Ameliorative effects of stinging nettle (Urtica dioica) on testosterone-induced prostatic hyperplasia in rats

The present study investigated the effects of stinging nettle (Urtica dioica L.) (UD) on benign prostatic hyperplasia (BPH) induced by testosterone. In vitro studies were conducted to assess the 5α-reductase inhibitory potential of UD. Two biochemical markers viz., β-sitosterol and scopoletin, were isolated and characterised in the extracts utilising High-performance thin layer chromatographic, FTIR, NMR and overlain UV spectral studies. Hyperplasia was induced in rats by subcutaneous administration of testosterone (3 mg kg(-1) s.c.) for 28 days in all the groups except the vehicle-treated group. Simultaneous administration of petroleum ether and ethanolic extracts (10, 20 and 50 mg kg(-1) p.o.) and isolated β-sitosterol (10 and 20 mg kg(-1) p.o.) was undertaken. Finasteride was used as a positive control (1 mg kg(-1) p.o.). Measurement of prostate/body weight ratio, weekly urine output and serum testosterone levels, prostate-specific antigen levels (on day 28) and histological examinations carried out on prostates from each group led us to conclude that UD can be used as an effective drug for the management of BPH.     

EMLA for painful procedures in infants.

OBJECTIVES: Based on the content of the article, you will be able to: Identify the two drugs in EMLA and the youngest pediatric age for its approved use. List the procedures for which EMLA has been used to control pain in infants. Describe the efficacy of EMLA vs. other agents in treating pain. Discuss the potential adverse effects of EMLA in infants. See page 48 for instructions.     

Lack of nephrotoxicity in pediatric patients receiving concurrent vancomycin and aminoglycoside therapy

Based on retrospective studies, nephrotoxicity may occur in as many as 35% of adult patients receiving vancomycin and an aminoglycoside. Limited data are available about the incidence of nephrotoxicity in pediatric patients, especially when drug therapy is closely monitored. We prospectively evaluated the potential of nephrotoxicity in 90 infants and children (61 less than 1 year and 29 greater than 1 year of age) receiving concomitant vancomycin and gentamicin for a duration of 3 to 38 (mean 9) days. Vancomycin and gentamicin doses ranged from 20 to 60 (mean 35) mg/kg/day and 2.5 to 14 (mean 6.5) mg/kg/day. Peak and trough serum concentration of vancomycin ranged from 10 to 55 and 2 to 18 micrograms/ml, respectively. Gentamicin peak and trough serum concentration ranged from 4 to 9 and 0.5 to 2.0 micrograms/ml, respectively. Serum creatinine concentration prior to, during and at the end of therapy averaged 0.42, 0.40, and 0.43 mg/dl (p greater than 0.1), respectively. Clinical status and urinalysis results showed no evidence of renal toxicity. These data suggest that nephrotoxicity is uncommon in pediatric patients receiving a combined therapy with vancomycin and gentamicin, particularly when serum concentrations of gentamicin are within therapeutic range.     

Pharmacokinetics and cerebrospinal fluid (CSF) concentrations of vancomycin in pediatric patients undergoing CSF shunt placement

Staphylococcus epidermidis has been established as the common pathogen causing cerebrospinal fluid shunt infections. In addition, clinical isolates of S. epidermidis from infected shunts are typically resistant to methicillin. Vancomycin is often used for neurosurgical prophylaxis due to its excellent in vitro activity against methicillin-resistant staphylococci. Limited data are available about the pharmacokinetics and cerebrospinal fluid concentrations of vancomycin in pediatric patients intraoperatively. The objectives of this study were to characterize the pharmacokinetics and determine the cerebrospinal fluid concentrations of vancomycin. Eight patients (mean age 8.3 +/- 7.0 years) received three doses of intravenous vancomycin, 15 mg/kg every 6 h. The first dose was administered 1 h prior to surgery. Blood samples were collected at 0, 0.5, 1, 2, 4, and 5 h after the end of the infusion. A cerebrospinal fluid sample was collected at the time of shunt insertion. Urine samples were collected over a 24-hour period. Vancomycin was measured with a fluorescence polarization immunoassay. The peak serum concentrations ranged from 15.6 to 33.7 micrograms/ml; cerebrospinal fluid concentrations ranged from less than 0.6 to 0.8 microgram/ml. The mean total clearance, renal clearance, apparent volume of distribution, and elimination half-life were 0.11 +/- 0.05 l/h/kg, 0.07 +/- 0.02 l/h/kg, 0.54 +/- 0.15 l/kg, and 4.8 +/- 4.0 h, respectively. Approximately 70% of total vancomycin dose was excreted in the urine. A 2- to 5-fold variation in total clearance and a 2.5-fold variability in renal clearance were observed. Low cerebrospinal fluid concentrations of vancomycin were present at the time of shunt insertion in these pediatric patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prescribing Patterns for the Outpatient Treatment of Constipation in the United States

Background  

The incidence of constipation is rising. National data on the prescribing of pharmacologic and nonpharmacologic therapies, or factors influencing the prescribing of therapies for constipation are limited.