Search

Aromatic L-amino acid decarboxylase (AADC) deficiency is a disease in which neurological findings are dominant due to deficiencies in neurotransmitter synthesis. Hypoglycemia caused by autonomic dysfunction is one of the symptoms that may be encountered. Here we report a case of mild AADC deficiency presenting with hypoglycemia without any neurological signs. A 4-year-old girl presented with recurrent hypoglycemia. Her growth and development were normal. Plasma insulin and cortisol values were normal in the sample at the time of hypoglycemia. C8:1-Carnitine elevation was detected in the acylcarnitine profile. A clinical exome panel was performed with the suggestion of a fatty acid oxidation defect. However, a homozygous variant in the DDC gene was detected. Furthermore, cerebrospinal fluid neurotransmitter analysis revealed low 5-hydroxyindolacetic acid and homovanillic acid and high 3-O-methyldopa and methyltetrahydrofolate (5 MTHF) consistent with AADC deficiency. Plasma AADC enzyme activity was low. The episodes of hypoglycemia were treated with uncooked cornstarch. This case suggests that AADC deficiency should be considered in some patients with hypoglycemia. [ABSTRACT FROM AUTHOR]

BACKGROUND: Treatment of chronic hypertension during pregnancy has been shown to reduce the risk of adverse perinatal outcomes. In this study, we examined the prevalence and treatment of chronic hypertension during pregnancy and assessed changes in these outcomes following the release of the updated 2017 hypertension guidelines of the American College of Cardiology and American Heart Association. METHODS: We analyzed the MerativeTM Marketscan® Research Database of United States commercial insurance claims from 2007 to 2021. We assessed the prevalence of chronic hypertension during pregnancy and oral antihypertensive medication use over time. We then performed interrupted time series analyses to evaluate changes in these outcomes. RESULTS: The prevalence of chronic hypertension steadily increased from 1.8% to 3.7% among 1 900 196 pregnancies between 2008 and 2021. Antihypertensive medication use among pregnant individuals with chronic hypertension was relatively stable (57%-60%) over the study period. The proportion of pregnant individuals with chronic hypertension treated with methyldopa or hydrochlorothiazide decreased (from 29% to 2% and from 11% to 5%, respectively), while the proportion treated with labetalol or nifedipine increased (from 19% to 42% and from 9% to 17%, respectively). The prevalence or treatment of chronic hypertension during pregnancy did not change following the 2017 American College of Cardiology and American Heart Association hypertension guidelines. CONCLUSIONS: The prevalence of chronic hypertension during pregnancy doubled between 2008 and 2021 in a nationwide cohort of individuals with commercial insurance. Labetalol replaced methyldopa as the most commonly used antihypertensive during pregnancy. However, only about 60% of individuals with chronic hypertension in pregnancy were treated with antihypertensive medications. [ABSTRACT FROM AUTHOR]

The article discusses research which investigated physician approaches to the pharmacologic dystonia treatment in people with cerebral palsy. The study surveyed physician approaches regarding medications for dystonia in CP including baclofen, trihexyphenidyl, gabapentin, carbidopa/levodopa, clonazepam, diazepam, clonidine, tetrabenazine, clobazam and cannabidiol. It described physician's prescribing practices and choice of medications for dystonia.

