dosagem , Antipiréticos/administração & dosagem , Temperatura Corporal/fisiologia , Circulação Cerebrovascular/efeitos dos fármacos , Hipotermia Induzida/métodos , Pressão Intracraniana/fisiologia , Hemorragia Subaracnóidea/tratamento farmacológico , Idoso , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Injeções Intravenosas , Pressão Intracraniana/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Hemorragia Subaracnóidea/fisiopatologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-31739494

RESUMO

Although national and international guidelines on the management of childhood and adolescent fever are available, some inadequate practices persist, both from parents and healthcare professionals. The main goal of bringing children's temperature back to normal can lead to the choice of inappropriate drugs or non-necessary combination/alternation of antipyretic treatments. This behavior has been described in the last 35 years with the concept of fever-phobia, caused also by the dissemination of unscientific information and social media. It is therefore increasingly important that pediatricians continue to provide adequate information to parents in order to assess the onset of signs of a possible condition of the child's discomfort rather than focusing only on temperature. In fact, there is no clear and unambiguous definition of discomfort in literature. Clarifying the extent of the feverish child's discomfort and the tools that could be used to evaluate it would therefore help recommend that antipyretic treatment is appropriate only if fever is associated with discomfort.


Assuntos
Antipiréticos/administração & dosagem , Febre/tratamento farmacológico , Avaliação de Sintomas , Adolescente , Criança , Humanos , Pais , Pediatras , Guias de Prática Clínica como Assunto
20.
J Anim Sci ; 97(12): 4783-4791, 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31679022

RESUMO

In rodents, an acute-phase protein, α-1-acid-glycoprotein (AGP), was shown to provide a link between inflammation and suppression of feed intake by acting as a leptin receptor agonist. The objective of this study was to determine the effects of AGP on feed intake and rectal temperature in sheep. Ewes were ovariectomized, implanted with a cannula into a lateral ventricle of the brain, and kept indoors in individual pens. Feed intake and rectal temperature were determined for sheep in all experiments. In the first experiment, ewes (n = 4) received 1 of 4 treatments [0 (control), 0.012 (low), 0.06 (medium), or 0.30 (high) mg/kg BW AGP] into the lateral ventricle (ICV). All sheep received all treatments in a Latin square design balanced for carryover effects with 10 d between treatments. In the second experiment, ewes (n = 10) received 1 of 2 treatments (0 and 3 mg/kg BW of AGP) intravenously (IV) in a completely randomized design. In the third experiment, ewes (n = 19) received peripheral treatments (IV) of an antipyretic [0 (control) or 2.2 mg/kg BW flunixin meglumine (FLU)] 30 min before receiving central AGP [0 (control) or 0.3 mg/kg BW of AGP] in a completely randomized design. All data were analyzed using a mixed model analysis of variance and tested for effects of treatment, time, and the interaction of treatment and time. Cumulative 48-h feed intake after administration of treatments was also determined. In the first experiment, there was no effect of ICV treatment (P = 0.37) on feed intake rate or on cumulative feed intake (P = 0.31). There was an effect of ICV treatment (P = 0.002) on rectal temperatures, which were greater (P < 0.05) after the high dose of centrally administered AGP. In the second experiment, there was no effect of AGP administration IV on feed intake rate (P = 0.98), on cumulative feed intake (P = 0.41) or on rectal temperature (P = 0.71). In the third experiment, there was an effect of central AGP treatment (P < 0.0001) and an interaction of central AGP and time (P < 0.0001) on rectal temperature, whereas FLU had no effect (P = 0.93), demonstrating that AGP increased rectal temperatures regardless of antipyretic treatment. These results indicate that central AGP increases rectal temperature in sheep by pathways that do not involve prostaglandins. Further research is needed to determine whether AGP may be an important integrator of energy balance and inflammation.


Assuntos
Temperatura Corporal/efeitos dos fármacos , Comportamento Alimentar/efeitos dos fármacos , Orosomucoide/farmacologia , Ovinos/fisiologia , Animais , Antipiréticos/administração & dosagem , Antipiréticos/farmacologia , Clonixina/administração & dosagem , Clonixina/análogos & derivados , Clonixina/farmacologia , Feminino , Injeções Intravenosas , Injeções Intraventriculares/veterinária , Orosomucoide/administração & dosagem , Ovariectomia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...