Comparison of pharmacodynamics and celiac effects of olmesartan medoxomil formulations by using olmesartan-induced celiac-rat-model

2021 ◽  
Vol 18 ◽  
Author(s):  
Yelda Komesli ◽  
Bekir Ugur Ergur ◽  
Ercument Karasulu
Keyword(s):  
Weight Loss ◽  
Side Effects ◽  
Rat Model ◽  
Villous Atrophy ◽  
Case Reports ◽  
Olmesartan Medoxomil ◽  
Albino Rats ◽  
Pressure System ◽  
Severe Diarrhea ◽  
Clinical Changes

: Olmesartan Medoxomil (OM) is an angiotensin receptor blocker and has the adverse effect of celiac like enteropathy which was accepted by the FDA in 2013. This disease is characterized by severe diarrhea, weight loss and enteropathy. Although there are many case reports associated with olmesartan-related enteropathy in humans, it has not been described in a long-term animal model study so far. We developed a self-microemulsifying drug delivery system (OM-SMEDDS) in our previous study to reduce this side effect of drug and to enhance bioavailability. In this study, an artificial hypertension model was established with dose of 185 µmol /kg L-NAME (N ω-nitro-L-arginine methyl ester) twice in a day intraperitoneally in Wistar albino rats. To determine and compare side effects, the OM-Suspension and OM-SMEDDS were administered at 1.3 mg/kg therapeutic dose during one-month period to the rats. Tension of rats was recorded by measuring from their tails with non invasive blood pressure system. We observed celiac like enteropathy findings like villous atrophy and intraepithelial lymphocytosis and clinical changes like weight loss and severe diarrhea after the treatment with OM-Suspension during one-month experiment. It was also observed that the antihypertensive efficacy of the OM-SMEDDS formulation was higher than the suspension during the experiment and did not cause enteropathy, diarrhea and weight loss by reducing intestinal exposure. Hereby we evaluated the side effects of two different pharmaceutical forms by designing a sustainable and reproducible celiac rat model that can be induced with olmesartan medoxomil.

Severe Diarrhea Secondary to Propranolol

1981 ◽  
Vol 15 (1) ◽  
pp. 49-50 ◽  
Author(s):  
J. Daniel Robinson ◽  
David E. Burtner
Keyword(s):  
Adverse Drug Reaction ◽  
Weight Loss ◽  
Drug Reaction ◽  
Side Effects ◽  
Severe Diarrhea

Although propranolol is effective and widely used for many disorders, there are reports of it causing side effects severe enough to warrant its discontinuance. A 71-year-old female is reported to have experienced diarrhea and weight loss from the use of propranolol 20 mg qid. On discontinuing the drug, the diarrhea quickly resolved. On rechallenge with 10 mg qid the patient displayed no problems; however, when the dosage was increased to 20 mg qid, the diarrhea returned. When the drug was discontinued the second time, the diarrhea stopped again. The occurrence of diarrhea in any patient receiving propranolol should cause consideration of an adverse drug reaction.

Drug-Induced Enteropathy

2015 ◽  
Vol 33 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Eric V. Marietta ◽  
Amanda Cartee ◽  
Abdul Rishi ◽  
Joseph A. Murray
Keyword(s):  
Weight Loss ◽  
Celiac Disease ◽  
Prolonged Exposure ◽  
Case Reports ◽  
Disease Diagnosis ◽  
Nutrition Support ◽  
Drug Induced ◽  
Severe Diarrhea ◽  
Patient Demographics ◽  
Celiac Disease Diagnosis