Copyright of Baghdad Science Journal is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The β1,2-adrenergic receptor blocker propranolol, β1-blocker bisoprolol, and central presynaptic α2-adrenergic receptor agonist methyldopa are used in clinical practice to treat the hyperadrenergic type of postural orthostatic tachycardia syndrome. There are no literature data on the effects of these drugs on vena cava flows during postural tests. In acute experiments on anesthetized rabbits, we studied blood flow changes in the cranial vena cava (CrVC) and caudal vena cava (CdVC) during orthostatic (head-up tilt by 25°) and antiorthostatic (head-down tilt by –25°) tests for 20 s after propranolol, bisoprolol and methyldopa intravenous preadministration. Before drug pretreatment, both CrVC and CdVC flows decreased in response to orthostasis at the 4th and 20th s. During antiorthostasis, CdVC flow increased at the 4th s and decreased to the baseline value by the 20th s, while CrVC flow decreased by the 4th s and exceeded the baseline level by the 20th s. After propranolol pretreatment, CdVC flow decreased to a greater extent than in response to bisoprolol and methyldopa pretreatment. After methyldopa pretreatment during orthostasis, by the 20th s, CrVC flow decreased more notably than CdVC flow, while after propranolol and bisoprolol pretreatment under conditions of orthostasis, both CrVC and CdVC flows decreased about equally. During antiorthostasis, 20 s after propranolol pretreatment, CdVC flow increased more considerably compared to CrVC flow. After bisoprolol and methyldopa pretreatment, CrVC flow increased in response to antiorthostasis not only to a greater extent than CdVC flow but even more pronouncedly compared to its initial increment. Thus, postural tests after the pretreatment with the above drugs reveal differences in the mechanisms of blood flow redistribution in CrVC and CdVC basins. [ABSTRACT FROM AUTHOR]

Background. Testing and titration of the right levodopa equivalent dose are usually performed during a hospital admission. However, optimal dose titration in people with Parkinson's disease (PwPs) may depend on home environment, emotional stress, and physical activity of everyday life. Objective. Firstly, to evaluate the feasibility and safety of a home-based LCIG titration program and patients'/caregivers' satisfaction. Secondly, to identify barriers and facilitators for home-based titration. Method. This study assesses the feasibility and safety of home-based titration of levodopa duodenal infusions with the use of self-reported evaluation questionnaires with open-ended questions included, registration of total time used, and number of contacts/visits. A telemedicine solution was used to remotely monitor the patients, adjust treatment, and provide support and guidance to patients and caregivers. Results. Ten of 12 PwPs (5 females and 7 males) completed the total titration program. Eight of the 12 PwPs were dependent on help. These 8 PwPs also had a high burden of nonmotor symptoms (NMS). Cognitive impairments varied in severity (range 16–30). Time spent with home visits was on average 93.4 minutes (ranging from 35 to 180 minutes), and the length of the total titration (LCIG initiation to termination of titration) was on average 3.4 days with 2–5 (mean 3.2) contacts/visits with PD team members. The average score on the satisfaction evaluation questionnaires was lower in the caregiver group (mean 31.8) than the PwP outcome (mean 36.2). Conclusions. Telehealth-assisted home-based titration programs are feasible due to the length of the titration period, number of contacts, and time spent in PwPs' private homes, are rated satisfactory and safe by PwPs and caregivers, and may be a substitute for in-hospital treatment. Clinical recommendations including facilitators and barriers from a patient/caregiver perspective are displayed. This trial is registered with NCT4196647. [ABSTRACT FROM AUTHOR]

Based on oxidative coupling reactions utilizing the synthesized organic reagent 2-amino-5-(paraaminophenyl)-1,3,4-thiadiazole in acidic media, and with potassium dichromate as an oxidizing agent, a spectrophotometric method has been established for determining methyldopa and levodopa. For these drugs, the resultant complex exhibits peak absorption at 401.5 nm and 415 nm, respectively. The method adheres to Beer's law in the ranges of 1-55 µg ml-1 and 2.5-170 µg ml-1, with molar absorption coefficients of 0.24 x 104 and 0.116 x 104 L mol-1 cm-1, respectively. The quantification limit (LOQ) is set at 1.5769 µg ml-1 for methyldopa and 3.0616 µg ml-1 for levodopa, yielding recovery rates of 100.14% and 100.34%, and relative standard deviation rates of 2.748% and 0.779%. The nature of the resulting complex was examined using the continuous variation method (Job's method) and molar ratios, revealing a 1:2 ratio (reagent to drug compound) for both drugs. This method has been successfully applied to pharmaceutical formulations. [ABSTRACT FROM AUTHOR]

