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At least 631 records · Page 35Linked to original sources
PubMed2005

Amla (Emblica officinalis Gaertn.) extracts reduce oxidative stress in streptozotocin-induced diabetic rats.

The antioxidant properties of amla extracts and their effects on the oxidative stress in streptozotocin-induced diabetes were examined in rats. Amla in the form of either the commercial enzymatic extract SunAmla (Taiyo Kagaku Co. Ltd., Yokkaichi, Japan) (20 or 40 mg/kg of body weight/day) or a polyphenol-rich fraction of ethyl acetate extract (10 or 20 mg/kg of body weight/day) was given orally for 20 days to the streptozotocin-induced diabetic rats. Amla extracts showed strong free radical scavenging activity. Amla also showed strong inhibition of the production of advanced glycosylated end products. The oral administration of amla extracts to the diabetic rats slightly improved body weight gain and also significantly alleviated various oxidative stress indices of the serum of the diabetic rats. The elevated serum levels of 5-hydroxymethylfurfural, which is a glycosylated protein that is an indicator of oxidative stress, were significantly reduced dose-dependently in the diabetic rats fed amla. Similarly, the serum level of creatinine, yet another oxidative stress parameter, was also reduced. Furthermore, thiobarbituric acid-reactive substances levels were significantly reduced with amla, indicating a reduction in lipid peroxidation. In addition, the decreased albumin levels in the diabetic rats were significantly improved with amla. Amla also significantly improved the serum adiponectin levels. These results form the scientific basis supporting the efficacy of amla for relieving the oxidative stress and improving glucose metabolism in diabetes.

Adiponectin↗
PubMed2006

Respiratory tract secretions in the dying patient: a comparison between glycopyrronium and hyoscine hydrobromide.

The evidence for the management of respiratory tract secretions (RTS) in dying patients with antimuscarinic drugs remains inconclusive. This study investigated the effectiveness of glycopyrronium versus hyoscine hydrobromide in controlling RTS using the Liverpool Care of the Dying Pathway (LCP) in 72 patients matched for age, diagnosis, and gender who died on a 30-bed specialist palliative care unit. All patients in the glycoypyrronium group had some response to glycopyrronium, whereas 22% of patients in the hyoscine group had no response to hyoscine hydrobromide. There was a significant difference in overall response between the two groups (p < 0.01). Twenty-eight percent of patients in the glycopyrronium and 42% of patients in the hyoscine group died with RTS present. There was no statistically significant difference in the levels of agitation following administration of either drug. This study provides further evidence that the LCP can be a useful tool in the evaluation of new drugs for symptom control in dying patients and suggests that glycopyrronium may be at least as effective in controlling RTS in dying patients as hyoscine hydrobromide.

Aged↗
PubMed1979

Studies of drugs given before anaesthesia. XVII: anticholinergic premedicants.

The effects of premedication with the anticholinergic drugs atropine, hyoscine and glycopyrronium when administered by oral and i.m. routes have been evaluated in patients undergoing minor surgery and compared with a placebo using a double-dummy double-blind technique. Although the mouths of those patients who received adequate doses of anticholinergic drugs were dry, subjectively and observed, as compared with those who received a placebo, the overall course of anaesthesia did not appear to be different. Of the three drugs atropine seemed to be absorbed best following oral administration. Equally effective oral and i.m. doses of atropine were considered to be 2.0 and 1.0 mg respectively; of hyoscine 1.0 and 0.25--0.5 mg. The appropriate dose of glycopyrronium was 0.2 mg i.m. The routine use of anticholinergic drugs in preanaesthetic medication in minor surgery appears to be unnecessary.

Administration, Oral↗
PubMed1989

Glycopyrronium requirements for antagonism of the muscarinic side effects of edrophonium.

