RESUMO
BACKGROUND: The inhibition of gastric acid secretion with ranitidine is frequently prescribed off-label to newborns admitted to neonatal intensive care units (NICU). Some studies show that the use of inhibitors of gastric acid secretion (IGAS) may predispose to infections and necrotising enterocolitis (NEC), but there are few data to confirm this association. This study aimed to compare the rates of neonatal infections and NEC among preterm infants (<37 weeks gestation) hospitalised in a NICU exposed or not to treatment with ranitidine. METHODS: A retrospective cohort study was conducted with all consecutive preterm newborns admitted to a NICU between August-2014 and October-2015. The rates of infection, NEC, and death of newborns exposed or not to ranitidine were recorded. RESULTS: A total of 300 newborns were enrolled, of which 115 had received ranitidine and 185 had not. The two groups were similar with regard to the main demographic and clinical characteristics. Forty-eight (41.7%) of the 115 infants exposed to ranitidine and 49 (26.5%) of the 185 infants not exposed were infected (RR = 1.6, 95%CI 1.1-2.2, p = 0.006). The late onset (>48 h) blood culture positive infection rate was higher in the group exposed to ranitidine than in the untreated group (13.0% vs. 3.8%, p = 0.001). There was no significant association between the use of ranitidine and NEC (Bell stage >II) (p = 0.36). The mortality rate risk was 4-fold higher in infants receiving ranitidine (16.5% vs. 8.6%, p < 0.001). CONCLUSION: Ranitidine use in neonates was associated with an increased risk of infections and mortality, but not with NEC.
Assuntos
Infecção Hospitalar/epidemiologia , Enterocolite Necrosante/epidemiologia , Ranitidina/efeitos adversos , Adulto , Brasil/epidemiologia , Estudos de Coortes , Infecção Hospitalar/induzido quimicamente , Infecção Hospitalar/etiologia , Enterocolite Necrosante/induzido quimicamente , Enterocolite Necrosante/etiologia , Feminino , Idade Gestacional , Mortalidade Hospitalar , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Ranitidina/administração & dosagem , Ranitidina/uso terapêutico , Estudos RetrospectivosRESUMO
Ranitidine is a drug, which seldom causes adverse reactions, nevertheless, allergic reactions have been described varying in type and intensity after its administration. In contrast to other drugs, there are not many validated and standardized diagnostic tests in order to demonstrate this drug produces an allergic reaction. In this article we present a 9-months-old girl with a ranitidine allergic reaction with the diagnosis established by a non-intentional challenge test. We also provide information from the National Drug Surveillance Center in Mexico concerning ranitidine adverse drug reactions (including allergic reactions) in a 10-year period.
Assuntos
Hipersensibilidade a Drogas/etiologia , Antagonistas dos Receptores H2 da Histamina/efeitos adversos , Ranitidina/efeitos adversos , Feminino , Humanos , LactenteRESUMO
The hippocampus, basolateral amygdala and ventromedial prefrontal cortex participate in the extinction of inhibitory avoidance and contextual fear conditioning. We studied the effect of drugs acting on receptors involved in synaptic modulation on extinction of both tasks. The drugs were given bilaterally right after the first of two sessions of extinction in each task through cannulae implanted into the mentioned areas. The doses used are known to influence memory consolidation of the original tasks. Their effects were evaluated on a second extinction session 24h later, and assumed to result from influences on the consolidation of extinction. The glutamate NMDA receptor stimulant d-serine (50 µg/side) and the histamine methyl-transferase inhibitor SKF9188 (12.5 µg/side) enhanced, and the NMDA antagonist amino-phosphonopentanoate (5 µg/side) and the H2 histamine receptor antagonist ranitidine (17.5 µg/side) inhibited, extinction of both tasks regardless of the region into which they were administered. Thus, glutamate NMDA receptors are involved in the consolidation of extinction of both tasks, and histamine H2 receptors modulate that process in all areas studied. Norepinephrine (1 µg/side), the ß-adrenoceptor antagonist timolol (1 µg/side), the D1 dopamine receptor agonist SKF38393 (12.5 µg/side) and the D1 antagonist SCH23390 (1.5 µg/side) also affected extinction of both tasks, but their effects varied with the task and with the site of infusion, suggesting that extinction modulation by ß- and D1 receptors is more complex. In conclusion, extinction of two different aversive tasks is modulatable by various systems, which bears upon the behavioral and pharmacological treatment of fear-motivated brain disorders.
