Suppositories

Publication Title: 
The Cochrane Database of Systematic Reviews

BACKGROUND: Antipsychotic-related constipation is a common and serious adverse effect, especially for people taking clozapine. Clozapine has been shown to impede gastrointestinal motility, leading to constipation, and has been reported in up to 60% of patients receiving clozapine. In rare cases, complications can be fatal. Appropriate laxatives should be prescribed to treat constipation in people taking antipsychotics, but there is a lack of guidance on the comparative effectiveness and harms of different agents in this population.

Author(s): 
Every-Palmer, Susanna
Newton-Howes, Giles
Clarke, Mike J.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

A randomized pilot study to compare the safety and efficacy of artesunate suppositories (15 mg/kg/day for three days) versus oral artesunate (6 mg/kg/day for three days), both in combination with mefloquine (25 mg/kg), was conducted in 52 Thai children with uncomplicated multidrug-resistant falciparum malaria. Forty-five patients (87%) had a full 28-day follow-up in the hospital to assess efficacy and exclude reinfection. Mean [range] times to fever clearance of the two groups were similar (42 hr [15-104] versus 42 hr [6-119]).

Author(s): 
Sabchareon, A.
Attanath, P.
Chanthavanich, P.
Phanuaksook, P.
Prarinyanupharb, V.
Poonpanich, Y.
Mookmanee, D.
Teja-Isavadharm, P.
Heppner, D. G.
Brewer, T. G.
Chongsuphajaisiddhi, T.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

A thermostable suppository of artesunate (artesunic acid) has been developed. In Gabon, 12 children with Plasmodium falciparum malaria received two administrations of this suppository in a 4-hr interval. Parasitemia and fever were then measured and the plasma levels of artesunate and its active metabolite, dihydroartemisinin, were determined by means of a reversed phase high-pressure liquid chromatography method using reductive electrochemical detection.

Author(s): 
Halpaap, B.
Ndjave, M.
Paris, M.
Benakis, A.
Kremsner, P. G.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

Eight healthy Vietnamese male subjects received 400 mg artemisinin formulated into fatty suppositories (FS), and six different subjects received 500 mg of artemisinin formulated in polyethylene glycol suppositories (PEGS). Plasma concentrations were measured by high-performance liquid chromatography with electrochemical detection; concentration versus time curves were analyzed with nonparametric methods. No statistically significant differences were found between the two formulations.

Author(s): 
Koopmans, R.
Ha, L. D.
Duc, D. D.
Dien, T. K.
Kager, P. A.
Khanh, N. X.
van Boxtel, C. J.
de Vries, P. J.
Publication Title: 
Antimicrobial Agents and Chemotherapy

A detailed pharmacokinetic analysis was performed with 47 children from Papua New Guinea with uncomplicated falciparum or vivax malaria treated with artesunate (ARTS) suppositories (Rectocaps) given in two doses of approximately 13 mg/kg of body weight 12 h apart. Following an intensive sampling protocol, samples were assayed for ARTS and its primary active metabolite, dihydroartemisinin (DHA), by liquid chromatography-mass spectrometry. A population pharmacokinetic model was developed to describe the data.

Author(s): 
Karunajeewa, Harin A.
Ilett, Kenneth F.
Dufall, Kitiya
Kemiki, Adedayo
Bockarie, Moses
Alpers, Michael P.
Barrett, P. Hugh
Vicini, Paolo
Davis, Timothy M. E.
Publication Title: 
BMJ (Clinical research ed.)

OBJECTIVE: To compare the efficacy and safety of rectal artemether with intravenous quinine in the treatment of cerebral malaria in children. DESIGN: Randomised, single blind, clinical trial. SETTING: Acute care unit at Mulago Hospital, Uganda's national referral and teaching hospital in Kampala. PARTICIPANTS: 103 children aged 6 months to 5 years with cerebral malaria. INTERVENTION: Patients were randomised to either intravenous quinine or rectal artemether for seven days.

Author(s): 
Aceng, Jane Ruth
Byarugaba, Justus S.
Tumwine, James K.
Publication Title: 
BMC public health

BACKGROUND: Malaria is a serious illness among children aged 5 years and below in Zambia, which carries with it many adverse effects including anemia and high parasites exposure that lead to infant and childhood mortality. Due to poor accessibility to modern health facilities, malaria is normally managed at home using indigenous and cosmopolitan medicines.

Author(s): 
Kaona, Frederick A. D.
Tuba, Mary
Publication Title: 
Antimicrobial Agents and Chemotherapy

Drug treatment of severe malaria must be rapidly effective. Suppositories may be valuable for childhood malaria when circumstances prevent oral or parenteral therapy. We compared artesunate suppositories (n = 41; 8 to 16 mg/kg of body weight at 0 and 12 h and then daily) with intramuscular (i.m.) artemether (n = 38; 3.2 mg/kg at 0 h and then 1.6 mg/kg daily) in an open-label, randomized trial with children with severe Plasmodium falciparum malaria in Papua New Guinea (PNG). Parasite density and temperature were measured every 6 h for > or = 72 h.

Author(s): 
Karunajeewa, Harin A.
Reeder, John
Lorry, Kerry
Dabod, Elizah
Hamzah, Juliana
Page-Sharp, Madhu
Chiswell, Gregory M.
Ilett, Kenneth F.
Davis, Timothy M. E.
Publication Title: 
PLoS medicine

BACKGROUND: Intra-rectal artesunate has been developed as a potentially life-saving treatment of severe malaria in rural village settings where administration of parenteral antimalarial drugs is not possible. We studied the population pharmacokinetics of intra-rectal artesunate and the relationship with parasitological responses in patients with moderately severe falciparum malaria.

Author(s): 
Simpson, Julie A.
Agbenyega, Tsiri
Barnes, Karen I.
Di Perri, Gianni
Folb, Peter
Gomes, Melba
Krishna, Sanjeev
Krudsood, Srivicha
Looareesuwan, Sornchai
Mansor, Sharif
McIlleron, Helen
Miller, Raymond
Molyneux, Malcolm
Mwenechanya, James
Navaratnam, Visweswaran
Nosten, François
Olliaro, Piero
Pang, Lorrin
Ribeiro, Isabela
Tembo, Madalitso
van Vugt, Michèle
Ward, Steve
Weerasuriya, Kris
Win, Kyaw
White, Nicholas J.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

We compared two dose forms of artemisinin derivatives, dihydroartemisinin suppository (DHA) and intramuscular artemether (ART), in children 6 months to 10 years of age with moderately severe malaria for which oral therapy was not appropriate. Children were randomly allocated to receive three daily doses of DHA or ART followed by a single oral dose of sulfadoxine-pyrimethamine on the third day of both treatment regimens and were monitored for parasitologic and clinical response for 14 days.

Author(s): 
Falade, Catherine O.
Fadero, Francis F.
Happi, Christian T.
Dada-Adegbola, Hannah O.
Gbotosho, Grace O.
Ayede, Idowu
Falade, Adegoke G.
Oduola, Ayoade M. J.
Salako, Lateef A.

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