We have compared, in 60 adult patients, the cardiovascular effects of glycopyrronium 5 micrograms kg-1 and 10 micrograms kg-1 given either simultaneously or 1 min before edrophonium 1 mg kg-1. Significant differences between the four groups were detected (P less than 0.001). Both groups receiving 10 micrograms kg-1 showed increases in heart rate of up to 30 beat min-1 (95% confidence limits 28-32 beat min-1). Use of glycopyrronium 5 micrograms kg-1 provided greater cardiovascular stability and, given 1 min before the edrophonium, was sufficient to minimize early, edrophonium-induced bradycardias. This low dose of glycopyrronium provided good control of oropharyngeal secretions.

Adult↗
PubMed1990

The myasthenic syndrome: anaesthesia in a patient treated with 3.4 diaminopyridine.

A case of anaesthesia in a patient with myasthenic syndrome treated with 3.4 diaminopyridine is described. Despite symptomatic improvement and an improved electromyogram (EMG) on treatment, extreme sensitivity to neuromuscular block occurred with vecuronium. Antagonism of block was poor with an anticholinesterase, while oral 3.4 diaminopyridine improved neuromuscular transmission further. A combination of anticholinesterase with aminopyridine may be the antagonistic combination of choice in this condition.

4-Aminopyridine↗
PubMed1990

Pharmacokinetics of i.m. glycopyrronium.

A sensitive radioreceptor assay was used to determine the pharmacokinetics of glycopyrronium following a single i.m. injection of 8 micrograms kg-1 in nine surgical patients. Rapid absorption was found, with a mean peak plasma concentration after 16.1 min and mean elimination half-life of 75.4 min. Almost half (49.3%) of the drug was excreted in pharmacologically active form in the urine within 3 h. A significant increase in heart rate (P less than 0.05) occurred in 15 min, lasting up to 60 min, and an antisialagogue effect in 10 min, lasting up to 8 h (P less than 0.05). There was no measurable glycopyrronium in lumbar cerebrospinal fluid samples (n = 9) taken 40 min after administration of drug.

Blood Pressure↗
PubMed1991

Oesophageal contractility during total i.v. anaesthesia with and without glycopyrronium.

Somatic movement and spontaneous and provoked oesophageal contractions were noted at time of incision in 51 patients receiving total i.v. anaesthesia with alfentanil and propofol. Probit analysis of the dose of propofol required to prevent spontaneous movement revealed an ED50 (95% confidence limits) of 2.5 (1.8-2.9) mg kg(-1) h(-1) and ED95 of 4.7 (4.0-7.5) mg kg(-1) h(-1). Corresponding venous blood concentrations gave an EC50 of 1.2 (0.4-1.6) micrograms ml(-1) and an EC95 of 4.0 (2.8-18.5) micrograms ml(-1). ED50 of propofol for preventing spontaneous oesophageal contraction was 3.0 (1.9-3.6) mg kg(-1) h(-1). ED95 was 6.9 (5.0-27.3) mg kg(-1) h(-1); EC50 for oesophageal contractions was 1.7 (0.7-2.3) micrograms ml(-1) and EC95 was 5.9 (3.7-70.6) micrograms ml(-1). Another group of 10 patients were given glycopyrronium 5 micrograms kg(-1) at induction; oesophageal contractility was significantly reduced in this group.

Adult↗
PubMed1991

Total i.v. anaesthesia with propofol and alfentanil for coronary artery bypass grafting.

The haemodynamic effects of total i.v. anaesthesia with a combination of propofol and alfentanil infusions were studied in eight patients with good left ventricular function undergoing coronary artery bypass surgery. Haemodynamic indices were measured before anaesthesia and at specified intervals before cardiopulmonary bypass. The technique resulted in haemodynamic changes comparable to those reported with opioid-based anaesthesia for coronary artery surgery, and has potential advantages.

Alfentanil↗
PubMed1992

Effect of doxapram on neostigmine evoked antagonism of vecuronium neuromuscular block.

We have examined the effect of doxapram on neostigmine-evoked antagonism of vecuronium neuromuscular block in a double-blind study in anaesthetized patients. Neuromuscular transmission was measured with a Datex Relaxograph. The mean time to recovery of the first contraction of the train-of-four (T1) from 25% to 75% was significantly longer in the presence of doxapram (138 (SEM 21) s; n = 23) than in its absence (95 (13) s; n = 29) (P = 0.014). The recovery of the train-of-four ratio was prolonged also in the presence of doxapram, although this difference was not statistically significant.