Background/Aims: Many medications can cause diarrhea by increasing motility, inflammation or enteropathy. Olmesartan and mycophenolic acid (CellCept) are drugs that are capable of increasing inflammation and enteropathy in some individuals and, if not recognized, can lead to chronic diarrhea. It is this type of drug-induced diarrhea that is the focus of this review. Methods: A summary of our findings (recent and earlier published) as well as a review of published works from other centers were conducted. Results: There is increasing evidence that olmesartan use is associated with enteropathy in a small number of individuals who use angiotensin receptor II blockers, and that this enteropathy is characterized by severe diarrhea capable of inducing severe dehydration and, in some instances, failure of organs such as the kidney. Typical patient demographics are Caucasian individuals who are older (>50 years old) and obese or overweight prior to weight loss. Prolonged exposure to olmesartan use for 1-2 years is typical, although case reports of irbesartan and valsartan have been reported as well. Discontinuing olmesartan leads to improvement of symptoms; however, the period for healing is variable, with some patients requiring steroid therapy and even prolonged parental nutrition support. In addition, many histological features of olmesartan-associated enteropathy are also present in celiac disease, including villi shortening and lymphocyte infiltration. Other drug-associated enteropathies have also been reported with mycophenolate mofetil used in transplantation. Conclusions: Of the drug-associated enteropathies discussed in this review, olmesartan can generate the most severe symptoms, albeit quite rare. Therefore, with patients who present with severe diarrhea and weight loss, one should consider olmesartan-associated enteropathy. In addition, many of the features associated with olmesartan-associated enteropathy are also found in celiac disease enteropathy; as such, one should review any celiac disease diagnosis for any use of olmesartan at the time of diagnosis.

scholarly journals A117 A CASE OF ADULT AUTOIMMUNE ENTEROPATHY AND PRIMARY SCLEROSING CHOLANGITIS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 135-137
Author(s):  
Y Lei ◽  
H Azhari ◽  
M Raman
Keyword(s):  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Chronic Diarrhea ◽  
Villous Atrophy ◽  
Case Reports ◽  
Rare Condition ◽  
Mucosal Damage ◽  
Severe Diarrhea ◽  
Autoimmune Enteropathy ◽  
Repeat Endoscopy

Abstract Background Autoimmune enteropathy (AIE) is a rare, immune-mediated condition causing severe diarrhea and mucosal damage. The diagnostic criteria are chronic diarrhea with malabsorption, blunting of the small bowel villi, specific histologic changes, and the exclusion of other causes of villous atrophy. Anti-enterocyte and anti-goblet cell antibodies are supportive of the diagnosis, but not specific or sensitive enough to make the diagnosis. It has several clinical and histologic phenotypes and affects children more than adults. To our knowledge, there are only 2 published cases of AIE with concurrent primary sclerosing cholangitis (PSC). Aims To review the literature for adult AIE, any previous cases of concurrent PSC, and present a case of both conditions. Methods We searched PubMed for “autoimmune enteropathy psc”, “autoimmune enteropathy”, “autoimmune enteropathy case report”, “autoimmune enteropathy adult” and collected all the relevant articles. Relevant clinical features of demographics, IBD status, liver diseases, immune conditions, antibody status, and treatment agents were summarized. Results A 31-year-old man presented with a 20-year history of diarrhea and 11kg weight loss over 3 months. He had gout, no regular medications, and relevant no family history. All initial investigations were normal. Repeat endoscopy showed increased intra-epithelial lymphocytes (IEL) in the colon consistent with lymphocytic colitis. He was given budesonide with moderate improvement. He then developed biliary stasis, and was found to have early PSC. Repeat colonoscopy for ongoing diarrhea showed increased colonic IEL. Ulcerative colitis (UC) was suspected, and he was given oral 5-ASA and prednisone, with subsequent switch to vedolizumab. He then relapsed, requiring IV fluids, total parenteral nutrition (TPN), and IV steroids. Repeat endoscopy showed persistent colonic IEL, and villous blunting in the terminal ileum and duodenum. Celiac disease, IBD, combined variable immunodeficiency (CVID), and enteric infections were excluded. In this context, AIE was considered. He improved with IV steroids, and was switched to infliximab. Despite initial improvement, he had worsening diarrhea and malnutrition. After dose escalation of infliximab, and further IV steroids and TPN, he was started on a trial of ustekinumab. We found 35 articles that reported on 100 adult cases of AIE. There were two previous adult cases of concurrent PSC. We found 7 cases where TNF-alpha inhibitors were used, one case where vedolizumab was used, and no cases using ustekinumab. Details are in Table 1. Conclusions AIE is a rare condition causing chronic diarrhea and gut mucosal damage reported only in case reports and series. There have only been 2 other reported cases of concurrent PSC with AIE in adults. This is the first reported case of ustekinumab being tried to control symptoms. Funding Agencies None