Pregnancy in patients with end-stage renal disease (ESRD) is considered a very high-risk and is not recommended as it might cause fatal consequences for both the mother and the fetus. Even though chronic kidney disease affects the physiological components of fertility, decreasing the possibility of spontaneous conceptions, unwanted pregnancies still happen, and a small percentage of women with ESRD become pregnant. All women with kidney disease should have access to specialists in renal disease and pregnancy who can support, care for, and monitor them during their pregnancy. We reported a case of a 37-year-old primigravida who has ESRD on hemodialysis. The pregnancy journey was uneasy, but eventually she successfully passed through it. The most challenging issues to treat and manage throughout this pregnancy are anemia, the risks of eclampsia, and uncontrolled hypertension. The management of this patient requires multidisciplinary and shared care monitoring by the nephrologist, obstetrician, and primary care doctor. [ABSTRACT FROM AUTHOR]

Recent studies have highlighted the indispensable role of oxidized lipids in inflammatory responses, cell death, and disease pathogenesis. Consequently, inhibitors targeting oxidized lipids, particularly lipid-derived radicals critical in lipid peroxidation, which are known as radical-trapping antioxidants (RTAs), have been actively pursued. We focused our investigation on nitroxide compounds that have rapid second-order reaction rate constants for reaction with lipid-derived radicals. A novel screening system was developed by employing competitive reactions between library compounds and a newly developed profluorescence nitroxide probe with lipid-derived radicals to identify RTA compounds. A PubMed search of the top hit compounds revealed their wide application as repositioned drugs. Notably, the inhibitory efficacy of methyldopa, selected from these compounds, against retinal damage and bilateral common carotid artery stenosis was confirmed in animal models. These findings underscore the efficacy of our screening system and suggest that it is an effective approach for the discovery of RTA compounds.

The catalytic oxidation reaction between Coomassie Brilliant Blue and N-bromosuccinimide was used in an acidic medium to develop a spectrophotometric method for the estimation of dopamine and methyldopa in their pure forms and in pharmaceutical preparations. The developed method exhibited high sensitivity, with molar absorptivity values of 1.77 × 104 and 2.97 × 104 L mol-1 cm-1, and Sandell's sensitivity values of 0.0080 and 0.0107 mg cm-2, respectively. The estimated quantities of dopamine hydrochloride and methyldopa were within the range of 0.5-18 μg/mL and 0.5-13 μg/mL, respectively. The developed method was successfully applied to tablet and injection formulations, and the results were in accord with the original drug content. The developed method was compared with standard addition and standard method in the British Pharmacopoeia, and no significant differences were revealed thus confirming the success of the developed method in the estimation of the studied drugs. Other statistical values were also studied . [ABSTRACT FROM AUTHOR]

Hypertension in pregnancy including chronic hypertension with or without pre-eclampsia, gestational hypertension increases maternal and infant mortality significantly. The treatment for hypertension in pregnancy is the administration of methyldopa. Methyldopa transdermal patch is made by mixing the polymer first and then adding the active substance, namely methyldopa drug. It is intended that the polymer becomes an outer layer that controls the release of the drug. The resulting transdermal patch formulation was then evaluated, including organoleptic test, pH test, weight uniformity test, patch thickness test, folding resistance test, moisture test and penetration test using Franz diffusion cell. SPSS statistical data analysis. The penetration rate results showed F1 with 832.16 µg/cm2, F4 with 767.95 µg/cm2, F2 with 2819 µg/cm2 and F3 with 275.38 µg/cm2 all formulas have met the requirements. Based on the results of physical characteristics evaluation research, all formulas have met the requirements. The results of the in vitro evaluation of the methyldopa patch transdermal penetration test found that the difference in concentration in each formula had no significant effect on the penetration test. Based on physical evaluation parameters and in vitro penetration tests, the most optimal formula is F4 with the ratio of HPMC and ethyl cellulose (300:100) seen by fulfilling all physical characteristic evaluation tests and having a constant percent of cumulative amount to rise.

