Treatment of patients with a duodenal ulcer with disorders of the motor evacuator function of the stomach and duodenal

Aim. The study of disorders of the motor-evacuation function of the stomach and duodenum (duodenum) in patients with duodenal ulcer and their use in choosing effective therapy.Materials and methods. The study included 107 patients with ulcerous duodenal ulcer with the presence of motor-evacuation disorders of the gastroduodenal zone — group I and 99 patients with ulcerous duodenal ulcer without a violation of motor-evacuation function of the stomach and duodenum — group II. Anamnestic and physical data, results of X-ray and endoscopic examinations were used in verification of the ulcer. Assessment of the motor function of the stomach and duodenum was carried out using the gastroenteromonitor GEM-01 “Gastroskan-GEM”. Depending on the treatment method, patients with ulcerous duodenal ulcer of group I were divided into 2 groups: observation group — 52 patients with ulcerous duodenal ulcer of the duodenal ulcer received 50 mg 3 times a day prokinetic itopride hydrochloride as a part of complex anti-ulcer therapy and a comparison group — 55 patients with ulcerous duodenal ulcer underwent standard antiulcer therapy.Results. In the observation group after treatment, pain disappeared in 90.0% of patients, decreased in 10.0%. In the comparison group, pain completely disappeared in 18.8% of patients, decreased in 76.6%, remained unchanged in 4.7%. Against the background of treatment in patients of the observation group, the frequency and amplitude of the stomach and duodenum corresponded to the normokinetic type of curve. When using itopride hydrochloride in the treatment of patients of the observation group, restoration of the closure function of the pylorus was revealed. After the treatment, the ulcer healed in the observation group in 97.8% of patients (in 88.2% of cases at the stage of a high-quality “white” scar); in the comparison group, ulcer healing occurred in 94.5% of cases, of which in 67.1% — in the stage of poor-quality “red” scar).Conclusion. The use of the prokinetics of itopride hydrochloride as part of complex therapy increases the effectiveness of the treatment of ulcerative duodenal ulcer by restoring the motor-evacuation function of the stomach and duodenum.

Pharmacodynamics and Pharmacokinetics Evaluation of Ranitidine Microemulsion on Experimental Animals

Ranitidine microemulsion was investigated for its pharmacodynamic and pharmacokinetic evaluation to find out the suitability of microemulsion as a potential drug delivery system in the treatment of ulcer. The bioavailability of ranitidine after oral administration is about 50% and is absorbed via the small intestine; this may be due to low intestinal permeability. Hence the aim of present investigation was to maximize the therapeutic efficacy of ranitidine by developing microemulsion to increase the intestinal permeability as well as bioavailability. A ground nut oil based microemulsion formulation with Tween-80 as surfactant and PEG-400 as cosurfactant was developed for oral delivery of ranitidine and characterized for physicochemical parameters. In pharmacodynamic studies, significant (P<0.05) variation in parameters estimated was found between the treated and control groups. Ranitidine microemulsion exhibited higher absorption and Cmax (863.20 ng·h/mL) than the standard (442.20 ng/mL). It was found that AUC0–24 hr obtained from the optimized ranitidine test formulation (5426.5 ng·h/mL) was significantly higher than the standard ranitidine (3920.4 ng·h/mL). The bioavailability of optimized formulation was about 1.4-fold higher than that of standard drug. This enhanced bioavailability of ranitidine microemulsion may be used as an effective and alternative drug delivery system for the antiulcer therapy.