Assuntos
Tonsila do Cerebelo/efeitos dos fármacos , Extinção Psicológica/efeitos dos fármacos , Medo/psicologia , Hipocampo/efeitos dos fármacos , Motivação/efeitos dos fármacos , Córtex Pré-Frontal/efeitos dos fármacos , 2,3,4,5-Tetra-Hidro-7,8-Di-Hidroxi-1-Fenil-1H-3-Benzazepina/administração & dosagem , 2,3,4,5-Tetra-Hidro-7,8-Di-Hidroxi-1-Fenil-1H-3-Benzazepina/farmacologia , 2-Amino-5-fosfonovalerato/administração & dosagem , 2-Amino-5-fosfonovalerato/farmacologia , Antagonistas Adrenérgicos beta/farmacologia , Animais , Aprendizagem da Esquiva/efeitos dos fármacos , Benzazepinas/administração & dosagem , Benzazepinas/farmacologia , Região CA1 Hipocampal/fisiologia , Cateterismo , Antagonistas de Dopamina/administração & dosagem , Antagonistas de Dopamina/farmacologia , Antagonistas de Aminoácidos Excitatórios/administração & dosagem , Antagonistas de Aminoácidos Excitatórios/farmacologia , Medo/efeitos dos fármacos , Antagonistas dos Receptores H2 da Histamina/administração & dosagem , Antagonistas dos Receptores H2 da Histamina/farmacologia , Masculino , Microinjeções , Ranitidina/efeitos adversos , Ranitidina/farmacologia , Ratos , Ratos Wistar , Timolol/farmacologiaRESUMO
¿Cuál es el efecto de la ranitidina en el colesterol total promedio de Rattus var. albinus hembras? Objetivo: Determinar el efecto de la ranitidina en el colesterol total promedio en Rattus rattus var. albinus hembras. Materiales y Métodos: Se realizó un estudio experimental prospectivo y de doble ciego. Se utilizó 60 rattus rattus albinus hembras divididos en grupo control y experimental. El colesterol total se determinó mediante la prueba enzimática de colesterol éster hidrolasa y colesterol oxidasa. El colesterol total se determinó mediante la prueba enzimática de colesterol éster hidrolasa y colesterol oxilasa. Para el análisis estadístico se utilizó mediante de tendencia central y prueba t-student para medidas pareadas con una confianza de 95 por ciento. Resultados: Se encontró que el colesterol total promedio basal en el grupo control fue de 74,3+16,9 mg/dl y que luego de 21 días fue de 65,4+21,4 mg7dl (p>0.05), mientras que en el grupo experimental de colesterol total promedio basal fue de de 50,9+18,2 mg/dl y luego de 21 días de administración de ranitidina fue de 111.9+48,4 mg/dl (p<0.001). Conclusiones: El valor de colesterol total promedio en Rattus rattus vas. albinus hembras aumenta tras la administración de ranitidina.
What is the defect of ranitidine om the total cholesterol of frenale Rattus var, albinus?. Objective: To determine the effect of ranitidine in the average total cholesterol in Rattus rattus var. albinus females. Materials and Methods: We performed a prospective pilot study and double blind. Rattus rattus was used albinus 60 females divided into control and experimental group. Total cholesterol was determined by an enzymatic test cholesterol ester hydrolase and cholesterol oxidase. Total cholesterol was determined by an enzymatic test cholesterol and cholesterol ester hydrolase oxilasa. The statistical analysis was used by central tendency and t-student test for paired measures with a confidence of 95 percent. Results: We found that the mean baseline total cholesterol in the control group was 74.3 +16.9 mg / dl and after 21 days was 65.4 +21.4 mg7dl (p> 0.05), while in the experimental group mean total cholesterol from baseline was 50.9 +18.2 mg / dl and 21 days after administration of ranitidine was 111.9 +48.4 mg / dl (p <0.001). Conclusions: The average total cholesterol value in Rattus rattus you. albinus females increases after administration of ranitidine.