scholarly journals Severe spruelike enteropathy and collagenous colitis caused by olmesartan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shiho Kaneko ◽  
Kana Matsuda ◽  
Yasuko Mizuta ◽  
Shoya Shiratori ◽  
Kazuma Kishi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Clinical Symptoms ◽  
Villous Atrophy ◽  
Collagenous Colitis ◽  
Clinical History ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Medication History ◽  
Severe Diarrhea ◽  
History Of

Abstract Background Olmesartan, which is an angiotensin II receptor blocker, reportedly causes spruelike enteropathy, with intestinal villous atrophy as its typical histopathological finding. Interestingly, collagenous and/or lymphocytic gastritis and colitis occur in some patients. We report the case of a 73-year-old Japanese man with a 2-month clinical history of severe diarrhea and weight loss. There were few reports in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. Case presentation We report a case of a 73-year-old man with a 2-month clinical history of severe diarrhea and weight loss. He had taken olmesartan for hypertension treatment for 5 years. Endoscopic examination with biopsies revealed intestinal villous atrophy and collagenous colitis. Suspecting enteropathy caused by olmesartan, which was discontinued on admission because of hypotension, we continued to stop the drug. Within 3 weeks after olmesartan discontinuation, his clinical symptoms improved. After 3 months, follow-up endoscopy showed improvement of villous atrophy but not of the thickened collagen band of the colon. However, the mucosa normalized after 6 months, histologically confirming that the preexistent pathology was finally resolved. Conclusions This report presents a case in which spruelike enteropathy and collagenous colitis were both observed and could be followed up. In unexplained cases of diarrhea, medication history should be reconfirmed and this disease should be considered a differential diagnosis.

scholarly journals European Guidelines for Obesity Management in Adults with a Very Low-Calorie Ketogenic Diet: A Systematic Review and Meta-Analysis

Obesity Facts ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 222-245
Author(s):  
Giovanna Muscogiuri ◽  
Marwan El Ghoch ◽  
Annamaria Colao ◽  
Maria Hassapidou ◽  
Volkan Yumuk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Body Composition ◽  
Body Weight ◽  
Side Effects ◽  
Ketogenic Diet ◽  
Meta Analysis ◽  
Dietary Treatment ◽  
Obesity Management ◽  
Weight Loss Interventions

<b><i>Background:</i></b> The very low-calorie ketogenic diet (VLCKD) has been recently proposed as an appealing nutritional strategy for obesity management. The VLCKD is characterized by a low carbohydrate content (&#x3c;50 g/day), 1–1.5 g of protein/kg of ideal body weight, 15–30 g of fat/day, and a daily intake of about 500–800 calories. <b><i>Objectives:</i></b> The aim of the current document is to suggest a common protocol for VLCKD and to summarize the existing literature on its efficacy in weight management and weight-related comorbidities, as well as the possible side effects. <b><i>Methods:</i></b> This document has been prepared in adherence with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Literature searches, study selection, methodology development, and quality appraisal were performed independently by 2 authors and the data were collated by means of a meta-analysis and narrative synthesis. <b><i>Results:</i></b> Of the 645 articles retrieved, 15 studies met the inclusion criteria and were reviewed, revealing 4 main findings. First, the VLCKD was shown to result in a significant weight loss in the short, intermediate, and long terms and improvement in body composition parameters as well as glycemic and lipid profiles. Second, when compared with other weight loss interventions of the same duration, the VLCKD showed a major effect on reduction of body weight, fat mass, waist circumference, total cholesterol and triglyceridemia as well as improved insulin resistance. Third, although the VLCKD also resulted in a significant reduction of glycemia, HbA1c, and LDL cholesterol, these changes were similar to those obtained with other weight loss interventions. Finally, the VLCKD can be considered a safe nutritional approach under a health professional’s supervision since the most common side effects are usually clinically mild and easily to manage and recovery is often spontaneous. <b><i>Conclusions:</i></b> The VLCKD can be recommended as an effective dietary treatment for individuals with obesity after considering potential contra-indications and keeping in mind that any dietary treatment has to be personalized. <b><i>Prospero Registry:</i></b> The assessment of the efficacy of VLCKD on body weight, body composition, glycemic and lipid parameters in overweight and obese subjects: a meta-analysis (CRD42020205189).

