Evaluation of Polyethylene Glycol 4000 Solution (PEG) Efficacy versus Lactulose in Treatment of Hepatic Encephalopathy = تقييم فاعلية محلول البولي إيثيلين جلايكول 4000 مقارنة باللاكتيلوز في مناجزة الإعتلال الكبدي الدماغي

2016 ◽  
Vol 45 (3) ◽  
pp. 585-594
Author(s):  
Mohamed Bastawy ◽  
Sayed Gaber ◽  
Ahmed Abdelalim
Keyword(s):  
Polyethylene Glycol ◽  
Hepatic Encephalopathy ◽  
Polyethylene Glycol 4000

scholarly journals Polyethylene glycol versus lactulose in the treatment of hepatic encephalopathy: a systematic review and meta-analysis

2021 ◽  
Vol 8 (1) ◽  
pp. e000648
Author(s):  
Gilles Jadd Hoilat ◽  
Mohamad Fekredeen Ayas ◽  
Judie Noemie Hoilat ◽  
Ahmed Abu-Zaid ◽  
Ceren Durer ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Hepatic Encephalopathy ◽  
Web Of Science ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Brain Dysfunction ◽  
Cochrane Library ◽  
Continuous Data ◽  
Inverse Variance ◽  
Scoring Algorithm

BackgroundHepatic encephalopathy (HE) is defined as brain dysfunction that occurs because of acute liver failure or liver cirrhosis and is associated with significant morbidity and mortality. Lactulose is the standard of care till this date; however, polyethylene glycol (PEG) has gained the attention of multiple investigators.MethodsWe screened five databases namely PubMed, Scopus, Web of Science, Cochrane Library and Embase from inception to 10 February 2021. Dichotomous and continuous data were analysed using the Mantel-Haenszel and inverse variance methods, respectively, which yielded a meta-analysis comparing PEG versus lactulose in the treatment of HE.ResultsFour trials with 229 patients were included. Compared with lactulose, the pooled effect size demonstrated a significantly lower average HE Scoring Algorithm (HESA) Score at 24 hours (Mean difference (MD)=−0.68, 95% CI (−1.05 to –0.31), p<0.001), a higher proportion of patients with reduction of HESA Score by ≥1 grade at 24 hours (risk ratio (RR)=1.40, 95% CI (1.17 to 1.67), p<0.001), a higher proportion of patients with a HESA Score of grade 0 at 24 hours (RR=4.33, 95% CI (2.27 to 8.28), p<0.0010) and a shorter time to resolution of HE group (MD=−1.45, 95% CI (−1.72 to –1.18), p<0.001) in favour of patients treated with PEG.ConclusionPEG leads to a higher drop in the HESA Score and thus leads to a faster resolution of HE compared with lactulose.

scholarly journals EFFECT OF SELECTED POLYMERS ON DISSOLUTION AND STABILIZATION OF AMORPHOUS FORM OF MELOXICAM

2017 ◽  
Vol 9 (9) ◽  
pp. 33
Author(s):  
Rana Obaidat ◽  
Bashar Al-taani ◽  
Hanan Al-quraan
Keyword(s):  
Polyethylene Glycol ◽  
Solid Dispersions ◽  
Dissolution Profile ◽  
X Ray Diffraction ◽  
Scanning Calorimetry ◽  
Polyethylene Glycol 4000 ◽  
Amorphous Form ◽  
Molecular Weights ◽  
Low Solubility ◽  
Reproducible Manner