Assuntos
Animais , Ratos , Colesterol , Ranitidina , Ranitidina/efeitos adversos , Ranitidina/farmacologia , Estudos ProspectivosRESUMO
Patients with reflux esophagitis (grade II or III, Savary-Miller, intention-to-treat, n=256, age range 19-82 years) were randomly assigned to a double-blind, double-dummy treatment with either pantoprazole 40 mg once daily or ranitidine 150 mg twice daily. After 4 weeks, each patient was clinically and endoscopically assessed. Failure to heal required a further 4 weeks of treatment and a new evaluation thereafter. After 4 weeks, healing of lesions was confirmed in 63% (69 out of 109) of patients receiving pantoprazole and in 22% (25 out of 113) receiving ranitidine (P < 0.001, per protocol population). After 8 weeks, the cumulative healing rates were 88% and 46%, respectively (P < 0.001). Complete freedom from esophagitis-related symptoms (acid eructation, heartburn, pain while swallowing) was greater in the pantoprazole than in ranitidine group after 2 and 4 weeks (74% vs. 47%; 87% vs. 52%, respectively, P < 0.001). After 4 weeks, the healing rate was 76% in Helicobacter pylori (Hp)-positive vs. 45% in Hp-negative patients treated with pantoprazole (P < 0.01). The Hp status did not influence healing rates in patients treated with ranitidine. The most frequent adverse events in the pantoprazole group were diarrhea and somnolence (2-3% of patients), and in the ranitidine group, headache, diarrhea, dizziness, increase of liver enzymes and pruritus (2-4% of patients). In conclusion, pantoprazole was more effective than ranitidine in the healing rate and relief from reflux esophagitis-associated symptoms, and Hp infection was associated with higher healing rate during therapy with pantoprazole but not with ranitidine.
Assuntos
Benzimidazóis/administração & dosagem , Esofagite Péptica/tratamento farmacológico , Infecções por Helicobacter/complicações , Helicobacter pylori/isolamento & purificação , Ranitidina/administração & dosagem , Sulfóxidos/administração & dosagem , 2-Piridinilmetilsulfinilbenzimidazóis , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Benzimidazóis/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Esofagite Péptica/complicações , Esofagite Péptica/diagnóstico , Feminino , Seguimentos , Infecções por Helicobacter/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/análogos & derivados , Pantoprazol , Probabilidade , Ranitidina/efeitos adversos , Medição de Risco , Sulfóxidos/efeitos adversos , Resultado do Tratamento , Cicatrização/efeitos dos fármacos , Cicatrização/fisiologiaRESUMO
One of the major problems when evaluating dyspeptic patients at public hospitals is the large interval between the consultation and the endoscopy, leading to the prescription of antisecretory drugs, what can be responsible for false results on examinations. AIM: To evaluate changes in ultrarapid urease test and histopathological examination for Helicobacter pylori by antisecretory drugs. METHODS: In a prospective double-blind study, 50 patients with dyspeptic complaints and endoscopic diagnosis of peptic ulcer, erosive gastritis, esophagitis or duodenitis, with a positive urease test, were randomized to a 7-day course of treatment with either omeprazole 20 mg or ranitidine 300 mg a day. Before and after treatment, two biopsy specimens each were obtained from the antrum and corpus and an ultrarapid urease test and a histopathological examination for Helicobacter pylori were performed. RESULTS: There were no significant changes in the results of ultrarapid urease test and histopathological examination for Helicobacter pylori after treatment with ranitidine. With omeprazole, we observed a decrease in positive results in ultrarapid urease test and histopathological examination for Helicobacter pylori in the antrum, but not in the corpus. CONCLUSION: Omeprazole, used for 7 days, can lead to negative results in ultrarapid urease test and histopathological examination for Helicobacter pylori in the antrum, and should not be employed in patients before the endoscopy is performed.