Copyright of Farmacie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pramipexole, a dopaminergic agonist, has rarely been implicated as a cause of hyponatremia in patients with Parkinson's disease (PD). Pramipexole-induced stimulation of anti-diuretic hormone results in euvolemic hyponatremia. This is often neglected, and hyponatremia may lead to worsening of the motor symptoms with PD and an unnecessary increase in dopaminergic medications, causing disabling dyskinesias. This case report describes a patient with young-onset PD who developed newonset hyponatremia due to pramipexole-induced syndrome of inappropriate anti-diuretic hormone within 3 months of starting the drug. [ABSTRACT FROM AUTHOR]

Chronic kidney disease significantly increases the risk of adverse maternal and perinatal outcomes. A growing body of evidence suggests that intensive dialysis, achieving physiologic pre-dialysis blood urea, is associated with decreased morbidity. We report a case of a successful pregnancy outcome in a 32-year-old nulliparous woman with stage 4 chronic kidney disease who underwent haemodialysis from 11 to 31 weeks' gestation for fetal benefit and concurrently trialled a plant-based diet. We hypothesise that her dietary changes assisted with urea reduction, enabling her to become dialysis independent. Although we must recognise that such pregnancies remain high risk, as demonstrated both in this case and more recent literature, advances in complex obstetric care and dialysis protocols may now give women with chronic kidney disease a realistic hope of a successful pregnancy. [ABSTRACT FROM AUTHOR]

Hypertensive disorders in pregnancy are associated with increased risk of maternal, fetal, and neonatal morbidity and mortality. It is important to distinguish between pre-existing (chronic) hypertension and gestational hypertension, developing after 20 weeks of gestation and usually resolving within 6 weeks postpartum. There is a consensus that systolic blood pressure ≥ 170 or diastolic blood pressure ≥ 110 mmHg is an emergency and hospitalization is indicated. The selection of the antihypertensive drug and its route of administration depend on the expected time of delivery. The current European guidelines recommend initiating drug treatment in pregnant women with persistent elevation of blood pressure ≥ 150/95 mmHg and at values > 140/90 mmHg in women with gestational hypertension (with or without proteinuria), with pre-existing hypertension with the superimposition of gestational hypertension, and with hypertension with subclinical organ damage or symptoms at any time during pregnancy. Methyldopa, labetalol, and calcium antagonists (the most data are available for nifedipine) are the drugs of choice. The results of the CHIPS and CHAP studies are likely to reduce the threshold for initiating treatment. Women with a history of hypertensive disorders in pregnancy, particularly those with pre-eclampsia, are at high risk of developing cardiovascular disease later in life. Obstetric history should become a part of the cardiovascular risk assessment in women. [ABSTRACT FROM AUTHOR]

Oxidative coupling reactions are one of the significant methods used in the estimation of certain drugs in pharmaceutical formulations. This study describes the development of a fast and sensitive spectroscopic method considering the determination of trace amounts of methyldopa in an acidic aqueous solution.The adopted method centered on oxidative coupling due to the drug Methyldopa with the reagent 1, 5-diaminonaphthalene in the presence of ceric (IV) ammonium nitrate as oxidizing agent to form a stable blue-colored product, giving the highest absorption at 730 nm. The product was appeared to agree Beer's law within the limits of (5.4 - 39.6) μg /ml, and a value of molar absorptivity equal to 4.79471 ×104 L/ mol. cm. Sandell’s index, 0.0044 μg/ cm2, Relative standard deviation was in the range (0.5942 - 0.9687) %, whereas recovery average and determination factor were 99.908% and 0.9998. The proposed method has been successfully applied in the determination of Methyldopa in its pharmaceutical preparations.

HIGHLIGHTS 1. Preeclampsia, or hypertension in pregnancy, remains a serious problem that has negative short and long-term consequences for the mother and the baby. 2. The use of antihypertensive medications has its own precautions as it they may harm the fetus. 3. Prophylactic measures with minimal or moderate impact may be beneficial for mothers with hypertension in pregnancy. ABSTRACT Treatment of hypertension in pregnancy, such as preeclampsia (PE), is still a difficult issue with negative short and long-term consequences for both the mother and the baby. Screening for preeclampsia at 11-13 weeks' gestation using a combination of maternal demographic characteristics and medical history with biomarker measurements can identify approximately 75% of women who develop premature preeclampsia with delivery at 37 weeks gestation and 90% of those with early preeclampsia. Preeclampsia has a 10% positive screen rate at 32 weeks. Another important worry on the use of antihypertensive medications during pregnancy is the potential harm to the fetus. Methyldopa, hydralazine, labetalol, and nifedipine are some common antihypertensive medications. Aspirin use is frequently related to a decrease in the prevention of early preeclampsia, but it must be accompanied by medication adherence. Aspirin can be coupled with heparin. Recent investigations on the use of furosemide and nifedipine in preeclampsia have also revealed a new combination.