Objective: Meloxicam is classified as class II corresponding to its high permeability and low solubility (12μg/ml). This study aims to compare the effect of selected polymers on stabilization of amorphous form, and dissolution of meloxicam by preparation of different solid dispersions using selected polymers (chitosan oligomers, polyvinylpyrrolidone K30, and polyethylene glycols).Methods: These solid dispersions were prepared using two different methods; solvent evaporation method for the two molecular weights chitosan carriers (16 and 11KDa) and polyvinylpyrrolidone-K30 and melting method for the two different molecular weights polyethylene glycol (4000 and 6000). The physicochemical properties of solid dispersions were analyzed using differential scanning calorimetry, Fourier transform infra-red analysis, Powder X-ray diffraction, and scanning electron microscopy. Selected dispersions were then compared to two selected marketed drugs (Mobic® and Moven®).Results: Best dissolution rates were obtained for both polyvinylpyrrolidone-K30 and polyethylene glycol 6000, followed by chitosan 16 kDa, chitosan 11 kDa, and polyethylene glycol 4000. Increasing polymeric ratio increased dissolution rate except for chitosan. Precipitation of the drug as amorphous form occurred in chitosan and polyvinylpyrrolidone-K30 dispersions, while no change in crystallinity obtained for polyethylene glycol dispersions. Failure of polyvinylpyrrolidone-K30 in the maintenance of stability during storage time was observed while re-crystallization occurred in chitosan-based dispersions, which ends with preferences to polyethylene glycol dispersions. After comparing the release of selected dispersions with the two selected polymers; all dispersions got a higher release than that of the two marketed drugs release.Conclusion: The dissolution profile of meloxicam has been increased successfully in a reproducible manner.

A Dose Determination Study of Polyethylene Glycol 4000 in Constipated Children: Factors Influencing the Maintenance Dose

2006 ◽  
Vol 42 (2) ◽  
pp. 178-185 ◽  
Author(s):  
Christophe Dupont ◽  
Bernard Leluyer ◽  
Fatme Amar ◽  
Nicolas Kalach ◽  
Pierre-Henri Benhamou ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Maintenance Dose ◽  
Polyethylene Glycol 4000 ◽  
Dose Determination ◽  
Factors Influencing

Efficacy of Two Regimens for Colon Cleansing Using Polyethylene Glycol 4000: A Randomized Open Label Trial

2021 ◽  
Vol 58 (12) ◽  
pp. 1119-1123
Author(s):  
Phan Thi Hien ◽  
Vu Huu Thoi ◽  
Nguyen Thu Ha ◽  
Nicolas Kalach
Keyword(s):  
Polyethylene Glycol ◽  
Open Label ◽  
Polyethylene Glycol 4000 ◽  
Colon Cleansing ◽  
Open Label Trial

Non-Lactulose Medication Therapies for the Management of Hepatic Encephalopathy: A Literature Review

2020 ◽  
pp. 089719002095302
Author(s):  
Justin P. Reinert ◽  
Kevin Burnham
Keyword(s):  
Clinical Trials ◽  
Polyethylene Glycol ◽  
Hepatic Encephalopathy ◽  
Literature Review ◽  
Clinical Outcomes ◽  
Medication Regimen ◽  
Double Blind ◽  
Comprehensive Literature Review ◽  
Medical Librarian

Objective: The most appropriate medication regimen to mitigate the consequences hepatic encephalopathy remains inconclusive. This review seeks to serve as a reference for clinicians to help guide therapy decisions with regard to hepatic encephalopathy. Methods: A comprehensive literature review between August 2018 and April 2019 was accomplished with the assistance of a medical librarian. Sources of literature review include PubMed, MEDLINE, SCOPUS, ProQuest Central, CINAHL, and ProQuest Dissertations. The authors selected randomized clinical and double-blind cross-over trials evaluating probiotics, zinc, polyethylene glycol, rifaximin, and flumazenil. Sixteen clinical trials are discussed in this review. Pertinent safety, efficacy, and statistical and clinical outcomes are summarized by the authors. Conclusions: The most appropriate regimen to mitigate the consequences of hepatic encephalopathy remains elusive; however, the agents discussed within this review offer alternative options for patients unresponsive to or intolerant of traditional lactulose therapy. This review seeks to serve as a repository for relevant clinical trials, and as a reference for clinicians to help guide therapy decisions.

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