scholarly journals Cutaneous Side Effects of BRAF Inhibitors in Advanced Melanoma: Review of the Literature

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Bilgen Gençler ◽  
Müzeyyen Gönül
Keyword(s):  
Side Effects ◽  
Metastatic Melanoma ◽  
Mapk Pathway ◽  
Case Reports ◽  
Mitogen Activated Protein Kinase ◽  
Braf V600e ◽  
Braf Inhibitors ◽  
Braf Mutations ◽  
Cutaneous Side Effects ◽  
Downstream Signaling

The incidence of melanoma has recently been increasing. BRAF mutations have been found in 40–60% of melanomas. The increased activity of BRAF V600E leads to the activation of downstream signaling through the mitogen-activated protein kinase (MAPK) pathway, which plays a key role as a regulator of cell growth, differentiation, and survival. The use of BRAF inhibitors in metastatic melanoma with BRAF mutation ensures clinical improvement of the disease. Vemurafenib and dabrafenib are two selective BRAF inhibitors approved by the Food and Drug Administration (FDA). Both drugs are well tolerated and successfully used in clinical practice. However, some adverse reactions have been reported in patients in the course of treatment. Cutaneous side effects are the most common adverse events among them with a broad spectrum. Both the case reports and several original clinical trials reported cutaneous reactions during the treatment with BRAF inhibitors. In this review, the common cutaneous side effects of BRAF inhibitors in the treatment of metastatic melanoma with BRAF V600E mutation were reviewed.

Scam Alert 2022 !! Best Health Keto UK Reviews – Negative Side Effects or Safe Diet Pills? Is £39.76 Worthy for “Best Health Keto United Kingdom” Customers? Read This Before Buy v1

2022 ◽  
Author(s):  
health not provided
Keyword(s):  
Weight Loss ◽  
United Kingdom ◽  
Side Effects ◽  
Fat Cells ◽  
Promote Weight Loss ◽  
Negative Side ◽  
Negative Side Effects ◽  
Official Site ◽  
Diet Pills ◽  
Loss Formula

Best Health Keto UK Reviews is an all-natural weight loss formula and it works in an efficient way to promote weight loss and burn off stubborn fat cells. Best Health Keto works by allowing your body to enter into the ketosis process. Must See: Visit the Official Site of Best Health Keto [Up to 70% Discount Available Here]

Ampicillin-Associated Diarrhea: Effect of Dosage and Route of Administration

PEDIATRICS ◽  
1976 ◽  
Vol 58 (6) ◽  
pp. 869-872
Author(s):  
John A. Phillips ◽  
Frederick H. Lovejoy ◽  
Yoichi Matsumiya
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
High Dose ◽  
Total Dosage ◽  
Pediatric Practice ◽  
Severe Diarrhea ◽  
Bowel Movements ◽  
Gastrointestinal Side Effects ◽  
Tract Infections ◽  
Mild Diarrhea

Ampicillin is one of the most frequently used antibiotics in pediatric practice.1 Its clinical efficacy has been widely studied, but its gastrointestinal side effects are poorly documented. In adults with urinary tract infections, 11% taking 1 gm/day of ampicillin orally had bowel movements which were at least twice as frequent as normal.2 Another series in adults receiving ampicillin reported an increase in stools with 16% having ≤5 and 5% having ≥5 stools per day. The change in stools increased with total dosage and was equal after oral or intravenous administration.3 In children, ampicillin ranging from 50 to the unusually high dose of 200 mg/kg/day resulted in mild diarrhea (≤5 stools per day) in 18% to 30%, moderate diarrhea (5 to 10 stools per day) in 2% to 11%, and severe diarrhea (≥10 stools per day) in 1% or less of cases.

Sign in / Sign up

Export Citation Format

Share Document