6-pyruvoyl tetrahydropterin synthase deficiency (PTPSD) is a rare neurometabolic disease that can be diagnosed in newborn screening (NBS) and is part of the family of tetrahydrobiopterin deficiency disorders (BH4Ds). It is essential to diagnose and treat this disease early to prevent permanent neurological damage secondary to this neurotransmitter disorder. We present the first two cases of PTPSD in Romania that were genetically confirmed and treated late. Improving the diagnosis and monitoring procedures in Romania with correct metabolic management will prevent severe neurological impairment from PTPSD or other BH4Ds. [ABSTRACT FROM AUTHOR]

• Methyldopa and amlodipine were the most frequently prescribed in the first trimester. • Nifedipine was the most frequently prescribed antihypertensive during pregnancy. • The MCM risk of first-trimester antihypertensives was not suggested. • The MCM risk of first-trimester amlodipine and methyldopa was not suggested. To evaluate the major congenital malformation (MCM) risk of first-trimester antihypertensive exposure, specifically of amlodipine and methyldopa. A large administrative claims database was used. The prevalence of antihypertensive prescriptions during pregnancy was described in 91,390 women giving birth between 2010 and 2019. The MCM risk of first-trimester antihypertensives was evaluated in 1,185 women diagnosed with hypertensive disorders in the first trimester. The MCM risk of first-trimester amlodipine and methyldopa was evaluated in 178 women who were prescribed antihypertensives in the first trimester. Antihypertensives were prescribed to 278 (0.30%) women during their first trimester. The prescription prevalence in the first trimester was highest for methyldopa (115, 0.13%), followed by amlodipine (55, 0.06%). Antihypertensives were prescribed to 2,955 (3.23%) women during pregnancy. Nifedipine (903, 0.99%) and nicardipine (758, 0.83%) were the most frequently prescribed oral and injectable antihypertensives during pregnancy, both with a significant increase in annual prevalence. Of the 1,185 women diagnosed with hypertensive disorders in the first trimester, antihypertensives were prescribed to 178 women. The adjusted odds ratio (aOR) of MCMs in the first-trimester prescription of any antihypertensive medication was 1.124 (95% confidence interval [CI], 0.618–2.045). Amlodipine and methyldopa were prescribed to 44 and 93 of the 178 women, respectively. The aORs of MCMs in the first-trimester prescription of amlodipine and methyldopa were 1.219 (95% CI, 0.400–3.721) and 0.921 (0.331–2.564), respectively. The MCM risk of first-trimester exposure to antihypertensives, including amlodipine and methyldopa, was not suggested. [ABSTRACT FROM AUTHOR]

In this study, gold nanoparticles (AuNP) were synthesized using a novel stabilizer based on dialdehyde starch polymer (DAS) and dimethyl sulfoxide (DMSO) and the nanomaterial was applied to develop a sensor for methyldopa detection. The nanoparticles were characterized by transmission electron microscopy and the proposed sensor was electrochemically characterized by electrochemical impedance spectroscopy, chronocoulometry and square‐wave voltammetry. Under optimized conditions (0.1 mol L−1 McIlvaine buffer solution at pH 3.5 and 50 μL AuNP/DAS‐DMSO), using square‐wave voltammetry, the calibration curve presented a linear range of 0.99 to 19.60 μmol L−1, with a detection limit of 0.50 μmol L−1. The sensor showed good accuracy, with coefficients of variation of 7.8 % (inter‐day; n=6) and 5.9 % (intra‐day; n=3), and recovery values in the range of 95.3 to 105.2 %. The methyldopa content in a pharmaceutical sample was determined and the results show good correlation with the label value and the method recommended by the Pharmacopoeia, representing a fast and accurate alternative for detecting methyldopa in pharmaceutical products. [ABSTRACT FROM AUTHOR]