Adult↗
PubMed1993

Glycopyrronium prolongs topical anaesthesia of oral mucosa and enhances absorption of lignocaine.

We have studied the effect of glycopyrronium on the anaesthetic action and absorption of topical lignocaine in 10 healthy, non-smoking volunteers. Lignocaine 100 mg was sprayed on the oral mucosa 15 min after random administration of glycopyrronium 4 micrograms kg-1 or normal saline i.v. Glycopyrronium decreased the mean analgesia score from 2 to 0.1 (2 = baseline; 0 = anaesthesia) at 4 min compared with a change from 2 to 0.5 after normal saline (P < 0.05). All scores returned to baseline by 40 min and 20 min in the glycopyrronium and control groups, respectively. The mean (SD) peak plasma lignocaine concentration was 0.57 (0.29) microgram ml-1 after glycopyrronium and 0.31 (0.10) microgram ml-1 after saline (P < 0.05) and were attained in 17 min (range 10-40 min) and 29 min (range 8-40 min), respectively. Pretreatment with glycopyrronium enhanced absorption and prolonged the analgesic action of topically administered lignocaine.

Absorption↗
PubMed1993

Pharmacokinetics of glycopyrronium in uraemic patients.

We studied the pharmacokinetics of glycopyrronium in 11 uraemic patients undergoing cadaveric renal transplantation and in seven ASA I control patients undergoing general surgery. Glycopyrronium 4 micrograms kg-1 was given i.v. before induction of anaesthesia. Blood and urine samples were collected for up to 24 h for measurement of glycopyrronium concentrations using a radioreceptor assay. Volume of distribution in the elimination phase (V beta) was similar in both groups, the elimination half-life (T1/2 beta) was longer (P < 0.05), area under the plasma concentration-time curve (AUC) larger (P < 0.01) and plasma clearance (CI) smaller (P < 0.01) in the uraemic patients. In 3 h, mean 0.7 (range 0-3)% and 50 (21-82)% of glycopyrronium was excreted in the urine in the uraemic and healthy patients, respectively (P < 0.001). The 24-h renal excretion was 7 (0-25)% in uraemic and 65 (30-99)% in control patients (P < 0.001). We conclude that the elimination of glycopyrronium is severely impaired in uraemic patients.

Glycopyrrolate↗
PubMed1994

Respiratory sinus arrhythmia: comparison with EEG indices during isoflurane anaesthesia at 0.65 and 1.2 MAC.

Respiratory sinus arrhythmia (RSA) is a cyclical variation in heart rate during breathing, where the heart rate increases during inspiration and decreases during expiration. RSA and the electroencephalogram (EEG) were monitored in 10 patients undergoing elective surgery with isoflurane and nitrous oxide in oxygen anaesthesia after induction with propofol. All patients were subject to controlled ventilation and recovery from competitive neuromuscular block was facilitated by neostigmine and glycopyrronium (seven patients) or atropine (three patients). Median and spectral edge (95%) frequencies of the raw EEG were derived off-line. RSA and EEG indices were obtained during preinduction (baseline), induction, incision, 0.65 and 1.2 MAC of isoflurane maintenance during surgery and recovery. Significant decreases in the level of RSA, median and spectral edge frequencies were observed during induction and significant increases in all indices were observed at recovery in all patients. Significant decreases in the median and spectral edge EEG frequencies occurred in patients treated with atropine both to counteract bradycardia after propofol induction and at antagonism of neuromuscular block (n = 3), compared with patients treated with glycopyrronium (n = 7). In contrast, the level of RSA did not decrease significantly with atropine. It is concluded that measurements of RSA could form the basis of a useful index of anaesthetic depth during isoflurane anaesthesia, even during the use of pharmacologically appropriate doses of atropine. However, any effects of atropine on the raw EEG and on indices derived from the EEG, should be characterized further so that these effects are not confused with changes in anaesthetic depth.

Adult↗