Drugs online research references
J Microencapsul. 1997 Mar-Apr;14(2):137-53.
Use of cellulose ether containing excipients with microcrystalline cellulose for the production of pellets containing metformin hydrochloride by the process of extrusion-spheronization.
Gouldson MP, Deasy PB.
Department of Pharmaceutics, Trinity College, University of Dublin, Ireland.
The project is concerned mainly with the evaluation of two cellulose ether containing excipients, Aquacoat WG and Avicel 955 MCC for the improved extrusion-spheronization of metformin hydrochoride. Factorially designed experiments subject to statistical analyses were employed and products obtained were evaluated by sieve, packing density and image analysis, scanning electron microscopy and dissolution testing at pH 6.8. Aquacoat WG did not improve the ease of spheronization of drug mixes containing microcrystalline cellulose wetted with the optimum level of water. However, Avicel 955 MCC, which is a new experimental excipient containing 95% microcrystalline cellulose and 5% methylcellulose, did aid ease of spheronization facilitating acceptable yield of good spheres with high drug loadings (70%). Avicel 955 MCC containing drug mixes were more tolerant to minor alterations in level of hydration and yielded spheres which showed a small retardation of drug release despite the very high solubility of metformin hydrochloride.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9132466&dopt=Abstract
Diabet Med. 1997 Sep;14(9):798-802.
Monitoring of metabolic control in patients with non-insulin-dependent diabetes mellitus on oral hypoglycaemic agents: value of evening blood glucose determination.
Guillausseau PJ.
Service de Medecine B, Hopital Lariboisiere, Paris, France.
Monitoring of metabolic control in patients with non-insulin-dependent (Type 2) diabetes (NIDDM) is usually based upon blood glucose assay in the morning (after an overnight fast) and in the postprandial state (breakfast or lunch). However, this schedule does not seek low blood glucose values, especially in the evening. We have conducted a prospective study of laboratory blood glucose profiles (8 am, 9.30 am after a 35 g carbohydrate breakfast and in the evening between 5 and 7 pm). We have included 58 consecutive NIDDM patients regularly followed in our clinic (39 men, age 60 +/- 11.5 years, diabetes duration 8.6 +/- 6.5 years, BMI 25.5 +/- 3 kg m-2), treated with the sulphonylurea gliclazide, alone (40-320 mg 24 h-1, mean 170 +/- 110 mg) (group 1, n = 32) or in combination with metformin (1000-3000 mg 24 h-1, 2400 +/- 620 mg) (group 2, n = 26). All patients were stable, with no change in dosage for at least 3 months. Mean glycaemic control was good (group 1 HbA1c: 6.5 +/- 1.1%, group 2: 6.9 +/- 0.7%). Evening blood glucose values were the lowest of the day in 26 patients of group 1 (81.3%) and in 22 of group 2 (84.6%). Mean evening blood glucose levels were lower (p = 0.001) than 8 am values (group 1: 5.8 +/- 1.4 vs 6.1 +/- 1.6 mmol l-1, group 2: 6.5 +/- 1.8 vs 6.9 +/- 1.9) and than 9.30 am values (group 1: 7.6 +/- 1.5, group 2: 12.3 +/- 2.8). No blood glucose values in the hypoglycaemic range were observed. HbA1c was strongly correlated (p = 0.002 to 0.0001) in the whole group with 8 am (r = 0.39), 9.30 am (r = 0.56), and evening blood glucose values (r = 0.42). These results indicate that, in patients treated with the sulphonylurea gliclazide, alone or in combination with metformin, the lowest blood glucose values occur in the evening more frequently (4/5) than in the morning. Therefore, evening blood glucose determination should be performed systematically in the course of the metabolic evaluation of NIDDM patients on oral hypoglycaemic agents.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9300232&dopt=Abstract
Arch Med Res. 1992 Spring;23(1):19-24.
Biguanide related lactic acidosis: incidence and risk factors.
Aguilar C, Reza A, Garcia JE, Rull JA.
Diabetes and Lipid Metabolism Department, Instituto Nacional de la Nutricion Dr. Salvador Zubiran, Mexico, D.F.
The objective of this study was to evaluate in an open population the incidence and risk factors of biguanide related lactic acidosis. All patients currently treated in the Department of Diabetes and Lipid Metabolism of the Instituto Nacional de la Nutricion and their records were reviewed for the present use or history of administration of biguanides. The study was complemented with a revision of all admissions of diabetic patients to the emergency room during 1987-1990. In the outpatient study, 235 cases were included. No case of lactic acidosis was found. A high percentage of the biguanide treated patients had one or more lactic acidosis related risk factors. In the emergency study, 609 admissions of 273 patients were included. In 17 patients a metabolic non-ketotic acidosis was diagnosed. The frequency of non-ketotic acidosis for the different treatments was: 29.4 cases x 1000 emergency admissions for sulphonylurea treated group, 32 for sulphonylurea plus phenformin treated and 47.94 for type II insulin treated patients. All cases had severe precipitant diseases that can cause lactic acidosis with or without associated biguanide administration. No metformin related cases were found. The conclusions of this study are that biguanides in general and metformin in particular are not associated with a high risk of lactic acidosis. Severe systemic dysfunction associated with intercurrent diseases, frequently observed in diabetic patients, is the main determinant for the appearance of lactic acidosis.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1308787&dopt=Abstract
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