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      Efeitos colaterais da ranitidina aplicada em dose terapêutica em cães saudáveis Translated title: Adverse effects of ranitidine applied in therapeutic dosage in healthy dogs

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          Abstract

          O objetivo deste trabalho foi verificar se a dose de ranitidina 2mg kg-1, aplicada via intravenosa, causa êmese ou hipotensão em cães saudáveis. Foram selecionados 10 cães da raça Retriever do Labrador, 10 da raça Beagle e 10 cães sem raça definida, sendo cinco animais de cada sexo. Os animais foram submetidos ao exame clínico e à avaliação da pressão sanguínea antes da aplicação do fármaco e também 10 minutos e quatro horas após a administração deste. Após a aplicação, observou-se que 13,3% dos animais apresentaram-se normais; 6,7% dos cães apresentaram apatia; 50% dos animais apresentaram salivação e 30% apresentaram apatia, salivação, mímica de vômito ou êmese. Não houve diminuição significativa da pressão arterial após a administração do fármaco. Conclui-se que o uso de ranitidina na dose terapêutica, aplicada via intravenosa, pode provocar apatia, salivação, mímica de vômito e êmese.

          Translated abstract

          The purpose of this study was to verify if the ranitidine dosage of 2mg kg-1 by intravenous path causes emesis or hypotension in healthy dogs. They were selected 10 Labrador Retriever, 10 Beagles and 10 mongrel dogs, five animals of each sex. The animals were submitted to clinical examination and blood pressure evaluation before ranitidine administration and also 10 minutes and 4 hours after administration of it. After administration was observed that 13.3% of the animals presented normal; 6.7% of the dogs presented apathy; 50% of the animals presented salivation and 30% presented apathy, salivation, emesis mimic or emesis. There was no significative arterial blood pressure decrease after ranitidine administration. It was concluded that ranitidine useful in therapeutic dosage by intravenous path may provoke apathy, salivation, emesis mimic and emesis.

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          Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community-acquired pneumonia in children.

          Gastric acidity (GA) inhibitors, including histamine-2 receptor antagonists (H2 blockers) and proton pump inhibitors (PPIs), are the mainstay of gastroesophageal reflux disease (GERD) treatment. A prolonged GA inhibitor-induced hypochlorhydria has been suggested as a risk factor for severe gastrointestinal infections. In addition, a number of papers and a meta-analysis have shown an increased risk of pneumonia in H2-blocker-treated intensive care patients. More recently, an increased risk of community-acquired pneumonia associated with GA inhibitor treatment has been reported in a large cohort of adult patients. These findings are particularly relevant to pediatricians today because so many children receive some sort of GA-blocking agent to treat GERD. To test the hypothesis that GA suppression could be associated with an increased risk of acute gastroenteritis and pneumonia in children treated with GA inhibitors, we conducted a multicenter, prospective study. The study was performed by expert pediatric gastroenterologists from 4 pediatric gastroenterology centers. Children (aged 4-36 months) consecutively referred for common GERD-related symptoms (for example, regurgitation and vomiting, feeding problems, effortless vomiting, choking), from December 2003 to March 2004, were considered eligible for the study. Exclusion criteria were a history of GA inhibitors therapy in the previous 4 months, Helicobacter pylori infection, diabetes, chronic lung or heart diseases, cystic fibrosis, immunodeficiency, food allergy, congenital motility gastrointestinal disorders, neuromuscular diseases, or malnutrition. Control subjects were recruited from healthy children visiting the centers for routine examinations. The diagnosis of GERD was confirmed in all patients by standard criteria. GA inhibitors (10 mg/kg ranitidine per day in 50 children or 1 mg/kg omeprazole per day in 50 children) were prescribed by the physicians for 2 months. All enrolled children were evaluated during a 4-month follow-up. The end point was the number of patients presenting with acute gastroenteritis or community-acquired pneumonia during a 4-month follow-up study period. We obtained data in 186 subjects: 95 healthy controls and 91 GA-inhibitor users (47 on ranitidine and 44 on omeprazole). The 2 groups were comparable for age, gender, weight, length, and incidence of acute gastroenteritis and pneumonia in the 4 months before enrollment. Rate of subjects presenting with acute gastroenteritis and community-acquired pneumonia was significantly increased in patients treated with GA inhibitors compared with healthy controls during the 4-month follow-up period. In the GA inhibitor-treated group, the rate of subjects presenting with acute gastroenteritis and community-acquired pneumonia was increased when comparing the 4 months before and after enrollment. No differences were observed between H2 blocker and PPI users in acute gastroenteritis and pneumonia incidence in the previous 4 months and during the follow-up period. On the contrary, in healthy controls, the incidence of acute gastroenteritis and pneumonia remained stable. This is the first prospective study performed in pediatric patients showing that the use of GA inhibitors was associated with an increased risk of acute gastroenteritis and community-acquired pneumonia in GERD-affected children. It could be interesting to underline that we observed an increased incidence of intestinal and respiratory infection in otherwise healthy children taking GA inhibitors for GERD treatment. On the contrary, the majority of the previous data showed that the patients most at risk for pneumonia were those with significant comorbid illnesses such as diabetes or immunodeficiency, and this points to the importance of GA suppression as a major risk factor for infections. In addition, this effect seems to be sustained even after the end of therapy. The results of our study are attributable to many factors, including direct inhibitory effect of GA inhibitors on leukocyte functions and qualitative and quantitative gastrointestinal microflora modification. Additional studies are necessary to investigate the mechanisms of the increased risk of infections in children treated with GA inhibitors, and prophylactic measures could be considered in preventing them.
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            Effects of Metoclopramide and Ranitidine on Preoperative Gastric Contents in Day-Case Surgery