We present a case of a pregnant woman with systemic lupus erythematosus (SLE) who was diagnosed with asymptomatic complete heart block (CHB) during pregnancy. To evaluate possible risks and benefits of pacemaker (PM) implantation, a multidisciplinary counselling board was held. Its recommendation was to perform PM implantation to prevent intra-uterine growth restriction from insufficient cardiac output using a fluoroscopic protective shield. The procedure was performed without complications and established permanent pacing on onwards ECG examinations. The patient subsequently gave birth to a healthy newborn. After a retrospective clinical case evaluation and review of relevant literature, a presumptive association between CHB and the primary diagnosis was proposed. Above that, pregnant women with SLE who develop hypertension are commonly treated with methyldopa, which may cause conduction abnormalities. Clinical recommendations for young female patients expecting pregnancy are lacking in this area. Careful diagnostic and treatment approaches should be used in the management of possible SLE-related complications in women of child-bearing age, focusing on preventable events. [ABSTRACT FROM AUTHOR]

Methyldopa is a medication usually used to regulate and treat hypertension. It is one of the most commonly used therapies for high blood pressure during pregnancy. Methyldopa acts on blood vessels by providing additional relaxation, therefor blood can flow more easily through the body. Also, Methyldopa is a common medication used during pregnancy and is unlikely to cause any risk to the baby. [ABSTRACT FROM AUTHOR]

Summary: Estrogen receptor-α (ERα) promotes breast cancer, and ER-positive cancer accounts for ~ 80% of breast cancers. This subtype responds positively to hormone/endocrine therapies involving either inhibition of estrogen synthesis or blockade of estrogen action. Carbidopa, a drug used to potentiate the therapeutic efficacy of L-DOPA in Parkinson's disease, is an agonist for aryl hydrocarbon receptor (AhR). Pharmacotherapy in Parkinson's disease decreases the risk for cancers, including breast cancer. The effects of carbidopa on ER-positive breast cancer were evaluated in cell culture and in mouse xenografts. The assays included cell proliferation, apoptosis, cell migration/invasion, subcellular localization of AhR, proteasomal degradation, and tumor growth in xenografts. Carbidopa decreased proliferation and migration of ER-positive human breast cancer cells in vitro with no significant effect on ER-negative breast cancer cells. Treatment of ER-positive cells with carbidopa promoted nuclear localization of AhR and expression of AhR target genes; it also decreased cellular levels of ERα via proteasomal degradation in an AhR-dependent manner. In vivo, carbidopa suppressed the growth of ER-positive breast cancer cells in mouse xenografts; this was associated with increased apoptosis and decreased cell proliferation. Carbidopa has therapeutic potential for ER-positive breast cancer either as a single agent or in combination with other standard chemotherapies. [ABSTRACT FROM AUTHOR]

Background & Aims: The placenta has been described as the most accurate record of the infant’s prenatal experience. The present study was a quantitative study and it was carried out to see the effect of pre-eclampsia on histopathology of placenta and the comparative changes in placenta of preeclamptic patients taking antihypertensives. Materials & Methods: A total of 60 patients were selected from the Obstetrics and Gynecology Department of Jawahar Lal Nehru Medical College & Hospital, AMU, Aligarh, UP, India and were grouped into control, untreated, and treated groups. Placenta of each group was fixed in 10% formalin solution and processed for section cutting. 5-micron thick sections were prepared and stained with Hematoxylin-eosin and Wiegerts & Van gieson stain and observed under the light of the microscope. A total of 200villi/hpf was counted and percentages for each parameter were expressed. Result: It has been shown that there was a significant reduction (