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Antiulcerosos/efeitos adversos , Gastroenteropatias/tratamento farmacológico , Infecções por Helicobacter/patologia , Helicobacter pylori/isolamento & purificação , Antagonistas dos Receptores H2 da Histamina/efeitos adversos , Urease/análise , Método Duplo-Cego , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/microbiologia , Gastroenteropatias/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/efeitos dos fármacos , Omeprazol/efeitos adversos , Estudos Prospectivos , Ranitidina/efeitos adversosRESUMO
OBJECTIVE: The aim of this study was to compare the effectiveness and tolerance of pantoprazole versus ranitidine in the treatment of duodenal ulcers in the Brazilian population. METHODS: A total of 222 patients with active duodenal ulcers (DU) were randomly allocated to a double dummy blind treatment, either with ranitidine (RAN) 300 mg (111, aged from 20-68 yr old, 56 female) or with pantoprazole (PANT) 40 mg (111 patients, 18-70 yr old, 45 female). After a 2-wk course of treatment, each patient was clinically and endoscopically assessed for ulcer healing. Failure to heal required a further 2-wk course of treatment and a new evaluation thereafter. RESULTS: In all, 77 of the 103 patients in the PANT group (74.8%) and 42 of the 94 patients in the RAN group (44.7%) who completed the study had ulcer healing after one 2-wk treatment course, and an additional 23 in the PANT group (22.3%) and 28 in the RAN group (29.8%) after the second 2-wk treatment course, totaling 100 (97.1%) and 70 (74.5%), respectively. Therapeutic gain in favor of pantoprazole was significant both at the end of the first and the second 2-wk treatment course (p<0.001). At 2 wk, symptoms remission was significantly higher in the PANT group (97.6%) than with the RAN group (77.5%) (p<0.001). The Intention-to-treat analysis showed results statistically similar to those observed in the per-protocol analysis. Minor adverse events were reported by four patients in the PANT group and three in the RAN group. No relevant laboratory abnormalities were seen. No patient withdrew from the study due to adverse events. CONCLUSIONS: Our results show that pantoprazole is more effective than ranitidine in the treatment of duodenal ulcer providing faster ulcer healing in most patients (97.1%), in 4 wk. Adverse events were rare and were similar in both groups, and had no influence on the therapeutic outcome.
Assuntos
Antiulcerosos/uso terapêutico , Benzimidazóis/uso terapêutico , Úlcera Duodenal/tratamento farmacológico , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Ranitidina/uso terapêutico , Sulfóxidos/uso terapêutico , 2-Piridinilmetilsulfinilbenzimidazóis , Adolescente , Adulto , Idoso , Antiulcerosos/efeitos adversos , Benzimidazóis/efeitos adversos , Método Duplo-Cego , Feminino , Antagonistas dos Receptores H2 da Histamina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/análogos & derivados , Pantoprazol , Ranitidina/efeitos adversos , Sulfóxidos/efeitos adversosRESUMO
OBJECTIVE: To evaluate whether the addition of bismuth subnitrate to a dual oral therapy regimen with omeprazole plus amoxycillin could improve Helicobacter pylori eradication. METHODS: Fifty consecutive Helicobacter pylori-positive patients were randomly enrolled to receive either (A) bismuth subnitrate (300 mg q.d.s.), omeprazole (20 mg b.d.) and amoxycillin (500 mg q.d.s.), or (B) omeprazole (20 mg b.d.) and amoxycillin (500 mg q.d.s.). Both groups (n=25 each) received the medication for 14 days. H. pylori status was reassessed 30 days after completion of the therapy in order to evaluate eradication rates. RESULTS: Six patients were lost to follow-up and therefore excluded from the study (three patients from each group). One patient from Group B withdrew from the study because of side-effects. The addition of bismuth subnitrate to omeprazole and amoxycillin significantly improved its efficacy in eradicating H. pylori, with 72% (18/25) eradication in Group A and 52% (13/25) in Group B (P=0.027). The addition of bismuth subnitrate to dual oral therapy was also capable of improving the healing of peptic ulcers when compared with dual oral therapy alone (100%, 8/8 vs. 58%, 4/7; P=0.021). CONCLUSION: Our results demonstrate that the addition of bismuth subnitrate to dual oral therapy enhances H. pylori eradication, and improves healing of peptic ulcers.