            This prospective, randomized, double-blinded study was performed to evaluate the effects of intravenous metoclopramide and ranitidine on preoperative gastric contents in outpatients receiving intravenous anesthesia for laparoscopic gynecologic surgery. Fifteen minutes before the induction of anesthesia, the Z-M group (n = 20) received 50 mg ranitidine and 10 mg metoclopramide intravenously and the control group (n = 20) received the same volume of normal saline. Before the surgery, a 14-F multiorifice nasogastric tube was inserted to aspirate the gastric contents of patients under sedation with propofol and midazolam. The mean pH values of the gastric fluid were 2.7 ± 2.0 (SD) [median 1.6 (range: 1.2-7.2)] in the control group, and 6.1 ± 1.9 [median 6.8 (range 1.4-7.8)] in the Z-M group. The mean aspirated volumes (mL) were 15.3 ± 10.4 (SD) [median 11.0 (range: 5.0-44.0)] in the control group, and 6.9 ± 10.0 (SD) [median 4.5 (range: 0-38.0)] in the Z-M group. There were significantly more high-risk (gastric fluid volumes > 25 mL and pH < 2.5) patients in the control group (4/20, 20%) than in the Z-M group (1/20, 5%). In conclusion, intravenous prophylactic ranitidine and metoclopramide may be an easy and useful method to decrease the volume while increasing the pH of gastric contents, and therefore may reduce the number of patients at risk for aspiration pneumonitis in ambulatory laparoscopic procedures who receive an anesthesia.
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              FR145715, a novel histamine H2 receptor antagonist, with specific anti-Helicobacter pylori activities

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                Author and article information

                Journal
                cr
                Ciência Rural
                Cienc. Rural
                Universidade Federal de Santa Maria (Santa Maria, RS, Brazil )
                0103-8478
                1678-4596
                February 2010
                : 40
                : 2
                : 326-329
                Affiliations
                [01] Belo Horizonte MG orgnameUniversidade Federal de Minas Gerais Brasil
                [02] Jaboticabal SP orgnameUniversidade Estadual Paulista Brasil
                [03] Lavras MG orgnameUniversidade Federal de Lavras Brasil
                Article
                S0103-84782010000200015 S0103-8478(10)04000215
                64b2c753-ad19-4993-9a88-6c15432c6595

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 02 November 2009
                : 22 March 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 13, Pages: 4
                Product

                SciELO Brazil

                Categories
                Clínica e Cirurgia

                ranitidina,emesis,caninos,efeitos indesejados,vômito,ranitidine,canines,undesired effects

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