Purpose: Antihypertensive drugs are among the most prescribed drugs during pregnancy. Methyldopa, labetalol, and nifedipine have been perceived safe to use during pregnancy and are therefore recommended in international guidelines for treatment of hypertension. In this review, we provide a complete overview of what is known on the pharmacokinetics (PK) of the antihypertensive drugs methyldopa, labetalol, and nifedipine throughout pregnancy. Methods: A systematic search was performed to retrieve studies on the PK of methyldopa, labetalol, and nifedipine used throughout pregnancy. The search was restricted to English and original studies. The systematic search was conducted on July 27, 2021, in Embase, Medline Ovid, Web of Science, Cochrane Library, and Google Scholar. Keywords were methyldopa, labetalol, nifedipine, pharmacokinetics, pregnancy, and placenta. Results: A total of 1459 unique references were identified of which title and abstract were screened. Based on this screening, 67 full-text papers were assessed, to retain 30 PK studies of which 2 described methyldopa, 12 labetalol, and 16 nifedipine. No fetal accumulation is found for any of the antihypertensive drugs studied. Conclusion: We conclude that despite decades of prescribing methyldopa, labetalol, and nifedipine throughout pregnancy, descriptions of their PK during pregnancy are hampered by a large heterogeneity in the low number of available studies. Aiming for evidence-based and personalized dosing of antihypertensive medication in the future, further studies on the relationship of both PK and pharmacodynamics (including the optimal blood pressure targeting) during pregnancy and pregnancy-related pathology are urgently needed to prevent undertreatment, overtreatment, and side effects. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the effect of baicalein or Scutellaria baicalensis root extract interaction with methyldopa in pregnant spontaneously hypertensive rats (SHR) at the pharmacodynamic, molecular, and biochemical levels. The rats, after confirming pregnancy, received baicalein (200 mg/kg/day, p.o.) and extract (1000 mg/kg/day, p.o.), in combination with methyldopa (400 mg/kg/day; p.o.), for 14 consecutive days, 1 h before blood pressure and heart rate measurements. In the heart and placenta from mothers after giving birth to their offspring, mRNA expression of factors related to inflammatory processes (TNF-α, Il-1β, IL-6) and vascular diseases (TGF-β, HIF-1α, VEGF, PlGF) was measured. Levels of markers of oxidative stress (superoxide dismutase and malondialdehyde) in the placenta and indicators of myocardial damage (troponin cTnC and cTnI, creatine kinase, myoglobin, and lactate dehydrogenase) in the heart were also assessed. Baicalein co-administered with methyldopa was associated with reduced blood pressure, especially during the first three days. The interactions were more pronounced for such factors as TGF-β, HIF-1α, VEGF, and PlGF than TNF-α, Il-1β, and IL-6. Combined application of baicalein and extract with methyldopa may be of value in the development of a new antihypertensive medication intended for patients suffering from preeclampsia or pregnancy-induced hypertension. [ABSTRACT FROM AUTHOR]

Copyright of Kirkuk University Journal for Scientific Studies is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sensitive and simple colorimetric method was developed for determination of methyldopa and terbutaline sulphate in pure and pharmaceutical dosage forms. The method was based on reduction of silver ions by the cited drugs in basic medium at 90 ℃ to silver nanoparticles in the presence of stabilizing agent as polyvinylpyrrolidone. The formed silver nanoparticles were distinguished by UV-Vis absorption spectroscopy indicating the characteristic surface plasmon resonance which can be also observed as intense yellow color solution. The plasmon absorbance of the silver nanoparticles was measured at 410 nm for quantitative estimation of methyldopa and terbutaline sulphate over the range of 80-480 and 40-600 ng/mL respectively. Limit of detection was obtained as 26, 13 ng/mL for methyldopa and terbutaline sulphate respectively. The eco-friendly developed method could be successfully applied to the pharmaceutical formulations with studying the interference of different excipients.