Assuntos
Amoxicilina/uso terapêutico , Antiulcerosos/uso terapêutico , Bismuto/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Omeprazol/uso terapêutico , Penicilinas/uso terapêutico , Ranitidina/análogos & derivados , Úlcera Gástrica/tratamento farmacológico , Adulto , Idoso , Amoxicilina/administração & dosagem , Amoxicilina/efeitos adversos , Antiulcerosos/administração & dosagem , Antiulcerosos/efeitos adversos , Bismuto/administração & dosagem , Bismuto/efeitos adversos , Quimioterapia Combinada , Feminino , Seguimentos , Gastroscopia , Infecções por Helicobacter/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/administração & dosagem , Omeprazol/efeitos adversos , Penicilinas/administração & dosagem , Penicilinas/efeitos adversos , Ranitidina/administração & dosagem , Ranitidina/efeitos adversos , Ranitidina/uso terapêutico , Úlcera Gástrica/microbiologiaRESUMO
BACKGROUND/AIMS: To evaluate whether the addition of 2 weeks of ranitidine to a 1-week oral triple therapy (OTT) regimen improved ulcer healing and H. pylori eradication. METHODOLOGY: Two hundred and eleven consecutive patients with an endoscopic diagnosis of active duodenal ulcer (DU) and a positive antrum biopsy for H. pylori were enrolled. Those attending the Hospital Vera Cruz (Group A, n=142) received a 14-day course of ranitidine (150 mg after breakfast and dinner) plus a 1-week OTT, consisting of bismuth subcitrate, (240 mg after the 3 meals), tetracycline (500 mg, 10 min before the three meals and at bedtime), and furazolidone (200 mg after breakfast and dinner). Patients from the Hospital das Clinicas (Group B, n=69) received the same OTT as Group A but without ranitidine. Patients underwent endoscopy again on average 40 days (range: 30-60 days) after completing therapy in order to assess ulcer healing and H. pylori status. RESULTS: Both schedules were equally efficient in eradicating H. pylori with 90% (128/142) eradication in group A, and 84% (58/69) in group B (p=0.2). In contrast, the addition of ranitidine to OTT improved ulcer healing when compared with OTT alone (96%, 137/142, vs. 70%, 48/69; p<0.001). CONCLUSIONS: Our results demonstrate that the association of acid suppression, obtained with 2 week ranitidine administration with OTT improved ulcer healing but did not enhance H. pylori eradication.
Assuntos
Antiulcerosos/administração & dosagem , Úlcera Duodenal/tratamento farmacológico , Determinação da Acidez Gástrica , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Ranitidina/administração & dosagem , Adolescente , Adulto , Antiulcerosos/efeitos adversos , Brasil , Esquema de Medicação , Quimioterapia Combinada , Úlcera Duodenal/microbiologia , Endoscopia Gastrointestinal , Feminino , Seguimentos , Furazolidona/administração & dosagem , Furazolidona/efeitos adversos , Infecções por Helicobacter/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos/administração & dosagem , Compostos Organometálicos/efeitos adversos , Estudos Prospectivos , Antro Pilórico/microbiologia , Ranitidina/efeitos adversos , Tetraciclina/administração & dosagem , Tetraciclina/efeitos adversos , Resultado do TratamentoRESUMO
La Hemorragia digestiva alta (HDA) en pacientes trasplantados renales constituye un cuadro de gravedad no solo por poner en riesgo la vida del paciente, sino la funcionalidad del injerto. Se han documentado cuatro casos (1,2 por ciento) de HDA en pacientes trasplantados renales con riñon funcionante sobre un total de 340 trasplantes en 328 pacientes desde el advenimiento de la ciclosporina como droga inmunosupresora en el país en enero de 1986 hasta el 11 de abril de 1996. No hubo defunciones ni pérdidas del injerto directamente vinculadas a la HDA. La baja incidencia de HDA estaria relacionada a la profilaxis perioperatoria con bloqueantes H2 y a la rigurosa selección de los receptores. La cirugía profiláctica pre trasplante no está indicada. El tratamiento quirúrgico esta indicado en los casos refractarios a la terapéutica médica. El adecuado tratamiento y profilaxis de cualquier patología causante de una potencial HDA, especialmente la enfermedad ulceropéptica, y la selección de los pacientes receptores aseguran un trasplante renal con muy baja incidencia de complicaciones hemorrágicas esofagogastroduodenales