Background: Chronic hypertension (CH) adversely impacts pregnancy. It remains unclear whether antihypertensive treatment alters these risks. We examined the role of antihypertensive treatment in the association between CH and adverse pregnancy outcomes.Methods: Electronic health records from the UK Caliber and Clinical Practice Research Datalink were used to define a cohort of women delivering between 1997 and 2016. Primary outcomes were preeclampsia, preterm birth (PTB), and fetal growth restriction (FGR). We used multivariable logistic regression to compare outcomes in women with CH to women without CH and propensity score matching to compare antihypertensive agents.Results: The study cohort consisted of 1 304 679 women and 1 894 184 births. 14 595 (0.77%) had CH, and 6786 (0.36%) were prescribed antihypertensive medications in pregnancy. Overall, women with CH (versus no CH), had higher odds of preeclampsia (adjusted odds ratio [aOR], 5.74 [95% CI, 5.44-6.07]); PTB (aOR, 2.53 [2.39-2.67]); and FGR (aOR, 2.51 [2.31-2.72]). Women with CH prescribed treatment (versus untreated women) had higher odds of preeclampsia (aOR, 1.17 [1.05-1.30]), PTB (1.25 [1.12-1.39]), and FGR (1.80 [1.51-2.14]). Women prescribed methyldopa (versus β-blockers) had higher odds of preeclampsia (aOR, 1.43 [1.19-1.73]); PTB (1.59 [1.30-1.93]), but lower odds of FGR (aOR, 0.66 [0.48-0.90]). Odds of adverse outcomes were similar in relation to calcium channel blockers (versus β-blockers) except for PTB (aOR, 1.94 [1.15-3.27]). Among women prescribed treatment, lower average blood pressure (<135/85 mm Hg) was associated with better pregnancy outcomes.Conclusions: Treatment with antihypertensive agents and control of hypertension ameliorates some effects but higher risks of adverse outcomes persist. β-Blockers versus methyldopa may be associated with better pregnancy outcomes except for FGR. Powered trials are needed to inform optimal treatment of CH during pregnancy. [ABSTRACT FROM AUTHOR]

A sensitive electrochemical sensor was developed by modifying a glassy carbon electrode (GCE) with hematoxylin and MWCNTs/Fe3O4/TiO2 nanocomposite for the improved detection of methyldopa in the presence of folic acid. Electrochemical methods such as cyclic voltammetry (CV), differential pulse voltammetry (DPV) and chronoamperometry (CHA) were used to describe the electrochemical performance of the hematoxylin–MWCNTs/Fe3O4/TiO2/GCE for methyldopa and folic acid sensing studies. Methyldopa and folic acid were detected by DPV method at 190 and 720 mV, respectively. Due to the synergistic effect of the hematoxylin and MWCNTs/Fe3O4/TiO2 nanocomposite, the modified electrode exhibited good sensing performance to methyldopa and folic acid in the range of 0.5–300 μM with detection limit of 0.02 μM. Also, this method was applied for the quantification of methyldopa and folic acid in real samples. [ABSTRACT FROM AUTHOR]

A new and direct colorimetric method has been established for the determination of catecholamine (methyldopa, MD) in both pure form and in pharmaceutical formulations. The method is based on the oxidative coupling reaction of MD with 3-methyl-2-benzothiazolinone hydrazone hydrochloride monohydrate (MBTH) and potassium ferricyanide at pH 10.4 in aqueous medium to form an orange product that has a maximum absorption at 460 nm. Beer's law plot showed good correlation in the concentration range of 1.0−56.0 µg mL-1, with detection limit of 0.31 µg mL-1. Molar absorptivity for the above method was found to be 6.56×103 L mol-1 cm-1. All the measurements were carried out at 25 ± 1.0 °C, the formation constant (logKf) value of colored species is 9.48 and the standard free energy (DG‡) is − 54.09 KJ mol-1. This method was applied successfully to determination of MD in tablets and the results were compared with the USP method. Common excipients used as additives in tablets do not interfere in the proposed method. The method is accurate, precise and highly reproducible, while being simple, cheap and less time consuming and hence can be suitably applied for routine analysis of MD in bulk and dosage forms.

The Parkinson's passport is a compact document consisting facts and tips about managing PD. The aim of the study was to examine the impact of 'The Parkinson's Passport booklet' on the care and management of patients with Parkinson's admitted to an Australian hospital. The results suggest the implementation of the Parkinson's passport booklet does not improve the care and the management of a patient with PD who present to hospital which in turn challenges the efficacy of the document. However, the major unexpected finding during the course of the study was a high incidence of cognitive impairment in PD patients (85%) presenting to hospital. [ABSTRACT FROM AUTHOR]